The history of health records (later also called medical records), including ones regarding individual patients, is thousands of years old. It finds it roots in the first ancient civilisations. Up until the 19^th century the records’ purpose was mainly an educational one. In the 19^th and 20^th century they started becoming significant in other roles as well, including those not strictly limited to medicine. In particular, to account for medical procedures, insurance proceeds or legal action. Currently we are living in a revolutionary era when it comes to health records, in which their character has changed from a “paper-based” to an electronic one. This paper presents the development of health records from the ancient to modern times, mainly in Europe and North America. Other cultures and civilisations, including China and India, are not discussed. An analysis of available sources was conducted, inter alia digital versions of manuscripts up to hundreds of years old. The analysis was based on PubMed and Google Scholar (several key words, all the available sources). Sources published in non-international languages (e.g. Dutch) were also investigated. Overall, approximately 600 articles were analysed, 158 of which were used and cited in this paper. The conclusions drawn from the analysis are as follows: (1) Health records, priorly used mostly for educational purposes, for about 100 years now have acquired a fully formal status. (2) We are currently facing the most revolutionary changes regarding the transformation of paper-based records into electronic ones. (3) The consequences of this process include systematic applications of solutions within the area of e-health, which allow us to make medical services more flexible, improve the health of individual patients and entire populations and potentially limit expenditure. (4) In the light of the ongoing COVID-19 pandemic, introducing electronic health records could be beneficial in terms of limiting the potential sources of contamination (physical copies of health records), saving time and resources, and improving the network of communication between medical centres.

Aims: The aim of our work was to demonstrate the possibility, in carefully selected cases, to perform operations under local anesthesia with a benefit to the patient and savings for national health care. Method: 123 patients with breast cancer underwent quadrantectomy or wide tumorectomy and sentinel lymph node removal under local anesthesia in out-patient surgery. Results: Of the 123 patients, 9 had micro-metastases and 4 had macro-metastases and only three of this had metastasis in other lymph nodes. Conclusions: Our results demonstrate that it is possible in selected cases to operate on breast cancer in out-patient surgery, with an advantage for the patient and savings for national health care.

Context: The impact of forced migration on mental health is far reaching and compounded by post- migration contexts in which social determinants of health, such as resettlement, employment and gender, play a key role. Research on refugee men has shown that employment and life transitions are key determinants of mental health. However, a gap in knowledge exists on refugee men’s perspectives on the factors that impact their mental health. Methodology: This study used community-based participatory action research and the arts-based method of Photovoice to understand Syrian refugee men’s (n = 11) experiences of forced migration, resettlement, and employment in a Canadian context, as well as the impacts of these experiences on their mental health. Analysis and Results: Drawing on the critical theoretical perspective of intersectionality, we analyzed photographs taken by research participants, which showed that language and literacy barriers, time and stage of life, isolation and loneliness, belonging and identity and gender-based stress intersected to shape their mental health. Conclusion: Meaningful employment was central to the men’s identities; however, they engaged in low wage, precarious work due to both discriminatory policies that favored Canadian experience and credentialing assessment processes that devalued their experience and knowledge. Adopting gender-responsive and caring policies and practices could shift dominant discourses on masculinity and support the mental health of refugee men in resettlement contexts.

Thromboprophylaxis of hospitalized patients at risk of venous thromboembolism (VTE) presents challenges owing to patient heterogeneity and lack of adoption of evidence-based methods. Intuitive practices for thromboprophylaxis have resulted in many patients being inappropriately prophylaxed. Multiple interventions for thromboprophylaxis have been tested, including use of multifaceted approaches such as national VTE prevention programs with audits, use of passive alerts (either human or electronic), and more recently use of active clinical decision support (CDS) tools incorporated into electronic health records (EHRs). Multifaceted health-system interventions have shown mixed results in their ability to increase appropriate thromboprophylaxis and reduce VTE, unless mandated through a national VTE prevention program, though the latter approach is potentially costly, effort- and time-dependent. Studies utilizing passive human or electronic alerts have also shown mixed results in increasing appropriate thromboprophylaxis and reducing VTE. The use of active CDS tools holds the greatest promise, especially with further refinement and widespread implementation within various EHRs and clinical workflows. Recent-ly a universal cloud-based and EHR-agnostic CDS VTE tool revealed high adoption and effectiveness in increasing appropriate thromboprophylaxis and reducing major thromboembolism. This narrative review summarizes the literature on system-wide thromboprophylaxis interventions in hospitalized patients, with a focus on CDS tools.

The intensification of modern farming methods in developed nations has exacerbated the issue of soil degradation and over-utilization of naturally available resources, hence, tinkering negatively with the health and productive capacity of soil. Chemical fertilizers, while increasing crop yields, have resulted in environmental pollution and health hazards. Green manuring presents a sustainable alternative by enriching soil fertility and reducing reliance on chemical fertilizers. This paper reviews the impact of green manuring on soil properties, crop yield, and farm economies. In-situ green manuring involves growing and incorporating the crops within the field, while ex-situ green manuring incorporates plant material from external sources. Leguminous green manures are particularly effective owing to nitrogen fixation capability and rapid decomposition. The inclusion of green manure improves the availability of nutrients, microbial count and carbon content of the soil, thereby, enhancing the overall health of soil and crop productivity. Additionally, green manures reduce pests and diseases, suppress weeds, and provide supplementary forage. Despite the benefits, challenges such as limited water resources, seed availability, and farmer reluctance hinder widespread adoption. Future research should focus on raising awareness, quantifying benefits, and developing location-specific cropping systems to optimize green manuring practices.

Backgorund and Objectives: In this study, we aimed to evaluate and compare the changes in visual and structural outcomes in patients with intravitreal aflibercept (IVA)-resistant neovascular age-related macular degeneration (nAMD) switched to either intravitreal brolucizumab (IVBr) or intravitreal faricimab (IVF) injections in a clinical setting. Materials and Methods: This obser-vational clinical study included 20 eyes of 20 patients switched to brolucizumab and 15 eyes of 14 patients switched to faricimab for aflibercept-resistant nAMD. We measured the structural outcome (central macular thickness (CMT)) and the visual outcome (best-corrected visual acuity (BCVA); logMAR) as follows: just before the most recent IVA injection (B0), one month after the most recent IVA injection (B1), just before the first IVBr or IVF injection (A0), one month after (A1) and three months after (A3) the first IVBr or IVF injection. Results: BCVA showed significant im-provement at A1 (0.25 ± 0.34) and at A3 (0.19 ± 0.24) compared to A0 (0.38 ± 0.35) in IVBr group (p = 0.0156, p = 0.0166, respectively). CMT (μm) was significantly thinner at A1 (IVBr; 240.55 ± 51.82, IVF; 234.91 ± 47.29) and at A3 (IVBr; 243.21 ± 76.15, IVF; 250.50 ± 72.61) compared to at A0 (IVBr; 303.55 ± 79.18, IVF; 270.33 ± 77.62) in IVBr group (A1; p = 0.0093, A3; p = 0.0026) and in IVF group (A1; p = 0.0161, A3; p = 0.0093). There was no significant difference in BCVA and CMT improvement observed between two groups at any time point (p > 0.05 for all). Conclusion: Switching from aflibercept to either brolucizumab or faricimab has a significant anatomical ef-fect on eyes with aflibercept-resistant nAMD and both treatments appear to be effective short-term treatment options. There is a trend towards greater visual improvements and reductions in CMT with brolucizumab.

Accurate estimation of the state of health (SOH) of batteries for automotive applications, particularly in electric vehicle battery management systems (EV-BMS), is still under study and is highly relevant to ensure battery system availability. This paper proposes a comprehensive SOH estimation method that goes beyond the methods that are based on the estimation of the battery available capacity by the integral of the current, or the estimation of the increase of the internal resistance of the battery. The SOH estimator is based on a partial capacity discharge method and a linear state of charge (SOC) observer based on an equivalent electrical circuit model. This method uses readily available manufacturer data and is designed for real-time applications. The proposed method was tested and validated with three different automotive battery technologies in a Model-In-Loop (MIL) environment with OPAL-RT platform, utilizing voltage and current measurements of pulsed discharge current profiles at temperature-controlled conditions and an electric vehicle’s driving profile.

Wild-grown edible mushrooms are important in world diet, which are also efficient metal accumulators. Yunnan, southwest China is the main producing region with typically high geochemical metals. Environmental factors, bioaccumulation, distribution and human health risk of metals were examined in paired soil and Tricholoma matsutake (n=54). T. matsutake grows on acidified soils (pH=3.95–6.56) and metals showed strong heterogeneity with Fe, Mn, Zn and Cu ranged at 16–201, 0.046–8.58 g kg–1 and 22.6–215, 3.7–155 mg kg–1. High soil Fe content led to its great accumulation in T. matsutake (0.24–18.8 g kg–1). However, though soil Mn content was great higher than Zn and Cu, their concentrations in T. matsutake were comparable (21.1–487 vs. 38.7–329 and 24.9–217 mg kg–1). This suggested that T. matsutake prefers to accumulate Zn and Cu than Mn, and supported by bioaccumulation factor (BAF=0.32–17.1 vs. 0.006–1.69). Fe was mainly stored in stipe, while Mn, Zn and Cu were in cap, with translocation factor (TF) was 0.58 vs. 1.28–1.94. Therefore, stipe Fe showed the highest health risk index (HRI) at 1.28–26.9, followed by cap Cu (1.01–2.33), while 98–100% of Mn and Zn were risk-free. The higher concentration and greater risk of Fe was attributed to the significant effect of soil Fe content (R=0.34) and soil pH (R=–0.57). This study suggested that Fe as an essential mineral may exert toxic effects via T. matsutake consumption from geochemical high background areas.

The rapid growth of urban areas has led to a decline in the amount of green space available to residents. This has a number of negative consequences for human health and well-- being. Green spaces provide a number of benefits for human health, including improved physical, mental, and social health. They also have a number of economic benefits, such as increased property values and reduced crime rates. Given the many benefits of green spaces, it is clear that they are essential for the health and well-being of urban residents. Policymakers and planners should prioritize the creation and preservation of green spaces in urban areas.

Worldwide, depressive disorder is one of the leading determinants of disability-adjusted life years. Although the benefits associated with physical activity (PA), there is a lack of information related to depression, especially in countries like Czechia, where modern approaches to mental health care only recently emerged. The PA levels were associated with aspects of depression such as clinician-diagnosed history; different severities; continuous depression scores; and specific symptoms that characterize the depression. The multivariable-adjusted Poisson regression models were carried out on 2123 participants (45.3% men, median 48 years). Compared to subjects with insufficient PA, the moderate and high PA levels were inversely associated with clinician-diagnosed depression history (respectively, prevalence rate [PR]= 0.84; 95% CI 0.66-0.82 and PR=0.50; 95% CI 0.36-0.67); and with continuous depression scores (PR=0.85; 95% CI 0.75-0.97; and PR=0.79; 95%CI 0.70-0.90).; but only high PA showed association with depression categories (PR=0.75; 95%CI 0.60-0.95). Depressed mood and worthlessness were the symptoms associated with moderate and high PA. Tiredness, change in appetite, and problems with concentration only with high PA. Although only high PA was sufficient for people intending changes among depression categories, the moderate PA may be enough for slight changes in depressive symptoms, and a good strategy when starting.

Cause-Related Marketing (CRM) has emerged as a new concept that links CSR activities to marketing, enabling corporations to pursue both building company-consumer partnership and gaining sustainable mutual benefits that are elicited from the partnership. Among various cause-related marketing activities, on-line cause-related advertising is the most commonly used one. The purpose of this study is to examine the effects of on-line cause-related advertising and moderating role of ethical consumption propensity. In particular, this study intends to contribute to successful development of on-line cause-related advertising strategy by focusing on the relationship between the four factors: customers' perception of on-line cause-related advertising, brand-consumer relationship, brand attachment and loyalty. The results of this study are as follows: First, customers' perception of on-line cause-related advertising was related positively to consumer-brand- relationship. Second, brand-consumer relationship was related positively to brand attachment and customer loyalty. Third, brand attachment was related positively to customer loyalty. Furthermore, from the consumer’s psychological viewpoint, ethical consumption propensity had a significant moderating effect to between customers' perception of cause-related advertising and brand-consumer relationship as well as brand attachment. The results of this study may contribute to the existing literature as an new empirical attempt to examine the effect of the on-line cause-related advertising.

This paper details the comprehensive activities conducted in a laboratory setting to assess the Structural Health Monitoring (SHM) of prefabricated building envelopes. Aimed at enhancing the structural evaluation of buildings, the focus of this research lies in employing nondestructive sensors for SHM with the objective to advance in the understanding and assessment of facade conditions. The paper outlines the methodologies employed, starting with a modal analysis to define the structural vibration's modal frequency. Subsequently, tests were defined and executed to validate building envelope compliance in case of stress typical of high-rise building. Throughout these tests, continuous monitoring of the façade was conducted using both conventional (accelerometers, extensimeter washers) and non-conventional sensors (Fiber Optic Sensing) The gathered data underwent thorough processing and analysis to provide an overall perspective on the structure's behavior during the stress test. The investigation aimed to identify whether specific physical phenomena correlate with distinct signals and to evaluate if continuous façade monitoring over the building's lifespan aids in preventing potential structural damage. Moreover, two modal analyses were conducted to compare final data and frequencies with earlier data, enabling the detection of any structural alterations. The results from compliance testing and structural analysis yielded noteworthy insights contributing to the evolving field of structural health monitoring, offering valuable findings that advance our ability to proactively manage and maintain the integrity of building structures.

An increasing global aridification due to climate change has made the health monitoring of vegetation indispensable to maintaining the food supply chain. Cost-effective and smart irrigation systems are required not only to ensure the efficient distribution of water, but also to track the moisture of plant leaves, which is an important marker of the overall health of the plant. This paper presents a novel electromagnetic method to monitor the water content (WC) and characterization in plant leaves utilizing the absorption spectra of water molecules in the terahertz (THz) frequency for four consecutive days. We extracted the material properties of leaves of eight types of pot herbs from the scattering parameters, measured using a material characterization kit in the frequency range of 0.75 to 1.1 THz. From the computed permittivity, it is deduced that the leaf specimens increasingly become transparent to the THz waves as they dry out with the passage of days. Moreover, the loss in weight and thickness of leaves were observed due to the natural evaporation of leaf moisture cells and change occurred in the morphology of fresh and water-stressed leaves. It is also illustrated that loss observed in WC on day 1 was in the range of 5\% to 22\%, and increased from 83.12\% to 99.33\% on day 4. Furthermore, we observed an exponential decaying trend in the peaks of the real part of the permittivity from day 1 to 4, which was reminiscent of the trend observed in the weight of all leaves. Thus, results in paper demonstrated that timely detection of water stress in leaves can help to take proactive action in relation to plants health monitoring, and for precision agriculture applications, which is of high importance to improve the overall productivity.

Objective: ISPOR is the leading professional society for health economics and outcomes research (HEOR) globally. Recently, it launched its Women in HEOR Initiative, that aims to serve as a catalyst for women’s leadership in the field. Therefore, we were interested to find out how well ISPOR itself is doing in terms of gender diversity at their biggest conference. Methods: We used the conference programmes of ISPOR Europe conferences in 2016, 2017 and 2018 to assess the gender distribution of speakers that participated in issue panels and plenary sessions in these years. Results: 70% of all speakers (N=346) at 85 issue panels and plenary sessions during 2016, 2017, and 2018 were male. Almost one in three panels was all-male (a ‘manel’) and 64% of all panels had mostly male speakers (>50%). In contrast, only 11% of panels had <50% female speakers. Conclusion: Despite laudable effort to support the growth, development and contribution of women in HEOR through its Women in HEOR Initiative, females appear to be severely underrepresented at ISPOR’s biggest conference. ISPOR should make gender diversity a formal requirement for issue panel abstract submissions if it wants to advance women’s leadership in HEOR.

The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring SARS-CoV-2 prevalence in a city in Northern Italy from October 2021 to May 2023. Starting from a widely applied deterministic model, this study proposed a variation to take into account population characteristics and virus biodegradation in the sewer network. The model calculated virus loads and corresponding COVID-19 cases over time in different areas of the city and was validated with healthcare data while considering viral mutations, vaccinations, and testing variability. The correlation between the predicted and reported cases was high across the three waves that occurred in the considered period, demonstrating the model’s capacity to predict relevant fluctuations in the number of cases. Population characteristics did not substantially influence the predicted and reported infection rates. Conversely, biodegradation significantly reduced the virus load reaching the wastewater treatment plant, resulting in a 30% reduction in the total virus load produced in the study area. This approach can be applied for comparing virus load values across cities with varying population demographics and sewer network structures, enhancing the comparability of WBE data for effective surveillance and intervention strategies.

Introduction: In recent decades, health literacy, in connection with a broad range of public 1 health terms, has become a burgeoning field. This study aims to explore trends and biases in this 2 area through a bibliometric analysis. Methods: A Random Forest Model was utilized to identify 3 keywords and other metadata that predict annual citations in the field. In order to supplement 4 this machine learning analysis, we have also implemented a bibliometric review of the corpus. 5 Results: Findings indicate a high positive coefficient for the keyword ’Covid-19’ and ’Male’, whereas a 6 negative coefficient was observed for ’Female’, suggesting potential biases. Evolving themes such as 7 Covid-19, Mental Health, and Social Media were discovered. A significant shift was noted in the main 8 publishing journals, while the major contributing authors remained the same. Discussion: The results 9 hint at the influence of the Covid-19 pandemic and potential gender biases on citation likelihood, as 10 well as changing publication strategies despite the fact that the main researchers remain as the ones 11 that have been studying health literacy since its creation.

Objective: The aim of this review was to identify newly discovered bacteria from individuals with periodontal/peri-implant diseases and organize them in new clusters (GF-MoR complexes) to update Socransky’s complexes (1998). Methods: The focus question was developed based on the PCC (Population, Concept, Context) strategy: “In patients with periodontal and/or peri-implant disease, what bacteria (microorganisms) were detected through laboratory assays?” The search strategy was applied to PubMed/MEDLINE, PubMed Central, and Embase. The search keyterms, combined with Boolean markers, were: (1) bacteria, (2) microbiome, (3) microorganisms, (4) biofilm, (5) niche, (6) native bacteria, (7) gingivitis), (8) periodontitis, (9) peri-implant mucositis, and (10) peri-implantitis. The search was restricted to 1998–2024 and English language. The bacteria groups in the oral cavity obtained/found were retrieved and were included in the GF-MoR complexes which were based on the disease/condition, presenting six groups: (1) Health, (2) Gingivitis, (3) Peri-implant mucositis, (4) Periodontitis, (5) Peri-implantitis, and (6) Necrotizing and Molar-Incisor (M-O) pattern Periodontitis. The percentual found per group refers to the number of times a specific bacterium was found associated with a particular disease. Results: A total of 381 articles were found; 162 articles were eligible for full-text reading (k=0.92); 9 articles were excluded with justification, and 153 were included in this review (k=0.98). Most of the studies reported results for Health condition, Periodontitis, and Peri-implantitis (3 out of 6 GF-MoR clusters), limiting the number of bacteria found in the other groups. Therefore, it is essential to understand that bacterial colonization is a dynamic process, and the bacteria present in one group can also be present in other one or others, such as observed with the bacteria found in all groups (Porphyromonas gingivalis, Tannarela forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans) (GF-MoR’s red Triangle); the second most observed bacteria were grouped at GF-MoR’s blue Triangle: Porphyromonas spp., Prevotela spp., and Treponema spp., present in 5 of the six groups; and the third most detected bacteria were clustered in the grey Polygon (GF-MoR’s grey Polygon): Fusobacterium nucleatum, Prevotella intermedia, Campylobacter rectus, and Eikenella corrodens. These three geometric shapes had the most relevant bacteria for periodontal and peri-implant diseases. Specifically, per group, GF-MoR’s Health had 58 species; GF-MoR’s Gingivitis presented 16 bacteria; the GF-MoR’s Peri-implant mucositis included 17 bacteria; GF-MoR’s Periodontitis group had 101 different bacteria; GF-MoR’s Peri-implantitis presented 61 bacteria; and the last group was a combination of Necrotizing diseases and Molar-Incisor (M-I) pattern Periodontitis, with seven bacteria. Observing the top seven bacteria of all groups, all were gram-negative; Groups 4 and 5 (Periodontitis and Peri-implantitis) presented the same top seven bacteria. Conclusion: For the first time in the literature, GF-MoR’s complexes are presented, gathering the bacteria according to the condition found and including more bacteria than Socransky’s complexes. On this understanding, this study can drive future research into treatment options for periodontal and peri-implant diseases, guiding future studies and collaborating to prevent and worsen systemic conditions. Moreover, it permits the debate about the evolution of the bacterial clusters correlated to periodontal and peri-implant diseases and conditions.

The study investigated determinants of open defecation among rural women in Ghana. The study extracted data from the female’s file of the 2003, 2008 and 2014 Ghana Demographic and Health Survey (GDHS). A total of 4,284 pooled sample size of rural women aged 15-49 with complete information about the variables analyzed in the study. The outcome variable was “open defecation” (i.e., defecating in an open space rather than a toilet facility) whilst fourteen (14) key explanatory variables were used. Two regression models were built, and output reported in odds ratio. Descriptively, 42 in every 100 women aged 15-49 practised open defecation (n=1811, 95’CI=49-52). Open defecation significantly correlated with educational attainment, wealth status, religion, access to mass media, partner's education, and zone of residence. The likelihood to practice open defecation reduced among those with formal education [aOR=0.69, CI=0.56-0.85], those whose partners had formal education [aOR=0.64, CI=0.52-0.80], women in the rich wealth quintile [aOR=0.12, CI=0.07-0.20], the traditionalist [aOR=0.33, CI=0.19-0.57], and those who had access to mass media [aOR=0.70, CI=0.57-0.85]. Residents in the Savannah zone were over 21-fold higher to defecate openly [aOR=21.06, CI=15.97-27.77]. The prevalence of open defecation is disproportionately pro-poor indicating that impoverished rural women are more likely to perform it.

Reliable access to electricity has become a necessity worldwide, and without it, no country can operate health systems and achieve sustainable development goals (SDGs). However, while developed countries have been successfully electrified for many decades, most developing countries have fallen short, contributing to significant impacts, particularly the health sector. The present study explores the relationship between electrification and health vulnerability in developing countries between 1990 and 2020 using the Feasible Generalized Least Square (FGLS) approach. The varied electrification across countries motivates the use of non-linear associations between electrification and health vulnerability. We demonstrate that electrification and health vulnerability have an inverted U-shaped association. Further analysis indicates that most developing countries have achieved a mature level of an inverted U-shaped curve, showing a reduction in health vulnerability with increasing electrification. There are few developing countries, mainly African countries, struggling to reach maturity. The results of this study indicate the need for increased access to electrification, in combination with a reduction in the use of biomass and fossil fuel feedstocks, to mitigate health vulnerability in developing countries.

Context: The global escalation of conflict, violence, and human rights violations sets a pressing backdrop for examining the resilience of forcibly displaced youth (FDY) in Canada. This study aims to unpack the multifaceted challenges and resilience mechanisms of FDY, focusing on their health, well-being, and integration into host communities. It seeks to identify current models of resilience, understand the factors within each model, and highlight gaps and limitations. Methodology: Using a university librarian-supported structured search strategy, this exploratory rapid review searched literature from Ovid Medline and Open Source databases, published in English between January 2019 and January 2024, that fit specific inclusion criteria. The eligible articles (N=12 out of 4,096) were charted and analyzed by two student researchers with the PI. Charted data were analyzed thematically. Results: The selected studies captured diverse geographical perspectives, resilience models (such as Ungar's ecological perspective and Masten's resilience developmental models), as well as protective and promotive frameworks. Key findings indicate the complexity of resilience influenced by individual, familial, societal, and cultural factors. Each model offers insights into the dynamic interplay of these influences on FDY's resilience. However, these models often fall short of addressing the nuances of cultural specificity, the impact of trauma, and the intersectionality of FDY's identities. Conclusion: Recognizing the diverse and evolving nature of FDY's coping mechanisms, this study advocates for a culturally appropriate approach to resilience that integrates an intersectionality framework of individual attributes and culturally sensitive models.

Neovascular age-related macular degeneration (nAMD) leads to visual impairment if not treated timely. Intravitreal anti-VEGF drugs have revolutionized nAMD treatment in two decades. We evaluated visual outcomes of anti-VEGF treatment in nAMD. A real-life population-based cohort study. Data included parameters for age, sex, age at the diagnosis, laterality, chronicity, symptoms, visual outcomes, lens status, and history of intravitreal injections. A total of 1088 eyes (827 patients) with nAMD were included. Visual acuity was stable or improved in 984 eyes (90%) after an average 36±25 months follow-up. Bevacitzumab was the first-line drug in 1083 (99.5%) eyes. Vision improved ≥15 ETDRS letters in 377 (35%), > 5 ETDRS letters in 309 (28%) and was stable (±5 ETDRS letters) in 298 (27%) eyes after anti-VEGF treatment. The loss of 5-<15 ETDRS letters in 44 (4%) and ≥15 ETDRS letters in 60 (6%) eyes was noted. At the diagnosis of nAMD, 110 out of 827 patients (13%) fulfilled the criteria of visual impairment, whereas 179 patients (22%) were visually impaired after the follow-up. Improvement or stabilization in vision was noted in 90% of the anti-VEGF-treated eyes with nAMD. In addition, anti-VEGF agents are crucial in diminishing nAMD-related visual impairment.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

BACKGROUND: Social determinants of health are conditions in the environments that significantly influence the health of individuals and communities. Various factors like income, socio-economic status, stress, customs, culture, healthcare services largely affect the health status of individuals and communities. OBJECTIVE: This study was carried out to identify the factors responsible for the social determinants of health among residents of Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria. METHODOLOGY: A descriptive cross – sectional study was utilized, and multi-stage random sampling method was employed in selecting 60 households of Buari Ishola Isibo in Ede North Local Government Area, Osun State, Nigeria. Questionnaire was used for data collection and data was analyzed using SPSS version 21. RESULTS: The respondents’ ages were between 15 – 60 years and above. 29 (48.3%) were between 31 – 60 years old, 31 (52.0%) were males, 40 (66.7%) were married, 57 (95.0%) were Islam and Yoruba. 29 (48.3%) earned 10,000 – 30,000 monthly, 23 (38.3%) had secondary school education, 39 (65.0%) were traders and 27 (45.0%) have 6 – 10 households respectively. Of the 60 respondents, 34 (56.7%) visit government health facility when they are sick, 21 (35.0%) make use of hand dug well in their compound as the source of their water supply, 27 (45.0%) uses flush water closet toilet as the means of disposing off their excreta, 36 (60.0%) lives in concrete with zinc roof house, 27 (45.0%) have between 6 – 10 rooms in their house, 55 (91.7%) sleep in a room and 21 (35.0%) make use of charcoal as source of fuel for their cooking. CONCLUSION: Poverty or lower income affects the health of individuals through a person’s health throughout their life span. Issues that affect social determinants of health of individuals and community in a negative way should be accosted with all seriousness.

Keywords: Marine Coasts; Protected Areas; Defense and Conservation; Asbestos Cement Materials; Wastes; Contamination; Human Health Risk; Medical Geology.

Chemo-resistance is a substantial challenge in the realm of cancer treatment that requires exploring new therapeutic approaches for effective mitigation. Achieving this goal requires examination of the molecular mechanisms involved in both tumor growth and therapeutic interventions. The potential of NRF2 (Nuclear factor E2-related factor 2) in addressing resistance to chemotherapy across diverse cancer types highlights its value as a promising therapeutic approach based on cancer characteristics. Manipulating the NRF2 signaling pathway has a dual impact, offering promise for both preventing and treating cancer, as well as inhibiting carcinogenesis. The influence of the NRF2/KEAP1 pathway on the progression of tumor formation and resistance to drugs has been well-documented. The interplay between the NRF2 signaling pathway and processes such as endoplasmic reticulum (ER) stress, unfolded protein response (UPR), and autophagy plays a crucial protective role. A deeper understanding of NRF2's role in the modulating these pathways is necessary to develop novel approaches for improving chemotherapeutic efficacy. This article discusses the significance of the NRF2-KEAP1 pathway in preventing/promoting cancer and resistance mechanisms to various chemotherapeutic agents, with a focus on the complementary effects of antioxidants via NRF2-mediated signaling pathways. This study aims to provide a molecular basis for targeting NRF2 via inhibitors/activators as promising therapeutic strategies to overcome chemo-resistance.

Perfect cardiovascular health (CVH) has been defined by the American Heart Association as the lack of cardiovascular disease and the presence of seven key factors and health behaviors. In this study, we aimed to estimate the prevalence of ideal and poor CVH among the Polish adult population, taking the chosen socio-demographic factors into consideration. This is a cross-sectional study conducted among 3,901 adults without cardiovascular diseases, aged between 35 and 64 years. Participants completed a questionnaire, and they had anthropometric and physiological measurements taken. Blood samples were analyzed for fasting glucose and cholesterol levels. Ideal CVH was found in 5.4% of the participants, with the advantage of being toward city dwellers over those living in the rural areas (6.3% vs. 5.0%) p = 0.02. In case of the residents of rural areas, their likelihood of having an ideal body mass index (BMI) was found to be 22% lower (odds ratio (OR) = 0.78; 95% CI: 0.66–0.92), their likelihood of having an ideal diet was found to be 27% lower (OR = 0.71; 95% CI: 0.54–0.94), their likelihood of having perfect blood pressure was found to be 29% lower (OR = 0.71; 95% CI: 0.56–0.89), and their likelihood of having the perfect glucose levels were found to be 28% lower (OR = 0.72; 95% CI: 0.63–0.84), than the residents of urban areas. The prevalence of ideal cardiovascular behaviors and factors is lower in the rural community compared with people living in the city. Results indicate that more effort should be dedicated toward the country’s health policy, specifically concerning primary prevention. Preventive actions in the field of cardiovascular disease should be addressed to the residents of rural areas to a larger extent.

Exercise facilitates weight control, partly through effects on appetite regulation. Single bouts of exercise induce a short-term energy deficit without stimulating compensatory effects on appetite, whilst limited evidence suggests that exercise training may modify subjective and homeostatic mediators of appetite in directions associated with enhanced meal-induced satiety. However, large variability in responses exists between individuals. This article reviews the evidence relating to how adiposity, sex and habitual physical activity modulate exercise-induced appetite, energy intake and appetite-related hormone responses. The balance of evidence suggests that adiposity and sex do not modify appetite or energy intake responses to acute or chronic exercise interventions, but individuals with higher habitual physical activity levels may better adjust energy intake in response to energy balance perturbations. The effect of these individual characteristics and behaviours on appetite-related hormone responses to exercise remains equivocal. These findings support the continued promotion of exercise as a strategy for inducing short-term energy deficits irrespective of adiposity and sex, as well as the ability of exercise to positively influence energy balance over the longer term. Future well-controlled studies are required to further ascertain potential mediators of appetite responses to exercise.

In a dynamic production processes, mechanical degradation poses a significant challenge, impacting product quality and process efficiency. This paper explores a novel approach for monitoring degradation in the context of viscose fiber production, a highly dynamic manufacturing process. Using causal discovery techniques, our method allows domain experts to incorporate background knowledge into the creation of causal graphs. Further, it enhances the interpretability and increases the ability to identify potential problems via changes in causal relations over time. The case study employs a comprehensive analysis of the viscose fiber production process within a prominent textile industry, emphasizing the advantages of causal discovery for monitoring degradation. The results are compared with state-of-the-art methods, which are not considered to be interpretable, specifically LSTM-based autoencoders, showcasing the alignment and validation of our approach. This paper provides valuable information on degradation monitoring strategies, demonstrating the efficacy of causal discovery in dynamic manufacturing environments. The findings contribute to the evolving landscape of process optimization and quality control.

In this work, we analysed human isolates of nontyphoidal Salmonella enterica subsp. enterica (NTS), which were collected from salmonellosis cases in Armenia from 1996 to 2019. This disease became a leading food-borne bacterial infection in the region, with the younger age groups especially affected. The isolates were characterised by serotyping, Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR) typing, and whole genome sequencing (WGS). The main serotypes were S. Typhimurium, S. Enteritidis, and S. Arizonae. ERIC-PCR indicated a high degree of clonality among S. Typhimurium strains, which were also multidrug-resistant and produced extended spectrum beta-lactamases. During the study period, the frequency of S. Typhimurium and S. Arizonae isolations were decreasing, but with the increase of S. Enteritidis and other NTS. A total of 42 NTS isolates were subjected to WGS and explored for virulence-related traits and the corresponding genetic elements. Some virulence and genetic factors were shared by all NTS serotypes, while the main differences were attributed to the serotype-specific diversity of virulence genes, SPIs, virulence plasmids, and phages. The results indicated the variability and dynamics in the epidemiology of salmonellosis and a high virulence potential of human NTS isolates circulating in the region.

Background: Patients’ effective hand hygiene helps to reduce healthcare-associated infections, prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. This study aimed to describe effective hand hygiene decisions based on the Health Action Process Ap-proach (HAPA) and whether this pattern is invariant for mental health. Methods: Data were collected cross-sectionally from patients who had previously been admitted to a hospital (N=279; study 1) and longitudinally from psychosomatic rehabilitation patients (N=1,073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding com-pliance, as well as social-cognitive variables of the HAPA, and mental health status were examined. Results: The trimmed HAPA framework fitted the data well (χ2=27.1, df=12, p<.01, CMIN/df=2.26, CFI=.97, RMSEA=.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior were found to be invariant with regard to mental health. Conclusion: The trimmed HAPA framework revealed to be a generic framework in explaining so-cial-cognitive processes relating to hand hygiene decisions. Helping individuals to perform hand hygiene recommendation requires intention formation and bridging the intention-behavior gap. This can be done by promoting planning and self-efficacy. All processes appear generic to partic-ipants with and without mental health challenges.

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

Monkeypox, once a rare zoonotic disease, was endemic to some African countries since its original identification among humans in 1970. Since then, cases in non endemic regions were linked to returning travelers or those who had contact with transported animals. The causative agent, Monkeypox virus, belongs to Orthopoxviruses, the same family as Variola; the causative organism for smallpox. Although most Monkeypox outbreaks until recently were linked to zoonotic transmission, secondary human-human transmission in smallpox unvaccinated individuals was observed in a small proportion of overall cases. Smallpox was declared eradicated in 1980 and since its eradication, monkeypox virus is the most significant poxvirus to cause human disease. The 2022 monkeypox outbreak marks a significant paradigm shift in the human and poxvirus association, with new modes of transmission, concerns of viral evolution and entrenchment as a sexually transmitted disease. Monkeypox clinically resembles smallpox but is far milder. At this time there are no approved therapies for monkeypox and antiviral agents effective against smallpox are being utilized. Additionally, preventive strategies being utilized include smallpox vaccination like JYNNEOS and ACAM2000. In this narrative review, we discuss the virology, epidemiology, transmission, clinical manifestations, diagnosis, management and prevention strategies associated with monkeypox.

This paper presents an on-device semi-supervised human activity detection system that can learn and predict human activity patterns in real time. The proposed semi-supervised learning (SSL) framework uses sparsely labelled user activity events acquired from Inertial Measurement Unit (IMU) sensors installed as wearable device. The objective is to learn classification of multiple classes of human activities in real-time. The proposed cluster-based learning model in this approach is trained with data from the same target user, thus preserving data privacy while providing personalized activity detection services. Two different cluster labelling strategies, namely, population-based, and distance-based, are employed to achieve the desired classification performance. A comparative study of these strategies has been presented in terms of classifiability and classification accuracies. The proposed system is shown to be computationally efficient, which is relevant in the context of limited computing resources on typical wearable devices. The trade-off between classification accuracy and computation complexity is analyzed for different algorithmic hyper-parameters and other system parameters. Extensive experimentation and simulation study have been conducted on a multi-user human activity data from the public do-main in order to validate the proposed learning paradigm.

Regulation (EU) 2016/429 establishes new extensive guidelines for managing transmissible animal diseases, including zoonoses. The Commission Implementing Regulation 2018/1882 classifies diseases into five categories based on their prevalence and the required response, ranging from eradication to surveillance. Key aspects of the regulations concern emphasis on animal traceability, biosecurity, wildlife pathogen control, sustainable farming, and the reduction of the impact of diseases on both public and animal health, as well as on the environment. These align with the European Green Deal, the Farm to Fork Strategy and the One Health approach. In Italian inner areas—similarly to other European regions that are fragile, remote from major service centers, and often neglected—agropastoral and agri-food activities are beneficial for tourism, commercialization of typical foods, and recreational activities. In these areas including the Molise Region, the activation of optional programmes within the framework of the aforementioned regulations could help control infectious animal diseases that are not subject to mandatory eradication but cause income loss and trade restrictions, such as infectious bovine rhinotracheitis and paratuberculosis, a suspected zoonosis potentially linked to Crohn's disease in humans. These programmes could boost the economic income of local extensive breeding, counteract depopulation, and protect human and animal health.

Digital weight-loss services (DWLSs) that supplement continuous lifestyle coaching with Semaglutide therapy have shown promise in delivering continuous and effective obesity care. However, the extent to which lifestyle coaching approach and Semaglutide brand influences patient engagement and program effectiveness is unknown. This study retrospectively analyzed several engagement markers and weight loss percentage over 16 weeks in a large Semaglutide-supported DWLS in the UK. The comparative analysis found that patients who received lifestyle coaching that was proactive and personalized sent a statistically higher number of messages to their health coach (M=19.37 vs M=8.55) and opened the program app more frequently (M = 49.31 days vs M = 40.06 days) than patients whose coaching was reactive and standardized. Mean 16-week weight-loss was 10.1% in the proactive group compared to 8.9% in the reactive group, but the difference was not statistically significant. A two-sample t-test found that female patients (M = 9.76) tended to lose more weight than male patients (M = 6.88), (t(152) = 1.89 , p = 0.04). The findings add vital layers of nuance to the emerging literature on Semaglutide-supported DWLSs, indicating that a proactive, personalized coaching approach leads to better patient engagement with DWLS health coaches and that Wegovy has a comparable effect to Ozempic as a supplement to DWLS coaching. Future research should seek to conduct comparable investigations of other obesity services and over a longer period.

Forestry workers play a crucial role in implementing forest management programs, but their outdoor work exposes them to rising temperatures caused by global climate change, which poses potential health risks related to heat. This study focuses on Indonesian forestry workers and examines the relationship between their knowledge of heat-related issues, risk perception, and precautionary behavior in dealing with increasing workplace heat exposure. Developing effective precautionary behavior is essential for preventing heat-related health disorders and promoting health protection programs. To facilitate a comprehensive comparison of the three variables, interviews were conducted with two groups of outdoor workers, comprising 210 forestry workers and 215 paddy farmers. The findings indicate that increasing knowledge about heat-related issues promotes precautionary behavior, and risk perception acts as a mediator between knowledge and behavior. Additionally, the study highlights that the emotion of "dread" intensifies perceived risk and predicts positive behavior change. To enhance heat-related knowledge, exploring the potential use of a "fear" tone is important. In conclusion, comprehensive strategies need to be implemented to promote precautionary behavior among vulnerable forestry workers, particularly manual laborers.

Monitoring the integrity of aeronautical structures is fundamental for safety. Structural Health Monitoring Systems (SHMS) perform real-time monitoring functions, but their performances must be carefully assessed. In this work the damage detection performances of a strain-based SHMS, were evaluated on a composite helicopter rotor blade root. The SHMS monitored the bonding between the central core and the surrounding antitorsional layer. A damage detection algorithm was trained through Finite Element analyses performed on the component. The effects of the loads variability and of damages were decoupled by including a load recognition step in the algorithm. Load recognition was accomplished in different ways: version#1 adopted an Artificial Neural Network (ANN) trained on blades in pristine condition; version#2 was trained also on damaged blades; version#3 adopted a calibration matrix method. Anomaly detection, damage assessment, and localization were performed by using an ANN. Results showed a higher load identification and anomaly detection accuracy for version#1 and version#2 compared to version#3. Gaussian noise reduced anomaly detection and damage assessment performances, and reduced damage localization accuracy for bigger damages. The damage detection performance were obtained for a fibre optic based-SHMS, including the trade-off between probability of detection and false alarm rate for different damage sizes.

In the whole world, including Mexico, the rising prevalence of diabetes poses significant challenges to healthcare systems, with a notable impact on hospital admissions even being an ambulatory care sensitive condition, that means, hospital admissions are avoidable. Traditional healthcare methodologies have been instrumental in managing diabetes and preventing complications, yet they often face limitations such as merging, cleansing, and outlier analysis of health data to identify and address diseases effectively. This paper aims to address this gap by conducting a comprehensive comparison of the methodologies used in healthcare and data science for this purpose. This work uses hospital diabetes discharge records from 2010 to 2023, a total of 36,665,793 records, which belong to medical units of the Ministry of Health of Mexico. In this work, we seek to provide the arguments why as a data scientist it is mandatory to learn the field of knowledge of the problem and its implications if this is not done, and therefore to disclose insights that can help in policy decisions and reduce the burden of avoidable hospitalizations. The approach is mainly based on the standardization or adjust rates by sex and age groups. This study provides the foundations for a new way of data scientist must deal with health data.

Cars are a highly inefficient mode of urban transport with significant negative impacts. Electric vehicles make it possible to eliminate direct CO2 emissions (though the total over a vehicle’s entire life cycle greatly offsets the advantages) but leave unchanged – or even aggravate – all the other negative effects on the quality of urban environments. Three visions for urban transport were presented: automobility, multimodality and accessibility. The first dominates North American cities, the second European one. The anomalies of these two visions have been examined. The automobility cities cannot manage the congestion and the attempts are self- defeating. The anomalies of multimodality city are related to the public space consumption for mobility and the impossibility to plan spatial proximity. The sustainable vision, that resolve the anomalies, is represented by the accessibility city in the Triple Access System (TAS) version which, however, still has a long way to go to be accepted and implemented.

(1) Background: Pedestrian injuries (PIs) represent a significant proportion of road traffic injuries. We aimed at investigating the incidence and mortality of PIs in different age groups and Socio-demographic Index (SDI) categories between 1990 and 2017. (2) Method: Estimates of age-standardized incidence and mortality along with trends of PIs by SDI levels were obtained from the Global Burden of Disease from 1990 to 2017. We also calculated forecasts until 2040. (3) Results: Globally, PIs incidence increased by 3.31% (–9.94 to 16.56) in 2017 compared to 1990. Men have a higher incidence of PIs than women. Forecasted incidence was 132.02 (127.37 to 136.66) per 100,000 population in 2020, 101.52 (65.99 to 137.05) in 2030 and reduced further to 71.02 (10.62 to 152.65) by 2040. Globally across all SDI categories, there was a decreasing trend in mortality due to PIs with the global estimated percentage reduction of 37.12% (–45.19 to –29.04). (4) Conclusions: The results show that PIs are still a burden for all SDI categories despite some variation. Although incidence and mortality are expected to decrease globally, some SDI categories may require particular attention in addition to specific vulnerable age groups. Further studies addressing incidence and mortality patterns in vulnerable SDI categories are needed.

Background: Pet ownership is a common wellbeing enhancing practice globally, offering com-panionship and emotional support. However, it also entails financial responsibilities that can pose challenges and have negative wellbeing impacts for both human and animal. Aims/Purpose: This study aimed to explore pet owners' the financial aspects of pet ownership in New Zealand, including the importance of pet insurance, the impact of veterinary costs, and the ethical considerations of owning a pet. Understanding these aspects of pet ownership is crucial for promoting responsible pet ownership and ensuring animal welfare. Study Designs: Data was collected through a nationwide online survey conducted in 2019 as part of the Furry Whānau Wellbeing research project. The survey included questions about the financial aspects of pet ownership, and respondents were asked to indicate their level of agreement with various statements. Findings: The study found that the cost of veterinary care is a significant concern for many pet owners, with 83.9% of respondents agreeing that expense is a factor in the level of healthcare their pets receive. While pet insurance can mitigate financial burdens, only a third of respondents considered it essential due to high costs and exclusions. The study also revealed disparities for rural and low-income households. Conclusions: The financial aspects of pet ownership present a complex challenge, impacting both pet and owner wellbeing. This research highlights the need for comprehensive strategies to promote sustainable and equitable pet ownership, including improving access to affordable vet-erinary care, enhancing financial literacy among pet owners, and providing support systems for those facing economic hardship.

In Spain, the National Health System, of a public nature, provides care to Spaniards and other residents in Spain. It is a system adapted to the State of Autonomies, decentralized. Each Auton-omous Community has legislative capacity in its organization and management. We studied the agreement of private hospitals by the public system in La Rioja, an Autonomous Community of Spain located in the North of the Iberian Peninsula. Documentary sources from the General archives of La Rioja, the Institute of Riojan Studies, municipal funds (Logroño, Haro, Calahorra), and in-formation from catalogs and censuses of hospitals from the Ministry of Health, National Institute of Statistics, and Institute of Statistics of La Rioja have been reviewed. The hospital model of La Rioja is characterized by a predominance of public beds over private ones, although there is a growing trend in the number of private beds from 2013 onwards, due to the incorporation of two conva-lescent socio-health hospitals. A characteristic element of La Rioja has been the promotion of pub-lic-private collaboration, conceived as a strategic alliance. Regarding agreements, in La Rioja there has been a specialization in the socio-health space, whose formulas have been the management service contract and the concession of work. The development of the Health System in La Rioja, 1986-2019, has been determined by the presence of a mixed public-private hospital system and a progressively lower dependence on specialized hospitals from other Autonomous Communities.

Medical records contain many terms which are difficult to process. Our aim in this study is to allow the visual exploration of the information in medical databases where the texts presents a large number of syntactic variations and abbreviations, through an interface which facilitates content identification, navigation and information retrieval. We propose the use of multi-term tag clouds as content representation tools and as assistants for the browsing and querying tasks. The tag cloud generation is achieved through a novelty mathematical method that allows related terms to remain grouped together within the tags To evaluate this proposal, we have used a database with 24,481 records. 23 expert users in the medical field were tasked to complete a survey to evaluate the generated tag clouds properties and we obtained a precision of 0.990, a recall of 0.870 and a F1score of 0.904 in the evaluation of the tag cloud as an information retrieval tool. The main contribution of this approach is that we automatically generate a visual interface over the text capable of capturing the semantics of the information and facilitating access to medical records.

The West Pomeranian Anti-Crisis Package was an effective tool of the Voivodeship Executive Board of West Pomeranian self-government, which was used to combat and counteract and counteract the social and economic effects of the COVID-19 pandemic. The Anti-Crisis Package was prepared with a view to undertaking systemic, but also point-based measures in order to save and protect regional health care, entrepreneurs, the labour market, but also to use the existing social capital of non-governmental organizations involved in measures reducing the effects of the COVID-19 pandemic. The West Pomeranian Anti-Crisis Package, as evidenced not only by the financial outlays incurred, but also by the outcome of implementing measures achieved in 2020 and their continuation in 2021.

Human resources management (HRM) development aims at career sustainability. Work-related flow, as originated and defined by Csikszentmihalyi, is a process experienced by those optimally challenged by their work, considered the optimal work-related experience. Happiness is a judgment-dependent state of a pleased satisfaction with one’s current experience that one hopes will continue. PERMA (Positive Emotions, Engagement, Relationships, Meaning, and Accomplishment) represents five measurable factors of positive psychology that constitute well-being. As the optimal work-related experience, flow determines career sustainability compared with either happiness or PERMA factors. HRM development programs focused on happiness or PERMA factors thus represents risk factors regarding an inability to develop career sustainability. Established from this publisher’s founding ongoing concern with sustainability, articles published in MDPI journals with the keywords “flow, Csikszentmihalyi, work” were searched, excluding those pertaining to education, health, leisure, marketing, non-workers, and spirituality. Of 628 results returned, 28 reports were included for potential assessment. Although current studies on flow represented only three, the results regarding flow position it as the best indicator of career sustainability, contrasted to either happiness or PERMA. Consequently, HRM is advised to concentrate on developing practices for assessing and encouraging employees’ engagement with work-related flow in its aim of career sustainability.

Pathologic angiogenesis is responsible for much of the vision loss that stems from several chorioretinal vascular diseases including neovascular age-related macular degeneration (nAMD), diabetic retinopathy (DR), and retinal vein occlusion (RVO). Because vascular endothelial growth factor (VEGF) serves as a pivotal angiogenic molecule, it has emerged as the primary target for therapeutic drugs. Current anti-VEGF therapy is dominated by bevacizumab, ranibizumab, and aflibercept, all of which have been available for more than a decade, but new drugs, both biosimilars (Byooviz and Cimerli) and drugs whose primary aim is to decrease treatment burden (brolucizumab, faricimab, and the ranibizumab port delivery system), have been approved. Recent failures (conbercept, abicipar, and KSI-301) emphasize the complexity of drug development and the difficulties faced by innovators. Most therapies under development, including tyrosine kinase inhibitors and gene therapy, include VEGF-A blockade as their primary function and aim to extend durability rather than increase peak efficacy. But even as many new drugs look to extend durability, cost containment with mandated use of biosimilars serves to balance the therapeutic landscape.

Pancreatic ductal adenocarcinoma (PDAC) a highly malignant neoplasm, is classified as one of the most severe and devastating types of cancer. PDAC is a notable malignancy that exhibits a discouraging prognosis and a rising occurrence. The interplay between diabetes and pancreatic cancer exhibits a reciprocal causation. The identified metabolic disorder has been observed to possess noteworthy consequences on health outcomes, resulting in elevated rates of morbidity. The principal mechanisms involve the suppression of the immune system, the activation of pancreatic stellate cells (PSCs), and the onset of systemic metabolic disease caused by dysfunction of the islets. From this point forward, it is important to recognize that pancreatic cancer-related diabetes (PCRD) has the ability to increase the likelihood of developing pancreatic cancer. This highlights the complex relationship that exists between these two physiological states. Therefore, we investigate into the complex domain of PSCs, elucidating their intricate signaling pathways and the profound influence of chemokines on their behavior and final outcome. In order to surmount the obstacle of drug resistance and eliminate PDAC, researchers have undertaken extensive efforts to explore and cultivate novel natural compounds of the next generation. Additional investigation is necessary in order to comprehensively comprehend the effect of PCRD-mediated apoptosis on the progression and onset of PDAC through the utilization of natural compound. This study aims to examine the potential anticancer properties of natural compound in individuals with diabetes who are undergoing chemotherapy, targeted therapy, or immunotherapy. It is anticipated that these compounds will exhibit increased potency and possess enhanced pharmacological benefits. According to our research findings, it is indicated that naturally derived chemical compounds hold potential in the development of PDAC therapies that are both safe and efficacious.

For earthquakes (M4.0) occurring along and arond the East Anatolian fault zone and the the Dead Sea fault zone between January 2002 and December 2022, we analyzed the correlation between the Earth's rotation and the earthquake occurrence before the Mw7.8 Gaziantep,Turkey earthquake occurring on 6 February 2023. We statistically evaluate the Earth's rotationally dependent seismicity. The results were judged by the P-value. There was a clear downward trend in the P-values from early 2020 to late 2022 in the study region. Starting in early 2021, the P-value drops below 0.1%, corresponding significant correlation between the Earth's rotation and the earthquake occurrence . We also calculated the spatial distribution of the P-values and obtained a result showing a low P-value area in the vicinity of the northeastern end of the aftershock zone. Although the stress caused by the Earth's rotation is very weak, when the focal medium is loaded to the critical state to release a large earthquake, the stress due to the Earth's rotation could control the earthauqke occurrence. Therefore, the lower P-values obtained in this study indicates the Earth's rotation-related seismicity prior to the Mw 7.8 Turkey earthquake and could be considered as its precursor.

Background: Cancer-related cognitive impairment (CRCI) is one of the most serious side effects of cancer that negatively impact the quality of life of cancer patients and survivors. There is evidence of CRCI in Hodgkin lymphoma patients (HL); however, there is a lack of studies examining the presence of cognitive deficits before starting any treatment in HL patients. Methods: Forty patients (N=40) newly diagnosed with HL (with no previous cancer diagnoses) and 40 healthy controls (N=40) matched for age, sex, education, and premorbid intellect completed the neuropsychological battery and subjective and objective measures of affective distress and quality of life. Results: The results showed impairment in three out of six cognitive domains: verbal memory and learning, speed of processing/ psychomotor speed, and abstraction/executive functions in the HL patients before the initiation of any treatment. Speed of processing/psychomotor speed domain negatively correlated with depression. Conclusion: Impairment in verbal memory and learning and abstraction/executive functions domains in HL patients seems to occur before the initiation of treatment independently of anxiety, depression, or physical symptoms. This suggests that HL itself may cause cognitive deficits in these cognitive domains. However, the underlying causes of CRCI still remain unclear.

Some studies show that patients with mutations in the SNCA gene, which codifies for the alpha-synuclein protein, show a particular phenotype. The effects of SNCA Single Nucleotide Polymorphism (SNPs) in recently diagnosed, drug-naïve patients with PD have been less explored. Therefore, we set out to explore the differences in the clinical characteristics of recently diagnosed drug-naïve sporadic PD patients with or without SNCA rs3910105 or rs356181 SNPs. Patients with a clinical diagnosis of PD in the Parkinson’s Progression Markers Initiative (PPMI) database entered the study. We excluded those with missing data, dementia, psychiatric conditions, a diagnosis change over the first five years from the initial PD diagnosis, or with a familial history of PD. Subjects were evaluated with the MDS-Unified PD Rating Scale (MDS-UPDRS), DAT imaging, the Geriatric Depression Scale (GDS), the State-Trait Anxiety Inventory (STAI), the Montreal Cognitive Assessment (MoCA), the SCOPA-AUT for autonomic function, the Epworth Sleepiness Scale (ESS), the RBD Questionnaire, and the University of Pennsylvania Smell Identification Test (UPSIT). We included 308 PD patients fulfilling all inclusion and exclusion criteria. A logistic regression analysis and Machine-Learning models did not disclose any difference between patients either with or without the SNCA rs3910105 SNP or with or without the SNCA rs3910105 polymorphism. Our results suggest that the SNCA polymorphisms rs3910105 and rs356181 have no impact on the phenotype of idiopathic, sporadic, recently diagnosed, drug naïve PD patients.

Erectile dysfunction (ED) is the inability to achieve or maintain an erection during sexual performance. ED is one of the most common and neglected complications of diabetes. Almost 35-75% of diabetic men around the world suffer from ED. Although the exact mechanism by which diabetes causes ED is not well understood. However, several studies suggested it may be related to damage to the nerve and vessels that supply the penis.

Background: The evolution of names, from “medical informatics” to “connected health”, implies that the evolvement of technology in health care has been shifted from technology-oriented to healthcare-oriented implementation. Connected healthcare, a healthcare platform of remote monitoring and self-management through technological measures, is suggested to contribute to the efficiency, cost effectiveness, and satisfaction of healthcare recipient enhancement. However, limited understanding of related connected health (CH) terminology may constrain its implementation. Whether CH is a Buzzword only or a practice that can contribute to an ageing society is controversial. Objective: This study aims to distinguish CH-related terminology and to identify the trend of CH through reviewing its definition, initiation, development, and evolvement, in order to offer management insights and implications. The objective is to understand what is connected and who is cared about in the connected health model, so that better applications can be addressed for the benefit of society. Method: This study reviews the evolution of names, from “medical informatics” in the 1970s to “connected health” after 2000, as well as relevant literature of CH, including e-health, telemedicine, telehealth, telecare, and m-health, to discover the trend of technology-related healthcare implementation. The current status and issues facing CH will be presented and its future trends will be explored through reviewing how changes in healthcare are managed, in addition to its operation and practice. Issues of accessibility, quality, and cost will be discussed, as well as its market status. Results: Preconditions and requirements for implementing CH are identified to select a typical case to study. Areas with a complete business ecosystem, including advanced technology and medical services, a payment system, an ageing population, geographic isolation, integrated health, and social care, are prevalent. These findings may be beneficial to designing and establishing comprehensive CH implantation and environments. Conclusion: The evidence and tendency of technological convergence create a demand for innovation and partnering with start-up companies that offer a competitive advantage in innovation. Specifically, it is necessary to innovate both the public and private operation model of the CH ecosystem. This focus will be further explored in future work.

To understand the health impacts of “hikikomori” lifestyle and to establish its first comprehensive health profile, a cross-sectional study was designed to measure how well the cases of hikikomori youths of Hong Kong were living, in terms of social, mental and physical aspects. This study involved 104 eligible participants at age 19.02 year-old who had completed the set of questionnaires and a series of anthropometric and physical health measurements. Despite SF36 score of 84.0 indicated good physical functioning in general, participants were lived sedentarily with high incidence of hypertension at 15.4% and prehypertension at 31.7%. Occurrence of hypertension in cases living as hikikomori >6 months was 3-times higher than those newly onset cases. The blood pressure levels were correlated with age and all obesity index parameters measured including waist circumference and body mass index. Half of the hypertensive cases involved the elevation of systolic blood pressure, which suggested higher odds of cardiovascular complications. Participants were mentally stable living with moderate levels of perceived stress and state anxiety, but borderline clinical depression. In conclusion, the hikikomori lifestyle could be a risk behavior that may harm the younger generation physically by promoting obesity and hypertension and probably other chronic illnesses.

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

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

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

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

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

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.

Disrupted biological function, manifesting through the hallmarks of aging, poses as one of the largest threats to healthspan and risk of disease development, such as metabolic disorders, cardiovascular ailments, and neurodegeneration. In recent years, numerous geroprotectors, senolytics, and other nutraceuticals have emerged as potential disruptors of aging and may be viable interventions in the immediate state of human longevity science. In this review, we focus on the decrease of nicotinamide adenine dinucleotide (NAD+) with age and the supplementation of NAD+ precursors, such as nicotinamide mononucleotide (NMN) or nicotinamide riboside (NR), in combination with other geroprotective compounds to restore youthful NAD+ levels. Furthermore, these geroprotectors may enhance the efficacy of NMN supplementation while concurrently providing their own numerous health benefits. By analyzing the prevention of NAD+ degradation through inhibition of CD38 or supporting protective downstream agents of SIRT1, we provide a potential framework of the CD38/NAD+/SIRT1 axis through which geroprotectors may enhance the efficacy of NMN supplementation and reduce the risk of age-related diseases, thereby potentiating healthspan in humans.

The rapid development of specific-purpose Large Language Models (LLMs), such as Med-PaLM, MEDITRON-70B, and Med-Gemini, has significantly impacted healthcare, offering unprecedented capabilities in clinical decision support, diagnostics, and personalized health monitoring. This paper reviews the advancements in medicine-specific LLMs, the integration of Retrieval-Augmented Generation (RAG) and prompt engineering, and their applications in improving diagnostic accuracy and educational utility. Despite the potential, these technologies present challenges, including bias, hallucinations, and the need for robust safety protocols. The paper also discusses the regulatory and ethical considerations necessary for integrating these models into mainstream healthcare. By examining current studies and developments, this paper aims to provide a comprehensive overview of the state of LLMs in medicine and highlight the future directions for research and application. The study concludes that while LLMs hold immense potential, their safe and effective integration into clinical practice requires rigorous testing, ongoing evaluation, and continuous collaboration among stakeholders.

Citizens Advice on Prescription (CAP), a Liverpool (UK) based service, provides welfare advice and link worker social prescribing support to people experiencing and at risk of financial or social hardship. CAP, which receives referrals from healthcare and third sector services, aims to improve service users’ financial security, health, and wellbeing. A mixed-method Social Return on Investment (SROI) analysis was used to evaluate the service. Between May 2022 and November 2023, a subset of service users (n=538) completed the Short Warwick-Edinburgh Mental Wellbeing Survey (SWEMWBS) at baseline and 2-month follow-up. Supporting quantitative and qualitative economic data was also collected (Feb 2023 - Feb 2024) through semi-structured interviews (n=16). Social value changes were generated using the change in SWEMWBS scores and social valuations from the Mental Health Social Value Bank (MHSVB). SROI ratios were calculated from change of social value against service provision costs. The mean service provision cost was £148.66 per person. The overall study reported a positive SROI return of £1: £3.40-£4.69. Results indicate that non-clinical support services, like CAP, can be an effective intervention to address the wider determinants of health and wellbeing.

More than twenty-five years ago the Global Solar UV index (UVI) has been introduced as a simple means of visualizing the intensity of ultraviolet radiation and to alert people to the need for sun protection. In our survey among directors of 436 kindergartens in southern Germany we investigated the level of awareness and knowledge about the UVI as well as the practical consequences for sun protection in kindergartens. Less than half of the directors (n=208, 47.7%) had ever heard of the UVI, and only a small minority of them (n=34, 8.7%) used the daily UVI information to adapt sun protective measures in their kindergartens. Detailed knowledge about the UVI was a rarity among the respondents. The proportion of respondents with self-perceived detailed UVI knowledge was five times higher than actual knowledge assessed by an in-depth structured interview using open-ended questions about the UVI (14.2% vs. 2.8%). No clear relationship of UVI awareness, knowledge, and use to directors' age and gender was found. The UVI-related variables also showed no association with directors' knowledge of risk factors for skin cancer and their attitudes towards tanned skin. Overall, the results paint a sobering picture regarding the penetration of the UVI into sun protection policies of German kindergartens. Future public health campaigns should target increasing awareness and understanding of the UVI as well as its importance for sun protection of children.

Functional health literacy is the ability to read, write, and speak about health. Functional health literacy events can nudge the development of children’s health identity when using valid and reliable reading materials that portray the “what, where, when, why, and with whom” to eat nutritious foods and be physically active. Children who lack social role models for healthy eating and physical activity may also lack development in language and motor skills. Therefore, literacy-rich environments are needed when developing cognitive-motor language skills with children. Children with obesogenic body frames can gain from the production of childcentric health narratives that draw upon the Habits of Mind and Habits of Health© Model to produce Electronic Texts for Health Literacy©. When health professionals plan and implement functional health literacy events so children can read, write, and speak about their own health, new behavioral patterns and routines emerge into performances of understanding. Constructivist pedagogical approaches can help children to create health narratives using multimodal language while practicing health literacy skills as a foundational impetus to health behaviors. Children who struggle with obesity can also gain social agency when writing with peer partners who serve as supportive collaborators when developing interactive health literacy.

Violence against paramedics has been described as a ‘serious public health problem’ but one that remains ‘vastly underreported’, owing to an organizational culture that stigmatizes reporting – hindering efforts at risk mitigation in addition to creating a gap in research. Leveraging a novel reporting process developed after extensive stakeholder consultation and embedded within the electronic patient care record, our objective was to provide a descriptive profile of violence against paramedics in a single paramedic service in Ontario, Canada. Between February 1, 2021, through January 31, 2023, a total of 374 paramedics in Peel Region (48% of the workforce) generated 941 violence reports, of which 40% documented physical (n=364) or sexual (n=19) assault. The violence was typically perpetrated by patients (78%) and primarily took place at the scene of the 9-1-1 call (47%); however, violent behavior frequently persisted or recurred while in transit to hospital and after arrival. Collectively, mental health, alcohol, or drug use were listed as contributing circumstances in 83% of violence reports. In all, 81 paramedics were physically harmed because of an assault. On average, our data correspond to a paramedic filing a violence report every 18 hours, being physically assaulted every 46 hours, and injured every 9 days.

During the last two years the COVID-19 pandemic has affected the world population in several ways. An important increase in mental health problems is a consequence of this pandemic that is ubiquitous worldwide. In this work we study the effect of the pandemic on the mental health of a population of teenagers and youth based on the analysis of natural language processing, machine learning algorithms and expert knowledge. The data analysed was obtained from a chat helpline called Safe time from theIt Get’s Better Foundation in Chile. The data consists of 10,986 conversations gathered from 2018 until 2020 between volunteers from the foundation and users of the platform. We compared the conversationsbefore and during the pandemic in terms of their thematic content. Our analysis found: a significantdecrease in self-image appreciation during the pandemic; a significant decrease in the quality of personalrelationships during the pandemic, and a significant increase of performance appreciation.

The main aim of the present study was to explore health professionals’ reported experiences and approaches to managing children who receive a designation of cystic fibrosis transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen positive inconclusive diagnosis following a positive NBS result for cystic fibrosis. An online questionnaire was distributed via Qualtrics Survey Software and circulated to a purposive, international sample of health professionals involved in managing children with this designation. In total, 101 clinicians completed the online survey; 39 from the US, six from Canada and 56 from Europe (including the UK). Results indicated that while respondents reported minor deviations in practice, they were cognizant of recommendations in the updated guidance and for the most part, attempted to implement these into practice consistently internationally. Where variation was reported, the purpose of this appeared to be to enable clinicians to respond to either clinical assessments or parental anxiety in order to improve outcomes for the child and family. Further research is needed to determine if these findings are reflective of both a wider audience of clinicians and actual (rather than reported) practice.

Dehydrolutein accumulates in substantial concentrations in the retina. The aim of this study was to compare antioxidant properties of dehydrolutein with other retinal carotenoids, lutein and zeaxanthin, and their effects on ARPE-19 cells. The time-resolved detection of characteristic singlet oxygen phosphorescence was used to compare the singlet oxygen quenching rate constants of dehydrolutein, lutein, and zeaxanthin. The effects of these carotenoids on photosensitized oxidation were tested in liposomes, where photooxidation was induced by light in the presence of photosensitizers, and monitored by oximetry. To compare the uptake of dehydrolutein, lutein, and zeaxanthin, ARPE-19 cells were incubated with carotenoids for up to 19 days, and carotenoid contents were determined by spectrophotometry in cell extracts. To investigate the effects of carotenoids on phototocytotoxicity, cells were exposed to light in the presence of rose bengal or all-trans-retinal. The results demonstrate that the rate constants for singlet oxygen quenching are 0.77x1010, 0.55x1010, and 1.23x1010 M-1s-1 for dehydrolutein, lutein and zeaxanthin, respectively. Overall, dehydrolutein is similar to lutein or zeaxanthin in protection of lipids against photosensitized oxidation. ARPE-19 cells accumulate substantial amounts of both zeaxanthin and lutein but no detectable amounts of dehydrolutein. Cells pre-incubated with carotenoids are equally susceptible to photosensitized damage as cells without carotenoids. Carotenoids provided to cells together with the extracellular photosensitizers offer partial protection against photodamage. In conclusion, the antioxidant properties of dehydrolutein are similar to lutein and zeaxanthin. The mechanism responsible for its lack of accumulation in ARPE-19 cells deserves further investigation.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

Background: Delivery of quality family planning services depends on availability of skilled health care providers, which is often a challenge in Low- and middle-income countries. This study evaluates the effects of a targeted training program on family planning services delivered by the Lady Health Workers (LHWs) in six districts of Punjab, Pakistan. The primary goal was to enhance the quality and accessibility of family planning services, recognizing the pivotal role of LHWs in community health. Methods: Using a robust panel data difference-in-differences (DiD) approach, we analyzed the electronic medical records (EMR) of 1,410 LHWs over a nine-month period. This timeframe in-cluded both pre-training (July to December 2022) and post-training (April to June 2023) phases. Our assessment focused on the impact of training on five outcome variables: the number of follow-up clients, the number of Intrauterine Contraceptive Device (IUCD) clients, the number of condom clients, the number of modern method clients, and the number of injection clients. We also con-sidered control variables such as LHW age, LHW education, the number of eligible couples in each LHW's catchment area, and a categorical variable for the districts. Results: The positive and statistically significant (p<0.05) coefficients across various service cat-egories – Follow Up Clients [Coeff: 1.00, CI: (0.30 - 1.70)], IUCD Clients [Coeff: 0.23, CI: (-0.01 - 0.46)], Condom Clients [Coeff: 1.41, CI: (0.97 – 1.86)], Modern Method Clients [Coeff: 1.82, CI: (0.96 – 2.68)], and Injection Clients [Coeff: 0.32, CI: (0.14 – 0.50)]. These findings indicate enhanced productivity among LHWs who have received training, with results significant at the 95% con-fidence interval (CI). Conclusion: The study highlights the effectiveness of targeted training programs in boosting family planning services at the community level and offers insightful implications for policy-makers and health practitioners. While focused on six districts in Punjab, these promising results emphasize the need for ongoing training and support for frontline health workers to bolster family planning initiatives.

ackground: This study aimed to examine the effects of a woodworking program on psychosocial health in older adults who had mild cognitive impairment (MCI) or mild dementia (MD) in Korea. Setting: The study was carried out in a dementia center in Seoul in Korea. Population: A total of 61 participants who had MCI or MD were allocated into two groups: the experimental group (EG, n = 35) and the control group (CG, n = 26). Methods: This study was carried out using a nonequivalent control group pre-test–post-test design. The EG participated in the woodworking program a total of 10 times for 120 min per session twice a week for 5 weeks, and the CG did not participate in the woodworking program. Both groups completed the same survey before and after the intervention. In the survey, demographic characteristics, psychological health (life satisfaction, depression, self-efficacy, and resilience), and social health (social isolation and social support) were measured. Results: In the within-group comparison, there was no significant difference between any factors of the CG before and after the intervention. In contrast, the EG had a significant improvement before and after the woodworking program. Participants in the EG with MCI and MD significantly improved their social support (p < 0.05). Psychological factors (life satisfaction, depression, and self-efficacy) were positively changed, although not significantly. Conclusions: The woodworking program promoted psychosocial health, such as life satisfaction, resilience, and social support, among older adults with mild cognitive impairment and mild dementia.

Extended-spectrum beta-lactamase (ESBL) -producing and multidrug resistant Enterobacterales pose a major threat to both human and animal health. This study assessed the prevalence of ESBL-producing Escherichia coli (ESBL-Ec) and Klebsiella spp. (ESBL-K) in cattle farms in Ouagadougou, Burkina Faso, using a One Health approach. From May 2021 to September 2022, cattle faeces, farmers’ stools, their drinking water and farm soil samples were collected from semi-intensive and traditional farms. ESBL-selective medium was used to obtain resistant isolates, which were further characterized using biochemical tests. An-timicrobial susceptibility testing was performed using the Kirby-Bauer disc dif-fusion method. ESBL-Ec and/or ESBL-K were detected in 188 of 322 samples (58.0%). The prevalence of ESBL-Ec isolates was 42.2% (136/322) and ESBL-K isolates 24.5% (79/322). Notably, 156 of the 188 ESBL isolates (83.0%) exhibited multidrug resistance. The highest resistance rates were observed against tetracy-cline and cotrimoxazole. Importantly, no isolates showed resistance to mero-penem, which was used to test for carbapenem resistance. This study highlights the presence of ESBL-Ec and ESBL-K among humans, animals and the envi-ronment of the cattle farms. Good hygiene and biosafety practices are essential to limit the potential spread of multidrug resistant bacteria between different inter-faces on farms.

Background: Strength assessment is one of the main fields in sports performance, physical rehabilitation, physical activity and health. Purpose: To compare maximal voluntary isometric contractions (MVIC) and paired voluntary isometric contractions (VIC) of knee extensors between an isokinetic dynamometer (BIODEX) and a portable and lightweight device (DINABANG). Methods: From 19 volunteers (age: 28.7±7 y; body mass: 72±10 kg and height: 173±7 cm) we obtained 114 paired MVIC measures and, from the force-time curves of these repetitions, 22507 paired VIC measures of knee extensors. Results: We observed “excellent” repeatability for MVIC (ICC:1.00; p&lt;0.001) between BIODEX (247±79.5 Nm) and DINABANG (247±74.8 Nm), with “trivial” effect (mean difference: 0.12 Nm (0.02%); 95%CI: -0.13 to 0.23 Nm; p=0.606; d=0.048). Bland-Altman plots revealed high accuracy for MVIC (bias: 0.12 Nm) and consistent distribution (precision) inside the limits of agreement (-4.81 to 5.06 Nm) and respective 95%CI. “Excellent” repeatability was also observed for VIC (ICC:1.00; p&lt;0.001) between BIODEX (219±84.1 Nm) and DINABANG (218±84.0 Nm), with “trivial” effect (0.24 Nm (0.11%); 0.08 to 0.11 Nm; p&lt;0.001; d=0.100). Bland-Altman plots revealed high accuracy for VIC (bias: 0.24 Nm) and consistent distribution (precision) inside the limits of agreement (-4.5 to 4.9 Nm) and respective 95%CI. Conclusion: DINABANG is accurate, precise and reliable for torque measurement.

The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) of Minnesota, “Sage”, provides breast cancer screening to uninsured women. We introduce a novel mapping technique, spatially adaptive filters (SAFs), to estimate utilization of Sage screening in Minnesota. Sage screenings (N = 74,712) were geocoded. The eligible population was modeled with the RTI synthetic population dataset. Between 2011 and 2015, 36,979 women a year were Sage eligible. Utilization was highly variable across Minnesota (M = 37.2%, range 0% - 131%, SD = 18.7%). This replicable approach modeled utilization rates to the neighborhood-level, allowing Sage to prioritize locations and engage communities.

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

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

Biological, environmental, behavioral, and social factors can influence sleep and lead to sleep disorders or diseases. Sleep disorders are common, numerous and heterogeneous in terms of their etiology, pathogenesis, and symptomatology. Management of sleep-wake circadian disorders (SWCD) includes education to sleep hygiene, behavioral strategies, psychotherapy (cognitive behavioral therapy (CBT), particularly), instrument-based treatments (i.e. positive airway pressure therapy, hypoglossal nerve stimulation), and pharmacotherapy. Depending on the disease, therapy varies and is executed sequentially, or can be a combination of several forms of therapy. Drugs used for SWCD include traditional sleep or wake-promoting agents, chronotherapeutic agents. Recently, novel medications, which are more precisely acting on specific neurochemical systems (i.e. orexin system) important for sleep and wake, are also increasingly being used. In this review, the pharmacotherapy of common sleep disorders (insomnia, sleep-related breathing disorder, central disorders of hypersomnolence, circadian rhythm sleep wake disorders, parasomnias, and sleep-related movement disorders) embedded in the overall therapeutic concept of each disorder is presented. There is also an outlook on possible future pharmacotherapies.

This research paper is divided into two aspects: first part describes the modelling techniques which are referred for handling infectious diseases in public health domain, second part describes the modelling techniques which are referred for building epidemiology cases in public health domain. To illustrate further, first part helps in understanding various modeling ordinary differential equations have been defined to develop the definition, described to know the terminologies involved in developing the equations and henceforth established to understand the end-to-end process. Second part helps in understanding various aspects of epidemiology in public health domain and how they help in addressing the public health domain policy-making.

The human polyamines spermine and spermidine are essential for cell function, and their properties have been extensively studied. However, research results of experiments conducted without understanding the properties of polyamines have been evaluated and published by reviewers who appear to have little knowledge of the properties of polyamines. It is sad that some studies repeat what was done more than half a century ago before polyamines were characterized. First, I explain the basic properties of polyamines that researchers need to know. Then, the relationship between changes in polyamine levels in the body and age- and lifestyle-related diseases is discussed. In addition, the epigenetic mechanism of action of polyamines in relation to healthy longevity and, conversely, age- and lifestyle-related diseases and the progression of senescence are discussed. Spermine, which increases with a polyamine-rich diet, acts to suppress aberrant gene methylation and proinflammatory status associated with aging. Meanwhile, chronic inflammation associated with aging induces the enzyme activity of spermine oxidase, which breaks down spermine and produces acrolein, resulting in reduced spermine levels. Acrolein, a toxic aldehyde that increases with age- and lifestyle-related diseases, is thought to accelerate these diseases.

Sleep-related eating disorder (SRED) is a non-REM parasomnia with potentially significant negative effects on general health (dangerous activities during night eating episodes, obesity, or metabolic syndrome, for example). Although the history of SRED encompasses more than six decades, public awareness and even the awareness of the mental health specialists of this disorder is very limited, a phenomenon that hinders the development of research in this field. Therefore, an updated review, based on a narrative methodology, explored the available evidence for SRED found in four electronic databases (PubMed, Cochrane Collaboration, Google Scholar, and Clarivate/Web of Science). A number of 94 primary and secondary reports were retrieved, investigating aspects regarding the risk factors, epidemiology, clinical data and differential diagnosis, epidemiology, structured evaluation, and treatment of SRED. Based on the results of these reports, Z-drugs, but also certain benzodiazepines, antidepressants, antipsychotics, and psychostimulants may trigger the onset of SRED. Psychiatric and neurologic disorders have also been associated with SRED, either as risk factors or comorbid conditions. Cerebral glucose metabolism dysfunctions, neurotransmitter dysfunctions, and genetic factors have been invoked as pathogenetic contributors. Structured assessment of SRED is possible, but there is a dearth of instruments dedicated to this purpose. Data on the prevalence and treatment of SRED exist, but good-quality epidemiological studies and clinical trials are still missing. In conclusion, future research is expected to address the shortcomings of SRED exploration by creating the conditions for better quality and larger group clinical research. The need for such investigation is granted by the importance of this pathology and its negative functional consequences.

The Galápagos archipelago is a vast reservoir of terrestrial and marine biodiversity and is particularly susceptible to human, animal, and environmental impacts. Climate change, globalization, and the blurring of human-domestic animal-wildlife interfaces are poised to bring new threats and challenges to the region. A One Health perspective that simultaneously considers human, animal, and environmental health is imperative in assessing and mitigating the challenges facing the Galápagos Islands. Many challenges facing biodiversity in the Galápagos Islands can ultimately be linked to anthropogenic factors. In Part I of this review, we reviewed the impacts of invasive species and identified infectious diseases of importance. In Part II of this review, we discuss the impacts of climate change and ocean acidification, and highlight the effects of several direct human activities, including tourism, overfishing, pollution, land use, and human-wildlife conflict. We also review the socioeconomic and political context of the Galápagos Islands, including current challenges in water and energy use, sanitation, and economic stability. We examine the importance of investment in local development for building resiliency and sustainability in the archipelago. Finally, we discuss the impact of the COVID-19 pandemic in the region. Throughout this two-part review, we build a cohesive picture of One Health in the Galápagos Islands by integrating past work, current needs, and emerging threats. We also consider overarching goals for conservation, ecosystem management, and socioeconomic sustainability that have been previously defined by both governmental and non-governmental stakeholders, and identify discrete, implementable, and interdisciplinary recommendations that will facilitate achievement of those goals.

Artificial Intelligence (AI) is revolutionizing decision-making procedures in healthcare information systems (HIS), increasing the efficacy, accuracy, and personalization of healthcare. Notwithstanding remarkable progresses, yet there remain gaps in the holistic comprehension and implication of AI-driven technologies across various HIS scenarios. These gaps, consisting limited integration of AI across a variety of HIS parts and inadequate emphasize on interpretability and privacy, motivate our study to conduct a structured evaluation of recent AI applications in this domain. In this study, we present a novel taxonomy for the AI implication in medical decision-making. We analyzed 30 articles and categorized them into six groups including: Clinical Decision Support Systems (CDSS), Predictive Analytics, Natural Language Processing (NLP), Computer-Aided Diagnostics (CAD), Robotic-Assisted Surgery, and Virtual Health Assistants (VHAs/chatbots). Our study aims to propose a holistic perspective of the fast evolving perspective of AI in HIS. The majority of the investigated studies were published from 2023 and 2022, with Springer as the leading publisher (33%). Python and MATLAB were the most well-known simulation languages, applied in 48% and 20% of the papers, respectively, reflecting the technical trends in the area. By emphasizing on pivotal criteria like interpretability, accuracy, and privacy, this research aims to elucidate the crucial issues and development driving AI-driven decision-making in HIS.

Introduction: Governance, the least studied health system component, comprises a system of rules and processes, and is a key determinant for effective decision making for health care planning. This study aims to identify institutional, legal and policy factors which are either barriers or facilitators for the implementation of integrated mental health in primary care in the India. Methods: Semi-structured interviews were conducted with 33 key informants at the district and national levels with policy makers, state level health care planners and district planners and managers in India. The data were analysed using thematic analysis using the qualitative software NViVO 10. Findings: Participants stated that a conducive environment for mental health service delivery is necessary at the legislative, policy and planning levels, to facilitate integration of mental health into primary care. Amongst other factors, the need for active involvement of civil society and service user organisations, strengthening mental health information systems, and building the non-technical skills of the mental health workforce, were identified as particularly necessary to deliver adequate mental health services.Conclusion: Amidst the favourable policy context supporting collaborative and integrated care in India, this study identified low resourcing, weak collaborations and inadequate information to be crucial for integrated mental health in India at present.

Asthma is a significant public health concern. This study identified the provinces with the highest morbidity and mortality rates due to asthma among the working-age population (15-69 years) in the Republic of Ecuador. The secondary objective was to explain the possible differences attribut-able to occupational exposure. This nationwide ecological and exploratory study was conducted in 24 provinces between 2016 and 2019. Government databases were used as sources of infor-mation. Standardized rates were calculated for codes the J45 and J46. The hospitalization mor-bidity rate for asthma decreased from 6.51 to 5.76 cases per 100,000 working-age population, and the mortality rate has consistently been low and stable from 0.14 to 0.15 deaths per 100,000 working-age population. Geographic differences between the provinces were evident. The risk of hospitalization and death due to asthma was higher in the Pacific coast (five provinces) and the Andean region (two provinces). The high rates observed in provinces with greater agricultural and industrial development could be the main determinants of national heterogeneity and could act as occupational risk factors. The contribution of occupational hazards in each province should be examined in depth through ad hoc studies. These findings provide valuable information for creating public policies aimed at promoting and safeguarding the respiratory health of the popu-lation, particularly that of workers.

There is a need for strategic healthcare workforce planning to address shortages and ensure universal health coverage, aiming to optimize work-force per population ratio, distribution, and competencies. Amidst rising demands exacerbated by aging populations and events like the COVID-19 pandemic, strategic workforce planning becomes crucial for addressing healthcare inequalities by forecasting needs, bridging skill gaps, and adapting to changing demographics and care models. Israel has invested in strategic planning to tackle healthcare workforce challenges; however, globally there is insufficient planning informed by health labor market analysis, which hinders efforts to address healthcare inequalities. The paper reviews national policies in Israel, Australia, Germany, and Norway, ex-amining statistics and government publications to highlight strategic plan-ning considerations and address challenges in healthcare workforce plan-ning. This paper focuses both on the critical role of physicians in healthcare systems, and on the changing borders between healthcare professions and different national contexts which demand more context dependent strategic workforce planning. We highlight common themes among national policies, including the need for data collection, increasing the capacity of domestic training programs, and the need to address geographic maldistribution of physicians. Ultimately, we aim to guide policy in the development of a re-silient and sustainable healthcare workforce capable of meeting diverse community needs and promoting equity in healthcare services.

The concept of ecosystem services (ESs) provides a valuable approach to communicate societies' dependence on natural ecosystems, assisting in the evaluation of measures to protect vegetation in watersheds that promote water-related ESs. Vegetation cover and land use are important factors related to the capacity of ecosystems to provide soil loss regulation and sediment retention services, which are highly relevant for sediment management in watersheds draining into reservoirs with multiple water uses. This study aims to assess the relationship between potential changes in land use and land cover and the sediment retention service provided by riparian vegetation in a watershed draining into a hydroelectric reservoir in the Brazilian Cerrado. Sediment load was selected as a physical variable that affects different water uses in reservoirs, with these uses being dependent on the quality or quantity of stored water. Scenarios were analyzed to represent landscape reconfigurations from a baseline condition in order to account for the recovery of riparian vegetation by the agricultural sector, as foreseen in the Brazilian Forest Code. To map and quantify variations in annual sediment retention, the InVEST model was used, which allows estimating an integrated response of the drainage basin to large-scale land use changes over time and space. The results show that for the drainage basin of the Corumbá IV Hydroelectric Power Plant (HPP), the recovery of riparian areas occupied by annual crops has the potential to generate greater benefits to water use in the reservoir. In the studied catchment area, 14% of the total vegetation deficit in riparian areas is occupied by crops, while 86% is occupied by pastures. This highlights the buffering role of riparian vegetation as an effective practice for managing sediment flows originating from sheet erosion in agricultural landscapes. The methodology employed in this study allows for the quantification and mapping of the effects of soil and water conservation measures in river basins. This enables the prioritization of sectoral efforts for the restoration of native vegetation, considering the highest returns in benefits perceived by water users affected by sediment input in reservoirs. The study's results reinforce the importance of conserving vegetation in riparian areas and their surroundings for sediment retention, highlighting the role of these areas as assets in providing water-related ecosystem services.

Admission and discharge diagnoses of in-hospital patients are often in discord. Incorrect admission diagnoses are related to increased cost of care and patient safety. Additionally, due to the seasonality of many conditions, this discord may vary across the year. In this paper, we used medical claims data to develop a methodological framework that examines these differences, for Medicare beneficiaries. We provide examples for pneumonia, a condition with seasonal implications, and aneurysm, where early detection can be life-saving. Following a Bayesian approach, our work quantifies and visualizes with time series plots the degree that any clinical condition is correctly diagnosed upon admission. We examined differences in weekly intervals, during a calendar year. The mean length of stay and hospital charges were furthermore compared between matching and non-matching {admission, discharge Dx} pairs, and 95% confidence intervals of the difference of means were estimated. We applied Statistical Process Control methods and then visualized differences, for the hospital charges and the length of stay, per week, with time series plots. Our methodology and the visualizations underline the importance of a rigorous and non-delayed diagnostic process upon admission since there are significant implications in terms of hospital outcomes and cost of care.

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide, including in Croatia. Since most patients have multiple disorders and diseases caused largely by the same risk factors, and as it is essential to approach each patient as a person with all disorders, today we are talking about a new paradigm - cardio-renal-metabolic (CKM) syndrome and cardio-renal-metabolic health, which necessarily includes brain health. Elevated systolic blood pressure, LDL cholesterol, smoking, obesity, diabetes, impaired renal function or chronic kidney disease, which all stem from insufficient physical activity, unhealthy diet with excessive intake of table salt, and air pollution, are the leading causes of overall morbidity and mortality from CKM diseases, especially mortality from CVD. Experts from various fields key to CKM health have written this document with the aim of integrating it as part of the national plan for the prevention of chronic non-communicable diseases with a focus on CVD, which should become mandatory and be based on the existing guidelines of professional societies.

During the last decades, zebrafish (Danio rerio) has become one of the most important model organisms to study different physiological and biological phenomena. Research field of carbonic anhydrases (CAs) and carbonic anhydrase related proteins (CARPs) is not an exception in this. The best-known known function of CAs is the regulation of acid-base balance. However, studies performed with zebrafish, among others, have revealed important roles for these proteins in many other physiological processes, some of which have been unpredicted in the light of the previous studies and suggestions. Examples are roles in zebrafish pigmentation as well as motor coordination. Disruption of the function of these proteins may generate even lethal outcomes. In this review, we summarize the current knowledge of CA-related studies performed in zebrafish.

Roma is the largest ethnic minority of Europe with poor health status, which is poorly explored due to legal constrains of ethnicity assessment. We aimed to elaborate health-indicators for adults living in segregated Roma settlements (SRS) representing the most vulnerable Roma subpopulation. SRSs were mapped in a study area populated by 54682 adults. Records of all adults living in the study area were processed in the National Institute of Health Insurance Fund Management. Aggregated, age-sex standardized SRS-specific and non-SRS-specific indicators on healthcare utilization and premature death along with the ratio of them (RR) were computed with 95% confidence intervals. The rate of GP appointments was significantly higher among SRS inhabitants (RR=1.152, 95%CI: 1.136–1.167). The proportion of subjects hospitalized (RR=1.286, 1.177–1.405), and the reimbursement for inpatient care (RR=1.060, 1.057–1.064) were elevated for SRS. Premature mortality was significantly higher in SRSs (RR=1.711, 1.085-2.696). Our study demonstrated that it is possible to compute the SRS-specific version of the routine healthcare indicators without violating the protection of personal data by converting a sensitive ethical issue to a non-sensitive small area geographical analysis; there is an SRS-specific healthcare utilization pattern, which is associated with elevated costs and increased risk of premature death.

The School Fruit and Vegetables Scheme (SFVS) implemented by the European Union during 2009/10 aims to improve the diet of school children and to support agricultural markets and environmental sustainability. The objective of this study was to characterize the SFVS implementation in Spain (2009-2017). A descriptive, longitudinal, observational and retrospective study was carried out based on document analysis of annual strategies of the SFVS. We studied the average budget for the EU, the number of students enrolled, the cost of the SFVS by student and by day, the duration of the SFVS, the quantity of fruits and vegetables (FV) per student, the variety of FV, the inclusion of local, seasonal and organic foods, and the education activities (EA). The results were studied by autonomous community (AC). The budget increased from 7.4 million euros in 2009/10 to 14.4 in 2016/17. Since 2014/15, the increase came from EU funds, the number of students increased from 18% in 2009 to 20% in 2016. The quantity of FV went from 2,579 to 4,000 tons, duration increased from 9.8 to 19.6 days and the variety of fruits and vegetables increased from 20 to 21 and from 5 to 6 respectively. In AC there were important variations in EA, in the number of enrolled students (7.4% to 45.6%), in the cost per student (2.3€ to 28€) and in the duration in days (5.6 to 70 days). The inclusion of local, seasonal and organic foods was identified in 5 of the 8 years studied. The development and reach of the SFVS in Spain is still insufficient to influence dietary patterns and health in the school population. However, the SFVS has generated an economic market for agricultural production.

Chloracne is the major skin symptom caused by dioxin intoxication. Dioxin activates the aryl hydrocarbon receptor (AHR)–cytochrome p450 1A1 (CYP1A1) system, generates oxidative stress, and induces hyperkeratinization of keratinocytes and sebocytes leading to chloracne. Nuclear factor-erythroid 2-related factor-2 (NRF2) is a master switch inducing expression of various antioxidative enzymes such as heme oxygenase-1. Cinnamaldehyde is an antioxidant phytochemical that inhibits AHR–CYP1A1 signaling and activates the NRF2–antioxidative axis. The cinnamaldehyde-containing Kampo herbal medicine Keishibukuryogan is capable of improving chloracne in Yusho patients who are highly contaminated with dioxin. Agents with dual functions in promoting AHR–CYP1A1 inhibition and NRF2 activation may be useful in managing dioxin-related health hazards.

This article examines the transformative role of artificial intelligence (AI) in mental health, with a particular focus on its potential to break down barriers for men facing mental health challenges. Historically, men have been less likely to seek help for mental health issues due to societal stigma, cultural expectations, and a reluctance to express vulnerability. AI technologies, including chatbots, generative AI, and machine learning algorithms, offer innovative solutions to address these challenges by providing accessible, anonymous, and personalized support. This paper explores how AI-powered mental health applications can create safe spaces for men to engage with their emotions, seek help, and access resources tailored to their specific needs. Furthermore, it highlights the importance of integrating AI into traditional mental health care models to enhance outreach and reduce stigma. By fostering a more inclusive approach to mental health support, AI has the potential to empower men, promote emotional resilience, and ultimately improve mental health outcomes in this underserved demographic.

Cheese consumption provides humans with minerals, proteins, carbohydrates, and vitamins. In Mexico, several cheese varieties are produced, each with its texture, scent, and flavor. The artisanal cheeses made in the states of Tabasco and Chiapas —including, among others, the varieties named crema (cream), doble crema (double cream), oaxaca, panela, fresco, bola, poro, Cotija, and asadero— have a high demand in the domestic and foreign markets. The intensification of anthropic activity in these states causes an increased emission to the environment of contaminants like heavy metals, which could reach human foodstuffs through the food chains. In particular, heavy metal contents in cheeses consumed daily by these states' local population might represent a public health risk. Because of that, our objectives in this work were to determine the concentrations of lead, cadmium, nickel, copper, zinc, and iron in artisanal cheeses produced in the states of Tabasco and Chiapas, and to determine the values of the Hazard Quotient (HQ), Total Hazard Quotient (THQ), and Cancer Risk Total (CRT) for adult and young men and women. The results of our analyses of cheese samples from the states of Tabasco and Chiapas showed that the average concentrations (mg kg-1) of cadmium (0.0023±0.002, 0.0023±0.002 mg kg-1, respectively for each state), lead (0.0047±0.00, 0.0051±0.002), nickel (0.0039±0.0046, 0.0031±0.0039), copper (0.0199±0.021, 0.0202±0.022), zinc (0.1611±0.18, 0.194±0.21), and iron (61.84±4.23, 65.76±6.61 mg kg-1), the first three values lower than the limits established by the FAO/WHO and Codex Alimentarius. The value of THQ that we obtained was less than one, and that of CRT was within the limits established by the US-EPA, which means that the consumption of artisanal cheeses from Tabasco and Chiapas by humans does not imply a risk of disease or cancer.

With enhanced life expectancy and ageing global populations, the prevalence of multimorbidity continues to increase. However, there is a dearth of evidence linked to multimorbidity diagnoses, treatments and health outcomes which remains a concern for future proofing optimal healthcare services. Generating evidence is critical to managing multimorbidity, promoting public health and minimizing health inequalities via effective healthcare policies that improve quality of life for vulnerable populations. This study assessed meta-epidemiology of multimorbidity to report the gaps in scientific knowledge and clinical practice. A systematic methodology was designed and published in PROSPERO (CRD42022347308) to report meta-epidemiology analyses using databases including PubMed, Web of Science, ScienceDirect, EMBASE, The Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials and MEDLINE for studies published between the 1^st of January 1980 - 31^st December 2022. A random-effects model was used to estimate the pooled proportion of multimorbidity in adults. Forest plots, pooled odds ratios and statistical heterogeneity metrics were used to assess the association between multimorbidity and investigated factors. Funnel plots and Egger’s regression were used to detect and correct for publication bias. Our findings identified women to be 0.32 times more likely to have multimorbidity in comparison to males. In regard to ethnicity, white people were 0.47 times less likely to develop comorbidities than black people. People who identified as a drinker or unmarried were more likely to develop comorbidities than those who are non-drinkers or married, respectively. Regardless of smoking status, people were equally likely to have comorbidity. In terms of environmental influences, people in rural areas were found to be 0.2 times less likely to have comorbidity in comparison to those living in urban areas. Interestingly, people with a higher education level were 0.57 times more likely to develop comorbidities than those with only a high school education. It is evident that multimorbidity has a significant burden globally and impacts the provision of care necessitated across populations given its association with several social determinants of health. Robust research and healthcare policies are required to better manage multimorbidity in patients. An example of such intervention includes employing prevention programs to reduce risk and incidence of multimorbidity within at-risk populations.

Metabolomics is an advanced technology, still under development, with multiple research applications, especially in the field of health. Individual metabolic profiles, the functionality of the body, as well as its interaction with the environment can be established using this technology. The body's response to various external factors, including the food consumed and the nutrients it contains, has increased researchers' interest in nutrimetabolomics. Establishing correlations between diet and the occurrence of various diseases or even the development of personalized nutrition plans, could contribute to advances in precision medicine. The interdependence between humans, animals and the environment are of particular importance today, with the dramatic emergence and spread of zoonotic diseases, food, water and soil contamination, and the degradation of resources and habitats. All these events have led to an increase of risk factors for functional diseases, burdening global health. Thus, this study aimed to highlight the importance of metabolomics, in particular of nutrimetabolomics, as a technical solution for a holistic, collaborative, and precise approach for the advancement of the One Health strategy.

Only 15% of the global population has access to occupational safety and health services. In Africa only 5% of employees working from major establishments, have access to occupational health services (OHS). Access to primary health care (PHC) services is addressed in many settings and inclusion of OHS in these facilities might increase efficiency in preventing occupational diseases. A cross-sectional study was conducted in four SADC countries aiming at assessing the availability of OHS at PHC facilities and the organization of OHS. We conducted a literature review to assess the provision and organization of OHS services. In addition to the review, a total of 23 doctors from PHC facilities were interviewed using questionnaires in order to determine the availability of OHS and training. Consultations with heads of ministries were done in four SADC countries. Results showed that in the SADC region, OHS are fragmented and lack a comprehensive approach. In addition, out of 23 PHC facilities only two (13%) provided occupational health and PHC. However, OHS provided at PHC facilities were limited to TB screening and audiometric testing. Our study showed a huge inadequacy of trained occupational health practitioners. This study supports the World Health Organization’s advocacy of integrating OHS at PHC level.

In hepatocellular carcinoma (HCC), recurrence usually occurs after curative surgical resection. Currently, no approved adjuvant therapy has been shown to reduce recurrence rates. In this report, the in vivo mouse effect of sequential combination treatment with recombinant mouse interferon-alpha (rmIFN-α) and an anti-mouse-PD1 antibody on hepatitis B virus (HBV) clearance was evaluated. A phase I clinical trial was then conducted to assess the safety, tolerability, and inhibitory activity of sequential therapy with ropeginterferon alfa-2b and nivolumab in HCC recurrence in patients who have undergone curative surgery for HBV-related HCC. In animal modeling, HBV suppression was significantly greater with rmIFN-α and anti-PD1 sequential combination treatment than with their treatment alone. In the Phase I study, eleven patients completed the sequential therapy with ropeginterferon alfa-2b every two weeks at the dose of 450 µg for six doses, followed by three doses of nivolumab every two weeks up to 0.75 mg/kg. A notable decrease or clearance of HBV surface antigen was observed in two patients. Dose-limiting toxicity of grade 3 alanine transaminase and aspartate aminotransferase increases was observed in one patient. The maximum tolerated dose was determined. Currently no HCC recurrence has been observed. The treatment modality was well tolerated. The data support further clinical development of sequential combination therapy as a post-surgery prophylactic measure against the recurrence of HBV-related HCC.

The WHO European Region defined the role of a new central professional for primary care, the Family and Community Nurse (FCN). The introduction of FCN in the framework of health policies highlight a key role of nurses in addressing the families’ and communities’ needs. A scoping review was conducted in order to identify and describe the available tools which has been adopted for the assessment of the community health needs by FNC. A comprehensive literature review on Embase, Cochrane Library, PubMed, CINAHL, Scopus and PsycInfo databases was conducted including all studies up to May 2021. A total of 1563 studies were identified and 36 of them were included. The literature review had made possible to identify studies employing twelve different community assessment's tools or modalities. Referring the WHO framework proposed in 2001 some common themes have been identified with an uneven distribution, as profiling the population, deciding on priorities for action and public healthcare programmes, implementing the planned activities, evaluation of health outcomes, multidisciplinary activity, flexibility and involving the community. To the best of our knowledge, this work is the first attempt to provide an overview of community assessment tools, keeping the guidance provided by the WHO as a reference.

Background: With new challenges to the health system, many new competencies within the scope of teaching public health need to be addressed in medical schools’ curricula such as disaster risk management and health system science. The aims of this study were to identify the needs of public health competencies for medical doctors in Thailand and to assess the level of integration for technical collaboration in teaching public health. Method: A total of 17 out of 21 Thai medical schools participated in the national survey. Qualitative inquiries applied focus group interviews of community representatives from ten sample villages and in-depth interviews of representatives from stakeholder organizations particularly employers. The list of public health competencies framework recommended by WHO-SEARO was applied. Quantitative analysis applied descriptive analysis using STATA 15 and qualitative findings were validated by interrelating the meaning of themes from Word Clouds created in NVivo12. Data integration applied a mixed-method Quan-qual approach. Results: 17 medical schools returned the questionnaires (80.95 % yield). The most common regionally-defined public health competencies (in over 70% of schools) were shown to be: Biostatistics, Community Medicine, Epidemiology, Family Medicine, Medical Ethics and Professional Laws, Preventive Medicine, Health Promotion, Holistic Care, and Research. The curriculum in only one medical school lacked Health Economics, whilst Disaster Management was lacking in two other schools. Discipline-based subjects were found to be more prevalent than interdisciplinary competencies. A variety of methods were being applied for teaching public health. The majority of the schools applied lecture as the main teaching method and multiple-choice questions as the main assessment method. Thai communities expect the doctors to get in touch with the community more often, lead the primary health care team through training the health professionals and community health volunteers, and educate the community for better health. Conclusion: Human resource is the main challenge in addressing interdisciplinary competencies. It is necessary to establish a collaborating mechanism among the big and small medical schools and the faculties of public health to improve the teaching of public health to undergraduate students in medical schools. There is also a need to strengthen the health system science and leadership so that future MDs can lead health service delivery according to the needs of their employers such as the Ministry of Public Health and the Rural Doctors Association. The findings of this study may help to identify a national framework of public health core competencies for medical schools and create a common platform for interdisciplinary collaborations.