Public Health and Healthcare
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ARTICLE | doi:10.20944/preprints202306.0458.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: musculoskeletal pain; COVID-19 era; physiotherapy studies; study hours; questionnaires
Online: 6 June 2023 (12:11:56 CEST)
Background: Online teaching has resulted in university students adopting a sedentary lifestyle. Prolonged sitting and reduced physical activity due to pandemic restrictions have led to musculoskeletal pain in various body areas, significantly impacting the students’ quality of life. This study aims to investigate the effects of remote learning on Sicilian physiotherapy students during the COVID-19 pandemic, specifically focusing on the occurrence of musculoskeletal pain. Methods: An observational study was conducted using an online survey administered through Google Forms. The survey consisted of 26 multiple-choice questions and was distributed to students enrolled in Physiotherapy programs at the Universities of Catania, Messina, and Palermo. Participants were contacted via social channels or email, and data collection spanned 5 weeks. The collected data were analyzed using R software. Results: A total of 128 questionnaires were collected. More than half of the students (51.6%) reported dedicating 15–22 h per week to distance learning for a duration of 6–12 months (50%). Regarding study location, most students preferred studying at a desk (82.8%), with slightly over half (57.8%) adopting a backrest while studying remotely. Analysis of the students’ posture during study hours revealed common positions, including tilting the head forward by more than 20 degrees (47.8%), leaning the trunk forward by more than 20 degrees (71.9%), both shoulders being hunched forward (57.0%), wrists positioned above the level of the elbows (46.1%), thighs pointing upwards (41.4%), and one or both feet in a downward or dorsiflexed position (69.5%). Conclusion: The questionnaire responses indicate that the lifestyle of university students, influenced by online teaching, has deteriorated, leading to musculoskeletal pain, including myofascial pain. These results are primarily influenced by the adopted posture and the duration of time spent in these positions.
CASE REPORT | doi:10.20944/preprints202306.0432.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: parasitological diseases; Oman; appendicitis; Enterobius vermicularis; case report; helminths; appendix; pinworms
Online: 6 June 2023 (09:50:22 CEST)
While the debate on the association between Enterobius vermicularis (E. vermicularis) and acute appendicitis has not been settled, a few case reports of this very rare encounter are beginning to come to light. While E. vermicularis is one of the most common parasitic infestations around the world, acute appendicitis, on the other hand, is also a commonly encountered condition in general surgery. However, the association between the two remains controversial. Here we present a case report of a young woman with appendicitis associated with (E. vermicularis).
REVIEW | doi:10.20944/preprints202306.0428.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: quality of life; health-related quality of life; psychosocial factors; psycho-oncology
Online: 6 June 2023 (09:36:11 CEST)
The quality of life (QOL) is an important indicator of human satisfaction and wellbeing. QOL is significantly and persistently affected for patients after a cancer diagnosis. Despite some evidence suggesting that psycho-oncologic interventions can provide lasting benefits, the inclusion of such interventions in cancer therapy is not universal. This article overviews known approaches to the evaluation of QOL in cancer patients and various interventions for improving patients’ outcomes with a focus on the Eastern European regional and specific Romanian context. With a mortality rate above and cancer care performance below the EU average and unequally distributed, Roma-nia urgently needs a national coordination program which is discussed in our review highlighting the main psychological tools needed for the assessment and its challenges towards implementing the program. In the end, we suggest some directions for future development of the psycho-oncologic approach in the context of social, policy and unexpected financial challenges the nation provides
REVIEW | doi:10.20944/preprints202306.0380.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: Biosimilars 1; Arab states 1; regulatory guideline 3; harmonization 4; centralized approval 5; EMA 6; FDA 7; Global Medicine Authority (GMA) 8.
Online: 6 June 2023 (08:49:00 CEST)
Additionally, the League’s four observing states, with an additional population of 1.7 billion, if join the group, will form the world’s largest consortium to enhance the accessibility of biotechnology drugs. This effort will also remove the criticism of regulatory agencies that are well-equipped to regulate these products. This should also be a significant economic incentive to consortium states to develop these products, particularly biosimilars, to capture the most critical market anticipated. This plan will also reduce the cost burden on regulatory agencies. The program is divided into two classifications; for products sold in any of the Stringent Regulatory Authority (SRA) states, the registration is automatic but with several requirements that assure ongoing pharmacovigilance; this also applies to copies of reference products or biosimilars. For non-SRA sourcing, a stepwise plan requiring a rapporteur review, as practiced by the EMA and a third-party cGMP audit, is necessary to ensure data and product integrity. However, to reduce the cost burden, approval of these products is based on current scientific findings as presented in this paper.
ARTICLE | doi:10.20944/preprints202306.0384.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: SARS-CoV-2; COVID19; Laboratory diagnostics; Cycle threshold; PCR platforms; median Ct; moving average; variants; continuous quality monitoring
Online: 6 June 2023 (05:35:27 CEST)
The high demand for SARS-CoV-2 tests but limited supply to South African laboratories early in the COVID19 pandemic, resulted in a heterogenous diagnostic footprint of open and closed molecular testing platforms. Novel approaches were required to monitor test quality especially during the introduction of newly circulating variants. The National Health Laboratory Service centrally collected cycle threshold (Ct) values from 1,497,669 test results reported from six commonly used PCR assays in 36 months, and visually monitored changes in their median Ct within a 28-day centered moving average for each assays’ gene targets. This continuous quality monitoring rapidly identified delayed hybridization of RdRp in the Allplex™ SARS-CoV-2 assay due to the Delta (B.1.617.2) variant; S-gene target failure in the TaqPath™ COVID-19 assay due to B.1.1.7 (Alpha) and the B.1.1.529 (Omicron); and recently E-gene delayed hybridization in the Xpert® Xpress SARS-CoV-2 due to XBB.1.5. This near “real-time” monitoring helped inform the need for sequencing and the importance of multiplex molecular nucleic acid amplification technology designs used in diagnostics for patient care. This continuous quality monitoring approach at the granularity of Ct values should be included in ongoing surveillance and with application to other disease use cases that rely on molecular diagnostics.
Mon, 5 June 2023
ARTICLE | doi:10.20944/preprints202306.0350.v1
Subject: Public Health And Healthcare, Other Keywords: Children; Malnutrition; India; Overweight; Stunting; Anaemia
Online: 5 June 2023 (16:22:25 CEST)
The study examines malnutrition's triple burden, including anaemia, overweight, and stunting, among children aged 6-59 months. Using data from the National Family Health Survey-5 (2019-21), the study identifies risk factors and assesses the contribution at different levels to existing malnutrition burden. A random intercept multilevel logistic regression model and spatial analysis are employed to identify child, maternal, and household level risk factors for stunting, overweight, and anaemia. The study finds that 34% of children were stunted, 4% overweight, and 66% anaemic. Stunting and anaemia prevalence were higher in central and eastern regions, while overweight was more prevalent in the north-eastern and northern regions. At macro-level, the coexistence of stunting, overweight, and anaemia circumstantiates the triple burden of childhood malnutrition with substantial spatial variation (Moran’s I: stunting-0.53, overweight-0.41 and anaemia-0.53). Multilevel analysis reveals that child, maternal, and household variables play a substantial role in determining malnutrition burden in India. The nutritional health is significantly influenced by a wide range of determinants, necessitating multilevel treatments targeting households to address this diverse group of coexisting factors. Given the intra-country spatial heterogeneity, the treatment also needs to be tailor-made for various disaggregated levels.
ARTICLE | doi:10.20944/preprints202306.0346.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: HPV vaccine; Vaccine awareness; Vaccine hesitancy
Online: 5 June 2023 (16:12:21 CEST)
Human papillomavirus (HPV) infection is a widespread sexually transmitted infection linked to various types of cancers. Although vaccination against HPV is available, global HPV vaccination rates remain low. This study aimed to evaluate the awareness and knowledge of the HPV vaccine and to identify predictors associated with vaccine hesitancy among health college students in Saudi Arabia. A cross-sectional survey was distributed to students enrolled in health colleges. The association of vaccine hesitancy with sociodemographic characteristics was examined using logistic regression analysis. The study found that approximately half of the students (49.9%) were aware of the HPV vaccine. Students from the College of Medicine showed the highest level of knowledge. Only a small proportion (5.2%) reported receiving the vaccine. The overall HPV vaccine hesitancy was 59.1% (43.9% for women and 75.9% for men). The most common reasons for vaccine hesitancy was not knowing enough about it. Men were twice as likely as women to believe that they did not need the HPV vaccine. The odds for HPV vaccine hesitancy were greater among men and younger age group compared to women and older age group. In conclusion, the study underscores the importance of awareness campaigns on HPV vaccination, targeting primarily male students.
ARTICLE | doi:10.20944/preprints202306.0333.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: virtual reality (VR); COVID-19; motor rehabilitation; multidisciplinary; virtual reality activity; serious games; game design; health communication
Online: 5 June 2023 (14:26:52 CEST)
Background: This work presents Com@Rehab, a technological patient-centred activity for individuals needing a physical rehabilitation approach and with a specific loss of functionality. Within this scope, this paper focuses on the description of the activity in virtual reality (VR), its components, design and user profile, and its versatility and future adaptability regarding different ages, pathologies and rehabilitation contexts. Methods: The VR activity has been customised according to the patient's clinical needs while replicating an activity of daily living, namely showering. In addition, to validate and get feedback on the developed system, a validation questionnaire was applied to a group of healthy individuals to test the efficiency of the technology that supports the VR activity. Results: Preliminary results show that 94% of the participants recommended the experience, the performance of the various components of the system was successfully implemented, participants quickly adhered to the VR technology, and the UI assistant’s functionality should be improved. Conclusion: This solution creates a more effective, interactive, humanised rehabilitation approach based on a Virtual Reality (VR) activity. The Com@Rehab Communication Module improves human-human and human-machine communication while contributing to health literacy.
ARTICLE | doi:10.20944/preprints202306.0326.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Dominicans; Hypertensive; Salt intake; Sodium and potassium excretion; Sodium-to-potassium ratio
Online: 5 June 2023 (13:29:58 CEST)
Higher salt (sodium) intake has been associated with a higher blood pressure (BP). The association degree may be influenced by factors such as age, origin and dietary components. This study aimed to evaluate the 24-hours urinary sodium (Na) and potassium (K) excretion in normotensive and hypertensive Dominicans adults and estimate their salt intake. 163 volunteers (18-45, 46-80 years) participated in a cross-sectional study. 24-hours Na and K urinary excretion were measured using an ion selective electrode technique. Na and K urinary excretion (99.4±46.5 and 35.0±17.5 mmol/24h) did not correlated with BP, except in the normotensive group in which K correlated with SBP (0.249, p=0.019). Na and K excretion were similar for normo- and hypertensive subjects. Na-to-K molar ratio (3.1±1.3) was higher in younger subjects (p=0.040). Na-to-K ratio was associated with DBP in the total group (r=0.153, p=0.052), in the hypertensive group (r=0.395, p<0.001) and in the older group with SBP (0.350, p=0.002) and DBP (0.373, p<0.001). In the older group, Na-to-K ratio and DBP correlated after controlling for subjects with hypertension controlled by treatment (r=0.236, p=0.041). The Na-to-K ratio correlated, when salt intake was over 5g/d (52.2%), with SBP (rho=0.219, p=0.044) and DBP (rho=0.259, p=0.017). Determinants of BP were age-dependent and in younger subjects were: sex (SBP, beta: 14.02±2.87, p<0.001) and body mass index (BMI) (beta:-12.07±3.72, p=0.001, beta:9.44±2.87, p=0.001, for SBP and DBP, respectively) and, in the olders, the Na-to-K ratio, for SBP (beta:6.7±2.4, p=0.005) and DBP (beta:3.8±1.1, p<0.001). The mean Na and salt intakes (2.3 and 5.8 g/d) were slightly higher and K intake lower (1.4 g/d) than WHO recommendations.
ARTICLE | doi:10.20944/preprints202306.0319.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: Pneumocystis pneumonia; immune status; real-time PCR; staining methods
Online: 5 June 2023 (12:55:05 CEST)
Background: Pneumocystis pneumonia (PCP) commonly affects immunocompromised individuals, whereas in immunocompetent persons, it occurs relatively rarely, and in most cases the Pneumocystis infection is detected as an asymptomatic colonization. The present study aimed to establish the prevalence of Pneumocystis jirovecii infection in human hosts with different immune status (immunocompromised and immunocompetent), using molecular diagnostic methods, and to compare their diagnostic value with that of classical staining methods. Methods: We used the collected to this moment data from a prospective study on the prevalence of pneumocystosis among the Bulgarian population. Clinical specimens (including throat secretion, induced sputum, tracheal aspirate, and bronchoalveolar lavage collected from 220 patients suspected of PCP (153 immunocompetent and 67 immunocompromised patients) were examined with staining microscopic methods and real-time PCR for detection of P. jirovecii. Results: DNA of the pathogen was detected in 38 (17%) specimens (32 immunocompromised patients and 6 immunocompetent subjects). From all 220 clinical samples examined by staining methods, only in five (2%) P. jirovecii cysts were detected by the Gomori's stain. All patients with PCP were treated with trimethoprim-sulfamethoxazole, but in ten of them (HIV- positive patients) the disease was with fatal outcome. Conclusions: This study is the first for the country including the main available laboratory methods for diagnosis of human pneumocystosis in Bulgaria. Regarding the etiological diagnosis of PCP, in our study the sensitivity of real-time PCR was higher compared to the staining methods. The choice of a method for sample collection and examination has an important role in the efficiency of the laboratory diagnostics.
ARTICLE | doi:10.20944/preprints202306.0316.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: primary care; grievances; complaints; satisfaction
Online: 5 June 2023 (12:04:49 CEST)
Primary Health Care is crucial in the healthcare system, being the first level of contact with health services for users and patients to take action using the available resources. Patient care units are created to facilitate direct user participation through the circuit of complaints, grievances, and suggestions, allowing the analysis of the population's unmet expectations and needs. To study complaints and grievances regarding the treatment and information received by users in the Santiago and Barbanza healthcare area during the year 2022. A descriptive cross-sectional study was conducted, in which complaints filed by patients in the year 2022 in the Santiago and Barbanza healthcare area were analyzed. A total of 326 users who filed a total of 512 complaints were studied in the year 2022, with 358 (70.0%) related to treatment/information. The mean age was 33.5±16.2 years. 72.4% were women (n=236). A Pearson correlation was performed to establish whether there was a dependence between the number of healthcare visits in both primary care and hospital settings in 2022 and the number of complaints filed in the same year. Pearson correlation coefficient was 0.14; 95% CI (0.02 - 0.27), p=0.012. There is a correlation between the number of consultations and the number of complaints filed. Frequent users are more likely to file a complaint. However, there is no correlation between the number of consultations and the likelihood of filing a complaint regarding treatment/information. Therefore, there seems to be a good relationship between healthcare personnel and users, which impacts patient satisfaction.
ARTICLE | doi:10.20944/preprints202306.0311.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: Rural; Telemedicine; Telehealth; Patient-Centered; Attitudes; Perceptions; Audio-only
Online: 5 June 2023 (10:51:10 CEST)
Purpose: This study aims to provide a foundational understanding of patient-centric perceptions of telemedicine implementation in rural Minnesota. Methods: This retrospective cohort study utilized a mail questionnaire to assess patient attitudes and behaviors regarding telemedicine during the emergency response to COVID-19. The target population was patients of a Primary Care clinic in eastern Minnesota. Descriptive statistics were used to assess respondents’ level of agreement with survey items scored on a 0-10 scale. Results: A majority of the respondents indicated that they were satisfied with using telemedicine (73.96%); that they gained an additional sense of control over their health condition due to the availability of telemedicine (52.08%); that they would support the use of telemedicine in the future (61.05%); that telemedicine increased access to care (65.63%); telemedicine was preferred over the clinic (61.46%), and that they would purchase new equipment to increase the utility of telemedicine services (54.17%). 51.04% of the respondents indicated a 10/10 level of satisfaction with telemedicine services. 48.96% indicated the strongest level of disagreement related to difficulty using telemedicine or a preference for in-person clinical appointments. Conclusions: Patients were found to have favorable perceptions of telemedicine overall. Though providers continue to recognize the benefit of face-to-face visits, their patients show an increased predilection for virtual care and telemedicine will likely remain an essential tool for providers to reach patients who would otherwise choose not to seek care.
ARTICLE | doi:10.20944/preprints202306.0259.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: SARS-CoV-2 infection; COVID-19 disease; women´s health; menstrual-related disturbances; formerly menstruating women; secondary amenorrhea; perimenopause; heavy menstrual bleeding
Online: 5 June 2023 (07:58:02 CEST)
After three years of the onset of the pandemic, there is scarce evidence about how COVID-19 disease affect the female reproductive system, and consequently, the menstrual cycle. Since the common causes of secondary amenorrhea are considered as exclusion criteria in the studies about menstrual changes following SARS-CoV-2 infection, the prevalence of this event and the influencing factors in formerly menstruating women remains unknown. A retrospective observational cross-sectional study was conducted on Spanish adult women (N= 17,512), using an online survey; a subpopulation of SARS-CoV-2-infected-formerly menstruating women was included in the present analysis (n= 72). Collected data included general characteristics, medical history, and specific information about COVID-19 disease. 38.9% of the respondents experienced menstrual-related disturbances after suffering from the COVID-19 disease, unexpected vaginal bleeding being the most common (20.8%). Other alterations related with the length – “shorter” by 12.5% − and the flow − “heavier than usual” 30.3% − of the menstrual bleeding were reported. The binary logistic regression showed that being a perimenopausal woman (AOR 4.608, CI 95%, 1.018 – 20.856, p = 0.047) and having heavy menstrual bleeding (AOR 4.857, CI 95%, 1.239 – 19.031, p=0.023) are influential factors. This evidence could help health professionals to provide scientifically up-to-date information to their patients, empowering them to actively manage their reproductive health, especially in those societies where menstrual health is still a taboo.
ARTICLE | doi:10.20944/preprints202306.0254.v1
Subject: Public Health And Healthcare, Other Keywords: Centella asiatica; body weight; obesity; adipocyte
Online: 5 June 2023 (07:36:10 CEST)
To understand the mechanisms involved in the anti-obesity effects Centella asi-atica (CA), we examined body weight, serum levels, white adipose tissue (WAT) weight, histological analysis, and the expression of cholesterol homeostasis- and lipid metabolism-related genes in mice with high-fat, high-sugar diet (HFHSD)-induced obesity that were orally treated with CA for 12 weeks. Eight-week-old, male C57BL/6J mice were assigned to the following four groups (eight mice/group): NOR, normal diet; Control, HFHSD; CA-L, HFHSD+CA 300 mg/kg; CA-H, HFHSD+CA 600 mg/kg. CA treatment signifi-cantly attenuated HFHSD-induced increase in body weight gain, serum glucose, serum triacylglycerol, and WAT weight (p < 0.05). Compared to that in Control group, adipocyte diameter and macrovesicular area of epididymal WAT signif-icantly decreased with CA treatment (p < 0.05). The mRNA expression levels of peroxisome proliferator-activated receptor gamma (PPARγ), fatty acid synthase (FAS), cluster of differentiation 36 (CD36), 3- hydroxyl-3-methylglutaryl CoA reductase (HMGCR), and stearoyl CoA desaturase 1 (SCD 1) were significantly downregulated in the CA-H group compared to the Control group (p < 0.05). CA exerts anti-obesity effects by lowering body fat accumulation via regulat-ing gene expression in the liver and thus, is a potential lipid-lowering agent.
REVIEW | doi:10.20944/preprints202306.0238.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Quality-of-Life; children; asthma
Online: 5 June 2023 (05:00:52 CEST)
Asthma, like other chronic diseases, affects children prone to transitions of various aspects of their lives. The purpose of this thesis is to investigate the level quality of life of children with bronchial asthma and to what extent the disease affects them their everyday life. The literature search was conducted a review of the articles was done in Greek and English, through electronic databases PubMed, Google Scholar and Scopus. The terms and conditions their combinations used for the search were: “kids”, “children”, "pediatric asthma", "quality of life (QOL)", "health", "adolescents". The search was limited to the last five years (2015 – 2020) and finally 12 were selected articles. The most important areas negatively affected by quality of life of children with asthma are physical activity, their emotional state, school performance and sleep quality when it is connected to other factors. Important role in quality of life of these children has asthma management, disease severity and other environmental factors. Medical and nursing staff need to guide them asthmatic children and their families to have a good everyday life. Having the necessary knowledge needed for the quality-of-life health professionals should include in their medical nursing caring methods of achieving and maintaining a lifestyle that is no different than that of healthy children.
DATA DESCRIPTOR | doi:10.20944/preprints202306.0237.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: retina; swept-source; optical coherence tomography-angiography; OCT-A; cardiovascular risk; CHA2DS2-VASc
Online: 5 June 2023 (04:46:25 CEST)
In a context of exponential demographic growth, the imbalance between human resources and public health problems is impelling us to envision other solutions to the difficulties faced in the diagnosis, prevention and large-scale management of the most common diseases. Cardiovascular diseases represent the leading cause of morbidity and mortality worldwide. A large-scale screening program would make it possible to promptly identify patients with high cardiovascular risk in order to manage them adequately. Optical coherence tomography-angiography (OCT-A), as a window into the state of the cardiovascular system, is a rapid, reliable, and reproducible imaging examination that enables prompt identification of at-risk patients through the use of automated classification models. One challenge that limits the development of computer-aided diagnostic programs is the small number of open-source OCT-A acquisitions available. To facilitate the development of such models, we have assembled a set of images of the retinal microvascular system from 499 patients. It consists of 814 angiocubes as well as 2005 en face images. Angiocubes were captured with a swept-source OCT-A device of patients with varying overall cardiovascular risk. To the best of our knowledge, our dataset, RASTA, is the only publicly available dataset comprising such a variety of images from healthy and at-risk patients. This dataset will enable the development of generalizable models for screening of cardiovascular diseases from OCT-A retinal images.
Fri, 2 June 2023
ARTICLE | doi:10.20944/preprints202306.0203.v1
Subject: Public Health And Healthcare, Other Keywords: root coverage; gingival recession; suturing technique; coronally positioned tunnel; acellular dermal matrix
Online: 2 June 2023 (12:17:15 CEST)
Objective. The primary aim of this 6-month randomized, controlled, blinded clinical pilot study was to compare the percent root coverage obtained using an acellular dermal matrix allograft (ADM) and a coronally positioned tunnel (CPT) technique with two different suturing techniques. Materials and Methods. Sixteen patients with at least one Miller Class I or II recession defect ≥ 3 mm were randomly selected to receive a CPT with ADM using either two independent continuous sling sutures to secure the graft and the soft tissue separately (SEP) or a single continuous sling suture to secure both the graft and the soft tissue together (TOG) in the test group. Percent defect coverage, predictability of achieving 100% root coverage, keratinized tissue width, and attachment levels were assessed. Results. Both TOG and SEP suturing techniques achieved a significant amount of defect coverage, 83 vs. 85%, respectively, with no significant differences between groups. The predictability of achieving complete defect coverage was 63% for both groups. All maxillary sites had 100% coverage. There was a statistically significant gain of keratinized tissue for the TOG (1.1 ± 0.9 mm), while the SEP group gained only minimal amount (0.2 ± 0.8 mm). Conclusions. The single sling, for simultaneous suturing of the soft tissue and acellular dermal matrix, worked as well as two sling sutures used separately for the soft tissue and ADM. Suturing time was reduced by about 50% for the single sling group indicating a significant clinical advantage for the patient and surgeon.
REVIEW | doi:10.20944/preprints202306.0165.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Egocentric neglect; Allocentric neglect; Digital therapeutics; Apple cancellation test; Broken hearts test
Online: 2 June 2023 (09:01:01 CEST)
Various therapeutic approaches have been developed for neglect. Many studies have demonstrated the effect of Digital therapeutics(DTx) on neglect. By contrast, only a few studies have reported on the effects of DTx on egocentric and allocentric neglect. In this article, seven studies on DTx of egocentric and allocentric neglect were reviewed. DTx, which was employed in these studies, could be classified as follows: 1) software adaptation in traditional treatment, 2) VR game using the head-mount display as treatment, and 3) development of new digital program like ReMoVES. In addition, more studies and effective results were reported on egocentric neglect than allocentric neglect. In future studies, each effect on egocentric and allocentric neglect should be identified in detail through the appropriate use of differential evaluation and long-term application of independent digital therapeutics.
REVIEW | doi:10.20944/preprints202306.0162.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Viral Encephalitis; Transmission Dynamics; Epidemiology; One Health
Online: 2 June 2023 (08:57:30 CEST)
Viral Encephalitis is a significant public health concern globally, especially west Africa. There are more than 500 known arboviruses with over 100 of them identified to cause encephalitic diseases in humans and animals, giving rise to a tremendous burden of the diseases, and socioeconomic strains in tropical and subtropical regions worldwide. Despite their importance, few effective preventive and control measures in form of vaccines and therapeutics are available and where they are, usage is limited. These limitations are largely hinged on the paucity of information about the molecular epidemiology and transmission patterns of VE in west Africa. Here, we reviewed the transmission dynamics, ecological drivers, and molecular epidemiology of VE in the region. Collectively, timely and accurate interventions are essential for encephalitic viral disease control. Moreover, the integrated health system approach, combining surveillance, vaccination, vector control, and community engagement could be effective in preventing viral encephalitis globally.
ARTICLE | doi:10.20944/preprints202305.2153.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: home health care routing & scheduling problem; resilience; discrete event simulation; optimization
Online: 2 June 2023 (03:32:02 CEST)
Home care centers face both an increase in demand and many variations during the execution of routes, compromising the routes initially planned: robust solutions are not effective enough, it is necessary to move on to resilient approaches. We create a close to reality use case supported by interviews of staff at home health care centers, where caregivers are faced with unexpected events that compromise their initial route. We model, analyze and compare three resilient approaches to deal with these disruptions: a baseline approach without any collaboration, a distributed collaborative approach, and a centralized collaborative approach, where we propose a centralization and sharing of information to improve local decision-making. The latter reduces the number of late arrivals by 11% and the total time of late arrival by 21%, and also halves the number of routes exceeding the end of work time (contrary to the distributed collaborative approach, due to the time wasted reaching colleagues). The use of a device, such as a smartphone application, to centralize and share information thus allows better mutual assistance between caregivers. Moreover, we highlight several possible openings like the coupling of simulation and optimization to propose a more resilient approach.
ARTICLE | doi:10.20944/preprints202306.0114.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Climate change; vulnerability; adaptation; health vulnerability index, Mozambique
Online: 2 June 2023 (02:55:34 CEST)
Climate change (CC) poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, a climate-vulnerable nation, has experienced significant natural disasters in the past 42 years, impacting its health system. This study aims to assess Mozambique’s health sector vulnerability and adaptation needs to climate change. Following a methodology proposed by the World Health Organization and Intergovernmental Panel for Climate Change, a six-step vulnerability and adaptation assessment was conducted. The Health Vulnerability Index (HVI), integrating historical climate, epidemiological, and socio-economic data at the district level (n=162), was computed using exposure, sensitivity, and adaptive capacity dimensions. The Results revealed spatial patterns in exposure to climate variables, extreme weather events, and variations in sensitivity and adaptive capacity across the country. The HVI mirrored the exposure findings. Notably, high vulnerability was observed in several districts, while major urban centers displayed lower vulnerability. These findings highlight the country’s vulnerability to climate change and underscore the potential for adverse impacts on livelihoods, the economy, and human health. The study provides a foundation for developing strategies and adaptation actions.
Thu, 1 June 2023
REVIEW | doi:10.20944/preprints202306.0080.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: Type 1 Diabetes mellitus; Insulin; Diabetes management; Technology; Continuous glucose monitoring systems; Insulin pumps
Online: 1 June 2023 (11:07:07 CEST)
Type 1 Diabetes mellitus (T1DM) occurs when insulin is not produced in the Pancreas due to the autoimmune destruction of the beta cells. The patients may be diagnosed after 80-90% of the beta cells are destroyed. Insulin remains the essential medicine in T1DM management, under continuous monitoring of glucose levels. T1DM management consists of a complex and precise set of self-care measures for the entire life; during this continuous process, the patients could become overwhelmed, angry, anxious, frustrated, and/or discouraged. Therefore, to be widely used and provide general benefits, new technologies for DM management must provide clinical advantages without compromising safety. The compliance of T1DM patients is also essential, thus improving their quality of life (QoL). Moreover, the accessibility of the new system for patients through healthcare coverage is critical; they must be able to buy the new devices and accessories and pay for their maintenance. In this context, our work aims to describe the most recent technologies regarding continuous glucose monitors (CGMs) and continuous subcutaneous insulin infusion (CSII) systems, correlated with psychosocial impact and capacity to improve T1DM patients' life quality.
ARTICLE | doi:10.20944/preprints202306.0035.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: patients with oral cancer; LINE official account; oncological case management; interdisciplinary team; SDG “Good Health and Well-being”
Online: 1 June 2023 (05:14:11 CEST)
Background: Cancer patients require cross-professional care during the diagnosis and treatment periods. Therefore, methods for effectively carrying out case management are essential to tumor care. Purpose: To investigate the effects of using the community software LINE Official Ac-count on oral cancer case management. Methods: An experimental design was used; 100 patients were randomly divided into two groups by using a computer-generated random number table. The experimental group used LINE Official Account, which gave them self-care information, timely messages, and one-on-one health-care consultations. The control group followed standard healthcare practices. Results: The experimental group was satisfied with the self-care information provided by LINE Official Account (86.9%), patients regularly checked the self-care information (89.4%) and would check the information when receiving a push notification (54.3%). Ten patients used the one-on-one consultation(20.0%). LINE Official Account had a significant effect on the rate of participation in support groups. Generalized estimating equations indicated a significant difference between the two groups regarding the overall quality of life over 7 days (P = 0.023). Conclusion: Community software applications used in oncological case management can improve self-management and empower, also enable tracking of long-term follow-up effectiveness and reinforce the case manager’s role as a family therapist. Therefore, this study recommends that case manager systems be incorporated into mobile applications to increase the sustainable management, accessibility, effectiveness, and satisfaction of oncological management systems. This study also provides the value of Sustainable Development Goals (SDGs) with Good Health and Well-being, and decreased social withdrawal among patients with oral cancer.
ARTICLE | doi:10.20944/preprints202306.0023.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Trans Fatty Acids; edible oils; cardiovascular health; fried foods; nutritional labeling; public health; fatty acid profile; Recommended limits.
Online: 1 June 2023 (04:14:19 CEST)
Trans fatty acids (TFA) are a concern for public health due to their negative impact on cardiovascular health. This study aimed to assess the levels of TFA and other fatty acids in popular edible oils and fried foods commonly consumed in Tanzania. A total of 57 samples from 38 brands of edible oils and 20 samples of fried street foods and fast foods were collected in Dar es Salaam, Tanzania. Capillary gas chromatography was used to determine TFA levels, while nutritional labeling and other fatty acid classes were also evaluated. Among the analyzed edible oils, 21% exceeded the recommended TFA levels, primarily found in popular brands of margarine, industrially refined sunflower oils, animal butter, and peanut butter. Only two food items surpassed the 2% TFA limit, but a majority of the foods had high levels of saturated fatty acids and a fatty acid profile similar to palm oil. Additionally, only 22% of the edible oils provided TFA content information. These findings indicate the persistence of TFA levels beyond recommended limits and inadequate TFA nutritional labeling in Tanzanian food products. Urgent interventions are necessary to reduce TFA levels and improve nutritional labeling practices to safeguard public health.
ARTICLE | doi:10.20944/preprints202306.0003.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: diabetes mellitus; lower extremity artery disease; red blood cell aggregation, transcutaneous partial tissue oxygen pressure
Online: 1 June 2023 (02:41:38 CEST)
Background: Intermittent claudication is a frequent complaint in lower extremity artery disease, but approximately two thirds of patients are asymptomatic, mostly in diabetic population. Non-invasive angiological and microrheological tests among diabetic patients with and without intermittent claudication were studied. Methods: 98 diabetic patients were included and divided into two groups: 20 patients (63.5±8.8 yrs, 55% men, 45% women) had intermittent claudication, 78 patients (65.5±9.3 yrs, 61.5% men, 38.5% women) were asymptomatic. Hand-held Doppler, transcutaneous tissue partial oxygen pressure (tcpO2) measurement, tuning fork test and 6-minute walk test were performed and erythrocyte aggregation was investigated. Results: Ankle/brachial index (p<0.02), and tcpO2 measured during provocational tests (p<0.003), 6-minute walk test (p<0.0001) were significantly deteriorated in the symptomatic group. Higher erythrocyte aggregation index and faster aggregate formation could be observed among claudicant patients (p<0.02). In spite of the statistically better results of the asymptomatic group, 13% of these patients had severe limb ischemia based on the result of tcpO2 measurement. Conclusion: Claudication could be associated with worse hemodynamical and hemorheological status in diabetics; nevertheless, severe ischemia can develop even in asymptomatic subjects which can be revealed by noninvasive vascular tests, which highlights the importance of the early instrumental screening of the lower limbs.
Wed, 31 May 2023
ARTICLE | doi:10.20944/preprints202305.2268.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Online surfing; Screen addiction; Physical inactivity; Mood; Cognition
Online: 31 May 2023 (14:40:04 CEST)
Background: The Internet has become an essential component of college students' lives, serving as a tool for academic pursuits, daily activities, and social interactions with individuals and the global community. Productive internet use is associated with student success, while pathological internet use can negatively impact psychosocial performance. This study aimed to assess the impact of internet addiction on the cognitive function, mood, and physical activity of college students. Study design: The study was based on a correlational observational study design. Settings: The study’s participants were taken using a convenience sampling method from the Manav Rachna International Institute of Research and Studies campus, Faridabad, Haryana, having a student strength of more than two thousand. Methods: With a response rate of 69.93%, one hundred male and female college students who could understand the self-administered questionnaires and obtained the internet addiction test (IAT) scores equal to or above twenty participated (aged 18-25 years) in this study. The participants were assessed for the study’s outcomes, such as the internet addiction (viz. average, moderate, and excessive) cognition, mood, and physical activity level, using an internet addiction test questionnaire (IATQ), cognitive failure questionnaire (CFQ), the profile of mood state questionnaire (POMS), and international physical activity questionnaire (IPAQ), respectively. A categorical analysis with mean scores was carried out for all the outcomes. The correlation between internet dependency and cognitive abilities, emotional state, and levels of physical activity among the participants was ascertained using Pearson's correlation coefficient. The threshold of significance was set to 95%, meaning any p-value < 0.05 was considered significant. Results: The study’s outcome variable- internet addiction, revealed a moderate positive correlation with cognition (r=0.793; p=0.001) and mood (r=0.703; p=012), while a moderate negative correlation with physical activity (r=-0.681; p=003). Conclusion: The study concluded that internet addiction is positively linked to cognition and mood disruption; however, it negatively affects physical activities among college students. An awareness program should be executed on “Internet addiction and its effects on college students’ Cognition, Mood, and Physical Activity” and advocating Internet use in a limited manner for getting aroused, feeling better, and avoiding physical inactivity.
ARTICLE | doi:10.20944/preprints202305.2260.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: neutrophil-to-lymphocyte rati; feline infectious peritonitis; white blood cells; biomarker; FIP
Online: 31 May 2023 (14:21:33 CEST)
Abstract: Systemic inflammatory response syndrome (SIRS) is a clinical diagnosis based on abnormalities in patients' vital signs and white blood cell count. Neutrophil-lymphocyte ratio (NLR) is used as an easily accessible parameter to assess the patient's inflammatory status and stress. There are some studies showing that NLR affected by the inflammatory response is a criterion to support the diagnosis of SIRS. In this study, it was aimed to compare the interrelation between SIRS (+) and SIRS (-) groups in patients with high positive feline coronavirus (FCoV) in the light of NLR. Based on the anamneses, physical examination findings, laboratory findings, enzyme immunoassay antibody test kit titer were included in the sick groups. These patients were further categorized based on the presence of SIRS symptoms, vital signs and laboratory findings. The NLR as diagnostic marker demonstrated to differ between high antibody titer FCoV positive and healthy cats. However the diagnostic significance of NLR remains questionable between the high antibody titer FCoV positive cats with SIRS (+) and SIRS (-). As a result of our study NLR can be used as a blood parameter like albumin/globulin ratio and elevated total bilirubin in cats with high FCoV antibody titer and high probability of developing FIP.
ARTICLE | doi:10.20944/preprints202305.2245.v1
Subject: Public Health And Healthcare, Other Keywords: HPV; Genotypes; lineages; India; women; cervical cancer; Andaman and Nicobar Islands
Online: 31 May 2023 (12:31:53 CEST)
Background: Human Papillomavirus causes various types of cancer in both men and women. Woman with HPV infection has a risk of developing invasive cervical cancer. Globally, HPV 16 and 18 were predominant. This study aims to find the distribution of various HPV types in South Andaman. Methods: A cross sectional study conducted among woman in South Andaman where cervical scrapes were collected after the collecting the written informed consent. Detection of HPV genotypes was carried out by using PCR assay. Further, sequencing analysis was performed using MEGA11 to identify various genotypes in this territory. Result: Of these 1000 samples, 32 were positive for HR-HPV16 and 4 were positive for HR-HPV18. Fifteen HPV genotypes were detected using molecular evolutionary analysis. Six cases were identified with multiple genotypes. Most prevalent genotype is HPV16 which belonged to Lineage-A and sub-lineage A2. HPV18 identified in South Andaman belonged to the lineage A1 to A5. Discussion: Various HPV types were identified among women in South Andaman. Global burden of cervical cancer associated with various HPV sub-lineages. HPV-16 A1 sub-lineage was globally widespread whereas sub-lineages A1, A2 and D1 was prevailing in South Andaman. Conclusion: High risk HPV identified in this study enlightening the importance of HPV vaccination among the woman in remote places. These findings will help to strengthen public health awareness programs and prevention strategies for the women in remote areas.
ARTICLE | doi:10.20944/preprints202305.2238.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: reinfection; COVID-19; vaccination; Omicron
Online: 31 May 2023 (11:38:23 CEST)
Reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants due to immune escape challenges the global response to the pandemic. We estimated the Omicron reinfection prevalence among people who had previous SARS-CoV-2 infections in Shanghai, China. We conducted a telephone survey in December 2022 for those who were previously infected with Omicron between March and May 2022. Information on demographics, coronavirus disease 2019 (COVID-19) testing, and vaccination history was collected. The overall and subgroup reinfection rates were estimated and compared. Among the 1981 respondents who were infected between March and May 2022, 260 had positive nucleic acid or rapid antigen tests in December 2022, with an estimated reinfection rate of 13.1% (95% confidence interval [95% CI]: 11.6-14.6). The reinfection rate for those who had a booster vaccination was 11.4% (95% CI: 9.2-13.7), which was significantly lower than that for those with an incomplete vaccination series (15.2%, 95% CI: 12.3-18.1) (adjusted odds ratio [aOR]: 0.579; 95% CI: 0.412–0.813). Reinfection with the Omicron variant was lower among individuals with previous SARS-CoV-2 infection and had completed a booster vaccination, suggesting that hybrid immunity can offer better protection against reinfection with Omicron sublineages.
Tue, 30 May 2023
ARTICLE | doi:10.20944/preprints202305.2149.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Community; Health Risk; Awareness; Knowledge; Air Pollution
Online: 30 May 2023 (13:15:46 CEST)
Exposure to air pollution have detrimental effects on the elderly, women, people with pre-existing medical conditions, people living in poverty and children. The aim of the study was to investigate the extent of community awareness and knowledge on the health risks associated with exposure to air pollution. A cross-sectional study design was used for the study, using self-administered questionnaires. A simple random sampling technique was used to select 376 respondents. Systematic sampling method was applied to select the households. SPSS version 26 was used to analyze data. Of 376 respondents, 221 were males and 154 females. 113 were aged between 23-47years and 353 were aware that if they don’t protect themselves against polluted air, they may get sick, with age and educational status associated with their awareness (p < 0.05). About 361 knew what air pollution is and 188 think the air they breathe in Annadale is moderate. A total number of 278 said they feel sick/uncomfortable when the quality of air is bad. About 293 knew that people are exposed to air pollution by breathing contaminated air and 237 identified sewage smell as the main cause of air pollution. Respondents who identified internet and television as the main source of information were 199 and 177 respectively. Those who were not aware of actions implemented to reduce air pollution were 180. Based on the results of the study, respondents are aware of the dangers of exposure to polluted air, and it is necessary that air pollution risk communication strategies be implemented to empower residents.
ARTICLE | doi:10.20944/preprints202305.2079.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Legionella; residential buildings; virulence factors; virulence genes; sequence type
Online: 30 May 2023 (08:10:06 CEST)
Legionella is an opportunistic pathogen with a biphasic life cycle and humans are occasional hosts of Legionella. The aim of the study was to assess the distribution of virulence genes and genetic diversity among L. pneumophila isolated from water-supply systems of residential buildings in Latvia. In total, 492 water samples from 200 residential buildings were collected. Identification of Legionella spp. was performed according to ISO 11731 and 58 isolates were subjected to whole genome sequencing. At least one Legionella positive sample was found in 112 out of 200 apartment buildings (56.0%). The study revealed extensive sequence type diversity where 58 L. pneumophila isolates fell into 36 different sequence types. A total of 420 virulence genes were identified of which 260 genes were found in all sequenced L. pneumophila isolates. Virulence genes enhC, htpB, omp28, and mip were detected in all isolates, suggesting that adhesion, at-tachment, and entry into host cells are enabled for all isolates. The relative frequency of viru-lence genes among L. pneumophila isolates was high. High prevalence, extensive genetic diver-sity, and the wide range of virulence genes indicated that the virulence potential of environ-mental Legionella is high and proper risk management is of key importance to public health.
CASE REPORT | doi:10.20944/preprints202305.2073.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: COVID-19; cancer; thrombotic complications; oncologic therapy
Online: 30 May 2023 (07:54:41 CEST)
Patients diagnosed with cancer are less frequently covered by preventive measures for cardiovascular diseases. The frequent co-occurrence of these diseases makes it necessary to apply parallel diagnostics and cardiological treatment with anti-cancer therapy. Case report: We present a case of a 73-year-old former smoker with hyperlipidemia, type 2 diabetes, and arterial hypertension, after a partial right nephrectomy in 2005 due to kidney cancer, diagnosed with SARS-COV-2 infection in April 2022. Follow-up chest imaging showed a 20 mm focal lesion in the left lung further classified as a small cell neuroendocrine carcinoma. Unexpectedly the patient was hospitalized for ST-segment elevation inferior left ventricular (LV) myocardial infarction treated successfully with coronary angioplasty, however heart failure (HF) with reduced left ventricle ejection fraction was diagnosed. One month later patient required another hospitalization due to the HF decompensation and cardiological treatment was optimized with flozin addition to the standard HF therapy. After cardiological approval chemotherapy was initiated with the cisplatinum-etoposide regimen and continued for 6 months without HF decompensation and significant deterioration of renal function. After that, the patient underwent radical radiotherapy. Follow-up chest computed tomography scans showed regression of the neoplastic lesion. Conclusions: Coincidence of newly recognized cancer and infection might contribute and provoke serious cardiological events . To reduce the risk of cardiovascular complications, early periodic cardiological surveillance and optimal pharmacotherapy are required.
REVIEW | doi:10.20944/preprints202305.2070.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: quality improvement; systematic review; papillomavirus vaccine; vaccination coverage; adolescent
Online: 30 May 2023 (07:47:30 CEST)
Background: Routine human papillomavirus (HPV) vaccine uptake continues to be suboptimal since its recommendation in 2006 for girls and in 2011 for boys. This paper aims to review published quality improvement (QI) methodologies on interventions to improve HPV vaccine uptake among adolescents; Methods: Science Direct and Scopus databases were searched for QI initiatives evaluating the effect of multimodal interventions to improve HPV vaccination rates (initiation and/or completion of series) among adolescents. Studies that included an outcome of interest among adolescents aged 10 to 18 years old were included. Two investigators worked independently to screen for potential articles and a designated investigator extracted data on study characteristics and evaluated the outcomes; Results: Preliminary search yielded a total of 523 articles and 13 were included in the final analysis. Common strategies were provider-specific and patient- and/or parent-specific interventions, with an emphasis on education and knowledge empowerment. System-level interventions such as policy changes and revised protocol were less commonly prescribed despite being associated with more significant weight on the overall outcome; Conclusions: Creative, sustainable, and economical multilevel interventions that focus not only on provider training and public education but also incorporate local policy and system enhancement can substantially improve HPV vaccination coverage among adolescents.
ARTICLE | doi:10.20944/preprints202305.2034.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: iodine deficiency; glucose challenge test; large for gestational age; thyroglobulin; io-dine-containing supplements; maternal dysglycemia
Online: 30 May 2023 (04:08:48 CEST)
It is unclear how maternal glycemic status and maternal iodine status influence birth weight in mild-to-moderate iodine deficiency (ID). We studied the association between birth weight and both maternal glucose levels and iodine intake in pregnant women with mild-to-moderate ID. Glucose values were assessed using a glucose challenge test (GCT), non-fasting glucose before delivery; iodine status was assessed using an iodine food frequency questionnaire, serum thyroglobulin (Tg) and urinary iodine concentrations (UIC). Thyroid antibodies and free thyroxine (FT4) were measured. Obstetric and an-thropometric data were also collected. Large for gestational age (LGA) was predicted using a Cox proportional hazards model with multiple confounders. Tg>13g/L was in-dependently associated with LGA (adjusted hazard ratio = 3.4, 95% CI: 1.4–10.2, p=0.001). Estimated iodine intake correlated with FT4 among participants reporting io-dine-containing supplements (ICS) after adjusting for confounders (β = 0.4 95 %CI: 0.0002-0.0008, p=0.001). Newborn weight percentiles were inversely correlated with maternal FT4 values (β=-0.2 95 %CI:-0.08 - -56.49, p=0.049). We conclude that in mild-to-moderate ID regions, maternal insufficient iodine status may increase LGA risk. Iodine status and ICS intake may modify the effect maternal dysglycemia has on offspring weight.
Mon, 29 May 2023
ARTICLE | doi:10.20944/preprints202305.2005.v1
Subject: Public Health And Healthcare, Nursing Keywords: Catheters; Cost Benefit Analysis; Economic evaluation; Healthcare-associated infections; Nursing care; Peripherally Inserted Central Catheter; Peripheral Venous Catheters; Ultrasound.
Online: 29 May 2023 (09:58:33 CEST)
Background: The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. Objective: Evaluate ex-ante whether the benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters with ultrasound-guided peripherally inserted central catheters and midline catheters by a vascular access specialist team outweigh their costs. Methods: Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when replacing peripherally inserted central catheters, midline catheters and peripheral venous catheters with ultrasound-guided peripherally inserted central catheters and midlines, as well as the additional resources required for their use. Results: Each ultrasound-guided peripherally inserted central catheter replacing a peripherally inserted central catheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, each ultrasound-guided midline catheter replacing a midline, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. Conclusion: The benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters by introducing a vascular access specialist team trained in the implantation of ultrasound-guided peripherally inserted central catheters and midline catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of healthcare-associated infections. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.
COMMUNICATION | doi:10.20944/preprints202305.1998.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: Oculomotor pursuits; Eye-movement; Concussion; Assessment; Learning effect
Online: 29 May 2023 (08:40:42 CEST)
Mild traumatic brain injury (mTBI) is the most common brain injury, seen in sports, falls, vehicle, or workplace injuries. Concussion is the most common type of mTBI. Assessment of impairments from concussion are evolving, with oculomotor testing suggested as a key component in a multi-modality diagnostic protocol. The aim of this study was to evaluate the reliability of one eye-tracking system, the EyeGuide Focus. Seventy-five healthy adolescent and adult participants (adolescents: n=28; female=11, male=17, mean age 16.5 ± 1.4 years; adults n=47; female=22; male=25, mean age 26.7 ± 7.0 years) completed three repetitions of the EyeGuide Focus within the one session. Intraclass correlation coefficient (ICC) analysis showed the EyeGuide Focus had overall good reliability (ICC 0.79, 95%CI: 0.70, 0.86). However, a familiarization effect showing improvements in subsequent trials was noticeable in both cohorts (p<0.001) with adolescent participants showing greater familiarisation effects than adults. No differences were observed between sexes (p=0.69). Overall, the EyeGuide Focus was found to be reliable, but the observation of familiarization effects suggests that a standardized protocol of a minimum of three trials be employed, similar to other eye-movement testing applications.
REVIEW | doi:10.20944/preprints202305.1969.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Cancer; Benzoic acid; Anti-cancer activity; Scaffold
Online: 29 May 2023 (05:00:08 CEST)
Cancer is a catchall term that refers to a collection of more than one chronic disease that can adversely affect the body, including the organs of the body. These diseases can be grouped together under the umbrella term "cancer." Cancer is a catch-all term that is used to refer to a number of different diseases. During the process of looking for new chemical entities, it was found that certain compounds with a basic nucleus of benzoic acid (BA) exhibit a remarkable anticancer potential. This was discovered while the researchers were looking for new chemical entities. In the sixteenth century, the aromatic chemical known as BA, which is also known as an aromatic carboxylic acid, was discovered. BA is also referred to as an aromatic carboxylic acid. When it comes to the chemical synthesis of a wide range of different active molecules, the utilization of a sizeable quantity of BA as a raw material is absolutely necessary. In addition to being present in a variety of other naturally occurring compounds, the BA moiety is the component that is responsible for the activity of the naturally occurring compounds vanillin, gallic acid, and syringic acid. In the synthesis of a wide variety of synthetic bioactive molecules, the BA scaffold is utilized as a building block. The drugs furosemide, bumetanide, benzocaine, tetracaine, and bexarotene are all examples of molecules that fall into this category. The scope of this review article allows for the discussion of a number of noteworthy and recent achievements of BA derivatives in terms of their effectiveness against cancer.
ARTICLE | doi:10.20944/preprints202305.1965.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: elderly medication reminder application; Kano model; AHP; QFD; PUGH decision matrix
Online: 29 May 2023 (04:42:27 CEST)
Poor medication adherence among older adults is a widespread problem worldwide. As the population ages, the design of smartphone medication management apps is critical to improving medication adherence among older adults. Taking the design of an elderly medication reminder APP as an example, this study proposes a sustainable design research method that integrates the KANO model, Analytic Hierarchy Process (AHP), Quality Function Deployment (QFD), and PUGH decision matrix. The method collects user demands through in-depth interviews, and applies the KANO model to classify these demands. The hierarchical structure of user needs is established by using AHP, and the priority is sorted according to the weight and importance determined by the judgment matrix. QFD is used to translate user needs into design requirements, and the house of quality matrix identifies key design requirements. Finally, design alternatives are evaluated using Pugh's concept selection method. The results of this study demonstrate that the integration of KANO-AHP-QFD-PUGH can be effective as a sustainable optimal design approach for the user experience of a medication reminder application for the elderly. This integrated method not only facilitates innovative optimization and sustainability of application design methods but also provides valuable theoretical and practical insights for future drug-assisted design for elderly users.
ARTICLE | doi:10.20944/preprints202305.1958.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Gestational diabetes; health promotion; behavior change; process evaluation; diabetes prevention; diet; physical activity; intervention; couple interviews
Online: 29 May 2023 (04:12:43 CEST)
Promoting diet and physical activity is important for women with recent gestational diabetes mellitus (GDM) and their partners to reduce the risk of future type 2 diabetes (T2D). The study aimed to understand how motivation for changing diet and physical activity behaviors among women with recent GDM and their partners was experienced after participation in the Danish Face-it intervention. Fourteen couple interviews were conducted. Data analysis followed reflexive thematic analysis. Guided by self-determination theory and interdependence theory, we identified four themes affecting couples’ motivation for health behavior change: 1) The need for relatedness after delivery, 2) Promoting competence and autonomy for health behavior change, 3) Individual and mutual preferences for health behaviors, and 4) The health threat of future T2D as a cue to action. We found that the couples in general perceived the Face-it intervention as useful and motivating. Using couple interviews increased our understanding of how the women and partners influenced each other’s perspectives after a GDM-affected pregnancy and thus how targeting couples as opposed to women alone may motivate health behavior change.
ARTICLE | doi:10.20944/preprints202305.1948.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Kyrgyz Republic; drug-sensitive pulmonary TB; electronic register system; paper-based records; completeness; concordance; treatment initiation; treatment outcomes; SORT IT; operational research
Online: 29 May 2023 (02:49:28 CEST)
This study evaluated the effectiveness of an electronic system for managing drug-sensitive pulmonary tuberculosis patients in the Kyrgyz Republic. This was a cohort study using programmatic data. The study included patients registered on the paper-based system in 2019 and the electronic system between June 2021 and May 2022. Data was taken from 302 individuals from the electronic system for completeness and concordance in comparison with the paper-based system. The study showed that for most variables the completeness and concordance was 85.3%-93.0% and was lowest for non-mandatory fields such as medication side effects (26.8% vs 13.6%). No significant difference was observed in time taken from symptom onset to diagnosis and treatment initiation between the two systems. However, the electronic system had a significantly higher percentage of patients who initiated treatment on the same day of diagnosis (80.3% vs. 57.1%). The proportion with successful outcomes was similar in both groups, but the electronic system had a significantly lower proportion of patients with outcomes that were not evaluated or recorded (4.8% vs. 14.3%, p < 0.001). The study highlights the potential advantages of implementing an electronic TB register system for improving records. We advocate for similar studies in other regions in Kyrgyz Republic.
REVIEW | doi:10.20944/preprints202305.1943.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: COVID-19 victims; family members; friends; psychosocial impacts; emotional health; Informal caregiving
Online: 29 May 2023 (02:08:03 CEST)
There exists a plethora of studies examining the psychological and physical impacts of COVID-19 on infected victims. Fewer studies have been published assessing the different types of impacts that an individual’s COVID-19 infection has on close friends and family members. This is the first scoping review to gauge the reported psychosocial issues and daily hassles that impact the relatives and friends of infected individuals. This study was conducted by inputting key terms/MeSH terms into selected internet databases to locate prospective studies. The frameworks of scoping reviews by Arksey et al. and the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) were utilized in the methodology for identifying and selecting the studies. After data extraction, 37 studies were deemed suitable for analysis. The findings generated from each study was placed into combined categories. A total of 16 combined categories were generated from the amalgamation of the findings. The results show that psychosocial feelings (e.g., anxiety, stress, depression) was the category with the highest prevalence of grouped findings. The results from this study may serve as the impetus for future interventions targeting the alleviation of psychosocial feelings or day to day hassles associated with having a loved one inflicted with a severe illness.
Fri, 26 May 2023
ARTICLE | doi:10.20944/preprints202305.1935.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Simple One-Step (SOS) stool processing method stool; Xpert MTB/RIF (Ultra) assay and children
Online: 26 May 2023 (13:38:35 CEST)
The introduction of stool as a readily obtainable sample and the recently developed simple-one-step (SOS) stool processing method offer an opportunity for TB diagnosis in children. We conducted this study at secondary health facilities in Ethiopia which are the first level referral facilities for childhood TB diagnosis and treatment with the aim to determine if stool-based TB diagnosis can be performed with reasonable level of concordance with sputum tests in using Xpert MTB/RIF Ultra. Eligible children 0-14 years with presumptive pulmonary TB were asked to provide stools in addition to routinely requested sputum samples. We computed Cohen’s kappa statistic in SPSS to determine the level of agreement between stool and sputum test results. Of the 373 children included in the study, 61% were <5 years of age and 56% were male. Thirty-six children (9.7%) were diagnosed with TB and all started treatment. The rate of concordance between stool and sputum was high with kappa value of 0.83 (P<0.001). There were more Xpert ultra positive test results on stool (n=27 (7.2%)) than on sputum/NGA (n=23 (6.2%)). Laboratories in secondary hospitals can perform stool-based TB diagnosis in children with high concordance between stool and sputum test results reaffirming the applicability of the SOS method.
ARTICLE | doi:10.20944/preprints202305.1915.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Arsenic, PGC-1α, Mitochondria, Hippocampus, Apoptosis
Online: 26 May 2023 (10:21:09 CEST)
Chronic exposure to arsenic in drinking-water damage to cognitive function, and nerve cells apoptosis is one of primary characteristic. The damage of mitochondrial structure and/or function is one of the main characteristics of apoptosis. Peroxisome proliferator activated receptor γ Coactivator α (PGC-1α) is involved in the regulation of mitochondrial biogenesis, energy metabolism and apoptosis. In this study, we aimed to study role of PGC-1α in sodium arsenite (NaAsO2)-induced mitochondrial apoptosis in rat hippocampal cells. We discovered that arsenic-induced apoptosis increased in rat hippocampus increased with NaAsO2 (0, 2, 10, and 50 mg/L, orally via drinking water for 12 weeks) exposure by TUNEL assay, and the structure of mitochondria was incomplete, swollen, lysosomes and lipofuscin increasing, and nuclear membrane shrunk observed by transmission electron microscope. Furthermore, NaAsO2 reduced levels of Bcl-2 and PGC-1α, increased the levels of Bax and Cytochrome C expression. Moreover, correlation analysis showed that brain arsenic content was negatively correlated with PGC-1α level and brain ATP content, respectively; PGC-1α level was negatively correlated with apoptosis rate; Brain ATP content was positively correlated with PGC-1α level; but no significant correlation between ATP content and apoptosis has been observed in this study. Taken together, the results of present study indicate that NaAsO2-induced mitochondrial pathway apoptosis is related to the reduction of PGC-1α, accompanied by ATP depletion.
ARTICLE | doi:10.20944/preprints202305.1904.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: internet-delivered therapy; depression; anxiety; cultural adaptation; patient-oriented research; digital health
Online: 26 May 2023 (09:46:55 CEST)
There has been limited research on improving Internet-delivered Cognitive Behavioural Therapy (ICBT) in routine online therapy clinics that serve people from diverse ethnocultural groups (PDEGs). This article describes a patient-oriented adaptation approach used to address this gap in research. A working group consisting of people with lived experience, community stakeholders, ICBT clinicians, managers, and researchers, was formed. The working group examined archival feedback on ICBT from past clients who self-identified as being from diverse ethnocultural back-grounds (N=278) and results of interviews with current patients (N=16), community stakeholders (N=6), and clinicians (N=3). The archival data and interviews revealed the majority of the pa-tients reported being satisfied with and benefitting from ICBT. Suggestions for improvement were not related to the cognitive-behavioural model and techniques, but rather to making treatment materials more inclusive. Consequently, the ICBT adaptation focused on adding content related to cultural influences on mental health, addressing stigma, diversifying case stories, examples and imagery, adding audiovisual introductions, and replacing English idioms with more descriptive language. Moreover, further training was offered to clinicians and efforts were made to improve community outreach. This study demonstrates a process for using patient-oriented research to improve ICBT within routine care serving patients of diverse backgrounds.
ARTICLE | doi:10.20944/preprints202305.1896.v1
Subject: Public Health And Healthcare, Other Keywords: Severe Dementia; Nutritional status; Percutaneous Endoscopic Gastrostomy
Online: 26 May 2023 (08:56:02 CEST)
Dementia is a rising public health concern. Feeding and nutritional problems increase as the disease progresses, affecting clinical course and caregiver burden. While some guidelines advise against percutaneous endoscopic gastrostomy (PEG) and tube feeding in advanced dementia, conflicting evidence exists. This study aims evaluating nutritional status and the influence of PEG-feeding on outcome and evolution of nutritional/progonosis markers of patients with severe dementia (PWSD) who underwent gastrostomy for nutritional support. We conducted a 16-year rectrospective study on 100 PEG-fed PWSD with strong familiar support. We evaluated survival PEG-feeding period, safety, and objective nutritional/progonosis data at the gastrostomy day and after 3 months: Body Mass Index (BMI), Mid Upper Arm Circumference, Tricipital Skinfold, Mid-Arm Muscle Circumference, albumin, transferrin, total cholesterol and hemoglobin. Most patients presented low values in these nutritional/progonosis parameters. No major life-threatening PEG complications were reported. The mean survival time after gastrostomy was 27.9 months (median of 17 months). Female sex, BMI recovery at 3 months, and higher baseline hemoglobin levels were associated with a reduced risk of death and increased survival time. The study concluded that, in carefully selected PWSD with strong familiar support, PEG feeding can improve nutritional status and have a positive impact on survival.
ARTICLE | doi:10.20944/preprints202305.1872.v1
Subject: Public Health And Healthcare, Other Keywords: radiomics; reproducibility; repeatability; validation; lung cancer; head and neck cancer; CT im-aging
Online: 26 May 2023 (07:15:55 CEST)
Radiomics involves the extraction of information from medical images not visible to the human eye. There is evidence these features can be used for treatment stratification and outcome prediction. However, there is much discussion about the reproducibility of results between different studies. This paper studies the reproducibility of CT texture features used in radiomics, comparing two feature extraction implementations namely Matlab toolkit and Pyradiomics when applied on independent datasets of CT scans of patients i) the open access RIDER dataset containing a set of repeat CT scans taken 15 minutes apart for 31 patients (RIDER Scan 1 and Scan 2 respectively) treated for lung cancer and ii) the open access HN1 dataset containing 137 patients treated for head and neck cancer. Gross tumor volume (GTV) manually outlined by an experienced observer available on both datasets was used. 43 common radiomics features available on Matlab and Pyradiomics were calculated using 2 intensity-level quantization methods with and without an intensity threshold. Cases were ranked for each feature for all combinations of quantization parameters and the Spearman’s rank coefficient, rs, calculated. Reproducibility was defined when a highly correlated feature in the RIDER dataset also correlated highly in the HN1 dataset and vice versa. 29 out of 43 reported stable features were found to be highly reproducible between Matlab and Pyradiomics implementations, having consistently high correlation in rank ordering for RIDER Scan 1 and RIDER Scan 2 (rs > 0.8). 18/43 reported features were common in RIDER and HN1 datasets, suggesting they may be agnostic to disease site. Useful radiomics features should be selected based on reproducibility. This study identified a set of features that meet this requirement and validated the methodology for evaluating reproducibility between datasets.
ARTICLE | doi:10.20944/preprints202305.1856.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: COVID-19; suicide; accident; pandemic; impact
Online: 26 May 2023 (05:07:16 CEST)
Globally 703 000 people commit suicide (4th leading cause of mortality among 15-29 year-olds, 1.4% of all deaths globally) every year, which have a negative effect on families, colleagues, and societies. India accounts for 36.6 percent of global suicide in women and 24.3 percent among men, while having only 17.8 percent of the global population, also remarkable fact is that the suicide ratio for female is 14.7 per 100,000 compared to 21.2 per 100,000 of male which is 2.1 times the global average in female, while 1.4 times higher for men. COVID-19 (coronavirus disease-2019) pandemic has certainly affected the physical, mental, economical and social well being of global population directly or indirectly in different ways. Deteriorating physical, mental, economical and social health of an individual could increase the suicidal tendency, leading to accidents and suicide. This study tried to find out the COVID-19 pandemic situation impact on accidental death as well as suicide rates in India. The study period is from 1st January 1967 to 31st December 2021, to assess the effect of the COVID-19 pandemic situation on suicide and accidental death rates. This study revealed that the suicide deaths percentage among males increased significantly in comparison to females in COVID-19 era and actual count and incidence also increased. This study revealed that the mean accidental death and suicide both increased during COVID period of study as compared to pre-pandemic whole period from 1967 by 25.47 % and 30.61% respectively. Alternatively we can say that the accidental death and suicides increased significantly in India, which is largely preventable.
ARTICLE | doi:10.20944/preprints202305.1846.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: team sports; explosive strength; body composition; CMJ
Online: 26 May 2023 (04:24:30 CEST)
Player’s performance in an intense sport such as basketball is known to be related to attributes like speed, agility, and power. This study presents a comparative analysis of associations between anthropometric assessment and physical performance in different age-group elite youth basketball players, while simultaneously identifying the predictors for speed and agility in these players. U14 (n=44), U15 (n=45) and U16 (n=51) players were tested for anthropometry, lower body power, speed, and agility. U16 players were found to be taller, heavier, more muscular than U14 and U15 players. Also, the U16 group showed better performance in all performance tests. Age had a significant positive correlation with countermovement (CMJ) and drop jump (DJ) performance in U14 players, and a significant negative correlation with 10m and 20m sprint times in U15 group. CMJ and DJ emerged as the most significant predictors for sprint and agility variables, respectively. Body fat percentage was found to be a significant predictor for the speed and agility tests in all age groups, but a negative lower-body power predictor. Therefore, besides all sport-specific and fitness tests, it is essential to place emphasis on the percentage of body fat when designing players’ individualized training programs, and during team selection.
REVIEW | doi:10.20944/preprints202305.1845.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: Low back pain; hip; strengthening; treatment; pain; disability.
Online: 26 May 2023 (04:22:58 CEST)
Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.
REVIEW | doi:10.20944/preprints202305.1832.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Breast cancer; convolution neural networks; computer-aided diagnosis systems; segmentation; classification
Online: 26 May 2023 (03:50:59 CEST)
Early detection of breast cancer, one of the most common cancers in women worldwide, raises survival rates and lowers the cost of treatment. Although breast cancer detection and classification (CAD) tools have improved, some issues and restrictions still require further research. The creation of breast cancer CAD systems, particularly with deep learning models, was significantly impacted by recent advancements in machine learning and image processing techniques. The current deep learning-based CAD system to identify and categorize masses in mammography is presented in a structured manner in this survey. The survey provides the most popular breast cancer CAD system evaluation metrics, publicly available mammographic datasets, and current image modalities. The survey examines the available literature, emphasizing its strengths and limitations. The survey also emphasizes the difficulties and drawbacks of the current methods for classifying and detecting breast cancer. We point out research gaps and make suggestions for further study. This systematic review may be beneficial for clinicians using CAD systems to diagnose breast cancer early on and for researchers looking for knowledge gaps and making more contributions to the field.
Thu, 25 May 2023
ARTICLE | doi:10.20944/preprints202305.1793.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: COVID-19; Clusters; Multivariate geospatial model; Minas Gerais state
Online: 25 May 2023 (10:12:34 CEST)
Abstract. Background: COVID-19's first victim was announced by Chinese health authorities on the 11th of January 2020. On January 13, the first official case was reported outside China, in Thailand. On January 25, the same occurred in São Paulo and on March 8, the first case was recorded in Minas Gerais. From that point onwards until the 3rd of October 2020, a total of 370,911 cases and 9,204 deaths were recorded in the state. This study aims to investigate spatiotemporal patterns of COVID-19 with incidence from March 22 to October 3 of 2020. Methods: The database itself was obtained from Health Division of Minas Gerais state. The vulnerability index was calculated using a principal component analysis. Moran's I autocorrelation was tested, z-score and P-value < 0.05. Results: From March 22 to October 3 of 2020 the incidence level varied from 45.680/100,000 to 312.130/100,000. The most influential variables were: illiteracy, gross domestic product and breath apparel per municipality. The clusters were concentrated in the metropolitan area of Belo Horizonte, Zona da Mata and Triangulo Mineiro. Conclusion: The spatial distribution of COVID-19 from week 13 until week 40 showed that different levels of endemicity and mesoregional vulnerabilities were represented in these maps.
ARTICLE | doi:10.20944/preprints202305.1783.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: Covid-19; Pandemic; Agent-Based Models (ABM); Human Movement Modeling; Envi-ronment modeling; Disease Propagation and Containment
Online: 25 May 2023 (09:01:44 CEST)
It is crucial to immediately curb the spread of a disease once an outbreak is identified in a pandemic. An agent based simulator will enable the policymakers to evaluate the effectiveness of different hypothetical strategies and policies with a higher level of granularity. This will allow them to identify the vulnerabilities and asses the threat level more effectively, which in turn can be used to build resilience within the community against a pandemic. This study proposes a PanDemic SIMulator (PDSIM ) which is capable of modeling complex environments while simulating realistic human motion patterns. The ability of PDSIM to track the infection propagation patterns, contact paths, places visited, characteristics of people, vaccination, and testing information of the population, allows the user to check the efficacy of different containment strategies and testing protocols. The results obtained based on the case studies of Covid-19 are used to validate the proposed model. However, it is highly extendable to all pandemics in general, enabling robust planning for more sustainable communities.
REVIEW | doi:10.20944/preprints202305.1779.v1
Subject: Public Health And Healthcare, Nursing Keywords: General hospital; General ward; Mental health care user; Non-psychiatric nurse
Online: 25 May 2023 (08:57:08 CEST)
Mental Health Care Users (MHCUs) are admitted in general wards with medical and surgical conditions where non-psychiatric nurses are allocated to render services for medical and surgical conditions. Non-psychiatric nurses are expected to care for MHCUs in general wards regardless of their knowledge and skills which is against the Mental Health Care Act. The purpose of the study was to explore and describe the experiences of non-psychiatric nurses in car-ing for MHCUs admitted in general wards in Limpopo Province. Qualitative approach using explorative, descriptive, and contextual design was adopted for the study. Methodology included the setting, population, sampling, ethical con-siderations, and the measures to ensure trustworthiness. The study was conducted in four general hospitals of Limpopo Province, South Africa with mental health care wards, medical ward and surgical ward which were selected through simple random sampling. Semi structured Individual interviews were used to collect data from twenty professional nurses until data saturation. Data was analysed using Tesch’ s method. Ethical considerations were adhered to throughout the study. Themes that emerged after data analysis were: Managing MHCUs, Types of patient’s behaviour. The study concluded that professional nurses without psychiatry caring for MHCUs in general wards need training to provide holistic care.
COMMUNICATION | doi:10.20944/preprints202305.1770.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: ethylene oxide (EtO); summa cannister; AERMOD air dispersion modeling; Human Exposure Model (HEM); Clean Air Act; EPA TO-15 method
Online: 25 May 2023 (08:32:59 CEST)
Ethylene Oxide (EtO) is a colorless, flammable gas at room temperature, produced by the catalytic oxidation of ethylene. EtO is widely used by medical sterilization facilities to clean medical supplies and equipment. Recent epidemiological studies showed that EtO is a more potent carcinogen than previously documented, leading the Environmental Protection Agency (EPA) to update, in December 2016, the inhalation unit risk estimate for EtO. This resulted in the identification of EtO as a potential health concern in several areas across the US, including the state of Utah. The geography surrounding Salt Lake Valley creates a bowl; ideal for collecting air pollution emissions. The region often experiences inversion episodes which inhibit vertical mixing and cause an accumulation of air pollutants, leading to unhealthy pollution levels. Using the EPA's dispersion modeling software, AERMOD, this study estimated EtO concentrations through facility stack and fugitive emissions modeling results. These values were compared with those of canister-based concentrations from ambient air samples taken near a medical device sterilization facility in the Salt Lake Valley. Stainless steel, whole-air passivated canisters were used to collect 24-hour ambient concentration samples of EtO. Eight locations surrounding a Salt Lake Valley medical device sterilization facility and four background sites were chosen to measure the ambient concentrations. Accounting for potential atmospheric impacts on EtO, measurements were sampled in winter 2022 (January-March) and summer 2022 (July-September). The modeled EtO concentrations were adjusted to account for background values associated with the winter or summer data. Then the two methodologies were compared using a Wilcoxon Sign-ranked, paired test. The statistical analysis resulted in six of the eight sample locations surrounding the sterilization facility being significantly different when comparing canister-based measurements of ambient EtO to modeled estimates. Canister-based measurements taken at sites one, three, and four were statistically greater than the modeled estimates, while sites two, five, and seven were statistically less than the modeled estimates. Also, the summer background value calculated was almost 2.5 times greater than the winter. The results do not suggest whether one method is more or less conservative than the other. In conclusion, the five of the closest sites and site seven were statistically different when comparing measured and modeled ambient concentrations of EtO. The comparison results do not clearly indicate if a correction factor could be derived for future human exposure to cancer risk assessment modeling. However, it is reasonable that the closer to the sterilization facility, the more total EtO exposure will be realized.
ARTICLE | doi:10.20944/preprints202305.1740.v1
Subject: Public Health And Healthcare, Other Keywords: Retrosigmoid approach; Parasterional; Burr-hole; Trigeminal neuralgia; Surgery; Minimal invasive
Online: 25 May 2023 (05:26:42 CEST)
Background: Trigeminal neuralgia associated to vascular compression, by aberrant or ectopic arterial or venous vessels, is a frequent condition in clinical practice. Management with microvascular decompression through a Minimal invasive retrosigmoidal has shown high rates of pain control, with low complication rates and excellent therapeutic results. Objective: To describe the surgical technique and clinical outcomes in terms of pain relief after microvascular decompression for trigeminal nerve, through a minimal invasive retrosigmoidal parasterional burr-hole technique. Methods: A group of patients with trigeminal neuralgia refractory to medical management who underwent microvascular decompression considering outcomes based on Visual Analogue Scale (VAS), and Barrow Neurological Institute Pain Scale (BNIPS). Added to a technical note of the surgical technique for a minimal invasive retrosigmoidal parasterional burr-hole. Results: Twenty-two patients were evaluated, clinical assessment after surgical intervention showed a decrease pain according to VAS, resulting from an average preoperative state of 9.5 ± 0.37 to a postoperative condition of 1.32 ± 1.28, exhibiting statistically significant changes (p < 0.0001, d = 9.356). On the other hand, in relation to the BNIPS scale, a decrease from an average preoperative status of 4.55 ± 0.25, to a postoperative status at 12 months of 1.73 ± 0.54 was also demonstrated, showing significant changes (p < 0.0001, d = 3.960). Conclusion: Microvascular decompression of the trigeminal nerve through a minimal invasive retrosigmoidal parasterional burr-hole is feasible and can be a safe and effective technique for the management of pain.
ARTICLE | doi:10.20944/preprints202305.1736.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Urban Garden; Perceived Restorativeness; Resillience; Sense of Community; Stress; Salivary cortisol
Online: 25 May 2023 (05:10:25 CEST)
This study aimed to investigate the influence of urban garden activities on participants' Perceived restorativeness, resilience, sense of community, and stress reduction. Ninety individuals who agreed to participate to the experiment were divided into experimental and control groups. To collect data 16 sessions of urban garden activities were conducted every two weeks from May to November of 2022. Perceived Restorativeness Scale, Conner-Davidson Resilience Scale, Sense of Community Index, and Brief Encounter Psychosocial Instrument were employed to measure participants’ psychological effects. To evaluate physiological effect salivary cortisol tests were performed. The results of the study revealed that urban gardening activities influenced on participants' physiological and psychological reactions in positive ways.
COMMUNICATION | doi:10.20944/preprints202305.1734.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Enterococcus faecalis; Enterococcus faecium; vancomycin; prevalence; resistance; antibiotics; oral cavity; screening
Online: 25 May 2023 (04:29:13 CEST)
Enterococci are commonly found in the environment and humans as a part of the normal micro-biota Among these, Enterococcus faecalis and Enterococcus faecium can convert into opportunistic pathogens, making them a major cause of nosocomial infections. The rapid diffusion of vanco-mycin-resistant strains and their impact on nosocomial settings is of considerable concern. Ap-proximately one-third of the E. faecium infections in Italy are caused by vancomycin-resistant strains. This study explored the hypothesis that the oral cavity could represent a silent reservoir of virulent enterococci. A sample of 862 oral flora specimens collected from healthy human volun-teers in Central Italy was investigated by real-time PCR to detect E. faecalis and E. faecium, as well as the genetic elements that most frequently determine vancomycin resistance. The prevalence of E. faecalis was 19%, a value that was not associated with alcohol consumption, tobacco smoking, or age of the subjects. Less frequently detected, with an overall prevalence of 0.7%, the E. faecium was more common among people older than 49 years of age. The genes conferring vancomycin resistance were detected in only one sample. Results indicate that the oral cavity can be considered a reservoir of clinically relevant enterococci; however, our data suggest that healthy individuals rarely carry vancomycin-resistant strains.
ARTICLE | doi:10.20944/preprints202305.1719.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: dog; domestic; leishmaniosis; Portugal; shelter
Online: 25 May 2023 (03:08:39 CEST)
Canine leishmaniosis (CanL) is a chronic, systemic and often severe disease. The main causative agent of CanL is a protozoan parasite, Leishmania infantum, with phlebotomine sand flies acting as vectors. In Europe and other continents, L. infantum is also responsible for leishmaniosis in other animals, such as cats, horses and humans. In Portugal, animal and human leishmanioses are endemic, and high prevalence levels of infection and disease have been reported in dogs. There is a prejudice against stray animals and also those housed in shelters, assuming they have higher levels of infection with vector-borne pathogens, including L. infantum, when compared to domestic animals. In north-eastern Portugal, serum samples were obtained from March to May 2022 in three shelters (n = 179) and 13 veterinary clinics (n = 164), resulting in 343 dogs being analysed for antibodies to Leishmania spp. by the direct agglutination test (DAT). The overall seroprevalence was 9.9%, with 15.2% seroprevalence in domestic dogs and 5.0% in the shelter ones (p = 0.003). The fact that shelter dogs had a lower seroprevalence could be explained by more regular veterinary care provided in shelters regarding preventive measures, including insecticides with an antifeeding effect, in comparison with domestic dogs.
Wed, 24 May 2023
BRIEF REPORT | doi:10.20944/preprints202305.1714.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: obsessive patient; suffering; cognitive patterns; phenomenology
Online: 24 May 2023 (14:36:24 CEST)
Obsessive-compulsive disorder (OCD) remains, despite significant scientific progress, a pathological condition that is incomprehensible, due toits paradoxical psychological and behavioral symptoms. The presentwork aims at assessing current phenomenological understandings of this pathology. Among the cognitive models used today, post-rationalist cognitivism and cognitive neuropsychological psychotherapy, which both incorporate a phenomenological approach, seem most effective at grasping OCD patients’ experiences of the world, which are typically characterized by hyper-reflexivity, at the expense of "natural evidence." For OCD patients, the emotional sense of the world becomes a set of sterile rules that determine a suffering life.
ARTICLE | doi:10.20944/preprints202305.1704.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: Force control; haptic; upper limb; rehabilitation; shoulder movements; medical rehabilitation
Online: 24 May 2023 (05:33:21 CEST)
This paper describes the design and development of an active device that was applied to shoulder rotation rehabilitation. It implements a force control in a similar way to the haptic devices that reflect a force on the user’s hand according to the rehabilitation parameters. This device was tested with patients, combining clinician manipulation and programmed exercises. The results were excellent, given that the range of movement of the shoulder increased in most of the pa-tients. The results of the Usability Scale questionnaire were also promising.
REVIEW | doi:10.20944/preprints202305.1702.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: necrotizing fasciitis; soft tissue infections; mediastinitis; cervical necrotizing fasciitis; descending necrotizing mediastinitis
Online: 24 May 2023 (05:29:09 CEST)
Necrotizing fasciitis is a life-threatening soft-tissue infection affecting the deep fascia and subcutaneous tissue. It is characterized by a fulminant course and high mortality rates. NF of the head and neck is very rare, most cases being odontogenic in origin. Streptococcus spp. and Staphylococcus spp. are the most common isolated organisms. If the infection progresses to descending mediastinitis the prognosis becomes very poor. Since the initial clinical features can be similar to those of a non-necrotizing deep cervical infection, a high degree of suspicion is critical for an early diagnosis. Computed tomography scan can be useful in the diagnosis and to define the extent of the infection. Early and aggressive surgical debridement of all compromised tissue and antibiotic therapy and fluid resuscitation are essential and should not wait for bacterial culture results. Despite prompt and adequate treatment, mortality of CNF can be as high as 35%.
ARTICLE | doi:10.20944/preprints202305.1671.v1
Subject: Public Health And Healthcare, Other Keywords: portable oxygen concentrators; chronic obstructive pulmonary disease; home oxygen therapy; respiratory care; oxygen therapy; obstructive lung disease
Online: 24 May 2023 (02:44:53 CEST)
Background: Portable oxygen concentrators (POCs) have shown efficacy in delivering adequate oxygen for various patient scenarios; however, there is a lack of research on POCs’ efficacy across different respiratory rates specifically among COPD patients. Methods: This bench study was conducted using the IngMar Medical Active Servo Lung 5000 attached to flexible tubing, which simulated an adult patient’s nares. An oxygen analyzer (Maxtec Handi+) was connected to the tubing 6 inches below the nares to estimate the inspired oxygen concentration at the adult trachea. A standard nasal cannula was placed in the simulated patient nares, which was also attached to each POC. The IngMar Lung was programmed to simulate a COPD patient at the following respiratory rates: 15, 20, 30, and 40 breaths/min. POC devices were then compared to an oxygen wall outlet and a standard oxygen concentrator (non-portable CAIRE device). The POCs included the CAIRE FreeStyle Comfort (with Autosat), CAIRE FreeStyle Comfort (without Autosat), Inogen G4, Inogen G5, Phillips SimplyGo Mini, GCE Zen-O lite, Drive Medical iGo2, and Kingon POCs. Descriptive statistics and ANOVAs were computed to determine statistically significant differences between POCS and control devices (wall oxygen and standalone oxygen concentrator). Results: Across most respiratory rate scenarios, the wall oxygen and standalone oxygen concentrator (control group) resulted higher oxygen measurements compared to the POCs. Among the POCs on setting 2, the highest oxygen measurement for 15, 30, and 40 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity 5 (24.43%, 24.81%, and 25.0%, respectively). On setting 2, the 20 breaths/min highest oxygen measurement was the Inogen G4 (24.43%). For setting 5, the highest oxygen measurement for 15 breaths/min and 40 breaths/min was the CAIRE FreeStyle Comfort without AutoSat (31.56% and 26.13%, respectively), while the highest oxygen measurement for 20 breaths/min was the Inogen G5 (30.26%), and the highest oxygen measurement for 30 breaths/min was the CAIRE FreeStyle Comfort with AutoSat on sensitivity level 5 (27.89%). Conclusions: The oxygen administered through the wall and the standalone CAIRE oxygen concentrator all delivered higher oxygen levels compared to the POCs (with the exception of the 40 breaths/min scenario on setting 2). However, among the POCs, the CAIRE Freestyle Comfort with AutoSat, CAIRE Freestyle Comfort without AutoSat, and the Inogen G4 all performed the best among the various breathing rate scenarios.
Tue, 23 May 2023
ARTICLE | doi:10.20944/preprints202305.1632.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: asthma management behavior; pediatric asthma; childhood asthma management; caregivers; wheezing; asthma triggers; inhaler; rural communities; and Nigeria
Online: 23 May 2023 (09:43:56 CEST)
Background: Caregivers of asthmatic children have poor knowledge of proper asthma man-agement practices in Nigeria. The objective of this study was to examine the knowledge, attitudes, and practice behaviors of caregivers in the management of asthma in children under age 5 in Oyo State, Nigeria, using the Health Belief Model. Methods: While a mixed method was used in the original research, this brief describes the quantitative method used in this study to evaluate caregiver’s asthma management practices A 55-item questionnaire investigating childhood asthma knowledge, attitude, and practice was administered during child welfare clinic visits to 118 caregivers. To gain insights into caregivers’ beliefs about asthma management practice behavior, focus group discussions were conducted among two groups of 10 caregivers. Data were analyzed using the IBM SPSS Version 25.0. Statistical significance was set at p < 0.05 and 95% CI. Result: More than 70% of caregivers knew that asthma is associated with airway inflammation and about 90% knew that Flu infections triggered asthma attacks in their children. Overall, 70% of caregivers from the focus group discussions found preventive measures including avoidance of common triggers like dust and smoke, wearing warm clothes in cold weather, environmental sanitation, regular visits to the clinic, and medication adherence helpful. Similarly, caregivers reported the use of quick-to-relieve OTC drugs rather than seeking medical attention. Caregivers with higher income (OR = 3.0; 95% CI = 1.558-5.778; P = 0.001) were 3.0 times more likely to practice proper asthma behavior than those with a lesser income. Conclusion: Despite having moderate knowledge of asthma, caregivers of asthmatic children had wrong perceptions and inadequate knowledge about preventive and treatment options. An optimal public health approach is needed to identify and target underserved communities that suffer poorer asthma outcomes and improve caregivers’ knowledge and skills in asthma management practices. The need to pay more attention to the proper management of childhood asthma among caregivers in underserved populations cannot be overemphasized.
ARTICLE | doi:10.20944/preprints202305.1628.v1
Subject: Public Health And Healthcare, Other Keywords: myocarditis; psoriasis; dilated cardiomyopathy; IL-17A
Online: 23 May 2023 (08:46:46 CEST)
Background. Psoriasis (PS) is a common immune-mediated disease of the skin with pos-sible extension to joints, aorta and eye. Myocardial inflammation has been rarely sug-gested. Aims: Report of PS-related myocarditis Methods and Results: One hundred consecutive patients with PS were screened for car-diac involvement. Among them, five male patients (aged 56 ± 9.5 years) with moder-ate-severe form showed a dilated cardiomyopathy (LVEF <35%) with normal coronary ar-teries and valves. They underwent a left ventricular endomyocardial biopsy for evaluation of myocardial substrate. Endomyocardial samples were processed for histology and im-munohistochemistry, including myocardial expression of Toll-Like Receptor 4 (TLR4) and interleukin-17A (IL-17A), which plays a major role in psoriasis pathogenesis; real-time PCR for cardiotropic viruses and Western blot analysis for myocardial expression of IL-17A. Patients’ sera were tested for anti-heart autoantibodies.An active lymphocytic myocarditis was revealed in all 5 patients, characterized by absence of viral genomes at PCR, positive anti-heart autoantibodies, overexpression of TLR-4 and enhancement of IL-17-A at western blot analysis showing a 2,48-fold increase in psoriatic myocarditis compared with no psoriatic myocarditis and a 6-fold increase compared to myocardial controls. Treatment included combination of prednisone (1 mg/Kg daily for 4 weeks, ta-pered to 0.33 mg/Kg) + azathioprine (2 mg/Kg, daily) in 3 pts or secukinumab (SK, 100 mg/monthly) in 2 pts for 6 months. LVEDD and LVEF improved in the first 3 pts (-14% and + 118%, respectively) while completely recovered (LVEF> 50%) in the last 2 pts on SK. Conclusion. IL-17A-related myocarditis can occur in up-to 5% of patients with psoriasis. It manifests as a progressive dilated cardiomyopathy. It may completely recover following SK administration.
REVIEW | doi:10.20944/preprints202305.1598.v1
Subject: Public Health And Healthcare, Other Keywords: COVID-19; Personal Protective Equipment (PPE); Plastics wastes.
Online: 23 May 2023 (07:39:52 CEST)
The years 2019 to 2022 are being marked by the pandemic resulting from a viral infection, COVID-19. The demand and use of PPE has never been so high and it is often discarded without considering the correct disposal route and the environmental impact that this type and volume of waste can generate. The aim of this study was to analyze the increased demand for PPE used during the pandemic and, consequently, the generation of these wastes. In addition to this analysis, it is extremely important to raise the discussion about the treatment of these residues and the possibilities of more ecological personal protection equipment, such as biodegradable or reusable ones. The extensive use of PPE, which is mostly plastics and is not easily degraded, mainly leads to its accumulation in landfills but, if disposed of incorrectly, it could reach marine environments, contributing to the formation of microplastics in the oceans. Therefore, this article also aims to relate these themes to the Sustainable Development Goals, as efficient management aligned with sustainable development goals is essential to mitigate these anticipated problems and ensure a more sustainable future.
ARTICLE | doi:10.20944/preprints202305.1594.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: HIV/AIDS; Mozambique; Quality of life; Schooling; Meaning in life; Social support
Online: 23 May 2023 (07:28:51 CEST)
Increasing quality of life (QoL) is both an end in itself and a means to optimize the impact of treatment in HIV-infected persons. Possibly due to cultural and social influences, the predictors of QoL vary across studies, which highlights the importance of studying specific populations. In the present study, we wanted to determine the sociodemographic (age, sex, schooling) and psychosocial correlates (meaning in life, social support, positive and negative affect) of QoL in HIV-infected patients living in Mozambique, a country with high prevalence of HIV, but also with well-structured strategies to fight the disease. To that end, we made correlational analyses followed by regression models, and we examined potential mediation processes among predictors. All correlates were relevant except sex. Meaning in life was the strongest predictor, while social support was the weakest. Schooling was both directly and indirectly related with QoL - in the latter case, it was mediated by meaning in life, social support and positive affect. Our findings suggest that investments in education may be highly rewarding to Mozambicans, and that satisfying needs of self-actualization and purpose may be more urgent than improving social connections.
ARTICLE | doi:10.20944/preprints202305.1579.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: Work engagement; burnout; health professionals; private sector; healthcare unit
Online: 23 May 2023 (05:17:04 CEST)
The aim of this study was to investigate the work engagement and burnout in healthcare professionals in a private health unit in Greece. A cross-sectional study was conducted with a sample of 151 professionals (doctors, nurses, administrative staff and professionals of other specialties). The questionnaire included demographic and work-related information and the Utrecht Work Engagement Scale and Maslach Burnout Inventory. Analysis was performed by SPSS v.26. With regard to the work engagement, the participants presented a medium score in absorption and a medium to high score in vigor and dedication. In addition, they presented low score in depersonalization, a medium score in emotional exhaustion and a high score in personal accomplishment. Those who had a working contract for an indefinite period had higher score in all the dimensions of burnout. Vigor, dedication and absorption were negatively correlated with emotional exhaustion and depersonalization and positively with personal accomplishment. Healthcare professionals in private health sector in Greece present moderate work engagement and experience moderate levels of burnout. Work engagement is associated with burnout and plays an important role in its prevention. There are some significant differences in work engagement and burnout based on several demographic and work-related characteristics.
REVIEW | doi:10.20944/preprints202305.1538.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Industrialized Foods; Epidemiologic Factors; Adolescent; Brazil; Review.
Online: 23 May 2023 (03:02:36 CEST)
Background: Considering its deleterious effects on health, as well as the importance of information to support actions, strategies and public policies, this study was aimed to identify and classify the risk factors for consumption of ultra-processed foods among Brazilian adolescents. Data sources: targeting observational studies involving samples of Brazilian adolescents (11 to 19 years old), which evaluated possible associations between the consumption of ultra-processed foods and individual, interpersonal, environmental and public policies variables, in October 2022, a systematic review was conducted, consulting electronic databases (Lilacs, Pubmed, Scielo, Scopus and Web of Science), Google Scholar and the reference lists of included articles. Data synthesis: The descriptive synthesis consisted of 11 papers, representing nine original studies. In general, the consumption of ultra-processed foods was associated with different individual, interpersonal and environmental variables. More specifically, the following variables can be highlighted: sedentary behavior (specially screen time), studying at a private school, having a higher Body Mass Index and being female. Conclusions: Based on this evidence, it is important to direct actions, strategies and public policies aimed at confronting the consumption of ultra-processed foods for these groups.
ARTICLE | doi:10.20944/preprints202305.1535.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: IBD; GERD; Mental-health; POST-SARS-CoV2-symdromes
Online: 23 May 2023 (02:37:42 CEST)
Abstract: Gastroesophageal reflux disease (GERD), the inflammatory bowel disease (IBD), and mental health issues are significant public health concerns in globally. Although rising peaks observed post-COVID-19, there is a sever paucity in high quality data. Using descriptive analysis, we identified the frequency and associations of age- and gender, sport, genetic, and psychiatric consequences in the coexistence of GERD and IBD in 2067 participants 18 to >60 years with mean age of 26.8 ± 12.9 years. Most were 18 -29 years old (66%, n=1364) of which majority were young Saudi females (72.4%, n=1496). Estimated 1099 (53.2%) were students, 428 (20.7%) were unemployed, and 540 (26.1%) were. The majority were Saudis (94.7%, n= 1957). Psychological syndromes anxiety (60.7%), stress (60.7%), and depression (60.6%) were most frequent; whereas, IBD (48.7%) and GERD (36.3%), respectively were the second and third. In 51 % respondents depression, anxiety, and stress occurred first while in 33.9%, and 24.3% IBD and GERD, respectively, were the first signs. In most respondents (59.2%, n=1178), these signs first appeared recently and 33.6% (n=669) reported occurrence during adult life, and only in 7.2% (n=144) the signs noticed during childhood (7.2%, n=144)). Aggravating factors were 32.9% (n=681) genetic and other factors of which 476 (69.9%) inherited IBD while 215(31.6%) and 175 ((25.7), respectively, inherited psychological (depression, anxiety, and stress) and GERD. However, only 18.3% sought treatment (n=378) and only 66 (3.2%) had colectomy or a colostomy bag. Little over half of the studied population (58.1%, n=1201) were active in outdoor. GERD or IBS and psychological factors (anxiety, depression, and stress), were significantly associated with age (P value =.001).; GERD with old age, IBD with mid-age 40-49 years, and psychological disorders among younger ages. Thus, while mental health issues predispose young millennial women to neurogastroenterological disorders, the IBD and GERD initiate psychological problems in old and mid-ages, respectively. Intriguingly, despite the significantly mosaic global genetic population structures, their lifestyles, and nutritional habits, the pattern of these disorders remains similar. Thus, this is potentially consistent with notion that the gut nerve cells are conserved and that the changes in gut dysbiosis of gut microbiome signatures are responsible. These findings have significant clinical implications in the patient treatment strategies and tailored educational and awareness programs in lifestyle medicine. Future microbiome studies would reveal more insight into the mechanisms of disorders.
Mon, 22 May 2023
ARTICLE | doi:10.20944/preprints202305.1520.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: Neuromuscular performance; blood flow restriction; occlusion; resistance training; velocity; EMG
Online: 22 May 2023 (11:31:23 CEST)
The aim of this study was to verify the effects of blood flow restriction on movement velocity and muscle activity during the back-squat exercise. Methods: Twenty-four university students participated in this study. In two randomized 72-hours apart sessions, participants performed a 4-set protocol consisting of 30-15-15-15 repetitions performed at 30% of their one-repetition maximum in the back-squat exercise. In both sessions, neuromuscular function was monitored by surface electromyography (EMG) and movement velocity (mean propulsive velocity [MPV], peak concentric velocity [Vmax] and the effort index [EI]). Blood flow restriction (BFR) was applied during exercise in one of the experimental sessions with 80% of full arterial occlusion pressure over lower limbs. Results: BFR condition showed higher (p<0.05) EI, peak and rooted mean square normalized EMG in set 1 compared to set 2. Similar MPV and Vmax were observed at each set for both BFR and control conditions. No significant differences were observed between conditions at any set. Conclusions: BFR did not imply changes in neuromuscular performance during low-intensity resistance training, but it might induce greater intra-series velocity loss and less activation of the muscles involved.
COMMUNICATION | doi:10.20944/preprints202305.1504.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Diabetes; pre-diabetes; early childhood dental caries; refined sugar; dietary counseling; Sri Lanka
Online: 22 May 2023 (10:42:40 CEST)
Diabetes mellitus and dental caries (tooth decay) are not only common Non Communicable Diseases (NCDs) contributing to high burden of diseases but costly diseases to manage. Diabetes mellitus is a leading cause of mortality and reduced life expectancy across the globe. Early child hood dental caries (ECC) denotes a common chronic childhood disease and cariogenic dietary patterns dominated by refined sugar is one of the main causative factors. Thus, high burden of ECC could be a proxy indicator of excessive refined sugar consumption of a child. If such unhealthy dietary patterns are continued through to adolescent to adulthood, there is a high probability of an individual becoming a diabetic. Therefore, it is rational to argue high ECC burden in a country could be an indicator of future burden of diabetes. Moreover, ECC provides a critical period and a window of opportunity across life-course perspective, to intervene with cariogenic dietary patterns underpinned by common risk factor approach. This could be achieved by tailored dietary counseling for parental care givers of children with ECC. A healthy dietary pattern fostered in the childhood, most probably would continue to adulthood which may become beneficial in reducing the incidence of diabetes. Against this backdrop, we provide a perspective from Sri Lanka: a lower-middle-income country (LMIC) which records the highest prevalence of diabetes and pre-diabetes in south Asia. Our perspective will provide novel insights and innovative ideas into prevention and control of diabetes burden in LMICs, harnessing the potential of preventive dentistry.
ARTICLE | doi:10.20944/preprints202305.1491.v1
Subject: Public Health And Healthcare, Other Keywords: Force-Velocity-Profile; Arm cranking; Ballistic push-off; Wheelchair basketball
Online: 22 May 2023 (09:51:50 CEST)
The upper limb force-velocity relationship (FVR) is a crucial aspect of athletic performance, par-ticularly in para sports where upper limb movements play a leading role in activities such as wheelchair propulsion. Athletes’ mechanical capacities can be evaluated on the field or in lab conditions. However, no studies have indicated a relationship between ergometers and field FVR or performances. Understanding para-athletes’ upper limb FVR can provide important insights for developing effective training programs and improving athletic performance in wheelchair bas-ketball players. Twenty-three wheelchair basketball players (12 women and 11 men) from French national teams performed a battery of three tests consisting of a 20 m sprint (SP) with Inertial measurement units (IMU) on wheels, a horizontal upper limb push-offs on a frictionless sled with two Kistler force plates (HBP), and a crank ergometer sprints test (CES) derived from arm er-gometer sprints using Brachumera, Lode. For the SP test, the FVR was computed with an estimation of force from the acceleration, the rolling resistance, and an estimation of the air resistance. Correlations between each variable measured were computed via Pearson correlations in R, as-suming strong relationships for r=0.7-1.0, moderate when r=0.40-0.69, and weak relationship when r<0.1-0.39. Significant differences were assumed when p<0.05. Strong correlations were found between the results of three tests conducted. The correlation coefficient between maximal theo-retical force (F0) data ranged from 0.85 to 0.88 and that between maximal theoretical power (P0) data ranged from 0.87 to 0.94. However, for maximal theoretical velocity (V0) data, the correlations between the three tests were less important. The performance variables showed a strong corre-lation with power measured on the HBP test without load. There is a significant relationship between HBP, CES, and SP variables. There is a correlation between performances on the three tests in our population, especially for the power. However, the V0 value of HBP was not representative of any performances. This work can show multiple protocols to assess para-athletes’ performances and show that upper limb symmetry depends on the gesture of the task and personal sports’ wheelchairs.
REVIEW | doi:10.20944/preprints202305.1474.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Functional foods; healthy diet; diseases; micronutrient
Online: 22 May 2023 (08:35:57 CEST)
Bioactive compounds are the food constituents, providing beneficial health effects to functional foods and nutraceuticals. These compounds have antioxidants activity including anti-inflammatory, antifungal, and have additional preventative actions. Since these compounds are important constituents enhancing function of the foods, therefore, these constituents are necessary to be incorporated under the umbrella of functional foods. Functional foods provides health benefits though bioactive compounds, as these compounds target mechanisms that manage, prevent, and/or treat chronic or acute diseases. The bioactive compounds are quite essential for functional foods that are crucial for optimal health, thereby leading to the inclusion of these compounds in the most recent definition of functional foods. Some experts have defined that bioactive compounds are the chemical components that contributes and regulates in biological mechanisms. These bioactive compounds are more accurately defined by Dr. Martirosyan and Pisarski as the “primary and secondary metabolites of nutritive and non-nutritive natural components generating health benefits by preventing or managing chronic disease or its symptoms”. These compounds have potential antioxidant and anti-inflammatory activity, which provide benefits to health. Although they are a small proportion of a food source, these compounds can also trigger the mechanisms that will alter and can improve human health. Certain bioactive compounds present in foods are extremely beneficial, but if consumed in excess, they can cause toxicity. Therefore, each bioactive compound must be fully evaluated in order to establish a beneficial and a toxic threshold amount.
REVIEW | doi:10.20944/preprints202305.1469.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Prostate cancer; Radical prostatectomy; Venous thromboembolism,; Mechanical prophylaxis; Pharmacological prophylaxis
Online: 22 May 2023 (07:12:49 CEST)
Radical prostatectomy (RP) is one of the recommended treatments to achieve oncological outcomes in localized prostate cancer. However, radical prostatectomy is a major abdominopelvic surgery. Venous thromboembolism (VTE) is a well-known complication associated with surgical procedures including RP. There is a lack of consensus regarding VTE prophylaxis in urological procedures. The aim of this systematic review was to investigate different aspects of VTE in post-Radical Prostatectomy patients. A comprehensive literature search was performed, and relevant data were extracted. The primary aim was to perform a systematic review and meta-analysis (wherever possible) of VTE occurrence in post-RP patients in relation to surgical approach, pelvic lymph node dissection, and type of prophylaxis (mechanical or combined prophylaxis). The secondary aim was to investigate- the incidence and other risk factors of VTE in post-RP patients. A total of 16 studies were included for quantitative analysis. Statistical methods for analysis included the DerSimonian-Laird random effects. We were able to conclude that the overall incidence of VTE in post-radical prostatectomy is 1% and minimally invasive procedures (MIS), including laparoscopic as well as robotic procedures for radical prostatectomy and RP without pelvic lymph node dissection (PLND) are associated with less risk of developing VTE. Additional pharmacological prophylaxis to mechanical methods may not be necessary in all cases and should be considered in high-risk patients only.
REVIEW | doi:10.20944/preprints202305.1463.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: parental triangulation; marital conflict; coparenting; adolescent; intergenerational family bond; divorced couples
Online: 22 May 2023 (04:59:36 CEST)
The triangulation process represents a violation of the boundary between parental and child relational subsystems which, in turn, affects family dynamics and relationships. The paper, with distinct reference to marital conflict and divorced couples, describes the main causes of the triangulation process and its impact on children (and adolescents) as significant third participants within the parental conflict. Besides, it fo-cuses on long-term consequences associated with triangulation process to parental conflict exposure, that can adversely affect the well-being of children during their life-cycle, and even into adulthood. A data-search was carried out for articles to be included in the review and articles were retrieved from different electronic databases (first: Scopus and Web of Science, then: PsychINFO, Google Scholar, EBSCO and ScienceDirect,). After having initially considered 152 articles, 58 studies were selected for this research. A qualitative analysis was conducted on selected studies, focusing on: (1) different types of triangulation commonly used in intergenerational family relationships; (2) an updated summary of the research around the impact of triangulation on the well-being of children and the parent-child conflict; and (3) the main characteristics of successful intervention of preventative and psychotherapeutic treatments. In conclusion, the results, examining the long-term effects of the triangulation process, highlight the developmental paths of children that are more exposed and at risk, and focuses on the importance of preventing the intergenerational transmission of marital conflict, as a way to reduce mental health costs and to improve the well-being of children and families who are all involved in these conflicting and destructive dynamics.
Fri, 19 May 2023
ARTICLE | doi:10.20944/preprints202305.1441.v1
Subject: Public Health And Healthcare, Primary Health Care Keywords: Vaccine hesitancy; Vaccination, COVID-19; Predictors; Prevalence; Health workers
Online: 19 May 2023 (11:58:06 CEST)
Introduction: COVID-19 vaccines have been the most effective means in curbing the infection, however, vaccine hesitancy has been seen as a threat to global health. Objective: the study aimed to assess the prevalence and predictors of COVID-19 vaccine hesitancy among healthcare workers in infectious disease centers in Ghana. Method: A cross-sectional study and proportionate stratified sampling method was used to recruit participants from various infectious disease centers. Result: data from 170 participants were analyzed, revealing a low prevalence of COVID-19 vaccine hesitancy (11.2%) among healthcare workers. However, only 31.1% of the fully vaccinated participants had taken the booster dose. Factors such as concerns about vaccine safety and side effects from previous doses, indecisiveness, a lack of time to receive the vaccine and lack of access to accurate information, prefered natural immunity were the significant predictors of vaccine hesitancy among healthcare workers. Participants with good perception of the risk posed by COVID-19 was positively correlated with COVID-19 vaccine acceptance. Conclusion: the study suggests that policies should be enacted to ensure health workers are vaccinated against highly contagious infectious diseases to prevent their spread among the general population. Training and health promotion campaigns should also be organized to encourage healthcare workers to accept and patronize the vaccines.
ARTICLE | doi:10.20944/preprints202305.1425.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Haemoglobin; Anaemia; Dietary, Diversity; Random-effect
Online: 19 May 2023 (10:06:34 CEST)
Anaemia is the most prevalent nutritional deficiency in the World and is associated with long-lasting developmental effects in children. Anaemia weakens the immune system and im-pairs cognitive development of children. Anaemia is multifactorial; therefore, anaemia’s pre-ventive/control measures should be evidence-based. This paper aimed to investigate the preva-lence and correlates of anaemia in preschool aged children at individual, maternal/household and community level in the Democratic Republic of Congo (DRC). Retrospective, nationally representative cross-sectional data, the 2013-2014 DRC Demographic and Health Survey (DHS) was used. Three -levels random intercept logistics regression models were fitted to the data using the outcome anaemia in children, defined as a haemoglobin concentration below 11dl with potential risk factors grouped at individual, maternal/household and community levels. Anaemia in children is a severe public health issue in the DRC, 63% of school-aged children are anaemic. Anaemia is highly prevalent amongst males, children with infections (fever/malaria and intestinal parasites), whose mothers are anaemic, from the poorest household, and whose drinking source of water is unclean, and who reside in provinces with recent/previous armed forces attacks. Results from this paper highlight the need for a clean and safe environment for children’s growth.
ARTICLE | doi:10.20944/preprints202305.1397.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: high dose rate brachytherapy; vaginal cuff brachytherapy; single channel cylinder; multiple channel cylinder, endometrial cancer.
Online: 19 May 2023 (07:42:29 CEST)
Purpose: The purpose of this study was to evaluate the dosimetric impact of multiple channels compared to a single channel in high dose rate (HDR) vaginal cuff brachytherapy (VCBT). Methods and materials: Sample plans of HDR VCBT from both single and multiple channel cylinders at 2.5, 3.0 and 3.5 cm in diameter were created and analyzed. The doses were prescribed either at the 0.5 cm depth with 5.5 Gy for 4 fractions or at the cylinder surface with 8.8 Gy for 4 frac¬tions, in various treatment lengths ranging from 3 to 8 cm. A 0.5 cm ring target volume called PTV_Eval was contoured for each plan and served as the target volume for dosimetric evaluation. Mean doses and the doses covering 90% (D90), 10% (D10), and 5% (D5) of PTV_Eval were calculated and compared. The same treatment lengths, same prescription regimens, same target volume contouring and same plan evaluation methods were repeated for the similar size single channel and multiple channel cylinders. Results: The mean doses of both regimens with the multi-channel cases (6.3 to 7.1 Gy) were comparable to single channel ones (6.4 and 7.5 Gy). The ranges of D90, D10 and D5 were from 3.654 to 5.04 Gy, 8.44 to 10.08 Gy and 8.84 to 10.86 Gy in the multi-channel cases, but from 5.36 to 5.76 Gy, 7.40 to 9.97 Gy and 8.16 to 11.93 Gy in the single channel cases, respectively. Conclusion: The single channel and multiple-channel cylinder deliver a similar mean dose, but with marked heterogeneity in D90, D5 and D10 for the same prescription dose and target volume. Multi-channel cylinders adequately cover the target volume, but given the heterogeneity, increased treatment time and cost are best suited for asymmetric target volumes.
REVIEW | doi:10.20944/preprints202305.1394.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Rural; well-being; infant welfare; risk factors
Online: 19 May 2023 (07:35:31 CEST)
Children from rural areas face numerous possibilities for neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present meta-analysis aims to integrate the qualitative and quantitative EEG findings, their relationship with cognitive impairment in children living in vulnerable or rural environments, and the main risk factors influencing EEG abnormalities. The method for this purpose was based on a systematic string-based review from Ebscohost and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. A total of 92 records were identified; however, only 20 were eligible, considering 11 for qualitative and 9 for quantitative analysis. The findings highlight a significant amount of literature on EEG and its relation with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence about the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Further research is needed to better describe and integrate the state of the art regarding EEG features extraction.
COMMUNICATION | doi:10.20944/preprints202305.1381.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: chronic viral hepatitis; socio-economic status; children
Online: 19 May 2023 (05:07:14 CEST)
In the present research, chronic viral hepatitis in children is approached from a multidisciplinary point of view, considering social status, economic and medical aspects. We conducted a 4-year observational prospective study. A questionnaire regarding the socio-economic status of pediatric patients diagnosed with chronic viral hepatitis B or C was applied. In total, 159 patients were included, 52 % from urban areas, 2.5 % coming from centres for abandoned children. Among 119 school-aged children, 66% were attending classes. All patients are registered with a general practitioner. Regarding the monthly income per family, 49% had less than 1000 RON (5 RON = 1$), of which 17% had no income, 28% had an income ranging between 1000 and 2000 RON and in only 23% of cases the income exceeded 2000 RON (5% had more than 4000 RON). There were between 3 and 12 members per family. Concerning parents` educational level, the average years of study for mothers was 7.8, while for fathers, it was 8.2. For 17 % of children, at least one of the parents was illiterate, and for 5.6 %, both parents were illiterate. For a third of patients, both parents were unemployed. Regarding social living conditions, 38.4% did not have water facilities or sewerage, and 32 % used personal objects (scissors, nail clippers) in common. The socio-economic level can have a significant impact on disease epidemiology (infectiousness) and access to treatment, and it is tightly related to educational level and access to information, which are critical factors in disease prevention through general and specific measures and in disease management (treating infected patients and limiting the transmission).
ARTICLE | doi:10.20944/preprints202305.1374.v1
Subject: Public Health And Healthcare, Other Keywords: Information; Sources of information; COVID-19; Vaccine hesitancy
Online: 19 May 2023 (04:20:44 CEST)
Vaccine hesitancy remains a public health challenge. It has been argued that the sources of vaccine-related information may serve as important condiments to one’s decision to be vaccinated. However, little empirical attention is given to the subject. We contribute to this debate by assessing the level of COVID-19 vaccine hesitancy and the role of information explaining hesitancy, using the Nelson Mandela Bay Municipality of South Africa as a case study. Findings confirm high level of vaccine hesitancy, representing 78.8 percent of the respondents (which is above the national level of 41%). Furthermore, findings reveal that vaccination decisions are influenced by family, which is the most trusted among all institutions in the society, especially on sensitive matters and those shrouded by myths and misinformation. Additionally, the majority trusts health care workers and mass media as sources of health-related and general information; however, the use of popular personalities to convey health information is not supported. The findings reveal key socio-demographic and institutional drivers of COVD-9 vaccine hesitancy, such as age, inadequate information on the vaccine, trust issues, conspiracy beliefs, vaccine-related factors, and perceived side effects associated with the vaccine. Recommendations based on the findings are provided.
Thu, 18 May 2023
ARTICLE | doi:10.20944/preprints202305.1334.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: victimizing and perpetrating violence; interpersonal and intimate violence; harmful alcohol and drug use; mental health symptoms; paths of violence; gender
Online: 18 May 2023 (10:46:13 CEST)
The COVID-19 pandemic may have increased interpersonal and intimate violence, harmful use of alcohol and other drugs (AOD), and mental health problems. The present study uses a valid path model to describe relationships between these conditions of young Mexicans during the second year of the pandemic. A sample of 7,420 young Mexicans ages 18 to 24—two-thirds of whom were women—completed the Life Events Checklist, the Alcohol, Smoking, and Substance Involvement Screening Test, the Major-Depressive-Episode Checklist, the Generalized Anxiety Scale, and the Posttraumatic Stress Disorder (PTSD) Checklist. Young Mexicans reported higher rates of victimization and perpetration of interpersonal and intimate violence and mental health symptomatology than those noted pre-pandemic and in the first year of the pandemic. Harmful use of AOD rates were like those reported by adolescents before. Findings suggested asymmetric victimization and perpetration of intimate violence by gender (with women being at a higher risk than men, p≤.05). More men than women engaged in the harmful use of AOD (except for sedatives, which more women abuse). In contrast, more women than men were at risk of all mental health conditions. The path model indicates that being a victim of intimate violence predicts harmful use of tobacco, alcohol, cocaine, and sedatives, depression, anxiety, and specific PTSD symptoms (such as re-experimentation and avoidance symptoms). Being a victim of interpersonal violence resulted in severe PTSD symptoms (including avoidance, negative alterations in cognition-mood, and hyperarousal signs). Harmful use of sedatives predicted depressive symptoms. Men´s victimizing intimate violence model contrasted with that of women, which also included being the victim of interpersonal violence and severe PTSD symptoms. The high school youth model had three paths -victimizing-intimate violence, victimizing-interpersonal abuse, and sedative use, which predicted depression. The findings of this study could serve as the basis for future studies exploring mechanisms that predict violence patterns to develop the most cost-effective preventive programs and public policies and to address mental health conditions during community emergencies.
ARTICLE | doi:10.20944/preprints202305.1292.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Carotid atherosclerosis [C10,228,140,300,200]; cardiovascular risk factors [E05,318,740,600,800,725,500,500]; carotid intima-media thickness [E01,370,350,850,150]
Online: 18 May 2023 (07:52:00 CEST)
Introdução: Os fatores de risco vasculares são decisivos na evolução da doença aterosclerótica e a ecografia Doppler carotídea e vertebral permite acompanhar o seu aparecimento e evolução. A medida do espessamento da parede arterial permite o diagnóstico precoce da doença potencializando seu tratamento e controle dos fatores de risco vasculares. Objetivo: Analisar a presença de doença ateromatosa em indivíduos com idade > 65 anos e compreender sua transformação com fatores de risco vascular. Materiais e Métodos: Estudo observacional transversal, em indivíduos com idade > 65 anos manifestados ao ecoDoppler carotídeo entre 1º de janeiro de 2012 e 31 de dezembro de 2021. Foi calculado o índice médio-intimal, a presença de placas ateromatosas, sua repercussão hemodinâmica e fatores de risco vascular foram registrados. Resultados: Obteve-se uma amostra de 5885 indivíduos, sendo 41,8% do sexo feminino e 58,2% do sexo masculino. A média de idade foi de 76,59 anos, variando entre 65 e 98 anos (+6,69). A hipertensão arterial foi a mais prevalente 81,3%. Houve relação positiva significativa entre índice médio-intimal, idade e história pessoal de doenças cardiovasculares e cerebrovasculares (p=0,001). Na presença de placas, sexo masculino, hipertensão arterial, diabetes, dislipidemia, tabagismo e história pessoal de doenças cardiovasculares e cerebrovasculares apresentadas de forma positiva. Conclusões: Nesta amostra, fatores de risco vascular não modificáveis parecem ser determinantes na presença de aumento da espessura da parede arterial. Na presença de sinais de um estágio mais avançado da doença aterosclerótica, os fatores de risco vascular modificáveis são decisivos,
ARTICLE | doi:10.20944/preprints202305.1279.v1
Subject: Public Health And Healthcare, Health Policy And Services Keywords: Optimal Allocation; Vaccine; Scarce Public Goods; COVID-19; Pandemic; COVAX
Online: 18 May 2023 (05:36:22 CEST)
How to optimally allocate COVID-19 vaccines and scarce public goods is a crucial and sensitive question to scholars, policy-makers, and practitioners. The ethical dimensions and principles of vaccine allocation between groups are widely agreed upon, whereas the ethical dimensions and principles of vaccine distribution between countries at the peak of the COVID-19 pandemic are highly controversial. This article aims to investigate how vaccines were globally allocated across countries and propose an optimal allocation mechanism for vaccines and scarce public goods. The results show that, to a certain extent, the global allocation of COVID-19 vaccines was fair and effective. Countries with more cases and deaths obtained more vaccines and vaccinations. Wealthier countries might receive more vaccinations but also suffer more severe consequences of COVID-19. Though COVAX could miss its initial vaccine delivery targets, the facility should be considered successful in its core goals and plays a critical role in controlling the pandemic. The study proposes a fair and effective mechanism of vaccine allocation that combines the roles of markets and interventions of international organizations and national governments with three degrees: emergency, priority, and market.
REVIEW | doi:10.20944/preprints202305.1270.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Obesity; overweight; prevention; lifestyle; diet; physical activity
Online: 18 May 2023 (05:08:25 CEST)
In this particular historical moment, the increase in mortality for cardiovascular disease in adults, the increase of metabolic diseases linked to overweight and obesity, it is necessary to focus the attention of medical doctors, researchers and policy makers on the promotion of correct lifestyles and prevention. The "prevention" and "cure or treatment" have long been considered distinct strategies, the almost exclusive prerogative of the public health authorities for the preventive aspects and of the clinician for the treatments. This approach has led, and still leads, to very high healthcare costs, without having a significant impact on obesity incidence. The promotion of correct lifestyles in the population and in subjects at risk in the fight against obesity/overweight, to contrast the reduction of physical activity and sedentary lifestyle, to promote the consumption of fruit and vegetables, to the reduction of the excessive consumption of salt as "Strategic lines of intervention" need to be pursued in all western countries. Actually, the preventive actions undertaken were not very effective, especially for the individuals in pediatric age. In this narrative review, based on published data, the critical points for obesity prevention will be discussed focusing on action needed during life from pre-conception to childhood, adulthood and in geriatric age to contrast obesity.
ARTICLE | doi:10.20944/preprints202305.1265.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: active and healthy ageing; intrinsic capacity; user-centered design; eHealth literacy; technology-based interventions
Online: 18 May 2023 (04:48:50 CEST)
The worldwide population is undergoing a fundamental change in its age structure, which challenges the health and social services system. The need to migrate towards a more person-centered and coordinated model of care that supports the optimization of abilities and capacities for older people has to be matched. In this sense, eHealth technologies can play a fundamental role. In this paper, through a questionnaire-based data collection on 30 primary (older people) and 32 secondary (informal caregivers) end-users, we share the sustainable way to develop a product optimizing the user experience and ensuring adoption. Both older adults and caregivers consider the use of smartphone and smartwatch to be very important, but also the use of digital devices for healthcare can be helpful. Seniors care about self-monitoring of health parameters using wearable devices, regardless of their health status, and would like to be included in the process of making good health decisions, because they need to feel in control of their healthcare process. Digital solutions in health and care can support the wellbeing of older adults in many areas of their daily lives at home and in their communities, but only if such innovation is designed around the natural voice of the intended target.
Wed, 17 May 2023
REVIEW | doi:10.20944/preprints202305.1206.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Pandemics; Immunization Programs; Poliovirus; Pakistan; World Health Organization
Online: 17 May 2023 (07:58:04 CEST)
Poliomyelitis, commonly known as “polio” is a paralytic and perilous disease caused by the poliovirus. Due to its highly contagious nature, the virus was a challenge to the world in the late 1980s. . Since 1988 the collective work of the Global Polio Eradication Initiative (GPEI), Centre for Disease Control and Prevention (CDC), and World Health Organization (WHO) through immunizations, communication awareness, and monitoring have helped the world exonerate polio. The mission of polio-free Pakistan was herculean and had confronted enormous challenges in different ways but came out with positive results. In 2019, with only two remaining polio-endemic countries, Pakistan and Afghanistan, GPEI launched an “Endgame strategy 2019-2023” which aims to eradicate polio globally, with a targeted focus, especially on polio-endemic countries, the plan emphasizes the early detection of polio cases for complete eradication and to restrict the spread of polio. Pakistan has achieved a milestone in combating polio despite having a web of factors that have thwarted Pakistan’s polio eradication efforts, but this is not the end, the struggle continues until we really get an internationally verified certification of Polio free nation, for this WHO has designed a multidisciplinary strategy 2022-2026 to really end this polio for once and for all.
BRIEF REPORT | doi:10.20944/preprints202305.0688.v2
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: hypertonic salt solution; impregnation; filtering face piece; human monoclonal antibody; dry blood spot
Online: 17 May 2023 (04:33:54 CEST)
There is little doubt that final victories over pandemics, such as COVID-19, are attributed to herd immunity, either through post-disease convalescence or active immunization of a high percentage of the world's population with vaccines, demonstrating protection from infection and transmission, being available in large quantities and at reasonable prices. However, it is assumable that humans with immune defects or immune suppression, e.g., as a consequence of allograft transplantation, cannot be immunized actively nor produce sufficient immune responses to prevent SARS-CoV-2 infections. These subjects desperately need other strategies, such as sophisticated protection measures and active immunization. Hypertonic salt solutions attack vulnerable core areas of viruses, i.e., salt denatures surface proteins and thus prohibits virus penetration of somatic cells. It has to be ensured that somatic proteins are not affected by denaturation regarding this unspecific virus protection. Impregnating filtering facepieces with hypertonic salt solutions is a straightforward way to inactivate viruses and other potential pathogens. As a result of the contact of salt crystals on the filtering facepiece, these pathogens become denatured and inactivated almost quantitatively. Such a strategy could be easily applied to fight against the COVID-19 pandemic and other ones that may occur in the future. Another possible tool to fight the COVID-19 pandemic is passive immunization with antibodies against SARS-CoV-2, preferably from human origin. Such antibodies can be harvested from patients´ human sera, which have successfully survived their SARS-CoV-2 infection. The disadvantage of a rapid decrease of the immunoglobulin titer after infection ends can be overcome by immortalizing antibody-producing B-cells via fusion with, e.g., mouse myeloma cells. The resulting monoclonal antibodies are then of human origin and available in, at least theoretically, unlimited amounts. Finally, dry blood spots are a valuable tool for surveilling the population´s immunity.
ARTICLE | doi:10.20944/preprints202305.1181.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: influenza vaccination; health personnel; health care worker; surveillance system; epidemiology; prevention; public health
Online: 17 May 2023 (04:27:18 CEST)
(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than general population. (2) The study purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs Non-HP (NHP). We analysed 2014-2018 data (N=105,608) from the Italian Behavioural Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8% - 26.1%) of MDs and 8.5% (CI 7.5% - 9.5%) of NMHP reported to have been vaccinated vs 6.3% (CI 6.1% - 6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34yy, respectively, 9.9%, 4.4%, 3.4% vs 28.4%, 13.9%, 10.6% in 50-64yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs 30.5% in 2018). (4) Despite such increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.
ARTICLE | doi:10.20944/preprints202305.1168.v1
Subject: Public Health And Healthcare, Physical Therapy, Sports Therapy And Rehabilitation Keywords: self-management; Covid-19; aging management; PTSD; PTG; anxiety
Online: 17 May 2023 (02:28:45 CEST)
The restrictions imposed by the Covid-19 pandemic left many older adults isolated and confined. Under active aging theory, self-management is crucial for well-being among older adults coping with aging. The current study examines how (a) initial self-management, and (b) changes in self-management due to independent physical training, affect psychological outcomes in a sample of care home residents following outbreak of the pandemic. 64 older adults (53 females, 11 males), mean age is 82.23, reported on their self-management abilities, then embarked on six months of training in chair exercises (one session per week). The training exercises were halted after 22 sessions due to the pandemic, but some residents continued to practice independently. Eight weeks after the outbreak of the pandemic, residents who had continued to practice at least once per week (n = 35) and those who had not continued to practice (n = 29) were questioned again about their self-management, and about five psychological outcomes: anxiety, traumatic stress, satis-faction, general mood, and post-traumatic growth (PTG). Self-management improved among older adults who independently practiced the exercises, and declined among those who did not. Pre-pandemic self-management significantly predicted post-outbreak traumatic stress symptoms, anxiety, general mood, and satisfaction with life, but not PTG. However, the difference in self-management between the pre-pandemic and post-outbreak measures was associated with PTG, and made a unique contribution to prediction of the other effects. Self-management abilities among older adults can be seen as a protective factor against adverse psychological outcomes at times of trauma. Further, the improvement in self-management among older adults who independently practiced physical excises made a unique contribution beyond initial self-management abilities.
Tue, 16 May 2023
ARTICLE | doi:10.20944/preprints202305.1109.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: actor-partner interdependence model; depression; couple; dyadic analysis; infertility; mental health
Online: 16 May 2023 (05:45:35 CEST)
Background: Infertility can affect a couple's mental health, marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and the relationships with other factors. Methods: This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The Actor-Partner Interdependence Model (APIM) was used for dyadic analysis. Results: The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion, and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction, and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = .039). Conclusions: Like other populations, depression in infertile couples seems to be associated with aggression, extraversion, and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration.
REVIEW | doi:10.20944/preprints202305.1101.v1
Subject: Public Health And Healthcare, Other Keywords: Cognitive stimulation; physical activity; combined interventions; older adults; new technologies; exergaming; e-mental health
Online: 16 May 2023 (05:27:32 CEST)
Background: Demographic aging is a reality in developed countries, which poses a social challenge of great responsibility. Thus, numerous studies have been developed in an attempt to understand which factors best predict healthy aging. The aim of this study was to investigate and systematize literature on intervention programs that simultaneously include cognitive stimulation and physical activity, understand the importance of the use of new technology in these programs, and understand their impact on cognitive function in older adults, giving indications about their contribution to healthy aging. Methods: A narrative approach was used for extraction and synthesis of the data. Relevant studies were identified from electronic databases such as PubMed, Scopus, Web of Science and Academic Search Complete. Results: Thirty-two articles, involving 2815 participants, were identified. All selected studies were randomized controlled studies. The studies were published between 2011 and 2020. All studies included a combination of cognitive and physical interventions. Many of the studies used technology to administer the cognitive stimulation program. Conclusions: Most of the analyzed studies use new technologies in physical and cognitive interventions, demonstrating that this new form of intervention exerts lasting and stable benefits in cognition.
ARTICLE | doi:10.20944/preprints202305.0874.v2
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: online frailty check application; older adults; co-design; co-development; reliability; participatory action research
Online: 16 May 2023 (05:25:59 CEST)
Frailty, an age-related decline in homeostatic reserves, markedly proceeded during the coronavirus disease 2019 pandemic. To continuously assess frailty status, a remote system is urgently required. We aimed to co-design/co-develop an online frailty check (FC) application alongside FC supporters who were facilitators in a pre-existing onsite FC program. The online FC included a screening measurement for sarcopenia and an 11-item questionnaire covering dietary, physical, and social behaviors. Using prototype applications, 55 opinions obtained from 32 FC supporters (median 74.0 years) were categorized and reflected refinement. Regarding the self-efficacy of FC supporters, a significant increase in social positioning was seen after the mock test (P=.031). For FC supporters and participants, the average system usability scale (SUS) score was 70.2±10.3 points, which was “marginally high” for acceptability and “good” for the adjective range. Multiple regression analysis showed that the SUS score was significantly correlated with online-onsite reliability but not online communication, even after adjusting by age, sex, education level, and ICT proficiency (b=0.400, 95% CI: 0.243-1.951, P=.013). Additionally, a significant association between onsite and online FC scores was observed (R=0.670, P=.001). Our online FC application was evaluated to be a valuable tool to practically assess frailty status remotely.
ARTICLE | doi:10.20944/preprints202305.1098.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: ST-segment elevation myocardial infarction; STEMI; air pollution; particulate matter; nitrogen dioxide
Online: 16 May 2023 (05:19:45 CEST)
ST-segment elevation myocardial infarction (STEMI), a major cause of mortality worldwide, has been shown through epidemiological studies to have a relationship with short-term exposure to air pollutants; however, the association between air pollutants and the outcome of STEMI has not been well studied. The aim of this study was to estimate the impact of air pollutants on the outcomes of STEMI. Data on particulate matter <2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) at each of the 11 air monitoring stations in Kaohsiung City were collected between January 1, 2012, and December 31, 2017. Medical records of non-trauma patients aged > 20 years who had visited the ED with a principal diagnosis of STEMI were extracted. The primary outcome measure was in-hospital mortality. After adjusting for potential confounders and meteorological variables, we found that an increase in the interquartile range (IQR) in NO2 was associated with an elevated risk of in-hospital mortality in patients with STEMI. Moreover, during the warm season, an IQR increase in NO2 corresponded to a higher risk of in-hospital mortality in patients with STEMI on lag 3 (OR=3.266; 95% CI:1.203–8.864, p=0.02). Conversely, an IQR increase in PM10 was associated with an increased risk of in-hospital mortality in patients with STEMI on lag 3 (OR=2.792; 95%CI:1.115–6.993, p=0.028) during the cold season. Our study suggests that exposure to NO2 (during warm season) and PM10 (during cold season) may contribute to a higher risk of poor prognosis in patients with STEMI.
Mon, 15 May 2023
REVIEW | doi:10.20944/preprints202305.1061.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Artificial Intelligence; A.I Cardiology; A.I in Cardiovascular Medicine; Machine Learning in Cardiology
Online: 15 May 2023 (16:03:01 CEST)
In this review we look at the developments in the field of artificial intelligence (A.I) and their current impact as well as future implications in the field of cardiology, we as physicians and cardiologists have tried to put our perspective on the rapidly evolving field, In light of the fact that many of the healthcare workers and professionals across the world still find the concept of A.I quite complicated, elusive and somewhat paradoxical, we have tried to simplify the concept of artificial intelligence and make it easy for everyone to understand from all walks of life. The Databases utilized for our review are PubMed, PubMed Central, Google Scholar. The Keywords used for our Data Search are “Artificial Intelligence”, “A.I Cardiology”, “A.I in Cardiovascular Medicine”, “Machine Learning in Cardiology”. We screened all relevant since inception till March 25th and included 44 relevant articles after careful consideration into our paper. We have discussed the implementation of and scope of artificial intelligence across a broad spectrum of applications including cardiovascular imaging and diagnostics like electrocardiograms, echocardiograms, cardiac CT/MRIs to novel cardiac monitoring devices, CRISPR gene editing in cardiology and implementation of artificial intelligence in the field of Cardiovascular Bioprinting. This is the initial review in a series of reviews regarding A.I in Cardiology.
ARTICLE | doi:10.20944/preprints202305.1052.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: personalized medicine; biologically-driven trial; sorafenib; randomised discontinuation design
Online: 15 May 2023 (14:22:29 CEST)
Background: MOST-plus is a multicenter, randomized, open-label, adaptive Phase II trial evaluating the clinical benefit of targeted treatments matched to molecular alteration in advanced/metastatic solid tumors. Sorafenib was tested on patients with tumors harboring sorafenib-targeted genes Methods: The MOST-plus trial used a randomized discontinuation design. After 12 weeks of sorafenib (400 mg, po BID), patients with progressive disease dis-continued study, patients with objective response were proposed to continue sorafenib, whereas patients with stable disease (SD) were randomly assigned (1:1) to maintenance or interruption of treatment. Primary endpoint was RE-CIST version 1.1 progression-free rate at 16 weeks after randomization (PFR-16w). Secondary endpoints included progression-free survival (PFS), overall survival (OS), and toxicity. Statistical analyses used a sequential Bayes-ian approach with interim efficacy analyses. The enrolment could be stopped in the case of a 95% probability for the estimated PFR-16w to be higher in the maintenance than in the interruption arm (NCT02029001). Results: 151 patients were included, of whom 35 had SD at 12 weeks of Soraf-enib. For the 35 patients with SD on sorafenib, the PFR-16w was 65% [95% credibility interval 43.4–83.7] in the continuation arm and 25% [7.8–48.1] in the interruption arm. Median PFS and OS were improved in maintenance versus interruption arm (mPFS: 5.6 [95%CI 1.97–6.77] months versus 2.0 [95%CI 1.61–3.91] months (p =0.0231) and mOS : 14.3 [95%CI 8.9–23.8] versus 8.0 months [95%CI 3.5–15.2] (p =0.0857)). Conclusion: Sorafenib showed activity in progressive patients with solid tu-mors harboring somatic genomic alterations in sorafenib-targeted genes. Con-tinuing sorafenib when SD is achieved improves PFR compared to interruption
ARTICLE | doi:10.20944/preprints202305.1050.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Kyrgyz Republic; TB presumptive; failure; operational research; SORT IT; key population; private sector
Online: 15 May 2023 (14:09:10 CEST)
Until 2021, in the Kyrgyz Republic, tuberculosis(TB) was diagnosed and treated only in the public sector. With funding support of the STOP-TB partnership, the private providers in four regions of the country and Bishkek city were mapped, trained and incentivized to screen for, identify presumptive TB patients, and refer them to the public facilities for diagnosis and treatment. In this study, we describe the cascade of care of such patients. This was a cohort study involving secondary analysis of routine data. Of 79,352 patients screened during February 2021-March 2022, 2,511(3%) had presumptive TB, of whom, 903(36%) were not tested for TB [pre-diagnostic loss-to-follow-up]. A total of 323(13%) patients were diagnosed as TB, of whom, 42(13%) were not started on treatment [pre-treatment loss-to-follow-up]. Among 257 patients eligible for outcome assessment, 197(77%) had treatment success, 29(11%) were lost-to-follow-up, 13(5%) died, 4(2%) had treatment failure and 14(5%) were not evaluated. While this donor-funded, pioneering initiative was successful in engaging the private sector, we recommend the national TB programme to scale-up the initiative nationally with dedicated budgets, activities and plans to monitor the progress. Qualitative research is urgently needed to understand the reasons for the gaps in the care cascade.
ARTICLE | doi:10.20944/preprints202305.1023.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Atypical anorexia nervosa; anorexia nervosa; Asian adolescents; eating disorders
Online: 15 May 2023 (10:33:45 CEST)
Atypical Anorexia Nervosa (AAN) had been found to have significant physical and psychological complications at presentation but has not been described in a multi-ethnic Asian population. This retrospective cohort analysis aimed to characterize the baseline presentation of adolescents with Anorexia nervosa (AN) (N=317) and AAN (N=141) in an Asian cohort that presented to a specialist paediatric eating disorder program between January 2010 to October 2020 for assessment. In patients with AAN, there were increased proportions of males (16% vs 7%) and of Malay ethnicity (11% vs 4%) compared to AN. Adolescents with AAN had lower admission rates (61% vs 81%) as well as lower rates of bradycardia (45% vs 75%) and hypotension (7% vs 21%) but higher rate of syncope (13% vs 7%) compared to adolescents with AN. However, adolescents with AAN had higher frequency of psychological complications including self-harm and drug overdose (14% vs 1.5%) requiring admission as well as higher rates of purging (45.1% vs 14.8%) and for Eating Disorder Questionnaire score in the shape domain was more severe. Asian adolescents with AAN manifest with physical complications of malnutrition and had worse eating disorder psychopathology with higher frequency of other psychological co-morbidities underlining the severity of the illness.
ARTICLE | doi:10.20944/preprints202305.1011.v1
Subject: Public Health And Healthcare, Public Health And Health Services Keywords: Vitamin B12 deficiency; Folate deficiency; School-age children; Adolescents; CNNS
Online: 15 May 2023 (09:45:12 CEST)
Deficiencies of vitamin B12 (B12) and folate (FA) are of particular interest due to their pleiotropic role in 1-carbon metabolism. In addition to adverse birth outcomes, deficiencies of B12 and FA, or an imbalance in FA/B12 status, are linked to metabolic disorders. Indian diets that are predominantly plant food-based could be deficient in these vitamins, but there are no national estimates of the prevalence of B12 and FA deficiency in Indian children and adolescents, nor of their associations with age, sex, and growth indicators. The recent Comprehensive National Nutrition Survey (CNNS-2016-18) provided estimates of the prevalence of B12 and FA deficiency at the national and state level among preschool (1-4y: 9,976 and 11,004 children respectively), school-age children (5-9y: 12,156 and 14,125) and adolescents (10-19y: 11,748 and 13,621). Serum B12 and erythrocyte FA were measured by the direct chemiluminescence method and their deficiency was defined using WHO cut-offs. The prevalence of B12 and FA deficiency was high among adolescents (31.0%, CI: 28.7-33.5 and 35.6%, CI: 33.1-8.2), compared to school-age (17.3%, CI: 15.4-19.3 and 27.6%, CI: 25.5-29.9) and preschool children (13.8%, CI: 11.7-16.2 and 22.8%, CI: 20.5-25.2, respectively). The prevalence of both B12 and FA deficiency was significantly higher by 8 and 5% points respectively, in adolescent boys compared to girls. The prevalence of B12 deficiency was higher in moderately stunted school children (by 18.9% points) than in normal children, but no such difference was observed for FA deficiency. There was wide regional variation in the prevalence of B12 and FA deficiency, but no rural-urban differences were observed across all age groups. The national prevalence of B12 deficiency among preschool or school-age children was <20% (the cut-off that indicates a public health problem). However, FA deficiency in these age groups and both FA and B12 deficiencies in adolescents were >20%, which warrants further investigation.
ARTICLE | doi:10.20944/preprints202305.0997.v1
Subject: Public Health And Healthcare, Public, Environmental And Occupational Health Keywords: SARS-CoV-2; COVID-19; temporary disability; cumulative incidence; healthcare workers; National Network of Epidemiological Surveillance; Spain
Online: 15 May 2023 (07:49:18 CEST)
Healthcare workers (HCW) have been the professional category most exposed to SARS-CoV-2. The pandemic’s impact on HCW was analyzed in terms of COVID-19-related temporary disability (TD) between February 15 2020 and May 1 2021. TDs in HCW for COVID-19 infection or quarantine were described. TD quarantine/infection ratios and TDs per 100,000 affiliated HCW were compared with the cumulative incidence (CI) of COVID-19 cases notified to the National Network of Epidemiological Surveillance. TDs rates by economic activity and occupation were computed. A total of 429,127 TDs were recorded, 36,6% for infection. Three-quarters (76%) were women. The median TD quarantine/infection ratio was 2.5 (Interquartile range [IQR] 1.5-3.9). TDs rates in HCW were always above the CI except for the last two months of the fourth wave. Hospital activities accounted for 84% of TDs and showed the highest TD rate for infection (8,279/100,000). The highest TDs rates were registered among Nursing assistants, Nursing professionals and Physicians: 7,426, 6,925 and 5,508/100,000, respectively. The results demonstrate the high impact of COVID-19 on HCW in Spain and it’s inequalities. They also confirm that TDs represent a complementary source of information for epidemiological and public health surveillance and could provide an early warning of new emerging infections.