The goal of our article was to systematize studies that investigated the impact of living conditions in large national regions on individual alcohol consumption. We sought publications on the research topic in PubMed, Google Scholar, OpenGrey, Crossref and eLibrary databases from the moment they were created until December 31, 2021. After removal of duplicates and unsuitable publications, and full-text review of remaining published sources, the final sample included 81 publications. The majority of ultimately selected papers were published after 2010, represented the United States of America, and considered samples of children and youths, either the younger population or the general adult population. High quality was characteristic for 19 studies, while satisfactory quality was exhibited by 46 publications. The most consistent associations with individual alcohol consumption were revealed for the legislative environment (especially for integral scales and indices), alcohol pricing policy, the prevalence of alcohol consumption and binge drinking in the population, and unemployment rate. Among the shortcomings of the reviewed articles, we should mention the prevailing assessment of the impact of only one type of regional characteristics, as well as the lack of studies analyzing the interaction of environmental influence at the territorial level of different scales. Protocol PROSPERO CRD42021234874.

INTRODUCTION: While postmenopausal osteoporosis management evolved in recent years, it nonetheless remains underdiagnosed and undertreated. Given that general practitioners are the keystone of patient screening and referral in France, the present study was conducted to assess their professional positioning in the management of postmenopausal osteoporosis. METHODS: The present is a qualitative study based on semi-directed interviews, carried out between July 2020 and February 2021, with randomly chosen Alsatian general practitioners. Interviews were conducted until data saturation. Consolidated criteria for qualitative research reporting grid was used as well as Nvivo software to categorize the datas. RESULTS: Twenty-three general practitioners (GPs) were interviewed. Study participants recognized that the investigation and treatment of osteoporosis begins at a primary care level, typically with the GP. While some initiated screening by prescribing bone mineral density (BMD) assessments, only few prescribed the associated laboratory assessment and spinal X-rays in search of curable osteopathy or vertebral fracture. For those GPs who do take the opportunity to initiate treatments for patients, there is an understanding that first line options often include calcium and vitamin D, at a “preventive” level. The interviewed physicians interacted mainly with gynecologists and rheumatologists. Fracture liaison services were widely acclaimed. Several barriers were identified in their care management. The absence of a defined role between specialists and the lack of communication between the latter were an additional highlighted barrier. CONCLUSION: This study sheds further light on the discrepancy between the means available to treat osteoporosis, and the modest impact of the care observed.

In this paper, we analyze data from the 2012 Encuesta de Integración Social y Salud (Social Integration and Health Survey) of the Instituto Nacional de Estadística (Spanish National Institute of Statistics) to obtain profiles created by combining disability, poverty and social exclusion. We hypothesize that the probability that people will experience social exclusion increases if they have a disability, chronic illness or limitation in conducting everyday activities, and that this probability is greater for women than for men. To conduct our analysis, we constructed a social exclusion model based on a series of social determinants that acts as a dependent variable. In this context, social exclusion is understood to go beyond the concept of financial poverty. We performed bivariate analyses, in which we calculated the Odds Ratios (OR) for certain variables considered to be predictors of social exclusion. We also performed a means comparison test and an ANOVA test to observe differences between individuals with recognized disability and those without. Finally, we conducted logistic regression analysis to determine which vulnerability profiles are most likely to experience a situation of social exclusion. We also discuss the limitations of our study, and suggest areas in, which the relationships between health, social exclusion and disability can be further investigated.

Art therapy fosters emotional healing and growth. This process can offer healthcare professionals (HCPs) novel insights into patients’ medication experiences. We developed a Metaverse Art Gal-lery of Image Chronicles (MAGIC), which depicted patients’ medication experiences symbolically as hero-villain portrayals. This gallery aimed to enhance healthcare students’ learning through re-latable insights into patients’ medication therapies. A character sheet was used to craft patients’ personifications of their medication experiences. ChatGPT, NightCafe, Canva, HeyGen and Cam-tasia were used to generate hero-villain portraits based on the character traits and mounted in MAGIC, which consisted of three virtual realms, each with a unique theme. Alpha-testing among sixteen Generation Z healthcare learners indicated that the content in MAGIC enabled them to understand the concepts of medication adherence (93.7%), art therapy (87.5%) and how patients related to their medications (81.3%). Perceived playfulness (rs=0.925, p

This study proposes a prototype (Business Intelligence) for monitoring the continuing education of indigenous health professionals at the Secretariat of Indigenous Health (SESAI) of Brazil’s Ministry of Health (MS). The prototype builds on SESAI/MS staff knowledge and takes into account the char-acteristics and demands of the 34 Special Indigenous Health Districts (DSEIs). The prototype provides information for managing SESAI/MS continuing education in order to meet strategic goals. By im-proving the effectiveness and efficiency of the continuing education of professionals who serve Bra-zil’s indigenous population, we will be acting directly on access issues and improving the quality of life of the indigenous population.

Tightly regulated and robust mitochondrial activities are critical for normal hearing. Previously, we demonstrated that Fus1 KO mice with mitochondrial dysfunction exhibit premature hearing loss. Molecular analysis of the cochlea revealed hyperactivation of the mTOR pathway, oxidative stress, altered mitochondrial morphology and quantity, suggesting compromised energy sensing and production. Here, we investigated whether pharmacological modulation of metabolic pathways using rapamycin (RAPA) or 2-deoxy-D-glucose (2-DG) supplementation can protect against hearing loss in female Fus1 KO mice. Additionally, we aimed to identify mitochondria- and Fus1-dependent molecular pathways and processes critical for hearing. We found that inhibiting mTOR or activating alternative mitochondrial energetic pathways to glycolysis protected hearing in the mice. Comparative gene expression analysis revealed dysregulation of critical biological processes in the KO cochlea, including mitochondrial metabolism, neural and immune responses, and cochlear hypothalamic–pituitary–adrenal axis signaling system. RAPA and 2-DG mostly normalized these processes, although some genes showed a drug-specific response or no response at all. Interestingly, both drugs resulted in a pronounced upregulation of critical hearing-related genes not altered in the non-treated KO cochlea, including cytoskeletal and motor proteins, and Ca2+-linked transporters and voltage-gated channels. These findings suggest that pharmacological modulation of mitochondrial metabolism and bioenergetics may restore and activate processes critical for hearing, thereby protecting against hearing loss

Although the number of unwed mothers have mental health problems and intellectual disability, little research have focused on their mental and cognitive status. Since there has been public stigma of unwed mother in South Korea, they tend to conceal their status and less likely to seek psychiatric and psychological help. In this context, this study aims to assess current status of their mental health and intellectual characteristics. A total 48 unwed mothers from two shelter homes in South Korea were agreed to participate in the study. To compare mental health and intellectual abilities of unwed mothers with the general women population, reference data from national studies was used. Unwed mothers were more likely to have mood disorder, post traumatic stress disorder(PTSD), alcohol and nicotine use disorder, attention-deficit hyperactivity disorder (ADHD) than the general women population. Among 48 participants, 20 (41.7%) were lower than 70 Intelligence Quotient (IQ) and the mean of IQ (78.31) was significantly lower than normalized IQ mean of general women population. In logistic regression analysis, psychiatric disorders were associated intellectual disability. This study confirmed that unwed mothers dwelling in Korean shelter homes have more experience of mental disorders and lower intellectual ability than general women population.

The main purpose of this research is to analyze the perception of climate change impacts on human health in Bangladesh through data from nationality representative surveys conducted in some district of Bangladesh. In Bangladesh there have a few research has been conducted on public perceptions about the impact of climate change on human health. A structured questionnaire method was conducted, and data collected from 615 respondents. The findings of this study reveal that out of 615 respondents, 76.0% of the respondents replied positively while remaining 24.0%, almost one-fourth of total respondents, indicated that they have not heard the term climate change before. Knowledgeable in climate change, 92.5% of respondents agreed that climate change has an impact on human health while only 7.5% respondents disagreed with this statement. 90.5% of respondents argued that they are agreed with the opinion that climate change is a serious threat to human health.

SIGNIFICANCE Putting worth on research and selection of studies by importance are crucial in medical innovation. Practical applications include choosing personal study topics, publication review, study grant selection, and decisions of spending or misspending billions in public health. Multiple studies raised alarm that current methods perform poorly in reproducibility, prediction of best research and objectivity. I propose using the metrics how much disease burden is reduced and calculating objective, numerical research value. The concept is that worth of medical research is not subjective but can be reproducible and numerically quantified. The method increases transparency by giving decision makers an externally accountable proof, and frees peer reviewers to check scientific integrity. Its numerical form can capture small differences important in competition between studies. ABSTRACT Finding value and selecting knowledge by importance are crucial in medical innovation. Applications include individuals designing research, funding organizations selecting grants, journals – publications, institutions – priorities in public health and health policy, and decision makers spending or misspending billions of research funds. Currently finding value of knowledge is done by peer review together with checking scientific integrity. Multiple studies raised alarm that it performs poorly in prediction of highest citations, bias, transparency and quality. The resulting problems include perception of slow medical progress and wasting funds and time. I introduce a standard, objective and numerical method for finding value of medical research. It measures disease burden prevented by new knowledge contained in a study or a publication. In its simple form, it is calculated by multiplying disease prevalence, disease burden, and efficacy of the therapy. It can be modified for risk of failure, multi-disease effect and for ethical considerations. The process is described step-by-step in terms common in medical practice. A quick estimate is often sufficient. The advantage is objectivity, since it is calculated from real world data. This gives transparency and externally accountability of decision making. The second advantage is a numerical form. This can measure small differences in research value which, in sharp competition, determine which studies are selected. A researcher can calculate the value of own future effort. Institutions might ask to provide it at submission. The method is also applicable to broad policy analysis, objective evaluation of scientific achievement and bibliometric studies.

Frailty is an important age-associated risk-state. Despite this, many countries lack population estimates and large heterogeneity exists amongst studies. The Global Burden of Disease (GBD) study, provides comparable high-quality population-level data for 195 countries and territories. Frailty has never been measured in the GBD studies. This analysis applies the deficit accumulation model to construct a novel frailty index (FI) using the GBD 2017 dataset. Standard FI criteria were applied to all GBD categories such that selected items were health-related, age-correlated, sufficiently prevalent, did not saturate at an early age, had little redundancy/duplication, covered a range of systems, were plausible and were available serially for the same population. From all 554 GBD items, 36 were selected including 26 non-communicable diseases, 3 metabolic risks, 3 biological impairments, infectious diarrheal diseases, protein-energy malnutrition, injurious falls, and low physical activity. Variable face validity was displayed against a selection of established FIs. The mean GBD-FI score for the global population aged ≥70 years in 2017 was 0.16; scores were higher in females than males (0.16 vs 0.15, respectively). Deficits accumulated with age at an estimated rate of 0.026 per year. Adding the mean GBD-FI scores to a regression model including country-level variables for demographics (proportion ≥85 years, proportion female), healthcare quality (HAQ index), and development (SDI) increased the adjusted r2 value from 27.0% to 39.6% (p<0.001) for predicting country-level death rates from non-communicable diseases, suggesting that the GBD-FI is a useful predictor of mortality. Further analysis is required to compare the reliability and predictive validity of the GBD-FI with existing frailty tools

Huanglongbing (HLB), or citrus greening, is a devastating disease impacting citrus trees worldwide, with severe effects particularly noted in Florida. Current strategies to combat HLB have focused on aggressive replanting despite the high susceptibility of young trees to infection. In this context, it is critical to explore agronomic practices that can enhance the health and resistance of young citrus trees to HLB. Here, we demonstrate that treatment with homobrassinolide (HBr), a type of brassinosteroid, on newly planted citrus trees can delay HLB infection and improve tree health amidst the high psyllid pressure conditions endemic to Florida. Our study reveals a significant reduction in HLB infection rates in HBr-treated trees compared to control trees, with only 25% of treated trees testing positive for HLB by six months, in contrast to 100% infection in untreated trees. This delay in infection may be attributed to HBr inducing an immune response and negatively impacting psyllid performance, as subsequently demonstrated in a greenhouse experiment. Our findings suggest that HBr applications could serve as a viable strategy to enhance the resilience of citrus production against HLB, underscoring the need for further investigation into their mechanisms of action and potential role in a comprehensive pest and disease management strategy.

Fruits, vegetables, and spices are natural sources of bioactive phytochemicals such as polyphenols, carotenoids, flavonoids, curcuminoids, terpenoids, and capsaicinoids, possessing multiple health benefits and relatively low toxicity. These compounds found in the diet play a central role in organism development and fitness. Given the complexity of the whole-body response to dietary changes, invertebrate model organisms can serve as valuable tools to examine the interplay between genes, signaling pathways, and metabolism. Drosophila melanogaster, an invertebrate model with its extensively studied genome, has more than 70% gene homology to humans and has been used as a model system in biological studies for a long time. The notable advantages of Drosophila as a model system, such as their low maintenance cost, high reproductive rate, short generation time and lifespan, and the high similarity of metabolic pathways between Drosophila and mammals, have encouraged the use of Drosophila in the context of screening and evaluating the impact of phytochemicals present in the diet. In this chapter, we summarize and review the benefits of Drosophila as a model system for use in the study of phytochemical ingestion and describe the previously reported effects of phytochemical consumption in Drosophila.

According to data from the U.S FDA, the likelihood of a new drug progressing from Phase I clinical trials to market approval is only 8% (DiMasi et al., 2016). Furthermore, a significant attrition rate of 35% occurs during Phase II studies due to the failure to demonstrate clinical efficacy (Arrowsmith, 2011). These statistics underscore the urgent need to reassess the current research and development (R&D) paradigm. To address this challenge, a promising approach called reverse translational pharmacology (RTP) has emerged, aiming to enhance the predictive value of preclinical models used in biomedical research by leveraging animal models that spontaneously develop analogous diseases to humans (Schneider et al., 2018). The rationale behind RTP is that knowledge gained from clinical trials in canines can subsequently inform and guide human clinical trials, leading to improved outcomes for both species. Additionally, this approach capitalizes on the opportunity to stimulate veterinary drug development by leveraging pharmacokinetic (PK), efficacy, and safety data obtained from human clinical studies (Schneider et al., 2018). The application of reverse translational pharmacology holds immense potential for expediting drug development and advancing medical knowledge. By employing animal models that naturally develop diseases akin to those found in humans, researchers can enhance the predictive capacity of preclinical models, thereby mitigating the high attrition rates encountered in later stages of clinical trials. Moreover, the exchange of knowledge and data between human and veterinary medicine engenders a synergistic relationship, fostering progress in both domains (Schneider et al., 2018). As this innovative approach gains momentum, fostering collaborations between basic and clinician scientists, pharmaceutical companies, and veterinary professionals becomes increasingly imperative. By sharing resources, expertise, and findings, we can pave the way for groundbreaking discoveries and the development of safe and efficacious treatments for diverse diseases. Embracing reverse translational pharmacology offers an avenue to redefine the R&D paradigm, bringing us closer to a future where a higher proportion of drugs successfully traverse the arduous path from the laboratory to market approval, ultimately benefiting patients across species. In this brief commentary, we highlight four examples of diseases where reverse translational modeling has been used to support pharmaceutical research, including some applications developed in our research laboratory (SMART Pharmacology) at the Iowa State University College of Veterinary Medicine. In doing so, this report also seeks to provide a brief overview of the heuristic value of computational approaches in comparative research. To further illustrate the value of these in silico approaches, we deliberately chose to employ some features of ChatGPT to produce the present summary (OpenAI. (2023). GPT-3.5 [ChatGPT]. Retrieved from https://openai.com).

Carbapenems have long been considered as treatment of choice for Gram-Negative Bacteria (GNB) infections, and today the clinical utility of this class is threatened by the emergence and spread of resistance favored by its increasing use. According to the WHO, Acinetobacter baumannii, nosocomial infection agent, tops the list of priority antibiotic-resistant pathogens, considered to be the most risky for humans. This study sought to determine the prevalence of Acinetobacter baumannii strains producing carbapenemases in four health facilities in the Center and Littoral regions of Cameroon and the associated risk factors. An analytical cross-sectional study was conducted over a six-month period from January to June 2022. All Acinetobacter baumanii or suspected strains isolated from pathological samples at the bacteriology laboratory of different health facilities were systematically collected and underwent a re-identification. After successfully subculturing and growing on nutrient agar, re-identification and antimicrobial susceptibility Testing (AST) were performed using the VITEK 2 System and the Kirby-Bauer method according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Detection and phenotypic characterization of carbapenemases was performed according to adequate standard procedures. A total of 168/226 clinical isolates of Acinetobacter baumannii were confirmed after re-identification of which 52.69% came from male patients, and 55.09% from participants aged between 10-39 years old and 46.71% from pus samples. A very high resistance rates to all families of antibiotics was noted except to colistin (10.2%). About 40.12% of these strains produced carbapenemases with 62.69% of class B and 37.31% of class A. In addition, frequent hospitalisation was significantly associated to the production of carbapenemase among Acinetobacter baumanii (Ajusted-OR=16.53, P-value<0.0001). This study highlighted the emergence of carbapenemase-producing Acinetobacter baumannii which is increasingly growing. Continuous drug-resistant monitoring and preventive measures could help to prevent and curb the dissemination of A.baumanii resistance genes, especially in hospital settings.

Background: The COVID 19 pandemic and associated public health measures have disrupted the lives of people around the world. It is already evident that the direct and indirect psychological and social effects of the COVID 19 pandemic are insidious and affect the mental health of young children and adolescents now and will in the future. The aim and objectives of this knowledge-synthesis study were to identify the impact of the pandemic on children’s and adolescent’s mental health and to evaluate the effectiveness of different interventions employed during previous and the current pandemic to promote children’s and adolescent’s mental health. Methodology: We conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included experimental randomized, nonrandomized controlled trials; observational studies; and qualitative studies. Results: Of the 5,828 articles that we retrieved, 18 articles met the inclusion criteria. We thematically analyzed and put up the major findings under the thematic areas of impact of pandemic on children and adolescent’s mental health. These studies reported that pandemics cause stress, worry, helplessness, and social and risky behavioral problems among children and adolescents (e.g., substance abuse, suicide, relationship problems, academic issues, absenteeism from work). Interventions such as art-based programs, support services, and clinician-led mental health and psychosocial services effectively decrease mental health issues among children and adolescents. Conclusion: Children and adolescents are more likely to experience high rates of depression and anxiety during and after a pandemic. It is critical that future researchers explore effective mental health strategies that are tailored to the needs of children and adolescents. Explorations of effective channels regarding the development and delivery of evidence-based, age-appropriate services are vital to lessen the effects and improve long-term capacities for mental health services for children and adolescents.

Aim: The purpose of this examination is determining predictors to oral health behaviors predict in Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study were randomly selected conducted on 351 eligible four grade female students in the first district of Tehran, Iran in 2017. The random Multi‑stage random cluster sampling method was used to recruit students. The inclusion criteria were being graded, four female students (aged 9-11 years), or education at the fourth grade of one of the elementary schools studied in the first district of Tehran and, The health of the student from a physical and psychological of view. Logistic regression analysis was used to identify the variables that predict oral health behaviors. To assess the predictors of oral health behaviors, all the expanded Health Belief Model constructs with the construct of “Commitment to Plan of Action” from “Health Promotion Model were examined as risk factors to see if they influence on the probability of brushing behavior and dental floss behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 308 four grade female students with mean age of 9.32 ± 0.81 years old took part in the study. The total 31.8% of the students reported that they were brushing behavior less than twice a day and 55.2% students claimed, use of dental floss behavior once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P<0.001), Commitment to plan (OR=1.13, 95% CI=1.04-1.23, P<0.001) and Cues to action (OR=1.42, 95% CI=1.14–1.76, P=0.002) were the significant predicting variables which is the key factor of brushing twice a day, and use of dental floss once a day or more (OR=1.02, 95% CI=0.23-3.53, P=0.003). Conclusion: This study has shown the effectiveness of the health belief model with added commitment to plan construct to predict oral health behavior in female students. So, it seems that the model as a framework for designing training programs to improve students to improve oral health behavior can be used.

Background: Children's environmental health encompasses a wide range of factors that impact the well-being of children, including physical, chemical, biological, and social elements in their immediate environment. Safeguarding children from harmful substances is the crucial role of nursing students. Nursing students play a vital role as valuable resources for individuals, families, communities, and policymakers. This study aims to assess the knowledge and skills of nursing students concerning children's environmental health at academic institutions delivering nursing program in Nekemte town, Ethiopia. Methods: An institutional-based cross-sectional study design was carried out from August 1–30, 2023, among nursing students in Nekemte Town, and 634 study participants were selected through simple random sampling. Data was entered into Epinfo version 6.4 and exported to STATA version 14 for analysis, and multicollinearity was checked. Finally, from the bivariate analysis, variables of < 0.2 were included in the multivariate analysis; an adjusted odd ratio with a 95% CI was computed; and variables with a P-value <0.05 in the multivariable analysis were taken as significant associated factors. Results: The overall nursing students' level of knowledge about children's environmental health was insufficient (56%). More than one-third (34%) demonstrate their skill towards children's environmental health insufficiently, and one-fourth (25%) and 27% of the learners conduct their craft to prevent children from ecological hazards to a good and better level, respectively. While gender of the participant, age of the participant, year of the study, training history of the participants, and field of study of the students were significantly associated variables with their knowledge of children's environmental health. Conclusion: The study reveals that nursing students' knowledge of children's environmental health is limited, with factors such as gender, age, training history, and field of study significantly influencing their understanding. Therefore, female students should be considered for more tutorials to be effectively knowledgeable regarding children’s environmental health.

Background. Depression and anxiety and its association with sexual orientation in Latvia is un-derstudied. Outcomes. Kinsey scale, primary outcomes for mental health disturbances were defined as per-son`s subjective feeling of depression and anxiety. Materials and Methods. Participants aged 18-30 year old (n=503) was asked to do a self-administered anonymous web-based survey regarding social and family status, sexual iden-tification and behaviour, violence experience and mental health information. To describe person`s sexual orientation Kinsey scale was used. Prevalence of depression and anxiety, univariate and multivariate regression analysis was performed to measure relations between investigated fac-tors. Results. A total of 503 participants (i.e., 365 females, 133 males, 5 others) were included in the study. Mean (SD) age of participants was 23.0 (3.7) years. Mean (SD) value on the Kinsey scale was 1.4 (1.8) and median (IQR) value was 1.0 (0-2.0) where 1 is defined as ‘mostly heterosexual, only slightly homosexual’ person and 2 is ‘mostly heterosexual, but more than slightly homosexual’. Prevalence of persons reported violence experience was 20.3%, anxiety 56.3% and depression 37.6%. Logistic regression analysis showed that experience of violence was associated with higher odds of developing anxiety and depression (OR: 2.6 [95% CI: 1.7-4.0] and 2.4 [95% CI: 1.5-3.9], respectively). Being in relationship was associated with higher odds of developing anxiety (OR: 2.8[95% CI: 1.3-6.3]). Male sex and income 1001-2000 euros a month were associated with lower odds of developing anxiety (OR: 0.4 [95% CI: 0.2-0.5] and aOR: 0.3 [95% CI: 0.1-0.8], respectively). Sexual orientation showed no significant value in association with anxiety and depression (OR: 1.1 [95% CI: 1.0-1.2] and OR: 1.1 [95% CI: 1.02-1.2], respectively). Conclusions. In our study, the significant factors for developing depression and anxiety were experiencing violence, being female, being in a relationship, and having no income, while sexual orientation showed no significance in relation to depression and anxiety.

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system. However, there is a lack of information about the cost of CLLU in Argentina.Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests, in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7,224 and the number of inpatient was 359. The mean age for male and female outpatient consultations was 59.53(±13.06) years and 59.04(±10.93), respectively. For CLLU male and female inpatient, the mean age was 63.9(±10.4) years and 54.5(±8.6) years, respectively. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$4,053.65 per inpatient and US$3,589.24 per outpatient. Conclusion: Cost information allows new public health policies to reduce socioeconomic burden due to CLLU.

The use of New-age (Nano) Modified Emulsions (NME) for the stabilisation of marginal materials for use in the upper-pavement layers of roads have been proven in laboratories, through Accelerated Pavement Tests (APT) and in practice. In addition, material design methods have been developed based on the scientific analysis of granular material mineralogy and the chemical interaction with the binder to design a material compatible NME stabilising agent for naturally available (often marginal) materials. However, the introduction of any new disruptive technology in a traditionally well-established industry, such as the road construction industry, is usually associated with considerable resistance. This is especially relevant when the new technology enables the use of granular materials traditionally considered to be of an unacceptable quality in combination with relatively new concepts such as New-age (Nano) Modified Emulsions (NME). In practice, few road construction projects are without any problems. The introduction of new-technologies obviously makes it an easy target to blame for any non-related problem that may arise during construction. This article aims to assist in pre-empting, recognising, preventing and resolving material or non-material related construction problems through the correct identification of the cause of the problem and recommending the best, most cost-effective way to correct any deficiencies on site.

Background: To identify and appraise the impacts and effectiveness of counseling interventions based on the 5A model on indicators of physical activity in adults. Methods: In May, 2022, a systematic review was carried out. Searches were performed in Embase, Lilacs, Pubmed, Scielo, Scopus, Sportdiscus and Web of Science. To avoid potential losses searches also were made in Google Scholar and in reference lists. Assessment of studies, data extraction and synthesis took place independently by two researchers. Results: Four studies composed the synthesis, which involved people with an average age between 40 and 55 years, being women in the majority of the samples. It was observed that counseling was carried out in conjunction with other strategies, such as drawing up an action plan, sending text messages and offering educational material. Only one study showed a statistically significant difference between the intervention and control groups in the “daily number of steps” indicator. Conclusions: counseling based on the 5A model did not reflect significant findings in relation to physical activity. Considering that behavior change for many people is neither a simple nor a quick process and that the 5A model is promising for other behavioral indicators, we indicate the need to carry out new intervention studies, with an expanded focus in relation to themes related to physical activity (e.g., types, dos-es, risks, benefits, identification of barriers and assessment) and, in parallel, the offer of practices in the Primary Health Care setting.

The Sustainable Development Goals provide a global development agenda that is meant to be inclusive of all people. However, the development needs for vulnerable populations such as youth are not reflected within the policy agenda of some developing countries. One of the reasons for this is that research that explores health and wellbeing concerns for young people are sparse in the region and where they exist, the focus has been on marginalized subgroups. To address this gap, this cross-sectional study explored the health and wellbeing of youth in Kenya. We conducted 10 focus group discussions and 13 in-depth interviews with youth ages 15 to 24 years. A thematic analysis of the data revealed that structural factors are important influencers of youth perceptions and their social constructions of health and wellbeing. Kenyan youth are concerned about the health status and healthcare services in their communities, as well as issues of community trust of youths and perceived risks of political misuse and emotional suffering. Our findings suggest that youth transitioning into adulthood in resource constrained areas experience feelings of being powerless and unable to take charge over their own life. This impacts how they perceive and socially construct health and wellbeing.

Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.

Widely consumed forest fruits in Gabon, were analyzed for nutrient and bioactive compositions and their potential contributions to meeting the nutrient requirements of consumers. Edible pulps of Panda oleosa, Gambeya lacourtiana and Poga oleosa contained substantial amounts of bioactive compounds; flavonoids (13.5–22.8 mg/100g), proanthocyanins (2.4–7.6 mg/100g), polyphenols (49.6-77.3 mg/100g) and vitamin C (6.7–97.7 mg/100g). The highest content of β-carotene (76.6 µg/100g) was registered in fruits of Pseudospondias longifolia. The fruits of P. oleosa had the highest essential minerals Fe, Zn and Se. If a child aged 1 to 3 years consumed about 200g or if a non-lactating and non-pregnant woman consumed 300g of P. oleosa, A. lepidophyllus, G. lacourtiana, P. longifolia and P. oleosa, they could obtain substantial RDI ranging between 20-100% for energy, vitamins C and E, iron, magnesium, iron and zinc. Forest fruits can considerably contribute towards the human nutrient requirements. Based on the results of this study, forest foods should be considered in formulating policies governing food and nutrition security in Gabon.

Air pollution, climate change and global warming show direct linkage. Introduction - Background: Research in the field has proposed and demonstrated their link to increased allergenicity in plants, leading to increased allergic diseases. Allergen patterns are changing in response to climate change. Across Europe, up to 12% of the population suffers from allergic diseases (bronchial asthma and allergic rhinitis) caused by the pollen grains. The medical costs of these types of allergies are enormous and are increasing with the spread of common ragweed - Ambrosia artemisiifolia* in Europe. In practice, more and more patients are turning to allergists. Methods: Based on these data, the research aims to identify safety measures and specific legislation to control and eradicate common ragweed in the countries most affected by the spread of this plant in Europe, increase in population exposure in countries affected by the presence of common ragweed and the socio-economic impact of allergic rhinitis and bronchial asthma at European level.[1][2] Our database search did not reveal any other research that has addressed this topic to date. Results: This research identifies specific legislation to the countries most affected by the spread of this plant pollen grains at European level, changes in allergen patterns and monitoring/safety eradication measures decided by local authorities, and data on the spread of common ragweed over the last two decades, costs per treatment, increased allergic rhinitis and bronchial asthma morbidity in the most affected areas. Conclusions: At European level, there are no universally valid models for eradicating this weed. Various methods can be used to limit the spread of common ragweed and its pollen production (e.g. mowing once or twice a year of overgrown land, ploughing, chemical control, public information, etc.). Local and regional cooperation should be considered essential to promote phytosanitary &amp; safety measures and exchange of information on methods to identify and manage the spread of common ragweed. Unified legislation at European level would help all affected countries; reduce morbidity from respiratory allergic diseases and the costs of treating these diseases.

Objective: To determine the association of edentulism with different chronic diseases in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, which had a probabilistic, multi-stage and cluster sampling. The results of the self-report of chronic diseases (diabetes, arthritis, depression, angina pectoris, asthma and schizophrenia) and of edentulism were analyzed. Dental data were available for 20 of the 32 States of the Mexican Republic. Statistical analysis was performed in Stata 14.0 using the svy module for complex samples. Results: In total, 4213 subjects were included, representing a population of 7,576,057 individuals. The mean age was 70.13 ± 7.82 years (limits 60 to 98). Women represented 56.2%. The chronic diseases analyzed were presented as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which represents 1,993,463 people aged 60 years and over with this characteristic. For the presence of angina in women aged 60 to 69 years (p &lt;0.05) and depression in men aged 70 years and over (p &lt;0.0001), a higher prevalence of edentulism was observed. Conclusions: In general, there was no observation of association between edentulism was observed on the different chronic diseases included in the study. In the stratified analysis, only in women aged 60 to 69 years, for angina, and in men aged 70 and over, for depression, were associated.

Age-related Macular Degeneration (AMD) is the major cause of elders’ vision loss, early screening and treatment are the most efficient way to reduce the rate of blindness. AI-based methods based on ophthalmic images play great potential for AMD diagnosis. However, low levels of accuracy, robustness, and explainability are challenges for AI approaches applied in clinics. Thus, this study proposed a multi-type of data source fusion method and a multi-model fusion approach for AMD detection. Typical unsupervised (Hierarchical Clustering and K-Means), typical supervised (SVM, VGG-16, and ResNet) methods, and proposed methods (multi-source data fusion-based method and multi-model fusion-based approach) are compared based on Optical Coherence Tomography (OCT), Fundus Autofluorescence (FAF), regular color fundus photography (CFP) and Ultra-Wide field Fundus (UWF) images. Data preprocessing and enhancements of each type of data are discussed. A feature extraction based on unsupervised ML models, feature combination and normalization, and multi-layer perception (MLP) algorithm are involved in the proposed multi-source data fusion-based method. Supervised ML and DL models and a voting mechanism are involved in the multi-model fusion-based approach. Findings show that the proposed methods present a high performance of accuracy and robustness. A real-world UWF database is involved from Shenzhen Aier Hospital. Practical and theoretical contributions are delivered. A reference value for medical diagnosis based on multiple digital images is contributed.

During the last years, significant initiatives have been launched for the dissemination of Open Access as part of the Open Science movement. Nevertheless, the other major pillars of Open Science such as Open Research Data (ORD) and Open Peer Review (OPR) are still in an early stage of development among the communities of researchers and stakeholders. The present study sought to unveil the perceptions of a medical and health sciences community about these issues. Through the investigation of researchers’ attitude, valuable conclusions can be drawn, especially in the field of medicine and health sciences, where an explosive growth of scientific publishing exists. A quantitative survey was conducted based on a structured questionnaire, with 51.8% response rate (215 responses out of 415 electronic invitations). The participants in the survey agreed with the ORD principles However they ignored basic terms like FAIR (Findable, Accessible, Interoperable and Reusable) and appeared incentive to permit the exploitation of their data. Regarding OPR, participants expressed their agreement, implying their interest for a trustworthy evaluation system. Conclusively, researchers urge to receive proper training for both ORD principles and OPR processes which combined with a reformed evaluation system will enable them to take full advantage of the opportunities that arise from the new scholar publishing and communication landscape.

Among earth’s microbial populations are the genes, functional capacities, generational memory and sentient cognition that enable microorganisms to adapt and thrive in the full range of ecological conditions found on planet earth. In prior sequential publications, we considered fundamental properties (e.g., use of and responses to sound, light, vibrations) and features of microorganisms that cause them to be critical co-partners of human and other holobionts as well as the potential benefits for humanity that can be gained by fully applying quantum-related and novel capacities of microbial life. In this narrative review we: 1) discuss key concepts concerning a microbially-enhanced and sustainable future, and 2) focus on electric- and magnetic- based features of microorganisms that make them pivotal for myriad benefits ranging from beyond pharma-based health and wellness to free- and/or renewable energy and restorative agriculture to improved human networking. While the benefits are many, the risks posed by hazardous electric or magnetic field exposures to both holobionts and microbial communities are significant. This review concludes that microbes and their remarkable capacities offer both humanity and the planet a much brighter future if we reverse the demonization of microbes and wanton microbiome degradation that has predominated much of the past century.

Organophosphate pesticides (also known OPPs) have for many years been the choice candidate globally for pest control. OPPs have for over 80 years, been used in gardens, fields and greenhouses as crop protection agents, and even in homes as insecticides and mosquito abatement. Thus, year after year and with the repeated application of organophosphate agents, many problems have appeared as a result of excessive use of pesticides. The adverse effects of pesticides are well documented in human health, environment, pesticide residue in crops, soil and water contaminated by these pesticides. Therefore, it is necessary to shed more light on the risks associated with the irresponsible usage of organophosphate pesticides.

Traditional Health Practitioners (THPs) are considered as the entry level of care in African societies and play an important role in the delivery of health services to the population. A phenomenological qualitative study was carried out among pur-posefully selected THPs in Mthatha to understand their roles and the challenges they face in providing maternal health services. The study included a focus group discussion with seven participants, which yielded three themes and seven sub-themes. The content analysis of descriptive data from the focus group discussion revealed threats posed by unregistered and counterfeit THPs to the lives of pregnant women in rural settings. THPs' wide range of services allowed pregnant women to receive prenatal, antenatal, and postnatal care in close proximity. This level of care, however, was characterized by high levels of secrecy and counterfeit practitioners who used human body parts, which jeopardized the practice and made it unpopular. Traditional health practice must be protected through registration of THPs and the establishment of functional referral pathways between THPs and conventional health services.

Bedbug (Cimex spp.) are a nuisance public-health pest that is on the rise globally, particularly in crowded cities such as Hong Kong. To investigate the health impacts of bedbug infestations among bedbug victims, online surveys were distributed in Hong Kong between June 2019 to July 2020. Data on sociodemographics, self-rated health, average hours of sleep per day, and details of bedbug infestation were collected. Bivariate and multivariable analysis were performed using logistic regression. The survey identified 422 bedbug victims; among them, 223 (52.9%) experienced ≥5 bites in the past month, most bites occurred on the arms (n=202, 47.8%) and legs (n=215, 51%), and the most common reaction to bites were itchiness (n=322, 76.3%), redness, and swelling of the skin (n=246, 58.1%), and difficulties sleeping or restlessness (n=125, 29.6%). Bites usually occurred during sleep (n=230, 54.5%). For impact on daily life in the past month, most bedbug victims reported moderate to severe impact on mental and emotional health (n=223, 52.8%) and sleeping quality (n=239, 56.6%). Lower self-rated health (aOR&lt;1) was independently associated with impact to physical appearance (p=0.008), spending money on medication or doctor consultation (p=0.04), number of bites in the past month (p=0.023), and irregular time of bites (p=0.003). Lower average hours of sleep per day (aOR&lt;1) was independently associated with impact on mental and emotional health (p=0.016). This study brings attention to the neglected issue of bedbug infestation by considering bedbugs as an infectious agent instead of a vector and providing empirical evidence describing its health impacts.

Global health is significantly impacted by antimicrobial resistance. Antibiotic misuse and overuse have resulted in the emergence of drug-resistant bacteria, viruses, parasites and fungi, which makes ordinary infections more difficult to cure and accelerates the spread of disease. The World Health Organisation has declared that antimicrobial resistance could result in up to 10 million deaths yearly by 2050, making it a worldwide health emergency. One of the greatest challenges to global health, food security, and development today, according to the World Health Organisation is the emergence of antibiotic resistance. Even though antibiotic resistance can arise naturally, improper usage of these medications and many other factors are accelerating its global spread. Antimicrobial resistance is frequently referred to as the "Silent Pandemic" and is a problem that requires current action and should be managed more effectively rather than considered as a future situation. This paper address a number of antimicrobial classes, global health, Onehealth and how drug resistance affects human health, and related risk factors. This review will also provide background information on the causes and processes of antimicrobial resistance in brief by identifying these characteristics, targeted interventions can be developed to lower the risk of illnesses that are resistant to antibiotics. It will also offer insights into new and emerging solutions that are being studied and may be created in the future to address the advancement of antimicrobial resistance.

Comprehensive studies into the various causes of this ubiquitous disease have been prompted by the worldwide increase in cancer incidence. There are many potential causes of cancer, but environmental factors are of particular concern now. This abstract explores the complex link between environmental factors and the growing cancer epidemic, shedding light on the role that our immediate environment plays in the emergence of cancers. The environment can contain carcinogenic agents that gradually influence the course of cancer, including air pollutants, water contaminants, workplace exposures, and industrial activities. The ways through which environmental carcinogens may cause DNA damage and unchecked cell proliferation are discussed in this abstract. Environmental justice and the moral necessity to reduce inequities in exposure and health effects are highlighted to underline the disproportionate impact on vulnerable groups. The study presented here highlights the need for preemptive action to reduce environmental risks. Society can reduce the hidden threat posed by environmental carcinogens through strict legislation, sustainable practices, and community-driven initiatives. In order to lessen the cancer burden and secure a healthier future for all, the authors of this abstract argue that there must be a concerted effort to create surroundings that promote health and well-being.

Recent years have seen an explosion of interest in the topic of gut health and food, revealing a complex interplay that affects many facets of human health beyond just digestion. This in-depth overview investigates crucial aspects of this connection, illuminating issues including the effects of processed meals, the advantages of fermented foods, individualized diets, and the harmonious relationship between gut bacteria and dietary components. In this article, we'll take a look at how processed foods affect your digestive system, and how their convenience might backfire by upsetting your body's delicate microbial balance. The effects of these diets have been studied, and the results suggest that there may be disruptions in microbial diversity, inflammation, and metabolic health. Instead, fermented foods are explored as potential allies in the fight for gut health. These foods' high probiotic content not only improves digestion and nutrition absorption, but may also have an effect on one's state of mind. There is growing evidence that eating fermented foods can help you maintain a healthy and robust gut microbiome. Recognizing that everyone has a different gut microbiota composition, the idea of individualized nutrition has come to the forefront. One novel strategy for improving digestive health is to provide nutritional advice based on a person's unique microbial profile. This paper looks at how microbiome testing can be combined with professional advice to create food programs that feed specific bacteria communities, improving both diversity and health. In conclusion, this review emphasizes the reciprocal interaction between dietary choices and the gut microbiota, and the significant impact that gut health has on numerous aspects of human health. The more we learn about the complexities of this interplay, the more we can take a holistic approach to nutrition, one that respects the uniqueness of each person's gut microbiome and encourages healthy eating habits. By taking a more all-encompassing view, we are reminded of the critical function of the gut microbiota in determining our health and of the significance of fostering this nuanced symbiotic connection.

Antimicrobial resistance (AMR) poses one of the significant challenges for the progress of modern medicine not only by its myriad manifestations on a microbiological plane but also due to its demand for a complex, multisectoral approach for its annulment. While some nations have been actively involved in the deployment of counter measures against AMR, the same have yet to be implemented in India. This can be attributed due to a combination of its epitomizing multivariate nature and the challenges encountered on a ground-level in policy implementation. This review surveys mechanisms and factors promoting incidence of AMR, potential Artificial Intelligence (AI) implementation alongside evaluating the efficacy of the One Health approach on national and state levels in curbing the rise of AMR.

Total edentulism is the loss of all teeth for any cause by a multifactorial process that involves biological and patient-related factors. Studies on edentulism and risk factors in Mexico are limited, and the epidemiological surveillance data is scarce and controversial since official governmental reports are not statistically representative of the country. We estimate the distribution for edentulism according to sociodemographic and socioeconomic variables in adults from a low-income state in 2003 and its progress in Mexico. We analyzed data from the National Performance Evaluation Survey in Oaxaca, Mexico, and the annual reports of the Epidemiological Surveillance System of Oral Pathologies in 2009-2019 using X². Oaxacan patients older than 75 y.o (17.9%, p<0.05), those with lower schooling (11.2%), and diabetes (14.5%) presented the highest percentage of edentulism. We do not observe differences in edentulism between sex or residence (p>0.05). From 2009 to 2019, country data reports the lowest rate of edentulism in adults over 20 y.o (0.32%; 95% CI 0.18%-0.48%) and the most affected population over 79 y.o. (7.29%; 95% CI 5.2%-9.30%). As it is a cumulative phenomenon, it is necessary to establish better surveillance, prevention, and treatment programs to improve the oral health of older thus reducing edentulism.

Culture, gender and religion are closely linked each other’s, profoundly affect the role of each person within the Society, and also affect the ability to access to the health resources. We are now living a worldwide crisis due to the SARS-CoV-2 pandemic. In order to appropriately tackle it, an alliance between science, politics and citizens is needed. In this article, we summarize current evidences of how religions can represent, on one hand, a risk moment for spreading the virus (in relation with overcrowded events), on the other, a precious opportunity to engage people, and in particular minorities, in fighting the pandemic. To win this fight, we need a multicultural approach that takes into account every aspect of human life, and among these religion, which influences so much culture, everyday life and well-being.

A strategy to propose solutions to health-related problems recognizes that people, animals, and the environment are interconnected. Fusarium and Neocosmospora are an example of this interaction due to the capable of infecting plants, animals, and human. This review provides information on various aspects of these relations and proposes how to approach fusariosis with a One Health methodology. Here we give a framework to understand infection pathogenesis, through the epidemiological triad and explain how the broad utilization of fungicides in agriculture may play a role in the treatment of human fusariosis. We assess how plumbing systems and hospital environments might play a role as a reservoir for animal and human infections. We explain the role of antifungal resistance mechanism in both humans and agriculture. Our review emphasizes the importance of developing interdisciplinarity research studies where aquatic animals, plants, and human disease interactions can be explored through coordination and collaborative actions.

Phthalates are esters of Pthalic acid, compounds mainly used as plasticisers. Phthalates are widely used chemicals which are of significant research interest as their exposure causes various consequences for human health. There are several categories of phthalates extensively used in many commercial productions with diverse uses, physicochemical properties and toxicological effects. This chapter discusses the toxicity of Phthalates and its potential risks to human health.

This study aimed to assess the feasibility of employing audio and vision technologies as an integrated monitoring system to monitor the health and behavior of pigs under different environmental conditions and to associate these factors. A total of 81 growing pigs ((Landrace x Largewhite) x Duroc) with distinct weight categories (10.47 ± 2.57 kg and 28.81 ± 5.03 kg) were distributed into two distinct housing conditions: Control (characterized by low NH3 levels and low stocking density) and Treatment (marked by elevated NH3 levels and varying stocking densities). Each house was installed with a SoundTalks monitor for automated daily evaluation of respiratory health status (ReHS), and a camera with a microphone to facilitate manual tracking of respiratory symptoms and behavioral patterns. Results showed that the Treatment group encountered significantly high room temperature, NH3 concentration, and carbon dioxide levels, resulting in compromised growth performance—a phenomenon further exacerbated in high stocking density conditions. Pigs within the treatment exhibited increases (p &lt; 0.05) in lateral and total lying behaviors, and incidences of ear and tail injuries, increases screaming frequency, conjunctivitis incidences, coughing frequency, elevated respiration rates, and a decrease in ReHS. The environmental conditions affect the behavior and health of the pigs. Moreover, the behavioral patterns of the pigs are associated with their health conditions. The SoundTalks system did not trigger any warnings during the experimental period. Nevertheless, trend analysis indicated a significant reduction in respiratory health in the treatment. In conclusion, this study underscores the efficacy of merging audio and visual technologies to holistically monitor pig health and behavior, enabling enhanced management strategies. Findings emphasize that monitoring the ReHS trend serves as a pivotal marker for identifying respiratory health problems, complementing the system's innate alarm functions.

Background Although COVID-19 outcomes vary between and within countries, there is little published data on how aspects of social determinants of health (SDoH) affect COVID-19 outcomes in the African context. Objective The current study set to examine COVID-19 case and death rates and their correlates among African countries using data from different sources. Methods An ecological cross-sectional study comprising 28 African countries with a recent Demographic and Health Survey, DHS (2010-2018). Response variables were COVID-19 case and death rates (as of August 15, 2020). Covariates comprised three healthcare systems measures; rates of hospital beds (2005-2017), ventilators (2020) and doctors (2010-2018) per 10,000 population, and 9 broad topics common to multiple SDoH frameworks aggregated to the country level; geography (urban residence), wealth index, education, employment, crowding, and access to information. Rates per 10,000 population were calculated for healthcare measures and mapped for visualization. A Negative Binomial regression was used to assess whether aspects of SDoH are correlated with COVID-19. Results Our analysis indicated that 1 in 4 (25.1%) households in study countries are without clean water and handwashing access. Country-level health system capacity (hospital beds, ventilators, and medical doctors) varied considerably between the countries. Negative Binomial regression showed that the odds of COVID-19 morbidity and death was higher in countries with a high proportion of households without access to quality water and doctors per 10,000 people. Having a high proportional of educated women (1.003: 95% CI, 1.001 – 1.005), hospital beds per population and less people per room (0.959: 95% CI, 0.920 – 1.000) was negatively correlated with COVID-19 deaths while being insured and owning a mobile phone was correlated with illness. Conclusion Both aspects of SDoH and healthcare system contribute either negatively or positively to COVID-19 outcomes. Addressing healthcare system capacity and economic and environmental SDoH will be critical for mitigating the spread of COVID-19 and re-emerging diseases on the African continent.

Immune checkpoint inhibition therapy (ICIT) is an emerging field in oncology especially opening new horizons to chemotherapy refractory patients. This paper provides deep insight into immune related adverse events (irAEs) posing a major challenge and drawback to ICIT, and presents right management strategies for very complex complications. Moreover, for the first time in literature, a non-linear mathematical model is introduced to measure the ICIT success rate and to decide about the optimum ICIT duration. Furthermore, a strategy is presented to overcome or to delay the progression after initial good response in a subset of patients.

Sleep is an essential component of a healthy lifespan, influencing both physical and mental well-being along with good quality of life. Adequate sleep quality and quantity are associated with a host of health advantages, including enhanced immune function, learning and memory, emotional well-being, and cardiovascular health. Chronic sleep deprivation, or poor sleep quality, is associated with a variety of negative health outcomes, including an increased risk of obesity, diabetes, hypertension, depression, cancer, and even premature death. One compelling argument in favor of sleep as a predictor of a healthy lifespan is its effect on cellular repair and regeneration. During sleep, the body goes through important activities such as tissue repair, muscular growth, and memory consolidation. Sleep also helps the brain eliminate toxins and metabolic waste, which contributes to its optimal functioning. Without adequate sleep, these important processes are jeopardized, resulting in accelerated aging and greater susceptibility to chronic illnesses. Furthermore, sleep is essential for maintaining hormone balance, particularly those involved in appetite regulation and metabolism. Sleep disturbances can disrupt the regulation of these hormones, resulting in weight gain, metabolic diseases, and, ultimately, a shorter life span. Finally, prioritizing optimal sleep is pivotal for increasing longevity and general health. Emphasizing the importance of sleep hygiene and treating sleep-related dysfunctions should be part of the modern approach to extending healthy life.

OBJECTIVE: Analyzing the effects of different physical exercise programs on the anthropometric, cardiovascular, metabolic, and strength variables of the elderly participating in health care programs. METHODS: Controlled clinical trial, with 60 elderly participants from health care groups, allocated into four groups: Group of resistance exercises in open-air gyms – GT1 (n = 17); Group of aerobic and localized exercises - GT2 (n = 11); Group of resistance exercises at GT3 gym (n = 17); Control group: non-exercise practitioners - CG (n = 15). Anthropometric (BMI, % body fat, and waist circumference), cardiovascular (SBP, DBP, HR, and DP), metabolic (total cholesterol, triglycerides, and glycemia), and strength variables were evaluated before and after 16 weeks of intervention. Descriptive statistics, Shapiro-Wilk and Kolmogorov-Smirnov normality test, equal variance test, T-Student test, non-parametric Mann-Witney test, ANOVA One Way, multivariate data analysis using data mining and machine learning techniques, Pearson and Spearman correlation tests, Classical Clustering (Agglomerative Hierarchical Method); Principal Component Analysis (PCA), Z score, Fruchterman-Reingold algorithm, Euclidian Similarity Index and, Cohen’s equations were applied. RESULTS: To observe effect size, morphofunctional variables for the GT1 group show a small effect for fat percentage, WHR, and ULS and a medium effect for LLS. For the GT2 group, there was a small effect for fat percentage, WHR, and ULS and a large effect for LLS. For the GT3 group, there was a small effect for the percentage of fat and HC, a medium effect for ULS, and a large effect for LLS. A small effect for glycemia in GT1, a medium effect for glycemia and triglycerides for GT2, a small effect for total cholesterol for GT3, and a large effect for glycemia in CG, with this effect being an increase in this analyte. For the cardiovascular variables, there is a small effect for SBP and HR in GT1, a small effect for DBP, HR, and DP, and a large effect for SBP in GT2, a small effect for SBP, DBP, and HR in GT3 and small effects for SBP and HR in CG. The correlation between BMI (P = 0.0007) and Body Fat% (P = 0.007) with ULS. The variables TG, LLS, and ULS were the ones that differed most in each type of stimulus chosen as an intervention in the present study. CONCLUSIONS: The results of this study indicate that GT2 caused more significant percentage reductions in body mass and BMI. However, GT3 caused greater fat percentage reduction. The GT2 caused the greatest decrease in waist circumference, while the GT3 caused the largest decline in hip circumference. The three groups induced an increase in strength (ULS and LLS). However, in ascending order, GT1 caused the smallest increase, GT2 an intermediate increase, and GT3 the greatest increase in strength, with considerable effects in GT2 and GT3. Finally, GT2 caused a greater percentage reduction in systolic blood pressure (large effect) and double product (small effect) than the other groups. The three methods proved to be efficient, but with particularities that may reflect the choice of one over another due to health conditions, objectives to be achieved, or characteristics of the patient at the time of their choice by the prescriber.

The aim of the study was to evaluate the impact of probiotics obtained from agro-industrial substrates fermented with lactic acid bacteria and/or yeasts on the health and changes in the microbiota of the digestive tract of guinea pigs. Eighty male guinea pigs, Kuri breed, 30 days old and 250 g live weight, were randomly selected and divided into four groups of 20 animals each. T0, Control, T1, Lactobacillus acidophilus and L. bulgaricus. T2, Saccharomyces cerevisiae and Kluyveromyces fragilis and T3. L acidophilus, L bulgariccus, S cerevisiae and K. fragilis. T1, T2 and T3 contained molasses-vinasse substrate in their base, the dose administered was 0.75 mL/animal orally. The parameters evaluated were weight gain, occurrence of diarrhea and mortality, blood profile, macroscopic lesions in the digestive tract organs and changes in the microbiota of the stomach, caecum, small and large intestine. Treatments T1, T2 and T3 improved weight gain (p<0.05) and reduced the presence of guinea pigs with diarrhea (p<0.05) and there was no mortality; hematic indices did not vary significantly (p>0.05) between treatments; animals in the control group presented a greater amount (p<0.05) of macroscopic lesions in the digestive tract organs; in the T1, T2 and T3 group there was an improvement in the natural microbiota. It is concluded that the inclusion of microbial additive in young guinea pigs improves intestinal health, consequently, improves weight gain, reduces diarrhea and deaths, and normalizes the natural microbiota of the gastrointestinal tract.

Rationale: Genetically modified (GM) foods have the potential to reduce food insecurity and address economic and environmental issues. Despite these benefits, GM foods continue to face significant criticism and there is limited information on public awareness and understanding of their nutritional and environmental health benefits in Nigeria. This study aims to fill this gap by investigating public knowledge and perceptions of GM foods in Victoria Island, Lagos. Methods: A convenience sampling method was used to recruit 369 respondents from Victoria Island, Lagos. Data were gathered using a structured questionnaire. The target population comprised employed adults either residing or working on Victoria Island. Statistical analyses were conducted to examine the relationship between sociodemographic factors and awareness of GM foods. Results: The study found that a majority of respondents (62.9%, n=232) were knowledgeable about GM foods and their associated issues. However, many believed that their community was not well-informed on the topic. Awareness of GM foods was significantly associated with sociodemographic factors such as marital status and education (P<0.01). Most respondents were well-informed about the environmental and health benefits of GM foods, with 61.8% believing that GM food production could sustainably reduce reliance on chemical pesticides, fertilizers, and other energy inputs, thus mitigating their ecological impacts. Additionally, most respondents did not feel that purchasing or consuming GM foods conflicted with their beliefs or would affect their food choices. Conclusion: The study concludes that while individual awareness of GM foods is relatively high, there is a perception that community awareness is low. Sociodemographic factors play a significant role in shaping public awareness and perceptions of GM foods. Recommendations: This includes government should actively educate the public on the ecological and health benefits of GM foods and address any safety concerns; Implement strict border controls and food labeling for GM products to protect consumer rights and preferences for organic foods, provide sufficient technical and financial assistance to farmers who participate in organic seed programs to enhance national food security. Significant Statement: This study highlights the importance of public education on GM foods and underscores the need for government intervention to ensure informed consumer choices and support for sustainable agricultural practices.

This study demonstrated that antibiotic residue in milk can be reduced when dairy farmers use Ethno-veterinary Practices (EVP) based on herbal alternatives to prevent and cure common clinical conditions in cattle instead of antibiotics. Of the 220 farmers selected for the study, 140 were trained and motivated to use validated herbal formulations, 80 were kept as control. Milk samples from the selected farmers (except Thirukanurpatti milk society) tested positive for antibiotic residue in the baseline survey. One year after interventions, the milk from 123 (87.86%) farmers out of 140, were without any detectable antibiotic residue, while samples from 11 farmers (7.85%) were low positive for either Beta-lactams or sulphonamides and 6 (4.29%) were positive for Beta lactams and/or sulphonamides. These 17 (11 + 6) farmers had used antibiotics along with herbal formulations. The milk samples from the control groups were positive for beta lactam and sulphonamide. There was suggestive significance of change in knowledge, attitude and practice of EVP among the farmers from Kerala and Tamil Nadu. A progressive reduction in the incidence of mastitis, enteritis, repeat breeding and cowpox were observed from 2016 to 2019 among the cows treated with EVP. Use of herbal alternative also resulted in a significant reduction in health care expenditure of cattle.

Dairy calves are susceptible to a great range of welfare and health issues up to the age of weaning. The aim of the current pilot study was to evaluate incidence of the main health disorders affecting dairy calves up to one year of age. The study was carried out at the Experimental Farm of the Research and Development Institute for Bovine Balotesti, Romania, were health data was collected for two consecutive years, between November 2017 and October 2019, from a number of 176 purebred Romanian Black and White calves. Diarrhea had the highest incidence in un-weaned calves (0-3months old), of 29.55±0.34%, significantly higher (p≤0.001) compared to 3-6 months (2.16±1.24) and 6-12 months age groups (5.88±2.17), respectively. Coccidiosis incidence was on average of 39.20±0.36% in un-weaned calves, 1.44±1.01% in the 3-6 months group and of 5.04±2.01% in the 6-12 months group, significantly higher (p≤0.001) in the 0-3 months age group, compared to older calves.

U.S. Spanish-speaking populations experienced gaps in timely COVID-19 information during the pandemic and disproportionate misinformation exposure. Brigada Digital de Salud was established to address these gaps with culturally-tailored, Spanish-language COVID-19 information on social media. From May 1, 2021-April 30, 2023, 495 Twitter, 275 Facebook, and 254 Instagram posts were published and amplified by 10 trained community health workers. A qualitative content analysis was performed to characterize topics and formats of 251 posts. To assess reach and engagement, page analytics and advertising metrics for 287 posts were examined. Posts predominantly addressed vaccination (49.45%), infection risks (19.12%), and COVID-related scientific concepts (12.84%). Posts were educational (48.14%), and aimed to engage audiences (23.67%), promote resources (12.76%), and debunk misinformation (9.04%). Formats included images/text (55.40%), carousels (27.50%), and videos (17.10%). By June 9, 2023, 394 Facebook, 419 Instagram, and 228 Twitter followers included mostly women aged 24-54. Brigada Digital reached 386,910 people with 552,037 impressions and 96,868 engagements, including 11,292 likes, 15,240 comments/replies, 9,718 shares/retweets, and 45,381 video play-throughs. The most engaging posts included videos, trending topics, and music or audio-narration. This community-based model to engage Spanish-speaking audiences on social media with culturally-aligned content to counter misinformation shows promise for addressing public health threats.

The COVID-19 pandemic has contributed to mental health problems worldwide. Nurses are particularly prone to stress because they directly care for individuals with suspected or confirmed cases of COVID-19. The aim of this study is to explore the association between the mental health promotion strategies used by nurses during the coronavirus disease (COVID-19) outbreak and their symptoms of depression, anxiety, and stress, and to compare the strategies and symptoms of mental health nurses and non-mental health nurses. Cross-sectional study was conducted with a sample of 821 nurses. Portuguese nurses demonstrated high symptoms of depressive symptoms, stress, and anxiety. Healthy eating, physical activity, rest between shifts, maintaining social contacts, verbalizing feelings/emotions, and spending less time searching for information about COVID-19 are associated with better mental health. Mental health nurses have less depression, anxiety, and stress, and use more strategies to promote mental health than other nurses. We consider it important to promote nurses’ mental health literacy by encouraging them to develop skills and strategies aimed at improving their resilience and ability to deal with difficult situations while caring for the population.

Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.

Shelter-in-place aimed at slowing COVID-19 transmission has altered nature accessibility patterns, creating quasi-experimental conditions to assess if retracted nature contact and perceived nature deprivation influences physical and emotional wellbeing. We measure through survey methods how pandemic mandates limiting personal movement and outdoor nature access effect self-assessed nature exposure, perceived nature deprivation, and subsequent flourishing as measured by the Harvard Flourishing Index. Results indicate that perceived nature deprivation strongly associates with neighborhood nature contact, time in nature and access to municipal nature during the pandemic, after controlling for shelter-in-place mandates, job status, household composition, and sociodemographic variables. Our hypothesis that individuals with strong perceived nature deprivation under COVID-19 leads to diminished wellbeing proved true. Interaction models of flourishing showed positive modification of nature affinity with age and qualitative modification of nature deprivation with race. Our results demonstrate the potential of local nature contact to support individual wellbeing in a background context of emotional distress and social isolation, important in guiding public health policies beyond pandemics.

Non-typhoid salmonellosis is a common and problematic foodborne zoonotic disease in which pork and pork products can be an important potential source of infection. In order to prevent this disease important efforts to monitor the situation in the main source, livestock, are conducted in most developed countries. In the European Union EFSA and ECDC compile information at the member state level, even though important differences in production systems and surveillance systems exist. Here, Salmonella surveillance systems in one of the main sources of foodborne salmonellosis, swine, and humans in Spain were reviewed to identify potential gaps and discuss potential ways of integration under a One Health approach. Despite the extensive information generated through the surveillance activities source attribution can be only routinely performed through ad-hoc outbreak investigations, and national reports on human outbreaks do not provide sufficiently detailed information to gain a better understanding of the epidemiology of the pathogen. Human and animal monitoring of Salmonella would benefit from a better exchange of information and collaboration. Analysis of spatio-temporal trends in livestock and humans could help to identify likely sources of infection and to target surveillance efforts in areas with higher prevalence or where specific strains are found.

Migrants are mainly employed in "3D Jobs" dirty, dangerous, difficult, characterized by monotony, intense rhythms, in sectors at higher risk as construction, heavy industry, agriculture. Aim of this study is to elaborate a systematic review, in order to identify the main occupational risks and occupational diseases of this category. Research included articles published from 2013 to 2018 on the major online databases (PubMed, Cochrane Library and Scopus), using a combination of some keywords (migrant workers, expatriates, physical health, diseases, illnesses, travel, travelers, work and occupational). The online search indicated 1.109 references. We excluded 977 studies, because unrelated to physical health and 64 due to duplication. They were analyzed 68 articles, including 6 reviews and 62 original article. The main risk emerged are to developing infectious diseases, metabolic cardiovascular diseases and to manifesting a lower quality of life, in particular due to difficulties in accessing local health services. It will be crucial to implement the role of occupational medicine in order to introduce multilevel interventions designed to prevent work-related injuries and illnesses and to promote healthier working environments.

The purpose of this study was to report data analysis results from the International Health Regulations (2005) Ship Sanitation Certificates (SSC), recorded in the European Information System (EIS). International sea trade and population movements by ships can contribute to the global spread of diseases. SSC are issued to ensure the implementation of control measures if public health risk exists on board. EIS designed according to the World Health Organization (WHO) “Handbook for Inspection of Ships and Issuance of SSC”. Inspection data were recorded and SSC issued by inspectors working at European ports were analysed. From July 2011-February 2017, 107 inspectors working at 54 ports in 11 countries inspected 5579 ships. Of these, there were 29 types under 85 flags (including 19 EU flags). As per IHR (2005) 10,281 Ship Sanitation Control Exception Certificates (SSCEC) and 296 Ship Sanitation Control Certificates (SSCC) were issued, 74 extensions to existing SSC were given, 7565 inspection findings were recorded, and 47 inspections were recorded without issuing an SSC. The most frequent inspection findings were the lack of potable water quality monitoring reports (23%). Ships aged ≥12 years (Odds Ratio, OR = 1.77, 95%Confidence Intervals, CI = 1.37–2.29) with an absence of cargo at time of inspection (OR = 3.36, 95%CI = 2.51–4.50) had a higher probability of receiving an SSCC, while ships under the EU flag had a lower probability of having inspection findings (OR = 0.72, 95%CI = 0.66–0.79). Risk factors to prioritise the inspections according to IHR were identified by using the EIS. A global information system, or connection of national or regional information systems and data exchange, could help to better implement SSC using common standards and procedures.

Introduction: The management performance of hospitals in emergency departments in coping with clinical hazards is necessary for their success in providing quality services. The purpose of this study is to provide an optimization procedure and applying management performance in health and medical emergency on the rate of emergency preparedness of the suburb city hospitals. Research method: A semi-experimental and interventional descriptive study in the emergency department of Shahid Motahari Hospital in 2015-2016. Data was collected through the standard checklist of hospital emergency responsiveness test to WHO disasters with 90 questions in 9 domains which is codified by the World Health Organization, in the form of interviews and observing evidences , and if necessary a numerical analysis. Initially, the situation was measured according to this checklist. In the next stage, a set of solutions was developed and then the solutions were implemented according to the obtained information. Data analysis before and after proposing the procedure and its application in order to improve the quality of health management performance and emergency preparedness was performed using central indices, and for describing and presenting the survey results, tables and graphs were used. Results: The highest and lowest emergency preparedness rates for disasters and emergencies before the proposed procedure were the Communication Factor (%77/8) and Human resource factor (%2/8) respectively. The degree of preparedness of the medical center was measured in the management performance according to the model (WHO) before proposing the procedure (%77.98). The researcher's procedure provided and applied based on the information obtained from survey environment, location and type of hospital structure. After providing the procedure, the maximum and minimum rates were the continuity of service factor (%58.3) and post-accident rebuilding factor (%100), respectively. Generally, the rate of emergency preparedness of studied medical center in management performance for coping with disasters and medical emergencies was measured (%97.2) according to hospital emergency responsiveness test for accidents and (WHO). The significance level is less than 0.05, so we can say that the effectiveness with confidence (95%) was effective. Conclusion: According to the statistics of accidents and disasters in the suburb cities, the results of the research and the importance of the role of emergency departments in interurban hospitals in controlling accidents, the need for planning and implementation of practical measures such as conducting training courses on health management in disasters and emergencies, having an estimate of critical and essential resources, changing the structure, providing manpower (emergency management) in order to more precise control and ease of service, maintenance and repair of equipment, timely triage and retrofitting of hospitals were effective in improving their preparedness.

In conclusion, the present study demonstrated the safety of practicing WFM at different TOD. Furthermore, it appears that practicing WF in the evening is safer, as indicated by HRR60s, [Gl], and MBP findings. The utilization of digital biomarkers for monitoring health status during WFM has been shown to be efficient.

Very poor oral health, common among older adults, is associated with cognitive decline.This study aimed to investigate the association between denture use, chewing ability, and cognitive function in Korean middle-aged adults using samples representing middle-aged people at the national level. This longitudinal study included 9,998 middle-aged adults via Korea Longitudinal Study of Aging 7th special survey data. Denture use, chewing ability, health-related factors, and general characteristics were assessed by the Computer Assisted Personal Interview. After controlling general characteristics using a generalized estimating equation model, the association of denture use and MMSE scores with chewing ability of those with or without dentures and MMSE scores were analysed. Twenty-four percent of participants wore dentures among them, 35.1% complained of difficulty chewing when wearing dentures. Among participants who did not wear dentures, 16.4% complained of difficulty chewing. MMSE scores were lower among denture-wearers than non-denture wearers (β = -0.026, p < 0.001). In both groups, MMSE scores decreased with chewing difficulty and were significantly reduced among non-denture wearers (p < 0.05). Chewing ability was closely associated with cognitive function. Given the negative effect of difficulty chewing on cognitive function, maintaining chewing ability should be of great concern.

Limited understanding exists concerning leptospirosis in Zanzibar. The objective of this study is to evaluate the degree of knowledge and awareness of leptospirosis within the urban and peri-urban populations of Unguja. A cross-sectional study was conducted utilizing semi-structured questionnaires from January to April 2022. Two hundred respondents were randomly selected (130 males and 70 females) aged between 18 and 89 years. Descriptive analysis was employed to assess the main trends in knowledge and awareness, and χ2 analysis was utilized to determine associations between demographic characteristics with respondents’ knowledge and awareness. The majority of respondents (64%) lacked awareness of leptospirosis' etiology, but a significant proportion of respondents had a favorable attitude (68.6%) towards leptospirosis compared to their average knowledge and awareness (35%) and practices (29.3%). Nonetheless, the livestock keeper, farmers, fishermen, and healthcare providers had low levels of knowledge and awareness. The findings also demonstrated that males had a strong association with occupational physical activities, while educational level was associated with preventive practices. Living in urban or peri-urban areas was significantly linked with the respondents' practices. The study's outcomes demonstrated low levels of community knowledge and awareness regarding leptospirosis' etiology, mode of transmission, and symptoms among livestock keepers, farmers, fishermen, and healthcare providers. Although most respondents had a favorable attitude, their low level of knowledge and poor practices indicate that supplementing a positive attitude with enhanced knowledge and awareness is necessary to promote individual engagement in preventive measures.

Availability of nasal spray treatments that inhibit the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry into nose and nasopharynx at early stages can be an appropriate approach to stop or delay the progression of the disease. We performed a prospective, randomized, double-blind, placebo-controlled, parallel-group, multicentric, phase II clinical trial comparing the rate of hospitalization due to COVID-19 infection between azelastine 0.1% nasal spray and placebo nasal spray treatment groups. The study furthermore assessed the reduction in virus load in SARS-CoV-2 infected subjects estimated via quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) using nasopharyngeal swabs in both the groups during the treatment period. A total of 294 subjects with mild COVID-19 infection were screened and randomized in a 1:1 ratio.

In this case series, we examine the impact of the Titan-iR Pro® deep spectrum biotherapeutic device on brain function in healthy individuals. Here we present 15 participants, aged 26-68 years, who enrolled in this open-label study, designed to assess the effect of a single 15-minute course of deep spectrum biotherapy on brain function. Although symptom-free upon enrollment, participants had diverse medical histories with some displaying early signs of cognitive decline. As part of the evaluation, all participants engaged in electroencephalogram (EEG) recording sessions that focused on assessing event-related potential (ERP) evaluations, including audio P300 amplitudes and latencies (speeds), neurocognitive testing, and physical reaction times. Following the Titan-iR Pro intervention an improvement in EEG-based cognitive markers was observed. These results underscore the importance of further investigation into the potential of advanced and deep spectrum photobiomodulation in the prevention and treatment of cognitive decline and other neurological disorders.

High-grade gliomas are extremely fatal tumors, marked by severe hypoxia and therapeutic resistance. Autophagy is a cellular degradative process that can be activated by hypoxia, ultimately resulting in tumor advancement and chemo-resistance. Our study aimed to examine the link between autophagy markers expression in low (LGG) and high-grade gliomas (HGG). In 39 glioma cases, we assessed protein expression of autophagy markers LC3B, p62, and DRAM by immunohistochemistry (IHC) and mRNA expression of autophagy genes; PI3K, AKT, m-TOR, PTEN, ULK1, ULK2, UVRAG, Beclin 1 and VPS34 using RT-qPCR. Livak’s method was used to analyze the relative changes in gene expression and multi-variate Anova test and Spearman's correlation tests were performed for statistical significance. LC3B, p62, and DRAM expression were positive in 64.1%, 51.3%, and 28.2% of glioma cases respectively. The expression of LC3B and p62 was notably higher in HGG compared to LGG. VPS34 exhibited a significant differential expression and increased fold change and demonstrated strong positive correlations with Beclin1 (rs=0.768), UVRAG (rs=0.802), and ULK2 (rs=0.786) in HGG compared to LGG, thus highlighting the potential link between autophagy and glioma progression. We Provide preliminary data for functional analysis of autophagy using cell culture model and to identify potential targets for therapeutic interventions

Device-mediated, non-invasive drug delivery across the blood-brain barrier (BBB) represents a significant advancement in treating neurological diseases. The BBB is a tightly packed layer of endothelial cells that shields the brain from harmful substances in the blood, allowing necessary nutrients to pass through. It is a highly selective barrier, which poses a challenge to delivering therapeutic agents into the brain. Several non-invasive techniques and devices have been proposed or investigated to enhance drug delivery across the BBB. This paper presents the current state of the art and case studies that address the pharmacology, technology, delivery systems, regulatory approval, ethical concerns, and future possibilities.

Amphetamine is a psychostimulant drug with a high risk of toxicity and death when misused. Abuse of amphetamines is associated with an altered organic profile, which includes omega fatty acids. Low omega fatty acid levels are linked to mental disorders. Using the Comparative Toxicogenomic Database (CTD), we investigated the chemical profile of the brain in amphetamine-related fatalities and the possibility of neurotoxicity. We classified amphetamine cases as low (0-0.5 g/ml), medium (&gt;0.5 to 1.5 g/ml), and high (&gt;1.5 g/ml) based on amphetamine levels in brain samples. All three groups shared 1-octadecene, 1-tridecene, 2,4-di-tert-butylphenol, arachidonic acid, docosahexaenoic acid (DHA), eicosane, and oleylamide. We identified chemical-disease associations using the CTD tools and predict an association between docosahexaenoic and arachidonic acids and curated conditions like autistic disorder, disorders related to cocaine, Alzheimer's disease, and cognitive dysfunction. An amphetamine challenge may cause neurotoxicity in the human brain due to a decrease in omega-3 fatty acids and an increase in oxidative products. Therefore, in cases of amphetamine toxicity, supplement therapy may necessitate preventing omega-3 fatty acid deficiency.

Cognitive and behavioural disturbances are growing public healthcare issue for the modern society, as stressful lifestyle is becoming more and more common. Besides, several pieces of evidence state that environment is crucial in the development of several diseases as well as compromising healthy aging. Therefore, it is important to study the effects of stress on cognition and its relationship with aging. To address these queries, Chronic Mild Stress (CMS) paradigm was used in the senescence-accelerated mouse prone 8 (SAMP8) and resistant 1 (SAMR1). On one hand, we determined the changes produced in the three main epigenetic marks after 4 weeks of CMS treatment, such as a reduction in histone posttranslational modifications and DNA methylation, and up-regulation or down-regulation of several miRNA involved in different cellular processes in mice. In addition, CMS treatment induced reactive oxygen species (ROS) accumulation and loss of antioxidant defence mechanisms, as well as inflammatory signalling activation through NF-κB pathway and astrogliosis markers, like Gfap. Remarkably, CMS altered mTORC1 signalling in both strains, decreasing autophagy only in SAMR1 mice. We found a decrease in glycogen synthase kinase 3 β (GSK-3β) inactivation, hyperphosphorylation of Tau and an increase in sAPPβ protein levels in mice under CMS. Moreover, reduction in the non-amyloidogenic secretase ADAM10 protein levels was found in SAMR1 CMS group. Consequently, detrimental effects on behaviour and cognitive performance were detected in CMS treated mice, affecting mainly SAMR1 mice, promoting a turning to SAMP8 phenotype. In conclusion, CMS is a feasible intervention to understand the influence of stress on epigenetic mechanisms underlying cognition and accelerating senescence.

Orthogonal operators can successfully be used to calculate eigenvalues and eigenvector compositions in complex spectra. Orthogonality ensures least correlation between the operators and thereby more stability in the fit, even for small interactions. The resulting eigenvectors are used to transform the pure transition matrix into realistic intermediate coupling transition probabilities. Calculated transition probabilities for close lying levels illustrate the power of the complete orthogonal operator approach.

Cardiovascular disease (CVD), comprising heart and blood vessel disorders, persists as the foremost contributor to global morbidity and mortality. In modern times, the intricate composition of gut microbiota has garnered significant focus, particularly for its varying impact on diverse ailments. Perturbations in gut microbiota and consequent dysbiosis have demonstrated connections with the advancement and origin of CVD, including conditions like atherosclerosis, hypertension, and heart failure. This comprehensive review delves into the pivotal role of gut microbiota in maintaining cardiovascular well-being.

During the last few decades bat lyssaviruses have become the topic of intensive molecular and epidemiological investigations. Since ancient times rhabdoviruses have caused fatal encephalitis in humans which has led to research into effective strategies for their eradication. Modelling of potential future cross-species virus transmissions forms a substantial component of the recent infection biology of rabies. In this article we summarise the available data on the phylogeography of both bats and lyssaviruses in Europe and the adjacent regions, especially in the contact zone between the Palearctic and Ethiopian realms. Within these zones three bat families are present with high potential for cross-species transmission and the spread of lyssaviruses in Phylogroup II to Europe (part of the western Palearctic). The lack of effective therapies for rabies viruses in Phylogroups II and III generates impetus for additional phylogenetic and virological research within this geographical region.

In 2014, a whistleblower reported that many U.S. veterans died while waiting for care at the Phoenix VHA. Problems with veteran’s care through 2018 reveal ongoing and systematic problem. In March 2018, the VA Inspector General identified critical deficiencies at the Washington, DC VA Medical Center including failures to track patient safety events accurately, ineffective sterile processing, and more than 10 thousand open or pending prosthetic / sensory aid consults. The VHA clearly has problems with access and quality in a budget-constrained environment. In this policy analysis, four separate interventions that address the gap between the magnitude as well as the use of the VHA’s fixed budget versus access and cost expectations are explored. These policy interventions include maintaining the status quo, returning to a “VHA-only” option, transitioning to a CMS central payer system, and consolidating care under the DoD TRICARE insurance plans. An objective evaluation suggests that extending TRICARE to veterans while phasing out the VHA’s care responsibilities, while politically unpalatable, would likely provide the best of four possible solutions under various criterion weighting schemes. A central payer solution under the CMS would also be viable consideration. A Friedman’s test with Wilcoxon rank sum post-hoc tests suggests that TRICARE patient perceptions of quality are superior to VHA and non-VHA / non-DoD (p<.001), that access provided by the TRICARE program is ranked second in terms of venue acceptance only to the CMS solution set based on primary provider acceptance, and that the cost per beneficiary of a TRICARE solution ($6.5K / beneficiary) is far better than a VHA-only solution ($14.0 K / beneficiary), the CMS central payer solution ($12.2K / beneficiary), or the status quo (between $12.2K and $14.0K / beneficiary). The intent of this paper is to provoke thoughtful consideration of solutions for providing access to high-quality healthcare for veterans within our outside of the VHA. In this policy analysis, separate interventions that address the gaps between cost, quality, and access are explored. These policy interventions include maintaining the status quo, returning to a VHA-only option, transitioning to a CMS central payer system, and consolidating care under TRICARE.

Background. Obesity is an important threat to national and global public health in terms of prevalence and economic burden due to the obesity-related complications (ORCs) and morbidities. Aim of this study is to calculate the obesity related public expenditures in Hungary, to estimate the expenses and contribution of patients in 2019 (before) and in 2022 (after) the covid-pandemic.Method. The National Health Insurance Fund is the only health-care financing agency in a single-payer social-insurance system in Hungary, managing all of the public payments. Expenditures related to the patients with obesity and more frequent co-morbidities were requested from the national database. Financing of the inpatient (hospital) and the outpatient (secondary or ambulatory care) providers, reimbursement for prescription of medicines and healing aids were collected. Lower and upper thresholds were estimated, representing the prevalence of the respective morbidities among obese persons. The upper values were used in the final estimation, because many of other obesity related morbidities and treatments were not included in the calculation. Results. Obesity-related morbidities represent 10-12 % of all cases in the public health care system. National public health care expenses could be about 144 Billion HUF (444 Million EUR) for 2019 and 133 Billion HUF (393 Million EUR). These sums represent 7-11% of the national spending for health care provision, without sick leave expenditures. The co-payment of patients was estimated 34 Billion HUF (104 Million EUR) and 43 Billion HUF (109 Million EUR), respectively. Public expenditures and co-payments related to diabetes Type2, and hypertension were the highest. The public and individual expenditures together represents 0.3-0.4% of the Hungarian GDP.This study presents whole national database which is appropriate for reliable calculation. Reducing of high expenses could be possible by weight maintenance, preferable as early prevention, and weight reduction among persons living with obesity at individual level. Beside these, more efforts are needed in the education and public health policy. To calculate the cost of obesity, to improve homogeneity and comparability an international consensus is required on standardized methods.

(1) Background: Research has shown that thoughts about pain are important for the management of chronic pain in children. In order to monitor changes in thoughts about pain over time and evaluate the efficacy of treatments, we need valid and reliable measures. The aims of this study were to develop a questionnaire to assess a child’s concept of pain and to evaluate its psychometric properties; (2) Methods: This is a cross-sectional, two-phase, mixed-method study. A total of 324 individuals aged 8 to 17 years old responded to the newly created questionnaire. The Survey of the Concept of Pain (SOCOPA) was calibrated using the Rasch model. The chi-square test was used for the fit statistics. Underfit and overfit of the model were determined and a descriptive analysis of infit and outfit was conducted to identify who responded erratically. Internal consistency was measured using the Person Separation Index (PSI); (3) Results: Fit to the Rasch model was good. Suitable targeting indicated which items were simple to answer; Person Fit identified 9.56% children who responded erratically; PSI=0.814; (4) Conclusions: The findings suggest that SOCOPA is a measure of a child’s concept of pain that is easy to administer and respond to. It has a good fit and a good internal consistency.

The current state-of-the-art does not provide a universal and rapid method of determining the state of health (SOH) of a battery or a supercapacitor without carefully examining the degradation of hundreds of full charge/discharge cycles. Lithium-ion batteries, sodium-ion batteries and supercapacitors of different cell chemistries were studied by impedance spectroscopy during lifetime tests. Faradaic and capacitive charge storage are distinguished by the relationships between stored electric charge and capacitance. For batteries, impedance spectroscopy is best applicable in the flat region of the voltage-charge curve. An approximately linear correlation between pseudocapacitance and Ah capacity is observed as long as overcharge and deep discharge are avoided. The correct calculation of quantities related to complex impedance and differential capacitance is outlined – which may also be useful as an introductory text and tutorial for newcomers to the field. Novel diagram types are proposed for the purpose of instant performance and failure diagnosis of batteries and supercapacitors.

One in three people globally suffer from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This literature review aims to understand the potential for impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We conducted a systematic search on PubMed and a rapid hand-search on Google Scholar to identify systematic reviews, meta-analyses, and randomized controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualized counselling and environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.

HIV/AIDS infection increases vulnerability to ill-health states and has a major impact on the general health status. This study aims to describe Angolan adolescents and adults’ comprehensive knowledge of HIV/AIDS and its associated factors based on the 2016 demographic and health survey (DHS). Data from 19,785 individuals between the ages of 15 and 49 years old, who re-sponded to all the DHS questions between October 2015 and March 2016 were included in this study. Multivariable analysis using logistic regression was used to compute the adjusted odds ratio and respective 95% confidence intervals. In Angola, 47.7% of the respondents had general com-prehensive knowledge of HIV/AIDS. The odds of having comprehensive knowledge about HIV/AIDS were higher among individuals who watch television (aOR: 2.40; 95% CI: 2.11, 2.72) or read journals and magazines (aOR: 1.99; 95% CI: 1.72, 2.30) more than once a week and, people with primary or higher-level education (aOR: 1.83; 95% CI: 1.67, 2.00). Similarly, for people living in urban areas (aOR: 1.51; 95% CI: 1.34, 1.71). These results may reflect important inequities and can assist decision-makers in advocating to continue to invest in health literacy for HIV but also in the development of tailored interventions in this area.

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.

Rural women in developing nations are especially vulnerable to higher health risks due to environmental pollution exposure and are more likely to experience poorer health outcomes. Using data from the 2013 China General Social Survey CGSS2013, this study empirically examined the relationship among environmental knowledge (EK), pollution, health investment, and health status of women residing in rural regions in China. We employed a nationally representative sample of 1,930 female individuals for our analysis. Our results showed that the level of EK for women in rural China significantly impacted their self-reported physical and mental health. In order to account for potential endogeneity due to mutual causality, this study employed television usage and network usage as two instrument variables (IVs) of EK. We performed an IV-probit method to correct the estimated errors due to endogeneity. Additionally, to assess the reliability and robustness of our results, we re-estimated our model by replacing health status with the variable Body Mass Index (BMI). The results were consistent, providing evidence of robustness. Additionally, we examined the relationship between health investment (holding and purchasing a public health insurance policy, engaging in frequent physical activity, and acquiring commercial insurance) and health status. Our results indicate that the level of EK had no significant impact on participating in the new rural cooperative medical system. However, the preference of purchasing commercial insurance was positively impacted by EK, though it does not have a direct impact on the health condition. Conversely, an increase in EK and pollution is associated with a greater likelihood of engaging in physical exercise, which could, in turn, improve overall mental health.

Age-related macular degeneration (AMD) causes visual impairment in individuals >50 years of age. However, no study has investigated AMD using ultra-wide-field swept-source optical co-herence tomography (UWF SS-OCT). We aimed to evaluate central and peripheral choroidal thickness using UWF SS-OCT and compare AMD subtypes. We included 75 eyes of patients with typical AMD (tAMD), 56 with polypoidal choroidal vasculopathy (PCV), 29 with pachychoroid neovasculopathy (PNV), and 12 with retinal angiomatous proliferation (RAP). To compare cho-roidal thicknesses in the central and peripheral choroids, we established subfields of <3 mm, <9 mm, and 9–18 mm from the fovea. PNV patients were significantly younger than those with tAMD (P=0.01). The choroidal thicknesses of PNV were significantly greater than that of tAMD in all subfields (P<0.01) and choroidal thickness significantly correlated with age and axial length in all subfields (P<0.05). Even after adjusting for age and axial length, the choroidal thickness in PNV was significantly greater than that in tAMD (P<0.05). In addition, the ratio of the posterior < 9 mm to peripheral 9–18 mm choroidal thickness in PNV was significantly greater than that in tAMD (P<0.01). A thickened choroid in PNV was more pronounced in the posterior choroid than in the periphery.

ETS exposure has been shown as an important environmental risk factor in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in the representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of passive smoking is the highest in the capital (27%) and southern cities. Significant relationships have been confirmed between ETS and the age, socio-economic status, the incompleteness of the family, the level of mother's education and the significantly higher prevalence of respiratory diseases (26.7%).The relationships of ETS with emotional (CIS scores ≥16) and behavioral functions (BPI score ≥14) were significant in children exposed to mother‘s and father‘s smoking at home. In the multivariate analysis this association was not significant; the factors such as income and completeness of the family were dominant. The results confirmed the impact of ETS and social factors on health state and health behavior and could be the argumentation for legislative changes.

Hen egg is a bioavailable and a palatable source of protein, fatty acids and vitamins. Egg being a bird embryo, it is adapted as an important part of a high quality carnivore and scavenger diet through evolution. The biological value of egg protein is near to 100 % with the ten essential amino acids, excluding taurine, required by cats and dogs. Functions of over 400 bioactive proteins are growingly recognized in targeting to support pet health. Egg shell membrane contains several of these biomolecules and has shown effect on joint and skin health, anti-inflammatory and antimi-crobial effect in adaptive immunity as well as in gastrointestinal disorders, such as metabolic diseases and obesity. The lipid composition of eggs is unique for an animal product with two-thirds of un-saturated fatty acids consisting of linoleic acid, arachidonic acid, eicosapentaenoic acid, and do-cosahexaenoic acid. Eggs are also a diverse source of vitamins providing both water and fat soluble vitamins, especially choline. The nutritional value of an egg assists in maintaining health and shows potential supporting the mobility, cognitive and gastrointestinal health as well as skin repair.

This work explores the significance of toothbrushing in maintaining optimal oral health, delving into its benefits, proper techniques, and types of toothbrushes. The primary cause of caries, periodontal diseases, and halitosis is oral biofilm development. One of the most fundamental practices in maintaining oral health is toothbrushing. Studies have confirmed that mechanical procedures for controlling plaque and toothbrushing, in particular, significantly decrease plaque accumulation. The significance of teeth brushing in preventing dental caries has been well-acknowledged for a considerable period. Dentists recommend brushing twice daily for at least two min to ensure thorough cleaning. Unfortunately, precise guidelines from dental associations are often missing. Authors mention that two min of brushing are insufficient for significant plaque removal; plaque removal increases with augmented brushing time, with maximum removal at 180 s. Multiple studies have documented that engaging in the practice of brushing one’s teeth twice a day has a preventive impact. Various toothbrush designs, including both manual and electric options, have been created to improve the elimination of dental biofilm and reduce the accumulation and persistence of bacteria. In conclusion, toothbrushing is a simple yet incredibly important practice for maintaining oral health. The benefits extend beyond just a bright smile, encompassing caries, gum disease, halitosis prevention, and the preservation of tooth enamel. Adhering to proper toothbrushing techniques, selecting the right toothbrush, and understanding the connection between oral health and overall well-being can lead to a healthier life. To foster favorable toothbrushing behaviors among the population, dental practitioners and public health experts must know the factors that influence toothbrushing habits.

Objective: To investigate the association between deprivation and COVID-19 outcomes in Italy during pre-lockdown, lockdown and post-lockdown periods.Design: Retrospective cohort study.Setting: All municipalities in Italy with less than 50,000 population.Participants: 38,534,169 citizens and 222,875 COVID-19 cases reported to the Italian epidemiological surveillance were assigned to quintiles based on the deprivation index of their municipality of residence.Interventions: The COVID-19 pandemic during pre-lockdown, lockdown and post-lockdown from the 20th of February to the 15th of October of 2020.Main outcome measures: Multilevel negative binomial regression models, adjusting for age, sex, population-density and region of residence were conducted to evaluate the association between deprivation and COVID-19 incidence, case-hospitalisation rate and case-fatality. The association measure was the rate ratio.Results: During pre-lockdown, lockdown and post-lockdown, the incidence rate ratios (IRR) with 95% confidence interval (CI) in the most deprived quintile with respect to the least deprived quintile were 1.17 (95% CI 0.98 to 1.41), 1.14 (1.03 to 1.27) and 1.47 (1.32 to 1.63), respectively. In those three periods, the case-hospitalization IRR were 0.68 (0.51 to 0.92), 0.89 (0.72 to 1.11) and 0.99 (0.81 to 1.22) and the case-fatality IRR were 0.92 (0.75 to 1.13), 0.95 (0.85 to 1.07) and 1.02 (0.73 to 1.41), respectively.Conclusions: During lockdown and post-lockdown, but not during pre-lockdown, a higher incidence of cases was observed in the most deprived municipalities compared with the least deprived ones. No differences in case-hospitalisation and case-fatality according to deprivation were observed in any period under study.

Environmental factors, such as drought-stress, significantly impact maize growth and productivity worldwide. To improve yield and quality, effective strategies for early detection and mitigation of drought-stress in maize are essential. This paper presents a detailed analysis of three imaging trials conducted to detect drought-stress in maize plants using an existing, custom-developed, low cost, high throughput phenotyping platform. We propose a pipeline for early detection of water stress in maize plants using a Vision Transformer classifier and analysis of distributions of near-infrared (NIR) reflectance from the plants. We also explored suitable regions on the plant that are more sensitive to drought-stress and show that the region surrounding the youngest expanding leaf (YEL) and the stem can be used as a more consistent alternative to analysis involving just the YEL. Our results show good separation between well-watered and drought-stressed trials for two out of the three imaging trials both in terms of classification accuracy from data-driven features as well as through analysis of histograms of NIR reflectance.

Introduction: Corona epidemic and quarantine enforcement, various effects on the psychological and social aspects of the population has left. The aim of this study is to investigate the relationship between depression, anxiety and relationship with medical staff and mental health is caused by corona. Methods: For this purpose, samples of 650 health personnel of private hospitals were selected. Inventory DASS, HADS, and selected social cohesion (Keyes) and the Internet and through social media networks were evaluated. To analyze the data, Pearson correlation and regression analysis were used. Results: The results showed that straw anxiety corona) to negative (and social cohesion caused by corona) to positive (mental health correlates. It was also found that anxiety and social cohesion caused by corona, respectively 47 and 26 percent predict changes in mental health. Conclusion: These results show the positive and negative effects of psychosocial interventions in quarantine and it have practical implications in the development of the epidemic crisis is Corona.

The paper proposes an approach to determine the optimal number of medical specialists in the region. According to the author's theoretical model, in order to maximize public welfare, the marginal contribution of the last physician recruited to the growth of the public utility function should be equal to the marginal cost of attracting him and providing conditions for his work. To empirically assess the contribution of physicians to the number of lives saved, the CVD mortality rate is modeled using the instrumental variable method. On average, a 1% increase in the number of cardiologists is associated with a 0.6% decrease in cardiovascular mortality. At the level of provision with cardiologists in the amount of 1 per 100 thousand people, their marginal contribution to the number of lives saved is not less than 129 per 100 thousand people, with a further decrease by 5 people with the increase in the level of provision by 1 unit. The use of the obtained results will increase the validity of managerial decisions and in determining the optimal level of doctors when choosing between alternative possibilities of spending money on hiring doctors of different profiles or other expenses, especially in the case of limited resources.

In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC) - a campaign to educate 50,000 health professionals about health impacts of climate change - launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty 1) integrated resources into didactic and clinical settings such as population or organ-system content, leadership, and policy and 2) used resources to support assignments. In four years, faculty reported educating over 37,700 students using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a disabling condition affecting millions of adults and children worldwide. Despite the development of multiple criteria sets for defining this disorder, agreement on the core symptoms and other implications of ME/CFS point to the importance of understanding their role in oral health care. Overall, care for the homebound and bedbound population with ME/CFS issues has been under-addressed in the literature to date and there has been little consideration of the oral health needs of this population. Evaluation, diagnosis and treatment of dental concerns may be hindered by many of the diverse symptoms of ME/CFS. The present paper utilizes the International Consensus Criteria (ICC) in discussing treatment considerations for the most severely affected patients with ME/CFS, both in oral evaluation and active care. While no specific dental pathology is linked to ME/CFS, proper care for the patient so affected must take into account the disorder’s symptoms and severity.

Viruses with encephalitogenic potential can cause neurological conditions of clinical and epidemiological importance, such as Saint Louis encephalitis virus, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, Western equine encephalitis virus, dengue virus, Zika virus, Chikungunya virus, Mayaro virus and West Nile virus. The objective of the present study was to determine the number of arboviruses with neuroinvasive potential isolated in Brazil that corresponds to the collection of viral samples belonging to the Section of Arbovirology and Hemorrhagic Fevers (SAARB/IEC) of the Laboratory Network of National Reference for Arbovirus Diagnosis from 1954 to 2022. A total of 1,090 arbovirus samples with encephalitogenic potential were isolated from mice. From a total of 7,054 samples intended for cell culture. The isolates from mosquitoes totaled 659 viruses. The emergence of new arboviruses may be responsible for diseases still unknown to humans, making the Amazon region a hotspot for infectious diseases due to its fauna and flora species characteristics. The detection of circulating arboviruses with the potential to cause neuroinvasive diseases is constant, which justifies the continuation of active epidemiological surveillance work that offers adequate support to the public health system regarding the virological diagnosis of circulating arboviruses in Brazil.

The COVID-19 pandemic creates anxiety among hospitalised SARS-CoV-2 patients. Therefore, this study aims to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia's leading COVID-19 hospitals from 15th April until 30th June 2020 who were chosen using quota sampling. General Anxiety Disorders 7 items (GAD-7), Coping Orientation to Problems Experienced Inventory (Brief-COPE) and Socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. The results showed that prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female (p < 0.05), fear of infection (p < 0.05), lack of information (p < 0.05), maladaptive coping mechanism of behavioural disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Whereas adaptive coping mechanisms via instrumental support (p < 0.001) was a significant protective predictor of anxiety. COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provides baseline findings on prevalence of anxiety among stabilized COVID-19 inpatient in Malaysia. Despite the relative low prevalence, the data has the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances

Preparation of students for adult life also includes the area of health care. Health education is part of the core curriculum of Polish schools. The leading role of the health educator is assumed by the physical education teacher, but many other educational tasks are carried out by all school staff. The present study attempts to answer the question: How is health education implemented at school? The research project was carried out among students of various colleges in the city of Szczecin in Poland. At the same time, similar studies were conducted among students from other university in other cities. The research method was a diagnostic survey, with the main assessment tool being the ‘Questionnaire for Assessment of Implementation of Physical Education at Secondary School’ by Krystyna Górna-Łukasik from the Jerzy Kukuczka Academy of Physical Education in Katowice. On the basis of the study results, an attempt was made to determine the forms and methods of work and the involvement of various types of teachers in health education. The statistical analysis sought correlations between the students' opinions about the ways in which the curriculum content was implemented, university majors, and PE teachers’ sex.

The quadruple burden of diseases, early discharge from hospital and hospital at home have resulted in home-based care services becoming a requirement in South Africa. The home-based care services generate a significant amount of health care risk waste that is mismanaged. However, more attention is given to the health care risk waste generated in hospitals and clinics than to health care risk waste generated by home-based caregivers. Therefore, this study investigates the health care risk waste management practices by home-based caregivers. The study adopted a mixed research approach, qualitative and quantitative methods, using a literature review, interviews, and questionnaires as means of data collection. Results show that there are different types of health care risk waste generated as a result of different activities performed by home-based caregivers, but that the waste was found to be managed in an unsafe manner. The majority of households receiving home-based care did not have basic sanitation facilities such as toilets, running water and waste removal services, aggravating the issue of health care risk waste mismanagement. The study recommends a new policy framework that will lead to safe management practices of generated health care risk waste to be adopted by home-based caregivers.

Background: Foodborne disease is a major public health concern in both developed and developing countries. China has established a nationwide Foodborne Disease Outbreak Surveillance System (FDOSS) for collection and periodic reporting of data on the occurrence and causes of foodborne disease outbreaks in China. Each provincial Centers for Disease Control and Prevention (CDC) conducts the system working. Methods We reviewed foodborne disease outbreaks that occurred during 2011-2016 in Shandong Province from the FDOSS. The Wilcoxon test was used to compare the median number of ill persons in outbreaks. All data analysis was performed using Epi Info 7. Results: During 2011-2016, Shandong CDC received reports of 1043 foodborne disease outbreaks, resulting in 8078 illnesses, 2442 hospitalizations, and 17 deaths. Hotels were the most common setting. Among the 744 (71.3%) outbreaks with an implicated food or contaminated ingredient reported, 704 (94.6%) could be assigned to one of 17 predefined commodity categories. Of the 280 outbreaks with a known aetiology, 117(41.8%) were caused by poisonous plants and animals and their toxins, 39(13.9) were caused by nitrite, and 27(9.6%) were caused by vibrio parahaemolyticus. Conclusion: Timely investigation, disposal and reporting of foodborne disease outbreaks provides information that might help FDOSS to make full use of efficiency and FDOSS should be continued and strengthened even more in Shandong Province, such as an increase in diagnostic laboratory capacities.

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and out-comes including disabling and life-threatening complications. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordina-tion, and psychosocial support for patients and their caregivers. This study examined factors as-sociated with hospital discharge to home health care and subsequent utilization of home health care among a cohort of Medicare beneficiaries with diabetes, age 50 and older, living in the United States. The cohort (n=786,758) was followed for 14 days after a diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014-2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood area deprivation, and rural/urban setting. In ful-ly adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8-0.8) and American Indian (OR 0.8, CI 0.8-0.8) compared to white patients. Among those discharged to home health care, all racial/ethnic minority patients were less likely to receive services within 14-days. Further work should focus on eliminating systemic racism in home health care referral and systemic barriers to receiving home health care services.

Telemedicine has emerged as a transformative tool in modern healthcare, particularly during the COVID-19 pandemic, which catalyzed its rapid expansion. Despite its demonstrated potential in enhancing remote patient monitoring, AI-driven diagnostics, and telepsychiatry, widespread adoption of telemedicine remains constrained by persistent barriers. This review examines the current state of telemedicine, identifying major advancements alongside key challenges that impede its full integration into global healthcare systems. These barriers include the digital divide, regulatory inconsistencies across regions, and patient concerns about data security and the quality of virtual care. Addressing these issues requires a coordinated multi-sectoral approach, emphasizing infrastructure development, regulatory harmonization, patient education, and the incorporation of emerging technologies such as AI, blockchain, and virtual reality. By overcoming these challenges, telemedicine can be established as a cornerstone of equitable, accessible, and patient-centered healthcare worldwide.

This research was aimed to apply probiotics in aquaculture to improve fish health and growth performances of Nile tilapia. Fingerlings with a mean initial body weight of 11.43±1.27 and mean initial body length of 6.2±0.84 were stocked in 12 happas. Fish were fed four times daily with four different diets having 30% crude protein at 5% of their body weight and reared for two months. The four diets were control diet, diets treated with Saccharomyces cervisiae, Lactobacillus fermentum and their combinations at a dosage of (1.5×108CFU/ml). Growth performance and gut pathogenic microbial of fish were investigated. Accordingly results indicated that the highest performance interims of body weight gain (33.43±1.65g), daily growth rate (0.51±0.05g), feed conversion ratio (1.89±0.10), and protein efficiency ratio (1.78±0.09) was achieved in fish fed with L. fermentum whereas, the lowest performance (19.83±2.23, 0.33±0.04, 3.52±0.39, and 0.97±0.11) respectively was achieved in fish fed with control diet. Salmonella, Shigella, E. coli and, Proteus were detected in gut of fish. In conclusion, the present study confirmed that Nile tilapia fed with probiotics Lac-tobacillus fermentum and Saccharomyces cerevisiae based diets improved growth and health of Nile tilapia reared under pond culture condition.

The study of the distribution and health risk assessment is meaningful to provide basic data for environmental management．To investigate the pollution of potential toxic organics and their health risk to human beings, water samples were collected at 7 sites of main surface water of Beijing during wet and dry seasons respectively. The targeted 92 organics were detected, including phthalates (PAEs), volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs) and phenols. The results showed that: there were 56 organics detected out, and the number ratios of detected compounds to the total compounds of the same kind increased as the following: VOCs, phthalates, phenols, PAHs. 8 VOCs were detected in wet season, and 3 in dry season. The concentration of 2,2-Dichloropropane was highest as 10.62ug/L, while the concentrations of other VOCs were below 5ug/L; There were 11 phthalates detected during dry season. The content of Bis(2-methoxyethyl) phthalate was highest as 188.47ng/L; 17 phenols were found in samples during wet season, and the highest concentration was 1244.73ng/L for 4-nitrophenol; PAHs could be detected in all samples, and the detected compounds and the corresponding average concentrations were higher in wet seasons than those in dry seasons, which indicated that non-point pollution was possibly the main pollution source. The health risk assessment of the detected 56 pollutants by using a model from US EPA showed that, the risk caused by the four kinds of toxic organics in this study was in the acceptable ranges.

A study was conducted to investigate the occurrence of Trypanosoma vivax infection in 72 Murrah buffaloes from Soure, a municipality located on Marajó Island. The aim of the research was to identify the presence of T. vivax in the buffalo population. Blood samples were collected, followed by DNA extraction and polymerase chain reaction (PCR) analysis using the primers TviCatL1 and DTO 155. T. vivax DNA was detected in one 36-month-old female with a body condition score of 2 (on a scale of 1 to 5), although the animal exhibited no clinical signs of infection. These findings suggest that T. vivax is not frequently circulating among the tested buffaloes, or that the animals may be in the chronic phase of infection, which is often characterized by low parasitemia levels. The identification of T. vivax in a clinically asymptomatic animal underscores the importance of using molecular diagnostics for early detection and monitoring of the parasite in buffalo herds, especially in regions where the presence of T. vivax may be underestimated. This study contributes to understanding the epidemiological status of T. vivax in buffaloes on Marajó Island, highlighting the need for ongoing surveillance in endemic areas.

Brucellosis is an important infectious disease caused by bacteria of the genus Brucella. In the northeast region of Portugal, brucellosis is endemic in small ruminants, and there are also human cases. However, the epidemiological role of the wild boar in the dynamics of this disease in this region is unknown. For this reason, a total of 332 blood samples were collected from wild boar hunted in thirty-six hunting areas during the 2022/2023 hunting season. All were taken by the hunters for private consumption, with no evisceration and examination in the field. Serum sam-ples were tested by i-ELISA. It was observed that 88 wild boars were exposed to Brucella spp., pointing to a seroprevalence of 26.5% (95% CI: 21.8% – 31.3%). This high prevalence underlines the importance that wild boar may have in the dynamics of this disease in the region and its po-tential transmission to other animals and to human, for example, during the handling of carcasses. Increased awareness and knowledge of brucellosis in wild boar is essential for the implementation of effective practices and habits and, consequently, for the control and prevention of this important zoonosis.

This study explored the living situations, financial conditions, religious obligations, and social distancing of Muslims during the covid 19 pandemic. In total, 20 Muslim community members living in the Kanto region were recruited, 15 of them were included in the in-depth qualitative and five in the focus group interviews. The Snowball method was used, and the questionnaires were designed into four themes. The audio/video interviews were conducted via Zoom and NAVIO was used to analyse the data thematically. The major Muslim events were cancelled, and the recommended physical distancing was maintained during the prayers at home and in the mosques. The Japanese government's financial support to each person was a beneficial step towards social protection, which was highlighted and praised by every single participant. Regardless of religious obligations, the closer of all major mosques in Tokyo demonstrates to the Japanese community how serious they are about adhering to the public health guidelines during the pandemic. This study highlighted that the pandemic has affected the religious patterns and behaviour of Muslims from inclusive to exclusive in a community and narrated the significance of religious commitments.

Along with the increasing number of Covid-19 cases, the development of false news or misinformation about Covid-19 -19 is getting bigger. This article aims to analyze public opinion about the various hoaxes that were widely spread in Indonesia during the pandemic. The method used is a mixture, namely literature review, in the form of searching for related journals regarding the distribution of hoaxes during the pandemic and conducting online surveys via a google form. The research conducted indicates that during the pandemic there were rapid spreads of fake news, it is proven with more than 45% of the participants who were often heard hoax news about Covid-19 on online media. From this evidence, it also can be discovered that hoax news can affect a person's belief in the Covid-19 virus.