It has been shown that assessing the capacity and quality of sports equipment is important to develop a better understanding of sport participation. Different organizations are involved in the provision of sports products and services. In this regard, policymakers need to design a framework to give people more access to sports facilities. It appears that geographical access to such facilities can affect differences in sport participation around the globe. In this study, Shiraz city districts and the Shiraz sports clubs list were collected. The list of sports clubs was matched with Shiraz districts in March 2020. The significance of the relationship between area, the population of each region, per capita construction budget, frequency of clubs, green area, number of parks, population to number of club’s ratio, and area to the number of club’s ratio indicators and the number of sports clubs were analyzed by SPSS version 22 Using the Spearman correlation coefficient test. There were statistically significant relationships between district and population of each region, District and sports club, District and Population to the number of clubs, area and green area, per capita construction budget and the number of parks, per capita construction budget and population of each region (p<0.05 for all). A significant correlation between the districts and the Population to the number of club’s ratio shows that there is no proper distribution of sports facilities in different urban areas. For this reason, in some areas, people may not have adequate access to sports facilities. Also, a significant correlation was observed between total area and green area, per capita construction budget and the number of parks and Per capita construction budget and the population of each region. So, the health level of the people who live in undeveloped districts is endangered and more attention should be paid to them.

The Sustainable Development Goals provide a global development agenda that is meant to be inclusive of all people. However, the development needs for vulnerable populations such as youth are not reflected within the policy agenda of some developing countries. One of the reasons for this is that research that explores health and wellbeing concerns for young people are sparse in the region and where they exist, the focus has been on marginalized subgroups. To address this gap, this cross-sectional study explored the health and wellbeing of youth in Kenya. We conducted 10 focus group discussions and 13 in-depth interviews with youth ages 15 to 24 years. A thematic analysis of the data revealed that structural factors are important influencers of youth perceptions and their social constructions of health and wellbeing. Kenyan youth are concerned about the health status and healthcare services in their communities, as well as issues of community trust of youths and perceived risks of political misuse and emotional suffering. Our findings suggest that youth transitioning into adulthood in resource constrained areas experience feelings of being powerless and unable to take charge over their own life. This impacts how they perceive and socially construct health and wellbeing.

Researchers’ attention has been turned on Health expenditure, Carbon emissions, and economic growth as they play a focal role in the current debate on environmental protection and sustainable development. Our paper endeavors to investigate the impact of economic growth and CO2 emissions on Health expenditure for two main countries in Asia (China and India) using a dynamic panel data model estimated employing the Generalized Method of Moments (GMM) for the period 1960–2019. Our empirical results show that there is a significant relationship between health expenditure, CO2 emissions, and economic growth. The empirical evidence indicates a significant positive impact of CO2 emissions on health expenditure whiles economic growth has a negative impact on health expenditure for both countries for the period under study. The population growth rate has transposed effect on India's health spending; on the other hand, its impact on China’s health spending is significantly positive. The strong observable correlation between health expenditure and economic growth is crucial for economic development.

Given the pace of SARS-CoV-2 transmission and its relatively high mortality rate, COVID-19, has the potential to become the most severe pandemic in recent times. This virus’s spread across international borders has triggered different responses in countries around the globe with a spectrum of mild, moderate to severe outcomes. Nigeria, Africa’s most populous country with many densely populated cities, presents a unique situation for the explosive spread of SARS-CoV-2. However, at the point of this writing, the number of reported confirmed infection and mortality is comparatively lower to other countries with dense urban populations. The exact reasons for this are not clear but include societal, political and infrastructural factors that will influence the course of the outbreak in Nigeria. In this perspective, we have described the ongoing COVID-19 outbreak and its associated peculiarities. We identify critical steps that remain to be taken to contain and control the outbreak in Nigeria.

Soft drinks exist in various forms and brands and are marketed by different brewery industries across the country. Nigeria been an underdeveloped country were aforesaid health problems are common, people tends to consume them lots believing it gives more energy. This study was therefore set to assess the sugar content from different soft drinks sold in Nigeria. Ten (10) soft drinks registered and licensed in Nigeria by their respective companies were purchased from a supermarket in Ihumudumu environment of Ekpoma, Nigeria. The sugar contents were assessed using standard methods. Result showed significant differences (p<0.05) in ranges of 0.36g/100ml (Limca) to 3.88g/100ml (Teem Bitter Lemon). Conclusively, the sugar contents were all below recommended value and it can be consumed by those who need low sugar in the body.

This work presents a compilation of data obtained by clinical psychologists during the Covid-19 pandemic in Brazil. Through searches on social media with #Covid19 and #MentalHealth and the exchange of information on networks of professionals, it was possible to compile and group the main psychological symptoms presented during isolation. Information was clustered according to the period it appeared, in order to guide future situations. Moreover, to prepare a group of clinical psychologists to provide online assistance.

George Satayana stated that “those who do not learn from history are doomed to repeat it”. As our UK “good outcome” death toll of 20,000 from coronavirus (SARS CoV -2/ COVID -19) in 2020 has sadly been surpassed; never has a phrase been more pertinent. The last major pandemic on a similar scale to COVID-19 is “Spanish Flu” from 1918. We aim to delineate the timeline of events in response to the 1918 Spanish flu pandemic and compare this to the timeline of COVID 19 response, given that the NHS and WHO have since both been long established. In the last 102 years many changes have occurred. Health services across the world have significantly improved, with the advent of mechanical ventilation and antimicrobial treatments. Vaccination programmes against common pathogens have prevented many large-scale disease threats, however novel illnesses have also emerged. Worldwide communication through the Internet and many agencies including the World Health Organisation has improved, and the awareness and surveillance of disease is more prominent. Despite advances in healthcare and communication, the national and international timeline for public health intervention in the current COVID pandemic in comparison to the Spanish flu pandemic of more than 100 years ago is virtually identical. The World Health Organisation operates to promote global health and prevent spread of disease, with this in mind; should the WHO have intervened earlier?​ We need to learn quickly from this pandemic and improve planning for the future.

Social distancing policies put in place during COVID-19 epidemic in addition to helping to limit the spread of the disease also contributed to improving urban air quality. Here we show a decrease in air pollutant concentration as a consequence of mobility reduction in São Paulo during the containment measure which began on 22^nd March 2020. When comparing to foregoing weeks to equivalent periods of 2019, the concentration of most air pollutants sharply decreased in the first days of mobility restriction, to then increase again after government officials downplayed the threat of the disease. This trend is also followed by a decrease in hospital admissions by SARS-influenza. Therefore, despite the great economic and social unrest caused by the pandemic, this unique situation shows that large-scale mobility reduction policy had a significant impact on air quality, benefiting, directly and indirectly, the public health system.

The environment impacts human health in profound ways, yet few theories define the form of the relationship between human physiology and the environment. Under current epidemiological constructs of causation, it is assumed that two complex systems (environment and humans) can transfer information directly. This is the underlying structure of the relationship when studies examine, for example, air pollution and brain health. In marked contrast, we conjecture that complex systems cannot interact directly, but rather such interaction requires the formation of an “interface”. Further, we contend that this dynamic, process-based interface incorporates components from all the interacting systems but exhibits operational independence. This property has many consequences, the foremost being that characteristics of the interface cannot be fully resolved by only studying the systems involved in the interaction. The interface itself must be the subject of inquiry. Without refocusing our attention on biodynamic interfaces, we cannot discern how our environment impacts health.

Neuropsin is a brain-expressed extracellular matrix serine protease that governs synaptic plasticity through activity-induced proteolytic cleavage of synaptic proteins. Its substrates comprise several molecules central to structural synaptic plasticity, and studies in rodents have documented its role in cognition and the behavioral and neurobiological response to stress. Intriguingly, differential usage of KLK8 (neuropsin gene) splice forms in the fetal and adult brain has only been reported in humans, suggesting that neuropsin may serve a specialized role in human neurodevelopment. Through systematic interrogation of large-scale genetic data, we review KLK8 regulation in the context of mental health and provide a summary of clinical and preclinical evidence supporting a role for neuropsin in the pathogenesis of mental illness.

Aim: The purpose of this examination is determining predictors to oral health behaviors predict in Iranian students in district 1 Tehran based on the health belief model with added commitment to plan construct. Methods: This cross-sectional study were randomly selected conducted on 351 eligible four grade female students in the first district of Tehran, Iran in 2017. The random Multi‑stage random cluster sampling method was used to recruit students. The inclusion criteria were being graded, four female students (aged 9-11 years), or education at the fourth grade of one of the elementary schools studied in the first district of Tehran and, The health of the student from a physical and psychological of view. Logistic regression analysis was used to identify the variables that predict oral health behaviors. To assess the predictors of oral health behaviors, all the expanded Health Belief Model constructs with the construct of “Commitment to Plan of Action” from “Health Promotion Model were examined as risk factors to see if they influence on the probability of brushing behavior and dental floss behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 308 four grade female students with mean age of 9.32 ± 0.81 years old took part in the study. The total 31.8% of the students reported that they were brushing behavior less than twice a day and 55.2% students claimed, use of dental floss behavior once a week or less than once a day. The results indicated that perceived self-efficacy (OR=1.46, 95% CI=0.57-3.78, P<0.001), Commitment to plan (OR=1.13, 95% CI=1.04-1.23, P<0.001) and Cues to action (OR=1.42, 95% CI=1.14–1.76, P=0.002) were the significant predicting variables which is the key factor of brushing twice a day, and use of dental floss once a day or more (OR=1.02, 95% CI=0.23-3.53, P=0.003). Conclusion: This study has shown the effectiveness of the health belief model with added commitment to plan construct to predict oral health behavior in female students. So, it seems that the model as a framework for designing training programs to improve students to improve oral health behavior can be used.

(1) Background: Travel medicine practice has not been a part of practice in the community pharmacies in Japan. However, it’s getting more common for pharmacists to run travel clinic in North America. With ongoing globalization, Japanese pharmacists might be practicing travel medicine in future. This descriptive study is to examine the current knowledge, attitudes, and practices among Japanese community pharmacists. (2) Methods: Invitation to the study was sent to all pharmacies or corporates listed on Nippon Pharmacist Association member list plus one another large size pharmacy chain that was not member of NPhA. Community pharmacists working under those companies received a weblink to the survey. The survey was conducted from June to July 2017 by online questionnaire. (3) Results: The self-declared knowledge level of infectious diseases as well as travel vaccinations was generally low. The frequency of correct answer of the antibiotic resistance in South East Asia was 48.5%. Knowledge level of qunine resistance to Plasmodium falciparum malaria in Ghana and Nicaragua was very low. (4) Conclusions: Japanese community pharmacists are not familiar with travel related infectious diseases and vaccines used in travel medicine. The knowledge on the antibiotic resistance in traveler’s diarrhea and malaria prophylaxis was all low that is consistent with low degree of exposure to travel health questions from patients in daily practice and low percentage of intention to earn travel health certificates.

Background: A prospective study was conducted to follow-up how the living lifestyle of hikikomori could change the social, mental and physical health profile. Methods: A cohort consisted of 104 young people living as Hikikomori were interviewed at baseline, 6 months and 12 months by using the same set of questionnaires and anthropometric measurements. Results: Besides the high attrition of 30% in wave 2 and 25% in wave 3, almost half of the participants have recovered from hikikomori by returning to the workforce in society. The three domains of health profile of hikikomori were significantly improved over the follow-up period by: 1) increasing the social network scores from 2.791.80 to 3.091.87, 2) decreasing the perceived stress scores from 21.185.87 to 20.115.79, and 3) reducing blood pressure levels from 118/75 to 115/71 and waist-to-hip ratios. Those variables were also predictable by lifestyle living with the hikikomori according to the Generalized Estimating Equation analysis, whereas the participants of current study had increased the practice of moderate-intensity exercises. Conclusion: Social work intervention was effective in helping the recovery of hikikomori while physical assessments followed by encouragement from social workers to do more exercises might enhance their awareness in health modification towards a better health.

Harmful algal blooms (HABs) are natural events produced by massive concentration of toxic phytoplankton that can color red, ocher, brown or yellow large extensions of water, its intensity depends on the different species of phytoplankton involved in the proliferation. The spreading of these formations involves an interaction of biological, chemical, meteorological and anthropogenic factors. Several species with potential toxicity have been reported along Mexican coasts, such as Gymnodinium catenatum, Karenia brevis, Pyrodinium bahamense var. compressum. The toxic bloom not only causes an impact during the event, it produces negative effects afterward, such as accumulating deposits of organic matter, alterations of benthic community structure and composition, species presence/absence, and bioaccumulation of toxins in organisms such as bivalve molluscs mainly. Poisoning may occur by consuming contaminated seafood or by direct exposure to aerosols of the toxins, which can provoke diarrhea or even death. Due to the impact of this type of event on the economy, environment and public health, strategies for monitoring, prevention, and systematic mitigation have been implemented for the evaluation of HAB effects. The aim of this review was to determine the state-of-the art of HAB, their reports and effects on the environment and public health in Mexico.

Widely consumed forest fruits in Gabon, were analyzed for nutrient and bioactive compositions and their potential contributions to meeting the nutrient requirements of consumers. Edible pulps of Panda oleosa, Gambeya lacourtiana and Poga oleosa contained substantial amounts of bioactive compounds; flavonoids (13.5–22.8 mg/100g), proanthocyanins (2.4–7.6 mg/100g), polyphenols (49.6-77.3 mg/100g) and vitamin C (6.7–97.7 mg/100g). The highest content of β-carotene (76.6 µg/100g) was registered in fruits of Pseudospondias longifolia. The fruits of P. oleosa had the highest essential minerals Fe, Zn and Se. If a child aged 1 to 3 years consumed about 200g or if a non-lactating and non-pregnant woman consumed 300g of P. oleosa, A. lepidophyllus, G. lacourtiana, P. longifolia and P. oleosa, they could obtain substantial RDI ranging between 20-100% for energy, vitamins C and E, iron, magnesium, iron and zinc. Forest fruits can considerably contribute towards the human nutrient requirements. Based on the results of this study, forest foods should be considered in formulating policies governing food and nutrition security in Gabon.

The microbioma is presently one of the hottest areas of scientific and medical research and exerts a marked influence on the host during homeostasis and disease. Fermented foods arise in the human relationship to the microbial environment. Further to the traditionally recognized effects of fermented foods and beverages on the digestive health and well-being there is now strong evidence on their general health benefits, namely the significance on the gut microbiota and brain functionality. We highlight the possibilities in this field, how little is still known, and call for a convergence of interdisciplinary research fields of One Health microbe-nutrition with fermented foods and gut-brain research. A consequence of civilisation, changes in present-day society in diets with more sugar, fat and salt, habits and lifestyle, contributes to the likelihood of an inflammatory microbiome, particularly the global epidemics of obesity and mental health. Although two recent papers claim that probiotics perturb rather than aid in microbiota recovery back to baseline after antibiotic administration in humans, consuming fermented foods has shown to reduce inflammation so improve gut health and the proper function of the body’s immune system.

Conservation Agriculture (CA) is capable of improving soil health and ecosystem functions. Soil carbon sequestration is one of the ecosystem processes that is of importance in sustainable land management involving reduction in greenhouse gas emissions and adaptation to climate change. In this study, we wanted to determine, during the first year of the process of establishing a CA cropping system in rain-fed areas in Madhya Pradesh state of India, which soil health indicators show measurable signs of improvement. Four field trials were selected, each comprising two neighboring plots. One plot (15×15 m) was managed conventionally under farmer practice and was tilled before sowing seeds, and in the adjacent plot Conservation Agriculture practices were applied. No mineral fertilizers or pesticides were applied in both treatments. Soil health indicators of soil aggregate stability, soil-atmosphere CO₂ fluxes, water infiltration, soil moisture, potentially mineralizable nitrogen, soil organic content and bulk density were measured. Results demonstrate that soil CO₂ emissions in CA soils decreased and soil aggregates stability improved in the first year. Generally, in CA soils, there were measurable improvements in all soil health indicators but only some of them were statistically significant.

We investigate the relationship between social isolation and subjective health, considering that this relationship is potentially affected by endogeneity due to the presence of self-reported measures. Thus, if an increase in social isolation may impact the perception on health, alternative paths of causality may also be hypothesized. Using data from round 7 of the European Social Survey, we estimate an instrumental variable model in which isolation is explained as being a member of an ethnic minority and having experienced some serious family conflicts in the past. Our results confirm that changes in social isolation influence subjective general health. In particular, greater isolation produces a strong and significant deterioration of the perceived health status. With respect to the literature on social isolation and health, we try to advance it by supporting a path of causality running from social isolation to subjective health.

Although the number of unwed mothers have mental health problems and intellectual disability, little research have focused on their mental and cognitive status. Since there has been public stigma of unwed mother in South Korea, they tend to conceal their status and less likely to seek psychiatric and psychological help. In this context, this study aims to assess current status of their mental health and intellectual characteristics. A total 48 unwed mothers from two shelter homes in South Korea were agreed to participate in the study. To compare mental health and intellectual abilities of unwed mothers with the general women population, reference data from national studies was used. Unwed mothers were more likely to have mood disorder, post traumatic stress disorder(PTSD), alcohol and nicotine use disorder, attention-deficit hyperactivity disorder (ADHD) than the general women population. Among 48 participants, 20 (41.7%) were lower than 70 Intelligence Quotient (IQ) and the mean of IQ (78.31) was significantly lower than normalized IQ mean of general women population. In logistic regression analysis, psychiatric disorders were associated intellectual disability. This study confirmed that unwed mothers dwelling in Korean shelter homes have more experience of mental disorders and lower intellectual ability than general women population.

The current study aimed to: i) Monitor levels of PM₁₀, at Shebika, Haram, Masfala, Azizia, Awali and Mina in Makkah city, KSA during the period of 01 Shawwal 1436H – 27 Rabi Al-Awwal 1437H, by using LVS instruments; and; 2) assess health risk (non-cancer and cancer risks) on humans (children and adult) exposed to PM₁₀ in ambient air of Makkah city.The results showed that: the high PM₁₀ levels were found in Haram site, while the lower levels were found in Awali site. These levels were lower than that set for PM₁₀ by PME (Daily limit of 340 µg/m³). Vehicles emissions and constructions sources may be the main source of PM₁₀ levels in Makkah city. The human health risk assessments showed that: the daily exposure doses of PM₁₀ were ranked in the order: D_ing > D_dermal > D_inh for children and adult in Makkah city. Ingestion of PM₁₀ particles was the main exposure pathway for both children and adults. The HIs and cancer risk values were within the safe level, indicating that (non-carcinogenic and carcinogenic) risks for humans exposed to PM₁₀ in Makkah city were negligible.

Introduction: The management performance of hospitals in emergency departments in coping with clinical hazards is necessary for their success in providing quality services. The purpose of this study is to provide an optimization procedure and applying management performance in health and medical emergency on the rate of emergency preparedness of the suburb city hospitals. Research method: A semi-experimental and interventional descriptive study in the emergency department of Shahid Motahari Hospital in 2015-2016. Data was collected through the standard checklist of hospital emergency responsiveness test to WHO disasters with 90 questions in 9 domains which is codified by the World Health Organization, in the form of interviews and observing evidences , and if necessary a numerical analysis. Initially, the situation was measured according to this checklist. In the next stage, a set of solutions was developed and then the solutions were implemented according to the obtained information. Data analysis before and after proposing the procedure and its application in order to improve the quality of health management performance and emergency preparedness was performed using central indices, and for describing and presenting the survey results, tables and graphs were used. Results: The highest and lowest emergency preparedness rates for disasters and emergencies before the proposed procedure were the Communication Factor (%77/8) and Human resource factor (%2/8) respectively. The degree of preparedness of the medical center was measured in the management performance according to the model (WHO) before proposing the procedure (%77.98). The researcher's procedure provided and applied based on the information obtained from survey environment, location and type of hospital structure. After providing the procedure, the maximum and minimum rates were the continuity of service factor (%58.3) and post-accident rebuilding factor (%100), respectively. Generally, the rate of emergency preparedness of studied medical center in management performance for coping with disasters and medical emergencies was measured (%97.2) according to hospital emergency responsiveness test for accidents and (WHO). The significance level is less than 0.05, so we can say that the effectiveness with confidence (95%) was effective. Conclusion: According to the statistics of accidents and disasters in the suburb cities, the results of the research and the importance of the role of emergency departments in interurban hospitals in controlling accidents, the need for planning and implementation of practical measures such as conducting training courses on health management in disasters and emergencies, having an estimate of critical and essential resources, changing the structure, providing manpower (emergency management) in order to more precise control and ease of service, maintenance and repair of equipment, timely triage and retrofitting of hospitals were effective in improving their preparedness.

Insecurity, corruption, and rising unemployment have resulted in a mass exodus of young adult Afghans seeking asylum in western nations. This has depleted Afghanistan of generations of young people which are critical to rebuild the country. This study aimed to examine the characteristics of young adult Afghans with no immediate intentions of seeking international asylum; that is, individuals who intend to stay in Afghanistan. In a cross-sectional study conducted in Kabul, we surveyed 232 young adults between 18 and 35 years of age. Surveys included measures assessing standard socio-demographic and -economic factors, as well as health and psychological factors. Univariate logistic regression analyses suggest that participants with an intent to stay in Afghanistan are more likely to be financially stable, possess higher health-related quality of life, lower psychological distress, and higher levels of hope and optimism, as well as higher resilience. When controlling for all other variables in the model, only hope, optimism, and higher resilience remained as significant correlates of intending to stay. Our findings suggest that young people who intend to stay in their country look forward to a better future, which provides strong evidence for the need to strengthen the social contract by fostering resilience, hope and optimism in war-affected communities, in order to prevent a generation of talented young people from seeking asylum in western nations.

Depression and anxiety are the most common mental health disorders worldwide. Internet-Delivered Cogni-tive Behaviour Therapy (ICBT) can reduce barriers to care for broad cross sections of the population. How-ever, People of Diverse Ethnocultural Backgrounds (PDEGs) other than White/Caucasian underutilize mental health services and are underrepresented in clinical trials of psychological interventions. To address this research gap, we adapted an evidence-based ICBT program for PDEGs. The current pilot study explores the effectiveness, satisfaction, and engagement in the adapted ICBT by PDEGs (N=41) when benchmarked against a sample of PDEGs (N=134) drawn from a previous non-adapted version of the ICBT program. Inntent-to-treat analyses showed that the adapted ICBT program is effective in reducing anxiety and de-pression symptoms among PDEGs. Large within-group pre-to-post-treatment Cohen’s effect sizes of d = 1.23, 95% CI [0.68, 1.77] and d = 1.24, 95% CI [0.69, 1.79] were found for depression and anxiety, respectively. Further, 81.8% of the PDEGs who received the adapted ICBT program reported high overall satisfaction, 90.9 % reported increased confidence in managing symptoms, and 70.7% of participants completed the ma-jority of the psychoeducational lessons in the ICBT program. No statistically significant differences in clinical outcomes, engagement, and satisfaction were found between the pilot study and benchmark sample. Future directions for ICBT research with PDEGs are described.

Vibrio vulnificus (Vv) is a bacterial pathogen native to warm and brackish water ecosystems that can cause fatal septicemia (Vv-vibriosis) in humans and various farmed fish species. From a One Health perspective, controlling Vv-vibriosis outbreaks on farms is essential not only for animal but also for human health, as it reduces the risk of Vv transmission to humans. Electrolyzed water (EW) is a sustainable control method, exhibiting transient disinfectant properties due to the formation of hypochlorous acid (HOCl). We hypothesized that EW could effectively reduce Vv populations in aquaculture facilities, preventing outbreak emergence. To test this hypothesis, survival assays in EW were conducted under varying conditions of salinity, pH, and free available chlorine (FAC). The results indicated that an intermediate concentration of FAC had a significant bactericidal effect on Vv populations regardless of the condition and tested strain. Consequently, the strategic use of EW could serve as an eco-friendly preventive and control measure against Vv-vibriosis by significantly decreasing the bacterial load in farm water.

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

There is a growing body of research exploring Complementary and Alternative Medicine (CAM) for the overall population; however, few studies have examined the effectiveness and applications of CAM practices in the paediatric population. According to the World Health Organization (WHO), parent's prevalence using CAM in their dependents is estimated to be as high as 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM applications and effectiveness caused mainly by variances in sociodemographic factors and national healthcare systems differences. Additionally, a lack of consensus and polarised positions among mainstream professionals regarding the CAM mechanism of action, applications, and effectiveness were identified. This narrative review shows debatable results for most CAM therapies and their applications. However, some evidence suggests that acupuncture, Yoga, Tai Chi, and massage might benefit users' physical and mental health. Additionally, meditation's available evidence indicates that it might be only helpful in the enhancement of mental health, whereas Reiki only displays an effect on patients' perceptions of comfort. Lastly, herbal medicine was observed to have non-specific evidence to support its claim, given the diverse nature and complexity of herbal compounds and procedures. This comprehensive narrative review might offer health professionals a reference to guide their health practices towards a personalised approach, taking into account the patient's values and beliefs, both important aspects of integrated, evidence-based practice, aiming to improve the quality of the offered health services and patients' satisfaction.

This study explores the intriguing relationship between personality traits, self-rated fitness (SRF), and physical activity (PA) variables among German university students (N = 4,244), and sheds light on the impact of personality on adherence to PA guidelines. Employing an online cross-sectional study, the short-form of the Big Five Inventory-2 assessed five domains of personality traits (Extraversion, Negative Emotionality, Agreeableness, Conscientiousness, and Open-Mindedness). PA, including sitting time, was assessed using the International Physical Activity Questionnaire (short-form). SRF and muscle-strengthening activities (MSA) were assessed with one item each. Multiple linear and logistic regression analyses examined associations of individual personality trait domains and all domains combined with SFR, PA variables, and adherence to PA guidelines, controlling for sociodemographic, behavioral, and (mental) health covariates. Most reliably, Extraversion and Conscientiousness revealed positive associations with PA variables, while Negative Emotionality yielded inverse relationships with PA variables. For instance, each unit increase in Extraversion corresponded to additional 17 minutes weekly MSA. Contrary, daily sitting time was unrelated to personality. Of note, high Open-Mindedness was associated with lower odds for adhering to current PA guidelines. The findings have implications for developing targeted interventions that promote a physically active lifestyle and support students' well-being and academic success.

Previous studies have shown that agricultural works bear a disproportionately higher burden of HIV, which is the highest HIV prevalence ever reported in any working population in South Africa. This study aimed to assess HIV knowledge, attitudes and practices of agricultural workers, as a precarious and vulnerable workforce. A cross-sectional study design was employed. A pre-piloted paper-based questionnaire was administered to a consenting sample of agricultural workers. Descriptive and inferential statistics were performed using stata version 16.1 software, 0.05 level was used as a measure of significance. The majority of agricultural workers had adequate knowledge level (72.1%) regarding HIV/AIDS. Knowledge was significantly associated with having some level of education,) secondary education (AOR: 1.46, 95% CI:1.01-2.12), and post-matric qualification (AOR: 3.07, 95% CI: 1.61-5.83). The attitudes level of workers towards HIV was good (88.1%). Attitude was negatively associated with residing in informal settlements (AOR: 0.64, 95% CI 0.43-0.97). Majority of participants exhibited poor prevention practices regarding HIV (60.9%). Half of participants reported low condom usage (50.9%) and multiple sexual partners (50.6%). The portrayed risky sexual behavior establishes agricultural workers as an HIV high-risk population. Strategizing non-conventional approaches to HIV prevention and behavior change communication targeting agricultural workers is recommended.

Socioeconomic conditions and social attitudes are known to represent epidemiological determinants. Credible knowledge on socioeconomic driving factors of the COVID-19 epidemic is still incomplete. Based on a linear random effects regression, a predictive model is derived to estimate COVID-19 incidence in German rural districts from local socioeconomic factors and popularity of political parties in terms of their share of vote. Thereby, time series provided by Germany's public health institute (Robert Koch Institute) of weekly notified 7-day incidences per 100,000 inhabitants per district from the outset of the epidemic in 2020 up to December 1, 2021, have been used to construct the dependent variable. Local socioeconomic conditions including share of votes, retrieved from the Federal Statistical Office of Germany, have been used as potential risk factors. Popularity of the right-wing party Alternative for Germany (AfD) bears a considerable risk of increasing COVID-19 incidence both in terms of predicting the maximum incidences during three epidemic periods (alternatively, cumulative incidences over the periods are used to quantify the dependent variable) and in a time-continuous sense. Thus, districts with high AfD popularity rank on top in the time-average regarding COVID-19 incidence. The impact of the popularity of the Free Democrats (FDP) is markedly intermittent in the course of time showing two pronounced peaks in incidence but also occasional drops. A moderate risk emanates from popularities of the Green Party (GRÜNE) and the Christian Democratic Union (CDU/CSU) compared to the other parties with lowest risk level. Socioeconomic parameters like \emph{per capita} income, proportions of protection seekers and social benefit claimants, and educational level have negligible impact. To the contrary, incidence significantly increases with population density. In order to effectively combat the COVID-19 epidemic, public health policymakers are well advised to account for social attitudes and behavioural patterns reflected in local popularities of political parties, which are conceived as proper surrogates for these attitudes. Whilst causal relations between social attitudes and the presence of parties remain obscure, the political landscape in terms of share of votes constitutes at least viable predictive "markers" relevant for public health policy making.

Syncope and presyncope occurring during work can affect safety and impair occupational performance. Few data are available regarding the prevalence of these events among workers. The possible role of sleep quality, mental stress and metabolic disorders in promoting syncope, presyncope and falls in workers is unknown. In the present study, 741 workers (male 35.4%; mean age 47±11 years), employed in different companies, underwent clinical evaluation and blood tests and completed questionnaires to assess sleep quality, occupational distress and mental disorders. The occurrence of syncope, presyncope and unexplained falls during their working life was assessed by an ad hoc interview. The prevalence of syncope, presyncope and falls of unknown origin was 13.9%, 27.0%, and 10.3%, respectively. The occurrence of syncope was associated with an increased risk of occupational distress (adjusted Odds Ratio aOR: 1.62, Confidence Intervals at 95%: 1.05-2.52), low sleep quality (aOR: 1.79 CI 95%: 1.16-2.77) and poor mental health (aOR: 2.43 CI 95%: 1.52-3.87). Presyncope was strongly associated with occupational distress (aOR: 1.77 CI 95%: 1.25-2.49), low sleep quality (aOR: 2.95 CI 95%: 2.08-4.18) and poor mental health (aOR: 2.61 CI 95%: 1.78-3.84), while no significant relationship was found between syncope or presyncope and metabolic syndrome. These results suggest that occupational health promotion interventions aimed at improving sleep quality, reducing stressors and increasing worker resilience might reduce syncope and presyncope events in the working population.

Motorcycles can be considered a new form of smart vehicle when taking into account their small and modern structure and due to the fact that nowadays they are used in the new role of ambu-lance to rapidly reach emergency patients in large cities with traffic congestion. However, there is no study regarding the measuring of access time for motorcycle ambulances in large cities of Thailand. Therefore, this study aims to compare access times to patients between motorcycle ambulances and conventional ambulances, including analysis of the use of AED installed on motorcycle ambulances to contribute to the sustainable development of public health policies. In two hundred and seventy-one operations, it was found that the times from dispatch to vehicle (ambulance and motorlance) being en route and times from the 1669 center (center for com-mand-and-control EMS in Thailand) call receipt to arrival on scene (response time) of motorcycle ambulances was shorter than that of a conventional ambulance and the use of AED on a motor-cycle ambulance can increase the chances of survival for patients with cardiac arrest outside the hospital in public places where AEDs are not available and in all cases where access to an AED was less than eight minutes.

We aimed to explore student and staff perceptions and experiences of a pilot COVID-19 asymptomatic testing service (P-ATS) in a UK university campus setting. This was a mixed-method study comprised of an online survey, and thematic analysis of qualitative data from interviews and focus groups conducted at the end of the 12-week P-ATS programme. Ninety-nine students (84.8% female, 70% first year; 93.9% P-ATS participants) completed an online survey, 41 individuals attended interviews or focus groups, including 31 students (21 first year; 10 final year) and 10 staff. All types of testing and logistics were highly acceptable (virus: swab, saliva; antibody: finger prick) and 94.9% would participate again. Reported adherence to weekly virus testing was high (92.4% completed ≥6 tests; 70.8% submitted all 10 swabs; 89.2% completed ≥1 saliva sample) and 76.9% submitted ≥3 blood samples. Students tested to ‘keep campus safe’, ‘contribute to national efforts to control COVID-19’, and ‘protect others’. 31.3% had high anxiety as measured by the Generalized Anxiety Disorder scale (GAD-7) (27.1% of first year). Students with lower levels of anxiety and greater satisfaction with university communications around P-ATS were more likely to adhere to virus and antibody tests. Increased adherence to testing was associated with higher perceived risk of COVID-19 to self (virus) and others (antibody). Qualitative findings revealed 5 themes and 13 sub-themes: ‘emotional responses to COVID-19’, ‘university life during COVID-19’, ‘influences on testing participation’, ‘testing physical and logistical factors’ and ‘testing effects on mental wellbeing’. Asymptomatic COVID-19 testing (virus/antibodies) is highly acceptable to students and staff in a university campus setting. Clear communications and support for mental wellbeing is likely to be important for testing uptake and adherence. Strategies are needed to facilitate social connections and mitigate the mental health impacts of COVID-19 and self-isolation.

During the last years, significant initiatives have been launched for the dissemination of Open Access as part of the Open Science movement. Nevertheless, the other major pillars of Open Science such as Open Research Data (ORD) and Open Peer Review (OPR) are still in an early stage of development among the communities of researchers and stakeholders. The present study sought to unveil the perceptions of a medical and health sciences community about these issues. Through the investigation of researchers’ attitude, valuable conclusions can be drawn, especially in the field of medicine and health sciences, where an explosive growth of scientific publishing exists. A quantitative survey was conducted based on a structured questionnaire, with 51.8% response rate (215 responses out of 415 electronic invitations). The participants in the survey agreed with the ORD principles However they ignored basic terms like FAIR (Findable, Accessible, Interoperable and Reusable) and appeared incentive to permit the exploitation of their data. Regarding OPR, participants expressed their agreement, implying their interest for a trustworthy evaluation system. Conclusively, researchers urge to receive proper training for both ORD principles and OPR processes which combined with a reformed evaluation system will enable them to take full advantage of the opportunities that arise from the new scholar publishing and communication landscape.

Despite several attempts by governments and non-governmental organizations to eliminate female genital mutilation or cutting, it is puzzling that this traditional procedure is widely practiced today in many parts of sub-Saharan Africa (SSA). Scholarly arguments on the influence of female genital mutilation on sexual behavior up until now remain inconclusive. The current study sought to examine the association between female genital mutilation and early sexual initiation among girls and young women (AGYW) in SSA. Data from Demographic and Health Surveys (DHS) of 12 SSA countries were combined. A total of 30,089 AGYW (15-24 years) who had ever had sex and had complete information on all the variables of interest were considered. The outcome variable for the study was early sexual initiation. The study employed multilevel logistic regression for the data analysis, with reported odds ratio and associated 95% confidence intervals (CIs). The overall prevalence of female genital mutilation among AGYW was 49.9%, with the highest and lowest prevalence in Guinea (95.8%) and Togo (3.3%) respectively. The prevalence of early sexual initiation was 42.4%, with the highest and lowest prevalence in Niger (59.9%) and Burkina Faso (30.6%) respectively. AGYW who had not experienced female genital mutilation were less likely to have early sexual initiation [OR= 0.74, CI= 0.70-0.78], compared to those who had experienced female genital mutilation, after controlling for significant covariates. The likelihood of early sexual initiation was high among AGYW aged 15-19 [OR=2.38, CI=2.26-2.51] but low among AGYW with secondary education [AOR=0.58, CI=0.54-0.63], those who had never married [OR=0.68, CI=0.60-0.78], those in households with richest wealth quintile [OR=0.64, CI=0.57-0.72], those who were exposed to mass media [OR=0.88, CI=0.83-0.93], and those working [OR=0.91, CI=0.87-0.96]. Not undergoing female genital mutilation in the midst of socio-economic factors (e.g., education level, household wealth) could limit AGYW from early sexual debut. These findings underscore the need for effective campaign and programs (e.g., educational programs, entrepreneurial training, micro-finance schemes) against the practice of female genital mutilation. Policy interventions (e.g., “schooling for the girl-child” initiatives) that might delay early sexual initiation among adolescent girls and young women in the midst of identified socio-economic factors should be developed.

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

The growing dependence on large language models (LLM)s highlights the urgent need to deepen trust in these technologies. Regular, rigorous validation of their expertise, especially in nuanced and intricate scenarios, is essential to ensure their readiness for clinical applications. Our study pioneers the exploration of LLM utility in the field of cardiology. We stand at the cusp of a transformative era where mature AI and LLMs, notably ChatGPT, GPT-4, and Google Bard, are poised to influence healthcare significantly. Recently, we put three available LLMs, OpenAI's ChatGPT-3.5, GPT-4.0, and Google's Bard, to the test against a significant Polish medical special-ization licensing exam (PES). The exams cover the scope of completed specialist training, focusing on diagnostic and therapeutic procedures, excluding invasive medical procedures and interven-tions. In our analysis, GPT-4 consistently outperformed the others, ranking first, with and Google Bard and ChatGPT- 3.5 following, respectively. The performance metrics underscore GPT-4's no-table potential in medical applications. Given a score improvement of over 23.5 % between two AI models released just four months apart, clinicians must stay informed and up-to-date about these rapidly evolving tools and their potential applications to clinical practice. Our results provide a snapshot of the current capabilities of these models, highlighting the nuanced performance dif-ferences when confronted with identical questions

How can neuroscience help everyone to live and care for our confined brains? Understanding and studying human behaviour allows us to measure the impact of such confinement on each of us and to identify those who need help. The challenges are to understand the psychological repercussions following confinement and to understand how neuroscience and neurotechnology can be very interesting tools for dealing with the health crisis. Neuroscience is changing our traditional philosophical and ethical views by providing information about the biological basis of our moral behaviour. The exception of the brain is at the heart of neuroethical thinking and discourse. Neuroethics is an interdisciplinary discipline placed at the intersection between the human sciences and the neurosciences, and aims to help understand how knowledge and research in neurosciences and neurotechnologies will affect the future of society, their impact on humans, relationships, daily life, the labour market ... but also how they can help and provide solutions and answers to the questions of citizens in a health crisis. But it's a double-edged sword, collecting and analyzing brain data in real time seems to be increasingly simple and within everyone's reach, without having the hindsight of the real meaning of these data, allowing one day to read people's thoughts, control them and manipulate them. It is becoming clear that the boundaries between medical and non-medical uses of neuroscience and neurotechnology are becoming very porous, inviting us to reflect on neuroethical issues in order to put safeguards on these uses.

Background: Ovarian, cervical, and endometrial cancers stand as fatal health killers for women's mental and physical health, especially affecting female reproductive systems. Exploiting weakly supervised learning and explainable AI techniques are crucial for fast, accurate, and robust automatic marker detection, efficient prevention, and primary treatment of gynecological tumors. Methods: With respect to the PRIMSA methodology, weakly supervised learning schemes and deep learning-based schemes are investigated in the cross-subject fields of clinical diagnostic imaging and explainable AI technology. Related methods, opening research problems, and challenging subjects are explored in the screening and treatment of gynecological tumors and performing cancer image diagnosis in the latest study. Results: Keynote approaches combining ultrasound medicine, explainable AI, and clinical imaging technology are summarized. In combination with learning-based methods with medical imaging, prospective insights are put forward for refreshed concepts on treatments in the area of gynecological oncology, with a feasible range of applications for their corresponding AI techniques. Conclusions: Explainable AI and deep learning-based approaches are capable of performing accurate classification between benign and malignant tumors, yielding a pathway to care for women's health, improving the survival rate of patients, pacing with disease prediction, and matching the strategic goal of "Healthy China 2030".

Background: Although electronic health records (EHR) provide useful insights into disease patterns and patient treatment optimisation, their reliance on unstructured data presents a difficulty. Because of their narrative structure, echocardiography reports, which provide extensive pathology information for cardiovascular patients, are particularly challenging to extract and analyse. Although natural language processing (NLP) has been utilised successfully in a variety of medical fields, it is not commonly used in echocardiography analysis. Objectives: To develop an NLP-based approach for extracting and categorizing data from echocardiography reports by accurately converting continuous (e.g. LVOT VTI, AV VTI, and TR Vmax) and discrete (e.g. Regurgitation severity) outcomes in semi-structured narrative format into structured and categorized format, allowing for future research or clinical use. Methods: 135,062 Trans-Thoracic Echocardiogram (TTE) reports were derived from 146967 baseline Echocardiogram reports and split into three cohorts: Training and Validation (n = 1075), Test Dataset (n = 98) and Application Dataset (n = 133,889). The NLP system was developed and iteratively refined using medical expert knowledge. The system was used to curate a moderate-fidelity database from extractions of 133,889 reports. A hold-out validation set of 98 reports was blindly annotated and extracted by two clinicians for comparison with the NLP extraction. Agreement, discrimination, accuracy and calibration of outcome measure extractions were evaluated. Results: Continuous outcomes including LVOT VTI, AV VTI, and TR Vmax exhibited perfect inter-rater reliability using intra-class correlation scores (ICC=1.00, P< 0.05) alongside high R2 values, demonstrating an ideal alignment between the NLP system and clinicians. Good level (ICC =0.75-0.9, P<0.05) of inter-rater reliability were observed for outcomes such as LVOT Diam, Lateral MAPSE, Peak E Velocity, Lateral E' Velocity, PV Vmax, Sinuses of Valsalva, and Ascending Aorta diameters. Furthermore, the accuracy rate for discrete outcome measures was 91.38% in the confusion matrix analysis, indicating effective performance. Conclusions: The NLP-based technique yielded good results when it came to extracting and categorising data from echocardiography reports. The system demonstrated a high degree of agreement and concordance with clinician extractions. This study contributes to the effective use of semi-structured data by providing a useful tool for converting semi-structured text to structured echo report that can be used for data management. Additional validation and implementation in healthcare settings can improve data availability and support research and clinical decision-making.

This work investigates the use of Non-destructive tests as a tool for monitoring the structural performance of concrete structures. The investigation encompassed four phases; the first of which involved the use of destructive and non-destructive mechanisms to assess concrete strength on cube specimens. The second phase research focused on site assessment for a twin engineering theatre located at the Faculty of Engineering, University of Lagos using rebound hammer and ultrasonic pulse velocity tester. The third phase was the use of linear regression analysis model with MATLAB to establish a relationship between calibrated strength as well as ultrasonic pulse velocities with their corresponding compressive strength values on cubes and values obtained from existing structures. Results show that the root-mean squared-R² values for rebound hammer ranged between 0.275 and 0.742 while ultrasonic pulse velocity R² values were in the range of 0.649 and 0.952 for air curing and water curing systems respectively. It initially appeared that the Ultrasonic pulse velocity was more suitable for predicting concrete strength than rebound hammer but further investigations showed that the latter was adequate for early age concrete while the former was more suited for aging concrete. Hence, a combined use is recommended in this work.

Background: After serious epidemics of chikungunya (CHIKV) and Zika (ZIKV) in the Americas, dengue (DENV) have reemerged in most countries. We analyzed the incidence, incidence rates, and evolution of DENV cases in Honduras from 2015-2018 and the ongoing 2019 epidemic. Methods: Using epidemiological weeks (EW) surveillance data on the DENV in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental, and municipal levels. Results: From 1 January 2016 to 21 July 2019, a total of 109,557 cases of DENV were reported, 28,603 in 2019, for an incidence rate of 312.32 cases/100,000 pop this year; 0.13% laboratory-confirmed. The highest peak was reached on the EW 28°, 2019 (5,299 cases; 57.89 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortes (8,404 cases, 479.68 cases/100,000 pop in 2019). Discussion: The pattern and evolution of DENV epidemic in 2019 in Honduras has been similar to that which occurred for in 2015. As previously reported, this epidemic involved the north and central areas of the country predominantly, reaching municipality incidences there >1,000 cases/100,000 pop (1%). Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.

Coffee production generates significant amounts of by-products, posing challenges for waste management in the industry. Recent research has revealed that coffee by-products are rich in bioactive compounds suitable to produce functional food ingredients and nutraceuticals. In this review, we explore biorefinery strategies for extracting and utilizing bioactive compounds from coffee by-products, including the production of bio-based chemicals and materials, as well as the extraction of phenolic compounds, antioxidants, and dietary fiber for food applications. We propose a stepwise approach for the development of functional food ingredients and nutraceuticals from coffee by-products, covering the identification of needs, comprehensive characterization, in vitro and in vivo research, unraveling the mechanism of action, food and nutraceutical formulation, sensory analysis, shelf-life stability, scale-up, randomized control trials, and biostatistic and bioinformatic integration. Additionally, we discuss the market potential, regulatory issues, and technological innovation surrounding the commercialization of coffee by-product-based products. Emphasizing the importance of regulatory compliance and sustainability in the coffee industry, this review highlights the potential of coffee by-products to be transformed from waste into valuable functional food ingredients and nutraceuticals, offering a promising avenue for waste reduction and promoting sustainability in the coffee industry.

The World Health Organization’s Health Economic Assessment Tool (HEAT) for walking and cycling is a user-friendly web-based tool to assess health impacts of active travel. HEAT, developed over 10 years ago, has been used by researchers, planners and policymakers alike in appraisals of walking and cycling policies of both national and more local scales. HEAT has undergone regular upgrades adopting the latest scientific evidence. This article presents the most recent upgrades of the tool. Health impacts of walking and/or cycling in a specified population are quantified in terms of premature deaths avoided (or caused). In addition to the calculation of benefits from physical activity, HEAT was recently expanded to include assessments of the burden associated with air pollution exposure and crash risks while walking or cycling. Further, impacts on carbon emissions from mode shift to active travel modes can now be assessed. Monetization of impacts using Value of Statistical Life and Social Costs of Carbon now uses country-specific values. As active travel inherently results in often substantial health benefits as well as not always negligible risks, assessments of active travel behaviour or policies are incomplete without considering health implications. The recent developments of HEAT make it easier than ever to obtain ballpark estimates of health impacts and carbon emissions related to walking and cycling.

Currently the majority of studies on vision-based measurement has been conducted under ideal environments so that an adequate measurement performance and accuracy is ensured. However, vision-based systems may face some adverse influencing factors such as illumination change and fog interference, which can affect the measurement accuracy. This paper develops a robust vision-based displacement measurement method which can handle the two common and important adverse factors given above and achieve sensitivity at the subpixel level. The proposed method leverages the advantage of high-resolution imaging incorporating spatial and temporal context aspects. To validate the feasibility, stability and robustness of the proposed method, a series of experiments was conducted on a two-span three-lane bridge in the laboratory. The illumination change and fog interference are simulated experimentally in the laboratory. The results of the proposed method are compared to conventional displacement sensor data and current vision-based method results. It is demonstrated that the proposed method gives better measurement results than the current ones under illumination change and fog interference.

Manual material handling (MMH) significantly impacts worker health and productivity, often leading to musculoskeletal disorders (MSDs) primarily in the lower back. As a novel assistive technology, exoskeletons may serve as ergonomic tools to mitigate these work-related MSDs. It is essential to examine exoskeletons from the users’ perspectives before their widespread implementation in occupational settings. This study investigates the effectiveness of a passive back-support exoskeleton (BExo) in reducing perceived physical exertion and improving ergonomic safety in manufacturing context. Twenty-two college students were recruited to perform MMH tasks in a controlled lab environment, both with and without the BExo, followed by completing a survey questionnaire on various aspects of the BExo. Using ANOVA, the study analyzed biomechanical exertion across various body parts and tasks. The findings indicate that the BExo substantially alleviates discomfort in the low back, shoulders and knees, thereby, enhancing ergonomic posture and reducing fatigue. These results underscore the potential of passive exoskeletons to boost workers’ safety and efficiency, providing valuable insights for future ergonomic strategies in industrial setting.

Despite the strong links between sleep, circadian rhythms, and mental health, sleep education has been neglected in mental healthcare provider training programs. The current pilot study examined the potential efficacy and acceptability of a sleep education workshop for trainee psychologists, called the Sleep Psychology Workshop. Eleven students completing their Master of Psychology degrees (90% female, 24.4 ± 1.6 years old) attended the Sleep Psychology Workshop as part of their Health Psychology course, delivered as three, two-hour lectures (total six hours). Trainees’ sleep psychology knowledge quiz scores (% correct) demonstrated significant improvement from pre- (M = 60%, SD = .09) to post-workshop (M = 79%, SD = .08), t (6) = -5.18, p = .002. Trainees also reported increased self-efficacy to use common sleep-related assessment instruments and empirically supported interventions to manage sleep and circadian rhythm disturbances, along with increased confidence to manage insomnia disorder in clinical practice (all p<.02). Trainees also endorsed the workshop as an acceptable sleep education program for trainee psychologists via a post-workshop feedback survey, focus group, and six-month follow-up survey. This pilot study provides preliminary evidence for the Sleep Psychology Workshop as an effective and acceptable sleep education program for trainee psychologists.

Conventional approaches in Structural Health Monitoring (SHM) tend to be complex, destructive, and time-intensive. Additionally, they often require a large number of sensors to thoroughly assess structural integrity. In this study, we present a novel, non-destructive SHM framework based on machine learning (ML) for the accurate detection and localization of structural cracks. This approach leverages a minimal number of strain gauge sensors linked via Bluetooth communication. The framework is validated through empirical data collected from 3D carbon fiber-reinforced composites, including three distinct specimens, ranging from crack-free samples to specimens with up to ten cracks of varying lengths and depths. Strain data from five sensors were analyzed using a combination of Shewhart charts, Grubbs Test (GT), and a hierarchical clustering algorithm, specifically designed to evaluate and classify fractures. Our ML-based framework offers a streamlined and efficient alternative to traditional laboratory procedures, delivering precise crack detection with significant potential for applications in the composites industry.

Diabetes mellitus is a widespread chronic metabolic disorder demanding regular blood glucose level surveillance (BGLs). Current invasive techniques, such as finger-prick tests, often result in discomfort for patients, leading to infrequent monitoring and potential health complications. The primary objective of this study was to design a novel, portable, non-invasive system for diabetes detection using breath samples, named as DiabeticSense, an affordable digital health device for early detection, encouraging immediate intervention. The device employed MOSFET-based electrochemical sensors to assess volatile organic compounds in breath samples, whose concentrations differ between diabetic and non-diabetic individuals. The system merged body vital signs with sensor voltages obtained by processing breath sample data to predict diabetic conditions. Our research used readings from 100 patients at a nationally recognised hospital to form the dataset. Data was then processed 10 using a Gradient Boosting Classifier model, and performance was cross-validated. The proposed system attained a promising accuracy of 86.6%, marking an improvement of 20.72% over an existing regression technique. The developed device introduces a non-invasive, cost-effective, and user-friendly solution for preliminary diabetes detection. It has the potential to increase patient adherence to regular monitoring.

The scarcity and pollution of freshwater are extremely crucial issues today and the expansion of water reuse have been considered as an option to reduce its impact. This study aims to assess the efficiency of an integrated greywater treatment system and hydroponic lettuce production as a part of a green wall structure and to evaluate the health risk associated with the production and consumption of lettuce through quantitative microbial risk assessment (QMRA) and chemical health risk assessment. The study was conducted based on the unique configuration of source separation system; on-site greywater treatment system; green wall structure as a polishing step; and hydroponic lettuce production in the green wall structure. The final effluent from the system was used to grow three lettuce varieties by adding urine as a nutrient solution. Both water samples and plant biomass were collected and tested for E. coli and heavy metals contamination. The system has gained a cumulative 5.1 log10 reduction of E. coli in the final effluent and no E. coli found in the plant biomass. QMRA results indicated that the system attained the health-based targets, 10–6 DALYs per person per year. Similarly, health risk index (HRI) and targeted hazard quotient (THQ) results did not exceed the permissible level, thus the chemical health risk concern was insignificant.

1) Background: Genomic medicine harbors the real potential to improve the health and healthcare jour-ney of patients, care provider experiences, and improve health system efficiency – even reducing health care costs. There is expected to be an exponential growth in medically necessary new genome- based tests and test approaches in coming years. Testing can also create scientific research and commercial opportu-nities beyond healthcare decision-making. The purpose of this research is to generate a better under-standing of Canada’s state of readiness for genomic medicine, and to provide some insights for other healthcare systems; (2) Methods: a mixed-methodsapproach of literature review and key informant in-terviews with a purposive sample of experts was used. Health system readiness was assessed using a pre-viously published set of conditions. (3) Results: Canada has created some of the established conditions but more needs to be done to improve the state of readiness for genome-based medicine. Important gaps are the need for linked information systems and data integration; evaluative processes that are timely, and transparent; navigational tools for care providers; dedicated funding to facilitate rapid onboarding and supports test development and proficiency testing; and broader engagement with a broader set of inno-vation stakeholders. These findings highlight the known role of organizational context, social influence, and other factors that are known to affect the diffusion of innovation within health systems

Employment implies economic independence, social inclusion, non-discrimination and impacts people’s life in areas beyond work. Therefore, for persons with disabilities (PwD), that include persons with chronic diseases (PwCD), equal employment opportunities must be provided and reasonable accommodation (RA) in employment carefully designed. The objectives of this study done in Slovenia were: (i) to translate and adapt RA Factor Survey (RAFS; Dong et al., 2010); (ii) to examine psychometric properties of its expanded Slovenian modification Aspects of RA survey (ARAS); (iii) to find out the views of professionals in the field by ARAS; (iv) to present Slovenian model of employment rehabilitation concerning PwD and PwCD. ARAS was developed with the collaboration of professionals performing focus groups, it consists of three parts Influencing factors, Contents areas and Barriers with 78 items. Data were collected from 140 professionals and underwent descriptive statistics and factor analysis. The results showed that the key factors for RA implementation are attitude and support of employer/organization. Other important factors are employee and his/her employment, the conditions to implement RA, and the awareness of employee and work environment. ARAS might be used as a framework to assist in the development, improvement, and implementation of RA in practice. This is discussed in the broader context of equal opportunities for employment of PwD including PwCD and the welfare model in Slovenia.

This paper responds to the research question, “can urban farming help Nepali cities become more sustainable”? Especially after the Covid-19 pandemic, urban residents have begun to realize that food transported from long distances could not always be reliable. Urban farming can help produce fresh food locally and avoid long-distance transportation, and refrigeration. This practice also helps reduce greenhouse gases through plant carbon use efficiency (CUE). Urban farming not only helps city-dwellers towards achieving self-reliance in food production but also in vegetation carbon dynamics (VCD) while supporting the circular economy. Urban farming consists of edible landscapes, which can also be an aesthetic public space. As urban lands command higher prices than agricultural land, urban farming usually happens on residential yards, roofs, balconies, community gardens, and dedicated areas in public parks. Rainwater harvesting, and redirecting can help irrigate urban farms which can be part of rain gardens. The national census of 2021 (CBS 2022, p5) identifies that 66 percent of Nepal’s population live in urban areas. However, the World Bank (2018), shows that only 21 of Nepal’s population was projected to live in urban areas in 2021. It is not debatable that the urbanization process in Nepal is on the rise. Thus, urban agriculture can play an important role to supplement the residents’ food needs. Many cities in Nepal have already successfully adapted to urban farming where residents grow food on their building site, balconies, and rooftop often growing plants on pots, vases, and other types of containers. The UN-Habitat, with the support of European Union and local agencies, has published a rooftop farming training manual (2014) showing the feasibility of urban farming in Nepal.The paper discusses how Public Private Partnership (PPP) can promote urban agriculture and make the process more effective and attractive to urban farming households. It also analyzes how a PPP approach also facilitates the use of better technology, advisory support, and use of research extension activities. This paper draws on literature review, secondary data (e.g., from National Census Nepal 2021) and authors’ professional experiences related to best practices in the areas to analyze the benefits and challenges related to urban farming in Arizona, USA. The paper will provide recommendations for Nepali cities to maximize the benefit provided by urban farming. It is expected to be useful to Nepali policy makers, and government agencies, and nonprofit organizations which promote sustainability, and organic farming.

Despite significant prevention efforts, the numbers of physically inactive individuals, chronic illnesses, exhaustion syndromes and sick leaves are increasing. A still unresolved problem with exercise promotion is the low participation of sedentary persons. This collective term covers heterogeneous subgroups. Their engagement with movement campaigns and resistance to change are influenced by numerous factors. Our aim was to analyse survey data on health, performance, lifestyle habits and the approachability to physical activity campaigns obtained from the Germany-wide ActIv survey. From 2,888 study participants aged 50-60 years, 668 persons were categorised into the subgroups "never-athletes", "sports-dropouts", "always-athletes" and "sports-beginners". Large and significant group differences were found for BMI, assessment of quality of life, health and fitness, risk factors and health problems. 42.5% of "never-athletes" and 32.5% of "sports-dropouts" did not state any barriers to sport. There are substantial disparities between the non-athlete groups in terms of their motivation to exercise. In contrast, there are comparatively minor differences in motivation between "sports-dropouts" and "sports-beginners", whose health and fitness are the primary motivators for sport. Our analyses suggest that (i) negative health and performance trends cannot be compensated by appeals for voluntary participation in exercise programmes and (ii) powerful incentive systems are required.

The availability of new self-sensing cement-based strain sensors allows the development of dense sensor networks for Structural Health Monitoring (SHM) of reinforced concrete structures. These sensors are fabricated by doping cement-matrix materials with conductive fillers, such as Multi Walled Carbon Nanotubes (MWCNTs), and can be embedded into structural elements made of reinforced concrete prior to casting. The strain sensing principle is based on the multifunctional composites outputting a measurable change in their electrical properties when subjected to a deformation. Previous work by the authors was devoted to material fabrication, modeling and applications in SHM. In this paper, we investigate the behavior of several sensors fabricated with and without aggregates and with different MWCNTs content. The strain sensitivity of the sensors, in terms of fractional change in electrical resistivity for unit strain, as well as their linearity are investigated through experimental testing under both static and dynamically varying compressive loadings. Moreover, the responses of the sensors when subjected to destructive compressive tests are evaluated. Overall, the presented results contribute to improving the scientific knowledge on the behavior of smart concrete sensors and to furthering their understanding for SHM applications.

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.

The emission of sulphur dioxide (SO2) from mining activities presents a substantial risk to public health, especially in populations located near mine industrial regions. This study investigated the potential correlation between exposure to sulphur dioxide (SO2) and its effects on respiratory health in Kankoyo Township, Zambia. A variety of methodologies were employed in this study, encompassing community participation, expert interviews, spatial analysis, and a retrospective examination of health and SO2 data for Kankoyo spanning 15 years. The results of our research indicated a worrisome correlation between the community and the presence of SO2, which has had a significant impact on their lives. The expert interviews also emphasized the effects of SO2, with respiratory cases accounting for approximately 75% of the reported cases. Additionally, the clinic officer observed that asthma cases have decreased following the implementation of a monitoring station in the community. Furthermore, overall emissions of SO2 have decreased since the upgrade of the smelter operation. A probable association was identified in the retrospective analysis between exposure to SO2 and the occurrence of asthma, respiratory non-pneumonia, and pneumonia infections. The findings of the retrospective research revealed a substantial association between SO2 concentrations and the susceptibility of individuals aged 5 years and older to asthma, respiratory non-pneumonia, and pneumonia infections. The results of the spatial study indicated that Kankoyo exhibited a significant level of SO2 pollution, above the established limitations set by the Zambian Environmental Management Agency (ZEMA) by an alarming margin of 1713%. In response to the challenges identified, this study proposed several measures. These measures encompassed the implementation of a requirement for regulators such as ZEMA and local communities to have access to real-time pollution data from mines, to enhance transparency. Additionally, the deployment of affordable air quality sensors, the resolution of medication shortages, the establishment of specialized respiratory health clinics, the initiation of IT-driven public awareness campaigns, and the expansion of research to investigate additional pollutants and confounding factors were also recommended.

This study assessed health inequality trends and the degree of maternal healthcare services utilization in the DRC, using two consecutive Demographic and Health Surveys, 2007 and 2013-2014. First, we assessed the changes in the magnitude of inequality in the utilization of MHCS using logistics and regressions. Second, we analyzed the distribution of inequality in each MHCS utilization variable using the Gini coefficient and the Lorenz curve. Third, we used the Wagstaff two groups concentration indices comparison method to assess health inequality trends. Finally, we fitted the concentration curves to estimate the inequality in the utilization of MHCS to the economic condition of women. Women were less likely to have their first ANC visit within the first trimester, less likely to receive checkups during ANC visits, and less likely to attend more ANC visits when living in eastern DRC compared to western DRC. Women in rural areas were less likely to have their last birth by C-section, and less likely to receive PNC than women in urban areas. Women with middle, richer, and richest wealth indexes were more likely to complete more ANC visits, more likely to deliver by C-section, most likely to receive PNC, and more likely to receive ANC than those with lower wealth indexes. Over time, inequality in the utilization of MHCS decreased for ANC and PNC but increased for the delivery by C-sections. These findings suggest that innovative strategies are still needed to improve the utilization of MHC services among poorer, rural, and underserved women in post-conflict DRC.

Bedbug (Cimex spp.) are a nuisance public-health pest that is on the rise globally, particularly in crowded cities such as Hong Kong. To investigate the health impacts of bedbug infestations among bedbug victims, online surveys were distributed in Hong Kong between June 2019 to July 2020. Data on sociodemographics, self-rated health, average hours of sleep per day, and details of bedbug infestation were collected. Bivariate and multivariable analysis were performed using logistic regression. The survey identified 422 bedbug victims; among them, 223 (52.9%) experienced ≥5 bites in the past month, most bites occurred on the arms (n=202, 47.8%) and legs (n=215, 51%), and the most common reaction to bites were itchiness (n=322, 76.3%), redness, and swelling of the skin (n=246, 58.1%), and difficulties sleeping or restlessness (n=125, 29.6%). Bites usually occurred during sleep (n=230, 54.5%). For impact on daily life in the past month, most bedbug victims reported moderate to severe impact on mental and emotional health (n=223, 52.8%) and sleeping quality (n=239, 56.6%). Lower self-rated health (aOR&lt;1) was independently associated with impact to physical appearance (p=0.008), spending money on medication or doctor consultation (p=0.04), number of bites in the past month (p=0.023), and irregular time of bites (p=0.003). Lower average hours of sleep per day (aOR&lt;1) was independently associated with impact on mental and emotional health (p=0.016). This study brings attention to the neglected issue of bedbug infestation by considering bedbugs as an infectious agent instead of a vector and providing empirical evidence describing its health impacts.

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.

In mountain communities like Sebei, Uganda, that are highly vulnerable to emerging and reemerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of Village Health Teams (VHTs) in Sebei communities of Mount Elgon in undertaking surveillance tasks for emerging and reemerging infectious diseases in the context of a changing climate. We used participatory epidemiology techniques to elucidate VHTs’ perceptions on climate change and public health and assess their capacities in conducting surveillance for emerging and reemerging infectious diseases. Overall, VHTs perceived climate change to be occurring with wider impacts on public health. However, they have inadequate capacities in collecting sur-veillance data. The VHTs lack transport to navigate through their communities and have in-sufficient capacities in using mobile phones for sending alerts. They do not engage in reporting other hazards related with the environment, wildlife and domestic livestock that would ac-celerate infectious disease outbreaks. Records are not maintained for disease surveillance ac-tivities and the abilities of VHTs to analyze data are also limited. However, VHTs have access to platforms that can enable them to disseminate public health information. The VHTs thus need to be retooled to conduct their work effectively and efficiently through equipping them with adequate logistics and knowledge on collecting, storing, analyzing, and relaying data, which will improve infectious disease response and mitigation efforts.

To identify gender- and age-related associations between adult dental checkups and unmet dental care needs, we analyzed data of 14,000 participants, ages ≥ 19, from the 7th Korea National Health and Nutrition Examination Survey (2016–2018) (KNHANES VII). Data was collected via self-report questionnaires and interviews. Complex sample chi-square test and multiple logistic regression analysis indicated 31.7% of participants had unmet dental care needs; in the prior 12months, 67.1% had not utilized dental services, and 43.3% had not received dental checkups. Odds ratios (ORs) for dental checkups and unmet dental needs were 8.87 (CI:7.80–10.09, p < 0.001) for those who used dental services and 1.28 (CI: 1.13–1.44, p < 0.001) for those who had not. Significant age-dependent associations between those not receiving dental checkups and the rate of unmet dental care include men and women aged 50–59 years (OR: 1.77; CI = 1.22–2.58 and OR: 1.43; CI: 1.02–2.02; p = 0.040, respectively) and women ≥ 70 years (OR = 1.79, CI = 1.20–2.66, p = 0.004). Reducing unmet dental care needs requires greater public health promotion and education regarding regular dental checkups; additional practical strategies could enhance dental checkup compliance.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

In the last decades there has been a progressive aging of the population, known as “demographic revolution” or “demographic transition”. As a consequence of the worldwide progressive aging of population and of the increasing of general life expectancy, the relationship between aging and disability became a very important one and received a huge interest in research for its consequences on participation, inclusion and quality of life of ageing people and for its consequences on socio-sanitary organizations. The aim of this paper is to analyze this relationship and to discuss consequences on participation, inclusion and quality of life of ageing people, according to recent conceptual models of disability and active ageing. According to previous papers this relationship could be considered in two ways: ageing with disability (which refers to people living with long-term effects of disabling conditions acquired from birth to middle age) and disability with ageing (which refers to people which disabling conditions acquired later or age-related conditions), but newer papers proposed a convergence of these two approaches, taking into account the similarities and the differences between the two ways.

ETS exposure has been shown as an important environmental risk factor in vulnerable population groups. The aim of the project is to analyze the relationships among the ETS and behavior and health in 6−15-year-old children in Slovakia. The status of physical and mental health of children in relation to exposure to tobacco smoke was examined in the representative group of 1478 school children. The methods used, included anonymous questionnaires filled in by parents, Columbia Impairment Scale (CIS), Behavior Problem Index (BPI) and anthropometry. The prevalence of passive smoking is the highest in the capital (27%) and southern cities. Significant relationships have been confirmed between ETS and the age, socio-economic status, the incompleteness of the family, the level of mother's education and the significantly higher prevalence of respiratory diseases (26.7%).The relationships of ETS with emotional (CIS scores ≥16) and behavioral functions (BPI score ≥14) were significant in children exposed to mother‘s and father‘s smoking at home. In the multivariate analysis this association was not significant; the factors such as income and completeness of the family were dominant. The results confirmed the impact of ETS and social factors on health state and health behavior and could be the argumentation for legislative changes.

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

This paper deals with the environmental characterization of a large and densely populated area, with a poor reputation for contamination, considering the contribution of environmental features (air, soil, soil hydraulic and groundwater) and the potential effects on human health. The use of Geographic Information System (GIS) has made possible a georeferenced inventory and, by overlaying environmental information, an operational synthesis of comprehensive environmental conditions. The cumulative effects on environmental features were evaluated, taking into account superposition effects, by means of the spatial multicriteria decision analysis (S-MCDA). The application of the S-MCDA for converging the combination of heterogeneous factors, related to soil, land and water, deeply studied by heterogeneous groups of experts, constitutes the novelty of the paper. The results confirmed an overall higher potential of exposure to contaminants in the environment and higher mortality rates in the study area for some tumours, but hospital admissions for tumours were generally similar to the regional trend. Besides, mortality data may be strictly dependent on the poor socioeconomic conditions, quality of therapy and a lack of welfare in the area relative to the rest of Italy. Finally, as regards the possible relationship between presence of contaminants in the environment and health conditions of the population no definite conclusions can be drawn, although the present study encourages the use of the new proposed methods, that increase the possibilities for studying the combined effect of more environmental factors.

The remaining capacity can only be measured with offline method. This brings great challenge for the online prediction of Li-ion battery’s RUL. A novel online prediction method for Li-ion battery’s RUL was proposed, which is based on multiple health indicators (HIs) and can be derived from the batteries’ historical operation data. Firstly, four indirect HIs were built according to the battery’s operation current, voltage and temperature data respectively. On that basis, a generalized regression neural network (GRNN) was developed to estimate the battery’s remaining capacity, and the non-linear autoregressive approach (NAR) was utilized to predict the battery’s RUL based on the estimated capacity value. Furthermore, to reduce the interference, twice wavelet denoising were performed with different thresholds. A case study is conducted with a NASA battery dataset to demonstrate the effectiveness of the method. The result shows that the proposed method can obtain Li-ion batteries’ RUL effectively.

Promoting diet and physical activity is important for women with recent gestational diabetes mellitus (GDM) and their partners to reduce the risk of future type 2 diabetes (T2D). The study aimed to understand how motivation for changing diet and physical activity behaviors among women with recent GDM and their partners was experienced after participation in the Danish Face-it intervention. Fourteen couple interviews were conducted. Data analysis followed reflexive thematic analysis. Guided by self-determination theory and interdependence theory, we identified four themes affecting couples’ motivation for health behavior change: 1) The need for relatedness after delivery, 2) Promoting competence and autonomy for health behavior change, 3) Individual and mutual preferences for health behaviors, and 4) The health threat of future T2D as a cue to action. We found that the couples in general perceived the Face-it intervention as useful and motivating. Using couple interviews increased our understanding of how the women and partners influenced each other’s perspectives after a GDM-affected pregnancy and thus how targeting couples as opposed to women alone may motivate health behavior change.

1) Background: Capturing patients’ medical histories significantly influences clinical decisions. Errors in this process lead to clinical errors, increase costs and dissatisfaction among physicians and patients. Physicians in developing countries are overloaded with patients and cannot always follow the proper history-taking procedure. The challenges are acknowledged; however, a comprehensive understanding of the status and the remedies remained unexplored. 2) Objective: This paper aims to investigate the workload, history-taking challenges, and the willingness of the physicians to accept digital solutions. 3) Methods: A cross-sectional online survey was conducted on 104 physicians across Bangladesh, featuring 22 questions regarding their professional environment, workload, digitization status of health records, challenges in history-taking, and attitudes toward adopting digital solutions for managing patient histories; 4) Results: 92.67% of the physicians face workloads, 88.46% struggle in medical history-taking, and only 4.81% use digital medical records. About 70% struggle to complete the necessary history-taking steps, emphasizing the urgent need for solutions. An AI-based Smart Health Gantt Chart (SHGC) system has been introduced for their instant feedback. 93.27% of physicians expressed their willingness to use such a system. 5) Conclusions: The proposed SHGC has the potential to enhance healthcare efficiency in developing nations, benefit physicians, and improve patient-centered care.

Shared public buildings have become centers of innovation, integrating advanced technologies to meet evolving societal needs. With a heightened emphasis on occupants’ health and well-being, these buildings serve as hubs for technological convergence, facilitating seamless connectivity and intelligent data analysis and management. Within this context, environmental monitoring emerges as a foundational element, pivotal to all aspects of building management. This article provides findings from the nationally funded RE-START project, which focuses on shared public buildings, with special regard to educational and medical facilities. The project explores enhanced indoor air quality monitoring, focusing in particular on CO2 concentration that is directly correlated with occupancy, as a fundamental element for developing health and safety protocols, energy efficiency strategies, integration of smart building technologies, and data-driven energy management. The intersection of environmental monitoring, energy efficiency, security, and IoT technologies in in indoor spaces are relevant. The outcomes of the study reveal the delicate nature of all the involved components, that need to be carefully developed in an integrated manner.

From 2020 to 2023 many people around the world were forced to wear masks for large proportions of the day based on mandates and laws. We aimed to study the potential of face masks for the content and release of inanimate toxins. A scoping review of 1003 studies was performed (database search in PubMed/MEDLINE, qualitative and quantitative evaluation). Twenty-four studies were included (experimental time 17 min to 15 days) evaluating content and/or release in 631 masks (273 surgical, 228 textile and 130 N95 masks). Most studies (63%) showed alarming results with high micro- and nanoplastics (MPs and NPs) release and exceedances could also be evidenced for volatile organic compounds (VOCs), xylene, acrolein, per-/polyfluoroalkyl substances (PFAS), phthalates (including di(2-ethylhexyl)-phthalate, DEHP) and for Pb, Cd, Co, Cu, Sb and TiO₂. Of course, masks filter bacteria, dirt and plastic particles and fibers from the air we breathe and have specific indications, but according to our data they also carry risks. Depending on the application, a risk-benefit analysis is necessary. However, mask mandates during the SARS-CoV-2 pandemic have been generating an additional source of potentially harmful exposition to toxins at population level with almost zero distance to the airways.

The average age of in-service bridges has increased in recent years in the United States. To address this issue, structural health monitoring and damage identification approaches can be employed to prioritize maintenance/replacement of aging bridges. Among the damage identification and operational health monitoring approaches, finite element (FE) model updating methods can offer a solution to evaluate the mechanics-based characteristics of bridges. However, in a real-world setting, unidentifiability and mutual dependency between model parameters, modeling errors, especially due to boundary conditions, as well as ill-conditioning of updating algorithms can pose challenges to the application of FE model updating methods. To address these challenges, this study presents a two-step FE model updating approach. In the first step, modal-based model updating is used to estimate linear model parameters mainly related to the stiffness of boundary conditions and material properties. In the second step, in order to refine parameter estimation accounting for nonlinear response behavior of the bridge, a time-domain model updating is carried out. In this step, boundary conditions are fixed at their final estimates using modal-based model updating. To prevent the convergence of updating algorithm to local solutions, the initial estimates for nonlinear material properties are selected based on their corresponding final estimates in the modal-based model updating. To validate the applicability of the two-step FE model updating approach, a series of forced-vibration experiments are designed and carried out on a pair of decommissioned and deteriorated prestressed bridge I-girders. After carrying out the two-step FE model updating, the final estimates of concrete compressive strength are shown to provide reasonable assessment of the damage extent in the girders.

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

Background: Cancer patients require cross-professional care during the diagnosis and treatment periods. Therefore, methods for effectively carrying out case management are essential to tumor care. Purpose: To investigate the effects of using the community software LINE Official Ac-count on oral cancer case management. Methods: An experimental design was used; 100 patients were randomly divided into two groups by using a computer-generated random number table. The experimental group used LINE Official Account, which gave them self-care information, timely messages, and one-on-one health-care consultations. The control group followed standard healthcare practices. Results: The experimental group was satisfied with the self-care information provided by LINE Official Account (86.9%), patients regularly checked the self-care information (89.4%) and would check the information when receiving a push notification (54.3%). Ten patients used the one-on-one consultation(20.0%). LINE Official Account had a significant effect on the rate of participation in support groups. Generalized estimating equations indicated a significant difference between the two groups regarding the overall quality of life over 7 days (P = 0.023). Conclusion: Community software applications used in oncological case management can improve self-management and empower, also enable tracking of long-term follow-up effectiveness and reinforce the case manager’s role as a family therapist. Therefore, this study recommends that case manager systems be incorporated into mobile applications to increase the sustainable management, accessibility, effectiveness, and satisfaction of oncological management systems. This study also provides the value of Sustainable Development Goals (SDGs) with Good Health and Well-being, and decreased social withdrawal among patients with oral cancer.

Brain health is a matter of great importance as we age, where memory loss and other cognitive declines become slowly apparent. There are numerous natural solutions, called nootropics, that can help mitigate this natural process. While some, such as ginkgo biloba, have been traditionally used for centuries, in many cases there is a lack of scientific evidence on their potential mechanisms and efficacy. To this end, the objective of the current study is to evaluate and compare several standardized herb extracts with potential nootropic effects, and from this analysis develop a formula and confirm its effect in healthy volunteers with mild cognitive impairment. A total of 9 standardized herb extracts were chosen based on previous scientific evidence and tested in human neural stem cell cultures exposed to oxidative stress. The expression of nerve growth factor (NGF), NRF2 and vascular endothelial growth factor (VEGF) were also analyzed. As a result, it was observed that an extract from Salvia officinalis revealed to have the most noticeable effect among the herbs analyzed. In further tests it was confirmed that its combination with rutin, a phenolic compound with potential nootropic effects, increased brain derived neurotrophic factor (BDNF) expression, as well as inhibiting acetylcholine esterase (AChE) activity. Finally, a randomized, double-blind placebo-controlled clinical study was conducted, testing the effects of the combination at two different doses, for 12 weeks, in healthy volunteers aged 50+ with mild cognitive impairment. Two questionnaires were applied, the MoCA and ADAS-Cog. As a result, both doses significantly improved several characteristics related to memory, particularly memory recall, with a more noticeable effect in the higher dose. Therefore, the results suggest that the long-term intake, at least 6-12 weeks, of a natural herb blend comprised of Salvia officinalis and rutin can help improve certain brain health-related parameters in healthy subjects with mild cognitive impairment.

The aim of the experiment was to investigate how induced stress can affect skin welfare of broodstock of lumpfish. From a population of approx. 300 fish of 1587 g (SEM ± 704 g), a sub-population of 20 fish were injected with 30 mg/kg fish cortisol implants 5 January 2018. The control group was not treated with implants. The stress-induced cortisol implant group showed elevated plasma cortisol over a period of approximately one month. Analyses of mucus cell area and density suggested that induced stress could produce a positive functional response (stimulus) in lumpfish early in the experiment, through a gentle increase in the barrier strength of the skin, and reduced mucus cell size and increased density of mucous cells, resulting in a strengthening of the respiratory capacity of the gills. Mucous cell density and calculated barrier strength in the skin were significantly negatively correlated with plasma cortisol, while in the gill filaments of females there was a significant negative correlation between mucous cell density and estrogen levels. The reduced volumetric density of "empty" cells (Q cells) after stress inducement indicates that these cells are important for the maintenance of homeostasis. The fish in this experiment were considered more robust compared to previous analyses on smaller lumpfish.

In this study, Caciocavallo Ragusano, a typical cheese produced in Sicily Island (Italy), was ob-tained from milk of dairy cows fed with and without enriched olive cake (ECO and CTR, respec-tively) in order to evaluate nutritional, microbiological, volatile, and sensory differences in cheeses. ECO cheese showed greater (p < 0.05) MUFA and PUFA and polyphenols content, and lower SFA content than CTR cheese. Microbiological analyses revealed the absence of Salmonella, Listeria monocytogenes, Escherichia coli, and E. coli O157, and no significant differences in the vi-able counts of the remaining microbial groups analyzed, between samples. Thermophilic lacto-cocci were more prevalent in ECO cheese. The implementation of culture-independent method, such as PCR-DGGE analyses, revealed the presence of a more diverse microbial population in both cheeses. Regarding the volatile compounds profile, long-chain free fatty acids were more abundant in the ECO cheese resulting in a healthier free fatty acid profile. This study also showed that, especially for their appearance and taste, the consumers mostly appreciated the ECO cheese. Results showed that using enriched olive cake could enhance the sustainability and the quality of Ragusano cheese, improving not only the health of the consumers but also positively influencing tastes and acceptability.

Health and social needs exist along a dynamic continuum. Recognizing that health status is inextricably impacted by social determinants of health, community paramedicine has opportunities and a responsibility to reduce inequities. The objective of this scoping review was to investigate peer-reviewed and grey literature to explore how community paramedicine supports community needs along a health and social continuum. We conducted a scoping review of English language literature using the JBI Scoping Review methodology. We searched CINAHL, EMBASE, MEDLINE, Google Scholar, and organisational websites. 30 peer-reviewed and 13 grey literature articles met inclusion criteria. The findings describe the ways community paramedicine models evolved from minimising system pressures on emergency health services to addressing health and social needs. A key recommendation across the literature was the need to meaningfully engage communities early in program development to understand how best to implement and co-design integrated service models addressing specific community needs, though there was a lack of evidence to guide this approach. There is a notable lack of evidence pertaining to optimising technologies in program design and implementation. Results highlight opportunities to determine best practices for conducting holistic community needs assessments that include equitable stakeholder engagement and enhancing education to prepare paramedics for expanded roles. Community paramedicine provides opportunities to better meet the needs of structurally marginalised communities. There is a social responsibility and opportunity to engage communities to co-design service delivery, advance paramedic education, and enhance interprofessional collaboration to better support community needs and generate upstream solutions for individuals and communities

Objective: A 1964 study challenged the consensus that saturated fat consumption increased the risk for myocardial infarction (MI). Roseto Pennsylvania, an Italian-American enclave of 1600 people, had similar rates of cigarette smoking, obesity and higher saturated fat consumption as neighboring towns, but far lower MI death rates. More than 50 years later, it remains uncertain if Roseto’s residents had better heart health than the average American and if so, what factors were responsible. Methods: We compared MI deaths in Roseto and neighboring towns to the Framingham Heart Study cohort matched for age and sex. Results: We found no evidence that MI deaths were lower in Roseto, PA than in Framingham, MA when controlling for age and sex. While the role of social support in health is uncontested, methodological issues, confounding factors and biases challenge the validity of the Roseto study. Conclusions: The dramatically lower MI and MI mortality rates among males in Roseto reflects biases in sampling and comparison populations, which also impacted the contrasting Diet-Heart hypothesis that saturated fats cause heart disease. Although social support enhances health outcomes, the Roseto study neither supported nor refuted this connection.

Recent mental health research has highlighted inflammation's critical role in conditions like depression and bipolar disorder, examining correlations with markers such as calcium levels, thyroid function, and inflammatory markers. The study aims to compare unipolar and bipolar d depression samples in terms of socio-demographic and clinical features. Prospective enrollment of patients hospitalized at the University of Insubria Psychiatric Unit. Patients were administered psychometric questionnaires (Beck Depression Inventory-II, Mental Pain Questionnaire, Beck Anxiety Inventory, Clinical Global Impressions Severity scale, and Reasons for Living Inventory). Thirty-six patients (17 males, 19 females) were enrolled. A statistically significant association emerged between calcium levels and bipolar depression (Pearson Chi square=0.050) and between CRP and bipolar depression (Pearson Chi-square=0.017). Additionally, a statistically significant association was observed between the unipolar and bipolar depression subgroups and current substance abuse (p=0.0275) A statistically significant difference between the BRLF scores and UDD subgroup emerged (p=0.0126). The results of the pilot study revealed significant associations between calcium/CRP levels with depressive symptoms, particularly in bipolar depression. Further research on inflammatory markers is needed to refine diagnostic subtypes and therapeutic strategies.

INTRODUCTION: While postmenopausal osteoporosis management evolved in recent years, it nonetheless remains underdiagnosed and undertreated. Given that general practitioners are the keystone of patient screening and referral in France, the present study was conducted to assess their professional positioning in the management of postmenopausal osteoporosis. METHODS: The present is a qualitative study based on semi-directed interviews, carried out between July 2020 and February 2021, with randomly chosen Alsatian general practitioners. Interviews were conducted until data saturation. Consolidated criteria for qualitative research reporting grid was used as well as Nvivo software to categorize the datas. RESULTS: Twenty-three general practitioners (GPs) were interviewed. Study participants recognized that the investigation and treatment of osteoporosis begins at a primary care level, typically with the GP. While some initiated screening by prescribing bone mineral density (BMD) assessments, only few prescribed the associated laboratory assessment and spinal X-rays in search of curable osteopathy or vertebral fracture. For those GPs who do take the opportunity to initiate treatments for patients, there is an understanding that first line options often include calcium and vitamin D, at a “preventive” level. The interviewed physicians interacted mainly with gynecologists and rheumatologists. Fracture liaison services were widely acclaimed. Several barriers were identified in their care management. The absence of a defined role between specialists and the lack of communication between the latter were an additional highlighted barrier. CONCLUSION: This study sheds further light on the discrepancy between the means available to treat osteoporosis, and the modest impact of the care observed.

It is aimed to examine the relationship between static and dynamic core training with strength, speed, jumping and taekwondo hitting performance in 12-14 years old taekwondo players. One of the most important features is the determination of the research design. The population of the study consists of male and female athletes between the ages of 12-14 who have been active in taekwondo for at least 2 years at Trabzon, Turkey. The sample of the study consists of app-proximately 30 athletes, approximately 15 female and 15 male athletes between the ages of 12-14, who voluntarily accepted to participate in the study. The data of the study were analyzed with SPSS 26.00 package program. Normality analysis was performed to determine whether the quantitative variables fit the normal distribution. Since the sample size of the study was 21 people (n=30), Shapiro-Wilk was analyzed According to the normal distribution criteria, nonparametric analyzes were performed because the variables were p<0.05. Frequency and descriptive statistics were used for descriptive statistics, and Wilcoxon Test was used for pretest-posttest comparison analysis. The results showed that core exercises had positive changes in muscle strength, anaerobic power and branch-specific striking techniques.

Myelination, the process of forming a myelin sheath around nerve fibers, is critical not only during early development but also throughout adulthood. This article explores the multifaceted impacts of myelination on the adult brain, highlighting its importance in cognitive functions, neurological health, and overall brain efficiency. In adults, efficient myelination enhances information processing speed, supports memory consolidation, and contributes to cognitive reserve, potentially delaying the onset of neurodegenerative diseases. Myelination ensures synchronized neural activity and energy-efficient brain function, playing a key role in complex cognitive tasks and coordination. Despite a slower rate of plasticity compared to early development, the adult brain retains the ability to adapt and learn, with myelination facilitating these processes. This article also draws parallels between myelination in the brain and learning curves in deep learning Perceptrons, emphasizing how reduced stimulation and experience can significantly slow down cognitive and learning processes. Additionally, the clinical implications of myelination are discussed, including its role in multiple sclerosis and age-related cognitive decline, along with strategies to maintain and enhance myelin health through lifestyle choices and emerging pharmacological interventions. Understanding the ongoing significance of myelination in the adult brain, and its comparison to artificial neural networks, is crucial for developing interventions to support cognitive health and mitigate neurological disorders.

Background: The Victorian era in Great Britain was a historical period that brought about profound changes for humanity. The confluence of various factors fostered the development of numerous scientific disciplines. In the field of health sciences, Florence Nightingale played a central role. Following her training as a nurse and her role as superintendent during the Crimean War, she made decisive contributions to establishing a public health network. Methods: This is a retrospective historical heuristic and hermeneutic study analyzing documentation of Nightingale's contributions to public health from around 1890 to 1900. The historical method was used to collect, classify, and analyze primary and secondary sources relevant to the study's objectives. Results: Nightingale supported the development of the concept of “health at home” by training women to implement healthy measures that contributed to the well-being of families and communities. Through the training and development of a formal “Health Missioners program”, she provided the necessary guidance to improve the health of rural communities across the English countryside. Conclusion: The role of Health Missioners has persisted, as health visitors continue to visit homes in the United Kingdom. Therefore, the contribution of Florence Nightingale to public health is unquestionable. This study was not registered.

Taking due account of users' perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. 501 communications (73.4% complaints, 16% appreciations, 10.6% enquiries) sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure (ACASM) was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor-patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor-patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users' assessment of the quality of care.

(1) Background: a study was undertaken to determine the prevalence of chronic diseases and health conditions that affect oral health and oral health self-care among independent living older adults in rural areas of Victoria, Australia; (2) Methods: The study analysed data from the Crossroads-II project, with a total of 1407 participants aged 55 years and older. Participants self-completed questionnaires about health conditions, service use, and demographics. 572 attended a 2-hour health screening that included an assessment of prescribed medications; (3) Results: Most participants were female (55.3%), with a mean age of 69.1 (SD=9.2) years. Participants had a high prevalence of medical conditions, the most common were high blood pressure, arthritis, high lipids, hearing loss, and chronic pain. Almost all participants reported taking medications, with an average of 4.3 medications per person. Among those who attended the health screening, 78.1% were taking medications that could cause xerostomia (dry mouth); (4) Conclusions: This study provides initial information on the prevalence of medical conditions, medication usage, with potential impact on oral health of older adults living in rural Victoria. This information would be valuable for healthcare and dental workforce planning, policy development, and improving the overall well-being of this population.

The issue of antibiotic resistance represents a significant threat that extends beyond human health, encompassing animal welfare and the sustainability of the natural environment. The inappropriate use of antibiotics, poor sanitation and inadequate control measures, have contributed to the emergence of drug-resistant bacteria, which can spread at the human-animal-environment interface. The documented presence of antimicrobials in agriculture, veterinary medicine and human medicine has convinced all stakeholders of the need to contribute to the development of a "One Health" approach, which recognises the interrelationships between animals, humans and their environment and the need to adopt a common strategy encompassing these sectors to limit the spread of antimicrobial resistance (AMR). Although a number of countries have implemented integrated surveillance systems to monitor antibiotic use and antimicrobial resistance, available data suggest that the use of antibiotics in humans, animals and the environment is increasing worldwide. Consequently, the emergence of antibiotic-resistant pathogens is becoming a recurring concern. This review provides a comprehensive overview of the measures that are necessary to be taken and implemented in order to guarantee global health security.

Similar to humans, the renin-angiotensin-aldosterone system (RAAS) plays a key role in regulating blood pressure and body fluid homeostasis in dogs and cats. The classical RAAS pathway, which involves the conversion of angiotensin I to angiotensin II by the angiotensin converting enzyme (ACE), leads to aldosterone production and associated maladaptive effects in cardiovascular and renal diseases. Recent studies have highlighted the alternative RAAS pathway, which counteracts these effects through angiotensin 1-7, promoting vasodilation and reducing inflammation. Beyond RAAS modulation, RAAS inhibitors have been shown to exert significant anti-inflammatory properties. This is particularly relevant given the American Heart Association's recent focus on Cardiovascular-Kidney-Metabolic (CKM) health, which emphasizes the interconnected risks of cardiovascular disease, chronic kidney disease (CKD), type 2 diabetes, and obesity. These conditions share common pathophysiological pathways, including chronic inflammation, oxidative stress, and metabolic dysregulation. Advances in biomedical research, including the development of adult stem cell-derived canine organoids, provide impetus to study the effects of RAAS modulators and new CVD drugs on CKM health, with a focus on epithelial inflammation within the context of One Health.

Sleep is an essential component of a healthy lifespan, influencing both physical and mental well-being along with good quality of life. Adequate sleep quality and quantity are associated with a host of health advantages, including enhanced immune function, learning and memory, emotional well-being, and cardiovascular health. Chronic sleep deprivation, or poor sleep quality, is associated with a variety of negative health outcomes, including an increased risk of obesity, diabetes, hypertension, depression, cancer, and even premature death. One compelling argument in favor of sleep as a predictor of a healthy lifespan is its effect on cellular repair and regeneration. During sleep, the body goes through important activities such as tissue repair, muscular growth, and memory consolidation. Sleep also helps the brain eliminate toxins and metabolic waste, which contributes to its optimal functioning. Without adequate sleep, these important processes are jeopardized, resulting in accelerated aging and greater susceptibility to chronic illnesses. Furthermore, sleep is essential for maintaining hormone balance, particularly those involved in appetite regulation and metabolism. Sleep disturbances can disrupt the regulation of these hormones, resulting in weight gain, metabolic diseases, and, ultimately, a shorter life span. Finally, prioritizing optimal sleep is pivotal for increasing longevity and general health. Emphasizing the importance of sleep hygiene and treating sleep-related dysfunctions should be part of the modern approach to extending healthy life.

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.

Effective teamwork is essential to the success of sport and athletic organizations. Interprofessional Collaboration (IPC) and team-based care has also been identified as a priority for health and social care organizations.(World Health Organization, 2010) The Interprofessional Education Collaborative (IPEC) Core Competencies of (1) Values and Ethics; (2) Roles and Responsibilities; (3) Communication; and (4) Teams and Teamwork provide a guiding framework for IPC. (Interprofessional Education Collaborative, 2023). Student-athlete well-being is a key objective for individuals working with or for university athletic departments, with high levels of well-being being correlated with sport, academic, and personal improvements (Navarro et al., 2020). Due to the multifaceted factors that influence student-athlete well-being (e.g., cultural factors, coaches, academic pressure, family stress, etc.), there is an increasing need for an interdisciplinary/interprofessional approach to well-being (Lemelin et al., 2022, Navarro et al., 2020; Ulrich et al., 2022) However, significant barriers exist in implementing IPC into university athletic departments and little research exists on how to overcome roadblocks to integrating IPC in university athletic departments for enhancing student-athlete wellness. This paper will describe how a university athletic department used a team approach to enhance student-athlete health and well-being. The Interprofessional Wellness Team (IWT) included a clinical sport psychology doctoral student, a licensed mental health professional, athletic trainer, and sport dietitian. A case vignette is used to demonstrate how IPEC core competencies are operationalized by the team to address athlete health and well-being through IPC. Recommendations on the further implementation of IPC centered around student-athlete well-being will be provided.

Objective: To evaluate the direct costs of treating patients with neuromyelitis optica spectrum disorders (NMOSD) in outpatient care, from a hospital and Unified Health System (SUS) perspective. Methods: Observational study with data collection by microfunding, carried out with patients diagnosed with neuromyelitis optics, treated at a university hospital, in the city of Rio de Janeiro. Mann-Whitney tests were performed to measure cost differences between patient groups by disease severity and analysis perspective. Results: Nine individuals with a median age of 48 years (IQR 30 - 59 years) were included. The median total costs for patients with greater severity from the perspective of the SUS and the hospital were R$ 21,638.22 (IIQ: R$ 15,614.63; R$ 25,985.32) and R$ 32,094.11 (IIQ: R$ 25,610 .60; R$ 38,617.25) respectively. For patients with moderate severity the median was R$ 7,339.85 (IIQ: R$ 6,235.45; R$ 11,912.05) from the SUS perspective and R$ 11,505.80 (IIQ: R$ 7,339.85; R$ 22,424.76) from the perspective of the hospital, where the use of medications had a major impact. Conclusion: The main cost drivers were medicines, especially those used off-label, and procedures.

Background/ObjectivesMental health and substance use disorders (MHD, SUD) affect cardiac allograft and VAD recipients and impact their quality of life and compliance. Limited research on MHDs and SUDs in transplant and MCS candidates and recipients. This study compares the incidence of MHDs and SUDs in transplant list, VAD, and post-transplant patients with that in heart failure patients. MethodsStudy cohorts were derived from the TriNetX using ICD-10 codes. Differences in incidence were examined using the log-rank test. Adults with mental health disorders before the window of time were excluded. Propensity score matching was performed using TriNetX to balance demographic and medical comorbidities. Statistical significance was set at p<0.05. All comparisons were made between propensity-matched cohorts. ResultsTransplant waitlist patients showed a statistically significant increase in the incidence of anxiety, panic disorder, adjustment disorder, depression, mood disorder, alcohol use disorder, and eating disorder. Post-transplant patients showed a statistically significant increase in the incidence of depression and opioid use compared to the heart failure population. VAD patients showed a statistically significant increase in the incidence of depression and a statistically significant decrease in panic disorder and anxiety. ConclusionsThe results pave the pathway for further investigations on prevention and coping strategies because deterioration of mental health will significantly impact compliance with medications as well as patient survival and quality of life. The use of opioids for pain management in the early postoperative period should be further investigated to assess its impact on long-term substance use and addiction. .

Keywords: Oral health, diabetes, periodontal disease, caries, periodontitis.

Nowadays, animal breeders look for effective innovations to care animal health. Use of probiotics, postbiotics, parabiotics and the other beneficial natural substances are dominated. Mundticin-like substance EM 41/3 is thermo-stable bacteriocin (postbiotic) with a broad antimicrobial spectrum. In this study its effect in broiler rabbits was assessed. Rabbits represent food-derived animal and they are also suitable animal model. The parameters tested were analyzed by validated methods. Administration of MLS EM 41/3 produced by non-autochthonous strain Enterococcus mundtii EM 41/3 lead to significant increase of parameter immunity-phagocytic activity, while it did not influence microbiota composition. It also did not influence blood biochemistry and no oxidative stress was noted. Moreover, higher growth parameters were noted and also stimulated hydrolytic activity. Finally, no negative influence on rabbit meat quality was noted. Postbiotic MLS EM 41/3 administration in feeding strategy seems to be contributing fact for rabbit health status maintaining.

Healthcare professionals constantly face situations that reflect ecosystems’ degradation. These can negatively affect their mental health. Research suggests that hope and resilience can play an important role in this scenario, since they are related to/predict mental health in highly heterogeneous samples (considering geography, age, profession, health, etc.). In this context, the aims of the present study are: to characterize and explore the relationship between hope, resilient coping and mental health of Portuguese healthcare professionals. Using Google Forms, 276 healthcare professionals answered to the GHQ-28, the (adult) Trait Hope Scale, and the Brief Resilient Coping Scale (cross-sectional study). The minimum and maximum possible scores were reached, with the exception of the maximum score of GHQ-28-Total. Regarding Hope, 19.6% scored below the midpoint (M=43.46, SD=11.97); 29.3% revealed low resilience (M=14.93, SD=4.05); and the average of 4 of the 5 Mental Health scores (exception: Severe Depression) indicates the probability of a psychiatric case. Hope correlated with Social Dysfunction and GHQ-28-Total; resilient coping proved to be a (weak) predictor of 4 of the 5 GHQ-28 indicators (exception: Severe depression). The results support the need to promote the sample's mental health, hope and resilient coping. They also suggest that stimulating resilient coping may contribute to improving healthcare professionals’ mental health.

Assessing dietary inadequacies can contribute to understanding the nutritional vulnerabilities of a country. This study aimed to investigate nutrient intakes and micronutrient inadequacies in the Brazilian adult population, with an interest in different age subgroups. Cross-sectional study with 1812 individuals aged 19 to 65 years from a population-based study with a representative sample of Brazilian adults. Dietary intake was assessed by two 24-hour food recalls, and the probabilities of inadequate intake were estimated using the Dietary Reference Intake targets. Adequate macronutrient intake was over 99% for proteins, 84.7% for carbohydrates, and 80.7% for total fats. There was a high probability of inadequacy (above 90%) for vitamins D and E, but vitamin D inadequacy was very similar between sexes. In contrast, vitamin E was more likely to be inadequately consumed among women. A high probability of inadequacy (above 85%) of calcium and magnesium was found in the population, regardless of age group. Except for iron, the probability of inadequacy of other minerals increased with age. The results showed a relevant proportion of nutrient inadequacies, with those most at risk being women and older individuals, helping with better targeting and monitoring of public health policies that address nutritional problems in the population.

In 2021, the American Association of Colleges of Nursing (AACN) added “the impact of climate change on environmental and population health” into The Essentials: Core Competencies for Professional Nursing Education. Presently, little guidance exists for nursing faculty new to climate education. The year prior, the Nurses Climate Challenge (NCC) - a campaign to educate 50,000 health professionals about health impacts of climate change - launched the School of Nursing Commitment through a series of focus groups and collaborative content development. With an aim of increasing access to knowledge and tools to support education about the health impacts of climate change, the NCC Commitment partners with nursing schools and provides a community of practice. Partner schools use NCC resources in courses and report the number of students educated. Within three years, 61 nursing schools in 30 states joined the Commitment. Participants included academic health centers, research institutions, multi-state schools, and small private colleges, and programs ranged from AD to PhD. Faculty 1) integrated resources into didactic and clinical settings such as population or organ-system content, leadership, and policy and 2) used resources to support assignments. In four years, faculty reported educating over 37,700 students using NCC resources in 439 educational sessions. The Commitment may be valuable for faculty fulfilling AACN Essentials by bringing climate change to the classroom, community, and bedside. Furthermore, the Commitment may be a replicable model for health professional education and inspiring action on climate change.

Background: Children's environmental health encompasses a wide range of factors that impact the well-being of children, including physical, chemical, biological, and social elements in their immediate environment. Safeguarding children from harmful substances is the crucial role of nursing students. Nursing students play a vital role as valuable resources for individuals, families, communities, and policymakers. This study aims to assess the knowledge and skills of nursing students concerning children's environmental health at academic institutions delivering nursing program in Nekemte town, Ethiopia. Methods: An institutional-based cross-sectional study design was carried out from August 1–30, 2023, among nursing students in Nekemte Town, and 634 study participants were selected through simple random sampling. Data was entered into Epinfo version 6.4 and exported to STATA version 14 for analysis, and multicollinearity was checked. Finally, from the bivariate analysis, variables of < 0.2 were included in the multivariate analysis; an adjusted odd ratio with a 95% CI was computed; and variables with a P-value <0.05 in the multivariable analysis were taken as significant associated factors. Results: The overall nursing students' level of knowledge about children's environmental health was insufficient (56%). More than one-third (34%) demonstrate their skill towards children's environmental health insufficiently, and one-fourth (25%) and 27% of the learners conduct their craft to prevent children from ecological hazards to a good and better level, respectively. While gender of the participant, age of the participant, year of the study, training history of the participants, and field of study of the students were significantly associated variables with their knowledge of children's environmental health. Conclusion: The study reveals that nursing students' knowledge of children's environmental health is limited, with factors such as gender, age, training history, and field of study significantly influencing their understanding. Therefore, female students should be considered for more tutorials to be effectively knowledgeable regarding children’s environmental health.

OBJECTIVE: Analyzing the effects of different physical exercise programs on the anthropometric, cardiovascular, metabolic, and strength variables of the elderly participating in health care programs. METHODS: Controlled clinical trial, with 60 elderly participants from health care groups, allocated into four groups: Group of resistance exercises in open-air gyms – GT1 (n = 17); Group of aerobic and localized exercises - GT2 (n = 11); Group of resistance exercises at GT3 gym (n = 17); Control group: non-exercise practitioners - CG (n = 15). Anthropometric (BMI, % body fat, and waist circumference), cardiovascular (SBP, DBP, HR, and DP), metabolic (total cholesterol, triglycerides, and glycemia), and strength variables were evaluated before and after 16 weeks of intervention. Descriptive statistics, Shapiro-Wilk and Kolmogorov-Smirnov normality test, equal variance test, T-Student test, non-parametric Mann-Witney test, ANOVA One Way, multivariate data analysis using data mining and machine learning techniques, Pearson and Spearman correlation tests, Classical Clustering (Agglomerative Hierarchical Method); Principal Component Analysis (PCA), Z score, Fruchterman-Reingold algorithm, Euclidian Similarity Index and, Cohen’s equations were applied. RESULTS: To observe effect size, morphofunctional variables for the GT1 group show a small effect for fat percentage, WHR, and ULS and a medium effect for LLS. For the GT2 group, there was a small effect for fat percentage, WHR, and ULS and a large effect for LLS. For the GT3 group, there was a small effect for the percentage of fat and HC, a medium effect for ULS, and a large effect for LLS. A small effect for glycemia in GT1, a medium effect for glycemia and triglycerides for GT2, a small effect for total cholesterol for GT3, and a large effect for glycemia in CG, with this effect being an increase in this analyte. For the cardiovascular variables, there is a small effect for SBP and HR in GT1, a small effect for DBP, HR, and DP, and a large effect for SBP in GT2, a small effect for SBP, DBP, and HR in GT3 and small effects for SBP and HR in CG. The correlation between BMI (P = 0.0007) and Body Fat% (P = 0.007) with ULS. The variables TG, LLS, and ULS were the ones that differed most in each type of stimulus chosen as an intervention in the present study. CONCLUSIONS: The results of this study indicate that GT2 caused more significant percentage reductions in body mass and BMI. However, GT3 caused greater fat percentage reduction. The GT2 caused the greatest decrease in waist circumference, while the GT3 caused the largest decline in hip circumference. The three groups induced an increase in strength (ULS and LLS). However, in ascending order, GT1 caused the smallest increase, GT2 an intermediate increase, and GT3 the greatest increase in strength, with considerable effects in GT2 and GT3. Finally, GT2 caused a greater percentage reduction in systolic blood pressure (large effect) and double product (small effect) than the other groups. The three methods proved to be efficient, but with particularities that may reflect the choice of one over another due to health conditions, objectives to be achieved, or characteristics of the patient at the time of their choice by the prescriber.