Sleep deficiency impacts the quality of life and may have serious health consequences in the long run. Questionnaire-based subjective assessment of sleep deficiency has many limitations. On the other hand, objective assessment of sleep deficiency is challenging. In this study, we propose a polysomnography-based mathematical model for computing baseline sleep deficiency severity score and then investigated the estimation of sleep deficiency severity using features available only from wearable sensor data including heart rate variability and single-channel electroen-cephalography for a dataset of 500 subjects. We used Monte-Carlo Feature Selection (MCFS) and inter-dependency discovery for selecting the best features and removing multi-collinearity. For developing the Regression model we investigated both the frequentist and the Bayesian ap-proaches. An Artificial Neural Network achieved the best performance of RMSE = 5.47 and an R-squared value of 0.67 for sleep deficiency severity estimation. The developed method is com-parable to conventional methods of Functional Outcome of Sleep Questionnaire and Epworth Sleepiness Scale for assessing the impact of sleep apnea on sleep deficiency. Moreover, the results pave the way for reliable and interpretable sleep deficiency severity estimation using a wearable device in Smart Health.

The work presents a Structural Health Monitoring (SHM) electronic system with real-time ac-quisition and processing for the determination of impact location in laminates. The novelty of this work is the quantitative evaluation of impact location errors using the Lamb wave guided mode S0, captured and processed in real-time by up to eight piezoelectric sensors. The differential time of arrival is used to minimize an error function for the position estimation. The impact energy is correlated to the amplitudes of the antisymmetric (A0 ) mode and the electronic design is de-scribed to avoid saturation for signal acquisition. The same electronic is designed to acquire symmetric (S0 ) low level signals by adequate gain, bandwidth and signal to noise ration. Such signals propagate into a 1.4mm thick aluminum laminate at the group velocity of 5150m/s with frequency frequency components above 270kHz and can be discriminated from the A0 mode to calculate accurately the differential arrival time. The results show that the error is not improved better than S0 wavelength in impact localization by using six out of eight sensors connected to the electronic system.

This work examines the effects of two problematic trends in diesel passenger car emissions – increasing NO2/NOx ratio by conversion of NO into NO2 in catalysts and a disparity between the emission limit and the actual emissions in everyday driving – on ambient air quality in Prague. NO2 concentrations were measured by 104 membrane-closed Palmes passive samplers at 65 locations in Prague in March-April and September-October of 2019. NO2 concentrations measured by city stations during those periods were comparable with the 2016-2019. The average measured NO2 concentrations at the selected locations, after correcting for the 18.5% positive bias of samplers co-located with a monitoring station, were 36 µg/m3 (range 16-69 µg/m3, median 35.3 µg/m3), with the EU annual limit of 40 µg/m3 exceeded at 32% of locations. The NO2 concentrations have correlated well (R2=0.76) with the 2019 average daily vehicle counts, corrected for additional emissions due to uphill travel and intersections. In addition to expected “hot-spots” at busy intersections in the city center, new ones were identified, i.e. along a six-lane road V Holešovičkách. Comparison of data from six monitoring stations during March 15-April 30, 2020 travel restrictions with the same period in 2016-2019 revealed an overall reduction of NO2 and even a larger reduction of NO. The spatial analysis of data from passive samplers and time analysis of data during the travel restrictions both demonstrate a consistent positive correlation between traffic intensity and NO2 concentrations along/near the travel path. The slow pace of NO2 reductions in Prague suggests that stricter vehicle NOx emission limits, introduced in the last decade or two, have so far failed to sufficiently reduce the ambient NO2 concentrations, and there is no clear sign of remedy of Dieselgate NOx excess emissions.

Fundamental principles of modern cities and urban planning are challenged during the COVID-19 pandemic, such as the advantages of large city size, high density, mass transport, free use of public space, unrestricted individual mobility in cities. These principles shaped the development of cities and metropolitan areas for more than a century, but currently, there are signs that they have turned from advantage to liability. Cities Public authorities and private organisations responded to the COVID-19 crisis with a variety of policies and business practices. These countermeasures codify a valuable experience and can offer lessons about how cities can tackle another grand challenge, this of climate change. Do the measures taken during the COVID-19 crisis represent a temporal adjustment to the current health crisis? Or do they open new ways towards a new type of urban development more effective in times of environmental and health crises? We address these questions through literature review and three case studies that review policies and practices for the transformation of city ecosystems mostly affected by the COVID-19 pandemic: (a) the central business district, (b) the transport ecosystem, and (c) the tourism-hospitality ecosystem. We assess whether the measures implemented in these ecosystems shape new policy and planning models for higher readiness of cities towards grand challenges. And how, based on this experience, cities should be organized to tackle the grand challenge of environmental sustainability and climate change.

Alzheimer’s disease and related dementias (ADRD) remain a public health challenge in developing counties. We developed a needs-based essential care service package (ECSP) for care planning of persons living with dementia (PLWD) using a cross-sectional survey among PLWD in institutions in six cities in China (n= 1,299). Face-to-face interviews were conducted with caregivers of PLWD by trained staff between 2018 and 2019. Care service needs and utilization by the level of cognitive impairment were summarized. The average age of PLWD was 80.7 years. 76% of participants had severe cognitive impairment. The needs-based ECSP with 30 service items would be sufficient in supporting care services of PLWD in China, of which seven items are core care. The selection plan for ECSP at different levels is designed as “General Care Services + Selective Care Services”, in which service items for low-, mid-and high-level care for PLWD are 7+3, 7+6, and 7+10, respectively. The findings provide the first large-scale data on service needs and utilization of PLWD in mainland China. The ECSP for PLWD advanced in the paper was a practicable and effective quantitative management means. It is deserved to application in a large scale.

The recent outbreak of the novel Coronavirus Disease (COVID-19) has given rise to diverse health issues due to its high transmission rate and limited treatment options. Almost the whole world, at some point of time, was placed in lock-down in an attempt to stop the spread of the virus, with resulting psychological and economic sequela. As countries start to ease lock-down measures and reopen industries, ensuring a healthy workplace for employees has become imperative. Thus, this paper presents a mobile app-based intelligent portable healthcare (pHealth) tool, called iWorkSafe, to assist industries in detecting possible suspects for COVID-19 infection among their employees who may need primary care. Developed mainly for low-end Android devices, the iWorkSafe app hosts a fuzzy neural network model that integrates data of employees' health status from the industry's database, proximity and contact tracing data from the mobile devices, and user-reported COVID-19 self-test data. Using the built-in Bluetooth low energy sensing technology and K Nearest Neighbor and K-means techniques, the app is capable of tracking users’ proximity and trace contact with other employees. Additionally, it uses a logistic regression model to calculate the COVID-19 self-test score and a Bayesian Decision Tree model for checking real-time health condition from intelligent e-health platform for further clinical attention of the employees. Rolled out in an apparel factory on 12 employees as a test case, the pHealth tool generates an alert to maintain social distancing among employees inside the industry. In addition, the app helps employee to estimate risk with possible COVID-19 infection based on the collected data and found that the score is effective in estimating personal health condition of the app user.

Few data are available on the health impact of tobacco heating products (THPs) at the population level. We used systems dynamics modelling to estimate effects in the established THP market in Japan. We projected effects of THP use in overall mortality up to 2100 and compare those projections against a baseline scenario based on smoking rates pre-THP launch, i.e., smoking only. The model was informed using data from publicly available sources and the literature, including population size, yearly deaths and smoking prevalence with initialisation year (2004) and, births and migration from 2004 to 2065. Transitions between products were estimated from cross-sectional population surveys in Japan. Potential life-years saved with the introduction of THPs was 13 million by 2100 compared with smoking only. In worst-case scenario, population health gains would be seen with THPs risk 10–50% lower risk than smoking. Assuming equal risk for dual use and smoking, THP risk would need to be at least 10% lower than smoking to achieve a population health benefit by 2100. In credible scenarios, substantial population health gains will follow the introduction of THPs in Japan in a relatively short time frame.

Since the emergence of the quantified self movement, users aim at health behavior change, but only those who are sufficiently motivated and competent with the tools will succeed. Our literature review shows that theoretical models for quantified self exist but they are too abstract to guide the design of effective user support systems. Here, we propose principles linking theory and implementation to arrive at a hierarchical model for an adaptable and personalized self-quantification system for physical activity support. We show that such a modeling approach should include a multi-factors user model (activity, context, personality, motivation), a hierarchy of multiple time scales (week, day, hour), and a multi-criteria decision analysis (user activity preference, user measured activity, external parameters). This theoretical groundwork, which should facilitate the design of more effective solutions, has now to be validated by further empirical research.

Determining disability prevalence is an important area for population statistics, especially among young adolescents. The Washington Group on Disability Statistics is one source of reporting disabilities through functional difficulties. However, young adolescents self-reporting this measure is in its infancy. The purpose of this study was to carry out an intra-rater test-retest reliability study on a modified set of items for self-reporting functional difficulties. Young adolescents (n=74; boys=64%; age m=13.7, SD=1.8) completed a self-reported version of the child functioning module in a supervised classroom. The second administration took place two weeks later. Intraclass correlation coefficient (ICC) and Kappa (k) statistics were used to test reliability of the items, and interpretation through Landis & Koch, and Cohen, respectively. The majority of items had substantial or moderate agreement, although there was only fair agreement for self-care (ICC=0.59), concentration (ICC=0.50), and routine (ICC=0.54). Kappa statistics of behaviour were interpreted to be large (k=0.65), and seeing (k=0.49), walking (k=0.49), and speaking (k=0.49) difficulties were moderate. The majority of the items in the self-reported version of the child functioning module can be used in a scale format, although some caution may be required on items of self-care and concentration when used as a dichotomous variable.

The paper presents the most comprehensive and large-scale study to date on how students perceive the impacts of the COVID-19 crisis on various aspects of their lives on a global level. With a sample of 30,383 students from 62 countries, the study reveals that amid the worldwide lockdown and transition to online learning students were most satisfied with the support provided by teaching staff and their universities’ public relations. Still, deficient computer skills and the perception of a higher workload prevented them from perceiving their own improved performance in the new teaching environment. Students were mainly concerned about issues to do with their future professional career and studies, and experienced boredom, anxiety and frustration. The pandemic has led to the adoption of particular hygienic behaviours (e.g. wearing masks, washing hands) and discouraged certain daily practices (e.g. leaving home, shaking hands). Students were also more satisfied with the role played by hospitals and universities during the epidemic compared to the government and banks. The findings also show that students with selected socio-demographic characteristics (male, part-time, first level, applied sciences, lower living standard, from Africa or Asia) were generally more strongly affected by the pandemic since they were significantly less satisfied with their academic work/life. Key factors influencing students' satisfaction with the role of their university are also identified. Policymakers and higher education institutions around the world may benefit from these findings while formulating policy recommendations and strategies to support students during this and any future pandemics.

Since its post-World War II inception, the science of record linkage has grown exponentially and is used across industrial, governmental, and academic agencies. The academic fields that rely on record linkage are diverse, ranging from history to public health to demography. In this paper, we introduce the different types of data linkage and give a historical context to their development. We then introduce the three types of underlying models for probabilistic record linkage: Fellegi-Sunter based methods, machine learning methods, and Bayesian methods. Practical considerations such as data standardization and privacy concerns are then discussed. Finally, recommendations are given for organizations developing or maintaining record linkage programs, with an emphasis on organizations measuring long-term complications of disasters such as 9/11.

In recent years, Lassa fever has been announced as an infectious disease in the world, a few imported cases have been accounted for in various pieces of the world and there are developing worries of the possibilities of Lassa fever Virus as an organic weapon. Regardless of its assaulting impact, no substantial arrangement has been created to reduce the hazard of the ailment, about a large portion of 10 years after identifying it. A Review based on the documents from the literature search on PubMed, Scopus, Goggle Scholar and Science direct. Out of these, the final 16 articles that met the criteria were selected. Relevant information on epidemiology, the burden of management and control were obtained. Timely and effective containment of the Lassa fever disease in Lassa village four decades ago could have minimized the devastating effect and threats posed by this illness in the West African sub-region and indeed the entire globe. That was a hard lesson calling for much more proactive measures towards the eradication of the illness at primary, secondary, and tertiary levels of health care. Hence, the paper is aimed at appraising the threats associated with Lassa fever disease; its demands on curtailing the menace of the epidemic, and recommendations on important focal points.

Background: Australia received its first case of coronavirus on 25 January 2020. Since then the demands of COVID-19 has presented unparalleled levels of strain on the public healthcare systems in the country. In this time of crisis, pharmacists and community pharmacy staff have modified work strategies according to the rapidly changing environment. With a delayed dissemination of resources and guidelines, pharmacist and pharmacies are practicing innovative infection control methods across Australia to protect their staff, patients and the community. This article seeks to explore the current activities undertaken by pharmacists in various community pharmacy settings across Australia in relation to the safety of the workplace environments for staff and patients. Information collected can help inform future decisions in pandemic preparation for pharmacies in response to similar health crisis now and in the future. Methods: An online cross-sectional survey study was conducted in Australia during the COVID-19 outbreak from 1^st to 30^th April 2020. The questionnaire addressed community pharmacist’s awareness and response to infection and sanitation control. Results: A total of 137 pharmacists took part in the survey, with almost half (45.26%) belonging to the age group of 25 to 34 years. Community pharmacy formed the bulk (89.05%) of the respondent’s primary place of practice. There was a good uptake of safety measures by pharmacists and their pharmacies to protect staff and patients. However the task of reassigning high health risk staff was not heavily practiced (34.31%). Regular cleaning took place in the pharmacy, but the use of gloves while cleaning was not practiced in 48.18% of respondents. In addition, only 46.72% of respondents reported observing script baskets being cleaned and disinfected. About one-third (37.96%) of pharmacists were aware of the two-step cleaning and disinfecting process, but only 18.98% of pharmacists reported observing or performing this sanitation procedure. More than half of surveyed pharmacists reported having difficulty keeping up with infection control changes and pharmacy practice guidelines during the pandemic. Conclusion: This study demonstrates that the majority of pharmacists are not fully aware of the infection control measures needed in a community pharmacy setting. The influx of coronavirus updates has made it difficult for pharmacists to implement accurate procedures on some aspects of workplace hygiene, which may have led to some gaps in infection control measures. Pharmacists must aim to uphold their public health ambassador role and aim to keep up-to-date with professional guidance to provide the necessary infection control measures to ensure staff, patient and public health safety.

The holistic approach of One Health, which sees human, animal, plant, and environmental health as a unit, rather than discrete parts, requires not only interdisciplinary cooperation, but standardized methods for communicating and archiving data, enabling participants to easily share what they have learned and allow others to build upon their findings.Ongoing work by NCBI and the GenomeTrakr project illustrates how open data platforms can help meet the needs of federal and state regulators, public health laboratories, departments of agriculture, and universities. Here we describe how microbial pathogen surveillance can be transformed by having an open access database along with Best Practices for contributors to follow. First, we describe the open pathogen surveillance framework, hosted on the NCBI platform. We cover the current community standards for WGS quality, provide an SOP for assessing your own sequence quality and recommend QC thresholds for all submitters to follow. We then provide an overview of NCBI data submission along with step by step details. And finally, we provide curation guidance and an SOP for keeping your public data current within the database. These Best Practices can be models for other open data projects, thereby advancing the One Health goals of Findable, Accessible, Interoperable and Re-usable (FAIR) data.

Background: Strengthening adherence to self-care behaviors in patients with periodontal disease (PD) and reducing plaque index is crucial for improving PD treatment. We evaluated the effectiveness of a theory of planned behavior (TPB)-based health education intervention involving planning strategy on self-care behaviors in patients with PD. Methods: A randomized controlled trial was conducted; 158 and 139 patients comprised the experimental group (EG) and control group (CG), respectively. Both groups received a leaflet, and the EG also received a planning intervention, which was a brief one-on-one counseling session with a planning sheet. Data were collected using a self-administered questionnaire. Results: Between-group comparisons of TPB measures revealed significant differences in all domains when controlling for baseline covariates. The EG exhibited significantly higher levels of action and coping planning than the CG at 2-week follow-up (effect size (ES) = 5.54 and 5.57, respectively) and 6-week follow-up (ES = 5.66 and 5.66, respectively). Between-group differences in changes of brushing behaviors increased significantly. More frequent use of dental floss was observed in the EG than in the CG at 2-week and 6-week follow-ups (24.7% and 22.8%, respectively). Conclusions: The intervention involving planning strategy effectively promoted adherence to self-care behaviors in patients with PD.

The Yezidis who represent a religious minority living in Northern Iraq were particularly affected of the persecution by ISIS that gained power after 2013. This paper gives an overview of the events and the mental health consequences as well as associated influences on affected female Yezidis. Based on systematic literature search the aspects “Persecution by ISIS and actual situation of the Yezidi community”, “Gender-specific aspects of the persecution and its consequences”, “Mental health of the affected women” and “Cultural-historical and religious context” are worked out. Research indicates a high burden of health strain and mental health problems in the surviving Yezidi women, especially PTSD and depression. Concerning transgenerational trauma, the recent genocide revive past experiences in the history of the community. Like the narrow cultural and religious rules of the community, this can be both a resource and a burden. The actual extent of the attacks is neither predictable for the affected individuals nor for the community, consequences could also be passed on descendants. Long-term care and support of the affected persons, their descendants and the Yezidi community seems indispensable.

Classification of electromyographic signals has a wide range of applications, from clinical diagnosis of different muscular diseases to biomedical engineering, where their use as input control of prosthetic devices has become a hot topic of research. Challenge of classifying this signals relies on the accuracy of the proposed algorithm and the possibility of its implementation on hardware. This paper consider the problem of electromyography signal classification, solved with the proposed signal processing and feature extraction stages, with focus lying on the signal model and time domain characteristics for better classification accuracy. The proposal considers a simple preprocessing technique that produces signals suitable for feature extraction, and the Burg reflection coefficients to form learning and classification patterns. These coefficients yield a competitive classification rate compared to used time domain features. Sometimes, the feature extraction from electromyographic signals showed that procedure can omit less useful traits for machine learning models. Using feature selection algorithms provides a higher classification performance with as fewer traits as possible. Algorithms achieved a high classification rate up to 100% with low pattern dimensionality, with other kinds of uncorrelated attributes for hand movement identification.

The stability assessment of aged tunnel linings were mainly evaluated based on the visual inspection, and the Tunnel-lining Crack Index (TCI) is one of the most widely used tunnel lining health assessment indexes in Japan. However, the intersection and distribution of cracks, which can influence the stability of tunnel lining greatly, were not considered in the TCI. A new method was proposed for the health assessment of tunnel lining, which evaluate the lining states according to the fractal dimension of cracks. Based on the machine vision-based method, the crack image can be extracted efficiently. The fractal dimension of lining cracks in one span can be obtained in a few minutes. A series of comparative tests and field tests were conducted to evaluate the validity of this new method. The comparative tests confirmed that fractal dimension can characterize the density, width, and distribution of cracks. The results also certificated that the influence of crack width is larger than the crack density. The intersection of cracks, which will increase the risk of lining collapse, can also increase the fractal dimension, whereas the TCI keep constant. The fractal dimensions of tunnel lining cracks were obtained according to the digital inspection test of Hidake Tunnel in Japan for all the 65 spans. Moreover, the TCI was obtained through statistical methods. The correlation between fractal dimension and TCI of tunnel lining was studied. The significance of the new evaluation index is that it can identify some unusual spans of tunnel lining and provide a basis for further internal testing. As a complement to the conventional visual inspection method, the fractal dimension of the cracks is a promising health assessment index.

Introduction: Since its discovery in late 2019, the novel coronavirus (SARSCOVID-2) that causes COVID-19 has spread fast, prompting the World Health Organization (WHO) to designate the disease a worldwide pandemic on March 11, 2020.The epidemic has profoundly altered the preexisting global sexual and reproductive health landscape .The virus’s load has put ordinary services in jeopardy and harmed other health priorities. This encompasses both the provision and the supply of contraceptives, sexual health, new born and maternal health services. This Scoping review therefore mapped the availability evidence on the impact and effects of the COVID-19 disease outbreak on sexual and reproductive health. Methods: The methodological framework by Arksey and O’Malley guided this scoping review. A literature search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The Strobe critical review checklist was used to determine the quality of the included studies. Results:19 studies were reviewed, out of which 4 were cross sectional studies, 1 was an observational study, 1 was a descriptive analytical study and the rest were qualitative studies .Majority of the studies showed evidence on the impact of COVID-19 and family planning service, maternal and child services, and three studies reported on COVID-19 and sexual behaviour. Five of the nineteen included studies reported on the impact of COVID-19 and family planning service. Conclusion: This scoping review has granted the assessment of the impact of novel SARS-CoV-2 on Sexual and reproductive health services with regards to sexual behaviour, family planning and maternal, neonatal and child health. From the 18 articles identified and reviewed, the overall responses stipulated a significant reduction in client’s utilization of services due to challenges experiences in service implementation such as stock outs. In addition, low demand for reproductive health services by clients due to restrictions imposed on the movements of people to curb the spread of the virus. It is therefore important that Governments and relevant stakeholders in Maternal and Sexual Reproductive Health prioritize development of policies and practices that protect women from the impacts of the pandemic. Furthermore, regular audits to detect trends in MSRH are necessary to inform on going mitigation efforts.

The electronic cigarette or e-cigarette is the new alternative method to deliver nicotine. In 2007, the United States introduced vaping devices on the market. Due to their attractive taste and lack of adverse effects, these vaping devices have gained popularity among youth and adults. However, there has been increasing evidence that vaping can cause severe lung injury, and these devices release toxic chemicals into the body. E-cigarettes are recognized as a global threat to public health. Nicotine, the most prevalent chemical in vaping devices, is associated with neurological problems and cognitive decline. Long-term use of e-cigarettes can cause adverse health problems, including respiratory illnesses, asthma, bronchitis, and lung inflammation. In 2019, the Centers for Disease Control and Prevention (CDC) officially declared vaping-associated illness EVALI (e-cigarette or Vaping Product Associated Lung Injury). The US Surgeon General published an alarm in December 2016 that e-cigarette consumption among adolescents and teens in the US is a "major public health concern" and that more young people are now vaping than smoking traditional cigarettes and cigars. Since its commercial introduction in 2003, modern electronic cigarettes (or E-cigarette s) have become increasingly popular with smokers, non-smokers, and those who used to smoke who have switched to them. With such a rise in consumption, people are becoming more aware of the irritating, harmful, and perhaps cancer-causing effects on the lungs. (Chadi et al., 2019; Dinardo & Rome, 2019; Lyzwinski et al., 2022; Marrocco et al., 2022; O’Callaghan et al., 2022)

Fatty acid desaturase 2 (Fads2) is the key enzyme of long chain polyunsaturated fatty acid (LC-PUFA) biosynthesis. Endogenous production of these biomolecules in vertebrates, if present, is insufficient to meet demand. Hence, LC-PUFA are considered as conditionally-essential. At present however, LC-PUFA are globally-limited nutrients due to anthropogenic factors. Attention of research is given therefore to find ways to maximize endogenous LC-PUFA production especially in production species, whereby deeper knowledge on molecular mechanisms of enzymatic steps involved is being generated. This review first briefly informs about the milestones in the history of LC-PUFA essentiality exploration before it focuses on the main aim – to highlight the fascinating Fads2 potential to play roles fundamental to adaptation to novel environmental conditions. Investigations are summarized, which elucidate the evolutionary history of fish Fads2 providing an explanation for the remarkable plasticity of this enzyme in fish. Further, structural implications of Fads2 substrate specificity are discussed and some relevant studies performed on organisms other than fish are mentioned in cases when such studies have so far not been conducted on fish models. The importance of Fads2 in the context of growing aquaculture demand and dwindling LC-PUFA supply is depicted and a few remedies in the form of genetic engineering to improve endogenous production of these biomolecules are outlined.

Suboptimal nutrition is a leading cause of cardiometabolic disease and mortality. Biological sex is a variable that can play a role in individual response to nutritional factors and may modulate the impact of nutrition on disease. This narrative review explores the intricate interplay between sex, nutrition, and health outcomes, and the consequent importance of considering sex in nutrition research, dietary recommendations, and disease management. We examine the impact of sex on how various dietary patterns, including the Mediterranean diet, macronutrient content and quality, Western diet, and energy restriction associate with or affect metabolic health and disease risk. Understanding how sex influences the response to the diet can inform precision nutrition interventions and approaches for disease prevention and management.

Access to medicines is one of the essential problems in Public Health of low- and middle-income countries (LMICs). The World Health Organization (WHO) defines access to medicines as the possibility of "having continuously accessible and affordable medicines in public or private health facilities that are within a kilometer of the place of residence." Access to medicines, as defined by the WHO, is not fully guaranteed in many LMICs and even in many regions of high-resource countries. The WHO identifies several factors as determinants of limitations in the access to medicines: rational selection, affordable prices, sustainable financing, and reliable health services. The action on these factors makes it possible to improve universal access to medicines with consequent improvement in Public Health. Adequate access to antibiotics and vaccination will avoid a large part of the deaths caused by infectious diseases in the LMICs. However, the emergence of resistance and the difficulties in vaccination campaigns due to socio-political or cultural problems make it challenging to fight many easily treatable infectious diseases. The use and abuse of antibiotics are inevitably associated with the appearance of resistances that make them ineffective. Thus, whereas limited access to antibiotics raises mortality rates from infectious diseases, generalized open access to them ends up eliminating their clinical value. Moreover, the contraction of research in this field for many years has reduced the success in discovering new drugs. Additionally, local market regulations, inadequate selection, inaccessible prices, especially for those of second and third-generation, inefficient health systems, and difficulties of administration and control of prescription compliance, especially in the case of combined therapies, are additional obstacles to universal access to antibiotics. In order to simultaneously improve access to antibiotics and keep resistances under control, it is necessary to develop training and education activities at different social levels (from patients to various Health Care Providers) to complement the national or supranational strategic plans.

Urbanization induced land use land cover (LULC) changes intensify the urban heat island effects. It magnifies the risk of urban dwellers and sometimes causes the loss of human life, defined as heat-related health risk (HRHR). Hence, urban LULC planning plays a crucial role. Present study analyses the impact of composition and configuration of urban LULC defined as urban landscape metric (ULM) on HRHR in Delhi at the ward level. Firstly, the HRHR is measured by using satellite thermal and other digital data. Then, measured HRHR is validated by conducting a rapid field survey. Thirdly, ULM measured at ward level using Fragstat 4 software. Finally, both, HRHR and ULM linked with bi-variate Moran's I and impacts of ULM are assessed using ordinary least square (OLS) and spatial error (SE) regression. The result indicates the high risk is found as clustered in north-east, central and middle of south-west Delhi. Built-up density intensifies HRHR and abundance of vegetation reduce it; however, it is not similar for all vegetation patches. Larger vegetation patches surrounded by dense built-up might not able to reduce the risk as much as a large vegetation patch could in other regions. Findings can be helpful for heat resilient city planning.

Study Objective: This study examined office workstation types’ impact on objective health-related metrics including stress, physical activity (PA), and sleep quality. We propose a sensor-based sleep quality index (SB-SQI) to fill a needed gap for objective sleep quality measurement over short timescales. Methods: We monitored 231 office workers using chest-worn sensors for 72 hours, yielding 11,736 hours of usable data from 163 participants (mean age 43.4, 56% women). SB-SQI was based on a validated algorithm estimating sleep-onset latency, total sleep time, and sleep efficiency, using the scoring method from the Pittsburg Sleep Quality Index (PSQI). We examined the relationships between SB-SQI, office workstation type (open-bench seating, cubicle, and private office), work-hours stress (standard deviation of heart rate variability), and after-work PA (relative duration of moderate-to-vigorous activity). Results: The sensor-derived poor-sleep ratio of the private office workers was higher than with other office workstation types (81% vs. 66.1%, p = 0.023). PSQI revealed a similar but insignificant trend with a lower effect-size. Among good-sleepers, open-bench seating workers had 22% (p = 0.018) less stress during work hours than others. A significant association between work-hours stress and after-work hours PA (r = 0.331, p = 0.000) was observed irrespective of office workstation type, with the highest PA level observed for open-bench seating workers. Conclusions: Office workstation type had a significant impact on work-hours stress, affecting PA after work hours, which influenced sleep quality. SB-SQI could be more sensitive than PSQI in determining the impact of office workstation types on sleep quality.

The focus of this article is the evaluation of the quality and the degree of community engagement in an expert-based, public-health communicative intervention for Alcohol Use Disorder (AUD). In 2023 the Canadian Alcohol Use Disorder Society collaborated with a grass-roots community health group, a regional health authority, and an academic participatory researcher to organize a working group to mount a social-marketing campaign to increase community support for AUD medical treatment in family-practice settings in a rural community in British Columbia. The partnership working group conducted a series of activities in the school system, the town council, and the community. This article covers the formative evaluation and the summative evaluation of the working group's effectiveness. The formative evaluation ("lessons learned" and "recommendations") consists of consensus evaluations of the quality of each activity using a variety of data sources. The formative evaluation followed improvement science methods and used consensus meetings to provide and reflect on formal and informal feedback. Formative results reflect the consensus of the participants in the working group and they record the reactions in the community. The summative evaluation measures evidence of community engagement found in transcribed text from meeting minutes. The summative evaluation used theory-based frameworks and text data visualization to assess the engagement dynamics of the working group. The summative evaluation helps to put the formative evaluation into perspective as communicative action. The summative evaluation validates the formative evaluation by revealing the communicative dynamics of engagement which resulted in the community’s increased capacity to understand and support Alcohol Use Disorder Treatment options. The working group and the entire intervention was seen by the participants and the public as a success and capable of replication. In a small community, it instilled new understandings and attitudes, bringing an emerging awareness of medication as an optional health mitigation strategy for Alcohol Use Disorder. Our study furthers this overall assessment by using theoretical constructs and analysis of communicative records to trace engagement characteristics of interest to researchers, societies, and community groups contemplating similar interventions in the future. The study also validates the effectiveness of communicative analysis as a measure of social-marketing for expert-based public health interventions.

Non-exhaust road transport emissions in cities contribute to poor air quality and create health impacts. This paper presents a new study of the emitted particles due to the tyres-road wear ‘TRWP’ in real driving and gives their emission factors EF. The most frequently observed particles were <1 µm; followed by particles size between [1µm, 4µm] for urban, suburban and highway areas. These particle sizes are well-known to have a higher degree of toxicity. An overall analysis of all the measured pollutants gave EF equal to 30 10+12 #/km and 35 10+12 #/km, respectively for urban and sub-urban areas; and 5 10+12 #/km on highway. The analysis of the 19 most emitted pollutants, taken individually, showed that their EFs ranged from 0.003 to 18.142 10+12#/km. The obtained EF are above the value of the Euro standard for vehicles, but are below the values for vehicles unequipped with a particle filter. Significant test analysis confirmed that inertia of chemical pollutants is homogeneous. EF assessment of the PM10 and PM2.5 emitted is equal to 1.45 mg/km and 0.35 mg/km respectively. These results should contribute to the emergence of future regulations of non-exhaust emissions and should help to analyse the exposure-impact relationship to TRWP.

The aim of the study was to identify factors associated with non-adherence to tuberculosis (TB) preventive treatment among contacts with latent TB infection of new cases of pulmonary TB cases reported in Catalonia in 2019-2021. All contacts aged 18 years or older with a latent TB infection who received a TB preventive treatment were included in the study. The Chi square test and the odds ratios (OR) were used to assess the association between non-adherence to TB preventive treatment and the study variables, considering a p < 0.05 as statistically significant. Multiple logistic regression analysis was used to detect the in-dependent factors associated with TB preventive treatment non-adherence, considering a p < 0.05 as statistically significant. The percentage of non-adherence to TB preventive treatment found in this study was 23.7%. A multivariable logistic regression analysis determined that the following factors were significantly associated with TB preventive treatment non-adherence among adult contacts: “exposure at school or workplace” (aOR = 3.34), “exposure to an index case without laboratory confirmation of TB” (aOR = 2.07), “immigrant contact” (aOR = 1.81), “male gender” (aOR = 1.75) and “exposure duration <6 hours per week or sporadic exposure” (aOR = 1.60). By contrast, the factor “short-term TB preventive treatment regimen” (aOR = 0.38) was significantly associated with a lower treatment non-adherence. Adherence to TB preventive treatment should be improved among adult contacts of TB pulmonary cases with latent TB infection by recommending short-term treatment regimens and by developing health education activities, with a greater focus on contacts with factors associated with treatment non-adherence.

Petroselinum crispum (Mill.) Fuss (Apiaceae), popularly known as parsley, is a ubiquitous aromatic herb used for culinary and medicinal purposes worldwide. Besides the richness in nutrients, sev-eral bioactive secondary metabolites, especially the flavone apigenin and its glycosides, have been described in the species. Parsley has already been shown to have several health-promoting activi-ties, such as antithrombotic, antihypertensive, and hypolipidemic. The multiple studies conducted in animal models so far suggest the species is a potential source of cardioprotective agents. This review provides up to date information and perspectives on the potential of parsley and its bioac-tive compounds for the development of nutraceutical products and drugs for the promotion of cardiovascular health. It includes not only a discussion on reported bioactivities, but also the knowledge of supplements and food additives developed as innovative parsley-based products.

Urban Green Space (UGS) has important impacts on human health, but an integrated participatory approach to UGS design for improved residents’ health was lacking to date. The aim of our study was to develop and evaluate such a novel approach to address this gap. The approach was developed following guiding principles from the literature, and tested with groups of children and elderly as participants in two neighborhoods of Maastricht (The Netherlands) with a low score on economic and health indicators. Novel aspects of the approach are the inclusion of both positive and negative health effects, the combination of participant self-assessment and model-based assessment of the health effects of UGS designs, and the use of maps to visualize UGS designs and health effects. The participant-generated UGS designs resulted in a considerable self-assessed increase in use of the UGS for meeting, stress reduction or leisure-based physical activity, as compared to the current situation. The model-assessed positive and negative health effects of the participant-generated UGS designs were limited. The major strength of the developed approach is that it combines active participation of residents in UGS (re)design with assessment of the health effects of these UGS designs. Whereas in other participatory approaches to UGS design it often remains unclear whether the resulting designs represent an improvement in terms of health, our combination of computer model-based assessment and a participatory process produced clear outcomes regarding the health benefits and use of UGS designs.

Objective: The objective of our study was to explore the potential benefits of combining moderate alcohol consumption with regular vigorous physical activity on HDL-cholesterol levels and its potential positive impact on cardiovascular health. Material and method: The study comprised two groups: group A (102 patients) who consumed 1 gram of alcohol per day, specifically red wine, and increased their exercise levels in addition to their standard medical treatment, and group B (108 patients) who adhered only to their standard medical treatment. The patients were monitored for a year, during which various clinical parameters were observed. Results:Our study showed that moderate alcohol consumption, particularly red wine, along with increased physical activity levels, was associated with enhancements in exercise tolerance and elevated levels of HDL-cholesterol. Our findings suggest the efficacy of the intervention in improving lipid profiles, with the group that consumed alcohol as part of their treatment scheme, generally experiencing more pronounced positive effects. Statistically significant differences between groups in terms of angina evolution, AMI recurrence, or arrhythmias evolution were not found. However, there were important differences in terms of EF improvement and quality of life, with the alcohol consuming group displaying greater improvements in both aspects. Conclusions:In conclusion, our study emphasizes the potential benefits of combining moderate alcohol consumption, specifically red wine, with increased physical activity levels for improving exercise tolerance and enhancing HDL-cholesterol levels. However, further research and clinical trials are essential to fully understand the mechanisms and optimize the integration of these lifestyle elements for improved cardiovascular health outcomes.

People with Intellectual Disability (ID) encounter several problems in their daily living regarding their needs, activities, interrelationships, and communication. On this concept, an interactive platform is proposed, aiming to provide personalized recommendations for information and entertainment, including creative and educational activities, tailored to the special users’ needs of this population. Furthermore, the proposed platform integrates capabilities of automatic recognition of health related emergencies, such as fever, oxygen saturation decline and tachycardia, as well as location tracking and detection of wandering behavior based on smartwatch/smartphone sensors, while providing automated assistance and appropriate alerts and notifications to the caregivers.

Ultrasonic-guided lamb wave approach is an effective non-destructive testing (NDT) method used for detecting localized mechanical damage, corrosion, and welding defects experienced in metallic pipelines. Signal processing of the guided waves is often challenged due to the complexity of operational conditions and environments in the pipelines. Machine learning approaches in recent years, including convolutional neural networks (CNN) and long short-term memory (LSTM), have exhibited their advantages to overcome these challenges for signal process and data classification of complex systems, thus great potential for damage detection of critical oil/gas pipeline structures. In this study, a CNN-LSTM hybrid model is utilized for decoding ultrasonic guided waves for damage detection of metallic pipelines, and twenty-nine features are extracted as input to classify different types of defects from metallic pipes. The prediction capacity of the CNN-LSTM model is assessed by comparing it to the CNN and LSTM. The results demonstrate that the CNN-LSTM hybrid model exhibits much higher accuracy, with 94.8%, as compared to those of CNN and LSTM. Interestingly, the results also reveal that predetermined features, including time-, frequency-, and time-frequency domains, could significantly improve the robustness of the deep learning approaches, even though the deep learning approaches are often believed they include automated feature extraction, without the hand-crafted steps as the shallow learning do. Furthermore, the CNN-LSTM model displays higher performance when the noise level is relatively low (e.g., SNR=9 or higher), as compared to the other two models, but its prediction drops gradually with the increase of the noise.

This paper proposes an AI-based approach to overcome the limitations of the SHM system in measuring global stress with limited sensors. Feature elements are selected based on correlation analysis among finite elements and used as stress-measured points. An ANN is used to establish the solution relationship between the feature and correlation elements. The proposed method is applied to the connector structure of an offshore platform, and an optimal ANN is established to optimize accuracy by considering factors like the number of sensors, neural network framework, and convergence criteria. The accuracy of the ANN is verified through a real-scale model test, demonstrating 93.6% accuracy. This technology represents a significant advancement, enhancing the practicality of the structural health monitoring (SHM) system from “point monitoring" to “field monitoring".

During the COVID-19 pandemic, online media were the most widely used source of scientific information. Often, they are also the only ones on science-related topics. Research has shown that much of the information available on the Internet about the health crisis lacked scientific rigor and that misinformation about health issues can pose a threat to public health. In turn, millions of Catholics were found to be demonstrating against vaccination against COVID-19 based on "false" and misleading religious arguments. This research analyses publications about the vaccine in Catholic online media with the aim of understanding the presence of information (and misinformation) in this community. An algorithm designed for each media outlet collected COVID-19 vaccine-related publications from 109 Catholic media outlets in five languages. In total, 970 publications were analysed for journalistic genres, types of headlines and sources of information. The results show that most publications are informative and most of their headlines are neutral. However, opinion articles have mostly negative headlines. Also, a higher percentage of the opinion authors come from the religious sphere and most of the sources cited are religious. Finally, 35% of the publications relate the vaccine to the framing issue of abortion.

This work investigates how integrated polyimide inlays with applied sensor bodies influence the guided ultrasonic wave propagation in narrow glass fiber-reinforced polymer specimens. Preliminary numerical simulations indicate that in a damping-free specimen, the inlays show reflections for the S0-mode propagation. Hence, an air-coupled ultrasonic technique and a 3D laser Doppler vibrometer measurement are used to measure different parts of the propagating waves’ displacement field after burst excitation at different frequencies. No significant reflections on the inlay can be seen in the experiments. However, it is shown that the reflections from the strip specimen’s narrow width cause periodical reflections that superimpose with the excited wave fronts. A continuous wavelet transformation in the time-frequency domain filters discontinuities from the measurement signal and is used for reconstruction of the time signals. The reconstructed signals are used in a spatial continuous wavelet transformation to identify the occurring wavelengths and hence to prove the assumption of reflections from the narrow edges. Since the amplitude of the reflections identified in the numerical data at the polyimide inlays are an order of magnitude smaller than the excited wave packages, it is concluded that material damping of the epoxy resin matrix extincts possible reflections from the inlays.

Structural health monitoring of lightweight constructions made of composite materials can be performed using guided ultrasonic waves. If modern fiber metal laminates are used, this requires integrated sensors that can record the inner displacement oscillations caused by the propagating guided ultrasonic waves. Therefore, we have developed a robust MEMS vibrometer that can be integrated with structural and functional compliance. This vibrometer is directly sensitive to the high-frequency displacements from structure-borne ultrasound when excited between its first and second natural frequency. The vibrometer is mostly realized by processes earlier developed for a pressure sensor but with additional femtosecond laser ablation and wafer bonding. The piezoresistive transducer made from silicon is encapsulated between top and bottom glass lids. The natural frequencies are experimentally determined using an optical micro vibrometer setup. The vibrometer functionality and usability for structural health monitoring are demonstrated on a customized test rig by recording application-relevant guided ultrasonic wave packages with a central frequency of 100 kHz at a distance of 200 mm from the exciting ultrasound transducer.

Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10-20% of patients, with a significant number remaining in a diagnostic dead-end. Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways. Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semi-structured interviews. The inclusion criteria were : suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients’ medical trajectories were collected using a biographical approach. Results: The diagnosis of Lyme disease was primarily triggered by identification with personal testimonies found on the internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP. Conclusion: GPs should first systematically explore patients’ etiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis.

Background. We aimed to assess the validity of the Mat-O-Covid Job Exposure Matrix (JEM) on SARS-CoV2 using compensation data from the French National Health Insurance compensation system for occupational-related COVID-19. Methods. Deidentified compensation data for occupational COVID-19 in France were obtained between August 2020 and August 2021. The acceptance was considered as the reference. Mat-O-Covid is an expert based French JEM on workplace exposure to SARS-CoV2. Bivariate and multivariate models were used to study the association between the exposure assessed by Mat-O-Covid and the reference, as well as the Area Under Curves (AUC), sensitivity, specificity, predictive values, and likelihood ratios. Results. In the 1140 cases included, there was a close association between the Mat-O-Covid index and the reference (p&lt;0.0001). The overall predictivity was good, with an AUC of 0.78 and an optimal threshold at 13 per thousand. Using Youden’s J statistic resulted in 0.67 sensitivity and 0.87 specificity. Both positive and negative likelihood ratios were significant: respectively 4.9 [2.4-6.4] and 0.4 [0.3-0.4]. Discussion. It was possible to assess Mat-O-Covid’s validity using data from the national compensation system for occupational COVID-19. Though further studies are needed, Mat-O-Covid exposure assessment appears to be accurate enough to be used in research.

Objectives: The aim of this study was to compare the performance of the EQ-5D-Y-3L (Y-3L) and the expanded five level version, the EQ-5D-Y-5L (Y-5L). Methods: Children/adolescents with an acute or chronic health condition and from the general population completed the Y-5L and Y-3L self-report questionnaires. Performance of the Y-5L and Y-3L was determined by comparing feasibility, redistribution of dimension responses, discriminatory power, validity, and test-retest reliability. Results. Five hundred and fifty children/adolescents completed baseline measures and 173 completed repeat measures. The ceiling effect decreased by 15% from the Y-3L to Y-5L. Informativity of dimensions improved by 0.094 on the Y-5L. There was a range of 4-9% inconsistent responses moving from the Y-3L to Y-5L. Convergent validity of the Visual Analogue Scale (VAS) and Y-3L, Y-5L dimensions was similar, weak to moderate (r_s range: 0.18 – 0.38) but similar and strong on paired Y-3L and Y-5L dimensions: Kendall Tau B (range 0.69 – 0.80) and Gamma (range 0.92 – 0.98). The Y-5L and Y-3L showed moderate to substantial agreement for test-retest reliability across dimensions and VAS scores in stable chronic health conditions and fair agreement for the general population. Conclusion: The EQ-5D-Y-5L is a valid, reliable extension of the Y-3L for children/adolescents across health conditions and healthy children/adolescents. The expanded levels reduced the ceiling effect. The relative informativity of report across dimensions increased on the Y-5L compared to the Y-3L with retention of the evenness of reporting. The convergent validity and test-retest reliability of the Y-5L was comparable to the Y-3L.

Deepfake technologies are known for the creation of forged celebrity pornography, face and voice swaps, and other fake media content. Despite the negative connotations the technology bears, the underlying machine learning algorithms have a huge potential that could be applied to not just digital media, but also to medicine, biology, affective science, and agriculture, just to name a few. Due to the ability to generate big datasets based on real data distributions, deepfake could also be used to positively impact non-human animals such as livestock. Generated data using Generative Adversarial Networks, one of the algorithms that deepfake is based on, could be used to train models to accurately identify and monitor animal health and emotions. Through data augmentation, using digital twins, and maybe even displaying digital conspecifics where social interactions are enhanced, deepfake technologies have the potential to increase animal health, emotionality, sociality, animal-human and animal-computer interactions and thereby animal welfare, productivity, and sustainability of the farming industry.

This study aimed to assess the differences in the importance and performance of health awareness in Korean middle school students according to the types of online physical education classes they attended during the coronavirus disease-2019 pandemic. Overall, 583 participants were selected using a convenience sampling method; the data were obtained through an online survey using Google forms. Frequency analysis, reliability analysis, independent sample t-test, and importance-performance analysis were performed. First, the differences between importance and performance were found to be the most for sleep and physical activity management, and the least for disease and hygiene management. In addition, both the groups demonstrated higher importance and performance for hygiene and disease management. There were significant differences in the importance and performance of all the sub-factors. Second, hygiene, disease management, and mental health management were found in quadrant I in both the groups, while physical activity, sleep, and dietary habit management were in quadrant III. No factors were in quadrant II and IV.

The Covid-19 pandemic has severely tested the mental health of frontline health care workers. A repeated cross-sectional study can provide information on how their mental health evolved during the various phases of the pandemic. The intensivists of a COVID-19 hub hospital in Rome were investigated with a baseline survey during the first wave of the pandemic in April 2020 and were contacted again in December 2020, during the second wave. 152 of the 205 eligible workers responded to an online questionnaire designed to measure procedural justice, occupational stress (effort/reward imbalance), sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and turnover intention. Workers reported a further increase in workload and compassion fatigue, which had already risen during the first wave, and a marked reduction in the time devoted to meditation and mental activities. A low level of confidence in the adequacy of safety procedures and the need to work in isolation, together with an increased workload and lack of time for meditation were the most significant predictors of occupational stress in a stepwise linear regression model. Occupational stress was, in turn, a significant predictor of insomnia, anxiety, low job satisfaction, burnout, and intention to leave the hospital. The number of workers manifesting symptoms of depression increased significantly to exceed 60%. Action to prevent occupational risks and enhance individual resilience cannot be postponed.

Let us all take a moment to talk, once again, about this new coronavirus pandemic that the world has been facing since November 2019 and about its global response. After a short period marked by the pandemic underestimation risk by most governments, the Western world went nuts and overreacted, most probably so as not to be accused of inaction. In many cases, the overall benefits of the chosen policies were not sufficiently questioned, which resulted in many side effects on global health .The medical motto “primum non nocere”, a moral principle everyone should at least consider following, was evidently not taken into account. It has been overlooked, and the virus has become an obsession, to the extent that nearly everything else, even the most valuable things in life, is still now under appreciated if not simply ignored. This review highlighted facts against this simplistic, one-dimensional view.

Probiotics make up a large and growing segment of the commercial market of dietary supplements and are touted as offering a variety of human health benefits. Some of the purported positive impacts of probiotics include, but are not limited to, stabilization of the gut microbiota, prevention of gastrointestinal disorders and modulation of the host immune system. Current research suggests that the immunomodulatory effects of probiotics are strain specific and vary in mode of action. Here, we examined the immunomodulatory properties of Bacillus subtilis strain DE111 in a healthy human population. In a randomized, double blind, placebo-controlled four-week intervention, we examined peripheral blood mononuclear cells (PBMCs) at basal levels pre- and post-treatment as well as in response to stimulation with bacterial lipopolysaccharide (LPS). We observed an anti-inflammatory effect of B. subtilis, manifested as a decrease in immune cell populations within the basal state along with an increase in anti-inflammatory immune cells in response to LPS stimulation. Overall gastrointestinal health, microbiota, and circulating and fecal markers of inflammation and gut barrier function were largely unaffected by DE111 treatment. These data suggest that the novel probiotic B. subtilis DE111 may have clinical applications in modulating immune homeostasis via anti-inflammatory mechanisms.

A workplace sleep health promotion program was implemented in an Italian police unit from 2016 to 2017. Of the 242 police officers in the unit, 218 (90%) agreed to take part in the program. A crossover trial was made in which the police officers were divided into two groups that performed sleep health promotion activities in the first and second year, respectively. The first group of officers showed significant sleep improvements at the end of the first year, while the second group had similar or worse parameters than at baseline. At follow-up, a significant improvement in the quantity and quality of sleep was reported in both groups. Sleep improvements at follow-up were associated with a marked reduction in the frequency of accidents at work and near-misses. All sleep parameters showed a significant association with injuries and near-misses in univariate logistic regression analyses. Before the intervention, sleepiness was the best predictor of injuries (aOR 1.220; CI95% 1.044-1.426) and near-misses (aOR 1.382; CI95% 1.182-1.615). At follow-up, when sleep conditions had improved, insomnia symptoms were the most significant predictors of work accidents (aOR 13.358; CI95% 2.353-75.818). Sleep health promotion can be useful in police officers.

The epidemic of Coronavirus Disease 2019 (COVID-19) have affected all the regions of the world, nevertheless, in some countries there is a lack of studies on its main clinical and epidemiological features. We analyzed the incidence, incidence rates, and evolution of COVID-19 cases in Honduras from February 18-April 24, 2020.Methods: Using daily epidemiological data from surveillance about COVID-19 in Honduras, we calculated the rates of incidence (cases/100,000 population), and developed at national, departmental, and municipal levels GIS-based maps.Results: February 18 - April 24, 2020, a sum of 3,169 suspected COVID-19 cases have been assessed by RT-PCR, 533 (16.8%) of them were positive, for an incidence rate of 5.73 cases/100,000 pop. The highest peak was reached on March 31 (48 cases). The department with the highest number of cases and incidence rate was Cortes (383 cases, 71.9% of the total, 21.45 cases/100,000 pop). Discussion: The pattern and evolution of COVID-19 epidemic in Honduras has been particularly focused in the major urban areas, San Pedro Sula and Tegucigalpa, the capital city. Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of the evolution of the pandemic and monitoring interventions.

The COVID-19 pandemic has great adverse impacts on personal life, the U.S. economy, and the world economy. Freezing all human activities is not a sustainable measure. Thus we want to develop a public intervention framework that allows people to resume personal and economic activities. In this article, we examined transmission routes, disease severity, personal vulnerability, available treatments, and person-person interactions to establish a general public intervention framework. We divide people into risk groups, non-risk group and group that may serve as viral transmitters, explore interactions between individual persons within each group and between different groups, and propose interaction behavior modifications to mitigate viral exposures. For the non-risk groups, we identified preventive measures that can help them avoid the most serious exposures and infections that pose higher death risks. The invention measures for the vulnerable groups include prior-exposure measures, heightened protective measures, interaction behavior changes, post-exposure remedial measures, and multiple factors treatments to reduce death and disability risks. The multiple interventions and two-ways defensive behavior modifications are expected to result in reduced rate of detectable infections and lowered disease severity for the vulnerable groups. In this framework, most human activities and economic activities can continue as normal. With time passing, the population acquires population immunity against the COVID-19 virus. Implementation of this intervention framework requires considerable resources and governmental effects while the multiple factors treatment protocol requires the support of health care professionals.

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Well-controlled chronic background pain during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). Results: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (Linear p-value = 0.1) and dyspnoea (Linear p-value =0.05). The ESAS and PSQI questionnaires confirmed these positive results (p<0.0001 and p=0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance

Age-in-place can reduce the progress of dementia syndrome and improve the quality of life of the sufferers and their families. This work proposes an innovative information home support system to be established at the houses of people suffering from dementia. The main innovation of the system are its transparent character that overcomes the need for training of the sufferer, as well as the exploitation of a well-known technique for dementia, namely music therapy. It addresses the need of people suffering from dementia as well as their familiars to be recognized by them and have better interaction and collaboration. The system offers a ubiquitous recognition system, just by using smart devices like smart-phones or smart-wristbands. When a familiar person is detected in the house, then a sound file is reproduced on smart speakers placed in the house, in order to trigger the memory, based on the principles of music therapy. The system reproduced the appropriate time at 100% of the cases and the benefits of music therapy are evident daily. To the best of the authors' knowledge, this is the first system of its kind ever reported in the literature.

Hippocrate, the father of medicine, already said:"Wine is a thing wonderfully appropriate to man if, in health as in disease, it is administered with appropriate and just measure according to the individual constitution." wine has always accompanied humanity, for religion or for health. Christians and Jews need wine for the liturgy. For Platon the wine was an indispensable element in society and took all its importance in the symposium. In this second part of the banquet, mixed with water, the wine gave the word. If the french paradox made a lot of ink flow; it was the wine that was originally responsible for it. Many researchers have tried to share the alcohol and polyphenols in order to solve the mystery. Beyond its cardiovascular effects, there are also effects on longevity, metabolism, cancer prevention and neuroprotection, and the list goes on. The purpose of this work is to make an analysis of current knowledge on the subject. Indeed, if the paradigm of the antioxidants is seductive, it is perhaps by their prooxidant effect that the polyphenols could act, by an epigenetic process mediated by nrf2. Wine is a preserve of antioxidants for the winter and it is by this property that the wine acts, in alcoholic solution. A wine without alcohol is pure heresy. By the way, we were not talking about elixir to design all this millennial pharmacopee that made the man was able to heal and prosper on the planet. From Alvise Cornaro to Serge Renaud, nutrition was the key to health and longevity, whether Cretan or Okinawa diet, it is the small dose of alcohol (wine or sake) that allows the bioavailability of polyphenols. Moderate drinking give a protection for diseases and a longevity potential. In conclusion, let’s drink fewer, but drink better to live older.

To assess the presence of organochlorine pollutants (OCP) in Alaskan sub-Arctic latitudes, we analyzed ice core and meltwater samples from Jarvis Glacier, a polythermal glacier in Interior Alaska. Jarvis Glacier is receding as atmospheric warming continues throughout the region, increasing opportunity for OCP transport both englacially and into the proglacial watershed. Across all meltwater and ice core samples we identify the pesticides DDT, DDE and DDD, α- HCH and ϒ-HCH. OCP concentrations in ice core samples were highest at the 7-14 m depth (0.51 ng/L of DDT) and decreased gradually approaching the bedrock at 79m. Meltwater concentrations from the proglacial creek slightly exceeded concentrations found in the ice core, potentially indicating aggregate OCP glacial loss, with peak OCP concentration (1.12 ng/L of DDD) taken in July and potentially associated to peak melt. Ongoing use of DDT to fight Malaria in Asia, and the extended atmospheric range of HCH may account for concentrations in near-surface ice, correlating with use and atmospheric transport. The opportunity for biota bioaccumulation of OCPs, or human uptake of OCPs from glacial meltwater, may increase as glacial melt continues.

Our skin epidermis constitutes the most important innate defense barrier against all pathogens. Therefore, even if skin lesions are common due to infections, scarring, genetic disorders, and other diseases, skin integrity is crucial for maintaining body homeostasis. Marine collagen peptides (MCPs) and Glycosaminoglycans (GAGs) have been described as potential wound healing (WH) agents. Recently, through an ex vivo clinical approach, we have demonstrated the nutricosmetic potential of fish cartilage hydrolysate (FCH), which presents a combination of collagen peptides and GAGs. Here, we coupled a clinical approach with in vitro experiments on human dermal fibroblasts (HDFs) and applied a Data Independent Acquisition - Parallel Accumulation Serial Fragmentation (diaPASEF) proteomic analysis, to assess the potential benefit of FCH in WH and its mode of action. Our results show that human serum enriched with circulating metabolites resulting from FCH ingestion, improved wound closure in scratch assays. In support, some proteins with anti-inflammatory and immunomodulatory properties or prone to promote hydration and extracellular matrix (ECM) stability showed increased expression in HDFs, after exposure to FCH-enriched serum. These findings suggest that FCH appears as a promising nutrient for WH and skin regeneration.

Life on Earth evolved to accommodate the biochemical and biophysical boundary conditions of the planet millions of years ago. The former includes nutrients, water, and ability to synthesize other needed chemicals. The latter include the 1 g gravity of the planet, radiation, and the geomagnetic field (GMF)of the planet. How complex life forms have accommodated the GMF is not known in detail considering that Homo sapiens evolved a neuro system and a cardiovascular system that develops electromagnetic fields as part of their functioning. In addition, many proteins and physiologic processes utilize Fe ions, an ion that exhibits magnetic properties. Thus, complex organisms such as current humans generate magnetic fields, contain significant quantities of the Fe ion, and also respond to exogenous-supplied static and electromagnetic fields. Whether humans can store information in self-generated magnetic fields remains to be determined. Given the current body of literature, it remains somewhat unclear how Homo sapiens use exogenous magnetic fields to regulate function, and what can happen if the boundary condition of the GMF of Earth is no longer exerting an effect. Proposed deep space flights to destinations such as Mars will provide some insights as space flight could not have been anticipated by evolution. The results of such space flight “experiments” will provide new insights in the role of magnetic fields on human functioning. The outcomes may also have implications for those on Earth as magnetic field influences may play a role in developmental conditions such as autism and senescence-associated conditions such as dementia when integration of the biological and biophysical aspects of humans of humans are required for effective functioning. This review will discuss the involvement of magnetic fields on various normal and disturbed processes in humans while on Earth and then further discuss potential outcomes when the GMF is no longer available to impact host systems. Thus, the GMF of the Earth has been present throughout evolution but details of its role in human functions still remain to be elucidated.

(1) Introduction: Every two hours, a Romanian woman is diagnosed with cervical cancer [1] as the country ranks second in Europe in terms of mortality and incidence rate [2]. This paper aims to identify the main reasons that have led to this situation, focusing on the measures taken by the Romanian Ministry of Health for the prevention of this type of cancer national - programs for cervical cancer screening and HPV vaccination. (2) Materials and methods: We performed a study based on available secondary data from the National Statistics Institute, World Health Organization and Bucharest Institute of Oncology in order to assess the burden associated with cervical cancer and placing it in the context of known global and European incidence and mortality rates, thus evaluating the importance of this health issue in Romania. The second component of our study was a cross-sectional study, using a 14 questions questionnaire, applied to the women participating in the National Screening Program for Cervical Cancer, aimed to evaluate the women’s level of knowledge about screening and HPV vaccination and their access cervical cancer specific health-care services. (3) Results: The results of the research shows that a high percentage of women postpone the routine checks due to lack of time and financial resources and indicate that low level of knowledge about the disease and the specific preventive methods determines low participation screening and HPV vaccination programs implemented in Romania contributing to the country’s situation of cervical cancer. (4) Conclusions: The national programs have complicated procedures, are underfunded, and do not motivate enough health care workers. This combined with the lack of information adds up to an extremely low number of women screened and vaccinated. Our conclusion is that the Romanian Ministry of Health must take immediate action by conducting major awareness campaigns, implementing measures to make the programs functional and ensuring coherent funding.

Background: The research is conducted against the backdrop of the rising incidence of diabetes and the demand for novel approaches to improve patient outcomes. With the goal of revolutionizing conventional methods and addressing the changing healthcare landscape, the study concentrated on the application of AI technology in diabetes treatment. Objective: Examining the various ways AI can be used in diabetes care and assessing how it can enhance automated screenings, tailored treatment recommendations, predictive modeling, and patient self-management were the main goals of the study. Result: The findings demonstrated how well AI works to anticipate a patient's unique reaction to a therapy, assist medical personnel in making decisions, and give patients more control over their own care. Artificial intelligence (AI)-powered solutions showed promise in improving real-time monitoring and encouraging patient adherence, supporting a comprehensive strategy for managing diabetes. Conclusion: The research indicates that artificial intelligence (AI) has great potential to change the way diabetes is treated. However, it also highlights the need for more research, ethical issues, and validation of AI. The results advocate for joint efforts to ensure responsible and patient-centered technology innovation in diabetes care and encourage the integration of AI with new technologies.

Suicide dynamics form a complex system deeply influenced by interrelated factors, necessitating advanced methodologies for comprehensive analysis. This study pioneers the application of Particle Markov Chain Monte Carlo (PMCMC) methods in suicide research, recognized for their enhanced sampling efficiency over traditional techniques in complex, high-dimensional models. PMCMC is particularly adept at handling non-Gaussian distributions and navigating parameter spaces efficiently, preventing the entrapment in local optima. Utilizing PMCMC, our research simulated a broad spectrum of potential outcomes, clarifying the probable scenarios and their likelihoods, thus enriching the predictive accuracy and understanding of suicide dynamics. These methods facilitated the exploration of dynamic interactions among key risk factors such as mental health issues, trauma, substance use, social isolation, and access to harmful means, whose complex interplays challenge predictive modeling. The study extends previous applications of PMCMC in complex systems like H1N1, opioid crises, and COVID-19 to the domain of suicide, suggesting its potential in enhancing decision-making and intervention strategies. However, limitations due to the model's simplified assumptions and the specificity of the data to certain populations underscore the necessity for broader application to validate findings across varied demographics. In summary, while PMCMC offers robust capabilities for the dynamic modeling of suicide, it requires careful parameter selection and consideration of computational demands. Future research should continue to leverage this approach in more complex settings, enhancing our ability to predict and mitigate suicide risks effectively.

Synthetic fiber ropes are frequently used as mooring lines in floaters supporting Floating Offshore Wind Turbines (FOWTs) due to their various advantages. Damages in these lines can lead to the disruption of the FOWTs normal operation and thus their early detection is crucial. Currently, this damage detection problem has been investigated exclusively for FOWT chain mooring lines. This study focuses on the damage detection in FOWT synthetic mooring lines under varying environmental-operational conditions (EOCs) via two types of vibration-based Structural Health Monitoring methods: those based on Multiple Models and those based on a single Functional Model. The methods are based on multivariate AutoRegressive or on scalar Transmittance Function (TF) AutoRegressive with eXogenous input models. All methods are evaluated through a Monte Carlo study involving 390 simulations with a 10MW wind turbine mounted on the semi-submersible OO-Star wind floater and two damage scenarios (10%, 14% stiffness reduction) to a single mooring line. The results using acceleration signals from only two measuring positions on the mooring line, indicate the great potential for robust SHM in FOWTs synthetic mooring lines with the TF model-based methods successfully detecting the considered early stage damage scenarios, even for EOCs not encountered in the methods training.

One of the main problems for managing global crises is to clarify and reduces drivers of systemic weaknesses to face complex emergencies. This study here analyzes the relation between public debt, healthcare expenditures and fatality rates in the presence of pandemic crises, such as COVID-19. Statistical evidence, based on a sample of European countries, here shows that high public debt over time reduces health expenditures and increases the vulnerability of countries to face emergencies, such as COVID-19 pandemic crisis. Regression analysis with a log-log model suggests that when European countries experience a 1% increase in healthcare expenditure per capita, in general they have a 1.2% reduction in the COVID-19 fatality rate. Main implications of this study to reduce the systemic risk and vulnerability to environmental threats are that countries must reduce public debt with good governance and institutions without reducing the allocation of economic resources to the healthcare sector in order to improve the preparedness to unforeseen emergencies and crises, such as pandemics, natural disasters, conflicts, and other environmental threats.

Global rapidly evolving events, e.g., COVID-19, are usually followed by countermeasures and policies. As a reaction, the public tends to express their emotions on social media platforms. Therefore, predicting emotional responses to events is critical to put a plan to avoid risky behaviors. This paper proposes a machine learning-based framework to detect public emotions based on social media posts in response to specific events. It presents a precise measurement of population-level emotions which can aid governance in monitoring public response and guide it to put in place strategies such as targeted monitoring of mental health, to react to a rise in negative emotions in response to lockdowns, or information campaigns, for instance in response to elevated rates of fear in response to vaccination programs. We evaluate our framework by extracting 15,455 tweets. We annotate and categorize the emotions into 11 categories based on Plutchik’s study of emotion and extract the features using a combination of Bag of Words and Term Frequency-Inverse Document Frequency. We filter 813 COVID-19 vaccine-related tweets and use them to demonstrate our framework’s effectiveness. Numerical evaluation of emotions prediction using Random Forest and Logistic Regression shows that our framework predicts emotions with an accuracy up to 95%.

According to Young Minds [1] ‘everyone gets angry sometimes’. Their website offers a number of de-escalating strategies, including staying calm, managing responses and setting limits to help young people who most deem resistive. Yet, Young Minds are not alone because such logical advice is ubiquitous in the literature about challenging behaviour despite the fact that in our experience when faced with high states of arousal, most young people tend to act first and deal with the consequences later. It’s not that they are stupid or non-caring, but they are human capable of great feats as well as stupidity. The same is true for any claims that solution focused (SF) conversations can put right the several decades of psychological theory suggesting resistance requires logic and better cognition. By giving the correct thinking skills, young people will walk away from risk, avoid physical confrontation, handle challenging situations like logical thinkers, and generally discount that the process of growing up is part of the challenge. It is with this in mind that over recent years in our current SF practice (with staff group supervision) we have examined the concept of ‘resistance’ and how it can be put to use as a process of collaboration. To do this, we have revisited SF theory that preoccupied many of its pioneers during the 1980’s and 1990’s and attempted to make it useful for the early 2020’s for professionals having conversations with young people, who, in traditional models, are labelled challenging. We want to introduce key differences of solution focused practice and how Anita started to formulate a 6D-SF model (details, dynamics, dimensions, dispositions, dislocations, descriptions) for contemplating how groups of professionals relate to each other and are triggered by challenging behaviour. We do not claim to have proof, logic or exactness on our side, but we’re happy to suggest how our resistance mirrors what many of the staff teams feel and describe when working through their work.

Adherence to the Mediterranean diet has been shown to lower the risk of developing chronic non-communicable diseases like cardiovascular and neurodegenerative diseases and cancer. Improvements in depression, participation in daily activities in older individuals, weight loss and reduction in adverse pregnancy outcomes are associated with adherence to the Mediterranean diet. The number of studies that have evaluated barriers to the adherence of the Mediterranean diet in the US and in particular, in racial and ethnic minority populations within the US are few. Among Native American and Alaskan Native populations, studies evaluating traditional or alternative Mediterranean diet adherence for chronic non-infectious diseases is unavailable. Mediterranean diet scoring instruments used in studies in European and Mediterranean countries and among white participants in the US fail to capture the dietary patterns of racial and ethnic minority populations. In this narrative review the food components of the traditional Mediterranean diet are discussed, adherence to the Mediterranean diet is examined in Mediterranean and non-Mediterranean countries and barriers preventing adherence to the Mediterranean diet in the US and among racial and ethnic minority populations is reviewed. Recommendations for improving nutrition education and intervention, and increasing adherence and cultural adaptions to the Mediterranean diet are provided.

Abstract: (1) Background: Post-COVID syndrome is defined as symptoms that occur simultane-ously with or after COVID-19 infection, last for 12 weeks, and are not due to another diagnosis. Limited data are available on people’s long-term quality of life (QoL) following COVID-19 infection. The aim of this cross-sectional study was to investigate long-term QoL after COVID-19 among employees of the St. Josef Hospital in Paderborn, Germany, and to identify risk factors. (2) Methods: A monocentric, cross-sectional study was conducted using the validated and digitized WHOQOL-BREF questionnaire via Netigate® between 10/2022 and 02/2023. Data on QoL and global health status were collected in the following four domains: physical health, mental health, social relationships, and environment. (3) Results: The response rate was 73.84% (923/1250). Furthermore, 63.45% of hospital staff respondents reported at least one persistent symptom after COVID-19 infection, leading to significant differences in QoL. Pre-existing conditions, persistent symptoms, and disability after COVID-19 infection, as well as high BMI, no partnership, and low educational level were found to significantly contribute to long-term low QoL. (4) Conclusions: Obesity, lack of partnership, and a low level of education were independent risk factors for lower QoL post-COVID-19 infection in this cohort of hospital staff. Further multicenter studies are re-quired to validate the incidence and their suitability as independent risk factors for post-COVID syndrome.

Background: In America, vaccine-related deaths constitute a significant contributor to child mortality. An essential means of reducing this is through broad vaccine coverage. The COVID-19 pandemic has posed a potential disruption to vaccine coverage due to its effects on the healthcare system. Objectives: This study aims to evaluate the impact of the COVID-19 pandemic on DTP3 vaccination coverage in the Americas, investigating trends from 2012 to 2022 to identify significant changes, regional disparities, and the overall effect of the pandemic on progress towards global immunization targets. Methods: This study used the coverage data for the third dose of the Diphtheria, Tetanus, and Pertussis Vaccine (DTP3) pulled from UNICEF databases spanning 2012 to 2022. We conducted a JoinPoint regression to identify points of significant trend changes. The annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated for America and its regions. We also used segmented regression analysis. Using the Chi-square test, we compared DTP3 vaccination coverage for each country between 2019 and 2022. Results: Overall, America saw a decrease in vaccine coverage during this period, with an APC of -1.4 (95% CI -1.8.; -1.0). This trend varied across regions. In North America, the decrease was negligible (-0.1% APC). South America showed the steepest decrease, with an APC of -2.5%. Central America also signif-icantly declined, with an APC of -1.3%. Our findings suggest a concerning trend of declining DTP vaccination rates in the Americas, exacerbated in certain regions, in the wake of the COVID-19 pandemic. The absolute decrease in vaccine coverage in the Americas was -4 % between 2019 and 2022, with the most significant drop observed in Central America (-7 %). However, six countries reported increased vaccination rates post-COVID-19, led by Brazil, with a 7% increase. Conversely, twenty-two countries registered a decline in DTP3 vaccine coverage, with the average decrease being -7.37%. This decline poses a significant challenge to achieving the WHO's target of 90% coverage for the third dose of DTP by 2030, as evidenced by the reduction in the number of countries meeting this target from 2019 to 2022. Conclusions: The COVID-19 pandemic has impacted vaccine coverage in America, leading to a decrease, especially across Central America.

BACKGROUNDRestrictive practices are defined by measures linked to physical and chemical restraints to reduce the movement or control behaviours during any emergency. Seclusion is an equal part of restrictive practices intended to isolate and reduce the sensory stimulation to safeguard the patient and those within the vicinity. Using interventions by way of virtual reality (VR) could assist with reducing the need for restrictive practices as it could help reduce anxiety or agitation by way of placing users into realistic and immersive environments. This could also aid staff to and change current restrictive practices.AIMTo assess the feasibility and effectiveness of using a VR platform to provide reduction in restrictive practice (RRP) training. METHODSThe study received ethics approval was obtained prior to starting the study from the Health Research Authority in United Kingdom (22/HRA/3030 REFERENCE). A randomised controlled feasibility study was conducted alongside of an evaluation at at 1 month and 6 within inpatient psychiatric wards at Southern Health NHS Foundation Trust, UK. Virti Virtual Reality scenarios will be used on VR headsets to provide training on reducing restrictive practices in 3 inpatient psychiatric wards. Outcome measures included General Self-Efficacy (GSE) scale, Generalised Anxiety Disorder Assessment 7 (GAD-7), Burnout Assessment Tool (BAT-12), The Everyday Discrimination (EDS) Scale, and the Compassionate Engagement and Action (CEA) Scale. RESULTSThe statistical significance of most variables is high, with the exception of the BAT12 score, compassionate engagement to others score, compassionate to others total score, compassionate engagement from others score, and compassionate from others total score, which exhibit lower statistical power in two-sample t-tests. To assess the acceptability, preference, and adherence of users to the Virti VR technology for RRP training, we calculated the System Usability Scale (SUS) scores and visualized the program's completion using pie charts. The majority of respondents reported SUS scores exceeding 70, with a mean SUS score of 71.79. In accordance with the insights provided by Bangor et al. (38), the VR platform demonstrated superior usability compared to approximately 62% of other products. we utilized the GAD7 score to assess the confidence levels within the two groups. We compared the data for the VR group and the control group after one month, as well as the baseline and one-month data for both the VR group and the control group. Given that the p-values are below 0.05 and the statistical power is high, it can be concluded that there are no statistically significant differences in confidence levels between the VR and control groups at baseline and day-30. CONCLUSIONSOur study has revealed the challenges associated with implementing such a program, even though the staff has given it high usability ratings. With the ongoing advancement of VR technology, we have the capability to create scenarios and simulations tailored to various healthcare environments. This empowers staff to receive more comprehensive and effective training for handling a wide range of situations.

Background: Depression, a multifaceted mental health condition, necessitates a multidimensional approach to treatment. This study aimed to elucidate the potential efficacy of various mitochondrial interventions, ranging from pharmacological treatments to lifestyle modifications, in alleviating depressive symptoms and enhancing overall mental well-being and assess the diverse range of mitochondrial assessments for managing depression by synthesizing findings from selected studies. Methods: A systematic compilation of studies, employing observational, interventional, and animal-based designs, was undertaken to elucidate the intricate relationship between mitochondrial function and depression as well as depressive signs and symptoms. The PRISMA guidelines were employed for conducting this review and a specific set of selection criterion were formulated by a team of reviewers for selection of relevant papers. Results: The synthesized results from the 21 selected papers highlighted the potential of these interventions to target diverse aspects of depression. Hyperbaric oxygen therapy and psychotherapy demonstrated significant reductions in depression and anxiety scores, with hyperbaric oxygen therapy particularly effective in improving nerve function and daily living activities. Whole-body cryotherapy displayed substantial improvements in depressive symptoms and quality of life. Frequent sauna bathing exhibited a lower risk of depressive symptoms in males. Dietary patterns, including Paleolithic and Mediterranean diets, showcased potential protective effects against depression, anxiety, and stress. The ketogenic diet revealed promise in ameliorating depression and psychosis symptoms alongside positive metabolic changes. Fasting interventions, though challenging, were associated with lower anxiety and depression levels without increased fatigue. Bright white light therapy enhanced remission rates and reduced depression scores in bipolar depression. Probiotic supplementation exhibited potential in reducing depression scores and improving metabolic markers, although further investigation is warranted. Conclusion: The diverse array of interventions explored in this study underlines the multifaceted nature of depression treatment. While these findings offer hope for more personalized and effective approaches, it is imperative to consider the variability in study designs, sample sizes, and methodologies among the selected papers. The mechanisms underlying the observed effects remain partially understood, emphasizing the need for continued mechanistic research. This study sets the stage for future investigations and clinical practices, showcasing the potential of various interventions in mitigating the challenges posed by depression and paving the way for more effective treatment strategies.

The main objective of the paper is to investigate the wave propagation behaviour in composites using numerical and experimental methods. Specifically, the study focuses on the actuation of waves by two PZT transducers placed on the surface and embedded at different positions within the composites, namely the quarter and middle positions. The numerical analysis provides simulated results, while the experimental analysis involves practical testing. The paper demonstrates that the numerical results are consistent with the experimental findings. It is observed that when the PZT transducers are placed at deeper positions within the composites, the peak amplitude of the first wave packet for the A0 mode decreases. Overall, the paper contributes to the understanding of wave propagation in composites by comparing the effects of different positions of PZT transducers, both on the surface and embedded within the material. The findings highlight the influence of transducer placement on wave characteristics, particularly the reduction in peak amplitude with deeper transducer positioning.

The home is becoming a key location for healthcare delivery, including the use of technology driven by autonomous systems (AS) to monitor and support healthcare plans. Using the example of a smart mirror, this paper describes the outcomes of focus groups with people with multiple sclerosis (MS; n=6) and people who have had a stroke (n=15) to understand their attitudes towards the use of AS for healthcare in the home. We thematic analysis to analyse the data. The results indicate that the use of such technology depends on the level of adaptability and responsiveness to the users’ specific circumstances, including their relationships with the healthcare system. A smart mirror would need to support manual entry, responsive goal setting, effective aggregation of data sources and integration with other technology, have a range of input methods, be supportive rather than prescriptive in messaging, and give the user full control of their data. Barriers to adoption include a perceived lack of portability and practicality, lack of accessibility and inclusivity, a sense of redundancy, being overwhelmed by multiple technological devices, and a lack of trust in data sharing. These results inform the development and deployment of future health technologies based on the lived experiences of people with health conditions who require ongoing care.

Infection with the porcine reproductive and respiratory syndrome virus type 1 (PRRSV-1) has serious economic consequences for the pig industry. Swine practitioners and other agricultural advisors often describe an increase in antibiotic use when PRRSV-1 is circulating. Our objective was to assess the impact of PRRSV-1 stabilization programmes on reducing antibiotic use. The study was carried out on 19 French farrow-to-finish farms that successfully implemented a PRRSV-1 stabilization protocol between 2007 and 2019. For each farm, antibiotic consumption (expressed in mg/PCU and ALEA) were compared one year before (P1) and one year after (P2) the implementation of such a protocol and the change between P1 and P2 were calculated in percentages. Data were then analysed by level of consumption. Antibiotic use decreased significantly between P1 and P2 if expressed in mg/PCU and showed a decreased tendency in terms of exposure (ALEA). Concerning the change from P1 to P2, our results showed that the higher consumption levels in P1, the greater antibiotic reduction in P2. This study highlights the ability of a stabilization protocol against PRRSV-1 to reduce antibiotic use, especially on farms that have high consumption. These hopeful results show that further investigations about the relationship between PRRSV-1 and antibiotic usage could be beneficial.

The 2019-2020 Australian bushfires followed by the COVID-19 pandemic brought the significant mental health implications of working in healthcare to the fore. The importance of appropriate support services to ensure the resilience and recovery of healthcare workers has been highlighted. In response to healthcare staff experiences during the bushfires, the SEED Wellness Program was created in 2020 in the Illawarra Shoalhaven Local Health District, in NSW Australia. SEED used a participatory action methodology to engage and collaborate with healthcare staff teams in workplace-based restorative activities. Guided by Practice Theory, this study aimed to identify and describe SEED wellness practices that supported healthcare staff. Thirty-three healthcare workers participated in focus groups or individual interviews between June 2021 and March 2022. The analysis involved inductive thematic individual and collective exploration of SEED practices, including co-analysis with participants. Eight core practices that supported participants’ wellbeing were identified including responsive and compassionate leading, engaging staff at every stage of the recovery process, creating a sense of connection with others, and collective caring. The study found that workplace wellness initiatives are optimised when place-based and grounded in local knowledge, needs, and resources incorporating a collective and supportive team approach. Moreover, to ensure engagement in, and sustainability of these initiatives, both bottom-up and top-down commitment is required.

Abstract: Ambulatory cancer centers face fluctuating patient demand and deploy specialized personnel who have variable availability. This undermines operational stability through misa-lignment of resources to patient needs, resulting in overscheduled clinics, budget deficits, and wait times exceeding provincial targets. We describe deployment of a Learning Health System framework for operational improvements within the entire ambulatory center. Known methods of value stream mapping, operations research and statistical process control were applied to achieve organizational high performance that is data-informed, agile and adaptive. We transitioned from a fixed template model by individual physician to a caseload management by disease site model that is realigned quarterly. We adapted a block schedule model for the ambulatory oncology clinic to align the regional demand for specialized services with optimized human and physical resources. We demonstrated improved utilization of clinical space, increased weekly consistency and im-proved distribution of activity across the workweek. Increased value, represented as the ratio of monthly encounters per nursing worked hours, and increased percentage of services delivered by full-time nurses were benefits realized in our cancer system. The creation of a data-informed demand capacity model enables application of predictive analytics and business intelligence tools that will further enhance clinical responsiveness..

The advent of high throughput sequencing has enabled researchers to systematically evaluate the genetic variations in cancer, resulting in identifying many cancer-associated genes. Although cancers in the same tissue are widely categorized in the same group, they demonstrate many differences concerning their mutational profiles. Hence there is no “silver bullet” for the treatment of a cancer type. This reveals the importance of developing a pipeline to identify cancer-associated genes accurately and re-classify patients with similar mutational profiles. Classification of cancer patients with similar mutational profiles may help discover subtypes of cancer patients who might benefit from specific treatment types. In this study, we propose a new machine learning pipeline to identify protein-coding genes mutated in a significant portion of samples to identify cancer subtypes. We applied our pipeline to 12270 samples collected from the International Cancer Genome Consortium (ICGC), covering 19 cancer types. Here we identified 17 different cancer subtypes. Comprehensive phenotypic and genotypic analysis indicates distinguishable properties, including unique cancer-related signaling pathways, in which, for most of them, targeted treatment options are currently available. This new subtyping approach offers a novel opportunity for cancer drug development based on the mutational profile of patients. We also comprehensive study the causes of mutations among samples in each subtype by mining the mutational signatures, which provides important insight into their active molecular mechanisms. Some of the pathways we identified in most subtypes, including the cell cycle and the Axon guidance pathways, are frequently observed in cancer disease. Interestingly, we also identified several mutated genes and different rates of mutation in multiple cancer subtypes. In addition, our study on “gene-motif” suggests the importance of considering both the context of the mutations and mutational processes in identifying cancer-associated genes. The source codes for our proposed clustering pipeline and analysis are publicly available at: https://github.com/bcb-sut/Pan-Cancer.

This paper focuses on parametric model order reduction (PMOR) of guided ultrasonic wave propagation and its interaction with damage in a fiber metal laminate (FML). Structural health monitoring in FML seeks to detect, localize and characterize the damage with high accuracy and minimal use of sensors. This can be achieved by the inverse problem analysis approach which employs the signal measurement data recorded by the embedded sensors in the structure. The inverse analysis requires to solve the forward simulation of the underlying system several thousand times. These simulations are often exorbitantly expensive and triggered the need for improving their computational efficiency. A PMOR approach hinged on the proper orthogonal decomposition method is presented in this paper. An adaptive parameter sampling technique is established with the aid of a surrogate model to efficiently update the reduced-order basis in a greedy fashion. A numerical experiment is conducted to illustrate the parametric training of the reduced-order model. The results show that the reduced-order solution based on the PMOR approach is accurately complying with that of the high fidelity solution.

The COVID-19 pandemic has severely tested the physical and mental health of health care workers (HCWs). The various stages of the epidemic have posed different problems; consequently, only a prospective study can effectively describe the changes in the workers’ health. This repeated cross-sectional study is based on a one-year investigation (spring 2020 to spring 2021) of intensive care physicians in one of the two COVID-19 hub hospitals in Central Italy. Changes in their work activity due to the pandemic were studied anonymously together with their perception of organizational justice, occupational stress, sleep quality, anxiety, depression, burnout, job satisfaction, happiness, and intention to quit. In May-June 2021, one year after the baseline, doctors reported an increased workload, isolation at work and in social life, lack of time for physical activity and meditation and compassion fatigue. Stress was inversely associated with the perception of justice in safety procedures and directly correlated with work isolation. Occupational stress was significantly associated with anxiety, depression, burnout, dissatisfaction, and intention to quit. Procedural justice was significantly associated with happiness. Doctors believed vaccinations would help control the problem; however, this positive attitude had not yet resulted in improved mental health. Doctors reported high levels of distress (73%), sleep problems (28%), anxiety (25%), depression (64%). Interventions to correct the situation are urgently needed.

Abstract: Wireless body area networks (WBANs) have strong potential in the field of health monitoring. However, the energy consumption required for accurate monitoring limits the time between battery charges of the wearable sensors, which is a key performance factor (and can be critical in the case of implantable devices). In this paper, we study the inherent trade-off between the power consumption of the sensors and the probability of misclassifying a patient’s health state. We formulate this trade-off as a dynamic problem, in which at each step we can choose to activate a subset of sensors that provide noisy measurements of the patient’s health state. We assume that the (unknown) health state follows a Markov chain, so our problem is formulated as a partially observable Markov decision problem (POMDP). We show that all the past measurements can be summarized as a belief state on the true health state of the patient, which allows tackling the POMDP problem as an MDP on the belief state. We then empirically study the performance of a greedy one-step look-ahead policy compared to the optimal policy obtained by solving the dynamic program. For that purpose, we use an open-source Continuous Glucose Monitoring (CGM) data set of 232 patients over six months and extract the transition matrix and sensor accuracies from the data. We find that the greedy policy saves ~50% of the energy costs while reducing the misclassification costs by less than 2% compared to the most accurate policy possible that always activates all sensors. Our sensitivity analysis reveals that the greedy policy remains nearly optimal across different cost parameters and a varying number of sensors. The results also have practical importance, because while the optimal policy is too complicated, a greedy one-step look-ahead policy can be easily implemented in WBAN systems.

Proper treatment of infectious air could potentially mitigate the spread of airborne viruses such as porcine reproductive and respiratory syndrome virus (PRRSV). The objective of this research is to test the effectiveness of ultraviolet (UV) in inactivating aerosolized PRRSV, specifically, four UV lamps, UV-A (365 nm, both fluorescent and LED-based), "excimer" UV-C (222 nm), and germicidal UV-C (254 nm), were tested. The two UV-C lamps effectively irradiated fast-moving PRRSV aerosols with short treatment times (<2 s). One-stage and two-stage UV inactivation models estimated the UV doses needed for target percentage (%) reductions on PRRSV titer. UV-C (254 nm) dose needed for 3-log (99.9%) reduction was 0.521 and 0.0943 mJ/cm2, respectively, based on one-stage and two-stage models. An order of magnitude lower UV-C (222 nm) doses were needed for a 3-log reduction, i.e., 0.0882 and 0.048 mJ/cm2, based on one-stage and two-stage models, respectively. However, the cost of 222-nm excimer lamps is still economically prohibitive for scaling-up trials. The UV-A (365 nm) lamps could not reduce PRRSV titers for tested doses up to 4.11 mJ/cm2. Pilot-scale or farm-scale testing of UV-C on PRRSV aerosols simulating barn ventilation rates are recommended based on its effectiveness and reasonable costs comparable to HEPA filtration.

The popularity of electronic cigarettes in the United States and around the world has led to a startling rise in youth nicotine use. The Juul e-cigarette was introduced in the U.S. market in 2015 and had captured approximately 13% of the U.S. market by 2017. Unlike many other contemporary electronic cigarette companies, the founders behind the Juul® e-cigarette approached their product launch like a traditional high-tech start-up company, not like a tobacco company. This article presents a case study of Juul’s corporate and product development history in the context of US regulatory actions. The objective of this article is to demonstrate the value of government-curated archives as leading indicators which can (a) provide insight into emergent technologies and (b) inform emergent regulatory science research questions. A variety of sources were used to gather data about the Juul e-cigarette and the corporations that surround it. Sources included government agencies, published academic literature, non-profit organizations, corporate and retail websites, and the popular press. Data was disambiguated, authenticated, and categorized prior to being placed on a timeline of events. A timeline of four significant milestones, nineteen corporate filings and events, twelve US regulatory actions, sixty four patent applications, eighty seven trademark applications, twenty three design patents and thirty two utility patents related to Juul Labs and its associates is presented spanning the years 2004 thought 2020. This work demonstrates the probative value of findings from patent, trademark, and SEC filing literature in establishing a premise for emergent regulatory science research questions which may not yet be supported by traditional archival research literature. The methods presented here can be used to identify key aspects of emerging technologies before products actually enter the market, this shifting policy formulation and problem identification from a paradigm of being reactive in favor of becoming proactive. Such a proactive approach may permit anticipatory regulatory science research and ultimately shorten the elapsed time between market technology innovation and regulatory response.

Unrecorded alcohol comprises all types of alcohol that is not registered in the jurisdiction where it is consumed. In some countries in Central and Eastern parts of Europe as well as the Balkan, the major amount of unrecorded alcohol consumption may derive from homeproduction of fruit spirits. Some studies found a high prevalence of lead and cadmium in such spirits. This article provides a quantitative comparative risk assessment using the margin of exposure (MOE) methodology for lead and cadmium, compared to ethanol, for unrecorded fruit spirits. For average concentration levels, the lowest MOE (0.8) was calculated for ethanol (alcohol itself). For lead, the MOE was 13 for moderate daily drinking and 0.9 for the worst case. For cadmium, the MOE was 1982 for moderate daily drinking and 113 for the worst case. The results of this study are consistent with previous comparative risk assessments that ethanol itself comprises by far the highest risk of all compounds in alcoholic beverages. Regarding the metal contaminants, the risk of cadmium appears negligible, however, lead may pose an additional health risk in heavy drinking circumstances. Strategies to avoid metal contamination in settings of artisanal homeproduction of spirits need to be developed.

Heart disease is one of the most common diseases in middle-aged citizens. Among the vast number of heart diseases, coronary artery disease (CAD) is considered a common cardiovascular disease with a high death rate. The most popular tool for diagnosing CAD is the use of medical imaging, e.g., angiography. However, angiography is known for being costly and also associated with a number of side effects. Hence, the purpose of this study is to increase the accuracy of coronary heart disease diagnosis by selecting significant predictive features in order of their ranking. In this study, we propose an integrated method using machine learning. The machine learning methods of random trees (RTs), the decision tree of C5.0, support vector machine (SVM), the decision tree of Chi-squared automatic interaction detection (CHAID) are used in this study. The proposed method shows promising results and the study confirms that the RTs model outperforms other models.

Complex blade responses such as a rotating stall or simultaneous resonances are common in modern engines and their observation can be a challenge even for state-of-the-art tip-timing systems and trained operators. This paper analyses forced vibrations of axial compressor blades, measured during the bench tests of the SO-3 turbojet. In relation to earlier studies conducted in ITWL with a small number of sensors, a multichannel tip-timing system let us observe simultaneous responses or higher-order modes. To find possible symptoms of a failure, blade responses in a healthy and unhealthy engine configuration with an inlet blocker were studied. The used analysis methods covered all-blade spectrum and the circumferential fitting of blade deflections to the harmonic oscillator model. The proposed modal solver can track the vibration frequency and adjust the engine order on the fly. That way, synchronous and asynchronous vibrations are observed and analysed together with an extended variant of least squares. The proposed approach helps to avoid common mistakes and saves a lot of work related to configuring the conventional solver.

Clients are increasingly looking for fast and effective means to quickly and frequently survey and communicate the condition of their buildings so that essential repairs and maintenance work can be done in a proactive and timely manner before it becomes too dangerous and expensive. Traditional methods for this type of work commonly comprise of engaging building surveyors to undertake a condition assessment which involves a lengthy site inspection to produce a systematic recording of the physical condition of the building elements, including cost estimates of immediate and projected long-term costs of renewal, repair and maintenance of the building. Current asset condition assessment procedures are extensively time consuming, laborious, and expensive and pose health and safety threats to surveyors, particularly at height and roof levels which are difficult to access. We propose a method for automated detection and localisation of key building defects from images using deep learning and convolution neural networks. The proposed model is based on a pre-trained VGG-16 classifier with Class Activation Mapping (CAM) for object localisation. The model has proven to be robust and able to accurately detect and localise mould growth, stains, and paint deterioration defects arising from dampness in buildings. The approach is being developed with potentials to scale-up to support automated detection of defects and deterioration of buildings in real-time using mobile devices and drones.

In Italy HPV vaccination was implemented for girls since 2007 but its coverage was lower than recommended level. Sicily is one of the Italian administrative regions with lower vaccination coverage, ranging in the birth cohorts 1996–1999 from 59% to 62%. Aim of the study was to investigate factors associated with refusal of anti-HPV vaccination among young adult women of Palermo, Italy. A cross-sectional study was conducted through the administration of a telephone questionnaire, consisting of 23 items on HPV infection and vaccination knowledge based on Health Belief Model framework. The eligible population were young women with at least a previous vaccination among all included in Sicilian Vaccination schedule, without starting or completing anti-HPV vaccination schedule. Overall, 141 young women were enrolled, of them 84.4% were unvaccinated and 15.6% had at least one dose of HPV vaccine. In multivariate analysis, factors associated with the failure to perform the HPV vaccination were degree as school level (OR = 10.2, p = 0.041), lower participation at school seminar on HPV (OR = 0.2, p = 0.047) and lower perception of anti-HPV vaccine benefits (OR = 0.4, p = 0.048). Public health educational program focusing and tailored on benefits perception of anti-HPV vaccine and HPV disease severity, especially if carried out at school, can improve HPV vaccination uptake.

Nutrition, diabetes, and mental disorders are interconnected and significantly impact an individual's overall health and well-being. This comprehensive review aims to explore the complex interplay between nutrition, diabetes, and mental disorders, highlighting the latest research findings in this field. While the influence of nutrition on the development and management of both diabetes and mental disorders is widely recognized, there remains a gap in understanding the intricate interplay between nutrition, mental health, and diabetes. Diabetes is associated with an increased risk of mental disorders, including depression, anxiety, and cognitive decline. Mental disorders can also contribute to the development of diabetes through various mechanisms including increased stress, poor self-care behaviors, and adverse effects on glucose metabolism. Thus, the mechanisms linking nutrition, diabetes, and mental disorders are complex and multi-factorial. Inflammation, oxidative stress, gut microbiota alterations, and neuroendocrine dysregulation have emerged as potential pathways that may mediate the relationship between nutrition, diabetes, and mental disorders. Additionally, deficiencies in essential nutrients such as omega-3 fatty acids, vitamin D, B vitamins, zinc, chromium, magnesium, and selenium have been implicated in the pathogenesis of both diabetes and mental disorders. Our findings indicate that the use of personalized dietary interventions and targeted nutrient supplementation can improve metabolic and mental health outcomes in patients with type 2 diabetes.

The traditional manual recording of vaccination records in Germany faced challenges during the COVID-19 pandemic, prompting the introduction of a Covid smartphone app with QR codes. However, this solution brought new challenges, emphasizing the need for a centrally managed European digital vaccination record for efficiency and validity. Thus, this study assesses the feasibility of using the HL7 FHIR standard in the healthcare industry for implementing a digital vaccination pass management and monitoring system. The system aims to offer convenience and improved efficiency for both patients and healthcare providers while promoting interoperability with other healthcare systems. We developed a prototype using modern technologies, such as React, Quarkus, and Keycloak, evaluating the applicability of FHIR in promoting interoperability within the healthcare industry. Results indicate potential benefits for patients and healthcare providers, offering secure access to immunization records, personalized recommendations, and streamlined management. However, challenges in integrating nuanced vaccination processes into the standardized FHIR system, necessitating custom extensions, and issues with manual data entry and identity provider integration, pose obstacles. Despite these challenges, the study suggests that implementing HL7 FHIR can enhance efficiency, data accessibility, and accuracy in the vaccination process, supporting broader digitization efforts in the German healthcare system and beyond.

In the era of digital information consumption, YouTube has emerged as a prominent platform for disseminating knowledge across various domains. One such area that has gathered significant attention is teeth whitening, with a plethora of videos offering insights into professional proce-dures, home remedies, and personal experiences. This study delves into the vast landscape of teeth whitening content on YouTube, meticulously categorizing videos into professional and amateur domains. The aim is to critically analyze the information presented, considering its accuracy, re-liability, and potential impact on public perceptions and oral health choices. A total of 100 videos in Greek (n1= 73) and in English (n2= 27) were studied. The analysis was based on views, likes, publication year, duration, presence of background music, and the presence of a description. The completion date of the search was October 7, 2023. Professional videos predominantly present whitening as a painless, conservative, and economical procedure, emphasizing safety measures. Bleaching mechanisms involving hydrogen peroxide and carbamide are explored, with various application techniques discussed, including whitening strips, splints, and in-office procedures. Contradictory findings on the efficacy of home versus in-office treatments are highlighted. In-ternal and external discoloration factors are delineated, with contraindications specified. Amateur videos, garnering greater public appeal, present personal experiences, product promotions, and homemade remedies, reflecting a concerning trend of misinformation. The analysis incorporates viewer engagement metrics, emphasizing the impact of non-professional content. As social media platforms play an increasingly influential role in shaping healthcare narratives, understanding the nuances of dental discourse on YouTube becomes crucial for both practitioners and the public. This exploration encompasses a spectrum of topics, ranging from the chemical intricacies of bleaching agents to the societal dynamics influencing viewer preferences. By unraveling the complexities of online dental information, this study seeks to contribute valuable insights to the evolving land-scape of oral health education in the digital age. Future research should adopt a multi-platform approach and explore the dynamic interaction between content creators and viewers for a more holistic comprehension of online dental information.

Clinical trials often involve new substances characterized or developed for a specific pathology or class of pathologies. At other times, a clinical trial is observational; in other words, a known sub-stance has a range of effects on a given cohort of subjects. The types of trials are different and complex, and often, young clinical novice and the inexperienced researchers may struggle to evaluate how to proceed correctly. In this paper, we aim to create a mini-guide for beginners in clinical trials and provide elements for designing a clinical trial. Our intention is to highlight where to find the materials and how to adapt, even in the absence of sponsors, so that even the most inexperienced and under-resourced researcher can gain an understqanding of the complexi-ty of the process andaddress it appropriately. We do not claim to be exhaustive or cover all ele-ments, but rather, we aim to create a checklist. With this approach, starting discussioms about the experimental phases of the drug and concluding with the clinical trial, we aim to assist those facing this challenging "world."

Accurate estimation of body fat percentage is essential for various health and fitness applications. Traditional methods for measuring body fat, such as underwater weighing, can be costly and inconvenient. In this study, we apply machine learning techniques to predict body fat percentage using easily accessible body measurements and data. The results highlight the effectiveness of regression models in estimating body fat, with Linear Regression, Ridge Regression, and Bayesian Ridge models achieving R-squared scores of approximately 74%, 73%, and 73%, respectively. These models provide a practical and cost-effective solution for individuals and professionals seeking reliable body fat estimates.

(1) Background: Human-generated greenhouse gas (GHG) emissions are the largest contributor to climate change worldwide. Climate change negatively impacts human and planetary health threatening the existence of life on earth. The healthcare industry is responsible for approximately 8.5% of carbon emissions in the United States. Measuring baseline GHG emissions is the first step in emissions reduction. However, very few models of measurement exist for health care organizations. This project aimed to develop and implement a program to measure and track GHG emissions at a Midwestern Academic Medical Center (MAMC) and to educate staff to manage the process. (2) Methods: A Plan, Do, Study, Act (PDSA) cycle and Quality Improvement methodology was used to develop, implement, and assess a standardized GHG emission inventory process to measure Scope 1 and Scope 2 baseline emissions, and provide virtual training and education to the accountable staff. A pre- and post-survey design was used to measure the knowledge and readiness of the staff after the implementation of the GHG inventory training. (3) Results: The GHG inventory process was validated through an external verification process and the measurement of Scope 1 and Scope 2 baseline GHG emissions was completed and verified for accuracy through a data comparison review. The pre-post-training survey showed an increase in the knowledge and readiness of staff in maintaining a GHG inventory. (4) Conclusions: This work shows the feasibility of obtaining baseline GHG emissions data at large medical centers. It represents the initial phase of the overarching goal to develop site-wide and system-wide carbon reduction strategies and a climate action plan within this health system.

As digital technologies rapidly integrate into Health Professions Education (HPE), gaining a comprehensive understanding of cyberethics becomes crucial. This scoping review aimed to explore the pedagogy of cyberethics within HPE, with an emphasis on its definitions, conceptualizations, theoretical foundations, and interventions. Drawing from 37 documents spanning 2012-2022, primarily originating from the U.S. and encompassing both peer-reviewed and grey literature, the study highlighted a significant gap in the explicit definition and conceptualization of cyberethics. Additionally, the evident lack of specific theoretical frameworks in the majority of these documents could hamper the progression and replicability of research. Among the reviewed articles, only four introduced cyberethics educational interventions, indicating a substantial avenue for future research. While the study utilized comprehensive search methods, limitations such as language biases and the potential omission of pertinent documents were present. Future investigations should broaden the cyberethics discourse to encompass emerging technologies and their ethical implications within HPE. Crafting comprehensive, culturally sensitive, and inclusive guidelines is pivotal in nurturing ethical digital practices in the health care community.

Through a partnership with three Federally Qualified Health Centers (FQHCs), the local health department in Los Angeles County implemented a produce prescription program (PPR) to increase fresh fruit and vegetable purchases among patients with diabetes or prediabetes. The PPR, which began in 2020, provided eligible patients with a $40 voucher every month for 6 months to promote the purchase of fresh produce at large chain grocery stores. This qualitative assessment describes staff experiences with the PPR, documenting the facilitators and barriers they encountered while implementing the program. Fifteen clinic staff (i.e., PPR implementers) were interviewed for this assessment. Thematic analysis and coding were conducted using the ATLAS.ti software; the coding was carried out by two separate coders. Interviewees discussed the importance of having preexisting partnerships and programs to support the PPR at their clinic site. Hidden costs related to implementing the program included a large and unexpected amount of staff time devoted to enrolling patients into the program. Collecting quality data and having limited expertise to rigorously evaluate the program were other challenges. Because patients often share their food with their family, the monthly $40 incentive was generally not enough to support their needs; interviewees suggested giving a higher inventive amount to those with a larger household. Future PPR efforts and similar food incentive programs should consider these and other facilitators and barriers to implementation and sustainability, especially when making adjustments to these programs to improve services and access to food resources.

Artificial intelligence (AI) has the potential to revolutionize research by automating data analysis, generating new insights, and supporting the discovery of new knowledge. The top 10 contribution areas of AI towards public health were gathered in this feasibility study. We utilized the “text-davinci-003” model of GPT-3, using OpenAI playground default parameters. The model was trained with the largest training dataset any AI had, limited to a cut-off date in 2021. This study aimed to test the ability of GPT-3 to advance public health and to explore the feasibility of using AI as scientific co-author. The AI was asked for input including scientific quotations and the human authors reviewed responses for plausibility. We found that GPT-3 was able to assemble, summarize, and generate plausible text blocks relevant for public health concerns, elucidating valuable areas of application for itself. However, most quotations were invented by GPT-3 and thus, invalid. Ac-cording to today’s rules, we conclude that AI can contribute to public health research as a team member. Nevertheless, good scientific practice needs to be also followed for AI contributions, and a broad scientific discourse on AI contributions is needed. Policies for good scientific practice should be updated timely following this discourse.

Many apps have been created for food and health-related purposes, given our app’s secondary focus on calorie metrics and health, surveying existing apps, and previous approaches to curtailing the dining experience and promoting health will be helpful. An important aspect to consider when designing an app is a user engagement and how many people one can expect to use an app. Research has been done to study usage metrics and user experiences and opinions regarding mobile app usage, particularly in the health and diet app sector, which pertains to our app’s health features. Even with high user engagement, an app's overall utility and benefit also need to be considered and measured in some qualitative and quantitative sense. Numerous studies have been conducted to determine the effectiveness of food and diet apps on personal behavior. Although the app that is the subject of this proposal is not mainly a “dieting” app, its features, such as the calorie counter, can help facilitate these use cases for users inclined to do so.

We present an integrable, sensor inlay for monitoring crack initiation and growth inside bondlines of structural carbon fiber reinforced plastic (CFRP) components. The sensing structures are sandwiched between crack stopping polyvinyliden fluoride (PVDF) and a thin reinforcing polyetherimide (PEI) layer. Good adhesion at all interfaces of the sensor system and to the CFRP material is crucial as weak bonds can counteract the desired crack stopping functionality. At the same time, the chosen reinforcing layer must withstand high strains, safely support the metallic measuring grids and possess outstanding fatigue strength. We show that this robust sensor system, which measures the strain at two successive fronts inside the bondline, allows to recognize cracks in the proximity of the inlay regardless of the mechanical loads. Feasibility is demonstrated by static load tests as well as cyclic long-term fatigue testing with up to 1,000,000 cycles. In addition to pure crack detection, crack distance estimation based on sensor signals is illustrated. The inlay integration process is developed with respect to industrial applicability. Thus, implementation of the proposed system will allow the potential of lightweight CFRP constructions to be better exploited by expanding the possibilities of structural adhesive bonding.

Age estimation in dental radiographs Orthopantomography (OPG) is a medical imaging technique that physicians and pathologists utilise for disease identification and legal matters. For example, for estimating post-mortem interval, detecting child abuse, drug trafficking, and identifying an unknown body. Recent development in automated image processing models improved the age estimation's limited precision to an approximate range of +/- one year. While this estimation is often accepted as accurate measurement, age estimation should be as precise as possible in most serious matters, such as homicide. Current age estimation techniques are highly dependent on manual and time-consuming image processing. Age estimation is often a time-sensitive matter in which the image processing time is vital. Recent development in Machine learning-based data processing methods has decreased the imaging time processing; however, the accuracy of these techniques remains to be further improved. We proposed an ensemble method of image classifiers and transfer learning techniques to enhance the accuracy of age estimation using OPGs from one year to a couple of months (1-3-6). This hybrid model is based on convolutional neural networks (CNN) and K nearest neighbours (KNN). The hybrid (HCNN-KNN) model was used to investigate 1,922 panoramic dental radiographs of patients aged 15 to 23. These OPGs were obtained from the various teaching institutes and private dental clinics in Malaysia. To minimise the chance of overfitting in our model, we used the principal component analysis (PCA) algorithm and eliminated the features with high correlation. To further enhance the performance of our hybrid model, we performed systematic image pre-processing. We applied a series of classifications to train our model. We have successfully demonstrated that combining these innovative approaches has improved the classification and segmentation and thus the age-estimation outcome of the model. Our findings suggest that our innovative model, for the first time, to the best of our knowledge, successfully estimated the age in classified studies of one year old, six months, three months and one-month-old cases with accuracies of 99.98, 99.96, 99.87, and 98.78 respectively.

Research has consistently found that people with mental illness (known as consumers) experience lower levels of participation in meaningful activities, which can limit their opportunities for recovery support. The aim of this study was to describe the outcomes of participation in a group program designed to address all stages of activity participation, known as Pathways to Participation (P2P). A descriptive longitudinal design was utilized, collecting data at three time points. Outcomes were measured by the Camberwell Assessment of Need Short Appraisal (CANSAS), Recovery Assessment Scale – Domains and Stages (RAS-DS), Behaviour and Symptom Identification Scale (BASIS-24), Living in the Community Questionnaire (LCQ) and time use diaries. All data was analysed using descriptive statistics, and Chi square analyses. Seventeen consumers completed baseline data, eleven contributed post program data and eight provided follow up data. Most were female (63.64%) and had been living with mental illness for 11.50 (± 7.74) years on average. Reductions in unmet needs and improvements in self-rated recovery scores were re-ported, but no changes were identified in either time use or psychosocial health. The findings indicate the P2P program may enable consumers to achieve positive activity and participation out-comes as part of their personal recovery.

Medically underserved communities have limited access to effective disease management resources in the U.S. Mobile health applications (mHealth apps) offer patients a cost-effective way to monitor and self-manage their condition and to communicate with providers; however, current diabetes self-management apps have rarely included end-users from underserved communities in the design process. This research documents key stakeholder-driven design requirements for a diabetes self-management app for medically underserved patients. Semi-structured survey-interviews were carried out with 97 patients with diabetes and 11 healthcare providers from medically underserved counties in South Texas to elicit perspectives and preferences regarding a diabetes self-management app, and their beliefs regarding such an app’s usage and utility. Patients emphasized the need for accessible educational content and for quick access to guidance on regulating blood sugar, diet, and exercise and physical activity using multimedia rather than textual form. Healthcare providers indicated that glucose monitoring, educational content, and graphical visualization of diabetes data were among the top-rated app features. These findings suggest that specific design requirements for the underserved may improve the adoption, usability, and sustainability of such interventions. Designers should consider health literacy and numeracy, linguistic barriers, data visualization, data entry complexity, and information exchange capabilities.

In light of the urgency raised by the COVID-19 pandemic, global investment in wildlife virology is likely to increase, and new surveillance programs will identify hundreds of novel viruses that might someday pose a threat to humans. Our capacity to identify which viruses are capable of zoonotic emergence depends on the existence of a technology—a machine learning model or other informatic system—that leverages available data on known zoonoses to identify which animal pathogens could someday pose a threat to global health. We synthesize the findings of an interdisciplinary workshop on zoonotic risk technologies to answer the following questions: What are the prerequisites, in terms of open data, equity, and interdisciplinary collaboration, to the development and application of those tools? What effect could the technology have on global health? Who would control that technology, who would have access to it, and who would benefit from it? Would it improve pandemic prevention? Could it create new challenges?

Bayesian model calibration techniques are commonly employed in the characterization of nonlinear dynamic systems, as they provide a conceptual and effective framework to deal with model uncertainties, experimental errors and procedure assumptions. This understanding has resulted in the need to introduce a model discrepancy term to account for the differences between model-based predictions and real observations. Indeed, the goal of this work is to enhance model-driven Structural Health Monitoring procedures by incorporating the posterior uncertainty linked to updated model discrepancy, and thus make relevant considerations for its use in the Structural Health Monitoring. Specifically, the Bayesian inference has been applied to the calibration of nonlinear hysteretic systems to both provide: (i) most probable values (MPV) of the parameters following the calibration, and; (ii) estimates of the model discrepancy posterior distribution. The effect of the model discrepancy in the calibration is first illustrated recurring to a single degree of freedom Bouc-Wen type oscillator, and then applied for calibrating a reference nonlinear Bouc-Wen model, deriving from real data acquired on a monitored masonry building.

A striking aspect of COVID-19 is the difference in the outcome of the infection between different countries, and different ethnic groups within one country. We surveyed the literature on SARS-CoV-2 complemented with comparative publications on SARS-CoV and other coronaviruses to capture the current understanding of virus – host interactions including virus subtypes, transmission, zoonotic aspects, and potential host determinants.

The purpose of work is to quantify the changes of the organism functional reserves during the successive phases of the human health Space-Time Continuum (STC) on the basis of postulates of reliability complex systems theory. The study is devoted to the problem of age-related human involution, which is evaluated not from the causal, but from the kinetic point of view. The analysis of 10 most important basic life support systems of human body — cardiovascular (CVS), respiratory (RS), nervous (NS), digestive (DS), endocrine (ES), immune (IS), excretory (EXS), brain (BS), musculo-skeletal (MSS), hematopoietic (HS) was carried out. Based on this analysis two levels of ensuring the reliability of organism’s work were revealed: sequential and parallel. The system of logical equations for reduced sequential system is: Ys1 = CVS ∧ RS ∧ BS, where ∧ is the notation for the conjunctions of set elements. The system of logical equations for the reduced parallel system is: Ys2 = NS ∨ DS ∨ ES ∨ IS ∨ HS ∨ EXS ∨ MSS ,where ∨ is the disjunction of the scheme elements. Visualization of human STC changes the concept of the kinetics of age-related changes in the organism and the role of determinants of health as a stable factor accompanying a uniform, smooth transition from the most pronounced functions of the body to their gradual extinction. For human STC is formulated the following regularity kinetics of involutionary processes: after 30 years of age in the human body morphological changes regress in arithmetic progression, and the functions of organs in a geometric one. Assumption of health as a state redundancy of functions is suggested.