Over recent decades, therapeutic proteins have had widespread success in treating a myriad of diseases. Glycosylation, a near universal feature of this class of drugs, is a critical quality attribute that significantly influences the physical properties, safety profile and biological activity of therapeutic proteins. Optimizing protein glycosylation, therefore, offers an important avenue to developing more efficacious therapies. In this review, we discuss specific examples of how variations in glycan structure and glycoengineering impacts the stability, safety, and clinical efficacy of protein-based drugs that are already in the market as well as those that are still in preclinical development. We also highlight the impact of glycosylation on next generation biologics such as T cell-based cancer therapy and gene therapy.

In this paper, we introduce the application of Type-I fuzzy inference systems (FIS) as an alternative to improve the prioritization in the FMECA analysis applied in cyber-power grids. Classical FMECA assesses the risk level through the Risk Priority Number (RPN). The multiplication between three integer numbers computes this, called risk factors, representing the severity, occurrence, and detectability of each failure mode and are defined by a team of experts. The RPN does not consider any relative importance between the risk factors and may not necessarily represent the real risk perception of the FMECA team members, usually expressed by natural language; this is the main FMECA shortcoming criticized in the literature. Our approach considers fuzzy variables defined by FMECA experts to represent the uncertainty associated with the human language and a rule base consisting of 125 fuzzy rules to represent the risk perception of the experts. To test our approach, we select a cyber-power grid previously analyzed by the authors using the classical FMECA. The results reveal our proposed fuzzy approach as promissory to represent the uncertainty associated with expert knowledge and to perform an accurate prioritization of failure modes in the context of electrical power systems.

Although there are several access control systems in the literature for flexible policy management in multi-authority and multi-domain environments, achieving interoperability & scalability, without relying on strong trust assumptions, is still an open challenge. We present HMBAC, a distributed fine-grained access control model for shared and dynamic multi-authority and multi-domain environments, along with Janus, a practical system for HMBAC policy enforcement. The proposed HMBAC model supports: (a) dynamic trust management between different authorities; (b) flexible access control policy enforcement, defined at domain and cross-domain level; (c) a global source of truth for all entities, supported by an immutable, audit-friendly mechanism. Janus implements the HMBAC model and relies on the effective fusion of two core components. First, a Hierarchical Multi-Blockchain architecture that acts as a single access point that cannot be bypassed by users or authorities. Second, a Multi-Authority Attribute Based Encryption protocol that supports flexible shared multi-owner encryption, where attribute keys from different authorities are combined to decrypt data distributedly stored in different authorities. Our approach was implemented using Hyperledger Fabric as the underlying blockchain, with the system components placed in Kubernetes Docker container pods. We experimentally validated the effectiveness and efficiency of Janus, while fully reproducible artifacts of both our implementation and our measurements are provided.

Classical and optimal control architectures for motion mechanics with fusion of noisy sensors use different algorithms and calculations to perform and control any number of physical demands, to varying degrees of accuracy, precision, and cost. Their performances are tested for the purpose of comparison through the means of a Monte Carlo simulation that simulates how different parameters might vary under noise, representing real-world imperfect sensors. We find that improvements in one figure of merit often come at a cost in the performance in the others, especially depending on the presence of noise in the system sensors. If sensor noise is negligible, open-loop optimal control performs the best. However, in the overpowering presence of sensor noise, using a control law inversion patching filter performs as the best replacement, but has significant computational strain.

Proton exchange membrane water electrolyzers (PEMWEs) for water electrolysis have received tremendous attention due to their immediate response, high proton conductivity, low ohmic losses and gas crossover rate. However, design high activity, economical and long-term durable electrocatalysts in an acidic environment is still the bottleneck to realize the large-scale commercialization of PEMWEs. Iridium-based materials represent one of the most promising classes of oxygen evolution reaction (OER) catalysts due to their intrinsic stability in acid media over ruthenium-based counterparts. However, only a few innovative approaches have been developed to synthesizing iridium-based catalysts (IBCs) in the past decade, mainly due to achieving high activity may deteriorate the stability of IBCs. Accordingly, various engineering strategies of optimizing IBCs have been proposed to address this issue, including doping engineering, morphology engineering, crystal phase engineering and support engineering. Herein, a critical overview focusing on various synthesis and modulation strategies of IBCs is presented, based on an in-depth understanding of the relationship between electronic structures, charge redistribution and activity as well as stability of the electrocatalysts. In addition, the unprecedented achievements in PEMWEs are summarized. The reaction mechanisms and future perspectives are critically discussed to inspire more rational design of IBCs toward practical applications.

Fluorescence microscopy is an important tool for disease diagnosis, often requiring costly optical components, such as fluorescence filter cubes and high-power light sources. Due to its high cost, conventional fluorescence microscopy cannot be fully exploited in low-income settings. Smartphone-based fluorescence microscopy becomes an interesting low-cost alternative, but raises challenges in the optical system. We present the development of a low-cost inverted laser fluorescence microscope, that uses a smartphone to visualize the fluorescence image of biological samples. Our fluorescence microscope uses a laser-based simplified optical filter system, that provides analog optical filtering capabilities of a fluorescence filter cube. Firstly, we validated our inverted optical filtering by visualizing microbeads labeled with three different fluorescent compounds or fluorophores, commonly used for disease diagnosis. Secondly, we validated the disease diagnosis capabilities, by comparing the results of our device with those of a commercial fluorescence microscope. We successfully detected and visualized Trypanosoma cruzi parasites, responsible of the Chagas infectious disease, and the presence of Antineutrophil cytoplasmic antibodies of the ANCA non-communicable autoimmune disease. The samples were labeled with the fluorescein isothiocyanate (FITC) fluorophore, one of the most commonly used for disease diagnosis. Our device provides a 400 X magnification and is at least two orders magnitude cheaper than conventional commercial fluorescence microscopes.

Nature-based solutions (NbS) - working with and enhancing nature to address societal challenges - are increasingly being featured in climate change adaptation policy and plans. While there is growing evidence that NbS can reduce vulnerability to climate change impacts in general, there is a lack of understanding on the mechanisms through which this can be achieved, particularly in the Global South. To address this, we analyse 85 nature-based interventions in rural areas across the Global South, and factors mediating their effectiveness, based on a systematic map of peer-reviewed studies encompassing a wide diversity of ecosystems, climate impacts, and intervention types. We develop and apply an analytical framework of people’s social-ecological vulnerability to climate change, in terms of six pathways of vulnerability reduction: social and ecological exposure, sensitivity, and adaptive capacity. Most cases (95%) report a reduction in vulnerability, primarily by lowering ecosystem sensitivity to climate impacts (73% of interventions), followed by reducing social sensitivity (52%), reducing ecological exposure (36%), increasing social adaptive capacity (31%), increasing ecological adaptive capacity (19%) and/or reducing social exposure (14%). An analysis of mediating factors shows that social dimensions are equally important as technical factors in NbS to achieving equitable and effective outcomes. Attention to the distinct social and ecological pathways through which vulnerability is reduced helps to harness the multiple benefits of working with nature in a warming world.

Reliable quantification of pulmonary arterial pressure is essential in the diagnostic and prognostic assessment of a range of cardiovascular pathologies including rheumatic heart disease, yet an accurate and routinely available method for its quantification remains elusive. This work proposes an approach to infer pulmonary arterial pressure based on scientific machine learning techniques and non-invasive, clinically available measurements. A 0-D multicompartment model of the cardiovascular system was optimized using several optimization algorithms, subject to forward-mode automatic differentiation. Measurement data were synthesized from known parameters to represent the healthy, mitral regurgitant, aortic stenosed and combined valvular disease situations with and without pulmonary hypertension. Eleven model parameters were selected for optimization based on 95 % explained variation in mean pulmonary arterial pressure. A hybrid Adam and limited-memory Broyden-Fletcher-Goldfarb-Shanno optimizer yielded the best results with input data including valvular flow rates, heart chamber volume changes and systematic arterial pressure. Mean absolute percentage errors ranged from 1.8 % to 3.78 % over the simulated test cases. The model was able to capture pressure dynamics under hypertensive conditions with pulmonary arterial systole, diastole, and mean pressure average percentage errors of 1.12 %, 2.49 % and 2.14 %, respectively. The relatively low errors highlight the potential of the proposed model to recover pulmonary pressures for diseased heart valve and pulmonary hypertensive conditions.

Previous research has either neglected to consider misbehaviour or misconduct in the virtual workplace during the current COVID-19 pandemic or highlighted some challenges encountered with remote working or work from home but in isolation, e.g., misbehaviours or ethical concerns associated with improper use of technology when accessing clients’ confidential information, without understanding their aetiology and context in a holistic manner. This has impacted the ability of existing research in providing recommendations organisations can practically implement to improve the sustainability and productivity of the virtual workplace, especially as they seek to navigate the current pandemic and prepare for the global business environment in the next decade. Instead, this study, for the first time, proposes a novel holistic methodology to identify the aetiologies of ethical and performance challenges with focus to the Information Technology consulting sector, as well as developing a set of recommendations companies can adopt to manage such behavioural and productivity challenges. Thus, this study illustrates the key issues associated with remote working implemented to respond to the current COVID-19 pandemic, which mine not only the individual performance in an organisation but also its overall productivity, as well as suggests the main performance and reward management strategies that can be leveraged to mitigate them. Tailored strategies are described and discussed as referred to this industry to help in navigating a more unstable yet competitive market to manage the virtual employees’ misbehaviours in the workplace and drive growth for individuals and organisations alike.

Coronavirus Disease-19 (COVID-19) is presently wreaking havoc on public health and socio-economic development. Besides the upper and lower respiratory tract involvement, gastrointestinal symptoms are also reported in COVID-19 patients through gut-lung axis. Finding its way through the feces of infected individuals and other sources, the genetic material of SARS-CoV-2 (ssRNA) is reported widely in wastewater and is being used as a fingerprint for its detection. With millions of cases arriving every day, there is a need to level up the testing speed efficiency. Due to the restricted sampling potential of testing laboratories, clinical testing is unable to track all the symptomatic and asymptomatic cases. Wastewater-based epidemiology (WBE) bestows an auxiliary monitoring tool that will contribute in community level screening. Sample collection, concentration, RNA extraction, quantification and data analysis are the main steps involved in implementation of WBE that can be relied upon as an alarm call for an upcoming wave, emergence of a new variant or any future pandemic. WBE can be a cheaper and more practical alternative to high end and sophisticated clinical testing for community transmission detection. Worldwide, there are more than 300 reports entailing the occurrence of SARS-CoV-2 in wastewater exhibiting unique temporal trends with five of them in India. This review aims to address the present knowledge on surveillance of SARS-CoV-2 in wastewater and its implications.

Premature ventricular contraction (PVC) is one of the common ventricular arrhythmias, which may cause stroke or sudden cardiac death. Automatic long-term electrocardiogram (ECG) analysis algorithms could provide diagnosis suggestion even early warning for physicians, however, they are mutually-exclusive in terms of robustness, generalization and low complexity. In this study, a novel PVC recognition algorithm that combines deep learning-based heartbeat template clusterer and expert system-based heartbeat classifier is proposed. Long short-term memory-based auto-encoder (LSTM-AE) network was used to extract features from ECG heartbeats for K-means clustering. Thus, the templates were constructed and determined based on clustering results. Finally, the PVC heartbeats were recognized based on a combination of multiple rules, including template matching and rhythm characteristics. Three quantitative parameters, sensitivity (Se), positive predictive value (P+) and accuracy (ACC), were used to evaluate the performances of the proposed method on the MIT-BIH Arrhythmia database and the St. Petersburg Institute of Cardiological Technics database. Se on the two test databases was 87.51% and 87.92%, respectively; P+ was 92.47% and 93.18%, respectively; and ACC was 98.63% and 97.89%, respectively. The PVC scores on the 3rd China Physiological Signal Challenge 2020 training set and hidden test set were 36,256 and 46,706, respectively, which could rank first in the open-source codes. The results showed that the combination strategy of expert system and deep learning can provide new insights for robust and generalized PVC identification from long-term single-lead ECG recordings.

Emotions or affective states recognition in farm animals is an underexplored research domain. Despite significant advances in the animal welfare research, the animal affective computing through the development and application of devices and platforms that can not only recognize but interpret and process the emotions, are in nascent stage. By capitalizing on the immense potential of biometric sensors, the artificial intelligence enabled big data methods substantially offers advancement of animal welfare standards and meet the urgent need of caretakers to respond effectively to maintain the wellbeing of their animals. Farm animals, numbering over 70 billion worldwide, are increasingly managed in large-scale, intensive farms. With both public awareness and scientific evidence growing that farm animals experience suffering, as well as affective states such as fear, frustration and distress, there is an urgent need to develop efficient and accurate methods for monitoring their welfare. At present, there are no scientifically validated ‘benchmarks’ for quantifying transient emotional (affective) states in farm animals, and no established measures of good welfare, only indicators of poor welfare, such as injury, pain and fear. Conventional approaches to monitoring livestock welfare are time consuming, interrupt farming processes and involve subjective judgments. Biometric sensors data enabled by Artificial Intelligence are an emerging smart solution to unobtrusively monitoring livestock, but their potential for quantifying affective states and groundbreaking solutions in their application are yet to be realized. This review provides innovative methods for collecting big data on farm animal emotions, which can be used to train artificial intelligence models to classify, quantify and predict affective states in individual pigs and cows. Extending this to the group level, social network analysis can be applied to model emotional dynamics and contagion among animals. Finally, ‘digital twins’ of animals capable of simulating and predicting their affective states and be-havior in real time are a near-term possibility.

In this paper we try to demonstrate that the classical model of certainty factos for dealing with innacurate knowledge can be efficiently implemented in a quantum environment. For this, we assume that certainty factors are strongly correlated with the quantum probability. We first explore the certainty factors approach for inexact reasoning from a classical point of view. Next, we introduce some basic aspects of quantum computing, and we pay special attention to quantum rule-based systems. We then build a use case: an inferential network to be implemented in both, the classical approach and the corresponding quantum circuit. Both implementations have been used to compare the behavior of the classical and the quantum approaches when confronted with the same hypothetical case. We analyze three different situations: (1) Only Imprecision (which refers to inaccuracy in declarative knowledge or facts) is present in the use case, (2) Only Uncertainty (which refers to inaccuracy in procedural knowledge or rules) is present in the use case, and (3) Both Imprecision and Uncertainty are present in the use case. Finally, we analyze the results to reach a conclusion about the eventually intrinsic probabilistic nature of the certainty factors model and to pave the way for future quantum implementations of this method for handling inaccurate knowledge.

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

The use of Information Communication Technologies (ICT) in education brings up new possibilities of promoting the learning and health experiences. In this sense, education contexts of 21st century must consider these two areas of knowledge, especially their integration. This article presents learning practices developed with mobile devices and games, in order to improve learning and well-being in children and adolescents undergoing cancer treatment in non-formal educational setting. The methodology is based on qualitative case studies with content-based data analysis, involving informal interviews and observation methods. The study considers data from 5 patients who participated in the research between 2015 and 2019. The results demonstrate a positive influence of the practices with mobile technologies and games in terms of learning and in the well-being feeling of patients during the treatment.

This paper provides a concise review of remote sensing of ocean fronts and its applications in marine ecology and fisheries, with a particular focus on the most popular front detection algorithms/techniques: Canny (1986), Cayula and Cornillon (1990, 1992, 1995), Miller (2004, 2009), Shimada et al. (2005), Belkin and O’Reilly (2009), and Nieto et al. (2012). A case is made for feature-based approach in marine ecology and fisheries that emphasizes fronts as major structural and circulation features of the ocean realm that play key roles in various aspects of marine ecology.

Nature-based Solutions (NbS) have rapidly been gaining traction across the research, policy, and practice spheres, touted as transformative actions to jointly address biodiversity loss and climate change. However, there are multiple, alternative ways to imagine NbS in those three spheres. To inform the NbS discourses across these three spheres, we critically reflect on the prevailing framing of NbS and consider the potential of a different framing of NbS to support transformations towards regenerative relationships between humans and nature. Such reflection is urgently needed to ensure that research, policy, and practice delivers on the transformative ambitions of NbS. We propose a novel “core framing” of NbS, charting two pathways for how such a framing can support a human value-based transformation – first through influencing individual beliefs and values, and second through the communication and application of the NbS concept in research, policy, and practice. We argue that for NbS to support transformation, it must support a reframing of human-nature relationships, one where the interdependencies between people and nature are recognized as essential for social and environmental well-being. We elaborate on how such a framing is key to support inclusivity and collaboration between diverse research perspectives, policy objectives across scales, and implementation practices, to deliver successful NbS.

The ongoing COVID-19 pandemic has raised numerous questions concerning the shape and range of state interventions whose goals are to reduce the number of infections and deaths. The lockdowns, which have become the most popular response worldwide, are assessed as being an outdated and economically inefficient way to fight the disease. However, in the absence of efficient cures and vaccines, there is a lack of viable alternatives. In this paper we assess the economic consequences of the epidemic prevention and control schemes that were introduced in order to respond to the COVID-19 pandemic. The analyses report the results of epidemic simulations that were obtained using the agent-based modelling methods under the different response schemes and their use in order to provide conditional forecasts of the standard economic variables. The forecasts were obtained using the DSGE model with the labour market component.

The global use of alcohol based hand sanitizers (ABHS) as a means of controlling the transmission of infectious disease increased dramatically in 2020 as governments and public health agencies across the world advocated hand hygiene as a preventative measure during the COVID-19 pandemic. Although the performance of these products is most commonly defined as a function of their alcohol concentration, they are multifaceted products in which an interplay of several factors is important in determining efficacy. The hand sanitizer tetrahedron, is a novel concept that considers both ABHS formulation factors and product performance factors from a multi-dimensional perspective. The four faces of the tetrahedron represent input/formulation factors: 1) the type and amount of alcohol, 2) inactive ingredients, 3) the type of formulation/delivery system and 4) manufacturing practices. The four corners of the tetrahedron represent output/product performance factors: 1) efficacy, 2) sensory characteristics, 3) usage, usability and compliance and 4) product safety/adverse effects. All factors are of importance to ensuring the effectiveness and utility of these products.

Gene editing tools such as CRISPR-Cas9 have created unprecedented opportunities for genetic studies in plants and animals. We designed a course-based undergraduate research experience (CURE) to train introductory biology students in the concepts and implementation of gene editing technology as well as develop their soft skills in data management and scientific communication. We present two versions of the course that can be implemented with twice-weekly meetings over a five-week period. In the remote-learning version, students perform homology searches, design guide RNAs and primers, and learn the principles of molecular cloning. This version is appropriate when access to laboratory equipment or in-person instruction is limited, such as closures that have occurred in response to the Covid-19 pandemic. In the in-person version, students design guide RNAs, clone CRISPR-Cas9 constructs, and perform genetic transformation of the model plant Arabidopsis thaliana. The highly parallel nature of the CURE makes it possible to target dozens to hundreds of genes, depending on the number of course sections available. Applying this approach in a sensitized mutant background enables focused reverse genetic screens for genetic suppressors or enhancers. The course can be readily adapted to other organisms or projects that employ gene editing.

In recent years, team-based learning (TBL) is gaining popularity as a student-centered active collaborative learning strategy in healthcare education. This paper reports the design, implementation, and impact of a "hybrid team-based learning" (H-TBL) for one respiratory lecture in year two undergraduate physiotherapy program in 2019. A retrospective study was conducted, including 136 second-year undergraduate physiotherapy students using H-TBL design for one respiratory lecture topic. Student engagement was evaluated based on the percentage of completion for pre-class work, attendance to classroom session, and submission of formative creative assignment. Student' performance on formative creative tasks was evaluated based on thinking and learning rubric. Student perceptions were assessed based on the student's feedback using "Mentimeter." 109/ 136 (80%) students attended the COPD 2 session. 90/109 (82%) students engaged in COPD 1 (web-based) and tRAT in COPD 2 session. 54/109 (50%) students provided feedback and 67/90 (74%) students submitted formal formative creative assignment on completion of COPD 2 session. This study confirms that H-TBL enhances student's active engagement, creativity, and equilibration of their subject knowledge. Future randomized studies are mandated to explore the validity and specificity of H-TBL in diverse physiotherapy curriculum to evaluate the long-term student engagement and academic performance.

Adaptive bitrate (ABR) algorithms optimize the quality of streaming experiences for users in client-side video players especially in unreliable or slow mobile networks. Several rule-based heuristic algorithms can achieve stable performance, but they sometimes fail to adapt properly to changing network conditions. Fluctuating bandwidth may cause algorithms to default to behavior that creates a negative experience for the user. ABR algorithms can be generated with reinforcement learning, a decision-making paradigm in which an agent learns to make optimal choices through interactions with an environment. Training reinforcement learning algorithms for bitrate streaming requires building a simulator for an agent to experience interactions quickly; training an agent in the real environment is infeasible due to the long step times in real environments. This project explores using supervised learning to construct a world-model, or a learned simulator, from recorded interactions. A reinforcement learning agent trained inside of the learned model, rather than a simulator, can outperform rule-based heuristics. Furthermore, agents trained inside the learned world-model can outperform model-free agents in low sample regimes. This work highlights the potential for world-models to quickly learn simulators, and to be used to generate optimal policies.

The advance of the medical field in the 21st century has influenced the development of many innovations, including in medical education. PBL (problem-based learning) is one of the pedagogical approaches that has been studying and implementing worldwide to attract medical students’ attention with their learning style and learning environment. China is the most significant “receiver” country of foreign students in Asia, and clinical medicine is one of the most chosen majors for undergraduate. In China, PBL has been implementing in some schools, but mostly with the local students and only a few implementations to the international students. International medical students in China faced a variety of challenges during their studies. In this review paper, we give the solution to adapt to the challenges by focusing on the implementation the integrated organ/system curriculum/syllabus with the PBL method to the school system with the support of the school stakeholders and students’ role.

In the present work, the state of the art of the most common additive manufacturing (AM) technologies used for the manufacturing of complex shape structures of graphene-based ceramic nanocomposites, ceramic and graphene-based parts is explained. A brief overview of the AM processes for ceramic, which are grouped by the type of feedstock used in each technology, is presented. The main technical factors that affect the quality of the final product were reviewed. The AM processes used for 3D printing of graphene-based materials are described in more detail; moreover, some studies in a wide range of applications related to these AM techniques are cited. Furthermore, different feedstock formulations and their corresponding rheological behaviour were explained. Additionally, the most important works about the fabrication of composites using graphene-based ceramic pastes by Direct Ink Writing (DIW) are disclosed in detail and illustrated with representative examples. Various examples of the most relevant approaches for the manufacturing of graphene-based ceramic nanocomposites by DIW are provided.

The major stress-inducible Hsp70 (HSPA1A) is overexpressed in the cytosol of many highly aggressive tumor cells including glioblastoma multiforme and presented on their plasma membrane. Depending on its intracellular or membrane localization, Hsp70 either promotes tumor growth or serves as a target for NK cells. The kinetics of the membrane Hsp70 (mHsp70) density on human glioma cells (U87) was studied after different irradiation doses to define the optimal therapeutic window for Hsp70-targeting NK cells. To maintain the cells in the exponential growth phase during a cultivation period of 7 days different initial cell counts were seeded. Although cytosolic Hsp70 levels remained unchanged on days 4 and 7 after a sublethal irradiation with 2 Gy, 4 Gy and 6 Gy, a dose of 2 Gy resulted in an upregulated mHsp70 density in U87 cells which peaks on day 4 and starts to decline on day 7. Higher radiation doses (4 Gy, 6 Gy) resulted in an earlier and more rapid onset of the mHsp70 expression on days 2 and 1, respectively, followed by a decline on day 5. Membrane Hsp70 levels are higher in G2/M than in G1, however, an irradiation-induced cell cycle arrest on days 4 and 7, was not associated with an increase in the mHsp70 density. Extracellular Hsp70 concentrations increased significantly compared to sham (0 Gy) irradiated cells on days 4 and 7 but not on day 1. Functionally, elevated mHsp70 densities were associated with a significantly better lysis by Hsp70-targeting NK cells. In summary, the kinetics of changes in the mHsp70 density upon irradiation on tumor cells is time- and dose-dependent.

Prediction of stock groups values has always been attractive and challenging for shareholders. This paper concentrates on the future prediction of stock market groups. Four groups named diversified financials, petroleum, non-metallic minerals and basic metals from Tehran stock exchange are chosen for experimental evaluations. Data are collected for the groups based on ten years of historical records. The values predictions are created for 1, 2, 5, 10, 15, 20 and 30 days in advance. The machine learning algorithms utilized for prediction of future values of stock market groups. We employed Decision Tree, Bagging, Random Forest, Adaptive Boosting (Adaboost), Gradient Boosting and eXtreme Gradient Boosting (XGBoost), and Artificial neural network (ANN), Recurrent Neural Network (RNN) and Long short-term memory (LSTM). Ten technical indicators are selected as the inputs into each of the prediction models. Finally, the result of predictions is presented for each technique based on three metrics. Among all algorithms used in this paper, LSTM shows more accurate results with the highest model fitting ability. Also, for tree_based models, there is often an intense competition between Adaboost, Gradient Boosting and XGBoost.

Visual Patient technology is a situation awareness–oriented visualization technology that translates numerical and waveform patient monitoring data into a new user-centered visual language. Vital sign values are converted into colors, shapes, and rhythmic movements—a language humans can easily perceive and interpret—on a patient avatar model in real time. In this review, we summarize the current state of the research on the Visual Patient, including the technology, its history, and its scientific context. We also provide a summary of our primary research and a brief overview of research work on similar user-centered visualizations in medicine. In several computer-based studies under various experimental conditions, Visual Patient transferred more information per unit time, increased perceived diagnostic certainty, and lowered perceived workload. Eye tracking showed the technology worked because of the way it synthesizes and transforms vital sign information into new and logical forms corresponding to the real phenomena. The technology could be particularly useful for improving situation awareness in settings with high cognitive demand or when users must make quick decisions. This comprehensive review of Visual Patient research is the foundation for an evaluation of the technology in clinical applications, starting with a high-fidelity simulation study in early 2020.

UAVNs (unmanned aerial vehicle networks) may become vulnerable to threats and attacks due to their characteristic features such as high mobility, highly dynamic network topology, and open-air wireless environments. Since previous work has focused on classical and metaheuristic-based approaches, none of these approaches have a self-adaptive approach. In this article, we examine the challenges of cyber detection methods to secure UAVNs and review exiting security schemes proposed in the current literature. Furthermore, we propose an agent-based self-protective method (ASP-UAVN) for UAVNs that is based on the Human Immune System (HIS). In ASP-UAS, the safest route from the source UAV to the destination UAV is chosen according to a self-protective system. In this method, a multi-agent system using an Artificial Immune System (AIS) is employed to detect the attacking UAV and choose the safest route. In the proposed ASP-UAVN, the route request packet (RREQ) is initially transmitted from the source UAV to the destination UAV to detect the existing routes. Then, once the route reply packet (RREP) is received, a self-protective method using agents and the knowledge base is employed to choose the safest route and detect the attacking UAVs. The method is evaluated here via extensive simulations carried out in the NS-3 environment. The experimental results of four scenarios demonstrated that the ASP-UAS increases the Packet Delivery Rate (PDR) by more than 17.4, 20.8, and 25.91%, and detection rate by more than 17.2, 23.1, and 29.3%, and decreases the Packet Loss Rate (PLR) by more than 14.4, 16.8, and 20.21%, the false-positive and false-negative rate by more than 16.5, 25.3, and 31.21% those of SUAS-HIS, SFA and BRUIDS methods, respectively.

As of today, 20 disease modifying drugs (DMD) have been approved for the treatment of relapsing multiple sclerosis (MS) and, based on their efficacy, they can be grouped into moderate-efficacy DMDs and high-efficacy DMDs. The choice of the drug mostly relies on the judgement and experience of neurologists and the evaluation of therapeutic response can only be obtained by monitoring clinical and magnetic resonance imaging (MRI) status during follow up. In an era where therapies are focused on personalization, the aim of this study is to develop a modeling infrastructure to predict the evolution of relapsing MS and the response to treatments. We built a computational modeling infrastructure named UISS (Universal Immune System Simulator) able to simulate the main features and dynamics of the immune system activities. We extended UISS to simulate all the underlying MS pathogenesis and its interaction with the host immune system. This simulator is a multi-scale, multi-organ, agent based simulator with an attached module capable of simulating the dynamics of specific biological pathways at the molecular level. We simulated six MS patients with different relapsing-remitting courses. These patients were characterized on the basis of their age, sex, presence of oligoclonal bands, therapy and MRI lesion load at onset. The simulator framework is made freely available and can be used following the links provided in the availability section. Even though the model can be further personalized employing immunological parameters and genetic information, based on the available data we generated a few simulation scenarios for each patient, including those who matched the real clinical and MRI history. Moreover, for two patients, the simulator anticipated the timing of subsequent relapses, which really occurred, suggesting that UISS may have the potential to assist MS specialists in predicting the course of the disease and the response to treatment.

The sensor nodes have limited computation, sensing, communication capabilities and generally operated by batteries in a harsh atmosphere with non-replenish able power sources. These limitations force the sensor network subject to failure because most of the energy is spent on sensing, computing and data transmission. This paper introduces an Energy Efficient Clustering and Shortest-Path Routing Protocol (EECSRP) to assist Wireless Sensor Networks (WSNs) by (a) extending the lifespan of the network (b) effectively using the battery power (c) decreasing the network overhead and (d) ensuring a high packet transmission ratio with minimal delay. The delay time-based Cluster Head (CH) is elected based on the node degree, residual energy and Received Signal Strength (RSS) to accomplish the goal. Additionally, the RSS-based network partitioning is implemented to evaluate the gradient based on demand routing between source (sensing node) and destination (BS). Whenever the current CH residual energy goes under the threshold level, the proposed protocol performs the clustering process, reducing the exchange of control packets. However, the BS periodically gathers the data from every single CH which helps to reduce the collision and Medium Access Control (MAC) layer conflict. From the simulation results, it is the evident that the proposed protocol performance in terms of average end-to-end latency, packet delivery ratio, average energy consumption and control overhead is better than the well-known current protocols.

This study presents a path planning method for a mobile robot to be effectively operated through a multi-objective decision-making problem. Specifically, the proposed Fuzzy analytic hierarchy process (FAHP) determines an optimal position as a sub-goal within the multi-objective boundary. The key features of the proposed FAHP are evaluating the candidates according to the fuzzified relative importance among objectives to select an optimal solution. In order to incorporate FAHP into path planning, an AHP framework is defined, which includes the highest level (goal), middle level (objectives), and the lowest level (alternatives). The distance to the target, robot’s rotation, and safety against collision between obstacles are considered as objective functions. Comparative results obtained from the artificial potential field and AHP/FAHP simulations show that FAHP is much preferable for the mobile robot’s path planning than typical AHP.

This study assessed bio-equivalence of high-quality, plant-based protein blends versus Whey Protein Isolate (WPI) in healthy, resistance-trained men. The primary endpoint was incremental area under the curve (iAUC) of blood essential Amino Acids (eAAs) 4 hours after consumption of each product. Cmax and Tmax of blood leucine were secondary outcomes. Subjects (n=18) consumed three plant-based protein blends and WPI (control). Analysis of Variance model was used to assess for bio-equivalence of total sum of blood eAA concentrations. The total blood eAA iAUC ratios of the three blends were: [90% CI]: #1: 0.66 [0.58-0.76]; #2: 0.71 [0.62-0.82]; #3: 0.60 [0.52-0.69], not completely within the pre-defined equivalence range [0.80-1.25], indicative of 30-40% lower iAUC versus WPI. Leucine Cmax of the three blends was not equivalent to WPI, #1: 0.70 [0.67-0.73]; #2: 0.72 [0.68-0.75]; #3: 0.65 [0.62 – 0.68], indicative of a 28-35% lower response. Leucine Tmax for two blends were similar to WPI (#1: 0.94 [0.73-1.18]; #2: 1.56 [1.28-1.92]; #3: 1.19 [0.95-1.48]). The plant-based protein blends were not bio-equivalent. However, blood leucine kinetic data across the blends approximately doubled from fasting concentrations whereas blood Tmax data across two blends was similar to WPI. This suggests evidence of rapid hyperleucinemia, which correlates with a protein’s anabolic potential.

Failure of various weight-loss programs and long-term maintenance of favorable body composition in all kinds of people is high, since the majority go back to old dietary patterns. Many studies have documented the efficacy of a plant-based diet (PBD) for body mass management, but there are opinions that maintaining a PBD is difficult. We aimed to evaluate the long-term success of a whole-food plant-based (WFPB) lifestyle program. We investigated the differences in the obesity indices and lifestyle of 151 adults (39.6 ± SD 12.5 years), who were on our program for short (0.5–<2 years), medium (2–<5 years), or long term (5–10 years). Body-composition changes were favourable for all three groups, both genders and all participants. There were no differences in relative body-composition changes (BMI, body fat percentage and muscle mass index (MMI)) between the three groups. All participants improved their BMI (baseline mean pre-obesity BMI range (kg/m²): 26.4 ± 5.6 to normal 23.9 ± 3.8, p < 0.001), decreased body mass (–7.1 ± 8.3 kg, p < 0.001) and body fat percentage (–6.4 ± 5.6 % points, p < 0.001). Those with the highest BMI at baseline lost the most of: a) BMI units, b) total body mass and c) body fat (a) (kg/m²) (–5.6 ± SD 2.9, –2.4 ± 1.8 and –0.9 ± 1.5), b) (kg) (–16.1 ± SD 8.8, –7.1 ± 5.4 and –2.5 ± 4.5) and c) (% points) (–9.5 ± SD 5.7, –6.6 ± 4.6 and –4.7 ± 5.3) for participants who had baseline BMI in obese, overweight and normal range, respectively; p_{baseline vs. current} < 0.001 for all). 85.6% (101 out of 118) of parents of underage children (< 18 years), introduced WFPB lifestyle to their children. WFPB lifestyle program provides long-term lifestyle changes for reversal of obesity and is effective transferred to the next generation.

Aquaporin-3 (AQP3) is one of the aquaglyceroporins, which is expressed in the basolateral layer of the skin membrane. Studies have reported that human skin squamous cell carcinoma overexpresses AQP3 and inhibition of its function may alleviate skin tumorigenesis. In the present study, we have applied a virtual screening method that encompasses filters for physicochemical properties and molecular docking to select potential hit compounds that bind to the Aquaporin-3 protein. Based on molecular docking results, the top 20 hit compounds were analyzed for stability in the binding pocket using unconstrained molecular dynamics simulations and further evaluated for binding free energy. Furthermore, examined the ligand-unbinding pathway of the inhibitor from its bound form to explore possible routes for inhibitor approach to the ligand-binding site. With a good docking score, stability in the binding pocket, and free energy of binding, these hit compounds can be developed as Aquaporin-3 inhibitors in the near future.

Public access to high quality green environments has become a key issue for city managers and a matter of environmental justice. Remnants of natural ecosystems allow citizens a direct contact with nature, but conversely the presence of people contributes further to the existing disturbances. Urban pressures on ecosystem remnants may act to favour the expansion of some invasive species in cities. Whilst the negative impacts of invasive species on ecosystem function is well documented little is known how invasive species influence the use of green spaces by people. Here, we examined one of the few remnants of urban riparian forests in Europe, the Vistula river valley in Warsaw which has recently become an attractive recreation site. Despite their high ecological value, the poplar and willow forests have been increasingly taken over by the invasive tree species Acer negundo. We examined the status of the invasion process and the relationship between recreational ecosystem services and the characteristics of the tree stands – tree species, tree density and age and NDVI values. We found the willow forest to be more susceptible to invasion by A. negundo than the poplar forest, which was revealed in significantly higher share of the maple individuals and their greater volume per unit area. Presence of A. negundo affected biodiversity resulting in decreased undergrowth density and number of species. The use intensity by the public, assessed on the basis of trampling intensity and the density of existing informal tracks, were negatively correlated to the presence of A. negundo. This study highlights the need to integrate invasive species management into green infrastructure planning and management.

This study aimed to evaluate the impact of selected pregnancy pathologies statistically depending on overweight/obesity and excessive maternal weight gain during pregnancy on women who gave birth in the years 2013–2015 at the Second Department of Gynecology and Obstetrics at the University Hospital in Bratislava, Slovakia. In a retrospective study, we analyzed data gathered from the sample, which consisted of 7,122 women. Our results indicate a positive statistical dependency of the groups of women with overweight and obesity and gestational hypertension (adjusted odds ratio [AOR]=15.3; 95% CI 9.0−25.8 for obesity), preeclampsia (AOR=3.4; 95% CI 1.9−6.0 for overweight and AOR=13.2; 95% CI 7.7−22.5 for obesity), and gestational diabetes mellitus (AOR=1.9; 95% CI 1.2−2.9 for overweight and AOR=2.4; 95% CI 1.4−4.0 for obesity). A higher incidence of pregnancies terminated by cesarean section was observed in the group of obese women. Gestational weight gain above the IOM (the Institute of Medicine) recommendations was associated with a higher risk of pregnancy terminated by C-section (AOR=1.2; 95% CI 1.0−1.3), gestational hypertension (AOR=1.7; 95% CI 1.0−2.7), and infant macrosomia (AOR=1.7; 95% CI 1.3−2.1). Overweight and obesity during pregnancy significantly contribute to the development of pregnancy pathologies and increased incidence of cesarean section. Systematic efforts to reduce weight before pregnancy through pre-pregnancy dietary counseling, regular physical activity, and healthy lifestyle should be the primary goal.

Research on bidirectional human-machine interfaces will enable the smooth interaction with robotic platforms in contexts ranging from industry to tele-medicine and rescue. This paper introduces a bidirectional communication system to achieve multisensory telepresence during the gestural control of an industrial robotic arm. We complement the gesture-based control by means of a tactile-feedback strategy grounding on a spiking artificial neuron model. Force and motion from the robot are converted in neuromorphic haptic stimuli delivered on the user’s hand through a vibro-tactile glove. Untrained personnel participated in an experimental task benchmarking a pick-and-place operation. The robot end-effector was used to sequentially press six buttons, illuminated according to a random sequence, and comparing the tasks executed without and with tactile feedback. The results demonstrated the reliability of the hand tracking strategy developed for controlling the robotic arm, and the effectiveness of a neuronal spiking model for encoding hand displacement and exerted forces in order to promote a fluid embodiment of the haptic interface and control strategy. The main contribution of this paper is in presenting a robotic arm under gesture-based remote control with multisensory telepresence, demonstrating for the first time that a spiking haptic interface can be used to effectively deliver on the skin surface a sequence of stimuli emulating the neural code of the mechanoreceptors beneath.

Educating for Sustainability involves promoting sustainable competences in students. Not in vain, wider societal changes that ensure a balance between economic growth, respect for the environment and social justice must start with individual actions, implying knowledge, capacity and willingness to act. However, and although there is wide consensus that education should promote the development of competences for life, putting this theoretical tenet into may entail more problems. Competence is most often expressed in general terms without a specific definition of the intervening elements (knowledge, skills, values, attitudes), which may collide with the necessity of teachers – as learning planners - concrete entities on which to base their process of design. So that, in this work we propose a series of indicators that serve to characterize the four dimensions of scientific competence – contents of science, contents about science, value of science and utility of science-. Although they are primarily intended to be used to filter multimedia resources in an educational platform, this proposal of indicators can be extrapolated to the management and selection of a variety of resources and activities, and for sharing the objectives and evidences for the acquisition of competencies.

Vanadium titano-magnetite is a significant resource in China, and in this study, we characterize its isothermal reduction mechanisms in the mixture of H₂, CO, and N₂ where the variables considered here include reduction time, reduction temperature, gas composition, and pellet size. The kinetics of the reduction process are mainly studied, which follows a shrinking core model. The results indicate that the reduction degree of oxidized VTM pellets increases with the increase of reduction time, reduction temperature but decreases with the increase of pellet size. Moreover, we found that an increase of H₂/(H₂+CO) ratio induces an increase of the reduction degree. Then the transformation of main Ti-bearing mineral phases is discussed, and the most probable reaction mechanism is revealed. In the whole reduction process, the kinetic results confirm the existence of an early stage and a latter stage, which are controlled by interface chemical reaction and diffusion, respectively. Furthermore, the results show that the diffusion-control step can be observably shortened with the decrease of pellet size because a thinner product layer is formed during the reduction process. Our study thus provides a valuable technical basis on the VTM industrial application.

Low carbon cities are increasingly forming a distinct strand of sustainability literature. Models have been developed to measure the performance of low carbon cities. The purpose of this paper is to formulate a strategy-based model to evaluate current performance and predict future conditions of low carbon cities. It examines the dynamic interrelationships between key performance indicators (KPIs), induces changes to city plan targets and then instantly predicts the outcome of these changes. Designed generic and flexible, the proposed model shows how low carbon targets could be used to guide the transformation of low carbon cities under four strategies: (1) passive intervention, (2) problem solving, (3) trend modifying and (4) opportunity seeking. Further, the model has been applied to 17 cities and then tested on 5 cities: London, New York, Barcelona, Dubai and Istanbul. The paper concludes with policy implications to realign city plans and support low carbon innovation.

"The wisdom of crowd'' is so often observed in social discourses and activities around us. The manifestations of it are, however, so intrinsically embedded and behaviorally accepted that an elaboration of a social phenomenon evidencing such wisdom is often cheered as a discovery; or at least an astonishing fact. One such scenario is explored here, namely conceptualization and modeling of a food safety system, a system directly related to social cognition. Food safety is an area of concern these days. Models representing the food safety systems are recently published to study the effect of interactions between important entities of the system. For example, Knowles’s model finds conditions leading to a more efficient and dependable system of entities like consumers, regulators and stores with specific focus on regulators behavior and their impact on the food safety. The first contribution of this paper is reevaluation of Knowles’s model towards a more conscious understanding of ``the wisdom of crowd'' effects on inspection and consuming behaviors. The second contribution is augmenting of the model with social networking capabilities, which acts as a medium to spread information about stores and help consumers find stores which are not contaminated. Simulation results reveal that stores’ respecting social cognition improve effectiveness of the food safety system for consumers and stores both. Simulation findings also reveals that an active society has a capability to self-organize effectively even in the absence of any regulatory compulsion.

Intersectoral and intermunicipal cooperation are still underdeveloped spheres of public and economic development policies. Academic discussions are invariably focused on pro-competitive activities, the economic efficiency of which is not always sufficient. In this paper the authors attempt to identify factors leading to cooperation between local government authorities and economic entities, focusing on examples from the forest and wood-based sector in Poland. These processes are analysed in the framework of the New Institutional Economy, both in the theoretical and practical context.

Efficient member revocation and strong security against attacks are prominent requirements in group signature schemes. Among the revocation approaches Verifier-local revocation is the most flexible and efficient method since it requires to inform only the verifiers regarding the revoked members. The verifier-local revocation technique uses a token system to manage members’ status. However, the existing group signature schemes with verifier-local revocability rely on weaker security. On the other hand, existing static group signature schemes rely on a stronger security notion called, full-anonymity. Achieving the full-anonymity for group signature schemes with verifier-local revocation is a quite challenging task. This paper aims to obtain stronger security for the lattice-based group signature schemes with verifier-local revocability, which is closer to the full-anonymity. Moreover, this paper delivers a new key-generation method which outputs revocation tokens without deriving from the users’ signing keys. By applying the tracing algorithm given in group signature schemes for static groups, this paper also outputs an efficient tracing mechanism. Thus, we deliver a new group signature scheme with verifier-local revocation that satisfies a stronger security from lattices.

In this article, management control has been studied from the perspective of intention towards sustainable development of companies. The main idea focuses on the analysis of relations between sustainable management control and the system of performance appraisal using as a reference the resource-based theory. These relations have been assessed both theoretically by reviewing literature in the field, and empirically based on data collected in a questionnaire from top management, as well as data from Annual Reports from the main segment of Bucharest Stock Exchange. The authors have shown that financial performance has a significant influence on management control, and the return on capital employed is one of the most recommended indicators. The sustainable nature attributed to management control is the result of institutional theory evolution, provisions of Directive 2014/95/EU and Guide of Global Management Accounting Principles (2015) using stewardship. Consequently, profits are not the main element any more in the assessment of financial „health” of a company. To ensure the sustainable success, sustainable balanced scorecard is one of real measures for managing financial and non-financial performance.

Modern mobile devices are replete advanced sensors that expand the array of possible methods of locating users. This is often viewed in a positive light, as a tool to gather and use spatial information, but it also brings with it the problem of “geosurveillance” in which the “Location” becomes a product in itself. In the realm of software developers, this has been reduced and discretized to a set of coordinates, devoid of human experiences and meanings. To function in such digitally augmented realities, people need to adopt specific attitudes, often accompanied with anxiety. We explored attitudes toward locational data collection practices using questionnaire surveys (n = 280) from Poznan and Edinburgh. The prevailing attitude is neutral with a strong undertone of resignation, in which surrendering personal locational information is viewed as a digital currency. A smaller number of people had stronger, emotional views, either very positive or very negative, based on uncritical technological enthusiasm or fear of privacy violation. Such a wide spectrum of attitudes is not only produced by interaction with technology but can also be viewed as a result of different perceptions and values associated with space and place itself.

Orbit and clock products are used in real-time GNSS precise point positioning without knowing their quality. This study develops a new approach to detect orbit and clock errors through comparing geometry-free and geometry-based wide-lane ambiguities in PPP model. The reparameterization and estimation procedures of the geometry-free and geometry-based ambiguities are described in detail. The effects of orbit and clock errors on ambiguities are given in analytical expressions. The numerical similarity and differences of geometry-free and geometry-based wide-lane ambiguities are analyzed using different orbit and clock products. Furthermore, two types of typical errors in orbit and clock are simulated and their effects on wide-lane ambiguities are numerically produced and analyzed. The contribution discloses that the geometry-free and geometry-based wide-lane ambiguities are equivalent in terms of their formal errors. Although they are very close in terms of their estimates when the used orbit and clock for geometry-based ambiguities are precise enough, they are not the same, in particular, in the case that the used orbit and clock, as a combination, contain significant errors. It is discovered that the discrepancies of geometry-free and geometry-based wide-lane ambiguities are coincided with the actual time-variant errors in the used orbit and clock at the line-of-sight direction. This provides a quality index for real-time users to detect the errors in real-time orbit and clock products, which potentially improves the accuracy of positioning.

The software industry has adopted component-based software development (CBSD) to rapidly build and deploy large and complex software systems with significant savings at minimal engineering effort, cost, and time. However, CBSD encounters issues on security trust, mainly with respect to dependability attributes. A system is considered dependable when it can produce the outputs for which it was designed with no adverse effect on its intended environment. Dependability consists of several attributes that imply availability, confidentiality, integrity, reliability, safety, and maintainability. Dependability attributes must be embedded in a CBSD model to develop dependable component software. Motivated by the importance of these attributes, this paper pursues two objectives: to design a model for developing a dependable system that mitigates the vulnerabilities of software components, and to evaluate the proposed model. The model proposed in this study is labelled as developing dependable component-based software (2DCBS). To develop this model, the CBSD architectural phases and processes must be framed and the six dependability attributes embedded according to the best practice method. The expert opinion approach was applied to evaluate 2DCBS framing. In addition, the 2DCBS model was applied to the development of an information communication technology (ICT) portal through an empirical study method. Vulnerability assessment tools (VATs) were employed to verify the dependability attributes of the developed ICT portal. Results show that the 2DCBS model can be adopted to develop web application systems and to mitigate the vulnerabilities of the developed systems. This study contributes to CBSD and facilitates the specification and evaluation of dependability attributes throughout model development. Furthermore, the reliability of the dependable model can increase confidence in the use of CBSD for industries.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

Vaccines decrease morbidity and mortality. Nevertheless, their benefits depend on public response. During COVID-19, vaccine hesitancy and refusal were rampant, threatening public health. A thorough understand-ing of opponents' arguments is required to address the diffusion of unreliable information on social media and prevent vaccine hesitancy from developing into vaccine refusal. Accordingly, the article examines vac-cine opponents' justifications on social media. Textual content analysis of reader comments on three health-related Israeli Facebook pages was conducted. Data collection encompassed the Israeli COVID-19 vaccination period from October 2020 to May 2022. The comments were analyzed according to the health beliefs model (HBM). We found that vaccine opponents were characterized by low perceptions of the severity of the disease combined with high perceptions of the damages of the vaccine; low perceived benefits of vac-cine compliance; vaccine hesitancy and fear along with public distrust as barriers to change; and call for ac-tion to resist the vaccine and spread related anti-establishment views on the web. As vaccination hesitancy was found to develop into public distrust in the state systems and escalate into conspiracy beliefs and an-ti-vaccination activism, its early detection may prevent future vaccine resistance.

We investigated how Artificial Intelligence (AI) reveals factors shaping COVID-19 vaccine hesitancy among healthcare providers by examining their open-text comments. We conducted a longitudinal survey starting in spring of 2020 with 38,788 current and former female nurses in three national cohorts to assess how the pandemic has affected their livelihood. In January and March-April 2021 surveys, participants were invited to contribute open-text comments and answer specific questions about COVID-19 vaccine uptake. A closed-ended question in the survey identified vaccine-hesitant (VH) participants who either had no intention or were unsure of receiving a COVID-19 vaccine. We collected 1,970 comments from VH participants and trained two Machine Learning (ML) algorithms to identify behavioral factors related to VH. The first predictive model classified each comment into one of three Health Belief Model (HBM) constructs (barriers, severity, and susceptibility) related to adopting disease prevention activities. The second predictive model used the words in January comments to predict the vaccine status of VH in March-April 2021; vaccine status was correctly predicted 89% of the time. Our results showed that 35% of VH participants cited barriers, 17% severity, and 7% susceptibility to receiving a COVID-19 vaccine. Out of the HBM constructs, the VH participants citing a barrier, such as allergic reactions and side effects, had the most associated change in vaccine status from VH to later receiving a vaccine.

Animal products, in particular dairy and fermented products, are natural, major sources of lactic acid bacteria (LAB). Due to their antimicrobial properties, LAB are used in humans and in animals, with beneficial effects, as probiotics or in the treatment of a variety of diseases. In livestock production, LAB contribute to animal performance, health, and productivity. In the food industry, LAB are applied as bioprotective and biopreservation agents, contributing to improve food safety and quality. However, some studies have described resistance to relevant antibiotics in LAB, with the concomitant risks associated to the transfer of antibiotic resistance genes to foodborne pathogens, their potential dissemination throughout the food chain, and the environment. Here, we summarize the application of LAB in livestock and animal products, as well as the health impact of LAB in animal food products. In general, the beneficial effects of LAB on the human food chain seem to outweigh the potential risks associated with their consumption as part of animal and human diets. However, further studies and continuous monitorization efforts are needed to ensure their safe application in animal products and in the control of pathogenic microorganisms, preventing the possible risks associated with antibiotic resistance and, thus, protecting public health.

There is little understanding of patients' experiences and perceptions with satisfaction by health professionals such as medical and dental clinicians. Furthermore, patient satisfaction is not well understood. The objective of this article is to better understand patients' satisfaction with their medical and dental care. The methods of the current article are based on a narrative review of the literature strategy. Patient satisfaction's multidimensional nature has been established since the perceived reasons for satisfaction varied widely among patients. Many aspects of the treatment influence participant satisfaction at different stages of the intervention's process. An improved understanding of the basis for managing patients' expectations with information reiteratively and efficiently may ultimately reduce patients' potential for negative feelings toward the medical and dental treatment experience. The consumerist method may misrepresent the concept of satisfaction in health service.

Abstract: Coal production in mining areas frequently results in a host of negative effects that spread to the neighboring populations, affecting their general well-being and health. This qualitative investigation, which sought to understand how communities living close to coal mines evaluated the effects of mining on their health and well-being, was motivated by the dearth of literature in the province of Limpopo. Eighty-one people in three villages close to the mine provided us with data. Results show that locals' opinions of the social, psychological, and bodily effects of coal mining are worrisome. There were themes that showed how several factors, such as noise pollution, land degradation, and pollution of the air and water, negatively affect physical well-being. Stress, anxiety, and terror were common as a result of safety worries and uncertain livelihoods that harmed mental health. Social wellbeing suffered as a result of the mining industry's negative effects on social cohesiveness, economic inequality, and stigma. Participants also noted that important environmental issues impacting community health and well-being include socioeconomic disparities, air and water pollution, occupational health and safety concerns, and social and cultural disturbances. This study emphasizes how urgently extensive research is needed to validate and

Conclusion: The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers.

Leptospirosis is a zoonosis with global public health impact, particularly in poor socio-economic settings of tropical regions. Transmitted through urine-contaminated water or soil from rodents, dogs, and livestock, leptospirosis causes over a million clinical cases annually. Risk factors include outdoor activities, livestock production, and substandard housing that foster high densities of animal reservoirs. This One Health study in southern Chile examined Leptospira serological evi-dence of exposure people from urban slums, semi-rural, and farm settings, using the Extreme Gradient Boosting algorithm to identify key influencing factors. In urban slums, age, shrub terrain, distance to Leptospira-positive households, and neighborhood housing density were contributing factors. Human exposure in semi-rural communities was linked to environmental factors (tree, shrub, and lower vegetation terrain) and animal variables (Leptospira-positive dogs and rodents, and proximity to Leptospira-positive households). On farms, dog counts, animal Leptospira preva-lence, and proximity to Leptospira-contaminated water samples were significant drivers. The study underscores that disease dynamics vary across landscapes, with distinct drivers in each community setting. This case study demonstrates how the integration of machine learning with comprehensive cross-sectional epidemiological and geospatial data provides valuable insights into leptospirosis eco-epidemiology. These insights are crucial for informing targeted public health strategies and for generating hypotheses for future research.

Vaccine hesitancy has emerged as a significant barrier to achieving herd immunity and protecting populations from preventable diseases. Despite the proven effectiveness and safety of vaccines, many individuals remain hesitant or refuse to vaccinate themselves or their children. This review aims to identify the factors contributing to vaccine hesitancy, including misinformation, lack of trust in authorities, cultural beliefs, and access barriers. We also discuss the impact of vaccine hesitancy on public health, including outbreaks of vaccine-preventable diseases and erosion of trust in public health authorities. Furthermore, we present evidence-based communication strategies for addressing vaccine hesitancy, including building trust, providing accurate information, addressing myths and misconceptions, engaging with local influencers, and utilizing social media and digital platforms. By understanding the factors contributing to vaccine hesitancy and implementing effective communication strategies, healthcare providers, public health officials, and community leaders can work towards promoting widespread vaccine acceptance and protecting public health.

Objective: To explore the hot spots and development trends of community public health research. Methods: The literature related to this topic was searched in CNKI and PubMed databases, and the trend map of the number of articles was drawn according to the obtained data. The included literature were analyzed with Vosviewer software for keyword and author co-occurrence, and CiteSpace 6.3.R1 Basic software was used for mechanism co-occurrence, key emergence and clustering analysis, and timeline distribution map drawing. Results: 189 Chinese literature and 77 English literature were selected. The Chinese literature focused on “community public health service, emergency management, and community governance”, and the research trend was “community public health emergency management and community governance”; English literature focuses on “nursing education, health education, human qualitative research”. Conclusion: Although the Chinese and English literature shows that scholars in this field have different emphases, the primary community health is the key and difficult point to realize the national public health service project, and improving the basic public health service in the primary community is related to the health of all the people, so it is very important.

Abstract. Myopia has become a major health problem around the world. The devel-opment of myopia is starting to appear at an earlier age than in previous generations and its consequences have prompted multiple studies, particularly regarding topical atropine treatment aiming at preventing or slowing myopia progression. Our objective is to review randomized and controlled studies on the efficacy and safety of topical atropine to prevent myopia progression in children. This was a narrative review compiled from literature of PubMed and Cochrane Library, including randomized and controlled clinical trials of atropine eye drops for myopia progression published within 2017 - 2023. Fourteen clinical trials were found in the 7 year-period analyzed. All study atropine concentrations were effective in reducing the progression of myopia compared to the placebo. The highest dose of atropine (1%) showed the best efficacy in reducing the spherical equivalent progression and axial elongation over the lower dose (0.01%). Side-effects were mild or moderate. The use of atropine eye drops to prevent myopia progression has shown benefits without involving serious adverse effects. Higher doses of atropine (0.5% and 1%) have been shown to have more efficacy in preventing myopia progression than lower doses (0.01%), so starting intervention with those doses of at-ropine could be considered for preventing myopic children from becoming severe myopia patients later in life.

Currently, health tourists primarily rely on independent facilitators to manage and book their medical appointments and vacation plans. There is a notable absence of dedicated booking applications for health tourism packages. This paper proposes HealthTourismHub, an application designed to provide personalized packages that include medical appointments, accommodation options and recommended tourism activities. It also serves as a platform for medical experts and accommodation providers, allowing health tourists to discover and connect with them. To incorporate personalization, HealthTourismHub uses an ontology that organizes medical and tourism data, along with a reasoner that generates new knowledge. This approach enables the application to offer customized packages and identify the most suitable providers for each user. Providers are strategically paired and located in close proximity, with the package also including personalized tourism recommendations. A survey was conducted to assess the usability of the application and general perspectives towards health tourism, including motivations, concerns, and preferences. The results revealed an above-average SUS score, indicating that users found the application user-friendly and effective. Some areas for improvement were identified, such as error handling and additional functionalities. Nonetheless, HealthTourismHub shows great potential as a pioneer in the field of health tourism applications.

Objective Objective of the study was to evaluate the public perception and acceptance of community pharmacists in providing mental health support in Saudi Arabia during COVID-19. Methods An online questionnaire-based cross-sectional study was carried out among the general public (aged 15 years or above) of Saudi Arabia during March-April 2020 using QuestionPro platform. The validated questionnaire was bilingual (English and Arabic), simple, detailed, and relevant to obtain focused responses from participants. Importantly, an item related to an agreement on a statement “Pharmacist can counsel people on psychological issues” was included on a five-point Likert scale. The survey link was shared across multiple social media platforms. Results A total of 773 participants completed the survey. The majority were female (65.2%) and youngsters (48.1%). Nearly half of the participants disagreed, while 19% agreed that pharmacists could provide support on psychological issues. Factors such as age, employment status, and the management of the psychological issues during the pandemic were significantly associated with the acceptance of community pharmacists’ role in providing mental health services (p

Introduction: Childhood obesity is becoming an emerging public health issue as it is associated with increased morbidity and premature deaths. Determinants like the child’s household characteristics, maternal weight before the preconception stage, and maternal weight in childhood are studied. There is no study available to understand the association between overweight women of reproductive age and overweight children under five years of age. Studying these determinants to understand the problem can help in framing policies to intervene in the issue. Methods: The data for the study was collected from the National Family Health Survey 5 (NFHS5). It has been sub-grouped into urban and rural categories. The percentage of women with high-risk Waist-Hip-Ratio (WHR) and the percentage of overweight women were independent variables whereas the percentage of overweight under-five children was dependent. Simple linear regression, multiple linear regression, and Pearson correlation coefficient analysis were done for the collected data. Results: Study shows the percentage of overweight women has increased by 4.1%, and the percentage of overweight children has increased by 2% during the NFHS5 (2019-21) compared to NFHS4 (2015-16). Pearson correlation coefficient (R) is 0.5662 and Ꞵ-coefficient for multiple linear regression is 0.1397 for central obesity in women (%) and percentage of overweight children. Conclusion: Central obesity in women is more common than the overweight. Overweight in women as well as in children under five is increasing. Central obesity in women shows a moderate positive relation with overweight in children under five years.

Objective: This study aimed to explore potential interventions or preventive measures to reduce the incidence of falls among the elderly in the Madinah region, and to provide recommendations for healthcare professionals, policymakers, and community stakeholders to enhance fall prevention strategies and improve the overall well-being of the elderly population in this area. Methods: The study adopted a cross-sectional study design, and was carried out in the Madinah region using convenient physical assignment among of Saudi and non-Saudi local residents aged 65 years and over. Questionnaire surveys were circulated and demographic characteristics were collected, including participants’ fall experience and health status data over the past year, in order to assess the incidence of falls among the elderly population. This design allows for the collection of data at a single point in time, aiming to evaluate the prevalence, risk factors, and consequences of falls among the target population. Results: A total of 189 participants were recruited to the study, and the data indicated that the prevalence of falls among those aged 65 years and older in the past year was 41.5%. We found that 73% of the participants had experienced falls and post-fall injuries within the past 12 months. There were minimal differences in terms of physical handicapped cases found between those with and without a fall history. Logistic regression analysis revealed a significant link between fall experience and maximum bite force. Conclusion: There is a high prevalence of falls in the elderly population in the Madinah region. Our study reveals that 50.79% of our elderly participants had experienced more than one fall during the preceding year. Some preventable risk factors were identified in an analysis of their daily routines. The impacts of these risk factors have potential consequences for their healthy lives.

Smartphone-based fundus camera and telemedicine are an opportunity for accessing ocular health inequalities in underresourced areas. The objective of this study is to evaluate the prevalence of retinal findings in a community in the Amazon and propose strategies to enhance ocular health. A cross-sectional study was conducted in a river side community. Retinal photos from the posterior pole and optic disc were captured using a portable fundus camera. All photos and data were analyzed remotely by a retina specialist. The final sample was 107 participants, aged 52±17. Retinal findings were detected in 37.4% (95%CI 28.7–46.8) of the sample, the three main retinal findings were epithelial changes (10.3%, 95%CI 5.6–17.1), chorioretinal scars (8.4%, 95%CI 4.2–14.8), and dry Age-related Macular Degeneration (7.5%, 95%CI 3.6–13.6). This study detected retinal alterations in similar prevalence of other underresourced areas. Telemedicine is an opportunity to address health inequities, especially in ophthalmology, through relatively low-cost portable devices, supporting clinical decisions in areas with low health access, however, maintaining assistance after implementation is a challenge. Enhancing medical education and training local non-specialized health professionals for risk assessment, device handling, and data base use is reasonable to ensure follow-up.

In this study, a critical review was carried out using the Web of ScienceTM Core Collection database to analyse the scientific literature published to date to identify lines of research and future perspectives on the presence of chemical pollutants in beer brewing. Beer is one of the world's most popular drinks and the most consumed alcoholic beverage. However, a widespread challenge with potential implications for human and animal health is the presence of physical, chemical and/or microbiological contaminants in beer. Biogenic amines, heavy metals, mycotoxins, nitrosamines, pesticides, acrylamide, phthalates, bisphenols, microplastics and, to a lesser extent, hydrocarbons (aliphatic chlorinated and polycyclic aromatic), carbonyls, furan-derivatives, polychlorinated biphenyls and trihalomethanes are the main chemical pollutants found during the beer brewing process. Pollution sources include raw materials, technological process steps, the brewery environment and packaging materials. Different chemical pollutants have been found during the beer brewing process, from barley to beer. Brewing steps such as steeping, kilning, mashing, boiling, fermentation and clarification are critical in reducing the levels of many of these pollutants. As a result, their residual levels are usually below the maximum levels allowed by international regulations.

Prostate Cancer remains a prevalent health concern, emphasizing the critical need for early diagnosis and precise treatment strategies to mitigate mortality rates. Accurate prediction of cancer grade is paramount for timely interventions. This paper introduces an approach to prostate cancer grading, framing it as a classification problem. Leveraging ResNet models on multi-scale patch-level digital pathology and the Diagset dataset, the proposed method demonstrates notable success, achieving an accuracy of 0.999 in identifying clinically significant prostate cancer. The study contributes to the evolving landscape of cancer diagnostics, offering a promising avenue for improved grading accuracy and, consequently, more effective treatment planning. By integrating innovative deep-learning techniques with comprehensive datasets, our approach presents a step forward in the pursuit of personalized and targeted cancer care.

Introduction: Cervical cancer is the fourth most common cancer in women globally and the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Research has shown an association between low levels of risk perception and knowledge of the prevention, risks, signs, etiology, and treatment of cervical cancer and low screening uptake, as contributing to high rates of cervical cancer-related mortality. However, there is scant literature on the perspectives of a wider group of stakeholders (e.g., policymakers, healthcare providers (HCPs), and women at risk), especially those living in rural and semi-rural settings. Methods: We adapted Risso-Gill and colleagues’ framework for a Health Systems Appraisal (HSA), to identify HCPs' perspective of the extent to which health system requirements for effective cervical cancer screening, prevention, and control are in place in Tanzania. We adapted interview topic guides for cervical cancer screening using the HSA framework approach. Study participants (69 in total) were interviewed between 2014-2018 –participants included key stakeholders, HCPs, and women at risk for cervical cancer. The data was analyzed using reflexive thematic analysis methodology. Results: Seven themes emerged from our analysis of semi-structured interviews and focus groups: 1) knowledge of cervical cancer risk and the role of screening and preventive care/services (e.g., prevention, risks, signs, etiology, and treatment), 2) training and knowledge of HCPs, 3) knowledge of cervical cancer screening among women at risk, 4) beliefs about cervical cancer screening, 5) role of traditional medicine, 6) risk factors, and 7) symptoms and signs. Conclusion: It is evident that there is a low level of knowledge of cervical cancer risk and the role of screening and preventive services among stakeholders, HCPs, and women living in rural and semi-rural locations in Tanzania. There is a critical need to implement more initiatives and programs to increase the uptake of screening and related services and allow women to make more informed decisions on their health.

In the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data was collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p&lt;0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p&lt;0.05, low vs. high sleep quality), and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p&lt;0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest insomnia as a predictive factor for both poor mental well-being and disordered eating habits. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study.

This study explores the elements that influence consumer vegetarian diet choices in parts of South Korean provinces. The study examines these explanatory variables: ethical-animal-welfare, health, environment, social issues , mood-emotion, and religious-beliefs with vegetarianism serving as the dependent variable. The Likert scale data from 264 respondents were analyzed using logistic regression analysis. Results show that health, ethical-animal-welfare ideals as well as environmental concerns emerge as significant variables influencing the decision to embrace a vegetarian diet. This shows that consumers (international students) in Korea are becoming more aware of and concerned about health, ethical and sustainable dietary choices. Secondly, health plays a crucial role in the vegetarian diet selection, indicating that health-conscious people are more inclined to choose a vegetarian lifestyle. Religious belief and mood have various degrees of influence on the vegetarian diet decision. The findings of this study have consequences for consumer behavior, marketing managers, and decision-makers. Businesses in the food industry, in particular, can gain from catering to the needs and tastes of consumers that prioritize ethical-animal welfare ideals, as well as those that value health and environmental sustainability. Creating and advertising vegetarian and vegan choices in local restaurants can effectively attract and serve this specific target demographic.

The ubiquitous presence of microplastics (MPs) in the environment poses a threat to ecosystems and increases concerns about their exposure to the human body. However, despite being consumed for health improvement, limited research has been conducted on MPs in functional foods. This study aimed to investigate the occurrence of MPs and the relation of the source of raw material or the manufacture in various omega-3 oil in the Korean market. MPs in omega-3 capsule and raw oil, sourced from both plant-based (PB) and animal-based (AB) sources, were investigated. We developed the method by direct filtration with acetone washing and analyzed MPs greater than 5 μm using microscope-Raman spectroscopy. The average number of MPs was found to be 1.2 ± 1.7 MPs/g for PB raw oil, 2.2 ± 1.7 MPs/g for AB raw oil, 3.5 ± 3.9 MPs/g for PB capsule oil, and 10.6 ± 8.9 MPs/g for AB capsule oil. Polypropylene and polyethylene terephthalate were major specious (83-95 %) found in omega-3 oil. The ratio of size range remained consistent across all groups, with a trend of higher detection rates as the size diminished. The results reveal that the main reason of MPs contamination is not the source of raw material but the manufacturing and packaging process for omega-3 oil.

This study explores how young people’s mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. This is important to understand so that policy and practice professionals can support those affected, prepare, and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16–18-year-olds (N = 21) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From artwork, four themes were identified; trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, relationships, hobbies, habits, and education or work were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This implies that young people’s mental health services should collaborate with other sectors to address wider life determinants in a holistic way, and that clearer guidance and support in these areas could mitigate the negative mental health impacts of major environmental changes on young people.

Technological advances in the last decades have led to the realization of the concept of a smart environment. A significant part of this development is decentralized ledger technology and its variant, a blockchain. The blockchain database is immutable, open to all stakeholders, secure by architecture and robust. Applying a blockchain in water supply sanitary control creates opportunities for optimization, higher quality of service, cost reduction, better sanitary standards and public control. Physical, chemical, and biological water supply contamination is a great source of public health hazards. Implementation of a blockchain for water supply IoT, from the source point to the consumption point, enables effective response to changing environments, possible cross-contamination, stormwater management or disaster and emergency action. The chapter encompasses all fundamental elements and principles of water collection, distribution and consumption, with a focus on the health hazards and sanitary requirements for potable water. The chapter listed the main contaminants, methods of their registration and elimination, and requirements for drinking water in accordance with WHO, EU Drinking Water Directive and EPA standards. Blockchain technology solutions are described for smart water supply, including smart supply management, smart contracts, tokenization, smart compliance systems, and, most importantly, effective utilization of distributed ledger technologies for sanitary monitoring of water sources, water treatment, and water distribution systems.

Rare earth elements (REEs) are a type of new material resources, which have attracted significant attention in recent years. REEs have emerged as essential metals in modern-day technology due to their unique functions. Long-term large-scale mining and utilization of rare earths have caused serious environmental pollution and constitutes a global health issue, which raised concerns about human health safety. However, the toxicity profile of suspended particulate matter of REEs in the environment interacts with the human body in remain largely unknown. Studies have shown that REEs can enter the human body through a variety of pathways, leading to a variety of organ and system dysfunctions through changes in genetics, epigenetics, and signaling pathways. Through an extensive literature search and critical analysis, we provide a comprehensive overview of the available evidence, identify knowledge gaps, and make recommendations for future research directions.

Due to the growth of tourism, mining and manufacturing, economy of the Hainan Island, southern China has swiftly expanded, but also poses a risk of soil pollution by mercury (Hg) due to the traffic and mineral processing. In order to investigate the characteristics of soil Hg pollution in the Hainan Island and assess the health risk, a total of 239 samples were gathered from five representative regions across the island. A vehicle-mounted potable mercury analyzer was used to measure the atmospheric Hg and soil Hg concentrations in the collected samples. The results indicate that the soil Hg concentration of the five sub-study areas exhibits notable fluctuations, which was found to be influenced by various factors, including wind direction, mining activities, and economic development conditions. The degree of Hg pollution was assessed using both the Single Pollution Index Method and the Geoaccumulation Index Method. The results showed that although nearly half of the sampling points were contaminated, the current soil Hg level does not pose a non-carcinogenic risk to human health.

Globally increasing antibiotic resistance has been connected to the use of antibiotics in medical, veterinary, and agricultural medicine, contributing to the burden of antibiotic resistance in Asia and Europe. The main objective of this study was to correlations of antimicrobial-resistant of various pathogens in three compartments: humans, animals and the environment in India and Germany. A systematic search was carried out in Medline via PubMed, Google Scholar, and science direct, including studies published in 2022. Out of 532 papers, 24 were considered for meta-analysis. This study reveals that in India, β-lactam is highly resistant in animals. Quinolone, on the other hand, was highly resistant in humans. Furthermore, in the environment and integrated studies, aminoglycosides and β-lactams is resistant. While in Germany, a high rate of AMR resistance in all three sectors was reported in β-lactam. However, E. coli was the most frequent pathogen in both countries and is highly resistant to β-lactam, followed by cephalosporin in all the compartments. Monitoring and evaluating antibiotic-sensitivity patterns and developing proper antibiotic regimens may lead to improved outcomes for inhibiting and controlling E. coli infections in various parts of the world.

Background: Perinatal exposure to pollutants could lead to side-effects in mothers and children, since this is a period of high vulnerability. Sparse and contradictory data are available on the impact of pollutants on breast milk. Objective: The present study consists of a scoping to review the recent research on the persistent presence of organic pollutants (POPs) and heavy metals in breast milk. Design: We performed a scoping review using two online databases to identify articles published from 1995 to 2023 on pollutants in breast milk, using the PRISMA Checklist. Results: A total of 54 articles were found relevant. POPs were present in breast milk in higher concentrations the longer the lactation period. In 3-year-old children, the presence of POPs correlated with the duration of breastfeeding. Estimated dietary exposure to Polychlorinated Biphenyls (PCBs) during pregnancy was positively associated with plasma concentrations in 3-year-old children, but not in pregnant women, suggesting transplacental transfer of these substances. Indeed, plasma concentrations were approximately 40% higher in children compared to pregnant women. In China, a clinical study assessed the risks of POPs in breastfed infants under 6 months of age. POPs decreased over time. Dichloro-Diphenyl-Trichloroethane (DDT) was present in infants living in coastal areas. Hexachlorobenzene (HCB) was the pollutant of greatest concern. Parity is a major determinant of POP levels in breast milk, as are heavy metals. Carcinogenic PAHs were found to a greater extent in obese mothers than in mothers with a normal body mass index. Discussion: POPs and heavy metals could be found in infant formula as well as maternal milk. furthers studies are needed to compare the concentrations between the two milks. Conclusions: Breastfeeding is the only food recommended by the WHO for optimal infant growth. It would seem advisable to pursue risk reduction policies to protect mothers and infants from contaminants in breast milk.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

: Suicide is a serious public health problem, with a global mortality rate of 1.4% of all deaths worldwide, and the leading cause of unnatural death in Spain. The use of clinical simulation has proven to be a beneficial tool in the training of nursing students. Such experiences allow them to develop cognitive and affective skills that are fundamental for the detection of warning signs and use of interventions in cases of people who want to take their own lives. Working in a mental health environment can be difficult for nursing students; therefore, the purpose of this study was to explore the perceptions of nursing students on the approach, management and intervention of suicidal crisis through clinical mental health simulation. Methods: qualitative descriptive phenomenological study through focus groups and reflective narratives in a sample of 45 students. A thematic analysis was performed using ATLAS-ti. Results: After the analysis, three themes were obtained: (a) management and handling of emotions (b) identification of suicide motives (c) intervention in suicidal crisis. Discussion: Clinical simulation in mental health allows students to exercise clinical judgment reasoning, detect warning signs for a better treatment approach, and provide tools for effective intervention and management of patient care. The results of this study indicate that nursing students face challenges in approaching mental health clinical simulation due to lack of prior exposure.

Background: There is a lack of knowledge about how nurses and general practitioners (GPs) collaborated during the COVID-19 pandemicin primary care settings. Our study examined the roles of primary care nurses during the pandemic’s first wave, between March and June 2020, in Switzerland. Methods: The study involved all eight general practices implementing of a nursing role to the practice’s team. Primary care practice staff members (nurses, GPs and medical assistants) have been involved on the development of a new organizational model. A mixed-methods design study collected quantitative data using daily activity monitoring and an electronic survey. Additionally, eight nurses and nine GPs participated in a focus group discussion and individual interviews. Results: GPs recognized the substantial contributions, versatility, and autonomy of the primary care nurses in their practices during the pandemic. Those nurses experienced their involvement positively, mainly thanks to their perceived autonomy. The distribution of activities between primary care practice professionals was heterogenous due to extrinsic and intrinsic factors. Conclusion: Both nurses and GPs agreed that there was added value in having primary care nurses ingeneral practices in time of crisis, and this agreement will bolster plans to integrate this workforce across the canton. The development of nurses’ roles in primary care during the pandemic was reliant on many factors, including practice organization and Switzerland’s healthcare reimbursement and payment system

Purpose：Herein, aimed to explore routines to improve students' physical health.Methods:We explored the integration of extracurricular fitness running "Lerun" into college physical education curriculum. Firstly, experimental and the referring groups were selected by experimental method, in which only the experimental group was intervened in combination with extracurricular fitness running "Lerun". After two experiments, the experimental and referring groups were compared in terms of physical fitness (speed, strength, endurance, flexibility, explosive force, etc.), sports skills, body shape, cardiopulmonary function, etc. Results:After T-test, significant differences (p<0.05) between these two groups prove that the students' physical health status of experimental group is better than that of the referring group. Conclusion：It manifests that integrating extracurricular fitness running "Lerun" into college physical education curriculum is an effective means to improve students' physical health.

The modern age offers many challenges in terms of health related physical condition, such as new technologies, fast and stressful lifestyle, unhealthy diets, alarming statistics on physical activity, etc. Additionally, the COVID-19 pandemic accentuated the existing problems, being necessary to answer the following questions: what is the fitness level of the population? and how important are physical exercises in human life? The purpose of this paper is to monitor the fitness level of a group of students, with the help of a new fitness test system, providing individualized feedback, guidance, or motivation to the subjects. Thus, we applied the new EFB system (European Fitness Badge), that evaluates certain components of physical condition in relation to health (endurance, strength, coordination, flexibility), on a group of 180 students, 78 male (43.3%) and 102 female (56.7%), with the average age m = 23.59 ± 7.38 years, from different specializations within the U.A.V. Arad. The subjects were divided into two groups: beginners - TP1 (N-93) and advanced - TP2 (N-87). The results showed significant differences in most components of overall fitness depending on the test profile (basic or advanced), demografic factors (sex and age), and student’s major (sport, economics, psychology, etc.), a stronger association between ABSI and overall fitness than BMI, and that test profile acts as mediator between demografic factors (sex and age) and fitness abilities. In conclusion this study evidenced tendencies toward differences between the groups of subjects based on the test profile. Also the advanced profile participant scores were higher than those of the basic profile participants. The results reflect as well a lower BMI and ABSI indexes for the advanced profile participants.

Sleep is a fundamental human need: sleep disruption, in fact, causes an increase in the activity of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms and pro-inflammatory responses. Sci-entific literature is finally starting to pay attention to the central role of sleep-wake rhythm alterations for patients health. Oxaliplatin is used extensively for the treatment of gastrointestinal cancer and other malignancies, with increased frequency of use in recent years. This study aims to understand the effects of sleep-wake rhythm alterations on health and quality of life on cancer patients treated with oxaliplatin. Study has been conducted through the creation and distribution of questionnaires to patients to inves-tigate the potential alteration of the sleep-wake quality. Evaluating the influence of the collected variables on sleep quality, only liver and biliary tract and pancreas tumor lo-calization, in males, and previous difficulty sleeping, and anxiety, worries and stress, in females, resulted statistically significant. The results obtained may serve as foundation for designing awareness campaigns and updating of patients, healthcare personnel and caregivers, to improve health and quality of patients life.

Urban dust samples were taken from the playgrounds of 27 schools located in the urban area of the city of Murcia (S.E. Spain). Their color and degree of magnetism were determined, as well as their heavy metal content (Cd, Cu, Cr, Ni, Pb and Zn) to evaluate contamination by environmental and health indexes. The highest concentration of contaminants is found in dusts of dark color and medium and high magnetism. The concentrations of heavy metals in the dust were, in this order, Zn (453.74 mg kg-1)> Cu (77.44 mg kg-1)> Cr (67.93 mg kg-1)> Pb (55.72 mg kg-1)> Ni (18.56 mg kg-1)> Cd (0.42 mg kg-1). The analysis of the magnetic and non-magnetic fraction indicates that there is a concentration of all heavy metals in the magnetic fraction. According to the geoenvironmental indices used, the ecological risk presented by school playgrounds is moderate. As for the health indices, ingestion was the main route of exposure and entry of dust particles into the body, being the main health risk for adults and children for all metals. The Hazard Index (HI) values for all elements for both adults and children were less than 1, indicating that there is no risk of developing adverse health effects. As for the Cancer Risk (CR), the values of this index indicate that there is no risk. The objective of this study was to evaluate pollution in the playgrounds of schools in the city of Murcia.

This comparative research paper examines the difference between sugarcane harvesting practices in Thailand and India. The objective of research was to investigate and compare current pattern of sugar harvesting and its impact of these approaches on labor health conditions in the sugarcane industry of both the countries as India and Thailand. Data were collected from target population groups (40 each) from study areas, namely Kanchanaburi and Saraburi provinces in Thailand and Beed District of Maharashtra state from India. The data showed that comparatively in Thailand, adoption of mechanized harvesting was seen more. However in India, mechanized harvesting was seen increasing but still people were largely involved in sugarcane harvesting and it had ill effects on the overall health of female workers specially. The result clearly indicated that there was drastic difference in harvesting system and labor health conditions in Thailand and India. The findings underscore the multifaceted impact of their occupation on various aspects of health including general well-being of female sugarcane cutters. The strenuous nature of sugarcane cutting, coupled with inadequate protective measures and limited access to healthcare has contributed to a range of health care challenges among female sugarcane cutters in India.

Staphylococcus spp. are among the main pathogens responsible for important infections worldwide, both in humans and in domestic or wild animals. Chiropterans, popularly known as bats, inhabit natural environments and human constructions, and have been considered potential disseminators of several pathogens. Studies have shown the expression of the mecA gene in these animals, being a significant threat to One Health. The objective of this study was to determine antibiotic resistance and the presence of the mecA gene in Staphylococcus spp. isolates from bats from forest areas in the municipalities of Paraná, Brazil. A total of 87 frugivorous chiropterans belonging to the family Phyllostomidae were captured. Of these, 87 rectal and 87 oral swabs samples were collected, re-sulting in 32 Staphylococcus spp. isolates. Twenty-four isolates were characterized as coagu-lase-negative, and 8 coagulase-positive Staphylococcus spp. (STACP), which showed notable re-sistance to oxacillin (78.12%), penicillin G (65.62%) and to other antimicrobials as well. One STACP isolate was mecA-positive. Therefore, further studies are needed to elucidate the mechanisms of contamination and dissemination of these pathogens, emphasizing that anthropic actions in na-tural environments, especially those related to the use of antimicrobials, pesticides may be the main reasons for the presence of resistant bacteria in bats.

: Background: The aim of this study was to evaluate Phenylketonuria (PKU) patients’ oral health habits and the efficiency of tailored recommendations for PKU patients in Latvia on the correct management of oral hygiene. The-free amino acid formula can negatively impact PKU patient’s oral health as it contains a high amount of complex carbohydrates. Materials and methods: In this study with a one-month interval pre and post implementation of oral hygiene recommendations, two questionnaires regarding oral hygiene habits and knowledge were prepared and provided by trained medical personnel to be filled in for all diagnosed PKU patients in Latvia who were not lost to follow-up. Results: Based on the questionnaires among the PKU patients under 18 years of age, 27% cleaned their teeth once a day. However, 6% of patients did not engage in regular teeth brushing at all. Among PKU patients over and 18 years of age, 26% brushed their teeth only once a day. Additionally, a mere 39% of PKU patients ≥18 years of age and 17% &lt; 18 years of age incorporated flossing into their oral hygiene routine. In total, 45% of PKU patients ≥18 years of age and 44% &lt; 18 years of age visited a dentist once a year, but 40% ≥18 years of age and 39% &lt;18 years of age visited a dentist less often than once per year. After reading the recommendations, a remarkable number of PKU patients &lt; 18 years of age had improved their daily oral hygiene routine, including toothbrushing (25%) and flossing (23%). Conclusion: Given the unique dietary requirements and the implementation of these daily at-home oral health practices, motivation and regular reminders should result in better oral health of PKU patients and cooperation with clinicians.

E-waste is considered the fastest-growing global waste stream and has become an emerging environmental challenge. The widespread usage of digital devices has generated a large amount of e-waste. According to the Ministry of Commerce, India annually generates ~14.5 lakh metric tons of e-waste and recycles only ~5 % of e-waste. Annually, the global production of e-waste has been expected to increase by 4–5 %. Advancements in IT and communication divisions have improved the usage of electronic equipment. Heavy metals such as (Pb), mercury (Hg), arsenic (As), tin (Sn), and organic chemicals such as polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), polybrominated biphenyls (PBBs), polybrominated dibenzo-p-dioxins (PBDDs), polybrominated diphenyl ethers (PBDEs) are subsequently released from e-wastes and contaminates soil and water sources. These toxic compounds are hazardous to human health and the environment. They are capable of entering various biological systems and causing alterations in respiratory functions of the lungs, DNA damage, impaired functioning of the thyroid, and increased risk of chronic diseases such as cancer and cardiovascular ailments. Such concerns raise the quintessential need to manage e-waste to prevent future hazards. This manuscript critically reviews the sources, health and environmental impact, disposal techniques, recycling, and regulation of e-waste.

Osteoporosis is characterized by low bone mass and structural deterioration of bone tissue with increased risk of fracture. The population that is most at risk for primary osteoporosis in-cludes post-menopausal women. Among different approaches, nutraceuticals are increasingly popular in developed countries since can contribute to bone health and can delay the onset of pathological bone loss. Our review covers three main aspects. Firstly, we discuss the current state of the two con-ditions, osteopenia, and osteoporosis. Secondly, we focus on the latest developments in natural Nutraceuticals and their effectiveness in reducing bone loss. Finally, we conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis to examine the pros and cons of Nutraceuticals assumption. Nutraceuticals hold great promise, but we must address challenges such as regulatory control and experimental evidence to fully realize their potential. Other challenges include identifying the source of raw materials, ensuring the purity of the compound, avoiding contamination or the presence of other active compounds, maintaining product quality, and preventing interactions with other elements or drugs. By addressing these challenges, the scientific community can ensure more reliable indica-tions for the use of Nutraceuticals and help people lead healthier lives.

Salmonella infection is one of major challenges to the poultry industry because of its pressing effects on health of poultry, food safety and human well-being that later may devastate economic losses to the poultry sector. The paper reviews public health implications and the use of antibiotics together with the risk of drug resistance. In recent years, the usage of probiotics in poultry industry has been growing to mitigate an increasing pressure to adopt sustainable farming practices. The mechanisms which probiotics may control Salmonella and important criteria for selecting effective probiotics in poultry are reported. Various studies highlighting the additional benefits of probiotics in poultry production in addition to Salmonella controls are also included. While probiotics offer promise in enhancing poultry health, challenges and limitations in their utilization must also be carefully considered.

Various environmental, food security and population health problems seem to be related to intensive agriculture production worldwide. This type of food production system impacted the loss of biodiversity and natural habitats; high usage rates of agrochemicals and natural resources had affected soil composition, human health, and nutritional plant quality in rural areas. Intercropping agroecological systems that respect agrobiodiversity could significantly benefit ecosystems, human health, and food security by modifying the nutritional profile and the content of some health-promoting bioactive compounds of the species cultivated in this system. Research on intercropping strategies focuses on the benefits they can offer to ecosystems and less on nutrient plant composition, leaving information scattered when this theme should be more studied due to the critical impact it could provide for human nutrition. Therefore, this review aims to collect viable details on the investigation status of nutrients and bioactive compounds profile in intercropping systems by verifying different regions of the world with unique mixed crops using plant species, along with the criteria for combining them, as well as the nutrients and bioactive compounds analyzed to show what intercropping systems can contribute to food availability and quality.

Background: Two types of medicinal systems are available in Korea: Western and oriental. These exist as separate services that independently provide medical care to patients. We determined the utility and benefits of compressive and integrated medical services (CIMS) comprising 12 sessions of acupuncture and healing programs over 6 weeks. Methods: In this two-group parallel single-center randomized controlled assessor-blinded trial, 24 participants were assigned to either the experimental (conventional medical treatment plus CIMS, n = 12) or control (conventional medical treatment, n = 13) group. Spinal nerve root block was performed on the compressed spinal nerve root (identified using magnetic resonance imaging) when no improvement was observed after the initial treatment. The experimental group received 12 cycles of acupuncture and manual therapy for 6 weeks; the control group received conventional medical treatment alone. Results: The average age of participants in the experimental and control groups was 70.73 ± 5.95 and 67.33 ± 8.89 years, respectively. There were no significant differences between the groups in terms of age, body mass index, Leeds Assessment of Neuropathic Symptoms and Signs, sex, and current medical history. We found high compliance for both programs (acupuncture and healing). On exclusion of between-group effects, the visual analog scale (VAS) score improved significantly over time (p = 0.045). Further, comparison of the groups after excluding the effects of visits revealed significantly lower VAS scores in the experimental group than in the control group (p = 0.000). Conclusions: Patients with degenerative lumbar spinal stenosis who mainly complain of radiating pain in the lower leg may benefit from CIMS after spinal nerve root block for ≤3 months after treatment. Our study findings suggest that this treatment improves spinal function and Oswestry Disability Index score. However, CIMS did not improve QoL.

Background: Several reports indicate that long stay at home for online schools due to the COVID-19 pandemic changed the normal physical activity and body weight of school-age students. Previous studies revealed that almost 50% of school students complained of increased or decreased more than 3 kg of weight due to lower physical activity. This study aims to provide insight about the Body Mass Index (BMI) among school students during COVID-19 pandemic. Methods: A retrospective matched-longitudinal study was conducted in 2022 based on previous data about BMI-for-age percentile in school-age students aged 6 to 18 years. These data were collected the year before and during COVID-19 pandemic (2019-2021). Results: All the included students were Arabic (N = 53,580) and were not diagnosed with chronic illness. The outcomes showed that the overall percentage of students with normal weight was 54%, 56%, and 53% during the 2019-2021 years, respectively. Overweight among students increased during the COVID-19 pandemic years, as almost 10% of the students were overweight in 2019 compared with 12% in 2020 and 2021 years. Besides, obese students also increased in the 2020-2021 period compared with the 2019 year (15-17% vs. 10%). In contrast, underweight trends among students declined, as 26% reported in 2019 compared to 17-18% in 2020 and 2021. Conclusion: There are significant variations in Arabic school-age students regarding their BMI values. Obesity was highly detected among children and adolescents during the COVID-19 pandemic years compared to 2019, while underweight cases declined.

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus in how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist.

The COVID-19 pandemic globally had worrisome effects on health-promoting behaviors of children. Currently, the impact on primary school children's membership in sports clubs, especially considering gender differences, is poorly studied. The main objective of this study was to analyze the status of sports club memberships among children in Austria after the stringent COVID-19 restrictions in June 2021 and to identify gender differences. 755 Austrian school children (mean age 9.9 years, 49.9% girls) were interviewed about their sports club memberships. Our results show significantly lower self-reported sports club membership in June 2021 compared to pre-pandemic studies. 50% of boys reported being a member of a sports club, while the percentage for girls was only at 29.7% (p<0.001). Besides, a significant gender difference in the type of sports club membership was observed with most boys being members of ball sports clubs, while girls were more likely to be members of other sports clubs (p<0.001). Reduced rates of sports club membership after the COVID-19 pandemic underline the need of intervention programs. Health authorities, schools, sports clubs and families should form an alliance to promote an overall increase of physical activity and thus to support the long-term healthy development of children.

Wastewater surveillance, initially conceived in the early 20th century during typhoid fever outbreaks, has evolved into a powerful tool for monitoring public health-relevant analytes. Recent applications in tracking SARS-CoV-2 infection highlight its potential. Beyond humans, it can be extended to livestock populations due to the increasing demand for livestock products. Livestock intensification poses risks of zoonotic disease emergence. Wastewater surveillance offers non-invasive, cost-effective means to detect potential outbreaks. This approach aligns with the "One Health" paradigm, emphasizing the interconnectedness of human, animal, and ecosystem health. By monitoring viruses in livestock wastewater, early detection, prevention, and control strategies can be employed, safeguarding both animal and human health, economic stability, and international trade. This integrated One Health approach enhances collaboration and a comprehensive understanding of disease dynamics, supporting proactive measures in the Anthropocene era where animal and human diseases are on the rise.

The employment rate of people who face severe mental health issues is extremely low, while the vast majority expresses their willingness to work. There are various obstacles that impede their work re-integration process. Apart from the illness’ symptoms and the employers’ stigma, these barriers are strongly associated with the effects of long-term unemployment and the lack of positive psychosocial resources, such as career adaptability and resilience. The present study aims at investigating career adaptability and resilience of mental health service users who receive career counseling services. The career counseling approach that was used combines elements from the IPS model and the career construction approach that has been developed to address the contemporary world of work challenges. We investigated how mental health service users view themselves in terms of career adaptability and resilience, and which factors contributed to their development or impeded them. We used a qualitative approach, which allows for an in-depth exploration of the participants’ views. Fifteen mental health users who receive career counseling services were interviewed. Results showed that mental health service users believe that they can overcome any difficulties and setbacks, when they have adequate support from their social network and when they receive career counseling services. They highlighted the importance of counseling services to maintain their work and cope with stressful events. Further implications of the results regarding vocational rehabilitation of mental health users as means for social inclusion are discussed.

The perception of the impacts of climate risks on health systems in the Grand Lomé region of Togo is diverse. This study was carried out based on information collected in the field. The investigation was based on a questionnaire, individual interviews and field observations. Data collection was carried out in a purposive manner in twenty-four (24) health facilities with a total of 112 health service people and 13 resource people affected. This article presents the results on the perception of the impacts of climate change on health personnel, the environment and buildings. The results show that 92.31% of respondents attest that climate change has impacts on health personnel; 84.62% on the environment and 84.62% on buildings and other health infrastructure. This study shows that climate change has real consequences on human health. It is therefore urgent that those responsible for health systems in the Grand Lomé region, which is home to the capital of Togo, can focus on finding adaptation measures in relation to each health structure and according to its intervention platform.

Since 2019, notable global viral outbreaks have occurred necessitating further research and healthcare system investigations. Following the COVID—19 pandemic, an unexpected duality has occurred of SARS–CoV–2 and monkeypox virus (MPXV) infections. Monkeypox virus is of the Orthopoxviridae genus, belonging to the family Poxviridae. Zoonotic transmission (animal to human transmission) may occur. The Orthopoxviridae genus includes other Orthopoxviruses (OPXV) present in animal host reservoirs that include cowpox viruses (CPXV), vaccinia virus (VACV) and variola virus (VARV), with the latter being causal agent of smallpox and excessive mortality. The aim in this review is to present facts about MPXV specific pathogenesis, epidemiology, and immunology alongside historical perspectives. Monkeypox virus was rarely reported outside Africa before April 2000. Early research since 1796 contributed towards eradication of VARV leading to immunisation strategies. The World Health Organisation (WHO) announcement that VARV had been eradicated was confirmed in 1980. On the 23rd of July 2022, the WHO announced MPXV as a health emergency. Therefore, concern due to propagation of MPXV causing MPOX disease requires clarity. Infected hosts display symptoms like extensive cellular initiated rashes and lesions. Infection with MPXV makes it difficult to differentiate from other diseases or skin conditions. Anti–viral therapeutic drugs were typically prescribed for smallpox and MPOX disease; however, the molecular and immunological mechanisms with cellular changes remain of interest. Furthermore, no official authorised treatment exists for MPOX disease. Some humans across the globe may be considered at risk. Historically, presenting symptoms of MPOX resemble other viral diseases. Symptoms include rashes or lesions like Streptococcus, but also human herpes viruses (HHV) including Varicella zoster (VZV).

Introduction: Research studies have shown that workplace stress and physical immobility can have a multi-layered effect on the human body. It causes degrade our physical functioning, and also having negative effect on our performance. Yoga techniques have proved to be effective at various levels, including physical, mental, and emotional health. Objective: This study aimed to determine the efficacy of a short-term Yoga protocol – Y break, for improved well-being and resilience to stress. It is intended to working population at work to de-stress, refresh, and refocus. Methods: This study was conducted as a single-arm, multi-centric, experimental pilot trial. Prominent yoga institutes in six metropolitan cities were engaged in this study. Participants practised specific yoga techniques for 5 minutes, twice a day, for 15 days. Pre & post-intervention data was collected along with feedback about the protocol. A self-report questionnaire, based on the Pancha kosha parameters, was used to record pre- and post-data. Results: The Statistical data analysis shown significant improvement in every parameter selected for the study. Conclusion: A five-minute yoga break can do wonders for the health-related parameters of the working population; therefore, it should be introduced in all organizations to improve the quality of life and work.

The complex and interconnected challenges of climate change, water stress, disasters, and health crises have far-reaching implications for sustainable development and global sustainability agendas, such as the Sustainable Development Goals (SDGs). However, one critical issue that has been overlooked is the nexus between climate change impacts and mental health (CCMH). Recognizing and addressing the negative emotions associated with this global phenomenon is essential to fostering a holistic approach to climate action planning and building long-term resilience. In this assessment, we present a set of narratives to argue that CCMH research requires a collaborative, transdisciplinary approach that integrates socio-economic and socio-cultural complexities. For this assessment, we used a case study approach to elucidate that the mental health impacts of climate change are unequally distributed, disproportionately affecting vulnerable groups based on age, gender, race, and socioeconomic status. The assessment presented in this study concluded that adequate mental health support programs are limited due to sociocultural stigmas and limited socioeconomic resources in some regions. Existing climate-related mental health services mechanisms lack coordination and specific action plans, leaving affected populations underserved. Unlike traditional understandings of the climate-health nexus, this research calls for experts from multiple fields to work together and for enhanced attention to and investment in CCMH research to bridge the gap between scientific knowledge and practical solutions. Such solutions will lead to scalable and lasting change as communities can implement research findings to support those in need and enhance disaster resilience. Furthermore, by collectively recognizing the climate and mental health nexus, global commitments such as the SDGs and the Paris Declaration can advance awareness and action in climate-related mental health, ultimately promoting a healthier relationship between humanity and nature.

Syphilis continues to be a significant global health concern, and understanding the latest advancements in immunology and pharmacological treatment is crucial for effective disease management. This review article provides an in-depth exploration of these advancements, aiming to contribute to the growing body of knowledge on syphilis research. The epidemiology of syphilis sets the stage for this review, highlighting the persistent burden of the disease worldwide. Current trends and challenges in disease control are discussed, shedding light on the need for comprehensive prevention strategies and improved surveillance systems. The immunological aspects of syphilis are the focus of this review. The intricate interplay between the host immune response and the evasive strategies employed by Treponema pallidum, the causative agent of syphilis, are explored. These include the mechanisms of immune evasion, the role of adaptive and innate immunity, and the development of immune-mediated tissue damage. The article also highlights advancements in diagnostic methods, with emphasis on the importance of accurate and timely detection. From traditional serological tests to the emergence of novel molecular and point-of-care assays, these developments have significantly improved the efficiency and accuracy of syphilis diagnosis. In terms of pharmacological treatment, the review covers the current recommendations and emerging strategies for managing syphilis infections. The challenges posed by antimicrobial resistance are addressed, emphasizing the importance of appropriate treatment regimens and close monitoring of therapeutic efficacy. Looking to the future, this review highlights the potential of vaccine development as a preventive measure against syphilis. Promising vaccine candidates and ongoing research efforts are discussed, offering hope for an effective means of disease prevention. In conclusion, this comprehensive review explores the advancements in syphilis research, from the understanding of immunological complexities to the development of innovative treatment strategies. By collectively advancing our knowledge, we can strive towards better disease management and minimize the impact of syphilis on global public health.