In European thought, the relationship among the fields of psychology, education, and health is both complex and obscured. Foucault’s acclaimed work, The Order of Things, offers a framework to evaluate their interconnection by identifying three distinct periods of European thought since the 16th century with respect to the ordering of phenomena—Renaissance, Classical and Modern. Theoretically dense and often difficult to decipher, the book’s categorization of language, value and being has been understandably underused, yet it provides deep insights into what have come to be known as psychology, education and health and remains invaluable in understanding the origin, limits and consequences of these fields. How Foucault’s analysis can be interpreted concerning the development of these areas as to each of the three periods of European thought is investigated. An approach based on narrative research appraises the analysis offered in the book. The results, presented for the first time in table form, compare these three periods, demonstrating a continuing practical value to Foucault’s insights. With the aid of the framework revealed by these tables, the boundaries and relationship of psychology, education and health become clear and their limitations—plus potential solutions to them—can be identified to mitigate anticipated negative consequences.

Background and Aims: Nurses are increasingly engaging with digital technologies to enhance safe, evidence-based patient care. Digital literacy is now considered a foundational skill and an integral requirement for lifelong learning, and includes the ability to search efficiently, critique information and recognise the inherent risk of bias in information sources. However, at many universities, digital literacy is assumed. In part, this can be linked to the concept of the Digital Native, a term first coined in 2001 by the US author Marc Prensky, to describe young people born after 1980 who have been surrounded by mobile phones, computers, and other digital devices their entire lives. The objective of this paper is to explore the concept of the Digital Native and how this influences undergraduate nursing education. Materials and Methods: A pragmatic approach has been used for this narrative review, working forward from Prensky’s definition of the Digital Native and backward from contemporary sources of information extracted from published health, education, and nursing literature. Results: The findings from this narrative review will inform further understanding of digital literacy beliefs and how these influence undergraduate nursing education. Recommendations for enhancing the digital literacy of undergraduate nursing students are also discussed. Conclusions: Digital literacy is an essential requirement for undergraduate nursing students and nurses, and is linked with safe, evidence-based patient care. The myth of the Digital Native negates the reality that exposure to digital technologies does not equate with digital literacy and has resulted in deficits in nursing education programs. Digital literacy skills should be a part of undergraduate nursing curricula, and National Nursing Digital Literacy competencies for entry into practice as a Registered Nurse should be developed and contextualised to individual jurisdictions.

(1) Background: Mpox was declared an international public health emergency by WHO. Initially, Smallpox vaccine in Italy was offered only to laboratory personnel at direct risk of infection. Currently, Healthcare workers (HCWs) are all considered by European Centre for Disease Prevention and Control (ECDC) to be at low or moderate risk. (2) Methods: To assess smallpox vaccination coverage among HCWs in an Italian hospital with different levels of risk of exposure to Mpox infection and to assess their attitudes toward vaccination, a self-report was administered to HCWs stratified at high and low/moderate risk. (3) Results: Of the 338 HCWs evaluated, 60.36% provided the requested data; among them the percentage of previously vaccinated staff was 38.7%, which corresponds to 23.4% of the total HCWs in the departments considered. Considering those born before 1979 as vaccinated, vaccination coverage increases from 23.4% to 41.4%. The department with the highest percentage of vaccinated is infectious diseases (60.5%); The percentage of HCWs who adhered to vaccination is 23%; only 8.8% of laboratory staff want to vaccinate, compared with 100% of midwives. The department with the highest percentage of vaccination adherence is proctology (85.7%). (4) Conclusions: Given the vaccination adherence rate and the vaccination coverage of the departments analyzed, it would be useful to extend vaccination against Smallpox to frontline HCWs involved in patient care in Italy too.

The primary purpose of this study was to determine the prevalence of drug-drug interaction (DDI) and duplicate therapy in chronic patients in a completely random study population engaged in digital health apps. In this cross-sectional study, polypharmacy checks for 100 completely anonymous patients were analyzed for the occurrence of DDIs and duplicate therapy. Logistic regression models were used to identify factors associated with DDIs and duplicate therapy. DDIs and duplicate therapy prevalence were 34% and 33%, respectively. Chi-Square test discovered a significant association between the DDIs and duplicate therapy variables. Logistic regression models showed a strong association between the number of medications taken and higher odds of DDIs occurring in our population only. In conclusion, our study shows that polypharmacy is a determining factor for the occurrence of unwanted DDIs, and the prevalence of duplicate therapy and DDIs is around 33%, increasing an issue regarding patient safety and its burden to the healthcare system.

Global emerge of zoonotic novel corona virus (COVID-19) became a pandemic and its effect to mankind is talk of the town now a days. This tiny, invisible enemy has affected every country in the world and almost every living directly or indirectly and nationwide complete lockdown has triggered a short-term environmental impact. Since 2003, corona virus came into existence in the form of Severe Acute Respiratory Syndrome (SARS) and more evolved Middle East Respiratory Syndrome (MERS) in 2012. This time, at the end of December 2019, outbreak of novel corona virus COVID-19 (also known as SARS-CoV₂, nCoV-2019) draw attention as global health emergency. World Health Organization (WHO) report says that the outbreak of this virus is so immense, it has already affected 35,57,235 people and caused death to 2,45,150 people worldwide and 46,433 Indians got affected with 1568 death as on 5^th May 2020 (2:00 am) and these numbers are increasing exponentially day by day. Virologist, micro-biologist and science community are hammering their head very hard to find out cure and vaccine against this powerful virus and to prevent mass demise of mankind. In order to curb the spread of COVID-19, Janta curfew on 22.03.2020 and nationwide complete lockdown was implemented in India for 21 days (phase-I, from 25.03.2020 to 14.04.2020) to stop community transmission of third stage, for 19 days (phase-II, 15.04.2020 to 03.05.2020) and 14 days (phase-III, 04.05.2020 to 17.05.2020) complete lockdown to minimize the community transmission effect. During complete lockdown and quarantine period a drastic change in Earth’s atmosphere, including reduction in emission of greenhouse gases, air pollution (~50% fall in air quality index), noise pollution, water pollution and solid waste pollution, have been recorded by government agencies as well as private agencies. In this paper we considered data of Janta curfew, phase-I and phase-II lockdown to link between geological and environmental aspect related to environmental impact due to emerge of COVID-19 and massive reduction in pollution level during complete lockdown in India. We propose future lockdown strategies to minimize the emission of greenhouse gas by ~100 Mt to ~200Mt (3.33% to 6.66%) of GHG_total per year by 2-4 days per month nationwide lockdown or ~70 Mt to ~140 Mt (2.33% to 4.66%) of GHG_total per year by 2-4 days per month complete lockdown of energy sectors only.

In this study, we present case studies to explore the dynamics of implementation and maintenance of health interventions. We analyze how specific interventions are built and eroded, how the building and erosion mechanisms are interconnected, and why we can see significantly different erosion rates across otherwise similar organizations. We use multiple comparative obesity prevention case studies to provide empirical information on the mechanisms of interest, and use qualitative systems modeling to integrate our evolving understanding into an internally consistent and transparent theory of the phenomenon. Our preliminary results identify reinforcing feedback mechanisms, including design of organizational processes, motivation of stakeholders, and communication among stakeholders, which influence implementation and maintenance of intervention components. Over time, these feedback mechanisms may drive a wedge between otherwise similar organizations, leading to distinct configurations of implementation and maintenance processes.

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.

Background: Occupational accidents contribute 46-65% of hepatitis B virus (HBV) infections among healthcare workers (HCWs). Vaccine against HBV infection offers protection of more than 90%. Despite availability of the vaccines in Tanzania, it’s uptake among HCWs in primary health facilities remains understudied. This study explored HBV vaccine uptake and associated factors among HCWs in rural and urban settings of north western Tanzania. Methodology: A cross-sectional analytical study was conducted between June and July in 2022 among HCW in Misungwi and Ilemela districts. Data were collected using a self-administered questionnaire and analyzed using IBM SPSS® version 25. Results: A total of 402 HCWs were recruited, their mean age was 34.9±7.77 years. Approximately half (54.7% (220/402) of HCWs had received at least one shot of HBV vaccine with only (18% (76/402) being fully vaccinated. Ilemela showed significantly higher uptake (χ2=23.64, df=1, p=0.00) of HBV vaccine as compared to their counterparts in Misungwi. Being male (aOR=2.38, 95% CI 1.28-4.45, p=0.006), working in urban (aOR=5.75, 95% CI 2.91-11.35, p=0.00) and employment duration of more than two years (aOR=3.58, 95%CI 1.19-10.74, p=0.023) were significantly associated with higher odds of HBV vaccination. Moreover, high perceived susceptibility to HBV infection (aOR=2.20, 95% CI1.02-4.75, p=0.044) and history of needle prick injuries (aOR=6.87, 95%CI 3.55-13.26, p=0.00) were also significantly associated with higher odds of HBV vaccination. Conclusion: There was low uptake of HBV vaccine among HCW in primary health facilities with a noteworthy difference between rural and urban settings.. Therefore, advocacy campaigns as well as resource mobilization towards promotion of HBV vaccination in primary health facilities are pivotal.

Objective: This study aimed to examine the relationship between health structure disparities and hospitalizations and deaths among the pediatric population in different regions. Method: The study employed an ecological time series design, utilizing population-based secondary data ob-tained from DATASUS, from the Brazilian Ministry of Health. The data included in this study encompassed the population aged zero to 19 years, health establishments, physicians working in health establishments, hospitalizations, and deaths related to Morbidities listed in the Interna-tional Classification of Diseases. The focus was explicitly on individuals diagnosed with Cere-bral Palsy and other paralytic syndromes. The data for this study were gathered from January 2018 to December 2021. TABNET was used for data collection, and Excel for tabulation and anal-ysis. Results: Analysis of health structure data across regions revealed notable disparities, par-ticularly in the North and Northeast regions, compared to other regions. These discrepancies prompted a decision to conduct a comparative assessment between these regions and the rest of the country. Conclusion: In the North region, a significant 50% difference in hospitalizations based on residence versus a place of care was observed for individuals with Cerebral Palsy and other paralytic syndromes, indicating the necessity for relocation to access appropriate medical treatment.

Monkeypox virus infection is a recognized public health emergency. Little research has been done on treatment options for this disease. Until recently, there was not a single published work describing the usage of specific drugs in human patients with monkeypox virus infection. This paper gives the first bibliometric analysis of monkeypox treatment options based on data available on PubMed and Scopus. It also reviews the specific drugs used in the treatment of monkeypox. That includes data on Tecovirimat, Cidofovir, Brincidofovir, and Vaccinia Immune Globulin. Tecovirimat is a promising option in progressive disease in terms of efficacy and safety. However, Brincidofovir has been associated with discontinuation of treatment. Cidofovir is also not the preferred drug among physicians. Currently, Tecovirimat can be further used for the management of aggravating cases. More studies should be conducted on Tecovirimat to treat this condition, mainly through controlled trials.

Latent Tuberculosis Infection (LTBI) poses a significant public health challenge, especially in populations with high HIV prevalence and limited healthcare access. Early detection and targeted interventions are essential to prevent the progression of active tuberculosis. This study develops predictive models for LTBI outcomes using logistic regression and machine learning approaches and evaluates strategies to improve LTBI awareness and testing. Data from rural areas in the Eastern Cape, South Africa, were analyzed to identify key demographic, health, and knowledge-related factors influencing LTBI outcomes. Logistic regression was employed to pre-dict LTBI positivity based on factors such as age, education, and HIV status. Machine learning models, including decision trees and random forests, were also applied to compare predictive accuracy. A knowledge diffusion model was used to assess the impact of educational interventions on increasing LTBI awareness and testing rates. Logistic regression achieved an accuracy of 66.67% with high precision (80%) but low recall (33%) for LTBI-positive cases, identifying age, HIV status, and LTBI awareness as significant predictors. The random forest model outperformed logistic regression in accuracy (59.26%) and F1-score (0.63), providing a better balance between precision and recall. Feature importance analysis revealed that age, occupation, and knowledge of LTBI symptoms were the most critical factors across both models. The knowledge diffusion model demonstrated that targeted interventions significantly increased LTBI awareness and testing, particularly in high-risk groups. While logistic regression offers more interpretable results for public health interventions, machine learning models like random forests provide enhanced predictive power by capturing complex relationships between demographics and health factors. These findings highlight the need for targeted educational campaigns and increased LTBI testing in high-risk populations, particularly those with limited awareness of LTBI symptoms.

This paper investigates the integration of SHM within the frame of Industry 4.0 technologies, highlighting the potential for intelligent infrastructure management through the utilization of Big Data analytics, Machine Learning, and the Internet of Things (IoT). The study also presents a success case focused on a novel SHM methodology for detecting and locating damages in metallic aircraft structures, employing dimensional reduction techniques such as Principal Component Analysis (PCA). By analyzing strain data collected from a network of sensors and comparing it to a baseline pristine condition, the methodology aims to identify subtle changes in local strain distribution indicative of damage. Through extensive Finite Element Analysis (FEA) simulations and a PCA contribution analysis, the research explores the influence of various factors on damage detection, including sensor placement, noise levels, and damage size and type. The findings demonstrate the effectiveness of the proposed methodology in detecting cracks and holes as small as 2mm in length, showcasing the potential for early damage identification and targeted interventions in diverse sectors such as aerospace, civil engineering, and manufacturing. Ultimately, this paper underscores the synergistic relationship between SHM and Industry 4.0, paving the way for a future of intelligent, resilient, and sustainable infrastructure.

The goal of this article is to provide a review of the experimental techniques and procedures using vibration methods for the Structural Health Monitoring (SHM) of Polymer-Matrix Composites (PMC). It aims to be a guide for any researchers to carry out vibration experiments. The linear methods are first introduced. But as PMC is a complex material, these classic methods showed some limits, such as low accuracy for small damages, and a high environmental dependency. This is why the nonlinear methods are secondly studied, considering that the complexity of PMC induces a nonlinear behavior of the structure after damage occurrence. The different damage mechanisms are well explained in order to evaluate the potential of each vibration method to detect them.

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.

Pregnancy at advanced maternal age is considered a risk factor for adverse maternal, fetal, and neonatal outcomes. Here we investigated whether maternal age could be associated with differences in the blood levels of newborn screening (NBS) markers for inborn metabolic disorders on the Recommended Universal Screening Panel (RUSP). Population-level NBS data from screen-negative singleton infants were examined, which included blood metabolic markers and covariates such as gestational age, birth weight, age at blood collection, infant sex, parent-reported ethnicity, and maternal age at delivery. Marker levels were compared between maternal age groups (age range: 15-44 years) using effect size analyses, which controlled for group size differences and potential confounding from other covariates. Our results showed that 13% of the markers had maternal age-related differences including newborn metabolites with either increased (C14, C16, C18, C18:1, C3DC) or decreased (C5OH) levels at advanced maternal age group (≥35 years, absolute Cohen’s d ≥ 0.2). The increased C3DC levels in this group correlated with a higher false-positive rate in newborn screening for malonic acidemia (p-value < 0.001), while no significant difference in screening performance was seen for other markers. Maternal age at delivery is associated with inborn metabolic differences and should be considered together with other clinical variables in genetic disease screening.

Spatial planners are nowadays strongly interested in the benefits of greenspace for the health of urban residents. However, concrete and context-specific guidance on effective greening strategies is still lacking. We present a novel, model-based approach to support the development of such strategies. The approach is quantitative and spatially-explicit, and accounts for multiple health benefits as well as burdens. In this study, we applied the approach to the city of Maastricht (The Netherlands), and conducted an integrated, city-scale assessment of the health benefits and burdens of four urban greenspace designs. These included: ‘No greenspace’, ‘Current greenspace’, ‘Green parking lots and squares’, and ‘Optimized greenspace locations’. For each greenspace design, indicator values were calculated for five health determinants: heat stress, air pollution, perceived unsafety, unattractive views, and tick-bite risk. To assess the health contribution of urban greenspace in a given design, these indicator values were compared with the values in the ‘No greenspace’ design. The study produced clear, quantitative conclusions about the health benefits and burdens of the urban greenspace designs for the case of Maastricht, but also generated novel, more general insights relevant to planning of urban greenspace for health. These insights concern the importance of translating health policy objectives into specific target values or thresholds, and the importance of ‘smart’ choices in greenspace type and location that can effectively reduce trade-offs between health benefits and burdens. Priorities for future research, addressing limitations of the presented approach, concern a further expansion of the range of health benefits and burdens covered by the model, and the development of a common metric for the entire range of health benefits and burdens allowing optimization of greenspace design to maximize its overall net health benefit.

The rapid spread of COVID-19 worldwide was accompanied by intense fears, confusion, worries, anger and stress threatening people’s mental health. Unprecedented measures to slow down and prevent the transmission of COVID-19 have had various impacts on the population’s health behaviour and mental health. The main purpose of the present study is to investigate the lockdown’s effects on university students’ mental health in Romania. Based on a cross-sectional design, the survey data were collected from a sample of 722 participants (247 males; M = 21.1 years; SD ± 1.73). A path analysis was performed to verify the hypothesised direct and indirect effects included in the multiple mediation model. The findings showed a positive association between stress and boredom proneness, missing daily social interactions, spending more time on phone conversations and the increasing interest in following news about the pandemic. The path analysis revealed an excellent fit between the proposed multiple mediation model and the sample data. Boredom proneness and missing daily social interactions both affected stress, directly and indirectly, through more time spent on phone conversations. In addition, it was found that the increased interest in following news about the pan-demic mediated the relationship between boredom proneness and perceived stress. In terms of gender differences, our findings revealed that female students experienced significantly higher stress levels than male students, perceived to a greater extent the lack of daily social interactions and spent more time on phone conversations. Overall, the findings further extend the empirical evidence on university students’ mental health in the context of the COVID-19 pandemic. Therefore, universities need to organise support programmes focused on developing university students’ coping strategies to maintain their mental health even in adverse contexts.

We do this research to investigate the relationship between renewable energy, public health expenditure, logistics performance indices, and economic and environmental sustainability in the ASEAN member states, through the analysis of a panel data from 2007 to 2017. The study used secondary data, which is downloaded from the World Bank Website and employs SEM (Structural Equation Modelling) model for testing hypothesis. The results show that the usage of renewable energy in logistical operations would enhance the environmental and economic performance in terms of mitigating carbon emissions and greenhouse gas emissions. While, public health expenditure and environmental performance is negatively correlated, which confirms that greater environmental sustainability with lower carbon emissions and greenhouse gases will improve human health and economic growth. Moreover, greater public health expenditure and poor environmental performance has negative effect on economic growth, inefficiency and low productivity of labor slowdown to the economic activities. For another side, the usage of renewable energy and the adoption of green practices in international logistics will develop the environmental sustainability, establish better image of a country and attract foreign direct investment inflows, and also minimize carbon emissions and public health expenditure, spurring sustainable economic growth with better export opportunities in pro-environmental countries.

Background and Aims: Late diagnosis of sepsis is associated with adverse consequences and high mortality rate. The aim of this study was to evaluate the diagnostic value of hematologic research parameters, that reflect the cell morphology of blood cells, available on the BC 6800 plus automated analyzer (Mindray) for the early detection of sepsis. Materials and Methods: A complete blood count (CBC) was performed by Mindray BC 6800 Plus Analyzer in 327 patients (223 with a confirmed diagnosis of sepsis following sepsis-3 criteria, 104 without sepsis), admitted at the Intensive Care Unit of the Novara’s Hospital (Italy) and in 56 patients with localized infection. Results: In univariate logistic regression, age, Hb, RDW, MO#, NMR, NeuX, NeuY, NeuZ, LymX, MonX, MonY, MonZ were associated with sepsis (p<0.005). In multivariate analysis, only RDW, NeuX, NeuY, NeuZ, MonX and MonZ were found to be independent predictors of sepsis (p<0.005). Morphological research parameters are confirmed to be predictors of sepsis even when analyzing the group with localized infection. Conclusions: In addition to already established biomarkers and basic CBC parameters, new morphological cell parameters can be a valuable aid in the early diagnosis of sepsis at no additional cost.

The COVID-19 pandemic has caused detrimental impacts on different population groups throughout the world. This study aimed to explore the impacts of the COVID-19 pandemic’s mandatory lockdown protocols on activities and mental health conditions of community-dwelling older people in Jakarta, Indonesia. A qualitative design using one-on-one in-depth interviews was employed to collect data from the participants (n=24) who were recruited using the snowball sampling technique. Data analysis was guided by a qualitative data analysis framework. The findings showed that before the COVID-19 outbreak participants engaged in different kinds of regular individual and social activities. However, the COVID-19 outbreak and its mandatory lockdown protocols significantly influenced both their activities and social life, which led to social disconnection and financial difficulties for them. COVID-19 outbreak, mandatory lockdown protocols, and disruption of individual and social activities of the participants also caused mental health challenges to them, including feelings of loneliness, loss, sadness, stress, and anger. The findings suggest that there is a need for intervention programs addressing the socio-economic and mental health impacts of the COVID-19 pandemic on older populations to help them cope with these challenges. Future studies involving large-scale older populations to comprehensively understand COVID-19 impacts on them are recommended.

The introduction of any new disruptive technology in a traditionally well-established industry, such as the road construction industry, is usually associated with considerable resistance. This is especially relevant when the new technology is based on the use of granular materials traditionally considered to be of an unacceptable quality in combination with relatively new concepts such as New-age (Nano) Modified Emulsions (NME). In such cases, the fact that the material design methods are based on fundamental scientific principles and have been proven in laboratories and through Accelerated Pavement Testing (APT), may be of little influence. However, the general acceptance of new disruptive technologies, e.g. telecommunications and Information Technologies (IT), have been based on the considerable advantages it presented. The same principles are applicable to the general acceptance and use of NME stabilisation/enhancement of materials in the road construction industry. This article is aimed at the practical demonstration of the advantages of the use of nanotechnologies in the construction of the highest order roads (i.e. inter-city multi-lane highways) to lower order access roads (i.e. Low-Volume-Roads (LVR) and even local accesses to farms and in villages/townships). The implementation of NME technologies is directly associated with ease of use, time and cost savings and the addressing and reduction of risks.

(1) Background: Targeted (TT) and immune checkpoint inhibitor (ICI) therapies have become available in the routine care of metastatic melanoma in recent years. (2) Objective: We compared mortality in patients with metastatic melanoma and different systemic therapies. (3) Methods: A retrospective cohort study, based on pseudonymized health insurance data of about 2 million individuals from Saxony, Germany, was conducted for the years 2010 to 2020. Only patients with an advanced stage, i.e. distant metastases were considered for the main analysis. Relative survival since metastasis and predicted survivor curves derived from a Cox model were used to assess potential differences in mortality. (4) Results: Relative survival was highest in the subgroup with sequential use of ICI and TT. All treatments except interferon had significant hazard ratios (HR) in the Cox model with time-dependent effects indicating a protective effect after treatment initiation (HR 0.01-0.146) but decreasing over time (HR 1.351-2.310). The predicted survivor curves revealed best survival under ICI-TT treatment and worst survival under TT treatment alone. (5) Conclusions: We found real-world evidence for survival benefits of patients with metastatic melanoma who received sequential ICI and TT treatment. It is conceivable that the observed high survival differences were overestimated due to bias, such as confounding by indication.

Despite extensive use of intravitreal anti-vascular endothelial growth factor (anti-VEGF) biologics for over a decade, neovascular age-related macular degeneration (nAMD) or choroidal neovascularization (CNV) continues to be a major cause of irreversible vision loss in developed countries. Many nAMD patients demonstrate persistent disease activity or experience declined responses over time despite anti-VEGF treatment. The underlying mechanisms of anti-VEGF resistance are poorly understood, and no effective treatment strategies are available to date. Here we review evidence from animal models and clinical studies that supports the roles of neovascular remodeling and arteriolar CNV formation in anti-VEGF resistance. Cholesterol dysregulation, inflammation, and ensuing macrophage activation are critically involved in arteriolar CNV formation and anti-VEGF resistance. Combination therapy by neutralizing VEGF and enhancing cholesterol removal from macrophages is a promising strategy to combat anti-VEGF resistance in CNV.

The Sei Dareh Bridge is a cable-stayed bridge located in West Sumatra Province, Indonesia. The bridge, has a main span of 123 meters length and 9 meters wide, crosses the Batanghari River. Traffic load is transmitted through 4 prestressed cables to a 42.4 meter high pylon made of concrete. Bridge deck and traffic loads are directly supported by steel box girders as main beams that are reinforced laterally with cross beams IWF 800.300.16.24 and stringers IWF 350.350.12.19. This paper discusses static and dynamic testing on the bridge which aims to assess the feasibility before it is opened for public. Based on the test, it was concluded that the 73% static load could not be achieved because the deflection that occurred was beyond the allowable deflection. This is exacerbated by the sound of a loud clanging sound on the ST2-X1 prestressed cable when loading to 240 tons or 58% of the targeted load. In addition, this bridge is included in the "lazy bridge" category because it takes 24 hours to return to an undeformed condition after loading. As a recommendation for this bridge, it is necessary to carry out a structural health monitoring system (SHMS) regularly on the vehicle floor and cables.

The accurate state of health (SOH) estimation of lithium-ion batteries (LIBs) during operation is crucial to ensure optimal performance, prolonging battery life and preventing unexpected failure or safety hazards. This work presents a storage and performance optimised deep learning approach to predict the capacity based SOH of LIBs using raw sensor data from partial charging curves under constant current condition. The proposed model is based on a combination of a 1-dimensional convolutional and long-short term memory neural network and processes time, voltage and incremental capacity of partial charging curves as time series. The model is cross-validated on different aging scenarios reaching an overall MAE = 0.418% and RMSE = 0.531%, promising an accurate SOH estimation of LIBs under varying usage and environmental conditions in a real world application.

Data dealing with the assessment of heavy metal pollution in road dusts in Jeddah, Saudi Arabia and its implication to human health risk of human exposure to heavy metals, are scarce. Road dusts were collected from five different functional areas (traffic areas TA, parking areas PA, residential areas RA, mixed residential commercial areas MCRA and suburban areas SA) in Jeddah and one in rural area (RUA) in Hada Al Sham. We aimed to measure the pollution levels of heavy metals and estimate their health risk of human exposure applying risk assessment models described by USEPA. Using geo-accumulation index (I_geo), the pollution level of heavy metals in urban road dusts was in the following order Cd > As > Pb > Zn > Cu > Ni > Cr > V > Mn > Co > Fe. Urban road dust was found to be moderately to heavily contaminated with As, Pb and Zn, and heavily to extremely contaminated with Cd. Calculation of enrichment factor (EF) revealed that heavy metals in TA had the highest values compared to that of the other functional areas. Cd, As, Pb, Zn and Cu were severely enriched, while Mn, V, Co, Ni and Cr were moderately enriched. Fe was consider as a natural element and consequently excluded. The concentrations of heavy metals in road dusts of functional areas were in the following order: TA > PA > MCRA > SA > RA > RUA. The study revealed that both children and adults in all studied areas having health quotient (HQ) < 1 are at negligible non-carcinogenic risk. The only exception was for children exposed to As in TA. They had an ingestion health quotient (HQ_ing) 1.18 and a health index (HI) 1.19. The most prominent exposure route was ingestion. The cancer risk for children and adults from exposure to Pb, Cd, Co, Ni, and Cr was found to be negligible (< 1 x 10^-6).

As breast cancer continues to take a devasting public health toll, most primary prevention approaches are targeted at individual actions. We have proposed, instead, developing systemic, population approaches to preventing the disease. We used a combined qualitative-quantitative methodology, Group Concept Mapping (GCM), to identify Importance and Feasibility ratings of systemic interventions across a wide spectrum of approaches and stakeholders. Participants (n=351) from across the state of California sorted 84 potential interventions into topical piles, and then rated each intervention on perceived Importance and Feasibility. Multidimensional scaling and cluster analysis identified eleven clusters or themes of interventions. Participants rated interventions on Importance and Feasibility differently depending on the region of the state in which they lived. The results of this study underscore the importance of sharing health information with and seeking public health solutions from community partners in general and from beyond the urban areas usually studied.

This study aimed to investigate the ability of lactic acid bacteria to remove cholesterol in simulated gastric and intestinal fluids. The findings showed that the amount of cholesterol removed was dependent on the biomass, viability, and bacterial strain. Additionally, some cholesterol binding was stable and not released during gastrointestinal transit. The presence of cholesterol affected the fatty acid profile of bacterial cells, which could potentially influence their metabolism and functioning. However, adding cholesterol did not significantly impact the survival of lactic acid bacteria during gastrointestinal transit. Moreover, the study did not find significant effects of storage time, passage, or bacterial culture type on the cholesterol content of fermented dairy products. The researchers observed differences in cell survival among lactic acid bacteria strains in simulated gastric and intestinal fluids, depending on the environment. Furthermore, dry matter content, such as high milk protein, was more protective of bacterial cells during gastrointestinal transit than fat content. Future research should aim to better understand the impact of cholesterol on lactic acid bacteria metabolism and identify potential health benefits or risks.

Atmospheric corrosion of aluminum aircraft structures occurs due to numerous reasons. A typical phenomenon leading to corrosion is the deliquescence of contaminants such as salts due to changes in relative humidity (RH) caused by aircraft operation at different altitudes and climate zones. Currently, corrosion of aircrafts is controlled by scheduled inspections. In contrast, the present contribution aims for a continuous monitoring approach by using the acoustic emission (AE) method to detect and further evaluate atmospheric corrosion. The AE method is frequently used for corrosion detection at typically immersion-like conditions or for corrosion types where stress-induced cracking is involved. However, it has not yet been demonstrated for atmospheric corrosion at unloaded aluminum structures. To address this question, the present investigation uses small droplets of a corrosive sodium chloride (NaCl) solution to induce atmospheric corrosion on aluminum alloy AA2024-T351. Operating conditions of an aircraft are simulated by a controlled variation in RH. In addition, videos of the corrosion site are recorded to visually observe the corrosion process. Pitting corrosion is generated and clearly measurable AE signals are detected. An automatic video processing algorithm looking for sudden changes on the corrosion site mainly detects hydrogen bubbles formed when aluminum reacts with aqueous solutions. A clear correlation between the observed pitting corrosion, the AE and the hydrogen bubble activity and the RH, i.e., the electrolyte present at the aluminum surface, is found. Thus, the findings demonstrate the applicability of the AE method for monitoring atmospheric corrosion of aluminum aircraft structures by today’s measurement equipment. Numerous potential effects that can cause measurable AE signals are investigated and discussed. Among these, bubble activity is clearly considered to be the most emissive one.

The main objective of the study is to analyse time trends in excessive body weight (obesity, overweight) of Czech adolescents between 2002 and 2018 with regard to the socioeconomic status (SES) of adolescents’ families and to find SES-mediated correlates of adolescents’ obesity. A nationally representative sample of 29,879 adolescents (49.6% of them boys) aged 10.5-16.5 years was drawn from the Health Behaviour in School-aged Children cross-sectional, self-reported questionnaire surveys conducted in 2002, 2006, 2010, 2014, and 2018 in the Czech Republic. Across the quadrennial surveys from 2002 to 2018, we observed a clear increase in the prevalence of excessive body weight (overweight/obesity) in all SES categories of adolescents, which was most striking (p < 0.05) in adolescents with low SES (boys: +5.2/+7.5 percent points (p.p.); girls +6.3/+2.4 p.p.). When all the survey cycles were compared, the highest prevalence of overweight/obesity was evident in the low-SES adolescents in 2018, both in girls (14.9%/5.1%) and boys (20.4%/12.0%). The lower odds of obesity were significantly (p < 0.05) associated with regular vigorous physical activity, participation in organized sport. An unreasonable increase in the prevalence of obesity in adolescents with low SES suggests that national health-related and sports programmes have the least impact on children from low-SES families.

The rising prevalence of autism internationally has been accompanied with an increased appreciation of the poorer mental health experienced by people with this condition and also of their family care-givers. In particular higher incidences of anxiety and depression are reported in high income nations and these conditions are likely to be under-recognised and under-reported in lower resourced regions or countries. Mainstream mental health services seem to be ill-equipped to respond adequately to the needs of autistic persons and their care-givers. This scoping review of 30 recently published literature reviews covering over 1,000 journal articles, summarises the insights and strategies that have been shown to promote the mental health and emotional wellbeing of autistic persons. In particular, a focus on family-centred, community-based supports is needed that aim to enhance social communication, extend social connections and promote an individual’s self-esteem, self-determination and social motivation. These low-cost interventions are especially pertinent in low resourced settings but they can be used internationally to prevent mental illness and assist in the treatment of anxiety and depression in autistic persons and their family carers. The priority is to focus on primary care responses with cross-sectoral working rather than investing in high-cost psychiatric provision.

This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5-26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data was collected from 14 young caregivers who participated in baseline interviews. The central research question guiding this study: What was, is, and will be the impact of changing public health restrictions on young caregivers and their families during the pandemic and pandemic recovery? Seven themes emerged through analysis: 1) Navigating Care During the Height of Public Health Restrictions, 2) Neighbourhood and Built Environment During the Pandemic, 3) Perceptions Towards COVID and Public Health Restrictions/Efforts, 4) The Impact of Public Health Restrictions on Relationships, 5) Mental Health Challenges of Being a Young Caregiver During a Pandemic, 6) Navigating Formal Services and Supports and 7) Recommendations from Young Caregivers. The findings from this empirical research suggest that young caregivers found it easier to navigate their caregiving responsibilities when public health restrictions and work-from-home mandates were initially implemented, however, this later changed due to challenges in finding respite from caregiving, maintaining social connections with friends, creating personal space at home, and finding adequate replacements of programs once offered in-person.

The objective of the study was to investigate the gap between data and evidence-based decisions among healthcare professionals considering the enormous amount of individual and aggregate data collected. Our study assessed the capacity, skills, and knowledge of the Ministry of Health leadership staff to understand data management, analysis, utilization, and dissemination. Three key components were assessed: 1) Knowledge through true/false questions, 2) Level of Skill (and Competency) using a Likert scale, and 3) Understanding of Key Concepts and Tools based on a Likert scale. The 183 study respondents were diverse healthcare professionals from Kenya, Tanzania, and Rwanda. Majority of respondents had not received any training on data management, analysis, interpretation, and utilization techniques, further there was a significant difference between those who had received training versus those who had not(p=0.005). The respondents were competent in work-related experiences but lacked skills and knowledge on: data concepts and tools, study designs, and types of data analysis. These findings explain the gap between data management, analysis, utilization, and dissemination among health professional’s cadre. To enhance service delivery and optimal provision of health care, it is imperative to have all health care professionals receive a well-designed training on data management, analysis, interpretation, and utilization.

This research explores the application of ARIMA (Autoregressive Integrated Moving Average) models and parallel computing techniques to analyze and forecast anemia diagnoses in children under 36 months in the Junín region of Peru. Using health data from 2023-2024, including insurance type, patient information, diagnosis dates, hemoglobin levels, and treatment details, we develop predictive models to understand trends and patterns in childhood anemia. The study aims to demonstrate the effectiveness of time series analysis and high-performance computing in addressing this critical public health issue. Results indicate improved forecasting accuracy and computational efficiency, potentially aiding in resource allocation and policy development for anemia prevention and treatment programs.

Most recent university campuses follow the North American model, built on city limits or countryside, with large separate buildings in open green spaces. Studies suggest that prevalence and severity of mental health issues among university students are increasing over the past decade in most countries. University services were created to face this growing problem, however individual based interventions have limited effects on mental health and well-being of a large population. Our aim was to verify if and how the natural environment in Campuses is focused on programs to cope with the issue of mental health and well-being among students. Systematic review of literature was undertaken with search in Scopus and LILACS with the keywords “green areas” AND “well-being” AND “Campus”, following PRISMA guidelines. As a result, 32 articles were selected. Research on the topic is recent, mostly in the USA, Bulgaria, and China. Most studies used objective information on campuses’ greenness and/or university students’ perception. Mental health was usually measured by validated scores. Findings of all the studies indicated positive association between campus greenery and well-being of students. We conclude that there is a large potential for use of university campuses in programs and sites for students´ restoration and stress relief.

At the beginning of 2023 the Italian former prime minister, the former health minister and 17 others including the current president of Lombardy region, were placed under investigation on suspicion of aggravated culpable epidemic in connection with the government’s response at the start of the COVID-19 pandemic. The charges revolve around the failure by authorities to take adequate measures to prevent the spread of the virus in the Bergamo area, which experienced a significant excess of deaths during the initial outbreak. The aim of this paper is to analyse pandemic data of Italy and Lombardy region in the first 10 days of the pandemic, spanning from the 24th of February 2020 to the 4th of March 2020. The objective is to determine whether the use early warning indicators could have facilitated the identification of a critical increase in infections. This identification, in turn, would have enabled the timely formulation of strategies for pandemic containment, thereby reducing the number of deaths. In conclusion, to translate our findings into practical guidelines, we propose a low-cost early warning method for infectious respiratory diseases with asymptomatic carriers.

The Digital Twin is one of the big technology trends of the last decade. In the course of its rapid expansion into the various fields of application, many different definitions emerged, tailored to the respective applications. Taxonomies can cluster the diversity and define application-specific archetypes. This paper presents a characterization of the Digital Twin in the context of structural mechanics and lightweight design. It begins by exploring various definitions of the Digital Twin concept and its application in different industries. The paper further analyzes the product life cycle of structures, dividing it into the design and operational phases and identifying the requirements for a Digital Twin in each phase. The structural design process is examined, including the definition of a structure and the stages of the product development process. Additionally, the paper discusses the operational phase of structures, highlighting the need for continuous monitoring, evaluation, and adaptation through Structural Health Monitoring (SHM) systems. The paper proposes two archetypes of Digital Twins for structures: a structure-designing Digital Twin for the design phase and a structure-monitoring Digital Twin for the operational phase. The findings provide a framework for implementing Digital Twins in structural mechanics, enabling digital design and monitoring of structures for improved performance and maintenance strategies.

Dietary guidance to recommend food patterns to deliver nutrients has been well accepted for the past century. Foods to deliver essential nutrients and energy are needed across the life cycle and are dependent upon local industries and accepted cultural practices to deliver essential nutrients to prevent nutrient deficiency diseases. Since the 1980s, dietary guidelines to prevent chronic diseases have relied on epidemiological research to predict what dietary patterns are linked to reduced risk of chronic disease or links to health outcomes. Dietary guidelines have been broad, typically recommending avoiding “too much sugar”, “too much saturated fat”, and “too much sodium”. Efforts to fine tune these recommendations have met with limited scientific data to support more specific recommendations across the life cycle. Consumers have become skeptical of dietary guidelines as media coverage of new studies is often in conflict with accepted nutrition dogma. We discuss whether we really have a science-based databank to support dietary guidelines, based on a scientific session at the 10th International Conference on Nutrition and Growth.

Dietary protein quality plays a key role in maintaining intestinal mucosal integrity, but also modulates the growth of luminal microorganisms. This work assessed the effect of dietary protein sources on the performance, gut morphology, and microbiome in Nile tilapia. Four isonitrogenous and isolipidic diets comprising equivalent amounts of the protein supply derived from either PLANT, ANIMAL, INSECT, or MICROBIAL (bacterial biomass) sources were fed to triplicate groups of fish (IBW: 12 g) during 46 days. Fish fed ANIMAL and MICROBIAL diets showed significantly higher growth than those fed the PLANT and INSECT diets (P < 0.05). Relative abundance at the phylum level shows Bacteroidetes, Fusobacteria and Proteobacteria as more abundant phyla in tilapia’s intestine, while Cetobacterium is the most representative genera in all treatments. Interesting patterns were observed in the correlation between amino acid intake and genus and species abundance. Metabolism prediction analysis showed that microbial amine and polyamine degradation pathways are modulated depending on diets. In conclusion, different protein sources interfere directly with the cross-talk of bacteria pathways and amino acid intake.

Climate Change is the most serious planetary emergency of our time. Carbon emissions secondary to the healthcare industry account for about ten percent of all emissions in the United States. Health professionals, therefore, need to understand how they can make a difference in their profession, by understanding the health-related impacts of climate change and the importance of healthcare sustainability. An 8-week telementoring Climate Change Healthcare Sustainability ECHO series was developed to educate healthcare professionals in these topics such as the health-related effects of climate change, healthcare sustainability, quality healthcare and carbon accounting. A total of 376 participants from throughout the US and 16 other countries- completed this 8-week series and received no-cost continuing medical education credits. The evaluation consisted of pre and post Zoom polls, weekly post-session surveys and the registration demographics. Participants were primarily physicians and public health professionals who significantly improved their knowledge and communication skills after the course as compared to starting the training.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

This study uses explainable artificial intelligence to analyze major predictors of poor self-rated health, dementia and their comorbidity, which include various aspects of social support. Data came from the Korean Longitudinal Study of Ageing (2016-2018), with 5527 participants aged 56 or more. The dependent variables were: (1) poor self-rated health (SRH) with 5 categories (very good, good, middle, poor, very poor); (2) dementia (no, yes); and (3) their comorbidity with 4 categories (SRH very good, good or middle, dementia no; SRH very good, good or middle, dementia yes; SRH poor or very poor, dementia no; SRH poor or very poor, dementia yes). The 49 demographic, socioeconomic and health-related predictors were included. The accuracy and area under the receiver operating characteristic curve (AUC) were compared for logistic regression and the random forest. Logistic regression and the random forest registered similar AUCs with the range of 0.80-0.87. Based on random forest variable importance, 18 out of top-20 predictors were identical for SRH, dementia and their comorbidity: previous SRH, life satisfaction - health, age, body mass index, income, chronic diseases, life satisfaction - economic, life satisfaction - overall, grandchildren alive, friendship meeting, brothers/sisters alive, class identity, children alive, social activity - friendship, education, children in weekly contact, religion and drinker. However, some variations were found among the three dependent variables, i.e., previous SRH for comorbidity (1st) and SRH (1st) compared to dementia (11th), grandchildren alive for SRH (6th) and dementia (4th) compared to comorbidity (9th), chronic diseases for comorbidity (6th) compared to SRH (10th) and dementia (10th). In terms of Shapley Additive Explanation (SHAP) values, the probability of dementia is expected to decrease by 5.57% in case a predictor grandchildren alive is included to the model. This study highlights the importance of social support for the prediction of poor self-rated health, dementia and their comorbidity. Specifically, the promotion of family support and friendship activity for elders would be vital for the prevention and management of their self-rated health and dementia.

The aim of this study was to use latent profile analysis to identify specific profiles of burnout syndrome in combination with work engagement and to identify whether job satisfaction, psychological well-being, and other sociodemographic and work variables affect the probability of presenting a profile of burnout syndrome and low work enthusiasm. A total of 355 healthcare professionals completed the Spanish Burnout Inventory, the Utrecht Work Engagement Scale, the Job Satisfaction Scale, and the Psychological Well-Being Scale for Adults. Latent profile analysis identified 4 profiles: 1) burnout with high indolence (BwHIn); 2) burnout with low indolence (BwLIn); 3) high engagement, low burnout (HeLb); and 4) in the process of burning out (IPB). Multivariate logistic regression showed that a second job in a government health care institution; a shift other than the morning shift; being divorced, separated or widowed; and work load are predictors of burnout profiles with respect to the HeLb profile. These data are useful for designing intervention strategies according to the needs and characteristics of each type of burnout profile.

BRCA1 and 2 pathogenic variants increase lifetime risks of breast (50-75%) and ovarian cancer (15-20%). Guidelines recommend breast screening (MRI and mammogram) or risk-reducing mastectomy with salpingo-oophorectomy for ovarian cancer prevention. We sought to 1) characterize the population of BRCA1/2 carriers in Newfoundland and Labrador (NL) 2) evaluate risk-reducing interventions 3) identify factors influencing screening and prevention adherence. Methods: This is a retrospective study from a population-based provincial cohort of BRCA1/2 carriers. Eligibility criteria for risk-reducing interventions were defined for each case and patients were categorized based on their level of adherence with recommended screening or prevention. Chi-squared and regression analyses were used to determine which factors influenced uptake and level of adherence. Results: 276 BRCA1/2 carriers were identified; 156 living NL females composed the study population. Unaffected females were younger at testing than those with a cancer diagnosis (44.4 y versus 51.7 y; p=0.002). Categorized by eligibility, 61.0%, 61.6%, 39.0% and 75.7% of patients underwent MRI, mammogram, risk-reducing mastectomy, and risk-reducing salpingo-oophorectomy, respectively. Individuals with breast cancer were more likely to have risk-reducing mastectomy (64.7% versus 35.3%; p<0.001), and those who attended specialty hereditary cancer clinic were more likely to be adherent with breast/ovarian cancer recommendations (73.2% versus 13.4%; p<0.001) and to undergo risk-reducing salpingo-oophorectomy(84.1% versus 15.9%; p<0.001). Conclusions: Nearly 40% of female BRCA1/2 carriers were not receiving breast surveillance according to evidence-based recommendations. Cancer risk reduction and uptake of breast imaging and prophylactic breast and pelvic surgeries are significantly higher in patients who receive dedicated specialty care. Organized hereditary cancer prevention programs will be a valuable component of Canadian health care systems and have the potential to reduce the burden of disease country-wide.

Urban agriculture is an early practice, especially for cities in the Global South that are expanding at an unprecedented rate, and in African cities, it can be a way to attend to essential social and health needs. However, it is unclear whether architects and urban planners have expressed interest or already incorporated urban farming within their designs of African cities. This literature review was conducted to understand to what extent architects and urban planners have researched urban agriculture and health. Comprehensive searches based on urban agriculture, health, and Africa were conducted in Scopus, PubMed, and Web of Science from 2000 to December 2020. Zotero, Mozilla Firefox search engine, and Google Chrome were used to collect paper metadata. The duplicate articles were excluded, and all the n = 240 publications remaining were included in the analysis. Food security and the immediate health impact of urban agriculture on health were the most addressed topics. These studies reported the harmful effects of urban agriculture on malaria and the wastewater irrigation of plants. The evidence on urban agriculture is increasing from public health researchers, but not in the field of urban planning or architecture. Future research on urban agriculture's impacts on urban health should be increasingly done by architects and planners to help shape urban planning practices and regulations that could help create urban agriculture that benefits urban health.

Achieving synchronization between the central and peripheral body clocks is essential for ensuring optimal metabolic function. Meal timing is an emerging field of research that investigates the influence of eating patterns on our circadian rhythm, metabolism, and overall health. This narrative review examines the relationship between meal timing, circadian rhythm, clock genes, circadian hormones, and metabolic function. It analyzes existing literature and experimental data to explore the connection between mealtime, circadian rhythms, and metabolic processes. The available evidence highlights the importance of aligning mealtime with the body’s natural rhythms to promote metabolic health and prevent metabolic disorders. Specifically, studies show that consuming meals later in the day is associated with a elevated prevalence of metabolic disorders, while early time-restricted eating, such as having an early breakfast and an earlier dinner, improves levels of glucose in the blood and substrate oxidation. Circadian hormones, including cortisol and melatonin, interact with mealtimes and play vital roles in regulating metabolic processes. Cortisol, aligned with dawn in diurnal mammals, activates energy reserves, stimulates appetite, influences clock gene expression, and synchronizes peripheral clocks. Consuming meals during periods of elevated melatonin levels, specifically during the circadian night, has been correlated with potential implications for glucose tolerance. Understanding the mechanisms of central and peripheral clock synchronization, including genetics, interactions with chronotype, sleep duration, and hormonal changes, provides valuable insights for optimizing dietary strategies and timing. This knowledge contributes to improved overall health and well-being by aligning mealtime with the body’s natural circadian rhythm.

Groundwater use for domestic and agricultural purposes is every day in rural communities. However, groundwater quality in those communities is still being determined due to the lack of water quality monitoring programs. The purpose of this study was to evaluate groundwater quality in rural communities using physiochemical parameters. Eight communities using communal boreholes were selected. Water samples were analysed for temperature, pH, electrical conductivity, total dissolved solids (TDS), ammonia, nitrate, and nitrite as Nitrogen. The pH means ranged from 6.6 to 8.1, whereas high TDS levels of 1390 mg/L and 1470 mg/L were observed in two boreholes. Three boreholes had higher electrical conductivity. Two boreholes had elevated nitrate levels of 15 and 21.5 mg/L. The high nitrate level correlates with the pH, EC, and TDS values. Our results suggest that high nitrate levels measured in communities’ boreholes pose ill health to the community, especially children, infants, and elders. Prenatal exposure to high nitrate has been found to have acute health effects in infants. Therefore, there is a need for further longitudinal studies on health risks among vulnerable groups in these communities.

Lamb wave-based structural health monitoring is widely acknowledged as a reliable 11 method for damage identification, classification, localization and quantification. However, due to 12 the complexity of Lamb wave signals, especially after interacting with structural components and 13 defects, interpreting these waves and extracting useful information about the structure's health is 14 still a major challenge. However, deep learning-based strategy offers a great opportunity to address 15 such challenges as the algorithm can operate directly on raw discrete time-domain signals. Unlike 16 traditional methods, which often require careful feature engineering and preprocessing, deep learn-17 ing can automatically extract relevant features from the raw data. This paper proposes an autoen-18 coder based on a bidirectional long short-term memory network with maximal overlap discrete 19 wavelet transform layer to detect the signal anomaly and determine the location of the damage in 20 the composite structure. This approach has the potential to greatly enhance our ability to detect and 21 locate structural damage in composite structures, thereby increasing safety and efficiency.

The urban environment induces stress on trees and the impact can be identified by observing the condition of the crown. The aim of this study is to correlate the variables crown density (Cdn), crown transparency (Ctr) and dieback (Cdie) with the following vegetation indices: normalized difference vegetation index (NDVI), enhanced vegetation index (EVI2), blue normalized difference vegetation index (BNDVI), green normalized difference vegetation index (GNDVI), green-red vegetation Index (GRVI) and red-green-blue vegetation index (RGBVI) of the tree crown located in urban green areas, as well as chlorophyll fluorescence (Fv/Fm) as an indirect indicator of tree health condition. A total of 549 trees were evaluated, represented in 24 families, 36 genera and 53 species; the variables had average values of 67.96 % in Cdn, 35.19 % in Ctr and 1 % in Cdie. Correlations were found between Fv/Fm, NDVI and BNDVI. NDVI and BNDVI correlated with variables such as Cdn and Ctr, mainly in species such as Ligustrum lucidum, Jacaranda mimosifolia and Fraxinus uhdei. Therefore, it is possible to evaluate tree health condition of trees in urban green environments through the identification of unfavorable conditions at the crown level by using vegetation indices for some of the species studied.

Several studies have shown that the traditional way of learning is not optimal when we aim to improve ICT users’ actual privacy behavior. In this research, we present a literature review of the theories that are followed in other fields to modify human behavior. Our findings show that the cognitive theory and the health belief model present optimistic results. Further, we examine various learning methods and we conclude that experiential learning is advantageous compared to other methods. In this paper aggregate the privacy behavior determinant factors found in the literature and we use the cognitive theory to we synthesize a theoretical framework. The proposed framework can be beneficial to educational policy makers and practitioners, such as public and private schools, and universities. Also, our framework provides a fertile ground for more research on experiential privacy learning and privacy behavior enhancement.

Damage assessment is one of the most crucial issues for bridge engineers, especially for existing steel bridges. Among several methodologies, the vibration measurement test is a typical approach in which the natural frequency variation of the structure is monitored to detect the existence of damage. However, locating and quantifying the damage is still a big challenge. In this regard, the artificial intelligence (AI)-based approach seems a potential way to accomplish those obstacles. This study deploys a comprehensive campaign to determine all dynamic parameters of a pre-damage steel truss bridge structure. Based on the results of mode shape, natural frequency, and damping ratio, a finite element model (FEM) is created and keeps updating. The artificial intelligence network's input data will be analyzed and evaluation from damage cases. The trained artificial neural network model will be curated and evaluated to confirm the approach's feasibility. During the actual operational stage of the steel truss bridge, this damage assessment system is showing good performance in terms of monitoring the structural behavior of the bridge under some unexpected accidents.

Detecting human head movement during sleep is important as it can help doctor to access some physical or mental health problems like infantile eczema, calcium deficiency, insomnia, anxiety disorder and even Parkinson’s disease, and provide useful clues for scientific diagnosing. To obtain the information of sleep head movement, current solutions either use the camera or require the user to wear intrusive sensors to collect the image or motion data. However, the vision-based schemes depend on the environmental light conditions and also bring privacy concerns. Some people including the elderly and infant may be reluctant to wear wearable devices during sleep. In this paper, we propose a novel system called Wi-Senser to address the issues mentioned above. Our Wi-Senser directly reuses the existing WiFi infrastructure and exploits the fine-grained channel state information (CSI) of WiFi signals to capture the minute human head movement during sleep without attaching any sensors to the human body. We design and implement our system with just one commercial off-the-shelf (COTS) router and one laptop equipped with Intel 5300 network interface card (NIC). We evaluate the performance of Wi-Senser with 6 volunteers (4 adults and 2 children). Extensive experiments demonstrate that Wi-Senser can achieve a 98.5% accuracy for head movement detection during sleep. Wi-Senser provides a new solution for achieving noninvasive, continuous and accurate human minute movement detection without any additional cost.

Abstract Peripartum depression (PPD) is a major complication of pregnancy and many risk factors have been associated with its development, including dysfunctional coping strategies and insecure attachment styles, both during pregnancy and postpartum. The aim of our study was to investigate the role of coping strategies in mediating the relationship between women’s attachment style and PPD in pregnancy, and one week after childbirth, in a large cohort of women. We hypothesized that the relationship between anxious and avoidant attachment and PPD would be mediated by use of maladaptive coping strategies. The assessment instruments were Edinburgh Postnatal Depression Scale (EPDS), Brief Coping Orientation for Problem Experiences (COPE), Experiences in Close Relationship Scale (ECR). The results indicated that the effect of insecure attachment styles (anxious and avoidant attachment) on antepartum depressive symptomatology was partially mediated by dysfunctional coping styles. Anxious attachment has also an indirect significant effect on postpartum depression through emotional coping; however, avoidant attachment does not seem to be significantly related to postpartum depression. Our findings revealed that not only it is important to consider attachment in understanding PPD but also that coping plays an important role in these relationships. These findings would help a preventive coping-based intervention strategy to enhance the capacity of women with insecure attachment styles to use more adaptive coping during and after pregnancy.

The Infectious and Tropical Diseases Department of University of Brescia organized free rapid screening tests for HIV and HCV as part of the Fast Track City commitment. A cross-sectional study was conducted, consisting of an anonymous, multiple-choice questionnaire that was administered to individuals who underwent the screening or consultation. The study aimed to compare knowledge and attitudes towards HIV and HCV between age groups (18-40 vs. >40) and sexual orientations (heterosexual vs. LGBTQ+). Overall, 333 questionnaires were completed. Individuals over the age of 40 and those who identified as heterosexual had the lowest level of knowledge about HIV transmission (7.9% and 30% respectively), undetectable=untransmittable (19.7% and 39.4% respectively) and PrEP (9.2% and 18.2% respectively). They were also less willing to cohabit with people with HIV (PLHIV). Only 9.6% of the population demonstrated high levels of knowledge for both HIV and HCV. People over the age of 40 had the largest gaps in knowledge and would benefit the most from educational and prevention interventions.

This empirical research is part of a larger project beginning in 2020 and ongoing until 2023 exploring the impact of the COVID-19 pandemic on young caregivers aged 5-25 years and their families in Canada. Utilizing the social determinants of health as a conceptual framework, this case study emphasizes the voices of professionals offering services to young caregiver clients during the pandemic, and explores their perspectives on the impact of the pandemic on young caregivers and their families. Across three (3) different organizations offering programs and services to young caregiver clients in Ontario, six (6) individual interviews were conducted with directors/program managers and four (4) group interviews were conducted with thirteen (13) staff members who worked directly with young caregivers and their families. Nineteen (19) service providers participated in total. The results of this study highlight five (5) primary themes that emerged through data analysis: i) the role of service providers, ii) the impact of the COVID-19 pandemic on organizations and service providers supporting young caregivers and their families, iii) barriers for service users, iv) helpful resources for service providers and organizations, and v) resources needed/preferred by service providers and organization. The pandemic significantly impacted young caregivers and their families, as reported by professionals, and organizations working with young caregivers and their families were tasked with addressing increased service demands and adapting service delivery to follow public health guidelines.

Although renal denervation (RDN) protects against hypertension, hypertrophy, and heart failure (HF), it is not clear whether RDN preserves ejection fraction (EF) during heart failure (HFpEF). To test this hypothesis, we simulated chronic congestive cardiopulmonary heart failure (CHF) by creating aorta-vena cava fistula (AVF) in C57BL/6J wild type (WT) mice. There are four ways to create experimental CHF: (1) myocardial infarction (MI) which is basically ligating coronary by instrumenting and injuring the heart; (2) trans-aortic constriction (TAC), although it mimics systematic hypertension but TAC again constricts aorta on top of the heart and exposes the heart; (3) acquired CHF such as by dietary factors, diabetes/salt diets etc. but it is multifactorial, and finally (4) AVF, which is the only one wherein AVF is created ~1cm below the kidney where the aorta and vena cava share the common middle-wall. By creating fistula, the red blood enters vena cava without an injury to the heart. This model mimics CHF such as during aging where with age the preload keeps increasing than the aging heart can pump out due to the weakened cardiac myocytes. This also involves the right ventricle to lung to left ventricle flow, thus creating congestion. The heart in AVF goes to transition from preserved to reduced EF (i.e., HFpEF to HFrEF). In fact, there are more models of volume overload, such as the pacing-induced and mitral valve regurgitation but these are also injurious models. Our lab is one of the original labs in creating and studying the AVF phenotype. The RDN was created by treating the cleaned bilateral renal artery. After 6 weeks, blood, heart, and renal samples were analyzed for exosome, cardiac regeneration markers and renal cortex proteinases. Cardiac function was analyzed by echocardiogram (ECHO). Fibrosis was analyzed with trichrome staining. The results suggested that there was robust increase in exosomes’ level in AVF blood, suggesting compensatory systemic response during AVF-CHF. During AVF there was no change in cardiac eNOS, Wnt1 and β-catenin, however; during RDN there was robust increase in eNOS, Wnt1 and β-catenin compared to the sham group. As expected in HFpEF there was perivascular fibrosis, hypertrophy and pEF. Interestingly, increased levels of eNOS suggested that despite fibrosis, the NO generation was higher that most likely contributed to pEF during HF. The RDN intervention revealed an increase in renal cortical caspase 8 and a decrease in caspase 9. Since caspase 8 is protective and caspase 9 is apoptotic, we suggest that RDN protects against renal stresses, and apoptosis. Our findings also suggest that RDN is cardioprotective during HFpEF via the preservation of eNOS and accompanied endocardial-endothelial function.

Toxocara canis is a helminth parasite with importance in public and veterinary health. Although different studies have evaluated the immune response, to date there are no studies where it is analyzed from the point of view of sexual dimorphism. At 7 days of infection, female rats had a higher number of larvae in the liver, while male rats had them in the lungs. The percentages of immune cells were evaluated, and in most cases, no significant differences were observed. Regarding the cytokines production, infection can generate a decrease in Th1 such as IL-1β in both sexes and IL-6 only in females. In the case of Th2, IL-4 increases only in infected males and IL-5 increases in males and decreases in females due to the effect of infection. IL-10 also decreases in both sexes as a consequence of the infection and TGF-β only in females. Finally, the infection generates the production of antibody against the parasite, however, their quantity is lower in females. Thus, this study demonstrates that Toxocara canis infection is dimorphic and affects females more than males. This is due to a polarization of the inadequate immune response, which is reflected as a higher parasite load in this sex.

During puberty and emerging sexuality, adolescents experience important physical, mental, and social transformations. In the process of dealing with these changes, adolescents can become potentially vulnerable to mental health problems.The aim was to identify and synthesize published research evidence on sexuality-related mental health stressors among adolescent girls and boys, identify gaps (if any) in current knowledge, and contribute to knowledge about the experiences of emerging sexuality and health among adolescents, to further inform research, practice, and policy initiatives in sexual health.A scoping literature review of peer-reviewed articles published between 1990 and 2018. MEDLINE, CINAHL, EMBASE, PsycINFO, Global health, ERIC, and Sociological Abstracts databases were searched for research studies that reported experiences of sexuality related mental health issues and symptomatology of adolescents. We targeted studies conducted with adolescent populations between ages 11-24 years living in LMICs.Data from 12 published research papers, including 8 qualitative studies, 3 quantitative studies, and 1 mixed method study, were systematically analyzed. Four major themes and 4 sub themes were identified regarding sexual health and mental health of adolescents: 1) Relationship of sexuality and mental health; 2) Social and cultural influences; 3) Challenges in seeking sexuality information and services among adolescents; and 4) Educational needs among adolescents related to sexuality; and 4) Educational needs among adolescents related to sexuality. Lack of social support, Unmet needs for accessible adolescent friendly sexual health services, counseling, and age-appropriate information may be associated with several mental health stressors and symptoms, such as sadness, depressive and anxiety symptomatology, regret, fear, embarrassment, low self-esteem, guilt, shame, and anger. Therefore, tackling sexuality-related stressors could play an important role in addressing the overall wellbeing of young people. Future studies need to generate a deeper understanding of the concept of sexual health and its relation to mental health in diverse contexts. Health care professionals need to be aware of sexuality-related experiences of adolescent girls and boys by offering effective youth-friendly sexual and reproductive health education to support overall mental health and improve the experiences of emerging sexuality in adolescents.

Background: Psychological sufferings are observed among dental students during their academic years, which had been intensified during the COVID-19 pandemic. Objectives: This study assessed the levels and identified factors associated with psychological distress, fear and coping experienced by dental undergraduate students in Bangladesh. Methods: A cross sectional online survey was conducted during October-November, 2021. The Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCV-19S) and Brief Resilient Coping Scale (BRCS) were used in order to assess psychological distress, fear and coping strategies respectively. Results: A total of 327 students participated; the majority (72%) were 19-23 years old and females (75%). One in five participants were infected with COVID-19 and 15% reported contact with COVID-19 cases. Negative financial impact (AOR 3.72, 95%CIs 1.28-10.8), recent or past COVID-19 infection, contact with COVID-19 cases were associated with higher levels of psychological distress; but being a 3rd year student (0.14, 0.04-0.55) and being satisfied about current social life (0.11, 0.03-0.33) were associated with lower levels of psychological distress. Being a 3rd year (0.17, 0.08-0.39) and a 4th year student (0.29, 0.12-0.71) were associated with lower levels of fear. Health care service use and feeling positive about life were associated with medium to high resilience coping. Conclusions: This study iden-tified dental students in Bangladesh who were at higher risk of psychological distress, fear and coping during the ongoing pandemic. Development of mental health support system within dental institution should be considered in addition to the academic and clinical teaching.

Macronutrient intake is important in the prevention and management of Metabolic Syndrome (MetS). We characterized energy and macronutrient intake of Koreans diagnosed with MetS at recruitment of the Health Examinee (HEXA) cohort. We included 130,423 participants aged 40-69 years for analysis. Odds ratios (OR) and 95% confidence intervals (CI) were estimated to evaluate the intake of macronutrient. Low energy (OR= 0.94, 95% CI: 0.89-0.98) and fat intake (OR=0.91, 95% CI: 0.86-0.97) was observed among 50-59 year-old men. Only postmenopausal women had lower intake of total energy (OR= 0.95, 95% CI: 0.92-0.97) while low fat intake was observed in all women (OR= 0.80 95% CI: 0.77-0.83). For carbohydrate intake, the OR were 1.14 (95% CI: 1.08-1.22) and 1.17 (95% CI: 1.08-1.27) among women in their 50’s and 60’s respectively. Protein intake was low (OR=0.90, 95% CI: 0.86-0.95) and (OR=0.88, 95% CI: 0.82-0.94) among women in their 50’s and 60’s respectively. High intake of plant carbohydrates in women (OR=1.16, 95% CI: 1.12-1.20) and plant protein in both genders (OR=1.09, 95% CI: 1.05-1.13) were observed, but low intake of total energy, fat and animal-source carbohydrates in both genders. Fat intake was low regardless of food source. In conclusion, high consumption of plant-source and low consumption of animal-source macronutrients was observed in Korean adult diagnosed MetS.

The ketogenic diet and walking exercise training activity are two key public health lifestyle factors. The potential of combined lifestyle factors interventions focused on getting to compliance in forced exercise. A balanced ketogenic diet and regular exercise activity is a key modifiable factor to the prevention and management of chronic diseases. Influence health across the lifespan and reduction of the risk of premature death through several biological mechanisms. Community older group’s lifestyle factors interventions contribute identity in their natural living environment. While the older health benefits of walking exercise training strategies are commonly to study, combined ketogenic diet and walking exercise interventions have induced greater benefits in community older groups.

Background: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. Methods: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts, and national media. Results: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%) or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with an increased risk of adverse mental health outcomes. Feeling appreciated by the community mitigated this risk in healthcare workers. Conclusions: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.

Metaheuristic algorithms have been frequently using to tackle optimization problems, however such algorithms in the analysis of health-related data is not commonly used as developing metaheuristic algorithms that work well on health-related data is a difficult task due to complexity of the health data in particular genomics and epigenetics data. One of the important tasks in genomics is to predict genomic elements that are incorporating together to regulate a disease-related genes. Predicting such elements are important as they can be used to develop a personalized cure. In this study, we present for the first time, a multi-object simulated annealing algorithm to identify enhancer-promoter like interactions from Hi-C (chromosome conformation capture) data. These regulatory elements can potentially play vital roles as promoters and/or enhancers in appearance and exacerbation of the regulation of gene.s To evaluate the efficiency of the proposed method, we applied our proposed method and traditional methods on the Hi-C data from mice and compared together. Our results show that the interacting elements identified by our new method are more likely to be functional. The source code of the method is publicly available.

Fogo (Fogo island, Cape Verde Republic) is the youngest and most active volcano of the archipelago. The last eruption occurred in 2014–2015. Aiming at studying dust emissions and transport during the eruption period and assessing their impact on air quality and human health, a mineralogical and chemical characterization was undertaken in outdoor dust from all over the island, as well as in the lava resulting from this event. Air quality monitors were used to obtain concentrations of atmospheric particulate matter (PM) and gaseous pollutants. The mineralogical constitution of the samples was analysed by X-ray diffraction and Electron Microprobe, while the chemical characterization was performed through X-ray Fluorescence Spectrometry and ICP-MS. The volcanic rock was found to be tephritic to basanitic, with high potassium content. Several minerals were identified, such as titanian augite with ilmenite, basaltic hornblendes, pyrrhotites, apatites, pyroxenes, basaltic hornblendes and hematites. Concentrations of the particulate matter inhalable fraction (PM10) exceeded the 24-hour mean of 50 µg/m3 recommended by the World Health Organization. Nevertheless, total volatile organic compounds (TVOCs) showed levels lower than the worrying range. The highest levels of CO2 were recorded in more populated villages and farthest from the volcano. The Pollution Load Index (PLI) for outdoor dust collected on rooftops was always above 1, suggesting enrichment, with higher values in the dust size fraction < 63 µm. In the same way, the Contamination Factor pointed to high enrichment of As, Ni and Pb, and very high enrichment of Cd in the same size fraction. The Non-carcinogenic Hazard Quotient and Hazard Index estimated for Children suggest that health problems may arise. The Carcinogenic Risk, for all size fractions, was above the target risk. The element that most contributed to the global risk was As, followed by Pb and Co. Ingestion was the main exposure route for all size fractions. The dust size fraction that represented the highest risk was < 63 µm, mostly due to the As concentration.

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3rd April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range and gender groups. 1082 participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders and age ranges should be considered in order to improve health recommendations and adherence to guidelines. It would also be crucial to identify vulnerable groups to promote the adoption of health behaviors that may help in the development of effective public health strategies. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.

Advances in machine learning (ML) and artificial intelligence (AI) are transforming the way we treat patients in ways not even imagined a few years ago. Cancer research is at the forefront of this movement. Infertility, though not a life-threatening condition, affects around 15% of couples trying for a pregnancy. Increasing availability of large datasets from various sources creates an opportunity to introduce ML and AI into infertility prevention and treatment. At present in the field of assisted reproduction, very little is done in order to prevent infertility from arising, with the main focus put on treatment when often advanced maternal age and low ovarian reserve make it very difficult to conceive. A shift from this disease-centric model to a health centric model in infertility is already taking place with more emphasis on the patient as an active participator in the process. Poor quality and incomplete data as well as biological variability remain the main limitations in the widespread and reliable implementation of AI in the field of reproductive medicine. That said, one of the areas where this technology managed to find a foothold is identification of developmentally competent embryos. More work is required however to learn about ways to improve natural conception, the detection and diagnosis of infertility, and improve assisted reproduction treatments (ART) and ultimately, develop clinically useful algorithms able to adjust treatment regimens in order to assure a successful outcome of either fertility preservation or infertility treatment. Progress in genomics, digital technologies and advances in integrative biology has had a tremendousimpact on research and clinical medicine. With the rise of ‘big data’, artificial intelligence, and the advances in molecular profiling, there is an enormous potential to transform not only scientific research progress, but also clinical decision making towards predictive, preventive, and personalized medicine. In the field of reproductive health, there is now an exciting opportunity to leverage these technologies and develop more sophisticated approaches to diagnose and treat infertility disorders. In this review, we present a comprehensive analysis and interpretation of different innovation forces that are driving the emergence of a system approach to the infertility sector. Here we discuss recent influential work and explore the limitations of the use of Machine Learning models in this rapidly developing area.

Understanding the strength of the associations between perceived risk and individuals’ behavioral intentions to protect their health is important for determining appropriate risk communication strategies in communities impacted by lead contamination. We conducted a survey within communities of northern Idaho, USA (n = 306) near a Superfund megasite with legacy mining contamination. We empirically test a theoretical model based on the Health Belief Model. Survey respondents had higher intentions to practice health protective behaviors when they perceived the risk of lead contamination as severe, recognized the benefits of health protective behaviors, and considered the risks of lead contamination. Women reported higher behavioral intentions than men, but age and mining affiliation did not have an association. Survey comments indicated that perceptions about the long-term environmental remediation in the region influenced risk perceptions. Understanding risk perceptions, behavioral intentions, and related factors can aid public health agencies in tailoring risk communication for increasing protective behaviors in mining-impacted communities internationally.

Latest evidence revealed a possible association between Parkinson’s disease (PD) and periodontitis. We explored the causal relationship of this association through two-sample Mendelian randomization (MR) in European ancestry populations. To this end, we used openly accessible data of genome-wide association studies (GWAS) on PD and periodontitis. As instrumental variables for periodontitis, seventeen single-nucleotide polymorphisms (SNPs) from a GWAS of periodontitis (1817 periodontitis cases vs. 2215 controls) and forty-five SNPs from a GWAS of PD (20,184 cases and 397,324 controls). Eight non-overlapping SNPs of periodontitis from an additional GWAS assisted in the validation of association being studied. Multiple approaches of MR were carried-out. There was no evidence of genetic liability of periodontitis being associated with a higher risk of PD (B= -0.0003, Standard Error [SE] 0.0003, P = 0.26). The eight independent SNPs (B= -0.0000, SE 0.0001, P = 0.99) validated this outcome. We found no association of genetically primed PD towards periodontitis (B= -0.0001, SE 0.0001, P = 0.19). This MR study found no conclusive evidence to support a bidirectional causal genetic liability between PD and periodontitis. Further GWAS studies are needed to confirm the consistency of these results.

Past public health crises (e.g. tobacco, alcohol, opioids, cholera, HIV, lead, pollution, venereal disease, even COVID-19) have been met with interventions targeted both at the individual and all of society. While the healthcare community is very aware that the global pandemic of non-communicable diseases (NCD’s) has its origins in our Western ultraprocessed food diet, society has been slow to initiate any interventions other than public education, which has been ineffective, in part due to food industry interference. This article provides the rationale for such public health interventions, by compiling the evidence that added sugar, and by proxy the ultraprocessed food category, meets the four criteria set by the public health community as necessary and sufficient for regulation — addiction, toxicity, ubiquity, and externalities (how does your consumption affect me?). To its credit, some countries have recently heeded this science and have instituted sugar taxation policies to help ameliorate NCD’s within their borders. This article also supplies scientific counters to food industry talking points, in order to guide both scientists and policy makers in instituting further appropriate public health measures to quell this pandemic.

Aim: The aim of this study was to assess the performance of the SF-36 health survey (SF-36) in a sample of subjects with physical disabilities. Material and Methods: 305 patients recruited using the convenient sampling method from September 2019 to March 2020 in Kermanshah, Iran. Another similar 300 patients were selected to assess the confirmatory factor analysis (CFA). Results: The Cronbach’s α ranged from 0.70 to 0.93, and intra-class correlation coefficients from 0.71 to 0.88; and with the no ceiling and floor effect for two main subscales. Convergent validity was supported by moderate to good correlation between SF-36 subscales and Moorong self-efficacy subscales (r= 0.25- 0.53). The SF-36 divergently validated with HADS total score and subscales (r= -0.24- -0.65), concurrently validated with its subscales (r=0.49- 0.88), and physically discriminated between persons with different level of disability (t-test: p<0.001). Factorial analysis identified seven factors, confirmed with second-order in another 300 samples (chi-square (χ2/df) = 2.61(p < .001); RMSEA = 0.07 (90% CI = 0.07–0.08); AGFI=0.75; GFI = 0.78; CFI= 0.85; and NFI = 0.78). Conclusions: the SF-36 is a reliable and valid tool in physical disables. However, SF-36 shows insufficient eight-factor validity. Future studies should focus on evaluating other psychometric properties, such as sensitivity to change in subjects with physical disabilities.

The mass concentration of particulate matter (PM) has been systematically used in epidemiological studies as exposure indicator, to relate airborne concentrations with a wide variety of human health effects, which can be hardly explained by using this single parameter. In fact, PM is a “particle cocktail” that includes a complex mixture of compounds with a wide range of sizes, chemical compositions and emission sources. Current research hypothesizes that many of the adverse health effects are derived from oxidative stress in biological systems caused by the deposition of PM into the lungs. This emerging hypothesis is called the oxidative stress paradigm. In this commentary article we analize how this new paradigm could help to answer the as-of-yet unanswered questions related to the mechanism of action of PM pollution on human health. Acellular oxidative potential (OP) assays have been emerged as a promising approach to quantify the PM potential to induce oxidative stress and to relate it with the chemical composition and size distribution of PM. Recent researches have shown that the OP is related to the presence of metals, organic carbon, polyaromatic hydrocarbons and quinones. However, the association between PM and particle-induced toxicity is still largely unknown. Therefore, additional research is needed to identify the specific PM characteristic(s), such as its specific size, emission source or chemical content, which contribute the most to its redox activity. Thus, the OP measurements provide information that allows us to evaluate and integrate the toxic potential of PM in a unique parameter, whose relationships with emission sources, size distribution and/or chemical composition should be faced in the near future.

The 2019 novel coronavirus (previously 2019-nCoV) or coronavirus infectious disease 2019 (COVID-19) outbreak has been summarized as on March 29, 2020. COVID-19 is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SERS-CoV-2). The disease was first seen during an outbreak in Wuhan, China and continuous spreading from human to human around the sphere. The disease is uncontrolled and increasing the death toll through. The world is facing a global challenge to protect human lives caused by coronavirus outbreak. The number of infected patients is increasing day by day due to COVID-19 as a pandemic. The world health organization (WHO) has declared global public health emergency on January 30, 2020. The disease has been spread around 201 countries with total confirmed cases 634835 and death cases 29891 as on March 29, 2020. The goal of this review to summaries and update the clinical/medical features and suggestions for diagnosis of the COVID-19 as a pandemic. The discussion of the various therapeutic algorithms, risk, prevention and control based on the latest reports has been provided.

Background: This study aimed to assess the dementia literacy (DL) level of community-dwelling adults in the four cities (Hong Kong, Guangzhou, Macau and Zhuhai) of the Greater Bay Area of China and to determine the preferred mass media for receiving dementia information. Methods: A multi-city cross-sectional study with 788 community-dwelling adults completed the survey. Dementia literacy was indirectly measured by two validated scales, 30-item Alzhiemer’s Disease Knowledge Scale (ADKS) and 20-item Dementia Attitudes Scale (DAS). When the ADKS total score was <15 and DAS total score was <70, it was considered as ‘inadequate dementia literacy’. Participants were also asked to indicate whether they would like to receive dementia information via digital media or traditional media. Chi-square tests and logistic regressions were undertaken. Results: About one-third of the participants had inadequate dementia literacy. Those with young age or secondary education preferred to get dementia information from social media. But people living in public housing would like to get information from government or hospital websites. Middle-aged participants inclined to learn dementia from television or radio. Conclusion: It is worthy to conduct territory-wide public education in dementia and develop strategies according to their preferences in the types of mass media.

We are witnessing a dramatic transformation in the way we do science. In recent years, significant flaws with existing scientific methods have come to light, including lack of transparency, insufficient involvement of stakeholders, disconnection from the public, and limited reproducibility of research findings. These concerns have sparked a global movement to revolutionize scientific practice and the emergence of Open Science. This new approach to science extends principles of openness to the entire research cycle, from hypothesis generation to data collection, analysis, replication, and translation from research to practice. Open Science seeks to remove all barriers to conducting high quality, rigorous, and impactful scientific research by ensuring that the data, methods, and opportunities for collaboration are open to all. Emerging digital technologies and "big data" (see "Ten simple rules for responsible big data research") have further accelerated the Open Science movement by affording new approaches to data sharing, connecting researcher networks, and facilitating the dissemination of research findings. Open scientific practices are also having a profound impact on the health sciences and medical research, and specifically how we conduct clinical research with human participants. Human health research necessitates careful considerations for practicing science in an ethical manner. There is also a particular urgency to human health research since the goal is to help people, so doing good science takes on a different meaning than simply doing science well. It also implores the scientist to reassess the conventional view of human health research as a pursuit conducted by scientists on human subjects, and lays a greater emphasis on inclusive and ethical practices to ensure that the research takes into account the interests of those who would be most impacted by the research. Openness in the context of human health research also raises greater concerns about privacy and security and presents more opportunities for people, including participants of research studies, to contribute in every capacity. At the core of open health research, scientific discoveries are not only the product of collaboration across disciplines, but must also be owned by the community that is inclusive of researchers, health workers, and patients and their families. To guide successful open health research practices, it is essential to carefully consider and delineate its guiding principles. This editorial is aimed at individuals participating in health science in any capacity, including but not limited to people living with medical conditions, health professionals, study participants, and researchers spanning all types of disciplines. We present ten simple rules that, while not comprehensive, offer guidance for conducting health research with human participants in an open, ethical, and rigorous manner. These rules can be difficult, resource-intensive, and can conflict with one another. They are aspirational and are intended to accelerate and improve the quality of human health research. Work that fails to follow these rules is not necessarily an indication of poor quality research, especially if the reasons for breaking the rules are considered and articulated (see rule 6: document everything). While most of the responsibility of following these rules falls on researchers, anyone involved in human health research in any capacity can apply them.

The variations in socioeconomic status (SES) between different social classes of a population correspond to differences in accessibility to all resources available and able to improve global health. SES can influence global health trajectory for an individual or a community, depending if SES is low or high. Sleep is sensitive to environmental stimuli, as well as living conditions. Plenty of studies linked sleep complaints with mood disorders, allostatic load or circadian disruption; but very few or none investigated deeply what happened earlier to sleep depending of SES. While SES is now known as one of the main determinants for a good health and a good aging, its influence on sleep disorders (SD) is not well understood. SES is a concept, not directly observable but estimated using indicators like income, education, occupational status and area of living. Even if recent evidence suggested that few of SES indicators like occupational status are linked with sleep disturbances, the relation between SES and health in general with sleep as an outcome or a mediator is not well documented. This scoping review synthetized studies which investigated physiological and psychological mechanisms resulting from a low SES and linked them with sleep disturbances as consequences or as mediators. This review also explore a possible role played by sleep in the relation between socioeconomic status and health inequalities.

Along with the advantages associated with access to information and fast communication, screen time from increased digital media consumption has recently been associated with adverse effects on youth well-being. To get a clearer picture of its value for global youth based sustainability initiatives, this study investigates the effects of increased digital media consumption on youth's interests in ecosystem services, sustainability and science as a means for disease prevention. We achieve this, using data on 187821 adolescent students from 50 countries worldwide. Methodologically, we rely on a mixed bivariate ordered probit representation of youth's joint interest in the biosphere (ecosystem services and sustainability) and science as a means for disease prevention, which we then estimate using Markov Chain Monte Carlo (MCMC) Methods. We found that each level increase in adolescent students' reported frequency of news blogs visits and web browsing on broad science adversely affect their interests in ecosystem services, sustainability and science as a means for disease prevention. Although each level increase in youth's frequency of ecological website visits also reduces by 20% (with 95% CI [-0.36; -0.32]) their interests in the biosphere, it is found to increase however by 3% (with 95% CI [0.02; 0.05]) their interest science as a means for disease prevention. Overall, our results highlight heterogeneous effects of digital media consumption on adolescents' well-being in terms of their interests in ecosystem services, sustainability, and science as a means for disease prevention.

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

Florida geologic units and soils contain a wide range in concentrations of naturally-occurring arsenic. The average range of bulk rock concentrations is 1 to 13.1 mg/kg with concentrations in accessary minerals being over 1,000 mg/kg. Soils contain natural arsenic concentrations of between 0.18 and 2.06 mg/kg with organic-rich soils having the highest concentrations. Anthropogenic sources of arsenic have added about 610,000 metric tons of arsenic into the Florida environment since 1970, thereby increasing background concentrations in soils. The anthropogenic sources of arsenic in soils include: pesticides (used in Florida beginning in the 1890’s), fertilizers, chromated copper arsenate (CCA)-treated wood, soil amendments, cattle-dipping vats, chicken litter, sludges from water treatment plants, and others. The default Soil Cleanup Target Level (SCTL) in Florida for arsenic in residential soils is 2.1 mg/kg which is below some naturally-occurring background concentrations in soils and anthropogenic concentrations in agricultural soils. A review of risk considerations shows that adverse health impacts associated with exposure to arsenic is dependent on many factors and that the Florida cleanup levels are very conservative. Exposure to arsenic in soils at concentrations that exceed the Florida residential cleanup level in residential environments does not necessarily pose a meaningful public health risk.

Environmental legislation is moving towards global standards for ease of application and to impose sanctions and penalties when necessary, without compromising human health and biota. International environmental measures for control and monitoring of atmospheric air only monitor emissions of SO_x, NO_x, O₃, and Pb. In general, most research work in air pollution done using the analysis of elements in rainwater show analysis of trace metals such as Na, Mg, Zn, and Mn. In this work, trace metals in the rainwater at the city of Goiânia, capital of the State of Goiás, were analyzed. Goiânia is a large city set in a predominantly agricultural province located in central Brazil. Presence of trace metals in rainwater was detected, indicating atmospheric air pollution levels higher than occupational limits set by WHO.

Education outside the classroom (EOtC) can be beneficial for students. The relationship between biological stress markers and sedentary behavior (SB) plus physical activity (PA) is insufficiently evaluated in school settings. This exploratory study aims to evaluate the association between students’ cortisol, plus circulating cell-free deoxyribonucleic acid (cfDNA) levels, and their SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) during outdoor and indoor classes in different seasons. We assessed data from an education outside the classroom (EOtC) program (n = 48; intervention group [IG], n = 37; control group [CG], n = 11). We sampled data on 3 school-days in three seasons (fall, spring, and summer) in normal teaching indoors (CG) and outdoor lessons (IG) in the forest. SB and PA were evaluated by accelerometry, and cortisol and cfDNA levels by saliva samples. The compositional data analysis approach analyzed SB and PA. Fitted Bayesian hierarchical linear models evaluated the association between cortisol and cfDNA, and SB/LPA/MVPA. A steady decline of cortisol in the outdoor setting is associated with relatively high levels of LPA. SB and MVPA tended to exhibit a similar effect in the indoor setting. CfDNA is positively associated with a relatively high amount of SB in the IG, the same association is likely for LPA and MVPA in both groups. LPA seems to support a healthy cortisol decrease in children during outdoor lessons. The relevance of SB/PA as a composition in relation to students stress response in school should be emphasized. This study facilitates the formulation of straightforward and directed hypotheses for further research.

This article takes an approach to explaining the behavioral manifestations of the decision making in US companies’ offer of health insurance that is grounded not only on their cost minimizing behavior, but also in a humanness dimension based on the African concept of Ubuntu. In this way, we define an Ubuntu based Random Utility modeling framework, describing the choice process as a tripartite decision making, and implemented using a nationally representative random sample of 1,061 American companies from the Dunn and Bradstreet Business data, supplied by Survey Sampling International to the Associated Press-NORC Center for Public Affairs Research. The results from the three sequentially implemented specifications showed that the relationship between management culture and health plan offering strategy is dependent on other relevant co-variates, which when left out, leads to the problem of omitted variables bias. However, when all variables are included but assumed to enter the relationship exogenously, this results in management culture not having any statistically significant effect on companies' decisions about scope of health plan offering. When the exogeneity assumption is relaxed through a recursively Bivariate Probit model, the system of two equations produces a highly significant management culture effect. In fact, in this later case we see that companies with groups and formal committee management culture are 1.58 times less likely to choose a multiple plan strategy over a single plan strategy, hence failing to show the more wholesome plan offering that would theoretically prevail under Ubuntu style management.

Fiber optic sensors cannot measure damage; for getting information about damage from strain measurements, additional strategies are needed, and several alternatives have been proposed. This paper discuss two independent concepts: the first one is based on detecting the new strains appearing around a damage spot; the structure does not need to be under loads; the technique is very robust, damage detectability is high, but it requires sensors to be located very close to the damage, so it is a local technique. The second approach offers a wider coverage of the structure, it is based on identifying the changes caused by the damage on the strains field in the whole structure for similar external loads. Damage location does not need to be known a priori, detectability is dependent upon the sensors network density, damage size and the external loads. Examples of application to real structures are given.

Research on fall and movement detection with wearable devices has witnessed promising growth. However, there are few publicly available datasets, all recorded with smartphones, that prevent authors to evenly compare their new proposals. Here, we present a dataset of falls and activities of daily living (ADL) acquired with a self-developed device composed of two types of accelerometer and one gyroscope. It consists of 19 ADL and 15 fall types performed by 23 young adults, 15 ADL types performed by 14 healthy and independent participants over 62 years old, and data from one participant of 60 years old that performed all ADL and falls. These activities were selected based on a survey and a literature analysis. We test the dataset with widely used feature extraction and a simple to implement threshold based classification, achieving up to 96~\% of accuracy in fall detection. An individual activity analysis demonstrates that most errors coincide in a few number of activities where algorithms could be focused on. Finally, validation tests with elderly people significantly reduced the fall detection performance of the tested features. This validates findings of other authors and encourages to develop new strategies with this new dataset as benchmark.

Background and Objectives: Elders’ needs are rarely examined beforehand, and thus, although technology-based tools can enhance self-management, acceptability rates are still low. This study aimed to examine and compare self-reported needs, priorities, and preferences of elders with heart failure (HF), diabetes mellitus (DM), and chronic obstructive pulmonary disease (COPD) toward technology use to enhance self-management. Materials and Methods: A convenience sample of 473 participants over 60s (60.5% females), diagnosed with HF (N=156), DM (N=164), or COPD (N=153) was recruited. They were administered a questionnaire about the usefulness of technology in general and in specific areas of disease management. Results: Most participants (84.7%) admitted that technology is needed for better disease management. This was equally recognized across the three groups both for the overall and specific areas of disease management (in order of priority: ‘Information’, ‘Communication with Physicians &amp; Caregivers’, and ‘Quality of Life &amp; Wellbeing’). Sociodemographic differences were found. Cell phones and PCs were the devices of preference. The four common features prioritized by all three groups were related to ‘information about disease management’ (i.e., monitoring symptoms, reminders for medication intake, management and prevention of complications), whereas the fifth one was related to ‘communication with physicians and caregivers (i.e., in case of abnormal or critical signs). The top disease-specific feature was also monitoring systems (of respiratory rate or blood sugar or blood pressure, oxygen), whereas other disease-specific features followed (i.e., maintaining normal weight for HF patients, adjusting insulin dose for DM patients, and training on breathing exercises for COPD patients). Conclusions: Elders in these three samples seem receptive to technology in disease management. mHealth tools, incorporating both common and disease-specific features and addressing different chronic patients, and being personalized at the same time, could be cost-saving and useful adjuncts in routine clinical care to improve self-management.

Background: Our study aimed to examine how modulating variables such as social support, health anxiety, coping, gender, being separated from home, and lockdown can modify or amplify the effect of perceived stress as a starting variable in the point of view of the output variable, dissociation. Methods: A cross-sectional survey was conducted in online form at two points in time: the beginning and the later stage of the COVID-19 pandemic. Results: We received a total of 1711 responses. Perceived stress moderately correlated with dissociation in both International and Hungarian samples. Health anxiety showed a strong direct and indirect correlation with dissociation. Regarding social support, the support of family significantly decreased the dissociative experiences in the Hungarian sample through mediating the stress and directly as well. In the international sample, the goal-oriented coping strategy had a strong decreasing effect on all dissociation scales in the first measurement, through mediation of perceived stress. As to the Hungarian sample, positive thinking was found to decrease dissociation through decreasing perceived stress. Conclusion: The cause and effect relationship between stress and dissociation may be tinctured by health anxiety, coping and social support, influencing dissociacion directly and indirectly. Social support, mainly support of the family and problem-focused coping strategies seem to alleviate dissociation-provoking effect of stress.

Abstract: Background: To determine the impact of a patient's ethnicity on the seeking preventive dental services at the Community Health Centers (CHCs) in South-Central Texas. Methods: Pri-mary electronic health records (HER) data were collected regarding each patient's medical and dental history, and comprehensive treatment planning. The researchers retrieved EHR from Jan-uary 2016 to 2022. Bivariate analysis was completed to test outcome with predicator and covariates using appropriate statistical tests. A multiple linear regression model was used to understand the association between the predictor and outcome variable while controlling for confounders. Results: The study findings revealed significantly higher dental visits (2.26 ± 2.88) for Hispanic patients. The results from the multiple regression model indicated that non-Hispanic patients had a 8% fewer chance of visiting the CHCs for preventive dental services compared to the Hispanic population (p-value<0.001) when all other variables are held constant. However, the study results were not significant as the effect size was small to conclude the effect of ethnicity on the patients visiting the dental clinic at the CHCs for preventive services. Conclusion: The study concluded that there is no difference in the preventive dental services completed by Hispanics and Non-Hispanics when all other variables are controlled.

This study presents a strategic approach to developing applications focused on implementing Large Language Models using the Langchain framework in Python. Three language models are highlighted: GPT-3.5 (turbo mode), LLaMA 2, and Vicuna 7B, each with their distinctive features and capabilities. The methodology used is described in detail, including data extraction from medical reports using zero-shot prompting data extraction techniques, interaction with language models, and structured storage of results. The performance of the models in data extraction is evaluated, presenting metrics such as precision, recall, and F1 score. The results demonstrate high model capability in extracting information, although areas for improvement are identified, particularly in data extraction precision. In conclusion, the efficacy of the models in extracting information from medical histories is not considerably acknowledged, with an emphasis on the importance of improving precision and increasing the volume of trained data for future research in healthcare digitalization.

Wearable antennas are increasingly vital in modern healthcare, facilitating continuous monitoring and communication for medical purposes. These antennas are integrated into wearable devices, allowing for the transmission and reception of vital health data, such as heart rate, body temperature, and blood pressure, to medical professionals or monitoring systems in real time. This instantaneous data transmission enables timely interventions, thus improving the quality of healthcare services. This review aims to comprehensively synthesize recent research from reputable databases, focusing on the functionality and effectiveness of wearable antennas in medical applications. The primary objectives of each study were categorized, including antenna design and integration, the performance of medical wearable antenna technology, safety considerations in wearable antenna biomedicine, and the use of antennas in clinical applications and their impact. This synthesis provides valuable insights for researchers and practitioners aiming to develop and deploy wearable antennas in medical settings, ultimately enhancing healthcare delivery and patient outcomes.

It is of merit to study the appropriate amount of fiber to add to free-range chickens feed to improve the microbial diversity and gut health in times of plant fiber deprivation. OptiCell is a useful source of fiber as a type of eubiotic lignocellulose, and its positive effects on the growth performance and laying performance of chickens has already been proven. However, few researchers have researched the effects of adding OptiCell on the gut microbiota of chickens. In this research we added three different levels of OptiCell (0%, 2% and 4%) to the feed of caged and free-range Bian chickens from September to November, aiming to observe the effects of adding OptiCell and different feeding modes on the gut microbial diversity and gut health of chickens, and aiming to determine an appropriate amount of OptiCell. The results showed that adding OptiCell could increase the thickness of the cecum mucus layer and the abundance of Akkermansia and Faecalibacterium in caged chickens, and 4% OptiCell was optimum. In addition, adding OptiCell increased the microbial diversity and the abundance of the butyrate-producing bacteria Faecalibacterium and Roseburia of fee-range chickens. The α-diversity and the length of the small intestine with 2% OptiCell in free-range chickens were better than with 2% OptiCell in caged chickens. In addition, compared with caged chickens, the free-range chickens had longer small intestine and lower GLP-1. Taken together, an appropriate amount of OptiCell benefitted the microbial diversity and health of chickens; it was necessary to add dietary fiber to the feed of free-range chickens when plant fibers was lacking, and 2% OptiCell was found to be optimum.

Social connectedness connection is a core dimension of health and wellness among all populations, yet the experience of moving to, and living in, a new country makes social and community-level influences particularly salient for immigrants. We interviewed 38 Latino immigrants living in a nontraditional migration area to explore the social and community foundations of health and wellness. Illustrated in a model of socioecological connectednesssocial connection, Using hybrid (inductive/deductive) qualitative analysis, we identified seven themesdomains of social connection from the perspective of the interviewed participants: 1) Lens of the individual is a filter for the social world; 2) Immigrant experience colors everything; 3) Interpersonal support enhances quality of life; 4) Community belonging fosters a sense of connectedness; 5) Community capital boosts security; 6) Community navigation promotes integration; and 7) Social acceptance strengthens inclusion. In the healthcare field, we lack conceptual clarity of the distinct connectedness domains that drive positive health outcomes in immigrant populations. Social connection domains generated by participants are consistent with the scientific literature, but this study identifies the specific social factors that immigrants describe as most salient to their own health and wellness. Our community-generated understanding of socioecological connectednesssocial connection can be used by healthcare providers to reduce risks and build on assets that will improve the health of immigrants living in nontraditional migration areas. health. Additionally, our model of socioecological connectednessthese results might serve as a foundation for a quantitative measure that can be used by providers to more accurately and comprehensively assess connectedness social connection of their patients and by researchers to evaluate the effectiveness of community-level interventions for immigrants.

The lexical analysis of seminal policy-to-diplomacy documents from the socio-environmental discourse of the last fifty year agendas allowed examining the evolution of five themes: resources/waste, pollution, social and economic development, justice, and health. Contextual affinities were strongest between resources, pollution, and health and are linked to societal trends and pressures. On those grounds, the central role of resource stewardship according to nature’s physical limits is highlighted, and dedicated concepts, analytical frameworks, and methodologies with different degrees of sustainability are analyzed. To reframe the identified social and economic problems, the work proposes criteria and choices that (1) allow to compare the dynamics of socioecological states across the planet, (2) help matching the pace of socioecological change by addressing path dependencies through participation and engagement of communities, and (3) enable stakeholders to make trade-offs and take decisions in specific social, economic, political, and cultural contexts. The prioritization of resource justice and responsibility becomes a societal project : from Wellfare State to commonfare communities.

Abstract: Background: This research aims to investigate the oral health status and needs of individuals with disabilities, a vulnerable population that is facing barriers in accessing and maintaining oral care. Methods: Data for this study were obtained through self-administered questionnaires distributed to individuals with disabilities who were receiving assistance from Helping Restore Ability and Neuro Assistance Foundation. The data were analyzed using statistical methods using SPSS and Microsoft Excel to identify patterns and associations related to oral health maintenance among individuals with disabilities. Results: The findings of this research indicate a high prevalence of poor oral hygiene, periodontal diseases, and untreated dental caries, risk factors of oral cancer among individuals with disabilities. Social determinants were found to have a significant influence on the oral health status of this population. The study also highlights the crucial role of caregivers in ensuring oral health maintenance. Conclusion: The results of this study underscore the urgent need for targeted interventions and improved caregiver awareness to address the oral health needs of individuals with disabilities. By addressing the disparities and barriers faced by people with disabilities in accessing dental care, we can mitigate the health, social, and economic burdens associated with poor oral health in this vulnerable population.

Background The workload of nurses in the intensive care unit (ICU) can affect the quality of nursing services. Aim This study aimed to determine the relationship between the nursing activity score and missed care in patients hospitalized in the ICU in Zanjan, Iran. Methods This observational and prospective study was conducted from April 3 to September 18 in 2021. In this study, the tools used included a patient and nurses' profile questionnaire, Nursing Activity Score (NAS). Missed care was observed in the 301 patients for whom the NAS was calculated. Analysis of variance (ANOVA) was used to investigate the differences in mean levels of missed care. Logistic regression models were used to assess the association between factors and missed nursing care. Results Results show that the Medical ICU's mean NAS was 76.31 (95% CI: -13.06 -14.89). In 9 dimensions of care, the extent of missed care was 40.7%. In the care dimensions of assessment, hand hygiene, and infection control, the mean NAS had a statistically significant increase at higher levels of missed care (P<.5). Furthermore, work experience was identified as a protective factor for missed care (OR =.59, 95% CI: .37–.94, χ2= =4.97, p =.026). Conclusion The study revealed a high incidence of missed care. The study revealed that the mean workload was high in certain dimensions of care such as assessment, hand hygiene, and infection control. The increase in workload for nurses results in lost care. Nonetheless, the utilization of experienced nurses can help mitigate this problem. However, utilizing experienced nurses can help reduce this problem.

Self-medication with natural products during disease outbreaks in developing countries poses significant public health challenges yet remains relatively unexplored in the published literature. This study aims to assess the implications of such practices, address the state and quality of evidence, identify gaps in the literature, explore determinants and contributing factors, elucidating the implications, and propose possible solutions. Using a modified systematic literature review methodology, 20 articles were selected from 1,683 reports after applying rigorous selection criteria and quality assessment using the AXIS critical evaluation tool. The findings revealed a dearth of literature concerning the implications of self-medication with natural products during disease outbreaks, highlighting the need for further investigation in this domain. Key determinants included gender, acquisition, and ideological factors, while common side effects comprised diarrhoea, stomach pain, sweating, headache, and nausea/vomiting. Notably, self-medication with natural products was associated with reduced communication with healthcare providers, leading to underreported side effects. It also creates a false sense of safety which may potentially exacerbate the spread of the prevailing disease. In conclusion, the rampant use of natural products for self-medication necessitates increased awareness among the population, encouraging individuals to seek professional medical care and support when faced with disease outbreaks.

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.

Background Research on the mental health of students in health disciplines mainly focuses on psychological distress and nursing and medical students. This study aimed to investigate the psychological well-being and distress and related factors among undergraduate students training in eight different health-related tracks in Geneva, Switzerland. Methods This cross-sectional study used established self-filled scales for anxiety, depression, stress, psychological well-being, and study satisfaction. Descriptive statistics and hierarchical regression analyses were applied. Results In October 2019, out of 2835 invited students, 915 (32%) completed the survey. Lower academic satisfaction scores were strongly associated with depression (β=-.26, p<.001), anxiety (β=-.27, p<.001), and stress (β=-.70, p<.001), while higher scores with psychological well-being (β=.70, p<.001). Being female was strongly associated with anxiety and stress but not with depression or psychological well-being. Increased age was associated with enhanced psychological well-being. The nature of the academic training had a lesser impact on mental health and the academic year none. Conclusion Academic satisfaction strongly predicts depression, anxiety, stress, and psychological well-being. Training institutions should address the underlying factors that can improve students’ satisfaction with their studies while ensuring that they have access to psychosocial services that help them cope with mental distress and enhance their psychological well-being.

(1) Background: Mindfulness-based interventions (MBIs) have shown interesting preliminary ef-fects over self-regulation processes in early adolescence. However, interventions usually integrate various types of practices with no clarity about the specific effect of each of them over attentional, emotional, and behavioral regulation. The objective of this research was to evaluate the effect of two MBIs, one focused on classic attentional practices and another one focused on the recognition and expression of emotions, over attentional, emotional, and behavioral self-regulation in early adolescents. (2) Method: An experimental method was carried out. A sample of 70 children be-tween 8 and 12 years old were randomized and assigned to three experimental conditions: 1) MBI with a focus on attentional practices, 2) MBI with a focus on recognition and expression of emotions, 3) control group, waiting list. The programs lasted 8 weeks, with a weekly 1-hour online synchronic session, plus home practices. Children were evaluated before starting the in-tervention and at the end of the 8-week program. The assessed variables were: 1) Mindfulness; 2) Emotional Regulation; 3) Attentional Regulation and 4) Behavioral regulation. (3) Results: Chil-dren that participated in both programs, increased their mindfulness and emotional and be-havioral regulation scores. Only children who participated in the program with a focus on at-tention showed significant changes in their ability to self-regulate attention. (4) Conclusions: online MBIs, with attention to external and internal stimuli practices, can be a good strategy to strengthen self-regulation skills of attention, emotions, and behavior in early adolescence.

Objective: This study investigated the effect of the hierarchical medical system under the national health insurance program on resident’s healthcare-seeking behavior in Taiwan. Background: Healthcare authorities in Taiwan initiated the allowance reduction of outpatient visits at regional hospitals and higher hierarchical hospitals from 2018. The ultimate goal is to implement a hierarchical medical system and provide the residents accessible as well as consistent medical services. Methods: This research was conducted through the questionnaire survey method and data were collected between August and December 2018 from the records of subjects who had recently sought medical attention. A total of 1,340 valid questionnaires were returned. Results: Regarding the effect on healthcare-seeking behavior, the following factors were significant: being aged between 40 to 49 (p＜.1), subjects with an educational background of junior high school (p＜.05), those who were not aware of the policy (p＜.001), and an awareness about both the hierarchical medical system and the policy to reduce outpatient visits to large hospitals (p＜.001). Conclusion: The public should be made aware about the hierarchical medical system to improve healthcare.

This study investigated the intersecting influence of socioeconomic status and cooking behavior on dietary habits using nationwide Japanese data. The study measured the frequency of balanced meals and breakfast intake as indicators of healthy eating habits and used subjective economic status, subjective spare time, and cooking behavior as the independent variables. It employed multivariate logistic regression analyses to elucidate the relationships among these variables. The results demonstrated that even among economically poor or time-constrained individuals, those preparing meals from ingredients were more likely to eat balanced meals and breakfast than those relying on commercial food or rarely cooking. This finding suggested that cooking behavior can mitigate disparity in healthful eating due to socioeconomic conditions. The study added new insights into the impact of combining socioeconomic status and cooking behavior on dietary habits, which highlights the potential of promoting cooking behaviors, such as teaching cooking skills, as a strategy for reducing socioeconomic dietary disparities.

Policies to require front-of-package labels (FOPLs) on foods may help Indian consumers better identify foods high in nutrients of concern including sugar, saturated fat, and sodium, and discourage their consumption, outcomes critical for preventing rises in diet-related non-communicable disease. The objective was to test whether FOPLs helped Indian consumers identify ‘high-in’ foods and reduce intentions to purchase them. We conducted an in-person randomized experiment (n=2,869 adults between ages 18 and 60 years old) in six states of India in 2022. Participants were randomized to one of five FOPLs: a control label (barcode), warning label (octagon with “High in [nutrient]”), Health Star Warning (HSR), Guideline Daily Amount (GDA), or traffic light label. Participants then viewed a series of foods high in sugar, saturated fat, or sodium with the assigned FOPL, and rated product perceptions and label reactions. Fewer than half of participants in the control group (39.1%) correctly identified all products high in nutrient(s) of concern. All FOPLs led to an increase in this outcome, with the biggest differences observed for the warning label (60.8%, p<0.001) followed by the traffic light label (54.8%, p<0.001), GDA (55.0%, p<0.001), and HSR (45.0%, p<0.01). Relative to the control, only the warning label led to a reduction in intentions to purchase the products. The results suggest that warning labels are the most effective FOPL to help Indian consumers identify and avoid unhealthy foods.