Stress during a pandemic increased the risk of alcohol consumption, which may require pharmacological management. The characteristics of emergency calls for alcohol-related issues for patients pharmacologically treated, admitted to, or not admitted to the emergency department (ED) were analyzed. An observational single-center retrospective study was conducted from January 1, 2018 to December 31, 2021, and divided into 2-year periods (2018–2019 and 2020–2021). This study focused on calls to one of the EDs of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ES) who were either admitted or not admitted, due to their refusal. A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, a reduced rate of pharmacological treatment for calls coded green (non-critical), and an increase in calls coded yellow (fairly critical) and red (very critical) were recorded. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.

Reliable and precise damage localization in mechanical structures is of high importance in the context of structural health monitoring (SHM). The acoustic emission (AE) method has already shown its excellent suitability for damage localization. However, low signal-to-noise ratios (SNRs) are often prevalent in SHM, thus an increase in localization accuracy and robustness is still in demand. The present study faces this task through the integration of various model knowledge for AE source localization. The basis of the presented algorithm is the consideration of the dispersive behavior of elastic waves in thin-walled structures. The continuous wavelet transform (CWT) is used to obtain time-frequency representations of the signals, where frequency-dependent values for time-of-arrival (TOA) are extracted. Furthermore, the algorithm incorporates the knowledge that all sensors receive signals with the same time and location of origin, as well as the slightly different sensitivity of the theoretically equal sensors. The final localization results are achieved by a two-parameter grid search optimization. The algorithm is experimentally tested on a large aluminum plate with four piezoelectric wafer active sensors (PWASs) arranged in an array of 100 mm × 100 mm. The mean localization error of pencil lead breaks at ten different positions within the sensor array is used as an accuracy measure. It is shown that as more of the described model knowledge is incorporated into the localization, the accuracy increases. With the final algorithm, the mean localization error is more than halved compared to AE localization based on classical TOA estimation. Although the experiment described is conducted under laboratory conditions, the remarkable increase in accuracy suggests that AE source localization may be successful even at low SNR as typical for operational conditions.

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

Approximately half of all women develop palpitations during pregnancy with a quarter experiencing arrhythmias. While most presentations are benign, some cases can result in sudden cardiac death or serious symptom development. Considering such clinical presentation, healthcare providers must acquire knowledge in this area to provide comprehensive prenatal, perinatal, and postnatal care. However, no study could be located that focused on women’s lived experiences of such complications during or in the post-pregnancy period. The study aims to share the results of a study that explored the lived experience of one woman who developed non-sustained ventricular tachycardia during her third pregnancy that lasted into the post-partum period. Using Narrative Inquiry self-study methodology, a woman’s experiences were explored to uncover the challenges she faced in coping with such complications during a period of transition for herself and her family. This methodology allowed for an in-depth understanding of how these complications could affect all aspects of her life. Four narrative threads were produced: 1) diagnostic challenges and delayed recognition; 2) impact on maternal identity and family dynamics; 3) navigating healthcare systems and treatment decisions; and 4) long- term adaptation and resilience. The intention was to add to this topic area to ensure future researchers, current and future healthcare providers, and patients have literature they can refer to when studying, providing care for, or experiencing similar health complications. Acquiring this knowledge can aid healthcare professionals to ensure appropriate care is provided, risks are minimized and their recovery is well supported.

Keywords: Energy harvesting, Hybrid, Medical Wearable Sensor Nodes, Health Monitoring, Power Management

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

Diabetic foot ulcers (DFUs) significantly affect the lives of patients and increase the risk of hospital stay and amputation. We suggest a remote-monitoring platform for better DFU care. This system uses digital health metrics (scaled from 0 to 10, where higher scores indicate a greater risk of slow healing) to provide a comprehensive overview through a visual interface. The platform features smart offloading devices that capture behavioral metrics such as offloading adherence, daily steps, and cadence. Coupled with remotely measurable frailty and phenotypic metrics, it offers an in-depth patient profile. Additional demographic data, wound characteristics, and clinical parameters, such as cognitive function, were integrated, contributing to a comprehensive risk factor profile. We evaluated the feasibility of this platform with 124 DFU patients over 12 weeks; 39% experienced unfavorable outcomes such as dropout, adverse events, or non-healing. Digital biomarkers were benchmarked (0-10), categorized into low, medium, and high risk for unfavorable outcomes, and visually represented using color-coded radar plots. The initial results of case reports illustrate the value of this holistic visualization to pinpoint the underlying risk factors for unfavorable outcomes, including a high number of steps, poor adherence, and cognitive impairment. Although future studies are needed to validate the effectiveness of this visualization in personalizing care and improving wound outcomes, early results in identifying risk factors for unfavorable outcomes are promising.

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

Emotional dysfunction, including flat affect and emotional perception deficits, is a specific symptom of schizophrenia disorder. We used a modified multimodal odd-ball paradigm with fearful facial expressions accompanied by congruent and non-congruent sounds to investigate the impairment of emotional perception and reaction to other people's emotions. We analyzed subjective assessments and ERP data for emotionally charging congruent and non-congruent stimuli in patients with schizophrenia and healthy peers. The results showed the deficit of multimodal perception of fearful stimuli in patients with schizophrenia compared to healthy controls. The amplitude of N50 was significantly higher in subjects of the control group for non-congruent stimuli than congruent and did not differ in patients with schizophrenia. The dynamics of P100 and N200 components confirmed the impaired sensory gating in patients with schizophrenia. The lower amplitude of P3a could be associated with deficits in verbal memory and attention, less emotional arousal, or incorrect interpretation of emotional valence as specific features of patients. The difficulties in identifying the incoherence of facial and audial components of emotional expression could be significant in understanding the psychopathology of schizophrenia.

Background- Fertilizers are essential to enhancing food security by enhancing crop growth. The selection of chemical fertilizers over organic fertilizers brings environmental consequences. The government is trying to achieve food security and promote organic fertilizers over chemical fertilizers by implementing various programs. Aim- The study is carried out to understand the effect of government policies on farmers' chemical fertilizer consumption patterns. Design- The data of fifteen years of chemical fertilizer consumption was divided into three sub-groups. Statistical analysis was done to understand the trend of chemical fertilizer consumption of the farmers. Results- The analysis of data clearly shows the steadily increasing pattern of chemical fertilizer consumption. Conclusions- The study clearly shows there is no effect of sustainable agriculture policies framed by the government on the consumption of chemical fertilizers by farmers. Across the study period, farmers were inclined to use chemical fertilizers, related to a lack of awareness of the principles of appropriate fertilizer management that can limit environmental damage.

Background and Objective: Although possible risk factors associated with maternal postpartum depression (PPD) have been elucidated, it is still unknown how some newborns characteristics could influence the appearance of PPD. Our research aimed to unravel the impact of newborn’s characteristics on PPD. Methods: The study was conducted in the Obstetrics & Gynecology Department, from our University Emergency County Hospital, between August 2019 and April 2021. We included women in the 2 nd day of the postpartum period (n=904), divided into 2 groups: women with PPD (n=236) and control (women without PPD, n=668), by using the Edinburg Postpartum Depression Scale. Characteristic information on newborns (i.e., the months in which they were born, premature delivery, birth weight, or gender) were assessed. Results: Our findings suggest that the winter season (i.e. December and January, p=0.01) births and male newborns (p=0.02) were associated with the appearance of depressive symptoms during postpartum. Conclusions: Therefore, our study showed that women who give birth to male newborns in winter are likely to develop PPD. This should be considered by all public health systems in order to prevent such manifestations in certain groups of women.

The pervasive use of plastic for milk packaging has raised significant health concerns, despite its advantages in terms of cost-effectiveness, convenience, and durability. The potential correlation between cancer and plastic packaging is one of these concerns. This mini-review examines the health implications of plastic materials used in milk packaging, with a particular emphasis on their carcinogenic hazards. This work endeavors to summarize the current state of knowledge regarding the influence of plastic components on human health and underscore the importance of ongoing research in this field by utilizing insights from a comprehensive review article. Harmful chemicals have been observed to leach into milk from plastics used in milk packaging, including high-density polyethylene (HDPE), low-density polyethylene (LDPE), and polyethylene terephthalate (PET), particularly under conditions of protracted storage and heat. Bisphenol A (BPA), phthalates, and styrene are among the most prevalent leachates. These chemicals have been associated with a variety of health issues, such as an elevated risk of cancer, and are recognized for their endocrine-disrupting properties. BPA and phthalates, in particular, have the potential to disrupt hormone function, which may result in breast cancer, prostate cancer, and other hormone-related malignancies.This review emphasizes the significance of comprehending the precise components of plastics utilized in milk packaging and their potential health consequences. It advocates for more rigorous research to completely elucidate the long-term health impacts of these materials by emphasizing the current state of knowledge and regulatory initiatives. Additionally, it underscores the necessity of innovative packaging technologies to guarantee consumer protection and mitigate the risk of exposure to carcinogenic substances.

Substance use is a growing problem among young people in sub-Saharan Africa; tobacco use is the dominant one among these practices. The aim was to analyse prevalence rates and determinants for cigarette smoking of school-attending adolescents in the capital, Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools among adolescents aged 14–19 (52% girls). The Chi-square (p<0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence of lifetime smoking experience among 1,845 participants was 14.8%; 6.5% were current users, and 2.2% were daily smokers. The most significant determinants for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances.

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

Introduction: Osteoarthritis (OA) and age-related degeneration (ARD) are stimulants for the development of the fabella in the knee joint. This meta-analysis updates previous studies and reviews on the prevalence of the fabella in OA or ARD knee joints. In addition, it provides a quantitative estimation of the fabellar prevalence in knees having OA and ARD. Methodology: Twenty studies comprising of data from 11,056 knee joints were included in the analysis, consisting of 6,819 Knees of OA subjects (including those with age more than 40 years) and 4,237 knees of non-OA subjects (including less than 40years) knees, respectively. 2,434 knees had fabellae present in OA subjects (including more than 40years), and 844 fabellae were present in non-OA subjects (including less than 40years). The Odds and Risk Ratios were calculated. Sensitivity analysis and cumulative analysis were conducted to assess the robustness of the findings. Results: Prevalence of fabella was found to be higher in OA knees, where the Risk Ratio of developing fabella was 2.50 (2.07-3.01). Compared with this, the Risk Ratio for the incidence of fabella in OA with ARD knee was 1.84 (1.66-2.03). The bilateral occurrence of fabella was more common than unilateral. The risk of developing fabella in individuals aged less than forty-year was 63% less than individuals aged more than forty years. Conclusion: OA and ARD would increase the prevalence of fabella by 84%, thus acting as stimulants and risk factors for ossified fabella.

Effective management of the medicine supply chain is crucial for ensuring the availability of essential medicines and supplies in public health facilities. This study aimed to determine the utilization of the electronic logistic management information system (e-LMIS) in public health facilities and its implications for the medicine supply chain. A mixed-methods approach, combining both quantitative and qualitative data collection methods was used. The study was conducted in 106 healthcare providers from 35 public health facilities in Singida District. Six key informants were interviewed in a qualitative method. Of 106 participants, (62.3%) said they were somehow competent in e-LMIS utilization. In in-depth interviews, respondents underscored the system's utility for tracking stock levels, procurements, and managing orders. Staff shortage and lack of customized training were mentioned as major challenges, hindering efficiency in managing drug supplies. This study highlighted the positive impact of e-LMIS on various aspects of the medicine supply chain, including the timely submission of orders and enhanced inventory management. Sustained management support and regular utilization of the e-LMIS system are crucial for building and maintaining competence among healthcare providers, thereby optimizing the medicine supply chain and ultimately improving healthcare delivery.

The world is facing an energy crisis. Governments are seeking to provide universal energy access and guarantee energy security while trying to mitigate climate change. One possible solution is energy transitions towards low carbon energy systems. Among other things (physical infrastructure, public policy and regulatory enablers and knowledge and capacities) changes in the energy systems require a well informed and participative citizenship. Within this context the concept of energy literacy appears. Energy literacy is the understanding of how energy is generated, transported, stored, distributed and used, awareness about its environmental and social impacts and the knowledge to use it efficiently in the different sectors of the economy. This paper provides a systematic literature review in the Web of Science’s Core Collection. Most of the work done around energy literacy addresses its evaluation among different groups, particularly students at different levels, and the construction, application and evaluation of tools for improving energy literacy. Other frequently studied issues are the influence of energy literacy in decision making, its drivers and conceptual research about the topic. Energy enables citizens to effectively contribute to energy efficiency and sustainable development, nevertheless energy literacy is not strongly correlated to energy consumption habits.

Telerehabilitation is an appealing service delivery option for optimising recovering. Internationally, the equity of telerehabilitation services for people from culturally and linguistically diverse (CALD) backgrounds has been questioned. Using a 31-item survey, our study explored the access, readiness, and willingness of 260 patients to use allied health telerehabilitation services for adults receiving interventions from a large tertiary health service located in Sydney, Australia. Overall, 72% patients reported having access to technology, 38% met our readiness criteria, and 53% reported willingness to engage in telerehabilitation. There were no difference in access, readiness and willingness to engage in telerehabilitation between patients from CALD and non-CALD backgrounds. Age was the only factor that influenced access, readiness and willingness to engage in telerehabilitation. Past experience of telerehabilitation was related to willingness, but not access or readiness. Findings highlight the importance of ensuring positive patient experiences to promote ongoing willingness to use telerehabilitation. Efforts are needed to improve patients’ digital health literacy, especially patients from older age groups, to ensure equitable access to telerehabilitation services.

Ulleung County, one of the most medically vulnerable areas in South Korea, requires public attention because of the high incidence of liver cancer. This study was conducted as a part of the Ulleung Liver Cancer Prevention and Management Project. The purpose of this study was to estimate the community prevalence of hepatitis B and C viruses and to identify the associated risk factors. The Project’s interagency workgroup established a procedure for conducting blood sampling and health behavior surveys at the Ulleung Public Community Health Center. A total of 1,792 residents aged 40 years and older voluntarily participated in the study between 2019 and 2022. The hepatitis B surface antigen (HBs Ag) and hepatitis C virus antibody (anti-HCV) positive rates in Ulleung were 7.19% and 1.37%, respectively. Low education level and lifetime smoking were associated with HBsAg positivity, whereas cupping therapy at non-medical institutions was associated with anti-HCV positivity. The odds of HBs Ag positivity were lower among those with tattoos than among those without. There was a difference in the risk factors associated with hepatitis B and C viral infection. While a high HBs Ag positivity rate alone may not fully explain the high incidence of liver cancer in Ulleung, it may be a contributing factor.

Substance abuse is a significant public health issue both globally and nationally. Substance abuse involves the detrimental or risky consumption of psychoactive substances, posing a significant global issue, particularly among the youth. In India, cannabis abuse is a major concern. Cannabis is consumed legally in many states as Bhang, also known as marijuana or weed, while Charas and Ganja are illegal under both international drug conventions and the Indian NDPS Act of 1985. The Cannabis users are at great risk of developing Cannabis use disorder which is a pattern of problematic cannabis use leading to clinically significant impairment or distress. It is the most widely used illegal substance worldwide, showing a high prevalence in India.

A well-prepared public health workforce is essential for reducing disease burdens and improving population health, requiring an education that addresses global and complex challenges. This paper examines the integration of the relational employability framework in public health education to cultivate critical global citizenship among students and graduates. Our research, conducted at Edith Cowan University in Perth, Western Australia, involved two case studies using qualitative interviews. Case Study 1, drawn from Cook’s doctoral research, explored student experiences with the relational employability framework within an undergraduate capstone unit. Case Study 2, a school-funded project, gathered graduate perspectives to inform ongoing curriculum development. The findings indicate that the relational employability framework enhances global competencies among students and graduates, through research skills development and critical reflective practice. Students reported improved awareness of their learning needs, self-confidence, and an increased ability to engage with diverse perspectives and societal challenges. Graduates highlighted the framework’s role in understanding ethical standards, conducting rigorous research and applying evidence-based practices in professional settings. Additionally, the framework supported the development of a reflective mindset, enabling graduates to make informed, value-based career decisions and advance their professional growth. The study suggests that adopting a relational employability approach can effectively prepare globally competent and reflective public health professionals. We advocate for the broader implementation of this framework in health education and higher education, offering practical recommendations for curriculum transformation. Such an approach will equip future professionals to contribute meaningfully to public health debates and embody the principles of global citizenship in their practice.

Plants respond to drought by major reprogramming of gene expression enabling the plant to survive this threatening environmental condition. One major upstream signal inducing this multifaceted process is the phytohormone abscisic acid (ABA). In this report, we investigate the drought response in barley plants (Hordeum vulgare, cv. Morex) at both epigenome and transcriptome levels. Leaves of barley plants after 10 days of drought treatment, when soil water content was decreased by about 40%, were compared to well-watered controls. Due to the drought treatment, chlorophyll content and photosystem II-efficiency were decreased by about 10% and some known drought-related genes were already induced. Global ChIPseq analyses were used to identify genes where histones 3 associated with promoter or gene body were modified with euchromatic K4 trimethylation or K9 acetylation during drought. Using stringent exclusion criteria, 129 genes loaded with H3K4me3 and 2008 genes loaded with H3K9ac in response to drought were identified, indicating that H3K9 acetylation reacts to drought more sensitive than H3K4 trimethylation. Comparison with differentially expressed genes enabled to identify those genes, which are loaded with the euchromatic marks and are induced in response to the drought treatment. The results show that a major part of these genes is involved in ABA-signaling and related pathways. Intriguingly, two members of the protein phosphatase 2C family (PP2Cs), which are involved in the central regulatory machinery of ABA signaling, were also identified by this approach.

Road safety is a critical public health concern in Nepal, especially in urban areas where inadequate infrastructure exacerbates traffic incidents. This study reviews and synthesizes 21 peer-reviewed papers to investigate how road infrastructure contributes to traffic accidents. Key factors include poor road conditions, reckless driving, and inadequate traffic management. Findings indicate that road traffic accidents (RTAs) significantly increase morbidity, mortality, and economic burdens in Nepal. To address these issues, the study recommends infrastructure improvements, stricter enforcement of traffic laws, and enhanced public education on road safety.

Climate change, recognized as a global crisis, is not only altering our environment but also significantly impacting human health. Particularly, its influence on non-communicable diseases (NCDs), a leading cause of global mortality, is becoming increasingly evident yet underexplored. This review aims to synthesize current research on the impact of climate change on NCDs, addressing a critical gap in our understanding of how environmental changes affect human health. We examine the complex interplay between climate change and NCDs, drawing insights from recent studies that highlight the adverse effects of climate variables on chronic diseases, such as cardiovascular and kidney diseases, and the role of food and nutrition security in this nexus. Furthermore, the review explores the disproportionate impact on vulnerable regions and populations, particularly in Pacific Island countries and territories, underscoring the urgent need for context-specific solutions and a cross-sectoral approach. By integrating findings from various disciplines, this review aims to inform policy and public health interventions, highlighting the necessity of collaborative efforts to mitigate the burgeoning burden of NCDs in a rapidly changing climate.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: 1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; 2) Perceived usefulness and acceptability of PLHP; 3) Preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

Of the 100,000 railroad bridges in the United States, 50% are over 100 years old. Many of these bridges do not meet the minimum vertical clearance standards, making them susceptible to impacts from over-height vehicles. Impacts can cause structural damage and unwanted disruption to railroad bridge services; rapid notification of the railroad authorities is crucial to ensure that the bridges are safe for continued use and to affect timely repairs. Therefore, researchers have developed approaches to identify these impacts to railroad bridges. Some recent approaches use machine learning to more effectively identify impacts from the sensor data. Typically, the collected sensor data is transmitted to a central location for processing. However, the challenge with this centralized approach is that the transfer of data to a central location can take considerable time, which is undesirable for time-sensitive events like impact detection that require rapid assessment and response to potential damage. To address the challenges posed by the centralized approach, this study develops a framework for edge implementation of machine learning predictions on wireless smart sensors. Wireless sensors are used because of their ease of installation and lower costs compared to their wired counterparts. The framework is implemented on the Xnode wireless smart sensor platform, thus bringing artificial intelligence models directly to the sensor nodes and eliminating the need to transfer data to a central location for processing. This framework is demonstrated using data obtained from events on a railroad bridge near Chicago; results illustrate the efficacy of the proposed edge computing framework for such time-sensitive structural health monitoring applications.

Hydroponic farming systems play an increasingly important role in the sustainable production of nutrient-rich foods. The contamination of surfaces in hydroponic fresh produce production poses risks to the food safety of crops, potentially endangering public health and causing economic losses in the industry. While sanitizers are widely used in commercial hydroponic farms, their effectiveness against human pathogens on surfaces, and their impact on plant health and quality are not known. In this study, we evaluated the efficacy of chemical sanitizers in eliminating Salmonella Typhimurium from inanimate surfaces in commercial hydroponic Nutrient Film Technique (NFT) systems. Further, we assessed the impact of sanitizers on the yield, quality, and nutritional value of lettuce and basil. Sanitizers (Virkon, LanXess; Sanitate 12.0, Bi-oSafe Systems; Kleen Grow, Pace Chemical Ltd.; Green Shield, United Labs Inc.; Zerotol, BioSafe Systems; Bleach, Pure Bright), were tested against Salmonella Typhimurium inoculated on NFT surfaces (nutrient reservoirs, growing channels, top covers, drain lines). The effective treatments were then tested for their impact on lettuce and basil in a split-plot experiment conducted in commercial NFT units. Crop yield, color, and nutrient content were measured throughout the crop life cycle. While all quaternary ammonium compounds (QAC), SaniDate 12.0 (200ppm), Zorotol (5%), and Virkon (1%) eliminated Salmonella Typhimurium from commercial NFT surfaces, chlorine-based sanitizer treatments were statistically similar to water treatments on most surfaces. All chemical sanitizers impacted the yield, color, and nutritional value of lettuce and basil. SaniDate 12.0 (200ppm) was the least detrimental to crops and was identified as a potential candidate for further validation in commercial hydroponic settings. The findings of this study will be translated into recommendations for the industry and will contribute to the development of future food safety guidelines and policies.

Background: The Covid-19 pandemic abruptly disrupted global healthcare systems, necessitating rapid adaptations. This study evaluates the impact on health systems and services in the aftermath of the first wave in the Indian context. It analyses the disruptions, adaptive measures, and changes made, as well as the challenges faced by healthcare providers and seekers. Valuable insights from this study will enhance the resilience and preparedness of healthcare systems for future challenges. Methods: The eligible studies included primary studies conducted in the Indian context that explore the impact of COVID-19 on health services provision, utilisation, and the well-being of healthcare providers and seekers. Electronic searches were conducted in six databases: PubMed, MEDLINE, Embase, Global Health, CINAHL, and the WHO database on COVID-19. The results were analysed using detailed narrative synthesis. Results: The review includes 38 articles, incorporating a total of 22,502 subjects. There has been a substantial impact on health service provision, particularly in outpatient departments (OPD) (n=19) and elective services (n=16), while emergency services continued at sub-optimal levels (n=20). Various adaptations and changes were implemented in precautionary measures, protocols, staff allocation and training, usage of personal protective equipment (PPE), preoperative, operative, and postoperative measures, as well as physical infrastructure and resources. Depression and stress (n=14), fear of contracting the infection (n=6), stigmatisation (n=5), and financial repercussions (n=5) significantly affected the mental health of healthcare providers, and healthcare seekers also faced significant challenges (n=11). Conclusion: The study reveals COVID-19's substantial impact on health services. The healthcare system responded by quickly adjusting staff management, resource allocation, and infection prevention measures. The study also highlights the mental health challenges faced by healthcare providers and the concerns of healthcare seekers regarding delays and suboptimal care. Looking ahead, the findings underscore the importance of preparedness for future pandemics, including improved healthcare infrastructure, resource optimisation, and comprehensive protocols. Lessons learned from COVID-19 should inform strategies to mitigate disruptions and ensure the well-being of healthcare providers and seekers in future outbreaks.

Sleep disorders have become a public health problem for many reasons. The aim of this systematic review is to describe social, economic, and environmental determinants of sleep disturbances in Australia and New Zealand. A total of 22 studies, 14 from Australia and 8 from New Zealand involving children, adolescents and adults are included in the review. In summary, we found that sleep health disparities among children and adolescents in both countries are strongly associated to parental SES. Overall, lower family SES such as low parental income, low parental education, low SES area index are associated with higher sleep disturbances among children and adolescents. In adults, results revealed that SES determinants such as low income, lower education, unemployment, and night work were associated with sleep disturbances. Specifically, unemployment was associated with poor sleep quality, insomnia, and increased likelihood of suboptimal sleep efficiency. Low income and lower education were associated with high risk of OSA, longer sleep duration, insomnia, higher odds of suboptimal sleep duration and sleep onset latency.

Accurate segmentation of skin lesions from dermoscopic images is crucial for early skin cancer detection, yet variations in lesion appearance and image artifacts present challenges. This study proposes two deep learning models, UCM-NetV2 and BNN-UCM-NetV2, to improve accuracy and computational efficiency. UCM-NetV2 enhances the UCM-Net architecture with a novel "cyber-structure" combining Multilayer Perceptron and CNN layers, improving prediction accu-racy without increasing the model's parameter count. BNN-UCM-NetV2 further optimizes for mobile deployment by binarizing activations and weights into 1-bit values, reducing computa-tional complexity and model size. Evaluations on the ISIC2017 and ISIC2018 datasets demonstrate that UCM-NetV2 outperforms existing methods in both accuracy and computational efficiency, achieving this with less than 0.04 GFLOPs. These models have the potential to make skin lesion analysis accessible to a broader population, particularly in resource-limited settings, allowing for proactive skin health monitoring and facilitating teledermatology. To foster further innovation in mobile health diagnostics, the source code for UCM-NetV2 will be available on GitHub: https://github.com/chunyuyuan/UCMV2-Net.

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

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

Type 1 diabetes (T1D) has shown an increase in the incidence rate of about 3% per year over the last two decades. Continuous Insulin Subcutaneous Therapy (CSII) is widely used in the paediatric population with diabetes; however, it requires more preparation by the treating team and careful selection of potential users. Prescriptive provisions vary from Region to Region and the perspective of health workers still remains an unexplored area. The aim of the research project is to explore the representations of a group of diabetologists and psychologists working in pediatric diabetology on the national territory, regarding roles, functions and activities as part of a multidisciplinary team; their views on the potential benefits of CSII and the types of individuals applying for the use of technology. A socio-anagraphic data sheet was administered and two homogeneous focus groups were conducted by profession; they were audio recorded. The transcripts produced were analysed using the Emotional Text Mining (ETM) methodology. Each of the two corpus generated three clusters and two factors: for diabetologists, a focus on the patient in different levels of care emerged, collaborating both with other health professionals and with the territory, through the proposal of an intervention where the medical aspect is often represented by technology; also for psychologists there was a representation of interdisciplinary networking, with a greater focus on the processes inherent the management of pathology, from acceptance to the elaboration and integration of diabetes in the family narrative. The understanding of the representations of health professionals working in pediatric diabetes about new technologies can contribute to the consolidation of a network of professionals through a targeted work on possible critical issues emerged.

Introduction: Adolescence is a critical period for the development of affectivity and sexual-ity. Adolescents begin to explore their sexual identity, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the 4th year of ESO, identifying risk factors, comparing behaviors and risks, monitoring these behaviors, analyzing pornography consumption, and evaluating the use of the in-ternet as a source of sexual information. Method: Descriptive cross-sectional study using questionnaires. Participants are 4th-year ESO students from a school in the Baix Llobregat province (Catalonia) aged between 14 and 18 years. Descriptive and bivariate statistical analyses were conducted using the Chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were also used to describe the health behav-iors of the participants. Results: The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use man-agement vary between genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in age of initia-tion and frequency between boys and girls. Conclusions: The study on adolescent affectiv-ity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors in municipal public health.

The prevalence of Noncommunicable Diseases (NCDs) in South Africa is increasing annually, with the burden projected to escalate by 2030. Devastatingly, factors such as lifestyle changes, urbani- sation, and an aging population significantly contribute to a rising burden of Cardiovascular disease (CVDs), diabetes, and cancer which directly impact the mortality and morbidity rates seen in South Africa. Recognising this, the South African government has seen the need for emphasis on developing policies and interventions tar- geting physical inactivity to prevent and manage NCD, particularly cost-free and easy to administer training protocols. However, phys- ical inactivity remains a significant issue, leading to various health concerns in rural communities, including injuries and Fetal Alcohol Spectrum Disorders (FASD). Despite effort to promote physical ac- tivity, the prevalence of NCDs continues to rise, necessitating target- ed interventions to ensure equitable healthcare among South African citizens. On the Contrast, preservation and promotion of traditional games is vital as they offer indigenous populations accessible and culturally relevant means to maintain health and wellness. In this regard, it is important to recognize the importance of preserving and promoting traditional games as they potentially serve as a method for indigenous people to maintain their health and wellness in a way that is accessible and culturally relevant to them. These games have gained popularity in South Africa, with initiatives underway to show- case them globally fostering cultural exchange. Further, revitalizing and conserving these games can cultivate a culture of health and wellbeing in South Africa.

Medicinal mushrooms, especially Ganoderma species hold immense promise for production of a wide range of bioactive compounds with various effects. The biochemical potential of indigenous fungal strains, specific to a region, could play a critical role in the continuous search for novel strains with superior activities on a global scale. This research focused on the ethanolic (EtOH) and hot-water (H2O) extracts of fruiting bodies of two wild-growing Ganoderma species: G. pfeifferi and G. resinaceum with an aim to assess its nutritional (total carbohydrate content-TCC), and mineral composition in relation to bioactive properties: antioxidant, antiproliferative and lipid-lowering. Atomic absorption spectrophotometry (AAS) revealed that G. pfeifferi is a promising source of minerals that are essential for numerous physiological functions in the human body like bone health and muscle and nerve function, with calcium (Ca 4.55 ± 0.41 mg/g d.w.) and magnesium (Mg 1.33 ± 0.09 mg/g d.w.), being the most abundant macro element present. Zinc (Zn), manganese (Mn), and chromium (Cr) were particularly notable, with concentrations ranging from 21.49 to 41.70 mg/kg d.w. The EtOH extract of G. pfeifferi demonstrated significantly elevated levels of TCC, essential macromolecules for energy and structural functions in the body, with higher quantities of all three standard carbohydrates detected in this type of extract. Similar to revealed composition the same species, G. pfeifferi stood out as the most prominent antioxidant agent, with H2O extract being stronger than EtOH in ABTS assay (86.85 ± 0.67 mg TE/g d.w.), while EtOH extract displayed the highest anti OH• radical scavenging ability (IC50 = 0.18 ± 0.05 μg/mL) as well as the most notable reducing potential among all. The highest antiproliferative effect against the breast cancer cell line (MCF-7), demonstrated the H2O extracts from G. resinaceum with the most pronounced activity after 24 hours (IC50 = 4.88 ± 0.50 μg/mL) which surpasses that of the standard compound, ellagic acid (IC50 = 33.94 ± 3.69 μg/mL). Administration of both Ganoderma extracts mitigated diabetic lipid disturbances and exhibited potential renal and hepatic protection in vivo on white Wistar rats by preservation of kidney function parameters in G. resinaceum H2O pre-treatment (urea: 6.27 ± 0.64 mmol/L, creatinine: 50.00 ± 6.45 mmol/L) and the reduction of ALT levels (17.83 ± 3.25 U/L) com-pared to diabetic control groups treated with saline (urea: 46.98 ± 6.01 mmol/L, creatinine: 289.25 ± 73.87 mmol/L, and ALT: 60.17 ± 9.64 U/L). These results suggest that pre-treatment with G. resinaceum H2O extracts may have potential antidiabetic properties. In summary, detected microelements are vital for maintaining overall health, supporting metabolic processes, and protecting against various chronic diseases. Further research and dietary assessments could help determine the full potential and applications of two underexplored Ganoderma species native to Serbia in nutrition and health supplements.

Low dietary intake of calcium, vitamin D, vitamin C and magnesium has been associated with increased risk of osteoporosis. The purpose of the study was to evaluate changes in several bone health indicators and metabolic biomarkers in postmenopausal women, with high osteopenia or osteoporosis, followed by a nutritional intervention program. 115 apparently healthy postmenopausal women (52±8 years old) were randomized into four groups: group I (n=40) received daily 1000 mg vitamin C, 100 mcg vitamin D3, 500 mg calcium(Ca) and 300 mg magnesium (Mg); group II (n=42) received daily 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg; group III (n=18) received daily 5 mg bisphosphonates, 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg; and group IV (n=15) received daily about 364 mg polyphenols via an innovative functional food (50 g olive paste enriched with mountain tea extract) along with 100 mcg vitamin D3, 500 mg Ca and 300 mg Mg. Groups I -III received supplementation for a year whereas group IV for 5 months. Changes in bone health indicators and metabolic biomarkers were assessed at the beginning and at the end of the study. Anthropometric indices and whole-body bone mineral density (BMD) were also evaluated at the beginning and at the end of the intervention period. The results revealed improved elevated levels of 25(OH)D3, in groups II, III and IV (+3,71% and +1.45% and +5.62% respectively). Significant positive changes were recorded, for whole-body BMD, in all four study groups. Significant beneficial changes for total cholesterol were observed in group IV (-2.07%, P<0.05) and positive changes in group I for HDL biomarker (+61.62%, P<0.05). Additional larger-scale clinical trials and intervention studies are considered essential, to fully investigate and elucidate associations between dietary components and biochemical indices of bone health.

Job characteristics shape organizational sustainability, conferring tangible benefits to employees. Job characteristics shape attitudes toward work, such as satisfaction and engagement, and are related to the well-being and health of employees. The aim of the study was to determine and describe the role of work engagement and support at work in the relation between selected job characteristics (organizational justice, job control, and role clarity) and self-rated health. The study was conducted on a sample of 368 employees representing various industries. The study used: Utrecht Work Engagement Scale (UWES), Organizational Justice Survey, Coworker Support Scale, Supervisor Support Scale, Role Clarity Scale, Job Control Scale. Cantril ladder was used to measure self-rated health. The presented study established the importance of lower scores on the UWES subscale: dedication as a significant moderator of the examined correlations. In relation to the correlation: justice and its dimensions, and self-rated health, support from supervisors showed a greater effect than that from coworkers. The conducted study expands knowledge on the formation of employees' self-rated health through the sense of justice experienced within the organization. The results obtained are applicable to organizational practice. This finding highlights the importance of supporting organizational justice, which contributes to employee well-being (particularly when combined with high levels of work engagement and supervisor support) and ultimately increases organizational sustainability. Further research can be continued taking into account the limitations of the previous procedure of selecting people for the study and the measurement tools used.

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.

International migrants comprised 14% of the UK population in 2020, but migrant health in the UK has rarely been studied at a population level using primary care electronic health records (EHRs). Given the difficulty of determining migration status using EHRs, this study developed a migration phenotype and assessed its validity. We developed a phenotyping algorithm using codes for country of birth, visa status, non-English main/first language and non-UK origin. It was applied to a Clinical Practice Research Datalink (CPRD) GOLD database of 16,071,111 primary care patients between 1997 and 2018. We compared the completeness and representativeness of the identified migrant population to Office for National Statistics (ONS) country of birth and 2011 census data by year, age, sex, geographic region of birth and ethnicity. Between 1997-2018, 403,768 migrants (2.51% of the CPRD GOLD population) were identified using the phenotype. 178,749 (1.11%) of these migrants were identified by codes indicating foreign country of birth or visa status, 216,731 (1.35%) a non-English main/first language, and 8,288 (0.05%) non-UK origin. The cohort was similarly distributed compared to ONS migration statistics in terms of sex and region of birth. Recording of migration improved from identifying approximately one-tenth of the expected proportion of migrants according to the ONS in 2004 to a quarter in 2018. Younger migrants were better represented than those aged 50 and over. The migration phenotype identified a large number of migrants and can be used to undertake large-scale migration health research in CPRD GOLD to inform healthcare policy, practice and action. While the cohort was representative of the UK migrant population in terms of sex and region of birth, migration status was under-recorded in earlier years and older ages, and future studies for these groups should therefore be interpreted with caution.

The combination of statistical learning technologies with large databases of psychophysiological data has appropriately generated enthusiastic interest in future clinical applicability. It is argued here that this enthusiasm should be tempered with the understanding that significant obstacles must be overcome before the systematic introduction of psychophysiological measures into neuropsychiatric practice becomes possible. The nonspecificity of psychophysiological measures complicates their use in diagnosis. Low test-retest reliability complicates use in longitudinal assessment, and quantitative psychophysiological measures can normalize in response to placebo intervention. Ten cautionary observations are introduced and, in some instances, possible directions for remediation are suggested.

Early childhood may be a stressful period for families with a significant impact on parents’ mental health and the child’s healthy development. The goal of the SKKIPPI cohort study was to assess the occurrence and determinants of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Based on random samples from three residents' registration offices, parents with infants up to 12 months of age at the time of sampling, were invited to participate in the study. A screening online questionnaire was newly developed, available in four languages, to assess common psy-chosocial stressors and mental health problems of parents with small children. The study enrolled 4,984 mothers and 962 fathers. The most common potential psychosocial stressors at baseline were professional problems (mothers 22%, fathers 33%), lack of social sup-port (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obses-sive-compulsive thoughts (21%, 16%), depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory prob-lems of the child were reported by between 1.5% and 5.1% of parents. The SKKIPPI study showed that a substantial proportion of parents are burdened by psychoso-cial problems and suffer from mental health problems in the first years after birth. Early pre-ventive and low-threshold support measures should be available in the health and social care system. The newly developed questionnaire can be used to screen in the relevant populations in order to avoid disturbances in the mother-child attachment.

The global burden of drug-resistant tuberculosis (DR-TB) continues to challenge healthcare systems worldwide. There is a critical need to tackle DR-TB by enhancing diagnostics and drug susceptibility testing (DST) capabilities, particularly for emerging DR-TB drugs. This endeavor is crucial to optimize the efficacy of new therapeutic regimens and prevent the resistance and overuse of these invaluable weapons. Despite this urgency, there remains a lack of comprehensive review on public health measures aimed at improving the diagnostics and DST capabilities. In this review, we outline strategies to enhance the capabilities especially tailored to address the challenges posed by resistance to new DR-TB drugs. We discuss the current landscape of DR-TB drugs, existing diagnostic and susceptibility testing methods, notable gaps and challenges in these methods, and explore strategies for ensuring fair access to DST while narrowing these disparities. The strategies include public health interventions aimed at strengthening laboratory infrastructure, workforce training, and quality assurance programs, technology transfer initiatives, involving drug developers in the DST development, establishing national or regional referral hubs, fostering collaboration and resources pooling with other infection control efforts, extending testing access in underserved areas through public-private partnerships, advocating for lowering costs or loans at low-interest, remote technical support, and implementing mandatory molecular surveillance monitoring. This review underscores the urgent need to enhance DST capacities for new DR-TB drugs and identifies opportunities for innovation and improvement. Assessing the extent of the global health impact of these measures is crucial to ensure their effectiveness in combating DR-TB.

Abstract Background The number of immune-related endocrine dysfunctions (irEDs) has concurrently increased with the widespread use of immunotherapy in clinical practice and further expansion of the approved indications for immune checkpoint inhibitor (ICI) combinations using different modalities of anti-cancer treatment. Method A retrospective analysis was conducted on consecutive patients >18 years of age with advanced solid malignancies who had received at least one dose of anti-programmed cell death protein 1 (anti-PD-1) and/or anti-CTLA4 antibodies between January 2014 and December 2019 at a Hong Kong university hospital. Patients were reviewed for up to two months after the last administration of an ICI. The types, onset times and grades of irEDs, including hypothyroidism, hyperthyroidism, adrenal insufficiency and immune-related diabetes mellitus, were recorded. Factors associated with irEDs were identified using multivariate analysis. Result A total of 953 patients (male: 603, 64.0%; median age: 62.0 years) received ICIs during the study period. Of these, 580 patients (60.9%) used ICI-alone, 132 (13.9%) used dual-ICI, 187 (19.6%) used an ICI combined with chemotherapy (chemo+ICI), and 54 (5.70%) used immunotherapy with a targeted agent (targeted+ICI). A significantly higher proportion of patients using targeted+ICI had irEDs and hypothyroidism; in contrast, a higher proportion of patients using dual-ICI had adrenal insufficiency. There was no significant difference in the incidence of irED between the younger (<65 years) and older (>65 years) patients. Using logistic regression, only treatment type was significantly associated with irEDs. Notably, older patients had a higher risk of having immune-related diabetes mellitus. Conclusions This large, real-world cohort demonstrates that combining ICI with targeted therapy has a higher risk of overall irED and hypothyroidism. Immunotherapy is safe and well-tolerated regardless of age, but close monitoring of fasting glucose is needed in older populations.

With a highly efficient optical absorption capability, bismuth selenide (Bi2Se3) nanomaterial can be used as an outstanding photothermal agent for anti-tumor treatment and shows promise in the field of nanotechnology-based biomedicine. However, little research has been done on the relevant mechanism underlying the photothermal killing effect of Bi2Se3 nanomaterial. Herein, the photothermal effects of Bi2Se3 nanoparticles on A549 cells were explored with emphasis put on autophagy. Firstly, we characterized the structure and physicochemical property of the synthesized Bi2Se3 and confirmed their excellent photothermal conversion efficiency (35.72%), photostability, biocompatibility and ability of photothermal killing on A549 cells. Enhanced autophagy was detected in Bi2Se3-exposed cells under an 808 nm laser. Consistently, an elevated expression ratio of LC3-II to LC3-I, a marker of autophagy occurrence, was induced in Bi2Se3-exposed cells upon NIR irradiation. Meanwhile, the expression of cleaved-PARP was increased in the irradiated cells dependently on the exposure concentrations of Bi2Se3 nanoparticles. Pharmacological inhibition of autophagy by 3-methyladenine (3-MA) further strengthened the photothermal killing effect of Bi2Se3. Meanwhile, stress-related signaling pathways including p38 and SAPK/JNK were activated coupled with the attenuated PI3K/Akt signaling. Our study figures out that autophagy and the activation of stress-related signaling pathways were involved in the photothermal killing of cancerous cells by Bi2Se3, which provides a more understanding of photothermal nanomaterials.

Migrate is a verb representing a process where the intention of providing social services to migrants is to reduce their instability and discomfort. Consequently, social service providers are inclined to view migrants as pitiful, often also those to be feared, with migrants learning to form negative views of themselves, decreasing their mental health. Considering migration as a verb neglects the noun initiating the migration when the migrant is heading to a person, place, thing, event, or idea. In viewing migration as noun-dependent, the migrant is identifiable as self-directed in seeking aid rather than pitiful or inciting fear. This study aims to examine the types of nouns migrants conceptualize for guiding their migration based on a Google Scholar search of “[noun-type] to which [whom] migrants head in their migration” for each noun type regarding the four most highly cited reports published since 2020. The purpose is to determine the social services applicable to migrants in their self-direction regarding theoretical foundations that contrast problem-focused with emotion-focused coping. Viewing such migration nouns as essential migration signifiers encourages migrants’ favorable identification. In recognizing the intended self-direction of the migrant, their mental health is improved and is supportable through relevant and appropriately available social services.

Attaining sustained soil fertility is essential for guaranteeing global food security and environmental well-being. Traditional farming methods that depend extensively on synthetic fertilizers have resulted in soil deterioration and environmental contamination. Biological fertilizers fortified with micronutrients have emerged as viable alternatives. This analysis examines many types of biological fertilizers and their contribution to improving soil fertility via micronutrient enhancement. Multiple sources of micronutrient-enriched biological fertilizers, such as microbial inoculants, compost, and organic amendments, are evaluated for their effectiveness in enhancing plant growth, increasing nutrient availability, and boosting soil health. Moreover, the effects of these fertilizers on agricultural productivity, soil microbial populations, and ecological sustainability are examined. Green manuring is a reasonable and ecofriendly scientific approach to enhancing robust and sustainable food production in agricultural systems. The integration of green manure improves soil quality by augmenting its chemical, physical, and biological properties, including the availability of organic matter, potassium, nitrogen, and phosphorus, while also enhancing soil structure by reducing erosion and improving water retention capacity. Green manure serves as a natural fertilizer, releasing nutrients into the soil during decomposition, so enhancing nutrient content and fostering plant growth and development. The results highlight the potential of biological fertilizers as sustainable solutions for improving soil fertility and decreasing reliance on synthetic inputs, hence promoting long-term agricultural output and ecosystem resilience.

Background/Objectives: The COVID-19 pandemic has had a profound impact on mental health worldwide, especially exacerbating Eating Disorders (EDs). This study aims to evaluate changes in the presentation and severity of EDs before and after the pandemic at the Regional Residential Center "Mariconda" in Salerno. Methods: This retrospective cohort study analyzed data from 162 patients admitted to the Regional Residential Center "Mariconda" between December 2018 and December 2023. The onset of pandemic restrictions in mid-2020 was the dividing line for the pre-COVID and post-COVID groups. Demographic and clinical data were collected, including age, gender, education level, previous hospital admissions, admission diagnosis, body mass index (BMI), and comorbidity with other psychiatric illnesses. Results: Of the 162 subjects, 115 were admitted post-pandemic. The post-pandemic group was significantly younger, had lower education levels, more frequent previous hospitalizations, and a higher frequency of severe comorbidity with other mental illnesses compared to the pre-COVID group. No significant differences were found between the groups regarding gender distribution, initial diagnosis upon admission, average and length of hospital stay. Conclusion: The COVID-19 pandemic has exacerbated the presentation and severity of EDs, particularly among younger individuals with lower educational attainment. These findings underscore the urgent need for targeted, integrated treatment approaches for EDs, especially global crises. Further research is essential to understand the long-term effects of the pandemic on EDs and to refine treatment strategies to better support affected individuals.

During pregnancy, profound physiological changes occur in the maternal body, including those affecting oral health. Dental stem cells (DSCs) have emerged as promising candidates for regenerative therapies in dentistry. This manuscript delves into the intricate interplay between DSC behavior and maternal oral health during pregnancy. We provide an overview of current knowledge concerning the impact of pregnancy on DSCs, highlighting their potential roles in maintaining oral homeostasis and responding to pathological conditions. Additionally, we identify key research gaps and propose future directions for investigating novel therapeutic strategies leveraging DSCs to improve maternal and fetal oral health outcomes. By elucidating this relationship, we aim to pave the way for innovative approaches in preventive and regenerative dentistry tailored to the unique needs of pregnant women.

Retiring coal power plants can reduce air pollution and health damages. However, the spatial distribution of those impacts remains unclear due to complex power system adjustments and pollution chemistry and transport. Focusing on coal retirements in Pennsylvania (PA), we analyze six counterfactual scenarios for 2019 that differ in retirement targets (e.g., reducing 50% of coal-based installed capacity vs. generation) and priorities (e.g., closing plants with higher cost, closer to Environmental Justice Areas, or with higher CO₂ emissions). Using a power system model of the PJM Interconnection, we find that coal retirements in PA shift power generation across PA and the Rest of PJM region leading to scenario-varying changes in the plant-level release of several air pollutants. Due to air pollution chemistry and transport and socio-demographics, these changes in turn give rise to a reduction of 10 to 182 PM_2.5-attributable deaths in PJM across the six scenarios, with most reductions occurring in PA. Scenarios that reduce more coal power generation yield greater aggregate health benefits due to air quality improvements in PA and adjacent downwind regions. In addition, vulnerable populations—in both PA and Rest of PJM—benefit most in scenarios that prioritize plant closures in PA near Environmental Justice Areas. These results demonstrate the importance of considering cross-regional linkages and socio-demographics in designing equitable retirement strategies.

Background: This study assessed the nature of healthcare services offered in the David Umahi Federal University of Health Sciences health clinic and students' disposition to access the facility. Objectives: To assess the knowledge, attitude and practice of students in accessing healthcare services in the David Umahi Federal University of Health Sciences health clinic.Methods: Used cross-sectional design, a structured questionnaire of a five-point Likert scale as a veritable instrument for collecting the data from 50 student respondents. The questionnaire is made up of four key sections comprising student’s demographic parameters, knowledge, attitude and practice of both students and the clinic staff. Data collected was analyzed in a table of descriptive statistics to determine the total, range, mean and median, which were used to ascertain students’ utilization/accessibility disposition, perception of barriers to accessing healthcare service and overall viability of the clinic.Results: The mean value outcome of knowledge of students falls between 3.1 and 3.9, the mean value for attitude of students falls between 2.5 to 3.4 and 4.0, while the practice of students falls between mean values 2.6 and 3.1. Most of these outcomes represent poor or weak weight factor which requires several levels of intervention.Conclusion: This study highlights the overriding importance of the university healthcare clinic in maintaining a healthy study season among students of David Umahi Federal University of Health Sciences and their health-seeking behaviour. This helps to promote health, attract higher intakes and retain them in the institution till graduation.

Burnout represents a concern for all healthcare providers, particularly those specializing in emergency medical care for whom burnout outcomes have been well-documented. What remains unknown is the effect of burnout on redeployed medical specialists during the COVID-19 pandemic from an appointment-centered practice to emergency care directed by public health considerations. This research aims to identify and assess the burnout responses of fourteen medical specialties noted in searched returns of the four most cited articles published since 2020 about non-emergency physicians regarding their burnout brought on by the unanticipated need for them to provide emergency care during the recent pandemic. The hypothesis is that medical specialists accustomed to planning for emergency possibilities in their appointment-centered practice would demonstrate the least burnout regarding COVID-19-related emergencies. Considering coping as a process based on Lazarus's research, comparing and ranking the COVID-19 emergency responses across the various normally appointment-centered medical specialties in their employed coping strategies determines the outcome. With the hypothesis supported, suggested interventions for future pandemics—when these specialists are, again, redeployed to emergency care directed by public health considerations—are those coping strategies identified as most effective in reducing burnout while maintaining the viability of the medical specialty and excellent patient care.

This paper investigates the safety profile of the Shingrix vaccine, focusing particularly on persistent adverse events post-vaccination. Shingrix, crucial for preventing shingles caused by the varicella-zoster virus, has shown efficacy in clinical trials but is associated with varying degrees of adverse reactions. This retrospective, cross-sectional survey-based study, spanning two years and involving 77 respondents who experienced severe adverse events after vaccination, reveals a spectrum of symptoms ranging from mild to severe, including reports of Guillain-Barré syndrome and neuropathy. These findings underscore the need for ongoing vigilance in vaccine safety monitoring and highlight the importance of personalized care approaches for managing post-vaccination adverse effects. The study aims to contribute to informed decision-making regarding shingles vaccination strategies and calls for continued research into the long-term safety and efficacy of Shingrix.

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.

Chlamydia trachomatis (Ct) infections are the most common sexually-transmitted infection (STI). Despite effective antibiotics for Ct, undetected infections or delayed treatment can lead to infertility, ectopic pregnancies, and chronic pelvic pain. Besides humans, chlamydia poses similar health challenges in animals such as C. suis (Cs) in pigs. Based on the similarities between humans and pigs as well as their chlamydia species, we use pigs as a large biomedical animal model for chlamydia research. In this study, we use the pig model to develop a vaccine candidate against Ct. The vaccine candidate consists of TriAdj-adjuvanted chlamydial protease-like activity factor (CPAF) protein. We tested two weekly administration options – twice intranasal (IN) followed by twice intramuscular (IM), or twice IM followed by twice IN. We assessed the humoral immune response not only in serum by CPAF-specific IgG including antibody avidity determination but also in cervical and rectal swabs by CPAF-specific IgG and IgA ELISAs. The systemic T-cell response was analyzed upon in vitro CPAF-restimulation via IFN-γ and IL-17 ELISpots as well as intracellular cytokine staining flow cytometry. Our data demonstrate that while the IN/IM vaccination mainly led to non-significant systemic immune responses, the vaccine candidate is highly immunogenic if administered IM/IN. This vaccination strategy induced high serum anti-CPAF IgG levels with strong avidity as well as high IgA and IgG levels in vaginal and rectal swabs and in uterine horn flushes. In addition, this vaccination strategy prompted a pronounced cellular immune response: Besides inducing IL-17 production, the vaccine candidate induced a strong IFN-γ response by CD4 T cells. In the IM/IN vaccinated pigs, these cells also significantly downregulated their CCR7 expression – a sign for differentiation into peripheral tissue homing effector/ memory cells. Conclusively, this study demonstrates strong immunogenicity of the IM/IN administered TriAdj-adjuvanted Ct CPAF vaccine candidate. Future studies will test vaccine efficacy of this promising Ct vaccine candidate. In addition, this project demonstrates suitability of the Cs pre-exposed outbred pig model for Ct vaccine development. Thereby, we aim to open the bottleneck of large animal models to facilitate the progression of Ct vaccine candidates into clinical trials.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of professional nurses in maintaining service standards under new governance.We conducted the study at sub-district health-promoting hospitals using a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes. We collected data from 340 nurses and 400 patients using structured questionnaires. We divided the questionnaires into seven sections, which captured a range of metrics such as the personal data of nurses, hospital service activities, and leadership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality. We used paired t-tests to compare performance metrics before and after the administrative transfer, one-way ANOVA to assess variability among different service units, and binary logistic regression to identify key determinants of service quality in our statistical analysis. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited minimal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities. This could contribute to improved healthcare delivery across restructured health systems.

Following the transfer of hospital services to provincial government oversight, it is essential to understand how such changes impact service quality and efficiency. This study, conducted from 1 March 2023 to 31 March 2024 at sub-district health-promoting hospitals in Thailand, aims to identify the factors affecting hospital service quality post-transfer and evaluate the role of profes-sional nurses in maintaining service standards under new governance. Utilizing a mixed-methods design based on the Global Fund-HSS framework (2012), which categorizes factors into accessibility, processes, productivity, and outcomes, we collected data from 340 nurses and 400 patients through structured questionnaires. These questionnaires were divided into seven sec-tions, capturing metrics such as the personal data of nurses, hospital service activities, and lead-ership qualities. We employed a Likert scale to gauge perceptions and expectations of service quality and conducted paired t-tests to compare performance metrics before and after the admin-istrative transfer. One-way ANOVA was used to assess variability among different service units, and binary logistic regression helped identify key determinants of service quality. The analysis revealed a significant correlation between the attitudes and competencies of healthcare teams and the levels of service quality. Notably, service units transferred less than 50% exhibited mini-mal changes, indicating that the degree of transfer significantly impacts service outcomes. Despite these variations, the fundamental mission of promoting health remained consistent. The study emphasizes the critical role of nurses and recommends further research to identify additional factors that could improve service quality in transferred healthcare facilities, potentially contributing to enhanced healthcare delivery across restructured health systems.

Student-centered active learning (SCAL) shifts the focus from the teacher to the student. Implementing SCAL requires the development of new forms of assessment beyond memorization and comprehension. This paper aims to demonstrate the effectiveness of SCAL by analyzing student performance at different cognitive levels. In flipped classrooms, students completed tasks with varying cognitive demands. The tests measured knowledge (level 1), comprehension (level 2), application (level 3) and analysis (level 4). This approach to assessment assesses not only the acquisition of content, but also skills that are critical to a health science student's future career. The results of expository learning were compared with student-centered collaborative learning in the Anatomy and Embryology I course over three academic years. Student opinions were collected through 326 anonymous Wooclap® surveys. No differences in performance were found for low cognitive level questions. However, SCAL significantly improved performance on higher cognitive level questions that required problem solving and application of knowledge. Despite the benefits of SCAL, it requires more effort from both teachers and students. The current assessment system, which measures the quality of teaching, penalizes this effort and requires teachers to believe strongly in the effectiveness of SCAL.

During the COVID-19 pandemic, the spread of the SARS-CoV-2 virus forced many individuals to confront their mortality and worry about losing loved ones also because social distancing policies often made it impossible to say goodbye. Those not directly experiencing loss were inundated with information about COVID-19-related deaths through various media, leading to vicarious grief. This study aims to explore the long-term effects of direct and vicarious mourning on people's mental health during the COVID-19 pandemic. A sample of 171 adults (65% female) aged 19 to 66 years (mean age = 25.8, SD = 8.57) voluntarily participated in an online survey assessing self-reported psychological measures of complicated grief, anxiety, stress, depression, dispositional neuroticism, and situational anxiety using the Fear of COVID-19 Scale. MANOVA tests revealed that individuals experiencing direct mourning had extremely severe scores for anxiety, stress, and fear of COVID-19, while those without personal losses had moderate scores. Participants reporting high media exposure had higher scores for depression and stress. In line with Terror Management Theory, the study supported that people during the COVID-19 pandemic engaged more in proximal defenses than distal ones, taking health-protective measures, experiencing increased anxiety levels toward SARS-CoV-2 infection, and feeling more distressed. Additionally, vicarious mourning was more strongly associated with depression due to emotional empathy with others. The discussion also addresses the strengths and limitations of the study.

Feed additive antibiotics have been used for many decades as growth promotors or antibacterial substances world-wide. However, the adverse impacts of using antibiotics in animal or poultry feeds were informed. Therefore, searching for alternatives such as probiotics, prebiotics, phytobiotics, post-biotics, bacteriophages, enzymes, essential oils, or organic acids (OAs) became urgent. The OAs are produced by beneficial intestinal bacteria through the fermentation process of carbohydrates. The OAs and their salts are still used as feed preservatives. They have been long added to feed in order to minimize contamination and growth of harmful bacteria and fungi, reduce the deterioration, as well as prolong the shelf life of feed commodities. Moreover, they have been mostly added to poultry feed as a blend to obtain a maximum beneficial effects. The supplementation of poultry with OAs could improve the growth performance parameters and carcass traits, promote utilization of nutrients, boost the immune response, and inhibit the growth of pathogenic bacteria. Therefore, this review article provides valuable insights into the potential benefits of using OAs-antibiotics alternative in reducing the microbial load, enhancing the performance parameters in broilers and layers, improving the gut heath, as well as boosting of the immune response.

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.

In northern Thailand, the problem of small particulate matter happens every year, with the pri-mary source being agricultural weed burning and wildfire. The tourism industry is strongly impacted and has been the spotlight for the past few years. Thus, the study aims to investigate the effect of small particulate matter on tourism and related SMEs in Chiang Mai, Thailand. The data was collected from 286 entrepreneurs in the tourism and related SMEs sectors. The data was analyzed using data mining and association rule techniques. The study revealed that small particulate matter has a considerable impact on customer factors, especially the number of customers has decreased. Operational factors and prod-uct/service factors are also affected by the dust in the form of adjustments to keep the business running and the protection of the health of employees and customers. Certainly, financial factors are affected by the small particulate matter situation, both lower revenues and higher costs.

Daphne wolongensis described on the basis of a few known individuals was investigated in the wild, in Baoxing Valey, Sechuan. Its status of valid species was verified morphologically and genetically. Three newly found populations were compared to the closely related species Daphne retusa, D. tangutica, D. longilobata, D. acutiloba, D. sureil, to clones available in cultivation and selected cultivars. The high bootstrap values indicate a good level of genetic differentiation between each of the studied species. The hypothesis whether D. wolongensis is a hybridogenous species was rejected, it is a well-defined independent species. Based on morphological and genetic data, it seems likely that another species, D. limprichtii can be a mountain form of D. tangutica. Variability of populations in Wolong gives a good opportunity to select genotypes with a higher or better performance of combination of traits. From 51samples collected in Wolong it was possible to select the top ten different types as genetic resources for breeding. Daphne wolongensis, in the visited sites of Wolong area, occupies less than 1 km2. Together with isolated finds, the number of found individuals is less than 500 and the area is not larger than 10 km2, thus it falls to the IUCN category of “Critically Endangered” plants.

Choroidal neovascularization (CNV) is a key pathological feature of several of the leading causes of vision loss including neovascular age-related macular degeneration. Here we show that a calreticulin anti-angiogenic domain (CAD)-like peptide 27, CAD27, inhibited in vitro angiogenic activities, including tube formation and migration of endothelial cells, and suppressed vascular sprouting from rat aortic ring explants. In rat model of laser-induced CNV, we demonstrate that intravitreal injection of CAD27 significantly attenuated the formation of CNV lesions as measured via fundus fluorescein angiography and choroid flat-mounts (19.5% and 22.4% reductions at 10μg and 20μg of CAD27 injected, respectively). Similarly, the reduction of CNV lesions was observed in the groups of rats that had received topical applications of CAD27 (choroid flat-mounts: 17.9% and 32.5% reductions at 10μg/mL and 20μg/mL of CAD27 installed, respectively). Retinal function was unaffected, as measured using electroretinography in both groups received interareal injection or topical applications of CAD27 at least for 9 days. These findings show that CAD27 can be used as a potential therapeutic alternative for targeting CNV in the diseases such as neovascular age-related macular degeneration.

The remote monitoring of clinical parameters plays a fundamental role in different situations, like pandemic health emergencies and post-surgery conditions. In these situations, the patients might be impeded in their movements and it could be difficult to have a specific health monitoring. In recent years, technological advancements in smartphones have opened up new possibilities in this landscape. The present work aims to propose a new method for respiratory kinematics monitoring via smartphone sensors. In particular, a specific application was developed to register Inertial Movement Unit (IMU) sensors data from the smartphone for respiratory kinematics measurement and to guide the user through a specific acquisition session. The session was defined to allow for the monitoring of the respiratory movement in five prescribed positions. The application and the sequence were successfully tested on a given population of 77 healthy volunteers. The resulting accelerometers and gyroscope signals were processed to evaluate the significance of differences according to participants sex, vector components and smartphone positioning and, finally, to estimate the respiratory rate. The emerged statistical differences revealed the significance of information in the different acquisition positions.

This study presents a novel statistical framework for evaluating the social and economic impact of delays in the reimbursement of innovative medicines. With the growing importance of timely access to advanced therapies, particularly in managing chronic diseases, we develop a model that quantifies social loss in terms of life years, productivity, productivity cost and overall well-being. The framework integrates several key factors, including years of life lost, years of potential productive life lost, deaths, delays in reimbursement, and cost of labor productivity losses. By providing a comprehensive assessment of the societal costs associated with delayed access, the model offers valuable insights for policymakers seeking to balance healthcare innovation with sustainability. The results emphasize the need for efficient pharmaceutical policies that reduce delays in access to innovative treatments, promote equity in healthcare, and ensure long-term system viability. This approach has broad implications for improving health outcomes and economic productivity, particularly in publicly funded healthcare systems.

Phubbing - the act of snubbing someone by concentrating on a smartphone - is claimed to be an increasing, even normative, behaviour receiving more research attention. However, evidence about the adequacy of instruments that allow screening for phubbing is limited. Thus, the main purpose of the present study was to analyze the psychometric properties of the Phubbing scale in a sample of adolescents and young adults, and present a reliable and valid short form. The final sample included a total of 1351 adolescent students (54.25% males), aged between 12 and 21. A two-dimensional model of a short version of the PS with 6 items (PS-6) displayed appropriate goodness of-fit indices. Strong measurement invariance for the two-dimensional model across gender and educational level was confirmed. McDonald’s Omega coefficients for the Communication, the Obsession, and the Total score of the PS-6 were 0.617, 0.669, and 0.701, respectively. The PS-6 was positively associated with several indicators of psychological difficulties and negatively associated with psychological well-being and self-esteem. The present study contributes valuable information about the psy-chometric adequacy of the PS-6, a short instrument that allows screening for Phubbing in adoles-cents and young adults.

Although health policy resides mainly with the government, industry can play an important role in building a health ecosystem. From March to May, we administered questionnaires to 1,200 individuals from the general Korean population asking about their perception of health-friendly labels, and if they would purchase such labeled products (foods, pharmaceuticals, etc.) and services (purifying water, preventing air pollution, etc.) at extra cost. The participants placed a high value on the importance of mental, social, spiritual, and physical health factors in terms of company’s products and services with a score of about 8 out of 10 (range, 7.74-8.33). Most respondents (72.4%) said they were interested in adopting health-friendly labels. When a health-friendly label is introduced (such as one by the Business for Social Responsiveness), 65.1% of the respondents said they intended to purchase the product or service, while 6.8% said they did not, and 75.0% said they were willing to pay extra for the health-friendly product or service. Multivariate logistic regression models showed urban residence, high education level, and good social health to be significantly associated with positive attitudes toward health-friendly labels. People with high income, no religion, or normal weight were more likely to say they intend to purchase products and services with health-friendly labels. They also had a more positive attitude toward paying more for such products and services, as did people with good spiritual health. This study provides data that illustrate the importance of health-friendly products and services to the general population and companies.

Background/Objectives: The World Federation of the Deafblind Global Report 2023 reports that many countries do not have a comprehensive identification, assessment, and referral system for persons with deafblindness, a combination of hearing and vision loss, across all age groups and geographic regions. The scan seeks to inform researchers, policymakers, and community-based organizations about the status of and gaps in sensory healthcare initiatives in Canada, with intent to raise awareness to enhance integration and coordination of eye and ear care services. Methods: We conducted an environmental scan of Canada’s healthcare system and current public health policies addressing vision and hearing care in Canada at federal and provincial levels. The scan was conducted using published literature searches from five scientific databases – Embase, Medline, PsycINFO, PubMed and CINAHL, in combination with the grey literature review of federal, provincial, and territorial government and non-profit organizations websites during April-October 2022. Out of 1257 articles screened, 82 studies included that met the inclusion/exclusion criteria. 13 reports were included in the grey literature search. Results: Thematic findings indicate stigma and discrimination towards individuals with disabilities and marginalized groups, including hearing, vision, or dual sensory loss, persist. Barriers to vision and hearing healthcare access include inadequate policies, underinvestment in vision and/or hearing services, limited collaboration and coordinated services between hearing and vision services, discrepancies in insurance coverages, and lack of health system support. Conclusions: This scan demonstrates the persistent barriers to vision and/or hearing services present in Canada, stemming from inadequate policy and limited-service coordination. Future work to address gaps, evaluate public education, and develop integrated sensory health care initiatives to enhance coordinate eye and ear care services as recommended in WHO Report on Hearing and Vision is imperative.

Objective: To explore the effect of rural-urban residence on self-reported health status with UK cancer survivors. Design: A cross-sectional postal questionnaire that collected data on demographics, post-code and self-reported health status. Methods: Independent Samples t test was used to detect differences in health status between rural and urban respondents. Pearson’s χ2 was used to control for confounding variables and multivariate analysis was conducted using Stepwise linear regression. Setting: East Midlands of England. Participants: Adult cancer survivors who had undergone primary treatment in the last five years. Participants were excluded if they had recurrence or metastatic spread, started active oncology treatment in the last twelve months and were in receipt of palliative or end of life care. Main Outcome: Residence was measured using the UK ONS RUC2011 Rural-Urban Classifications and Health Status via the UK ONS self-reported health status measure. Results: 227 respondents returned a questionnaire. Forty-five per cent (N=103) were resident in a rural area and fifty-three per cent (N=120) in an urban area. Rural (4.11±0.85) respondents had significantly (p<0.001) higher self-reported health status compared to urban (3.65±0.93) respondents (MD 0.47; 95% CI 0.23, 0.70). Conclusion: Rural respondents had significantly higher self-reported health status compared to their urban counterparts. It is hoped that the results will stimulate further work in this area and that researchers will be encouraged to collect data on rural-urban residency where appropriate.

Conventional farming relies on large-scale, intensive crop production using mechanical tillage and synthetic inputs like chemical fertilizers and pesticides, which, despite being economically beneficial, can be environmentally destructive, whereas organic cropping system offers a more sustainable alternative with less harmful environmental impact. But is organic system more beneficial for soil health than conventional? In this study, we focused on evaluating the functional potential of soil for the conversion of carbon, nitrogen, phosphorus, and sulfur, as well as measuring the actual activity of enzymes involved in these cycles. We used Chernozem soil samples from fields that were managed using organic (OCS) and conventional (CCS) methods as the objects of our study. Another objective of the study was to compare two methods: profiling of functional genes of the microbial community and measurement of actual enzyme activity. The comparison of OCS versus CCS indicates that functional gene profiling and enzymatic activity measurements similarly capture qualitative differences between these systems, but diverge in how they assess quantitative differences. A combination of these two methods for assessing soil conditions appears to be promising. Overall, the study demonstrated that the agronomic practices used in the conventional cropping system not only preserved the functional properties of the soil microbiome but also significantly enhanced its microbiological activity for nutrient bioconversion compared to the organic cropping system. However, the question remains as to how long the conventional system can sustain its high potential.

Longitudinal research into the impact of Covid-19 on university student mental health beyond the pandemic is lacking. This study aims to address the gap in the literature by tracking the mental health of university students over a two-year period, spanning the Covid-19 pandemic and its aftermath. A two-year longitudinal study surveyed a sample of university students (n=302) three times between May 2020 and May 2022. Students’ psychological distress, generalised anxiety, flourishing, and personal wellbeing were assessed at each time point. It was found that students’ psychological distress levels spiked during the first year of the pandemic, but reverted back to baseline levels at two-year follow-up. While generalised anxiety gradually improved, both their psychological distress and generalised anxiety remained considerably worse than pre-pandemic norms. Students’ flourishing scores remained very low, while their life satisfaction and state happiness improved slightly between May 2021 and May 2022. These findings clearly demonstrate that students’ mental health is still in crisis, even after the Covid-19 pandemic. More needs to be done to support students beyond the pandemic generally, including this particularly unique cohort of students who endured unprecedented challenges for prolonged periods, and are now transitioning into the working world. Practical implications and recommendations are discussed.

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.

In the following article, it is presented an investigation of the determinants of Beds for High-Care Specialties-BHCS in the Italian regions in the context of Environmental, Social and Governance-ESG approach. Data from ISTAT-BES for 20 countries in the period 2004-2021 are been used. Different econometric techniques have been applied i.e.: Pooled Ordinary Least Squares, Panel Data with Fixed Effects, Panel Data with Random Effects, Dynamic Panel at 1 stage. Furthermore, a cluster analysis performed with a k-Means algorithm optimized with the Silhouette Coefficient indicated the presence of three clusters. Finally, eight different machine-learning algorithms are analysed to predict the future value of BHCS. The results show that the Artificial Neural Network-ANN algorithm is the best algorithm. The future value of BHSC is expected to growth on average of 4.88% for the analysed regions.

Abuse of amphetamine-related drugs (ARDs) causes traffic accidents, violence, and overdose. In forensic toxicology, analysis for ARDs in biological samples can help identify those driving or performing other tasks under the influence of drugs, clarify the cause of death, and identify recent drug users. In this study, we validated a pseudo-isocratic UPLC-qTOF-MS method following mixed mode cation exchange (MMSPE) extraction for analysis of ARDs in blood. The procedure requires 250 μL of blood to achieve a limit of quantification (LOQ) and detection (LOD) of 20 ng/mL for all analytes. In aged animal blood samples, extraction recoveries of 63-90% and matrix effects of 9-21% were observed. Precision and accuracy for all analytes were within 20% and 89–118%, respectively. The analytical method was developed and validated in accordance with the Scientific Working Group for Forensic Toxicology (SWGTOX) Standard. It has acceptable accuracy and precision for use in doping control and forensic toxicology.

Objectives: To develop and validate the Communities Geriatric Mild Cognitive Impairment Risk Calculator (CGMCI-Risk), aimed at aiding community healthcare workers in the early identification of individuals at high risk of Mild Cognitive Impairment (MCI); Methods: Based on nationally representative community survey data, backward stepwise regression was employed to screen the variables, and logistic regression was utilized to construct the CGMCI-Risk. Internal validation was conducted using bootstrap resampling, while external validation was performed using temporal validation. The area under the receiver operating characteristic curve (AUROC), calibration curve, and decision curve analysis (DCA) were employed to evaluate the CGMCI-Risk in terms of discrimination, calibration, and net benefit, respectively; Results: The CGMCI-Risk model included variables such as age, educational level, sex, exercise, garden work, TV watching or radio listening, Instrumental Activity of Daily Living (IADL), hearing, and masticatory function. The AUROC was 0.781 (95% CI = 0.766 to 0.796). Calibration curve showed strong agreement, and the DCA suggested substantial clinical utility. In external validation, the CGMCI-Risk model maintained similar performance with an AUROC of 0.782 (95% CI = 0.763 to 0.801); Conclusions: CGMCI-Risk is an effective tool for assessing cognitive function risk within the community. It uses readily predictor variables, allowing community healthcare workers to identify the risk of MCI in older adults over a three-year span.

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.

In recent years, there has been an increasing interest in adopting novel sensing technologies for the continuous monitoring of structural systems. In this respect, Micro-Electro-Mechanical System (MEMS) sensors are widely used in several applications, including Structural Health Monitoring (SHM). Thanks to their significantly lower cost, ease of installation on the structure, and lower power consumption, they enable extensive, pervasive, and battery-less monitoring systems. This paper presents an innovative high-performance device for SHM applications, based on a low-noise triaxial MEMS accelerometer, providing a guideline and insightful results about the opportunities and capabilities of these devices. Sensor nodes have been designed, developed, and calibrated to meet structural vibration monitoring and modal identification requirements. These components include a protocol for reliable command dissemination through the network and data collection, and improvements to software components for data pipelining, jitter control, and high-frequency sampling. Devices were tested in the lab using shaker excitation. Results demonstrate that MEMS-based accelerometers are a feasible solution to replace expensive piezo-based accelerometers. Deploying MEMS is promising to minimize sensor node energy consumption. Time and frequency domain analysis show that MEMS can correctly detect modal frequencies, useful parameters for damage detection. The acquired data from the test bed were used to examine the functioning of the network, data transmission, and data quality. The proposed architecture has been successfully deployed in a real case study to monitor the structural health of the Marcus Aurelius Exedra Hall within the Capitoline Museum of Rome. The performance robustness was demonstrated and the results showed that the wired sensor network provides dense and accurate vibration data for structural continuous monitoring.

The mosquito-borne zoonotic nematode parasites, Dirofilaria immitis and Dirofilaria repens, primarily affect dogs. In recent years, their distribution has expanded due to various factors influencing vector-borne pathogens. This study aimed to investigate the comparative prevalence of infection in dogs and humans within a hyperenzootic region of Europe and to estimate the proportional relationship between infection prevalence in dogs and humans, in the concept of “One Health”. To this end, 604 blood samples from dogs and 625 serum samples from humans living in the Thrace region of northeastern Greece were collected. Dog samples were examined using Kott’s test for Dirofilaria spp. microfilariae and a commercial serological test for D. immitis antigen. Human sera were analysed by western blot for both parasites. The overall prevalence of infection in dogs was 177 (29.3%), with 173 (28.6%) testing positive for D. immitis and 7 (1.3%) for D. repens, including 6 (1%) cases of mixed infection. Specific IgG antibodies were detected in 42 (6.7%) human samples, with 24 (3.8%) positive for D. immitis and 18 (2.9%) for D. repens. The infection proportion in humans was 23.4% of the corresponding canine infection, indicating a high risk of human infection in this hyperenzootic region.

Background/Objectives: Alcohol consumption during pregnancy poses notable risks to maternal and foetal health, yet its prevalence and impact in Nigeria remain understudied. This commentary article aims to review the current state of alcohol intake by expectant mothers in Nigeria and provide an overview of Foetal Alcohol Spectrum Disorder (FASD) and recommendations for addressing this public health issue. Methods: Drawing on existing literature, we highlight the prevalence of alcohol intake by expectant mothers in Nigeria and explore the socio-cultural factors influencing drinking behaviours during pregnancy. Results: Despite limited empirical evidence, anecdotal reports suggest that alcohol consumption during pregnancy is not uncommon in Nigeria, driven by factors such as social norms, lack of awareness, and limited access to prenatal care and education. The implications of prenatal alcohol exposure for maternal and child health are substantial, with potential consequences including FASD, birth defects, and mortality. Conclusions: We provide recommendations for policymakers, healthcare providers, and community stakeholders to enhance awareness, prevention, and support systems for pregnant women and their families. Key recommendations include implementing public health campaigns to raise awareness concerning the dangers of alcohol use by expectant mothers, integrating alcohol screening and counselling into routine prenatal care services, strengthening regulations on alcohol advertising and availability, and providing support services for women struggling with alcohol use disorders during pregnancy. By addressing the gaps in knowledge and practice surrounding alcohol consumption during pregnancy, Nigeria can take meaningful steps toward promoting maternal and child health and preventing the lifelong consequences of FASD and related conditions.

Which measure is the most effective for solving health disparities, biological or economic? It is indispensable to delve into the factors of health disparities to answer this question. Our last paper in this journal analyzed the multi-dimensional factors of psychological health disparity under COVID-19 in Japan. This paper extends the analysis to physical health to explore the issue and proposes the concept of psychosomatic health, bridging the physical and psychological dimensions. It was found that　the factors of physical health disparities were close to those of psychological health. According to this new analysis concerning psychosomatic health disparity, not only biological factors but also socio-economic-political factors are essential for the psychosomatic health disparities in the static analysis． In addition, the ethico-political factor of justice/fairness plays a critical role in the dynamic analysis concerning the suppression of the damage to well-being by COVID-19. The result suggests the importance of multi-dimensional communitarian interventions, utilizing the term in political philosophy: it evaluates societal-community intervention as well as biological, political, and economic measures. Therefore, this study implies that, on this empirical basis, public deliberation with the ethical dimension and counting the relative weight of these factors with the temporal dimension in allocating resources is proposed as a theoretically desirable method of the new comprehensive intervention.

It seems that natural compounds with bioactivity are the food constituents, present in the diets, that may provide protective effects on health due to their biochemical effects. The main benefits appear to be decline in oxidative stress and inflammation that are crucial in the pathogenesis of obesity, diabetes and metabolic syndrome. Apart from anti-inflammatory activity, these molecules also possess antifungal, and anti-infective preventative effects. Further evidence indicate that these bioactive molecules are the constituents, which are known to increase function of the foods. This review aims to emphasize that plant based diet is rich in phytochemicals such as antioxidants, vitamins, minerals, polyphenolics and flavonoids, amino acids and fatty acids, that are able to cause benefits via these compounds. These bioactive molecules can target mechanisms of oxidative stress and inflammation that are crucial in the management of metabolic syndrome. These antioxidant compounds appear to be essential component of plant based diets and are crucial for healthiness. Most investigators have proposed that bioactive compounds act as nutraceuticals which are able to regulate certain patho-physiological mechanisms responsible for metabolic diseases. The bioactive compoundspresent in the plant based diets are primary and secondary metabolites of nutritive and non-nutritive natural components generating health benefits by preventing or managing chronic disease or its symptoms. The bioactive compounds are known for their beneficial effects to health. Despite their small quantity in the diets, these bioactive compounds may trigger certain mechanisms that may cause alteration with improvement in health. It seems that most of the bioactive compounds co-existing in the plant-based diets, may be extremely healthful. However, if they are taken in excess, they can cause toxic effects. There is an urgent need to evaluate each bioactive compound to establish a beneficial quantity and a threshold of toxicity, while treating metabolic syndrome.

Access to reliable water supply is critical for sustainable development and public health, yet many peri-urban and rural communities in the developing world face challenges such as poor maintenance, faulty infrastructure, and inadequate governance of water services, hindering the UN’s Sustainable Development Goals (SDG). In Emina-Boadi, a small town in Kumasi, Ghana, residents increasingly rely on boreholes due to substandard service from the Ghana Water Company Limited (GWCL). This shift highlights concerns about water reliability, quality, and affordability, impacting public health and hindering progress toward SDG 6. This case study assesses water service levels using key performance indicators (KPIs) such as quantity, quality, affordability, accessibility, and reliability, focusing on sources like boreholes, hand pumps, piped water, hand-dug wells, rainwater, and surface waters. The study aims to delineate the roles of different water providers, understand community dynamics, and evaluate contributions to rural development and SDG 6 through stakeholder interviews and questionnaires. Leveraging the WASHCost framework, which aims to improve planning methods and provision of water and sanitation services by addressing the lack of cost information in rural and peri-urban areas, and the Joint Monitoring Programme (JMP) framework, which monitors progress toward global targets related to water, sanitation, and hygiene, the study categorizes indicators and draws connections among them. Findings reveal a significant preference for borehole services, with 87% usage and an 83% reliability rate compared to 13% for GWCL. Daily water consumption averages 60.75 liters per person, with on-premises access improving water collection efficiency to 7 minutes. Dissatisfaction with GWCL services highlights the need for improved delivery aligned with community needs and SDG targets. Adopting sustainable management practices, enhancing infrastructure, and improving governance are crucial for ensuring safe and affordable water access for all residents of Emina-Boadi and similar communities.

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.

This narrative review provides a thorough examination of medication-related osteonecrosis of the jaw (MRONJ), encompassing its etiology, the role of drug holidays, and contemporary treatment approaches. By systematically analyzing literature from 2022 to 2023, this paper synthesizes the latest findings and trends in MRONJ research. The study emphasizes the importance of a holistic understanding of MRONJ, beginning with its etiological factors, assessing the therapeutic implications of drug holidays, and evaluating the efficacy of current treatment modalities. This review aims to offer clinicians and researchers a consolidated resource, highlighting the intricacies of MRONJ management and proposing directions for future research. Through this comprehensive approach, the paper seeks to advance the understanding and treatment of MRONJ, ensuring an evidence-based, patient-centric approach in clinical practice.

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.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients’ self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real time patients’ needs and the available resources. To achieve this goal different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

Tritordeum is an amphiploides species resulting from the hybridization between durum wheat (T. durum) and wild barley (H. chilense). This new cereal is considered a natural crop as it is obtained by traditional breeding techniques. Given its appreciable organoleptic characteristics, agronomic features, presence of interesting components, and good technological properties, tritordeum is of promising interest for the development of health-oriented foods. In this study, we evaluated two registered tritordeum cultivars, Bulel and Aucan. T. durum (Provenzal) was employed as the positive control. The extracted proteins were digested by gastric /pancreatic proteases and their biological effects on Caco-2 differentiated on transwell inserts were determined. Changes in cell viability, monolayer permeability, organization of F-actin microfilaments, and ER stress, triggered by protein-digested samples (DPs) were inspected. Our results showed that exposure to Provenzal-DPs promptly disrupted the tight junction barrier. Conversely, Aucan-DPs did not enhance monolayer permeability; whereas, Bulel-DPs exerted only slight effects. Provental-DPs-induced toxicity was also confirmed by changes in cell viability and by the deep reorganization of the enterocyte cytoskeleton. In contrast, Aucan-DPs and Bulel-DPs did not affect monolayer viability and cytoskeleton structure. Overall, our findings suggest that both tritordeum cultivars could be potential candidates for mitigating the toxicity of wheat flour.

The advent of immunotherapy and specifically of immune checkpoint inhibitors (ICIs) for the treatment of solid tumors has deeply transformed therapeutic algorithms in medical oncology. Approximately one third of patients treated with ICIs may develop immune-related adverse events, being the gastrointestinal tract often affected with different grades of mucosal inflammation. Checkpoint inhibitors colitis (CIC) presents with watery or bloody diarrhoea and in case of severe activity requires ICIs discontinuation. The pathogenesis of CIC is multifactorial and still partially unknow: anti-tumor activity that collaterally effects the colonic tissue and the upregulation of specific systemic inflammatory pathways (i.e., CD8+ cytotoxic and CD4+ T lymphocytes) are mainly involved. Many open issues remain on treatment timing and options, and biological treatment, above all with anti-TNF alpha, can be offered to these patients aiming to rapidly resume the oncological therapies. This review aims to summarize the pathogenetic mechanisms underlying CIC and to discuss evidenced-based management including the role of biological therapy.

Age-related macular degeneration (AMD) is a common ocular disease characterized by the de-generation of the central area of the retina in elderly population. Progression and response to treatment is influenced by genetic and non-genetic factors. Proteomics is a powerful tool to study, at the molecular level, the mechanisms underlaying the progression of the diseases, to identify new therapeutical targets and to establish biomarkers to monitor progression and treatment ef-fectiveness. In this work we pursue to systematically review the use of proteomic-based ap-proaches for the study of the molecular mechanisms underlying the development of AMD, as well as the progression of the disease and the on-treatment patient monitoring. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Proteomic approaches have identified key players on the onset of the disease, such as proteins involved in lipid metabolism and oxidative stress, but also in the progression to advanced stages, including factors related to extracellular matrix integrity and angiogenesis. Although an-ti-vascular endothelial growth factor (anti-VEGF)-based therapy has been crucial in the treatment of neovascular AMD it is necessary to get deeper into the underlying disease mechanisms to move forward to next-generation therapies of the later-stage forms of this multifactorial disease.

Music and language are hypothesized to share neural resources, particularly at the level of syntax processing. Recent reports suggest that attention modulates this sharing of neural resources, but the time-course of the effects of attention, and the degree to which attention operates similarly on music and language, are yet unclear. In this EEG study we manipulate the syntactic structure of simultaneously presented musical chord progressions and garden-path sentences in a modified rapid serial visual presentation paradigm, while varying top-down attentional demands to the two modalities. The Early Right Anterior Negativity (ERAN) was observed in response to both attended and unattended musical syntax violations. In contrast, an N400 was only observed in response to attended linguistic syntax violations, and a P3 only in response to attended musical syntax violations. Results show that top-down allocation of attention indeed affects the processing of syntax in both music and language, with different neural resources acting upon the two modalities particularly at later stages of cognitive processing. However, the processing of musical syntax at an earlier stage of the perceptual-cognitive pathway, as indexed by the ERAN, is partially automatic, and is strongly indicative of separate neural resources for music and language.

(1) The objective of this study is to describe and compare the levels of physical activity, preferences for leisure-time physical activity and the frequency of non-sedentary behaviors of Portuguese, Italian and Spanish students attending, respectively, higher education in Portugal, in Italy and Spain; (2) Methods: 1354 Portuguese, Spanish and Italian students (21.2 ± 2.9 years) participated in the study. An online questionnaire was used to collect data and a priori power analysis statistical procedures were used using G∗Power (3.1.9.7) and one-way Anova; (3) Results: The highest levels of sedentary lifestyles are found among Spanish students, followed by the Portuguese and lastly the Italians. Regarding the levels of physical activity Spanish students perform more minutes of low and moderate activity compared to Italians and Portuguese. Italians students are the ones who perform more vigorous activity; (4) Conclusions: We can conclude that Spanish students have a higher level of sedentary lifestyle with the majority of physical activity being low and moderate, while Italians are those who have more time spent on vigorous physical activity and naturally a lower level of sedentary lifestyle. However, it is worth highlighting that all three countries reach the minimum levels of physical activity recommended by the WHO.

Recent evidence suggests the existence of shared neural resources for rhythm processing in language and music. Such overlaps could be the basis of the facilitating effect of regular musical rhythm on spoken word processing previously reported for typical children and adults, as well as adults with Parkinson’s disease and children with developmental language disorders. The present study builds upon these previous findings by examining whether musical rhythmic priming also influences visual word processing, and the extent to which such cross-modal priming effect of rhythm is related to individual differences in musical aptitude and reading skills. EEG was recorded while participants listened to a rhythmic tone prime, followed by a visual target word with a stress pattern that either matched or mismatched the rhythmic structure of the auditory prime. Participants were also administered standardized assessments of musical aptitude and reading achievement. ERPs elicited by target words with a mismatching stress pattern showed an increased fronto-central negativity. Additionally, the size of the negative effect correlated with individual differences in musical rhythm aptitude and reading comprehension skills. Results support the existence of shared neurocognitive resources for linguistic and musical rhythm processing, and have important implications for the use of rhythm-based activities for reading interventions.

The following article presents an analysis of the impact of the Environmental, Social and Governance-ESG determinants on Hospital Emigration to Another Region-HEAR in the Italian regions in the period 2004-2021. The data are analysed using Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Squares-WLS, and Dynamic Panel at 1 Stage. Results show that HEAR is negatively associated to E, positively to S and negatively associated to the G within the ESG model. The data were subjected to clustering with a k-Means algorithm optimized with the Silhouette coefficient. The optimal clustering with k=2 is compared to the sub-optimal cluster with k=3. The results suggest a negative relationship between the resident population and hospital emigration at regional level. Finally, a prediction is proposed with machine learning algorithms classified based on statistical performance. The results show that the Artificial Neural Network-ANN algorithm is the best predictor. The ANN predictions are critically analyzed in light of health economic policy directions.

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.

Avian influenza viruses (AIVs) are highly contagious respiratory viruses of birds, lead-ing to significant morbidity and mortality globally and causing substantial economic losses to the poultry industry. Since their first isolation in 2013, the Asian-origin H5N1 highly pathogenic avian influenza viruses (HPAI) of clade 2.3.4.4b have undergone unprecedented evolution and re-assortment of internal gene segments and have spread to Asia, Europe, Africa, and America, caus-ing outbreaks in all the poultry categories. Novel epidemiological and pathobiological character-istics, distinct from other clades, are specific of clade 2.3.4.4b viruses. Wild waterfowl, the natu-ral reservoir of AIVs, are frequently found infected with clade 2.3.4.4b viruses, which can also cause high morbidity and mortality in these birds. The sustained clade 2.3.4.4b virus circulation in waterfowl has also led to virus infection in other wild bird species, with implications for the conservation of endangered species. Furthermore, clade 2.3.4.4b viruses have been isolated in var-ious wild and domestic mammals worldwide, and critical mutations related to virus adaptation to mammalian species have been identified, raising concerns about virus spillover to humans. The main clinical signs, and anatomopathological findings associated to clade 2.3.4.4b virus infection in birds and non-human mammals are hereby summarized.

Background/Objectives: The aim of the project is a longitudinal assessment of body image and mental health in scoliosis females pre-, postoperatively and in a follow-up, and implementation (one group-CBT scoliosis sample, CBTSS) or not (second group-control scoliosis sample, CSS) of CBT interventions. A healthy female sample (HFS) was also selected for comparative purposes. Methods. 36 in total AIS patients participated in the 1st and 2nd study phases, whereas 23 were eligible in the follow-up. Regarding HFS, 18 participants were included in the study. The CBT intervention took place pre- and postoperatively, during the patients' stay in hospital. Participants completed the Spinal Appearance Questionnaire (SAQ), Body Esteem Scale (BES) and Strengths and Difficulties Questionnaire-25 (SDQ-25). Body image was also assessed using a virtual reality-based application “Avatar Scoliosis 3D”. Results: The difference between the desired and objective, actual body shape is significant preoperatively both in the CBTSS and CSS at p

Indigenous peoples around the world are revitalizing their ancestral beliefs, practices, and languages, including traditional understandings of health and wellbeing. In the Aotearoa (New Zealand) context, a number of ground-breaking Māori health and wellbeing related models have emerged, each with their own unique applications and offerings. We sought in these qualitative studies to explore and identify some key sources of wellbeing for Māori individuals. Nine interviews were conducted with members of Māori communities to identify key themes of Māori wellbeing. A Reflexive Thematic Analysis was performed on these data, and then a further fifteen interviews were conducted to revise, refine, and reposition the previously generated themes. The Ngaruroro describes wellbeing as the embodied and active process of being in good relation with your 1) here tāngata (social and familial ties), 2) te taiao (the environment), and 3) taonga tuku iho (cultural treasures), while doing what you can to make lifestyle choices that are conducive to the health of your 4) tinana (body) and 5) wairua (spirit), while cultivating a balanced 6) ngākau (inner-system), fulfilling 7) matea (core needs), and exercising your 8) mana (authority). These themes illustrate and reiterate that Māori wellbeing is dynamic, interconnected, and holistic.

Both scleroderma and immunoglobulin G4-related disease (IgG4-RD) are systemic fibro-inflammatory diseases characterised by lymphoplasmacytic infiltrates. IgG4-RD and systemic Sclerosis (SSc) may share common pathophysiological mechanisms, but no examples of co-occurrence of the diseases have been found. Autologous haematopoietic stem cell transplantation (AHSCT) is implemented in selected rapidly progressive SSc with high risk of organ failure. However, existing guidelines are based on clinical trials that do not represent the entire patient population and exclude critically ill patients with no therapeutic alternatives. Examples of AHSCT in IgG4-RD are absent. We report the case of AHSCT in a female patient with overlapping progressive diffuse SSc and sinonasal IgG4-RD. Despite immunosuppressive therapy, IgG4-RD developed and clinically manifested shortly before AHSCT. Lacking therapeutic alternatives, after 11 years of SSc therapy, the 44-year-old successfully underwent AHSCT. The 63-month follow-up showed regression of symptoms. Only after surgical treatment (bilateral ethmoidectomy, sphenoidotomy, intranasal buccal antrostomy) the initially progressive clinical course of IgG4-RD remained indolent.