We describe how clinical researchers can exploit the Android cell phone as an economic platform for the gathering of data from clinical trial participants. The aim was to provide a solution with the shortest possible learning curve for researchers who are comfortable with setting up web pages. The additional requirement is that they extend their skills to the installation of a local webserver on the cell phone and then use four simple PHP templates to construct the clinical research data collection and processing forms. Data so collected is automatically written to local csv files on the cell phone. These csv phones can be retrieved from the device by the researcher simply by plugging the cell phone into their desktop PC and accessing the cell phone memory in just the same way as they would a USB memory stick. The results are presented as a list of recommended Android Apps along with settings that have proved to provide a stable combination likely to be easily used by clinical research participants. We have made a limited ‘user trial’ of this approach with satisfactory feedback received. We have concluded that this approach will reward researchers with a solution that is user friendly, will provide transcription free data and that is more than cost competitive with the conventional error prone/poor compliance ‘paper based participant form – researcher transcription’ cycle.

Background: Cancer therapies predispose survivors to a high symptom burden. This study utilized mobile health (mHealth) technology to assess the feasibility of collecting daily symptoms from adult survivors of childhood cancer and evaluate symptom fluctuation and associations with future health-related quality-of-life (HRQOL). Methods: A prospective study using an mHealth platform to distribute a 20-item cancer-related symptom survey (5 consecutive days each month) and an HRQOL survey (the day after symptom survey) over 3 consecutive months to participants from the Childhood Cancer Survivor Study. PROMIS-29 Profile and Neuro-QOL assessed HRQOL. Daily symptom burden was calculated by summing the severity (mild, moderate, or severe) of 20 symptoms. Univariate linear mixed-effects models analyzed total, person-to-person, day-to-day, and month-to-month variability for the burden of 20 individual symptoms. Multivariable linear regression analyzed the association between daily symptom burden in the first month and HRQOL in the third month, adjusting covariates. Results: Out of the 60 survivors invited, 41 participated in this study (68% enrollment rate); 83% reported their symptoms ≥3 times and 95% reported HRQOL, both in each week across 3 months. Variability of daily symptom burden differed from person-to-person (74%), day-to-day (18%), and month-to-month (8%). Higher first-month symptom burden was associated with poorer HRQOL related to anxiety (regression coefficient: 6.56; 95%CI: 4.10-9.02), depression (6.32; 95%CI: 3.18-9.47), fatigue (7.93; 95%CI: 5.11-10.80), sleep (6.07; 95%CI: 3.43-8.70), pain (5.16; 95%CI: 2.11-8.22), and cognitive function (-6.89; 95%CI: -10.00 to -3.79) in the third month. Conclusion: Daily assessment reveals fluctuations in symptomology, and higher symptom burden was associated with poorer HRQOL in the future. Utilizing mHealth technology for daily symptom assessment improves our understanding of symptom dynamics and sources of variability.

Colistin [polymyxin E] is a veterinary exclusive antimicrobial and one of the oldest antibiotics that is currently recognised as one of the highest priority critically important antimicrobials for humans. It is extensively used for multiple medical and non-medical purposes particularly for growth promotion, prophylaxis/metaphylaxis and therapeutic in food animals. As a result, colistin resistance was widespread along the food-chain linking to multidrug resistant bacterial infections in humans reflected by greater use of colistin in healthcare settings resulted in different types of bans/restrictions in food-producing animals, around the world. This report debates the testimonies of 23 countries representing the bulk of global food producing animal production, providing robust evidence on the essential need for colistin in animal production.

The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. The aim of the present study is to compare the health behaviour and indicators of adolescents with disabilities in Hungary with those of the HBSC survey in the Visegrad countries, and to compare the results of the Hungarian special needs adolescent population with those of the Visegrad countries. Eating habits are unfavourable for both the Visegrad countries and the young people we studied. Children with disabilities have significantly higher rates of schoolwork stress compared to other countries. Significantly higher prevalence of somatic complaints and worse mental well-being parameters higher in Hungary than in the other Visegrad countries. The results suggest that further interventions are needed in Hungary and that differentiated, professionalised health promotion is needed for young people with disabilities. The researchers propose to extend the research to adolescents with disabilities living in the Visegrad countries, on the basis of which a methodology for injury-specific health promotion could be developed, including through interna-tional interprofessional cooperation.

This article delves into the pivotal role that biodiversity of soil microbes plays in bolstering tree health and overall agroecosystem productivity. With the advent of regenerative agricultural practices, there has been a resurgence of interest in understanding the complex interactions between soil microbiota and plant roots, particularly through processes like rhizophagy. Rhizophagy, the digestion of living root cells by soil microorganisms, stands out as a fundamental mechanism in nutrient cycling and overall tree vitality. By examining the impact of enhanced microbial diversity on tree health, we shed light on the practical applications, such as the utilization of the BEAM Inoculant product, which has demonstrated remarkable efficacy in augmenting soil health and, consequently, tree Vigor

COVID-19 has proven to be detrimental across the globe, most notably affecting the United States at an alarming rate compared to comparable countries. The pandemic has had multifactorial implications on the way communities in the United States prevent, prepare for, and address the virus; however, the impact of the pandemic on rural health is less well understood. Historically, rural communities have faced a unique set of challenges regarding accessing and receiving adequate healthcare, addressing chronic illness, and eliminating health disparities closely associated with the population’s socioeconomic status; the pandemic has exacerbated these challenges. The purpose of the current study was to conduct a systematic review of the literature to evaluate the effect of the COVID-19 pandemic on rural populations both at the individual and community level. Results indicated that rural health disparities increased both at the individual and system-wide levels as a direct result of the pandemic. Budget cuts significantly affected the infrastructure of rural hospitals resulting in them being unequipped to handle such high volumes of COVID-19 cases. The lack of infectious disease specialists, access to larger medical centers with substantial numbers of ICU beds and ventilators, and an overall lack of preparedness overwhelmed rural communities. Although comorbidities such as diabetes and heart disease were associated with poorer health outcomes for a multitude of reasons, the lack of clinic and physician availability for routine care during the pandemic further exacerbated the clinical link from COVID-19 positivity to comorbidities. Furthermore, mental health deteriorated as substance use increased to a greater extent in rural communities compared to urban, during the pandemic. This study shows that health comorbidities, mental health, substance use, health literacy, access to healthcare, among others can serve as key indicators for improving healthcare in rural communities. Future studies should seek to identify key issues that disproportionately affected rural communities in comparison to their urban counterparts considering the pandemic, as well as identify gaps in the availability of rural health resources that can improve the lives of millions of Americans now and during the next pandemic.

Trees provide key ecosystem services, but the health and sustainability of these plants is under increasing biotic and abiotic threat, including from the growing incidences of non-native invasive plant pests (including pathogens). The island of Ireland (Ireland and Northern Ireland) is generally accepted to have a high plant health status, in part due to its island status and because of the national and international regulations aimed at protecting plant health. To establish a baseline of the current pest threats to tree health for the island of Ireland, the literature and unpublished sources were reviewed to produce a dataset of pests of trees on the island of Ireland. The dataset contains 396 records of pests of trees on the island of Ireland, the majority of pests being arthropods and fungi, and indicating potentially more than 44 non-native pest introductions. The reliability of many (378) of the records was judged to be high, therefore the dataset provides a robust assessment of the state of pests of trees recorded on the island of Ireland. We analyse this dataset and review the history of plant pest invasions, including (i) discussion on notable native and non-native pests of trees, (ii) pest interceptions at borders and (iii) pests and climate change. The dataset establishes an important baseline for the knowledge of plant pests on the island of Ireland, and will be a valuable resource for future plant health research and policy making.

Structural health monitoring has been studied by a number of researchers as well as various industries to keep up with the increasing demand for preventive maintenance routines. This work presents a novel method for reconstruct prompt, informed strain/stress responses at the hot spots of the structures based on strain measurements at remote locations. The structural responses measured from usage monitoring system at available locations are decomposed into modal responses using empirical mode decomposition. Transformation equations based on finite element modeling are derived to extrapolate the modal responses from the measured locations to critical locations where direct sensor measurements are not available. Then, two numerical examples (a two-span beam and a 19956-degree of freedom simplified airfoil) are used to demonstrate the overall reconstruction method. Finally, the present work investigates the effectiveness and accuracy of the method through a set of experiments conducted on an aluminium alloy cantilever beam commonly used in air vehicle and spacecraft. The experiments collect the vibration strain signals of the beam via optical fiber sensors. Reconstruction results are compared with theoretical solutions and a detailed error analysis is also provided.

Air pollution, particularly fine particulate matter (PM2.5), poses a significant threat to public health, especially in rapidly urbanizing areas like Lagos State. Despite the severity of the issue, there is a lack of comprehensive data on PM2.5 levels and the Air Quality Index (AQI) in Lagos. This study leverages data from AirQo, an innovative air quality monitoring network using low-cost sensors, to provide a detailed assessment of PM2.5 concentrations and AQI across eight locations in Lagos State, Nigeria. This approach offers real-time, continuous monitoring, filling a critical data gap in the region's air quality management efforts. This study uses AirQo data to assess the concentration levels and spatial distribution of PM2.5 and AQI across the selected eight locations. Data on PM2.5 concentrations were obtained from AirQo sensors deployed across the eight strategic locations in Lagos. The spatial distribution of PM2.5 levels and AQI were analyzed, and the results were compared with national and international air quality standards. The findings revealed that PM2.5 levels (minimum – 6.28 µg/m3 (Ikeja) and maximum - 204.68 µg/m3 (Banana Island) in many areas of Lagos exceed annual WHO and national air quality guidelines, indicating significant health risks. The spatial analysis identified pollution hotspots, particularly in densely populated and industrial regions. The data suggested vehicular emissions and industrial activities as major contributors to high PM2.5 levels. This study underscores the severe air quality issues in Lagos State, emphasizing the need for immediate and targeted interventions to mitigate PM2.5 pollution. The use of AirQo sensors proved effective in providing accurate and timely data for air quality assessment. It is recommended that Lagos State implements stricter emission controls, promotes cleaner technologies, and enhances public transportation systems to reduce traffic-related pollution. Additionally, expanding the air quality monitoring network and incorporating more environmental data will provide a more comprehensive understanding of air pollution impacts, thereby facilitating better policy and public health decisions.

Mobile applications, websites and social media networks are nowadays widely used communication tools. With the emergence of communication-related technologies in our lives and, consequently, the rise of social networks and mobile applications, health-related applications, generically encompassed under the term digital health, have become popular among the population. Smartphones and artificial intelligence have become very useful tools for health-related interventions. Because they are very accessible and cost-effective. They are also able to serve a larger number of communities than traditional interventions. Nutrition is not a field that has remained on the sidelines, and numerous mobile applications and technological tools have emerged that are intended to help and support diets or in the process of recovering from disease. However, many of these applications have limitations that are important to consider. For this reason, the aim of this review was to analyze the most widely used tools currently in use, discuss their advantages and disadvantages, and propose hypotheses for improvement.

Background and Aims: Paramedics attend an unprecedented number of drug poisoning events daily in British Columbia (BC), Canada due to the ongoing public health crisis related to an increasingly toxic and unregulated supply of illicit drugs. Paramedics have the potential to support alternative models of care to reduce harm, but their perspectives towards harm reduction initiatives are polarized. Understanding the drug-related substance use content in paramedic curriculum documents is important for deploying effective harm mitigating programs. The objective of this study was to understand what drug-related substance use content currently exists within paramedic curriculum documents in British Columbia. Methods: We performed a document analysis of curriculum documents in BC’s paramedic training institutions, the primary program textbook, and the 2011 National Occupational Competency Profile (NOCP). We used the Checklist for Assessment and Reporting of Document Analysis (CARDA) tool to perform our analysis. We analysed and coded documents both inductively and deductively and subsequently combined, refined, and used the codes to inform the development of themes via reflexive thematic analysis. Results: Of the 44 documents analysed, 22 included codes relevant to the research questions. Paramedics are primarily taught to care for people who use drugs in an acute drug-poisoning response only, with little consideration of holistic care, and no meaningful mention of harm reduction. Some stigmatizing language was found within the content. Conclusions: Many opportunities to introduce holistic models of care for people who use drugs along the entire continuum of care are unaddressed by paramedic curriculum documents in BC. Curriculum developers should include people who have lived and living experience of drug use in the co-design of educational programs involving their care. Further qualitative analyses are required to evaluate the relationship between paramedic education and provider-based stigma.

To supply stable and high-quality power according to the advancement of industrial growth, electric power companies have performed maintenance of power facilities using various meth-ods. In the case of domestic power distribution facilities, there are limitations in performing di-agnostic management on all facilities owing to the large number of facilities; therefore, old fa-cilities are managed by the health index assessment method. The health index assessment com-prises only facility operation data and external environmental data and is managed only for four types of distribution facilities, including overhead/underground transformers and switchgear. In the case of extra high–voltage overhead wires, there is no standard for old replacement, despite the large number of wires, such as transformers and switchgear, and the large ripple effect of power failure in the event of a power outage. Therefore, in this paper, a health index assessment methodology for extra-high voltage overhead cables was developed. In this paper, we devel-oped an economic health index assessment methodology that additionally considers risk cost, which is different from the existing health index assessment method that uses only operational data and external environmental data to determine facility performance evaluation and aging replacement criteria. Using the health index assessment methodology developed in this paper, it is possible to expect a reduction in facility operating costs and investment costs from the per-spective of electric power companies through the replacement of old extra-high voltage over-head cables. In addition, from the perspective of consumers, it is expected to increase power re-liability and reduce the ripple effect of failure by preferentially replacing equipment with a high probability of failure.

This study aims to comprehensively understand the provision of skincare solutions for individuals living with HIV, focusing on the efficacy of existing treatments, challenges in accessing dermatological care, and the preferences of individuals living with HIV for personalized skincare solutions. The study triangulated data from structured surveys and in-depth interviews with a purposive sample of individuals living with HIV, healthcare professionals, and experts in public health and social work, using a mixed-methods approach. The structured surveys provided specific data points, while the in-depth interviews and participant observations yielded rich, contextual insights. The results revealed a need for more personalized skincare solutions for individuals living with HIV, challenges in accessing dermatological care, and concerns regarding the efficacy of existing treatments. The integrated analysis of quantitative and qualitative data provided a nuanced understanding of the factors influencing skincare solutions for this population. Conclusions drawn from the study emphasize the importance of tailored skincare interventions, improved access to dermatological care, and the need for collaborative efforts between healthcare providers and individuals living with HIV. Future research directions include longitudinal studies to assess the long-term effectiveness of personalized skincare solutions and the exploration of innovative interventions integrating dermatological care and social support for individuals living with HIV.

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

More than 400 million tons of livestock waste are generated annually by approximately 25,000 concentrated animal feeding operations (CAFOs) located in the United States (US). These operations give rise to externalities, including adverse local and global health impacts from CAFO waste emissions, which can potentially outweigh their economic viability. However, a shortage of evidence synthesis research on US-based CAFO emissions may hinder effective policy development. This scoping review (ScR) study, conducted following guidance from the Joanna Briggs Institute, searched databases including Scopus, Web of Science, PubMed and Embase in May 2020, yielding ten publications meeting inclusion criteria. Results suggest possible CAFO worker exposures to multidrug-resistant Staphylococcus aureus (MDRSA), campylobacteriosis and cryptosporidiosis. Communities near CAFOs experienced higher rates of adverse health impacts compared to those in non-CAFO areas, with patterns suggesting proximity may correlate with increased odds of detrimental health effects. Implicit global health threats include Methicillin-resistant Staphylococcus aureus  (MRSA), MDRSA, campylobacteriosis, tuberculosis, and cryptosporidiosis. These studies provide foundational insights into CAFO proximity, density patterns, and adverse public health effects, indicating a need for evidence-informed environmental health policies to minimize local and global risks.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N=45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water were 19,674 with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, and concerned about waste production and climate change, coming from the North-East regions of Italy. Underweight people showed a higher prevalence of TW assumption as well as those who drink less than occasionally carbonated drinks, drink alcohol, consume vegetables more than once a day, and snacks less than once a week with a satisfying level perceived health status. Regressions showed that all age classes are less likely to drink tap water than people younger than 20 years old. The category with “inadequate” economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as Islands. A concern about waste production and climate change is associated with an increased likelihood of assuming tap water. Tap water consumption was negatively associate with obesity but not with a satisfactory Self-perceived health status. Insights from this study can inform public health strategies.

The Portuguese health system has a universal, public, general National Health Service (NHS), tending towards free healthcare access. Created in 1979, this delivery model developed from the integration and complementarity between the different response levels (primary, hospital, continuing, and palliative care). However, over these 40 years, the initially centralized system underwent a decentralization process with the creation of Regional Health Administrations in the five mainland administrative regions. Since then, the entire NHS has settled around this new organization. The most recent step started in 2018 with decentralizing primary health care skills to 190 municipalities. This paper presents the various critical issues involved in the latest gradual decentralization process in health, intending to bring services closer to the citizens, and more focused on their needs. The article identifies and discusses the implications of this experience based on the steps foreseen in the already published legal texts.

Along with environmental pollutions, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural-social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, the consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and consequently, the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture.

Health literacy describes skills and competencies that enable people to gain access to, understand and apply health information to positively influence their own health and the health of those in the social environment. In an increasingly media saturated and digitized world, these skill sets are necessary for accessing and navigating sources of health information and tools, such as television, the Internet, and mobile apps. The concepts of Media Health Literacy (MHL) and eHealth Literacy (eHL) describe the specific competencies such tasks require. This article introduces the two concepts, and then reviews findings on the associations of MHL and eHL with several contextual variables in the social environment such as socio-demographics, social support, and system complexity, as a structural variable. As eHL and MHL are crucial for empowering people to actively engage in their own health, a growing body of literature reports of the potential and the effectiveness of intervention initiatives to positively influence these competencies. From an ethical standpoint, equity is emphasized, stressing the importance of accessible media environments for all - including those at risk of exclusion from (digital) media sources. Alignment of micro and macro contextual spheres will ultimately facilitate both non-digital and digital media to effectively support and promote public health.

Cyber diplomacy is critical in dealing with evolving cybersecurity dangers and possibilities in the digital era. This article investigates the impact of Artificial Intelligence (AI), the Internet of Things (IoT), Blockchains, and Quantum Computing on cyber diplomacy. AI holds the potential for proactive threat identification and response, while IoT enables international information sharing. Blockchains enable secure data sharing and document verification, but they also pose new threats, such as AI-driven cyber-attacks, IoT privacy breaches, blockchain vulnerabilities, and the potential for quantum computing to break encryption. This article conducts case study reviews, in combination with secondary data analysis, and emphasises the value of international cooperation in developing global norms and frameworks to control responsible technology adoption. Cyber diplomacy can promote cybersecurity, protect national interests, and foster mutual trust among nations in the digital sphere by capitalising on possibilities and reducing threats.

This study investigated changes in the average BMI of 5th and 6th grade elementary school students in Korea and provided foundational data to suggest the role of physical education for student health and set future directions. The 2019–2021 Physical Activity Promotion System (PAPS) of the Korean Ministry of Education was used. Data corresponding to 5th and 6th grade students (124,693 from 2019, 126,226 from 2020, and 117,809 from 2021) in 1,208 elementary schools in Korea were collected. The BMI was obtained by dividing weight by the square of height (㎏/m2). Repeated measures ANOVA was conducted for data analysis, and confidence intervals were modified through the Bonferroni correction for multiple comparisons. The Greenhouse-Geisser correction was used for effects test. The study findings are: First, the average BMI of 5th and 6th grade elementary school students in Korea increased significantly in 2021 compared to 2019 and 2020. Second, changes in the yearly average BMI showed a significant difference depending on gender and grade. Obesity among 5th and 6th grade elementary school students in Korea increased steadily in 2019–2021, which may be due to a decrease in students’ physical activity. Male students showed a steeper increase, regardless of grade.

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.

During the pandemic, educational digitization experienced a significant increase. In Mexico, social service is a crucial component of technical and professional training, a phase during which individuals apply the knowledge gained throughout their university education. The aim of this study is to standardize a digital model for the management of social service in the health care sector within health care units. This study employed an analytical, observational, retrospective, and longitudinal approach, involving two groups of trainees: Group A (n=133), utilizing a Non-Digital Model, and Group B (n=50), employing a Digital Model. In Stage I. the model design underwent validation through the Delphi method with a panel of three experts. The model was implemented on a Classroom® digital platform with the integration of the elements 1) a monthly rotation rubric 2) care services rubric 3) clinical cases or nursing process rubric, and 4) innovation project rubric. The validation of the model achieved 100% agreement (K=1). The variables measured for each group included the school of origin, career, unit of assignment, timely enrolment, and timely delivery of rubrics on the platform. The difference between the two groups was measured using Chi-Square. To measure the impact, the difference in the timeliness of the products was considered. From the University of Quintana Roo, the difference was 20.3 vs 34%. According to the Unit of Attachment the most frequent was HGR No. 17 with Group A at 22.5 vs 52%. According to the product the least delivered was Product 4, with 69% vs 81%. Timely enrollment was observed in Group A at 89% vs Group B at 80% p=0.001. Overall timely delivery in Group A was 81% vs Group B at 91% p=0.001 in the first 6 months post-implementation. Demonstrating that the implementation of the digital platform was effective, representing a significant advance in the adaptation of medical education to the circumstances imposed by the pandemic, highlighting the feasibility and effectiveness of digital teaching methods in the training of health professionals.

Childbirth education classes represent an antenatal tool for supporting pregnant women and couples in increasing knowledge on pregnancy, delivery, breastfeeding, and newborn care. The aim of this study was to investigate the impact of the additional lesson to the prenatal course regarding the advantage of the vaccination on mitigation of maternal anxiety. An observational study was designed including participants in childbirth education classes, comparing courses enhanced by the extra lesson on vaccination during pregnancy versus those lacking it. Assessment of the impact of prenatal educational on vaccine was measured by using validated questionnaires (State-Trait Anxiety Inventory, STAI; Perceived Stress Scale, PSS; World Health Organization- Five Well-Being Index, WHO-5). A total of 145 pregnant women participated to the investigation by answering to the online survey. Of them, 33 patients (22.8%) belong to the course without lesson on vaccine, while 112 (77.2%) participated to online prenatal education inclusive of additional meeting on usefulness to get vaccinated during pregnancy. No statistical differences were found between study groups in demographics and perinatal outcomes. Participants to enriched course reported lower basal anxiety levels than those without lesson on vaccine (STAI-State, normal score <40, 30 vs. 19%, p-value 0.041; STAI-State, mild score 40-50, 78 vs 67%, p-value 0.037). With reference to the last two weeks, maternal wellbeing level was improved by the added class (score >13 as measurement of wellbeing: 62% vs 80%, p-value<0.05). Moderate perceived stress assessed by PSS was found in those pregnant women without prenatal education on vaccine (64 vs 50%, p-value 0.042). The introduction of a lesson regarding on vaccination during pregnancy in the program of prenatal education courses improves maternal anxiety levels and wellbeing, in addition to reducing perceived stress.

Patient symptoms play a critical role in disease progression and diagnosis, yet they are most often captured in unstructured clinical notes. This study explores use of large language models (LLMs) for extracting patient symptoms from clinical notes, comparing their performance against rule-based information extraction (IE) systems, like BioMedICUS. By fine-tuning an LLM on diverse corpora from multiple healthcare institutions, we aimed to improve symptom extraction accuracy and efficiency with symptoms related to acute and post-acute sequelae of SARS-CoV-2. We also conducted prevalence analysis to highlight significant differences in symptom prevalence across corpora and performed fairness analysis to assess the model's equity across race and gender. Our findings indicate that while LLMs can match the effectiveness of rule-based IE methods, they face significant challenges related to demographic bias and generalizability due to variability in training corpora. This evaluation revealed overfitting and insufficient generalization, especially when models were trained predominantly on limited datasets with single annotator bias. This study also revealed that LLMs offer substantial advantages in efficiency, adaptability, and scalability for biomedical IE, marking a transformative shift in clinical data extraction processes. These results provide real-world evidence of the necessity for diverse, high-quality training datasets and robust annotation processes to enhance LLM’s performance and reliability in clinical applications.

Rationale - From the year 1 anno Domini until 1855 with the third Plague, major pandemics occurred on average every 348 years. Since then, they have occurred on average every 33 years, with Coronavirus disease 2019 (COVID-19) now underway.Even though current technologies have greatly improved the way of life of human beings, COVID-19, with more than 700 000 000 cases and 6 950 000 deaths worldwide by the end of 2023, reminds us that much remains to be done. Objective - Given the frequency and duration of recent pandemics, it might be wise to start thinking about preventative methods to minimize the impact of future pandemics. This report looks back at 18 months of COVID-19, from March 2020 to August 2021, with the aim of highlighting potential solutions that could prove practical, or even essential, for the future. Material - COVID-19 data, including case and death reports, were extracted daily from the Worldometer platform to build a database for macroscopic analysis of the spread of the virus around the world. Demographic data were integrated into the COVID-19 database for a better understanding of the spatial spread of the SARS-CoV-2 virus in cities/municipalities. Method - Without loss of generality, we only analyzed data from the top 30 (out of 200 and above) countries ranked by total number of COVID-19 cases. Statistics (regression, t-test (p < 0.05), correlation, mean ± std, etc.) were carried out with Excel software. Spectral analysis, using Matlab software, was also used to try to better understand the temporal spread of COVID-19. Results - A good linear correlation was observed between the number of cases and the respective number of deaths depending on the country, i.e. y = 0.0121x + 19559 with R² = 0.8042. The analysis then focused mainly on the number of cases.This study showed that COVID-19 mainly affects G20 countries. The most interesting result is that cities/municipalities with high population density are a powerful activator of the spread of the virus. The current demographic context seems to be becoming a societal problem that must be addressed adequately.Spectral analysis highlighted that the very first months of spread of COVID-19 were the most notable with a strong expansion of the SARS-CoV-2 virus. On the other hand, the following six months showed a certain stability due mainly to multiple preventive measures such as confinement, closure of non-essential services, wearing of masks, distancing of 2 meters, etc. Discussion - Analysis of case and death data showed that COVID-19 mainly affects G20 countries. Nevertheless, the most interesting result of this study is that cities and municipal areas with population densities of several thousand inhabitants per square kilometer largely favored the spread of the SARS-CoV-2 virus. It is believed that such a demographic context is becoming a societal problem that developed countries around the world will sooner or later face and therefore needs to be adequately addressed. Conclusion - COVID-19 has made us understand that it is time to act both preventatively and curatively. Phenomenological insights suggest that the next pandemic could occur in less than 50 years. It may be time to launch new societal projects aimed at relieving congestion in densely populated regions.

Digital health has added numerous promising solutions to enhance the health and wellness of people with neurocognitive disorders (NCDs) and their informal caregivers: (1) Background: It is important to get a comprehensive view of currently available technologies, their outcomes, and conditions of success to inform recommendations regarding digital health solutions for people with NCDs and their caregivers. This environmental scan was performed to identify the features of existing digital health solutions relevant to the targeted population. This work reviews currently available digital health solutions and their related characteristics to develop a decision support tool for older adults living with mild or major neurocognitive disorders and their informal caregivers. This knowledge will inform the development of a decision support tool to assist older adults and their informal caregivers in their search for adequate digital health solutions according to their needs and preferences, based on trustable information.; (2) Methods: We conducted an environmental scan to identify digital health solutions from a systematic review and targeted searches in grey literature covering the regions of Canada and Europe. Technological tools were scanned based on a preformatted extraction grid. We assessed their relevance based on selected attributes and summarized findings; (3) Results: We identified 100 available digital health solutions. The majority (56%) were not specific to NCDs. Only 28% provided scientific evidence of their effectiveness. Remote patient care, movement tracking, and cognitive exercises were the most common purposes of digital health solutions. Most solutions were presented as decision aid tools, pill dispensers, apps, web, or a combination of these platforms. (4) Conclusions: This environmental scan allowed the identification of current digital health solutions for older adults with mild or major neurocognitive disorders and their informal caregivers. Findings from the environmental scan highlight the need for additional approaches to strengthen digital health interventions for the well-being of older adults with mild and major NCDs and their informal and formal healthcare providers.

This paper outlines the ongoing development of a specialised mobile application to address the mental health needs of vulnerable populations in the European Union (EU). Conducted as a mixed-methods research within two EU Science and Technology Cooperation Actions, the study prioritises stakeholder feedback to identify features for initial testing and strategies to improve application uptake, using critical digital health analysis. With a focus on marginalised groups such as refugees, migrants and socio-economically disadvantaged individuals, the application aims to provide an accessible and culturally sensitive platform for mental health support, integrating evidence-based interventions such as cognitive behavioural techniques and mindfulness exercises. Key features include multilingual support, habit tracking, personalised recommendations for support and services, and real-time crisis intervention. Collaboration with stakeholders and ongoing rigorous usability testing are driving the refinement process to ensure usability, acceptability and effectiveness, underscoring the importance of user engagement in technology-based mental health interventions in the EU context and highlighting the importance of collaborative science and technology for societal benefit.

Micro turbojets are used for propelling radio-controlled aircraft, aerial targets and personal air vehicles. When compared to full-scale engines, they are characterized by relatively low efficiency and durability. In this context, the degraded performance of gas path components could lead to an unacceptable reduction in the overall engine performance. In this work, a data-driven model based on a conventional Artificial Neural Network (ANN) and an extreme learning machine (ELM) was used for estimating the performance degradation of the micro turbojet. The training datasets containing the performance data of the engine with degraded components were generated using the validated GSP model and the Monte Carlo approach. In particular, compressor and turbine performance degradation were simulated for three different flight regimes. It was confirmed that component degradation had a similar impact in flight than at sea level. Finally, the datasets were used in the training and testing process of the ELM algorithm with four different input vectors. Two vectors had an extensive number of virtual sensors, and the other two were reduced to just fuel flow and Exhaust Gas Temperature. Even with the small number of sensors, the high prediction accuracy of ELM was maintained for takeoff and cruise but was slightly worse for variable flight conditions.

Public health is an important aspect of community activities, making research on health necessary because it is a crucial field in maintaining and improving the quality of life in society as a whole. Research in public health allows for a deeper understanding of the health problems faced by a population, including disease prevalence, risk factors and other determinants of health. This work aims to explore the potential of hospital patient data analysis as a valuable tool for understanding community implications and deriving insights for effective community health interventions. The study recognises the significance of harnessing the vast amount of data generated within hospital settings to inform population-level health strategies. The methodology employed in this study involves the collection and analysis of deidentified patient data from a representative sample of a hospital in Indonesia. Various data analysis techniques, such as statistical modelling, data mining and machine learning algorithms, are utilised to identify patterns, trends and associations within the data. A program written in Python is used to analyse patient data in a hospital for five years from 2018 to 2022. These findings are then interpreted within the context of public health implications, considering factors such as disease prevalence, socioeconomic determinants and healthcare utilisation patterns. The results of the data analysis provide valuable insights into the public health implications of hospital patient data. The research also covers prediction for the patient data to the hospital based on disease, age and geographical residence. The research prediction shows that in 2023, the number of patients was not considerably affected, but in in March to April 2024, the number significantly increased to 10,000 patients. These recommendations encompass targeted prevention strategies, improved healthcare delivery models and community engagement initiatives. The research emphasises the importance of collaboration between healthcare providers, policymakers and community stakeholders in implementing and evaluating these interventions.

Objective: To investigate whether the relationships between acute care occupational therapy (OT) and physical therapy (PT) utilization and community discharge are moderated by functional or physical performance at discharge among individuals hospitalized with traumatic brain injury (TBI). Setting: 14 acute care hospitals in the state of Colorado. Participants: We studied 5,599 adults hospitalized with TBI between June 2018 and April 2021. Design: In a secondary analysis of de-identified electronic health record (EHR) data, multivariable moderation logistic regression models were performed to calculate odds ratios (ORs) for the likelihood of community discharge among patients who utilized OT/PT services. Main Measures: Functional (activities of daily living [ADL]) and physical (mobility) performance at discharge, OT and PT utilization, and community discharge status. Results: Overall, 67% of patients discharged to the community. The mean age of the sample was 55 years (SD = 20 years). Most participants were male (64%) and non-Hispanic white (72%). Mean hospital length of stay was 6 days (SD = 6 days). Both OT and PT utilization (OT: OR= 1.21, 95% CI [1.11, 1.33]; PT: OR= 1.22, 95% CI [1.14, 1.30]) and discharge ADL and mobility scores (ADL: OR= 1.34, 95% CI [1.30, 1.39]; mobility: OR= 1.38, 95% CI [1.33, 1.42]) were significantly and positively associated with community discharge. The OT and PT utilization-by-discharge ADL and mobility interaction terms yielded slightly negative, but statistically significant moderation effects in both models (ORs= 0.99, 95% CIs [0.98, 1.00]); indicating the magnitude of the OT and PT utilization effect diminished as ADL and mobility scores increased. Several sociodemographic characteristics and clinical factors were also independently associated with community discharge in both models (p-values

Anthocyanins are among the best-known phenolic compounds and possess remarkable biological activities, including antioxidant, anti-inflammatory, anticancer, and antidiabetic effects. Despite their therapeutic benefits, they are not widely used as health-promoting agents due to their insta-bility, low absorption, and thus, low bioavailability and rapid metabolism in the human body. Recent research suggests that the application of nanotechnology could increase their solubility and/or bioavailability, and thus, their biological potential. Therefore, in this review, we decided to provide, for the first time, a comprehensive overview of in vitro and in vivo studies on nanocarriers used as delivery systems of anthocyanins, and their aglycones, i.e., anthocyanidins alone or com-bined with conventional drugs to the treatment or management of chronic diseases.

Trans fatty acids (TFA) are a concern for public health due to their negative impact on cardiovascular health. This study aimed to assess the levels of TFA and other fatty acids in popular edible oils and fried foods commonly consumed in Tanzania. A total of 57 samples from 38 brands of edible oils and 20 samples of fried street foods and fast foods were collected in Dar es Salaam, Tanzania. Capillary gas chromatography was used to determine TFA levels, while nutritional labeling and other fatty acid classes were also evaluated. Among the analyzed edible oils, 21% exceeded the recommended TFA levels, primarily found in popular brands of margarine, industrially refined sunflower oils, animal butter, and peanut butter. Only two food items surpassed the 2% TFA limit, but a majority of the foods had high levels of saturated fatty acids and a fatty acid profile similar to palm oil. Additionally, only 22% of the edible oils provided TFA content information. These findings indicate the persistence of TFA levels beyond recommended limits and inadequate TFA nutritional labeling in Tanzanian food products. Urgent interventions are necessary to reduce TFA levels and improve nutritional labeling practices to safeguard public health.

Migratory movements are a political, social and public health issue on a global scale. Access to sexual and reproductive health services for irregular migrant women (IMW) is a public health issue. The aim of this study is to identify qualitative evidence on IMW's experiences of sexual and reproductive health care in emergency and primary care settings. Methods: meta-synthesis of qualitative studies. Synthesis includes assembling and categorising findings based on the simili-arty in meaning. The search was conducted between January 2010 and June 2022 using PubMed, WOS and CINAHL databases. Results: of 131 articles found in the initial search, only 9 articles met the criteria and were included in the review. Four main themes were established: (1) The need to focus emergency care on sexual and reproductive health, (2) Unsatisfactory clinical experiences, (3) Forced reproduction, (4) Alternating between formal and informal healthcare services. Con-clusions: IMW’s attitudes towards sexual and reproductive health are influenced by culture, ed-ucational level, fear, barriers and the attitude of healthcare providers. Healthcare institutions need to be aware of the IMW’s experiences to understand the specific difficulties they face. IMW call for socially and culturally sensitive health care, cultural mediators, improved communication and safe environments that ensure confidentiality.

We aimed to study the knowledge of diabetes among high-risk individuals for diabetes in the Indian state of Kerala. The baseline data collected from 1007 participants of the Kerala Diabetes Prevention Program were analyzed. Diabetes knowledge was assessed using a scale adapted from a large nationwide study conducted in India. The composite score of the scale ranges from 0 to 8. The mean age of participants was 46.0 (SD: 7.5) years, and 47.2% were female. The mean diabetes knowledge score was 6.9 (SD: 2.1), with 59.5% having the maximum possible score of 8. Of 1007 participants, 968 (96.1%) had heard the term diabetes, and of them, 84.7% know what diabetes is, 87.2% think more and more people are getting diabetes nowadays, 79.6% know that diabetes can cause complications in organs, and 75.9% know that diabetes can be prevented. While the level of diabetes knowledge was high among our participants, a quarter of them (24.1%) were not aware that diabetes can be prevented. Thus, there is a need for health promotion programs to increase the knowledge of diabetes prevention among high-risk individuals in Kerala.

An outbreak of esophagitis and ingluvitis caused by Salmonella Typhimurium in passerines seized from illegal wildlife trafficking is described. This illegal activity causes stress and leads to lowered immunity in the birds. Additionally, inadequate hygiene conditions predispose the birds to diseases such as salmonellosis. Few studies report the occurrence of Salmonella-induced lesions in the esophagus and crop of wild birds; thus, this study aimed to describe the disease in these species, investigate its presence in the environment, and determine the antimicrobial resistance profile. Three birds of the genus Sporophila were necropsied. In the esophagus and crop, yellowish plaques corresponding to necrosis with bacterial aggregates were observed. Salmonella spp. was isolated from these lesions, with genus confirmation via MALDI-TOF. Environmental samples were collected from the enclosures and cages where the animals were quarantined, and the same bacterium was isolated. In two birds, the serotype S. Typhimurium was identified. Antibiograms performed on the strains from the birds and the environment revealed resistance to antibiotics in the classes of Penicillins, Sulfonamides, Aminoglycosides, Monobactams, Tetracyclines, and first and third-generation Cephalosporins. To the authors' knowledge, this is the first report of this agent causing death in Sporophila due to esophagitis and ingluvitis. It is also the first report of salmonellosis in three species of passerines in Brazil. The study underscores the importance of understanding the pathogens circulating in wild animals, especially within the context of One Health.

Metabolic syndrome is a growing global health problem. Evidence suggests that diets rich in phytochemical-containing herbs and spices can contribute to reduced risk of chronic disease. This review assesses the scope of evidence supporting the use of herbs and spices in the diet for prevention or treatment of metabolic syndrome and associated health conditions. A search of PubMed and Scopus databases was carried out to assess the available clinical or cohort evidence for culinary doses of commonly used herbs and spices. Trials that were measuring health factors related to metabolic disorders or the health of individuals with metabolic syndrome or associated diseases were included. Out of a total of 1742 papers identified, there were 146 relevant studies on black pepper, chilli, cardamom, cinnamon, coriander, cumin, fennel, fenugreek, garlic, ginger, Nigella seed, rosemary, sage and turmeric. No relevant research was found for cloves, mint, oregano, parsley or thyme. Cinnamon, fenugreek and ginger were the herbs/spices with the most published trials on them and showed promise for glycaemic control. Cardamom appears to have potential to reduce inflammatory markers, and cinnamon, ginger and turmeric for blood lipids. Patients with type 2 diabetes were the population most likely to be included in studies, but the preventative benefits of herbs/spices in healthy populations were also investigated, particularly for chilli, ginger and cinnamon. There is evidence for the beneficial effect of culinary doses of many common herbs/spices in the prevention and treatment of metabolic syndrome and associated disorders.

Background: Mental health is a growing concern worldwide. It is not well understood whether Nepali workers, including international labour migrants from Nepal, are at higher risk of developing mental health problems. The purpose of our study is to determine the prevalence of and examine the risks factors for depression among returnee migrants and non-migrant working male adults in Nepal. Methods: A cross-sectional survey of a probability-based sample of 725 participants was conducted in February 2020. The sample was comprised of two groups based on migration status: returning migrants and non-migrants. Logistic regression was applied to investigate factors associated with symptoms depression.Results: The overall prevalence of depression was 10.1%. However, the prevalence of depression was lower (7%) among returnee migrants compared to non-migrants (13.7%). Participants in the lower income group were more at risk of depression (OR=5.38, 95% CI: 1.96-14.78) than those in the higher income group. Similarly, Buddhists and Christians were more likely to be depressed (OR=2.17, 95% CI: 1.02-4.64) than Hindus. Interestingly, participants having more than two children had a higher prevalence of depression (OR=5.14, 95% CI: 1.22-21.63) compared with those having no children. Unmarried participants were more likely to be depressed (OR=4.05, 95%, CI:1.10-14.93) than those who were married. Conclusion: The working Nepali adult male population in Nepal, including returning migrants, is at risk of depression, but this risk is lower in those in the higher income group, returnee migrants, married, Hindus and those with no children. This study highlights the need to monitor and develop national policies to ensure the mental health of Nepali male adult population, including returnee migrants.

Background: The tsunami and earthquake occurred in 1927 and 2018 made life quality of Da’a Tribe women in refugee camps was affected by violence. It affects on women reproductive health in various aspects of life as high maternal mortality rate of 450 per 100 thousand live births and half of women victims of natural disasters have reproductive health problems such as anemia and malnutrition during pregnancy. The study objective is to explore the health quality of women related to the couple violence during the humanitarian crisis at refugees’ camps. Method: The population was 798 cases of violence. The 90 samples were selected by simple random sampling and calculated by Slovin method. Data analysis was done by descriptive qualitative and cross tabulation. The research location was Palu City. Results: The research findings showed that health quality of Da’a Tribe women after the couple violence is influenced by three factors, namely economic by 40%, psychological by 7%, violence during pregnancy 59.3%. Conclusion: Social life and women violence handling can be done by symbolizing the threat of criminal law for male perpetrators in accordance with applicable laws in Indonesia and improving the life quality of population, especially women in education and skills through empowering the family economy and increasing gender equality justice.

Programmable Object Interfaces are increasingly intriguing researchers because of their broader applications, especially in the medical field. In Wireless Body Area Network (WBAN), for example, the patients’ health can be monitored using clinical nano sensors. Exchanging such sensitive data requires a high level of security and protection against attacks. To that end, the literature is rich with security schemes that include the advanced encryption standard, secure hashing algorithm, and digital signatures that aim to secure the data exchange. However, such schemes elevate the time complexity rendering the data transmission slower. Cognitive Radio technology with a medical body area network system involves communication links between WBAN gateways, server and nano sensors rendering the entire system vulnerable to security attacks. In this paper, a novel DNA-based encryption technique is proposed to secure medical data sharing between sensing devices and central repositories. It has less computational time throughout authentication, encryption, and decryption. Our analysis of experimental attack scenarios shows that our technique is better than its counterparts.

Expert system approach, although quite old, is still quite effective in scientific areas where experts are required to make diagnoses and predictions. One of those areas is fish disease diagnosis. It is an application domain that currently employs complicated processes, which require high level skills for making accurate diagnoses. On the other hand, complete datasets for full diagnosis to be able to use machine learning techniques are not available. Therefore, in aquaculture, now more than ever, fish farmers do not have the required expertise or equipment to accurately diagnose a fish disease. For that reason, expert systems that can help in the diagnosis, prevention and treatment of diseases have been developed. In this paper, we attempt to give an overview of the expert system approaches for fish disease diagnosis developed in the last two decades. Based on the analysis of their technical and non-technical characteristics, we propose an expert system architecture and a fish disease diagnosis process aiming at improving the deficiencies of existing such systems. The proposed system can handle all kinds of fish diseases based on image and non-image data as well as on molecular tests results and can provide explanations. The diagnosis process goes through four consecutive levels, where each next level considers an additional category of parameters and provides diagnoses with higher certainty.

This review examines from a services perspective strategies for preparedness and response to mental health impacts of three types of climate-related events: 1) acute climate-related events such as hurricanes, floods and wildfires, 2) sub-acute or long-term changes in the environment such as drought and heat stress; and 3) the existential threat of long-lasting changes, including higher temperatures, rising sea levels and a permanently altered and potentially uninhabitable physical environment. Strategies for acute events include development and implementation of guidelines and interventions for monitoring and treating adverse mental health outcomes and strengthening individual and community resilience, training of non-mental health professionals for services delivery, and the mapping of available resources and locations of at-risk populations. Additional strategies for sub-acute changes include advocacy for mitigation policies and programs and adaptation of guidelines and interventions to address the secondary impacts of sub-acute events such as economic loss, threats to livelihood, health and well-being, population and family displacement, environmental degradation and collective violence. Strategies for long-lasting changes include implementation of evidence-based risk communication interventions that address the existential threat of climate change, promoting the mental health benefits of environmental conservation, and promoting positive mental health impacts of climate change.

Previous studies have examined the impact of Internet use on health in China, but they have not adequately addressed the issue of reverse causality or conducted a detailed analysis of health status. This study uses three waves of longitudinal data from the China Family Panel Studies conducted in 2014, 2016, and 2018 to investigate the association between Internet use and health status in China, aiming to address these gaps. The results indicate that Internet use may improve health status, including self-rated health, mental health, and outpatient visits. These effects vary by gender and age group: the positive effect of Internet use on health outcomes is more pronounced for women, and for middle-aged and older generations, compared to men and younger generations. These findings provide new evidence of the beneficial impact of Internet use on health outcomes in China, suggesting that policies promoting Internet utilization could enhance individuals’ health status, particularly among women and middle-aged and older populations.

Due to the increasing risk of extreme events caused by climate change (i.e. floods, fires, hurricanes) or wars, European veterinary public health may need some improvement. Utilizing a mix of qualitative (participatory observation) and quantitative methods (Internet mining), we analyzed the Greek media responses to the millennial flood in Thessaly (September 2023), focusing on animal health (including wild, companion animals and livestock) and public sentiment towards epizootic/epidemic threats. The study revealed a gap in crisis management plans regarding veterinary-related issues, emphasizing the need for comprehensive emergency response strategies. Our findings show how: (i) lay-referral system is projecting perception of epidemic threats into the population; (ii) emotional load of images of animal carcasses is misused by media creators aiming for big audience; (iii) pets owners are creating on-line communities for searching and treatment of their pets. Our results stress the importance of integrating crisis communication in consecutive phases of the discourse, such as (i) weather change; (ii) acute flood; (iii) recovery; (iv) outbreaks, into veterinary practices to better prepare for such disasters.

Aim: Shockwaves have been felt all over the world as a result of war, inflation, food shortages, and the COVID-19 pandemic's long tail. The aim of the study is to correlate present global conflicts, pandemic and socio-economic crises with present healthcare sustainability, identifying possible threats and visualize future global health crises if all these catastrophes persist for long. Materials and Methods: PubMed, ALTAVISTA, Embase, Scopus, Web of Science, and the Cochrane Central Registers were prioritized to collect public health issues. Results: The global economic slowdown, sharp decline in financial asset values, decline in imports and exports, contraction of industrial production, rise in inflation, decrease in wages, rise in unemployment, damage to the social security caused by numerous natural calamities, human displacement due to pandemic and ongoing conflicts tear down not only the economic sector but also the health sector. It is already late for taking corrective measure by the participation every country, community or intelligence. Only healthcare issues, highlighted in this study, if focused in the highest platforms, could compel global leaders to forego conflicts and work together. Conclusion: The global health sector will be collapsed soon, if proper initiatives are not taken right now, which has already been grossly mistreated by the pandemic.

The investment in digital e-Health services is a priority direction in the development of global health care systems. While people are increasingly using the Web for health information, it is not entirely clear what is the physicians’ attitude towards digital transformation, and the acceptance of new technologies in healthcare. The aim of this cross-sectional survey study was to investigate physicians’ self-digital skills, and their opinions on obtaining online health knowledge by patients, as well as the recognition of physicians’ attitudes towards e-Health solutions. Principal Component Analysis (PCA) was performed to emerge the variables from self-designed questionnaire, and cross-sectional analysis comparing descriptive statistics and correlations for dependent variables using the one-way ANOVA (F-test). 307 physicians participated in the study, reported using the internet mainly several times a day (66.8%). Most participants (70.4%) were familiar with new technologies and rate their e-Health literacy high, although 84.0% reported the need for additional training in this field, and reported a need to introduce a larger number of subjects shaping digital skills (75.9%) in medical studies 53.4% of physicians perceived Internet-sourced information as sometimes reliable, and in general assessed the effects of using it by their patients negatively (41.7%). Digital skills increased significantly with frequency of internet use (F = 13.167; p = 0.0001), and decreased with physicians’ age, and the need for training. Those who claimed that patients often experienced health benefits from online health showed higher digital skills (-1.06). Physicians most often recommended their patients to obtain laboratory test results online (32.2%), and to arrange medical appointments via the Internet (27.0%). Along with the deterioration of physicians’ digital skills, the recommendation of e-Health solutions decreased (r = 0.413), and lower the assessment of e-Health solutions for the patient (r = 0.449). Physicians perceive digitization as a sign of the times, and frequently use its tools in daily practice. The evaluation of Dr. Google’s phenomenon and online health is directly related to their own e-Health literacy skills, but there is still a need for practical training to deal with digital revolution.

Background: It is very important that nurses receive adequate training in Sexual and Reproductive Health (SRH). In this study, the contents of the SRH subject in the undergraduate nursing curricula of 77 Spanish universities were examined in order to determine what SRH training nursing students are receiving. Methods: The contents of the SRH subject of all the curricula that were available online were reviewed. The distribution of the contents (topics) in the two areas (reproductive health and sexual health) was analyzed, and the prevalence of each topic was established. It was also determined whether there were differences in topics between public (n=52) and private universities (n=25). Results: The training of nursing students focuses mainly on the area of Reproductive Health (15 topics). Most of the topics of this area had a prevalence greater than 50%. Although the area of Sexual Health had 14 topics, most of these topics had a low prevalence (&lt;20%), especially in private universities. Conclusions: It was found that there is considerable variation in the distribution and prevalence of SRH topics between universities. The contents of the area of Reproductive Health are usually prevalent in most of the curricula, however the contents of the area of Sexual Health are very limited in most of the universities. An organizational effort is required to determine and standardize the contents of SRH that nursing students should receive in Spain to avoid inequalities in their training.

Aedes aegypti mosquitoes are primary vectors of dengue, yellow fever, chikungunya and Zika viruses. Ae. aegypti is highly anthropophilic and relies nearly exclusively on human blood meals and habitats for reproduction. Socioeconomic factors may influence the spread of Ae. aegypti due to its close relationship with humans. This paper describes and summarizes the published literature on how socioeconomic variables influence the distribution of Ae. aegypti mosquitoes in the mainland United States. A comprehensive search of PubMed/Medline, Scopus, Web of Science, and EBSCO Academic Search Complete through June 12, 2019 was used to retrieve all articles published in English on the association of socioeconomic factors and the distribution of Ae. aegypti mosquitoes. Additionally, a hand search of mosquito control association websites was conducted in an attempt to identify relevant grey literature. Articles were screened for eligibility using the process described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 3,493 articles were identified through the database searches and previously known literature. After checking for duplicates, 2,145 articles remained. 570 additional records were identified through the grey literature search for a total of 2,715 articles. These articles were screened for eligibility using their titles and abstracts, and 2,677 articles were excluded for not meeting the eligibility criteria. Finally, the full text for each of the remaining articles (n = 38) was read to determine eligibility. Through this screening process, 11 articles were identified for inclusion in this review. The findings for these 11 studies revealed inconsistent relationships between the studied socioeconomic factors and the distribution and abundance of Ae. aegypti. The findings of this review suggest a gap in the literature and understanding of the influence of anthropogenic factors on the distribution of Ae. aegypti that could hinder efforts to implement effective public health prevention and control strategies should a disease outbreak occur.

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

The vast array of omics data in microbiology presents significant opportunities for studying bacterial pathogenesis and creating computational tools for predicting pathogenic potential. However, the field lacks a comprehensive, curated resource that catalogs bacterial strains and their ability to cause human infections. Current methods for identifying pathogenicity determinants often introduce biases and miss critical aspects of bacterial pathogenesis.In response to this gap, we introduce BacSPaD (Bacterial Strains’ Pathogenicity Database), a thoroughly curated database focusing on pathogenicity annotations for a wide range of high-quality, complete bacterial genomes. Our rule-based annotation workflow combines metadata from trusted sources with automated keyword matching, extensive manual curation, and detailed literature review. Our analysis classified 5,502 genomes as pathogenic to humans (HP) and 490 as non-pathogenic to humans (NHP), encompassing 532 species, 193 genera, and 96 families. Statistical analysis demonstrated a significant but moderate correlation between virulence factors and HP classification, highlighting the complexity of bacterial pathogenicity and the need for ongoing research. This resource is poised to enhance our understanding of bacterial pathogenicity mechanisms and aid in the development of predictive models. To improve accessibility and provide key visualization statistics, we developed a user-friendly web interface, accessible at https://bacspad.altrabio.com.

This article evaluates the reliability and consistency of nutrition- and supplementation-related advice for pregnant women provided by ten selected health-related Internet portals. The portals were chosen based on their perceived reliability and prominence in Google searches, with representation from both English and Polish language sources. The evaluation criteria included the adherence of the presented information to official recommendations and its evidence-based character based on specific items representing dietary aspects important in pregnancy. While the overall reliability was deemed acceptable, significant variations existed both among the portals and specific evaluated items. Notably, HealthLine, Medline Plus, and NCEZ emerged as the most evidence-based, while WebMD and Medycyna Praktyczna were identified as less reliable. Despite a number of issues, the analysed portals remain valuable sources of nutritional information for pregnant women, offering user-friendly accessibility superior to alternatives such as social media, on the one hand, and scientific articles, on the other. Improved consistency and attention to detail, especially in relation to vitamin intake and supplementation, would improve the overall quality of health portals.

There is a growing need to utilize community interventions to address modifiable behaviors that lead to poor health outcomes like obesity, diabetes, and heart disease. Poor health outcomes can be tied to community-level factors such as food deserts (identified areas with low access to fresh fruit, vegetables, and other healthful whole foods) and individual behaviors like sedentary lifestyles, consuming large portion sizes, and eating high-calorie fast food and processed foods. Through a social ecological approach with family, organization and community, the Faithful Families Cooking and Eating Smart (FFCES) intervention was created to address these concerns in a rural South Carolina community. FFCES used gatekeepers to identify 18 churches and 4 apartment complexes in low-income areas. 176 participants completed both pre- and post- survey measures. Student’s t-test measures found statistically significant change in participant perception of food security (0.39, p-value=0.005), self-efficacy with physical activity and healthy eating (0.26, p-value=000), and cooking confidence (0.17, p-value=.01). There was not significant change in cooking behaviors as assessed through the Cooking Behaviors Scale. FFCES shows that a social ecological approach can be effective at increasing and improving individual healthy behaviors and addressing community-level factors in low-income rural communities.

This study aims to investigate whether 16 weeks of High-Intensity Interval Training (HIIT) implemented on Physical Education classes (PEC), can improve physical fitness in high-school adolescents This study was a two-arm randomized controlled trial design with adolescents (15-17 years old). Twelve classes were randomized to either a 16 weeks of HIIT (HIIT-G, n = 106 students) implemented on PEC warm-up or a control group (CG, n = 123 students) of usual PEC warm-up. The HIIT sessions ranged from 14 to 20 all-out bouts intervals, adopting a 2:1 work-to-rest ratio. Post-intervention measures revealed a significant difference between groups in CRF and girls from HIIT-G increased their cardiorespiratory fitness (CRF) with significant difference between female groups and a medium to large effect size. The main findings from this study indicate that brief whole-body HIIT of an extremely low volume, over 16 weeks, can improve CRF in adolescent girls.

The COVID-19 pandemic and increased rates of documented Emerging Infectious Diseases (EIDs) in human populations over the last century have drawn attention on understanding pathogens spill over to humans and their zoonotic origin. In this paper we argue that we need to change the thinking about the fundamental cause of zoonoses. Our premise is that deforestation is the primary cause of EIDs events and that, to prevent future pandemics, it needs to be addressed without further delays. Therefore, we review recent trends of proximate and underlying determinants of deforestation, forest degradation and related biodiversity losses while seeking to clarify their links to the determinants of EIDs events. Acknowledging the magnitude of the challenge, we propose responses to stop global deforestation from a trans-disciplinary, intersectoral perspective led by indigenous people. While we envisage that stopping deforestation is the most important approach with long term direct and indirect effects on human, animal and plants health, providing climate changes mitigation and preventing otherwise difficult to predict EID events, we argue that such an initiative may usefully be complemented by reducing contacts between humans and wildlife animals and regulating rather than banning markets where wild animals are sold alive.Finally, we discuss transformative changes to improve planetary-wide forests preservation, soil, plants, animal, and human protection, together with a further understanding of EIDs transmission dynamics, public health veterinary and human disease surveillance, for improved global collective preparedness and action for the management of zoonotic EIDs.

Background/Objectives: Nail technicians frequently have musculoskeletal pain, which impairs their job performance. A high-risk profession linked to back discomfort that causes morbidity is nail technician. QEC is a tool used for observing and assessing risks in a work environment. The goal of this research is to assess the ergonomic risks, pain, and their relationship with posture among manicurists. Methods: The 35 nail technicians filled the assessment form which consists of occupational information, pain, European Community Respiratory Health Survey, Nordic Musculoskeletal Questionnaire and QEC worker part. Physicians assessed nail technicians’ workspace and QEC outcomes. Results: It was stated that they worked an average of 61.92±11.09 hours per week, served an average of 11±5 customers per day, and their condition lasted 53.96±36.51 months. There is a strong significant correlation between discomforts, time spent in occupation (p=0,000) and working hours. Manicure, pedicure, unwanted hair removal, correction of eyebrow were considered for ergonomic risk evaluation. Each occupation accompanied repeated bad postures. Most of them were scored in very high risk categorization for back static positions (more than 29 point). Conclusions: This study may be useful for nail technicians seeking ergonomic improvements in the areas of engineering, administration, behavior, or personal.

A Digital Twin can be understood as a representation of a real asset, in other words, a virtual replica of a physical object, process or even a system. As virtual models, they can integrate with all the latest technologies, such as the Internet of Things (IoT), Cloud Computing and Artificial Intelligence (AI), among others. Digital twins have applications in a wide range of sectors, from manufacturing and engineering to healthcare. They have been used in managing healthcare facilities , streamlining care processes, personalizing treatments , and enhancing patient recovery . By analyzing data from sensors and other sources, healthcare professionals can develop virtual models of patients, organs, and human systems, experimenting with various strategies to identify the most effective approach. This approach can lead to more targeted and efficient therapies while reducing the risk of collateral effects . Digital twin technology can also be used to generate a virtual replica of a hospital to review operational strategies, capabilities, personnel, and care models to identify areas for improvement, predict future challenges, and optimize organizational strategies. The potential impact of this tool on our society and its well-being is quite significant. This article explores how digital twins are being used in healthcare. The article also introduces some discussions on the impact of this use and future research and technology development projections for the use of digital twins in the healthcare sector.

Concerning the hippocampal mechanisms that simultaneously function to map environmental position and to generate episodic memories, a developing consensus emerged by the early 21st century. The hippocampus was recognized as embodying the primary location of personal narrative development, with the ability to create stable and coherent narrative largely representing the mental health of individuals. Determining recent advances regarding the relationship among the hippocampus, narrative, and mental health, a limited, six-database review was conducted for peer reviewed articles published since 2019. Of the 127 records located, 14 reports were included for study. The results support the necessity of creating and maintaining a stable and coherent narrative as fundamental to human mental health such that facts will be distorted in personal accounts, sleep will be disrupted, and DNA altered to retain one’s personal narratives. With narrative development fundamental to human mental health, a goal of interventions concerning hippocampal function and positive health outcomes is enhancing personal narratives in providing individuals with the ability to construct and recall those that are robust and effective. One such intervention that has proven successful in this regard, the Health Narratives Research Process, is outlined with its most recent results presented, offering opportunity for further such research.

The assessment of the prevalence of Subclinical Mastitis (SCM) in dairy farms is essential to validate the health status of the mammary gland. The aim of the study was to assess the prevalence of SCM in dual purpose livestock systems in Arauca, Colombian Orinoquia, through the analysis of the values found by the field diagnostic tests California Mastitis Test (CMT) and Electric Conductivity (EC). Milk samples were taken from the individual mammary quarters of 481 cows. The general prevalence, per affected room and the total number of rooms was determined according to the values obtained for each test using two methods of analysis. An ANOVA was performed to determine the difference between prevalence’s, a correlation analysis, and an analysis of sensitivity and specificity. The general prevalence was similar between the tests (CMT = 31.4%; EC = 29.7%) (p > 0.05). The prevalence of the total quarters was lower with EC (11.3% vs 14.2%) (p < 0.05). The correlations between tests were significant, but with low values (rs = 0.20-0.25). CMT and EC test concordance showed a sensitivity between 0.35-0.45 and a specificity of 0.75-0.90. The two tests showed positive results in detecting the same animals with or without the presence of the infection, although some animals that were positive for one test were not positive for the other test. The test EC classified animals and their quarters as SCM positive or negative in a more similar way to that obtained with CMT. The two diagnostic tests showed a general low prevalence of SCM in the livestock systems evaluated.

Health literacy is an indicator of a society’s ability to make better health judgement for themselves and the people around them. This study investigates the prevalence of health literacy among Malaysian adults and provides an overall picture of the current health literacy state of the society. The study also highlights socio-demographics markers of communities with limited health literacy which may warrant future intervention. A population based self-administered survey using the Health Literacy Survey Malaysian Questionnaire18 (HLS-M-Q18) instrument was conducted as part of the National Health Morbidity Survey 2019 in Malaysia. The nationwide survey utilized two-staged stratified random sampling method. A sample of 9478 individuals aged 18 and above participated in the study. The health literacy score was divided into three levels; limited, sufficient and excellent. Findings showed that majority Malaysian population has sufficient health literacy level, albeit leaning towards the lower end of the category with an average score of 35.5. The limited health literacy groups are associated with respondents with older age, lower education level and lower household income. Overall health literacy state for Malaysia is categorized at a lower sufficient level. Health literacy improvements should focus on communities with limited health literacy level.

Identifying health care equity indicators is an important first step in integrating the concept of equity into assessments of health care system performance, particularly in emergency care. We conducted a systematic review of administrative data-derived health care equity indicators and their association with socio-economic determinants of health (SEDH) in emergency care settings. Following PRISMA-Equity reporting guidelines, Ovid MEDLINE, EMBASE, PUBMED and Web of Science were searched for relevant studies. The outcomes of interest were indicators of health care equity and the associated SEDH they examine. Among 29 studies identified, 14 equity indicators were identified and grouped into four categories that reflect the patient emergency care pathway. Total emergency department (ED) visits and ambulatory care sensitive condition-related ED visits were the two most frequently used equity indicators. Despite some conflicting results, all identified SEDH (social deprivation, income, education level, social class, insurance coverage and health literacy) are associated with inequalities in access to and use of emergency care. In conclusion, the use of administrative data-derived indicators combined with identified SEDH could improve healthcare equity measurement in emergency care settings across health care systems worldwide.

The study aimed to estimate the prevalence and correlates of overweight and obesity among adults in Iraq. Data from a 2015 nationally representative cross-sectional survey of 3,916 persons 18 years and older were analysed that responded to a questionnaire, physical and biochemical measures. Multinomial logistic regression was utilized to predict determinants of overweight and obesity relative to under or normal weight. Results indicate that 3.6% of the participants were underweight (BMI <18.5 kg/m²), 30.8% had normal weight (BMI 18.5-24.9 kg/m²), 31.8% were overweight (25.0-29.9 kg/m²), and 33.9% had obesity (BMI ≥ 30.0 kg/m²). In adjusted multinomial logistic regression, aged 40-49 years (Adjusted Relative Risk Ratio-ARRR: 4.47, Confidence Interval-CI: 3.39-5.91), urban residence (ARRR: 1.28, CI: 1.14-2.18), hypertension (ARRR: 3.13, CI: 2.36-4.17) were positively, and male sex (ARRR: 0.47, CI: 0.33-0.68), having more than primary education (ARRR: 0.69, CI: 0.50-0.94), and larger household size (≥5 members) (ARRR: 0.45, CI: 0.33-0.60) were negativey associated with obesity. About two in three adult participants were overweight/obese, and sociodemographic and health risk factors were found that can be utilized in targeting interventions.

The epidemic of Coronavirus Disease 2019 (Covid-19) has brought many changes to people's life. This study aims to analysis Chinese people's psychological change and life after quarantining Wuhan and explore the influencing factors. Based on data from a web-survey after quarantining Wuhan (N=3268), the principal-component-analysis (PCA), multiple-linear-regression (MLR), propensity-score-matching (PSM) were used to explore the psychological change of people in China and the influencing factors. 83.3% of the respondents said that the impact of the epidemic on their life had increased after quarantining Wuhan. A considerable proportion of people's anxiety increased, being reflected in negative emotion, behavioral response and physiological response. The proportion of people who said their anxiety had increased in Wuhan was higher than that in other regions (p <0.05). The anxiety of people who were in medical isolation increased less than those who were not (p <0.05). All three aspects of people’s anxiety were positively related with time of medical isolation and degree of the attention on the epidemic (p＜0.05) except the effect of attention degree on the physiological response (p＝0.06). The measure of medical isolation at home should be advocated. Yet people should reduce the concern for the epidemic while paying attention to self-protection.

The COVID-19 crisis has brought unprecedented strain on healthcare systems around the world. It has perhaps taught us some key lessons that are worth considering and addressing to help build more sustainable health systems as well as improve our ability to combat future epidemics.

Recently there is a growing concern regarding potential health hazards linked with 5G deployment and radio frequency emitted by these stations. It becomes fundamentally important to scientifically address these concerns. In this paper, the health risks incorporated with 5G are discussed critically in the light of scientific work and debunk these tittle-tattles where required. We confute scientifically the “5G appeal”, discuss effects of 5G on health, its implications on privacy, pandemics, ecosystem and role of world health organization in fighting these narratives. Finally, we provide future direction to negate these false claims linked with 5G.

This study aims to evaluate the utilization and effectiveness of artificial intelligence (AI) applications in managing symptoms of anxiety and depression. The primary objectives are to identify current AI tools, analyze their practicality and efficacy, and assess their potential benefits and risks. A comprehensive literature review was conducted using databases such as ScienceDirect, Google Scholar, PubMed, and ResearchGate, focusing on publications from the last five years. The search utilized keywords including "artificial intelligence," "applications," "mental health," "anxiety," "LLMs" and "depression". Various AI tools, including chatbots, mobile applications, wearables, virtual reality settings, and large language models (LLMs), were examined and categorized based on their functions in mental health care. The findings indicate that AI applications, including LLMs, show significant promise in symptom management, offering accessible and personalized interventions that can complement traditional mental health treatments. Tools such as AI-driven chatbots, mobile apps, and LLMs have demonstrated efficacy in reducing symptoms of anxiety and depression, improving user engagement and mental health outcomes. LLMs, in particular, have shown potential in enhancing therapeutic chatbots, diagnostic tools, and personalized treatment plans by providing immediate support and resources, thus reducing the workload on mental health professionals. However, limitations include concerns over data privacy, the potential for over-reliance on technology, and the need for human oversight to ensure comprehensive care. Ethical considerations, such as data security and the balance between AI and human interaction, were also addressed. The study concludes that while AI, including LLMs, has the potential to significantly aid mental health care, it should be used as a complement to, rather than a replacement for, human therapists. Future research should focus on enhancing data security measures, integrating AI tools with traditional therapeutic methods, and exploring the long-term effects of AI interventions on mental health. Further investigation is also needed to evaluate the effectiveness of AI applications across diverse populations and settings.

Continuous glucose monitoring devices allow diabetes condition management. However, when limited data is available, one option is to increase their size by generating synthetic samples. From a homemade wearable prototype was created a real dataset with 18 instances and 53 attributes that capture characteristics of capillary and venous blood glucose, oxygen concentration, pulse rate, skin temperature, and 24 modules and 24 phases related to bio-impedance. The objective of this article is to generate synthetic datasets, and also it investigates the ideal features subset and optimal model for non-invasive diabetes prediction. Gaussian-Copulas (GC), conditional generative adversarial networks (CG), variational autoencoders, and Copula-GAN techniques' were used to generate five synthetic datasets. Experiments show that GC1 and GC2 datasets follow min/max boundaries and are not copies of the original data. Multilayer perceptron regressor outperformed (train and test) with 2.17, 2.51 in MAE; 9.29, 13.59 in MSE; 3.05, 3.69 in RMSE, and 0.95, 0.92 in R2 in GC1, and 2.64, 3.02 in MAE; 11.43, 15.11 in MSE; 3.38, 3.89 in RMSE, and 0.94, 0.92 in R2 in GC2 with eight features. Future work is necessary to explore autoencoder and generative architectures, datasets with diverse characteristics, and the effect of the number of features.

The relationship between the host and the microbiome, or the assemblage of microorganisms (including bacteria, archaea, fungi, and viruses), has been proven crucial for its health and disease development. The high dimensionality of microbiome datasets has often been addressed as a major difficulty for data analysis, such as the use of Machine Learning (ML) and Deep Learning (DL) models. Here we present BiGAMi, a bi-objective genetic algorithm fitness function for feature selection in microbial datasets to train high-performing phenotype classifiers. The proposed fitness function allowed us to build classifiers that outperformed the baseline performance estimated by the original studies by using as few as 0.04% to 2.32% features of the original dataset. In 19 out of 21 classification exercises, BiGAMi achieved its results by selecting 6-68% fewer features than the highest performance of a Sequential Forward Feature Selection algorithm. This study showed that the application of a bi-objective GA fitness function against microbiome datasets succeeded in selecting small subsets of bacteria whose contribution to understood diseases and the host state was already experimentally proven. Applying this feature selection approach to novel diseases is expected to quickly reveal the microbes most relevant to a specific condition.

Microplastics (of size < 5mm) pollution in our environment is of current concern by researchers, public media and non-governmental organizations. Implications by their presence in aquatic and soil ecosystems have been well studied and documented, but less attention has been paid on airborne microplastics (MPs). Studies concerning airborne microplastics started from 2016 and only a few (n=7) have been published till date. Although, studies may increase in the following years, since air is very important for human survival. Microplastics have been observed in atmospheric fallouts in indoor and outdoor environments using a sampling or vacuum pump, rain sampler and/or particulate fallout collector. Identification and quantification have been carried out by visual, spectroscopic and spectrometric techniques. Factors such as meterological, climatic and anthropogenic influence the distribution and movement of airborne MP. Human exposure may be through inhalation or dermal route with their potential biopersistence and translocation. Ingestion may cause localized inflammation and cancer due to responses by the immune cells, especially in individuals with compromised metabolism and poor clearance mechanisms. Ecological risks involve possible contamination of the ecosystem through a dynamic relationship of MPs in soil, water and air forming a MP contamination cycle. The present review aimed at providing a comprehensive overview of current knowledge or information regarding microplastics in air, identifies gap in knowledge and give suggestions for future research.

The COVID-19 pandemic has highlighted the critical need for telehealth and remote patient monitoring in healthcare delivery. Despite the growing use of on-body wearable sensors for continuous monitoring and predicting adverse events, such as hospitalizations or falls, their widespread adoption within the healthcare ecosystem remains a significant challenge. While the pandemic has accelerated the acceptance of these technologies, achieving widespread integration requires their sustained incorporation into routine healthcare practices beyond emergency situations. In this study, we extend the application of our previously developed remote patient monitoring system, originally designed for the geriatric frail population, to COVID-19 patients. Our objective is to assess whether the metrics obtained from this system, which includes physical activity and indoor localization sensors, along with vital sign monitoring, can provide additional insights into the recovery trajectory of individuals affected by COVID-19.

Background: Immersive therapy through virtual reality represents a novel strategy used in psychological interventions, but there is still a need to strengthen the evidence on its effects on health professionals’ mental health. Objective: To analyze the results of immersive therapy through virtual reality in the levels of anxiety and secondly, well-being of the health professionals working in a regional hospital in Olot (Spain). Methods: Pilot quasi-experimental study including a group of 35 women (mean age=45.7, SD=8.43) health professionals who undertook immersive therapy for 8 weeks. The intervention was implemented through virtual reality, and its effect on anxiety levels and well-being was evaluated through the Hamilton and Eudemon scales, respectively. Data on age, gender, active pharmacological or psychological treatment, mental health disorders and number of sessions were also collected. Results: Statistically significant (p<0.001) improvement in anxiety and well-being was found, with large and moderate effect sizes (0.90 and 0.63 respectively). In addition, these changes were clinically significant. No significant associations were found between the improvements and the different variables, but a greater trend was identified among the group of professionals with untreated or unidentified levels of anxiety. Conclusion: This group of health professionals showed statistically and clinically significant improvement in anxiety and well-being after the application of immersive therapy using virtual reality. Further studies with a control group are necessary to further analyze this novel intervention.

Since the college years represent an important period for forming oral health behaviors during adulthood, it is important that college students establish proper oral health-promoting behaviors. Therefore, this study aims to identify the effects of oral health education experience, knowledge, and practice behaviors on oral health care self-efficacy among college students, as studies related to this topic are scarce. A total of 236 college students participated in a questionnaire survey comprising 21 questions. The collected data were analyzed through a chi-square test, independent-samples t-test, and logistic regression analysis using SPSS version 22.0. Participants with oral health education experience showed higher levels of oral health knowledge and practice behaviors than those who did not, and the odds of them having oral health care self-efficacy was 3.743 higher. Moreover, a one-unit increase in oral health knowledge and practice behaviors was associated with a 1.199 and 1.351 increase in oral health care self-efficacy, respectively. For oral health promotion among college students, oral health care self-efficacy reinforcement programs tailored to college students should be developed. These should focus on expanding oral health education opportunities to promote improvement in oral health care self-efficacy by strengthening oral health knowledge and the motivation to practice oral health behaviors.

Hydrotherapy, including the use of therapeutic showers and bathtubs, has been studied for its potential benefits in labor pain management. Previous research has indicated that hydrotherapy can alleviate pain, but comparative studies between therapeutic showers and bathtubs are scarce. Objective: This study aims to compare the effects of therapeutic showers and bathtubs on pain perception, labor duration, use of epi-dural analgesia, and maternal and neonatal outcomes during labor. Methods: A total of 124 pregnant women were included in this study. Participants were divided into two groups: those who used a thera-peutic shower and those who used a bathtub during labor. Pain levels were measured using a visual analog scale (VAS). Labor duration, use of epidural analgesia, types of delivery, maternal outcomes (postpartum hemorrhage, perineal status, maternal hypotension, fever, and breastfeeding), and neonatal outcomes (APGAR scores, fetal heart rate, complications, and neonatal unit admissions) were recorded and analyzed. Results: Both the therapeutic shower and the bathtub effectively reduced pain perception, with the bathtub showing a greater reduction in VAS scores. The therapeutic shower group experienced a signifi-cantly shorter labor duration compared to the bathtub group. The majority of participants in both groups did not require epidural analgesia, with no significant differences between the groups. There were no sig-nificant differences in the types of delivery. Maternal outcomes indicated a lower incidence of perineal tears and episiotomies in the therapeutic shower group. Neonatal outcomes, including APGAR scores and fetal heart rate, were similar between the groups, with no significant differences in complications or neo-natal unit admissions. Conclusions: Both therapeutic showers and bathtubs are effective for pain relief during labor, with the bathtub showing a higher reduction in pain intensity. The therapeutic shower is as-sociated with a shorter labor duration and a lower incidence of perineal tears and episiotomies. Both meth-ods are safe for neonatal well-being, making hydrotherapy a viable non-pharmacological option for pain management in labor. However, the therapeutic shower may offer additional benefits in terms of labor du-ration and maternal outcomes.

Many relevant health social actors have voiced concerns about the danger of self-medication in times of growing use of over-the-counter medicines and, in some contexts, unregulated selling of them. Previous research has examined the incidence of parental self-medication as well as the use and abuse of antibiotics without professional advice. However, these studies have limited evidence on the role of family doctors and the perceived severity of self-medication in the case of parents. Based on Health Belief Model, our research tested the effects of exposure to medical information on the perceived level of self-treating the children without medical advice. Specifically, we aimed to assess whether exposure to information warning about the risks of treating children without a medical prescription influences parents' attitudes toward administering medicines to their children without medical advice. The results showed that our respondents evaluated the practices of self-medication negatively, especially when it came to treating their children without medical advice. However, their attitudes towards self-medication varied depending on their beliefs about administering certain medications. Additionally, the results showed that the perceived level of satisfaction with the family physician could be a significant factor in controlling and avoiding the treatment of children without professional advice.

Cardiovascular diseases (CVD) are prevalent and lead to high morbidity and mortality globally. Physiotherapists regularly interact with patients with or at risk of CVDs (pwCVDs). This study aimed to assess the nature of existing evidence, interventional approaches used, and the population groups included in physiotherapy-led health promotion (PLHP) for pwCVDs. The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Medline, PubMed, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and PEDro databases were searched from inception until June 2023. Two reviewers independently screened the titles, abstracts, full text and conducted data extraction. All conflicts were resolved with a third reviewer. A total of 4992 records were identified, of which 20 full-text articles were included in the review. The studies had varied populations, including those with stroke, coronary artery diseases, peripheral artery diseases, hypertension, diabetes, and multiple CVD risk factors. The interventions ranged from exercise and physical activity programs, dietary interventions, education, and counselling sessions with various supplementary approaches. Most interventions were short-term, with less than 12 months of follow-up. Interventions were personalised and patientcentred to promote adherence and health behaviour change. Among the included studies, 60% employed experimental designs, with the remainder using quasi-experimental designs. Although a wide range of PLHP strategies have been used for pwCVDs, exercise and physical activity were employed in 85% of included studies. Other components of health promotion, such as sleep, smoking, and alcohol abuse, should be investigated within PLHP.

There is a systematic exclusion of gender-based violence, safe abortion, reproductive cancers, infertility services, comprehensive sexuality education, sexuality services, and STI’s other than HIV in essential health packages in LMICs. To accelerate progress on sexual reproductive health (SRH), the Guttmacher–Lancet Commission proposed the adoption of these interventions into an essential health package of SRH services that should be universally available. In this commentary, we use a healthcare priority-setting processes lens to review the importance of these services for universal health coverage. We isolate inherent challenges in social value judgments for terminal, process and content evidence for their healthcare priority-setting. We then advance promising emerging practical examples from low to middle-income countries on evidence-informed decision-making processes. We recommend capacity development through regional support, generating equity and efficiency evidence and strengthening political and publicly acceptable processes to institutionalise and operationalise evidence-informed decision-making.

Wearable devices have become ubiquitous, collecting rich temporal data that offers valuable insights into human activities, health monitoring, and behavior analysis. Leveraging this data, researchers have developed innovative approaches to classify and predict time-based patterns and events in human life. Time-based techniques allow the capture of intricate temporal dependencies, which is the nature of the data coming from wearable devices. This paper focuses on predicting well-being factors, such as stress, anxiety, positive and negative affect, on the Tesserae dataset collected from office workers. We examine the performance of different methodologies, including deep learning architectures, LSTM, ensemble techniques, Random Forest (RF) and XGBoost and compare their performances for time-based and non-time-based versions. In time-based versions, we investigate the effect of previous records of well-being factors on the upcoming ones. The overall results show that time-based LSTM performs the best among conventional (non-time-based) RF, XGBoost, and LSTM. The performance even increases when we consider a more extended previous period, in this case, 3 past-days rather than 1 past-day to predict the next day. Furthermore, we explore the corresponding biomarkers for each well-being factor using feature ranking. The obtained rankings are compatible with the psychological literature. In this work, we validated them based on device measurements rather than subjective survey responses.

Background: Individuals living in rural areas often face challenges in accessing healthcare, increasing their risk of poor health outcomes. Farmers, a sub-population in rural areas, are particularly vulnerable to mental health issues and suicide, yet exhibit low rates of help-seeking behavior. The aim of our study was to develop an in-depth understanding of the issues influencing mental help-seeking among farmers living in rural areas from the perspectives of healthcare providers, as well as to explore the strategies providers use to navigate through these issues to effectively engage with this vulnerable population. Methods: We used a descriptive phenomenological approach to understand healthcare providers’ perspectives, experiences, and approaches to providing mental healthcare to farmer clients in rural areas. Semi-structured interviews were conducted with 21 participants between March and May 2023. Results: Our analysis yielded five thematic areas: (1) ensuring accessibility, (2) establishing relatability, (3) addressing stoicism and stigma, (4) navigating dual roles, and (5) understanding community trauma. Conclusions: Healthcare service delivery for farmers is multifaceted. This study fills a gap in knowledge by translating these the data to inform an evidence-based model and a list of recommendations for implementing agriculturally-informed practices in rural areas.

Pasture-based production systems are predominant in major beef-producing countries, however, these systems lack validated protocols to assess animal welfare under commercial conditions. The objective of this study was to validate an animal welfare protocol for fattening Zebu cattle farms in tropical pasture systems. The initial protocol was developed with the participation of producers, professionals, the general public, and the Colombian health authority, through workshops with a participatory approach and collaborative knowledge management. The validation was carried out in 24 pasture-based commercial Zebu cattle farms in the middle Magdalena region of Colombia. Visits were made with an average duration of 2.5 hours, which included the evaluation of 788 fattening cattle. The protocol evaluated animal-based, resource-based, and livestock management indicators through a questionnaire-guided interview to evaluate cattle handling and health, animal-based measurements, and documentation management. A protocol validation process was carried out by selecting indicators that remained unchanged, adjusting those that were feasible to implement, and eliminating inadequate or unnecessary indicators. The application of the protocol demonstrated that there are valid and feasible measures to include in the evaluation protocols of pasture-based fattening systems. Likewise, the active participation of producers is crucial to achieving a greater commitment to the implementation of this protocol.

Background: This study describes the attitudes and practices of Brazilian adults regarding the mandatory vaccination for COVID-19 and the hesitancy to children´s vaccination. Methods: The participants answered an online questionnaire disseminated on social networks. An adaptation of the SAGE-WG questionnaire was used to measure the children's vaccination hesitancy. Results: Among 1,007 participants, 677 (67.4%) believed that vaccination for COVID-19 among adults should be mandatory. Just over half of the participants (51.5%) believe that parents and guardians should be free to decide whether their children should be vaccinated against COVID-19, and 9.1% were unsure about this. Younger, non-religious people who have higher self-perceptions of risk for COVID-19, and who evaluate the federal government's performance in combating the disease as bad or very bad, have a higher agreement with mandatory vaccination, a lower agreement that parents and guardians should be free to vaccinate their children, and lower child vaccination hesitancy scores. Conclusion: In Brazil, mandatory COVID-19 vaccination for adults is far from a consensus, and an expressive part of the population believes that parents and guardians should be free to choose whether or not to vaccinate their children. These perceptions and vaccine hesitancy for children are associated with religious and political inclinations.

This paper presents a critical review of key issues related to the emergence of new networks for the spread of zoonotic diseases amid the mass extinction of species. Zoonotic and infectious diseases account for approximately 70% of new and existing diseases affecting humans and animals. The initial section argues that the term "zoonoses" should not be confined to single-cause events within veterinary medicine. Instead, zoonoses should be viewed as complex, systemic phenomena shaped by interrelated factors, including environmental, sociocultural, and economic elements, influenced by anthropogenic climate change. The second section presents bioethical principles and potential strategies for those engaged in zoonotic disease prevention. The third section uses the slaughter of animals in disaster settings as a case study to illustrate the need for further clarification of normative and interspecies justice conflicts in One Health ethics. This section concludes with an outlook on "zoonoethics." Section four develops the analysis of the interlinked elements that trigger zoonoses and examines antimicrobial resistance (AMR) from an ethical and political standpoint, concluding with policy recommendations for addressing AMR. Section five offers a critical reflection, integrating contributions from zoonoethics, human ecology, and the ecotheological turn. Finally, section six concludes with a call to action and policy recommendations for an inclusive, intercultural, and gender-sensitive One Health approach.

Data scarcity is a significant challenge in the field of Machine Learning (ML), as data collection can be expensive, time-consuming, and difficult, particularly in developing countries. This challenge is exaggerated on the need to use dataset for livestock disease predictions for early intervention and surveillance. To address this challenge, this paper presents a data synthesis method that has been used to accurately generate new data samples from few real-world data. With much data available to train the ML models, overfitting is eliminated. We present the use of Generative Adversarial Networks mainly the Conditional Tabular Generative Adversarial Network to synthesize categorical data for training machine learning models for prediction of the Pestes des Petits Ruminants (PPR) disease. The results showed that training score became 0.89 and the cross-validation score was 0.87 after synthesized data was used with Random Forest algorithm. The resulting dataset can be used to support the prediction and surveillance of the Pestes des Petits Ruminants (PPR) disease. The proposed method can also be applied to any domain with categorical data, and has the potential to improve the performance of machine learning models with increased data availability.

On March 11^th 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS-CoV2 transmission is aerosol/droplet spread, and by contacting virus contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols are produced, as well as the close proximity of dentists and patients during treatment, dentists and allied dental staff are considered the highest risk health professional group for acquiring SARS-CoV2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS-COV2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID-19, in the post-pandemic era.

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

Non-invasive continuous health monitoring has become feasible with the advancement of biosensors. While monitoring certain biomarkers such as heart rate or skin temperature are now at certain maturity, monitoring molecular biomarkers is still challenging. Progress has been shown in sampling, measurement and interpretation of data towards non-invasive molecular sensors that can be integrated in daily wearable items. Towards this goal, this paper explores the potential of embroidered interdigitated transducer (IDT)-based sensors for non-invasive, continuous monitoring of human biomarkers, particularly glucose levels, in human sweat. The study employs innovative embroidery techniques to create flexible fabric-based sensors with gold-coated IDTs. In controlled experiments, we have shown the variation of glucose concentration in water can be wirelessly detected by tracking the resonant frequency of the embroidered sensors. The current sensors operate at 1.8GHz–2GHz and respond to the change of glucose concentration with a sensitivity of 0.17 MHz/(mg/dl). The embroidered IDT-based sensors with wireless sensing will be a new measurement modality for molecular wearable sensors. The establishment of a wireless sensing mechanism for embroidered IDT-based sensors will be followed by investigation of sweat for molecular detection. This will require adding functionalities for sampling and interpretation of acquired data. We envisage the embroidered IDT-based sensors offer a unique approach for seamless integration into clothing, paving the way for personalised, continuous health data capture.

Machine learning has seen enormous growth in the last decade, with healthcare being a prime application for advanced diagnostics and improved patient care. The application of machine learning for healthcare is particularly pertinent in Africa, where many countries are resource-scarce. However, it is unclear how much research on this topic is arising from African institutes themselves, which is a crucial aspect for applications of machine learning to unique contexts and challenges on the continent. Here, we conduct a bibliometric study of African contributions to research publications related to machine learning for healthcare, as indexed in Scopus, between 1993 and 2022. We identified 3,772 research outputs, with most of these published since 2020. North African countries currently lead the way with 64.5% of publications for the reported period, yet Sub-Saharan Africa is rapidly increasing its output. We found that international support in the form of funding and collaborations is correlated with research output generally for the continent, with local support garnering less attention. Understanding African research contributions to machine learning for healthcare is a crucial first step in surveying the broader academic landscape, forming stronger research communities, and providing advanced and contextually aware biomedical access to Africa.

Positive Health (PH) has been described as a promising transformative innovation to address the challenges of promoting well-being and reducing the burden of disease. The aim of this study is to review the current state of knowledge about PH as introduced by Huber et al. (2016) within the available scientific literature. A rapid review of the literature following the Cochrane Rapid Review recommendations. Three databases were searched (PubMed, Google Scholar, and CINAHL). Data were extracted and synthesized using a narrative approach. A total of 55 articles were included. Initial evaluation studies reveal promising results both at individual and collective levels. However, a need is expressed in several articles for further refinement of the conceptualization of PH and ways to make the effects of the PH approach more measurable. Professionals also expressed a desire for a more informed application and elaboration of the PH method across various settings and populations to enhance its effectiveness in practice. This rapid review highlights the transformative potential of PH in shifting from a disease-focused to a health-oriented paradigm of healthcare. It underscores the need for continued research regarding further development of the concept and its practical method, along with the necessity for methodological innovation.

Fungi constitute a diverse group with highly positive and negative impacts in different envi-ronments, having several natural roles and beneficial applications in human life, but also caus-ing several concerns. Fungi can affect human health directly, but also indirectly by being detri-mental for animal and plant health influencing food safety and security. Climate changes are al-so affecting fungal distribution, prevalence, and their impact on different settings. Searching for sustainable solutions to deal with these issues is challenging due to the complexity of the inter-actions among fungi and agriculture, animal production, environment, and human health. In this way, the “One Health” approach may be useful to get some answers since it recognizes that human health is closely connected to animal and plant health, as well as to the shared environ-ment. This review aims to explore and correlate each of those factors influencing human health in this “One Health” perspective.

(1) Influenza causes a significant health and socio-economic burden every year, and health personnel (HP) are at higher risk of exposure to respiratory pathogens than general population. (2) The study purpose was to describe and compare influenza vaccine uptake and its prognostic factors among Medical Doctors (MDs) and Non-Medical Health Personnel (NMHP) vs Non-HP (NHP). We analysed 2014-2018 data (N=105,608) from the Italian Behavioural Risk Factor Surveillance System PASSI that, since 2008, has been collecting health-related information continuously in sampled adults. (3) MDs and NMHP represented, respectively, 1.1% and 4.6% of the sample. Among HP, 22.8% (CI 19.8% - 26.1%) of MDs and 8.5% (CI 7.5% - 9.5%) of NMHP reported to have been vaccinated vs 6.3% (CI 6.1% - 6.5%) in NHP. This difference is confirmed in the three categories (MDs, NMHP, NHP), even more across age groups: in 18-34yy, respectively, 9.9%, 4.4%, 3.4% vs 28.4%, 13.9%, 10.6% in 50-64yy. PASSI surveillance shows an increasing influenza vaccination uptake over time, especially among MDs (22.2% in 2014 vs 30.5% in 2018). (4) Despite such increase, especially among younger HP, influenza vaccination uptake is low. Even more under pandemic scenarios, these figures represent key information to address effective strategies for disease prevention and health promotion.

Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change.

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

White blood cells are crucial for immune defense in the human body, and fluctuations in their levels can lead to severe health issues. This research introduces a system designed for the localization and classification of white blood cells. The dataset utilized comprises two segments: one for localization consisting of 364 annotated images, and another for classification with 12,444 labeled images. The purpose of this study is to develop and evaluate a robust system for the accurate localization and classification of white blood cells using deep learning techniques. The study explores two localization methods—a traditional technique and a deep learning-based approach—and evaluates five deep learning architectures for classification, including three pretrained and two custom models. Upon testing these models on the dataset, the study identifies and evaluates the most effective approach. The localization process achieved an average Intersection over Union (IoU) of 71%, and the classification process reached an accuracy of 92%. The robustness of the model was further assessed by introducing different types of noise to test its resilience. The performance of this system demonstrates high accuracy and resilience to noise, which can be attributed to the use of a large dataset, our developed architectures, and our proposed methodology.

Background: Screening for postpartum depression can lower prevalence and ensure that mothers get adequate treatment and support. Yet, few practitioners screen.The present article is a brief review on barriers to screening and two screening scales that are validated for perinatal women. Findings: Despite recommendations from health organizations, most new mothers are not screened for depression. Providers cite lack of time, opening “Pandora’s box,” and lack of resources for mothers who screen positive as reasons for why they do not screen. The Edinburgh Postnatal Depression Scale and the Patient Health Questionnaires are brief screening scales that have been validated for new mothers and are widely available.Conclusions: Screening is the necessary first step to identifying new mothers who are depressed. Practitioners who screen need a clear plan, and to know how to access available community resources, so they will know what to do when a mother screens positive.

Antimicrobial resistance (AMR) is an increasing hazard to human and animal health that necessitates an international response. Surveillance methods in high-income nations aided in the development of measures to combat AMR in animals. Demand for meat is increasing in countries making it critical to implement anti-AMR initiatives. Surveillance of AMR, on the other hand, is at best in its infancy, and the current evidence base for informing policymakers is geographically disparate. All of the isolates had high rates of AMR to medicines that are critical/highly important in human and animal medicine. A higher incidence of AMR was found in poultry farms. Our findings show that AMR, including MDR, is common in coli, Salmonella spp., commonly found in poultry. The study promotes the development of national policies, programs, and additional research based on a "One Health" approach that helps humans and animals, as well as the environment.

Physical inactivity increases the risk of many adverse health conditions, including the world’s major non-communicable diseases, such as coronary heart disease, type 2 diabetes, and breast and colon cancers, shortening life expectancy. There are minimal medical care and personal trainers’ methods to monitor a patient’s actual physical activity types. To improve activity monitoring, we propose an artificial-intelligence-based approach to classify the physical movement activity patterns. In more detail, we employ two deep learning (DL) methods, namely a deep feed-forward neural network (DNN) and a deep recurrent neural network (RNN) for this purpose. We evaluate the proposed models on two physical movement datasets collected from several volunteers who carried tri-axial accelerometer sensors. The first dataset is from the UCI machine learning repository, which contains 14 different activities-of-daily-life (ADL) and is collected from 16 volunteers who carried a single wrist-worn tri-axial accelerometer. The second dataset includes ten other ADLs and is gathered from 8 volunteers who placed the sensors on their hips. Our experiment results show that the RNN model provides the accuracy performance compared to the state-of-the-art methods in classifying the fundamental movement patterns with an overall accuracy of 84.89% and an overall F1-score of 82.56%. Our results indicate that the proposed method will provide the medical doctors and trainers a promising way to precisely track and understand a patient’s physical activities for better treatment.

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

Pregnancy is a complex biological process which is associated with significant metabolic and hemodynamic changes of the maternal body which allow a normal fetal growth. The inability to adapt to these changes can affect the cardiovascular health. During pregnancy, women may experience mood swings, anxiety and emotional ambivalence. These symptoms can lead to stress and have a negative impact on the mental well-being of expectant mothers. It is crucial to know the aspects that can influence the development of cardiovascular problems among pregnant women in order to manage these cases properly. The current narrative review explores and summarizes the evidence regarding the impact of stress and anxiety on cardiovascular health in pregnant women. Understanding the physiological adaptations that the body undergoes throughout pregnancy is crucial for educating and supporting individuals as well as healthcare professionals. This enables them to recognize any risk factors or pathological conditions that may exacerbate pregnant women's health. In order to reduce maternal morbidity and mortality from cardiovascular disease, a psychological and cardiovascular risk factor screening that is done either before or during pregnancy may be able to identify situations that call for particular medical and/or psychological therapies.

The healthcare situation in Africa is characterized by limited resources and a high burden of disease, presenting significant challenges to the healthcare systems in the region. The integration of Artificial Intelligence (AI) technologies in African healthcare holds immense potential for addressing these challenges and improving health outcomes. This paper aims to provide a comprehensive understanding of the current healthcare landscape in Africa and the urgent need for AI-driven solutions.In addition to discussing the potential applications of AI in African healthcare, such as disease diagnosis, treatment planning, and medical imaging analysis, this manuscript seeks to shed light on the specific challenges hindering the implementation of AI in the region. By providing detailed examples and case studies, we aim to offer insights into the obstacles that need to be overcome and potential solutions that can be pursued.By leveraging AI technologies, Africa has the opportunity to revolutionize its health systems, bridging the gap in access to quality healthcare across the continent. The objective of this review article is to not only highlight the potential benefits that AI can bring to African healthcare but also to emphasize the urgent need for action and collaboration in implementing and scaling up AI innovations in the region. By doing so, African countries can pave the way for improved health outcomes and ensure that their populations receive the healthcare services they deserve.

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.

Individuals with low health literacy (HL) are known to have poorer health outcomes and to have higher mortality rates compared to individuals with higher HL: hence, the improvement of HL is a key outcome in modern healthcare systems. Healthcare providers are therefore asked to support patients’ literacy skills by encouraging the implementation of autonomy-supportive patient centered communication (PCC), which in turn requires the enhancement of patient engagement. Our main hypothesis is that the well-known relationship between autonomy-supportive PCC and HL is mediated by patient engagement which is known to play a role in HL promotion and that is related to PCC as well. The purpose of this study was to formulate a hypothetical structural equation model (SEM) linking PCC to patient engagement and HL. A cross-sectional survey design was employed involving 1007 Italian chronic patients. The hypothetical model was tested using SEM to verify the hypothesized mediation of patient engagement between PCC and HL. Results show that the theoretical model has a good fit indexes and that patient engagement fully mediates the relationship between PCC and HL. This finding suggests healthcare systems to implement a new paradigm where patients are supported to play an autonomous role in their own healthcare.

Diabetes and mental disorders have been recognized as two significant public health concerns globally. Recent research indicates that there is a bidirectional relationship between these two conditions, with each influencing the other's course and outcomes. Nutrition plays an essential role in the prevention and treatment of both mental disorders and diabetes. A comprehensive review of existing literature was conducted to examine the impact of anxiety and depression on the development of diabetes and the influence of diabetes on the occurrence of mental health disorders such as anxiety and depression. Additionally, the effects of nutrition on the prevention and management of mental disorders, diabetes, and related complications in at risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing mental health disorders, including depression, anxiety, and cognitive decline. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.