Misophonia, characterized by strong emotional reactions to specific sounds, poses significant challenges, particularly in academic settings. This study investigates the prevalence and psychometric properties of the MisoQuest, a tool designed to assess misophonia, in a sample of 549 high school and university students (Mean age = 23.2 years, SD = 9.3). The sample included 285 females, 260 males, and four individuals who did not disclose their gender. Using a predefined cutoff score of 61 on the MisoQuest, 4.5% of the participants were identified as positive for misophonia. Psychometric evaluation of the MisoQuest involved both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). EFA results indicated a dominant single-factor structure, with the first factor explaining the majority of the variance. The scree plot further supported this unidimensional model. CFA confirmed the single-factor structure, with most items showing factor loadings between 0.36 and 0.58. Despite some non-significant factor loadings, the model indicated a substantial relationship between the items and the underlying factor. The high internal consistency of the MisoQuest was demonstrated by a Cronbach’s alpha coefficient of 0.93. These findings are consistent with previous studies on misophonia prevalence and support the use of the MisoQuest as a reliable assessment tool. Given the observed prevalence and the significant impact of misophonia on students’ academic and social lives, early identification and targeted support are essential. This study contributes to the understanding of misophonia in young adults and underscores the need for further research and tailored interventions.

Background: Vaccination against influenza has proven to reduce influenza-caused hospital entries, treatment times in intensive care units and hospitalisation costs for treating people with Diabetes Mellitus. Despite the existing influenza vaccination recommendations for all persons with Diabetes Mellitus, in Spain, vaccination rates lag behind target. We aimed to assess predictors for vaccination uptake and reasons for non-adherence. Methods: Data from the 2020 European Health Interview Survey were analysed using uni-and multivariable logistic regression models, stratified by age group and including possible confounders and vaccination as an outcome. Associations to the sociodemographic profile, healthcare access and substance use were explored. Results: Our analysis included 2,194 individuals with Diabetes Mellitus over the age of 15, showing an influenza vaccination rate of 53%. The findings revealed significant predictors of vaccination uptake, including age over 60 years and robust social support. Conversely, younger age, higher education levels, infrequent healthcare interactions, and economic barriers emerged as significant obstacles to vaccination. Conclusions: To enhance vaccination rates, targeted public health interventions should emphasize the importance of vaccination for younger, more educated individuals with DM, those facing economic barriers, and those with lower levels of social support could bridge the existing gap in vaccination coverage.

The study examined the impact of social capital in moderating the effects of the Covid19 pandemic on workers' mental health. We posited that their level of social capital influences workers’ mental health during the Covid19 crisis. Data was sourced from a cross-sectional survey of 422 employees from various industries in Ghana, analyzed using partial least squares-based structural equation modelling (PLS-SEM). Results indicated that the pandemic adversely affected employees' mental well-being, increasing anxiety levels. However, a higher degree of social capital within the workplace buffered these negative effects, enhancing mental health during this period. Essentially, strong workplace relationships and networks mitigated the pandemic's impact on employees' mental health in Ghana. These findings underscore the importance of social capital in health outcomes, especially during crises. For industries in Ghana and beyond, the results emphasize the value of fostering strong social networks. In times of health crises, such as the Covid19 pandemic, robust social ties become crucial. As we navigate the aftermath of this pandemic and prepare for potential future crises, the lessons from this research highlight the need to integrate the knowledge gained from the Covid19 experience into our disaster response strategies. The role of social capital in such scenarios cannot be overstated

The study aims at evaluating the demand of forest bathing in the Northern Italy’s regions underlining the willingness to pay and the potential tourists’ habits and flows on attending alpine contexts. Through the submission of a questionnaire, the sample’s answers have been analyzed employing a stratified sampling methodology considering three different macro areas (Northwest regions, Northeast regions, and Friuli Venezia Giulia region). After analyzing the sample attitudes, the research approached the estimation section by calculating the flow as the number of potential forest bathing hikes per year and the willingness to pay trough the Contingent Valuation Method. The main results indicate that Forest Bathing activity in Northern Italy have a considerable monetary value and it is generally compared with positive feelings, particularly concerning well-being, and fascination factors.

Stem cells can be used in cellular therapy. This happended in order to replace damaged cells or having aim to regenerate organs. The definition of stem cells can be extended. From this point of view, we can mention taking in consideration the idea in which it is known that these cells form the base of the building body. More than, we can mention that stem cells are characterized by two knowing properties namely differentiation and self renewal. Based on the observation that differentiation of adult stem cells into specific derivative scan be controlled by laboratory techniques, it is anticipated that adult stem cells may become the basis of therapies for many, and various types of medical conditions. Taking on stem cells, regenerative medicine (RM) it is known as being one of the hottest topics in biotechnology nowadays. From this purpose, stem cells can be used in regenerative medicine (RM). The principles of regeneration are found in different types of cultures, from long time ago. As an interdisciplinary field of research, regenerative medicine, play a great role in tissues and organs damaged reparation with a higher potential in transplantation if necessary.

In this work, we propose a generalized partially functional linear regression model with an interaction term between functional predictors. The estimators of the regression coefficient of scalar predictors and regression coefficient functions of functional predictors and their interactions are obtained. The asymptotic property of the estimators is established. Extensive simulation studies illustrate the asymptotic results. Finally, the proposed model was applied to investigate the influence of air qualities, climate factors, medical and social indicators and the interactions on cancer incidence which is a binary response.

The importance of contact with nature for human health was confirmed by numerous research. One of the sometimes neglected fields is the landscape design of hospital premises. This study focuses on the perception and preferences of prospective patients regarding the hospital site design. The methodology included anonymous survey with images and lists of adjectives. The online questionnaire was distributed using e-mails and social media from 4th May to 8th July 2024. The objective was to include all age groups. The results confirm previous studies and demonstrate the importance of landscape architecture design of hospital premises for the well-being of patients. The findings may inform the design of hospital sites.

The mental health impact of the environmental crisis, particularly eco-anxiety, is a growing research topic whose measurement still lacks consensus. In this article, we use item response theory (IRT) to better un-derstand what existing questionnaires measure. To conduct this review, we used open-access data from the short French version of the Climate Change Anxiety Questionnaire (Mouguiama-Daouda et al. 2022, Heeren et al., 2023). Our results suggest that, of the different models tested, the unidimensional model seems to be the most appropriate for measuring eco-anxiety. The item difficulty parameter extracted from the IRT enabled us to discuss the level of severity of the items making up this tool. The Climate Change Anxiety Questionnaire is more appropriate for measuring severe to moderately severe eco-anxiety. Ave-nues for improving this questionnaire and the measurement of eco-anxiety in general are then discussed.

Fungal infections (FIs) are spreading globally causing a significant public health concern. However, its documentation remains sparse in Africa, particularly in Rwanda. This literature review, aims to assess the risk and document current gaps in evidence and policy. It summarizes the published data about FIs in Rwanda, including ten reports published between 1972-and-2022. Blastomyces, Candida, Cryptococcus, Histoplasma, Microsporum, Pneumocystis, Rhinosporidium, and Trichophyton caused human infections. These infections primarily affected the brain, respiratory, urinary and reproductive organs, and they were diagnosed using culturing, histopathology, immunology, and/or microscopic techniques. Our findings provide an overview of the diversity and distribution of FIs, highlighting significant limitations in the country’s diagnostic capacity and surveillance system for FIs. Also, indicating severe gaps in evidence to inform policymaking, guide strategic planning and intervention, underscoring the urgent need to build national capacity in fungal diagnosis, surveillance, and research. Raising awareness among the public, scientific community, healthcare providers, and policymakers remains crucial. Furthermore, this report reveals the threats of FIs on public health and food insecurity in Rwanda. A Multisectoral One Health Strategy is essential in research and intervention to determine and reduce the health and safety impacts of fungal pathogens on human, animal, and the environment.

Breast cancer mortality rates vary across ethnic groups in Israel, where protective factors such as high fertility and breastfeeding rates may be moderated by socioeconomic factors and mammography rates. We aim to investigate disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel and examine how sociodemographic variables and number of children are associated with mortality. Our retrospective follow-up study uses data from the Israeli Central Bureau of Statistics and multivariable Cox regression models, adjusting for age, number of children, country of origin, locality size, and socioeconomic status. Compared to Jewish women, Muslim Arab women exhibited lower breast cancer mortality rates. However, after adjusting for multiple sociodemographic variables, no significant differences persisted between Jewish and Muslim Arab women. Having more than three children was associated with lower mortality among Muslim Arab women, but not among Jewish women. European/American origin, larger localities, and medium socioeconomic status were associated with higher mortality. Sociodemographic factors may therefore explain the disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel. Targeted intervention programs considering unique characteristics and risk factors of different ethnic groups are needed to reduce disparities and improve outcomes.

Patient experience is key to patient-centered care and overall healthcare quality. This focus aligns with the growing trend of collaborative care, where patients actively participate in deci-sions alongside providers, leading to better outcomes. Patient experience goes beyond clinical results; it encompasses how patients feel throughout the care journey. Integrating patient per-spectives is essential for high-quality care. The study employed a multicenter, cross-sectional survey design utilizing a questionnaire-based approach. The data collection spanned two loca-tions within the Hospital Clínica Bíblica: San José, and Santa Ana, Costa Rica. The survey target-ed patients receiving treatment across the emergency department, surgery service, and inpatient department. A standardized Picker Patient Experience Questionnaire-33 (PPE-33) was adminis-tered to assess patients' overall experience with received services. A total of 390 questionnaires were analyzed. The participant demographics were as follows: 61.79% female, 56.15% aged be-tween 18 and 44, and 55.67% with undergraduate education. The hospital delivered high-quality service, with strong communication and accessibility (93.7%, 92.6%, and 94.4% positive respec-tively). Improvements are needed in patient rights education (22.7% positive), information about the patient's condition (74.3% positive), discharge instructions (36.5% and 71.4% positive for side effects and warning signs respectively) and addressing patient concerns (26.3% to 44.0%). Patients appreciated their privacy (95.2%), effective pain management (96.2%), respectful com-munication (97.0% and 94.8%), and overall respectful treatment. Satisfaction was influenced by factors like patient needs prioritization, rights communication, sociodemographic, health status, and comfort. The ward of admission had no significant impact on the experience. Enhancing pa-tient experience could boost loyalty and healthcare quality.

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalized, and coordinated intervention under the Value-Based Care approach to address frailty's multidimensional nature in older people. It em-ployed a pre-post randomized controlled design, involving frail individuals over 65 years in Valencia, Spain. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalized care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty and social frailty. The study found signifi-cant improvements in physical frailty, quality of life, reduced health resource use and hospitali-zations, and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalized, comprehensive programs for older individuals with frailty.

Background : Newly generated cardiomyocytes (NGC) concur to recovery of human myocarditis. However, Methods: We retrospectively assessed NGC in 213 consecutive patients with endomyocardial biopsy denoting acute myocarditis, with normal coronaries and valves. Tissue samples were processed for histology (H&E), immunohistochemistry for the evaluation of inflammatory infiltrates, immunostaining for alpha-sarcomeric-actin, junctional connexin-43, Ki-67, phosphorylated STAT3 (p-STAT3) and Western Blot (WB) for HMGB1. Frozen samples were analyzed with polymerase chain reaction (PCR) for cardiotropic viruses. Controls included 20 normal surgical biopsies. Results: NGCs were defined as small myocytes (diameter < 10 µm) with nuclear positivity to Ki-67 and p-STAT3, positive immunostaining for cytoplasmic α-sarcomeric actin and connexin 43. Their number/mm2 in relation with age and pathway of integration were evaluated. NGCs crossed the membrane and grew integrated within the empty necrotic myocytes. NGC mean diameter was 6.6 ± 3.34 vs 22.5 ± 3.11 µm adult cells; their number, in comparable LVEF, was 86.3 ± 10.3/mm2 in patients between 10 and 40 years; 50.4 ±13.8/mm2 in those between 41 and 60; 15.1 ± 5.7/ mm2 in those between 61 and 80; control NGC mean diameter was 0.2± 0.2/mm2. PCR was positive for viral genomes in 16% of cases; NGCs were not statistically different in viral and non-viral myocarditis. WB analysis revealed a higher expression of HMGB1 in myocarditis compared to myocardial controls. Conclusions: NGCs are constantly recognizable in acute human myocarditis. Their number declines with age. Their integration within necrotic myocytes consents preservation of cardiac structure and function.

Cardiovascular diseases (CVDs) and associated risk factors are a growing concern in Cameroon. Physiotherapists (PTs) can play a crucial role in prevention and management. However, the extent of Cameroonian PT involvement in health promotion (HP) activities remains unclear. This study assessed Cameroonian physiotherapists’ current HP practices for people at risk of developing or living with CVDs (pwCVDs). A cross-sectional survey was administered online to PTs practising in Cameroon. Out of 181 PT responses, 95% reported providing a variety of HP activities, including weight management (74%), dietary advice (73%), physical activity (69%), smoking cessation (69%), stress management (61%), and sleep promotion (48%). While PTs were confident in lifestyle assessments, they felt less confident about sleep interventions. Strong beliefs, confidence, team support, and time allocation enhanced HP practice. However, preference for passive modalities, patient adherence issues, organisational challenges within healthcare services, role ambiguity among healthcare providers, inadequate training opportunities, and the absence of established guidelines for CVD prevention negatively affect HP practice. These findings highlight the challenges and opportunities for enhancing HP delivery within the physiotherapy profession in Cameroon. Strategic investments and concerted efforts are necessary to address barriers and leverage facilitators effectively for scaling up HP initiatives, given the significant burden of CVDs in the country.

Objectives: To compare the effects of high-velocity resistance training to slow-velocity re-sistance training on neuromuscular and functional parameters and to analyze the relationship between changes in walking speed and improvements in neuromuscular parameters following intervetions. Methods: 40 participants were randomly assigned to either a high-speed resistance training group (GHS, n = 18; age = 80.41 ± 10.12 years; BMI = 23.81 ± 3.45 kg/m²) or a low-speed resistance training group (GLS, n = 22; age = 82.89 ± 5.32 years; BMI = 23.81 ± 3.45 kg/m²). Before and after the interventions, gait speed (m/s) was assessed using a 10-minute walking test, and relative maximal force (Relative F max, N/kg) was evaluated during maximal voluntary isometric con-traction of the plantar flexors. From the force-time curve, early (0 – 50 ms) and late (100 – 200 ms) rates of force development (RFD) were extracted from the linear slopes (Δ force / Δ time). Results: Gait speed significantly improved in both groups (p < 0.05). However, the improvement was more pronounced in the GHS compared to the GLS (p < 0.05). Relative Fmax showed a more significant increase in the GLS than in the GHS (p < 0.05). Moreover, a significant 10% increase in early RFD in the GLS and a 20.1% increase in the GHS were observed (p < 0.05). The improvement in early RFD was greater in the GHS (p < 0.05). Additionally, late RFD improved significantly only in the GHS (+20.4%, p < 0.05). Conclusion: High-velocity resistance training appears particularly effective in improving the ability to rapidly generate force, which is essential for many daily activities re-quiring explosive movements and quick responses.

Some preterm and sick neonates have altered biochemical profiles and follow-up newborn screening (NBS) collections are recommended. The Victorian NBS program historically recommended recollections for babies with birth weight &lt;1500g (managed by the maternity service provider) and 3 weeks post-transfusion (managed by the laboratory). We aimed to determine adherence to current guidelines and review the guidelines to improve NBS performance. To do this we audited data from 348,584 babies between January 2018 and June 2022. Babies with a recorded birth weight of &lt;1500g were filtered for inclusion. For the overall review and visualization of the protocol, we sourced information from the literature, our professional society and tertiary hospital services. A total of 2647 babies had a birth weight recorded between 200 and 1499g. Of these 2036 (77%) had a second sample collected, indicating that &gt;1 in 5 babies were not receiving a follow-up collection. Our timing of recollections for transfused babies, requiring a 3-week follow-up collection, was longer than in other Australasian jurisdictions. A new combined “sick-prem-protocol” was launched to support recollections and after a one-year review achieve 95% compliance. We recommend NBS laboratories audit preterm and sick neonate recollections to ensure appropriate follow-up. This should be supported with a visual process map to aid education and compliance.

: Background. Delivering bad news is a sensitive and challenging aspect of nursing healthcare, requiring a holistic approach that respects patients' preferences, cultural values, and religious beliefs to promote adaptation to the state's health. Aim: map the evidence of the dimensions present in the communication and management of bad news by nurses, with the person in a palliative situation, their caregivers, and family members. Methods: Based on Joanna Briggs Institute methodology, the search was conducted through MEDLINE Complete (EBSCOhost), CINAHL Complete (EBSCOhost), SciELO, and Open Access Scientific Repository in Portugal. From a total of 756 articles, 14 were included, published between 2018 and 2023. Results: Structure components in bad news are influenced by the characteristics of the palliative patients, their caregivers, family members; nurses; and the organizational environment. Promoting the quality of the communication process is desirable through continuous and advanced training in end-of-life; training in bad news; religiously and culturally sensitive nursing interventions centered on hope and maintaining faith; emotional management; and utilization of a checklist protocol. Conclusions: Honest communication allows people to actively participate in the decision-making process and in the trajectory of the care plan that is focused on themselves and their preferences, which has outcomes in functional capacity and readaptation.

Placing a nasogastric tube (NGT) is a frequent nursing technique in intensive care units. The gold standard for its correct positioning is the chest X-ray due to its high sensitivity but represents a radiation source for critically ill patients. Our study aims to analyze whether the ultrasound performed by an intensive care nurse is a valid method to verify the NGT’s correct positioning and to evaluate the degree of interobserver agreement between this nurse and an intensive care physician in the NGT visualization using ultrasound. Its correct positioning was verified by direct visualization of the tube in the stomach and indirect visualization by injecting fluid and air through the tube ("dynamic fogging" technique). 23 critically ill patients participated in the study. A sensitivity of 35% was achieved using direct visualization, increasing up to 85% using indirect visualization. The degree of interobserver agreement was 0.88. Therefore, the NGT indirect visualization by an intensive care nurse using ultrasound could be a valid method to check its positioning. However, the low sensitivity obtained by direct visualization suggests the need for further training of intensive care nurses in ultrasonography. According to the high degree of agreement obtained, ultrasound could be performed by both professionals.

Our target point within this following steps, is prostate cancer. Prostate cancer is classified structurally, by its Gleason Score. Phosphatases are implicated in differents cell alterations, including proliferation, differentiation and carcinogenesis. In specific life circumstances, proteins are regulators with implications in intracellular signaling pathways. Alterations in phosphatases functionality represent a key point in malignancy development. We try within our description, to focus on an important process refering to dysregulation of phosphatase activity. More than, we will discuss therapeutic key points refering to compounds that inhibits phosphatase proteins with implications in carcinogenesis. Researchers try to investigate and to conclude on prostate cancer using also genomic analyses, clinically useful biomarkers and imagistic methods. So finally after folowing describtion steps, purposed aim is to conclude on prostate cancer and different key points abordation.

Background: Peloids are therapeutic agents used in thermal and thalasso centers for curative, preventive, and skin care purposes. Marine peloids are those that include seawater and algae, both macro and/or microalgae. The aim of this study is to investigate the suitability of a marine peloid composed by seawater, clay and microalgae for thalasso-wellness and dermocosmetic uses; Methods: the thermophysical properties of the marine peloid were determined and compared with a non-marine peloid using different techniques as densimetry, conductimetry, calorimetry, and viscometry; skin hydration was also measured by means of Corneometry; Results: marine peloid has been shown to be suitable for thermotherapy and thalaso-wellness treatments as its thermophysical properties were similar to other peloids used for this purpose; marine peloids also showed to improve skin hydration after seven days of treatment; Conclusions: this research provides a comprehensive study of the thermophysical properties of a marine peloid composed by clay, seawater and microalgae for thalasso-wellness and cosmetic uses, as well as its moisturizing properties, highlighting its potential as a valuable natural product for skin care applications as well as for wellness treatments in form of cataplasm, poultices and/or wraps.

This study aimed to develop a state-of-the-art method for assessing chemical risks. The method combined desk research findings and the authors' practical knowledge to identify the major shortcomings in performing risk assessments at the workplace. Data were collected from nine SMEs across three sectors: agriculture, laboratory research, and conservation and restoration laboratories. The results of the discussions with the workers and on-site observations were used to develop the method to assess chemical risks. The method uses numerical factors to account for the level of conformity and the duration of exposure to support an estimation of the probability of an incident. The developed method was designed to enhance risk assessment practices and tackle common issues encountered by enterprises, including SMEs.

Many risk-modifying factors affect cancer incidence and mortality rates. We present an ecological study of incidence and/or mortality rates for cancers during 2007–2016 of 17 anatomical sites with respect to solar ultraviolet-B (UVB) doses and obesity prevalence. Solar UVB reduces cancer risk by producing vitamin D, which has many mechanisms to reduce risk of cancer incidence, progression, and metastasis. Obesity increases cancer risk through several mechanisms, including increased systemic inflammation. Data were averaged for 12 geographical regions. Solar UVB doses were significantly inversely correlated with mortality rates for five cancers for males and four for females. Obesity prevalence was directly correlated with mortality rates for three cancers for males and seven for females. The population attributable fraction of cancer mortality rates ascribed to low solar UVB dose was 0.03 for both males and females, whereas that for obesity prevalence was 0.05 for males and 0.08 for females. Thus, cancer mortality rates in France could be reduced through vitamin D supplementation and reducing the prevalence of obesity. Doing so also could reduce risk of other adverse health outcomes.

ABSTRACT：Background: Diagnosing rhabdomyolysis has usually defined at least five or ten times the upper limit creatine kinase level; but it is conservative for Exertional rhabdomyolysis. The aim was to analysis the biomarkers during a military operation in an extreme environment with high physical demand. Material and Methods: Seventeen male military personnel (age: 27.83 ± 2.96 years; weight: 76.31 ± 7.67 kg; and height 174.92 ± 5.91 cm) participated for this investigation. The creatine kinase (CK); blood urea nitrogen (BUN); creatinine (Cr); sodium (Na); potassium (K); aspartate amino transferase (AST) and alanine amino transferase (ALT) were analyzed. Urine specific gravity (USG) the hydration status was monitored. The Generalized Linear Models for repeated measures and the Friedman’s two-way test were used to comparative moments. Results: The BUN; Cr; Na; and K mean values showed a nonsignificant. The statistical significance of the test was found in CK and AST. There was considerable variability of CK between subjects during the operation. The moderate correlation between CK and Cr was found during study. Conclusion: Elevated CK levels after the operation were characterized as physiological pattern. These results reinforce that CK values are not predictors of renal function in activities with intense and continuous physical demand

Traumatic Brain Injury (TBI) is one of the leading causes of death and disability worldwide. Patient treatment and management pose a challenge for healthcare systems. The prognosis of these patients may be influenced by factors such as sex. This study aims to describe the clinical parameters of patients hospitalized in the Intensive Care Unit (ICU) of a Spanish hospital due to Trauma Brain Injury and to establish differences based on sex. Methodology: An observational, cross-sectional, and analytical study was conducted from March 2015 to December 2019. All patients admitted to the ICU during this period who presented isolated significant Traumatic Brain Injury, defined as an abbreviated injury scale (AIS) ≥ 3, were included. Data on baseline characteristics, mechanism of injury, substance use, and acute management in the prehospital and hospital stages (including the need for hospitalization) were recorded. A descriptive and in-ferential analysis was conducted using the chi-square test. Results: A total of 950 patients were ultimately included. The majority of the patients were men (723) with a mean age of 45.16 (± 17.55). There were statistically significant differences in terms of the mechanism of injury (p

Background: Atopic dermatitis is a chronic condition that significantly affects the daily life of those who suffer from it, requiring complex and personalized management with active participation of the patient in the management of their disease. Objective: to describe the design and development process of a mobile application, using the Design Thinking method, for the follow-up of patients with atopic dermatitis. Methods: User-centered design and prototype creation method, differentiating the phases of the empathize, define, idea, prototype, and test. A purposive snowball sampling was used to recruit patients with atopic dermatitis, family members, and health professionals. Three two-hour workshops were held, attended by 25 people. Results: the parameters to be monitored will include objective data (physical, behavioral, treatments, environmental, integration of daily routines) and subjective data (user experience). On the other hand, it will figure out behavior patterns, set up rewards, foster a feeling of community, and use notifications and a chatbot. Conclusion: The active integration of all stakeholders at each stage of the design and development of the digital solution has improved its relevance and acceptance, resulting in a tool that is expected to significantly improve the management of atopic dermatitis.

Introduction: Gestational diabetes mellitus (GDM) pregnant women are under more psychological stress than healthy pregnant women. The objectives of the current study were to examine: (1) The differences in anxiety, depression, stress, and somatization levels between women diagnosed with GDM and healthy pregnant women. (2) The differences in anxiety, depression, stress, and somatization levels among women with well-controlled blood sugar levels compared to those who are not well-controlled. Methods: A quantitative cross-sectional study was conducted, involving 103 women who had been pregnant at least once, including 40 women diagnosed with GDM and 63 healthy pregnant women. An online questionnaire was distributed and included three parts: a socio-demographic parameters, the DASS-21 questionnaire assessing anxiety, depression, and stress, and the BSI (Brief Symptom Inventory) questionnaire assessing somatization. Results: Differences in anxiety (t=14.470, <.001), depression (t=8.17, <.001), stress (t=16.354, <.001), and somatization (t=13.679, <.001) levels between women diagnosed with GDM and healthy pregnant women were found. Women diagnosed with GDM reported higher levels of anxiety, depression, stress, and somatization compared to those without GDM. Additionally, Women with better blood sugar control, indicated by lower glycated hemoglobin (HbA1c) levels, reported lower levels of anxiety. (t (38) = -2.04, p<0.05), depression (t(38)= -2.88, p<0.01), stress (t(38)= -1.88, p<0.05), and somatization (t(38)= -1.88, p<0.05) compared to women with poorer blood sugar control. Conclusion: Pregnant women diagnosed with GDM report higher levels of negative personality traits such as anxiety, depression, stress, and somatization compared to healthy pregnant women.

Purpose of research was to determine changes in optical quality for monthly disposable soft contact lenses (SCL) wearers with new and monthly worn SCL. Retinal straylight was assessed in SCL wearers using a C-Quant straylight meter. The study included 33 participants (age 22 ± 1.4 years) who wore monthly disposable silicone hydrogel contact lenses. Measurements were taken with month-old SCL that had been worn for no more than 4 hours. Participants then replaced the old lenses with new ones. After a 15-minute adaptation period, straylight measurements were taken with the new SCL. A questionnaire was administered to all participants, inquiring about vision complaints and the type of contact lens material used. The decimal logarithm of the stray-light parameter, log(s), was notably higher with month-old SCL (log(s) = 0.97±0.17) than with brand-new SCL (log(s) = 0.86±0.15), p < 0.001. The average increase in retinal straylight after a month of SCL use was log(s) = 0.11 ± 0.08. The questionnaire revealed that 35% of participants observed a reduction in visual quality after wearing the contact lenses for a month. Results showed that monthly disposable soft contact lenses could reduce visual quality when scheduled replacement time has been reached.

The present study evaluated the effect of Prosthechea karwinskii leaves extract on antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT) in a model of obese rats with insulin resistance to know its nutraceutical potential on insulin resistance and oxidative stress. Obesity and insulin resistance were induced in rats by administering 40% sucrose in water. Once the model was established, four groups were evaluated (control, obese, obese administered with extract, and obese administered with metformin), and the indices of insulin resistance and the activity of antioxidant enzymes were measured. In addition, compounds in the extract were identified with UHPLC-ESI-qTOF-MS/MS. The glucose, insulin, triglycerides, and insulin resistance indicators (HOMA-IR and TyG) increased in obese rats. The activity of the antioxidant enzymes evaluated increased in the obese group, apparently as an adaptive response to oxidative stress to inhibit reactive oxygen species formed by hyperglycemia. Administration of P. karwinskii extract and metformin reduced glucose, insulin, triglyceride levels, insulin resistance indicators and antioxidant enzymes to values like those of the control group. This study shows the nutraceutical potential of P. karwinskii extract as an ingredient in the formulation of food supplements or functional foods to help treat diseases related to insulin resistance and oxidative stress.

Background: Colorectal cancer (CRC) can significantly impact mental health, increasing suicide risk. Variables such as pain and threat perception may be crucial. This study aims to identify predictors of suicide risk in individuals with CRC. Methods: A total of 71 participants (76.06% men) aged 27 to 88 years (M = 65.18, SD = 12.02) were assessed using the SF-36 for pain, the Brief Illness Perception Questionnaire (B-IPQ) for threat perception, the Hospital Anxiety and Depression Scale (HADS) for emotional distress, and the Plutchik suicide risk scale for suicide risk. Descriptive, comparative, and correlational analyses were performed, followed by a linear regression analysis. Results: Nearly 20% of participants exhibited high suicide risk. There was a moderate to high association between suicide risk and the perception of threat, pain, and emotional distress. The linear regression model explained 39% of the variance in suicide risk, with threat perception, pain, and emotional distress as significant predictors. Conclusions: These results indicate the need for multidisciplinary care for individuals with CRC, including emotional support from health psychologists, and holistic, human-centered care from nursing and medical professionals. Future research is necessary to further explore these relationships and improve patient care strategies.

(1) Background: The purpose of this study was to assess the external load demands in futsal, con-sidering both home and away matches and their outcomes, in order to plan microcycles throughout the season based on the external load of each match. (2) Methods: The external load of 10 players from a First Division team in the Spanish Futsal League was recorded. The total dura-tion of player involvement with the clock stopped was 18.15 ±7.04 minutes. The players' external load was monitored using OLIVER devices. To analyse the influence of the match outcome and location on the external load, a univariate general linear model (GLM) analysis was conducted. (3) Results: There are no differences between the variables, except for accelerations of 2 to 3 m/s² (m) per minute and the number of accelerations of 2 to 3 m/s² per minute. Despite not showing significant differences, there is a trend indicating a higher demand for external loads in away matches as well as in matches won. (4) Conclusions: These findings are important for planning microcycles and providing the appropriate dosage to each player to achieve optimal performance in matches.

(1) Background: In a society with an advancing aging rate, medical systems are coming under pressure due to an increasing flow of elderly patients with multiple somatic diseases, exacerbated by their fragile psychological and sociological backgrounds. We aimed to investigate the relationship be-tween frailty and loneliness in elderly people. Our research question was “Is there a link between the loneliness and frailty in elderly people?” (2) Methods: To assess the link between loneliness and frailty, we conducted a search accessing Index Medicus and PubMed; the timeframe of our research was from 2013 till 2023. Data regarding the study population, as well as loneliness and fragility assessments and approaches, were extracted. (3) Results: A positive relationship between loneliness and the appearance and progression of frailty in elderly people is argued for. (4) Conclusions: Maintaining a balance in the body’s functionality for as long as possible requires the diagnosis and periodic assessment of health status at any age and, due to the various socio-financial and emotional implications, is particularly imperative for elderly patients. Frailty can be prevented, and it appears that it could even be reversed if early diagnosis and appropriate interventions are made. Therefore, knowledge of relevant risk factors—most likely including loneliness—is an absolute necessity to slow down, stop, and even reverse the frailty process.

This study investigates the effects of home-based Kakao health care breathing exercises and stretching on respiratory function and fatigue in COVID-19 cured patients. A total of 35 participants performed four movements of home-based breathing exercise and five respiratory muscle stretching exercises four times a week for four weeks. Respiratory function was measured using FVC, FEV1, FEV1/FVC, and PEF. Fatigue was assessed using the Fatigue Severity Scale (FSS). Data analysis was performed using Independent Samples and Paired Samples T-tests in SPSS 24, with a significance level set at p &lt; 0.05. After four weeks of Home based Kakao health care Breathing Exercise, there were significant increases in respiratory FVC, FEV1, FEV1/FVC, and PEF function values observed in the training group (T.G.) after the exercise intervention (p &lt; 0.05). Such an increase was observed when comparing these values with the pre-exercise measurements. In contrast, there was no statistically significant difference in respiratory function outcomes before and after exercise in the control group (C.G.) (p &gt; 0.05). The FSS scores were statistically significant within the training group (T.G.). (p &gt;0.05). The 4-week Kakao health care Breathing Exercise was found to be capable of improving some respiratory functions in COVID-19-recovered patients, but it showed no significant improvement in fatigue levels.

Developing effective cognitive training tools for older adults, specifically addressing executive functions such as planning, is a challenging task. It is of paramount importance to ensure the implementation of engaging activities, which must be tailored to the specific needs and expectations of older adults. Furthermore, it is essential to provide the appropriate level of complexity for the planning task. A human-centred approach was employed to address the issues identified in the design of the tool. Two pilot studies were conducted with older adults to fine-tune the training task and optimise its suitability for them. This also led to an enhancement of the underlying planning engine, transitioning from simple fast-forward planner (PDDL4J) to an advanced heuristic search planner (ENHSP). The results show that conducting user studies enabled the development of a cognitive training system that gradually increases the proposed difficulty levels of the planning task while maintaining usability and satisfaction among older adults. This highlights the importance of conducting user studies when implementing cognitive training tools for older adults.

Depression is one of the most prevalent mental disorders worldwide. This study examined the effect of a spiritual connectivity intervention on individuals with depression in a randomized waitlist control trial. Fifty-seven participants with mild or moderate depressive symptoms were randomly assigned to either the intervention group (n=28) or the waitlist control group (n=29). The intervention comprised eight weekly sessions focusing on divine connection, forgiveness and freedom, suffering and transcendence, hope, gratitude, and relapse prevention. The outcome measures included depressive symptoms, anxiety, hope, meaning in life, self-esteem, and social support. Participants completed self-administered questionnaires at baseline (week 0), post-intervention (week 8), and at a 3-month follow-up (week 20). Repeated-measures ANOVA and one-way ANCOVA were used to compare the within-group and between-group differences in the changes in outcome variables. Participants in the intervention group showed significant improvements in depression, anxiety, spiritual experience, hope, self-esteem, and perceived social support after the intervention. Effect size statistics showed small to large differences (Cohen’s d, 0.308 to -1.452). Moreover, 85.71% of participants in the intervention group also experienced clinically significant reductions in PHQ-9 scores from baseline to immediate post-intervention. This study highlights the effectiveness of a low-cost, accessible intervention suitable for community implementation by clergy and faith-based organizations.

Conversational artificial intelligence (AI) has shown strong capabilities in providing low-cost and timely interventions for a wide range of people and increasing well-being. Therefore, this study examined ChatGPT’s efficacy in conducting psychological counseling and its potential for providing accessible psychological interventions, especially in school settings. This study assessed the strengths and limitations of AI to inform future research. Data were generated from ChatGPT’s responses to 80 counseling questions that college students asked during a school counseling setting. All the responses generated during these simulated counseling sessions were then analyzed using three primary metrics—warmth, empathy, and acceptance—following APA guidelines. The analysis adopted several natural language processing methodologies for emotion detection and empathy measurement to quantify ChatGPT’s high efficacy in presenting the appropriate emotions and reactions for counseling. Some responses demonstrated randomness, which is crucial for consideration regarding the use of ChatGPT or relevant technology in psychological counseling. The Discussion section also highlights future directions in the application of conversational AI to enhance students’ mental health.

Legionella bacteria can proliferate in poorly maintained water systems, posing risks to users. All Legionella species are potentially pathogenic but Legionella pneumophila (L. pneumophila) is usually the primary focus of testing. However, Legionella anisa (L. anisa) also colonises water distribution systems, is frequently found with L. pneumophila and could be a good indicator for increased risk of nosocomial infection. Anonymized data from three commercial Legionella testing laboratories afforded analysis of 565,750 water samples. Data covered July 2019 to August 2021, including the COVID-19 pandemic. Results confirmed L. anisa commonly colonises water distribution systems, being the most frequently identified non-L. pneumophila species. Proportions of L. anisa and L. pneumophila generally remained similar but increases in L. pneumophila during COVID-19 lockdown suggests static water supplies might favour its growth. Disinfection of hospital water systems was effective but re-colonization did occur, appearing to favour L. pneumophila, although L. anisa colony numbers also increased as a proportion of the total. While L. pneumophila remains the main species of concern as a risk to human health, L. anisa’s role should not be under-estimated, either as a potential infection risk or as an indicator of the need to intervene to control Legionella colonization of water supplies.

Knee osteoarthritis (KOA) is a progressive and multifactorial disease that leads to joint pain, muscle weakness, physical disability, and decreased quality of life. In KOA, hyaluronic acid (HA) quantity and molecular weight (MW) are decreased, leading to joint pain due to increased wear of the knee articular cartilage. Arthrogenic muscle inhibition, which is usually found in patients with KOA, is associated with joint inflammation, pain, and swelling, also causing muscle atrophy, primarily of the anterior thigh muscles, and hindering the rehabilitation process. The aim of our work was to determine if a single HA infiltration could minimize the effects of arthrogenic muscle inhibition in patients with KOA in the short term, using isokinetic dynamometry to evaluate the strength of the knee extensor and flexor muscles of the thigh. Thirty patients with KOA who underwent both clinical and isokinetic assessment, and that received a single injection of HA, were retrospectively included. Our results showed that a single intra-articular injection of HA significantly reduces pain and improves joint function at four weeks, while non-statistically significant improvements were observed for the reference isokinetic parameter (maximum torque) at both 90°/s and 180°/s. Further high-quality studies are necessary to confirm the results of our study.

Background:Almost the entire country of Burkina Faso was endemic to onchocerciasis. Onchocerciasis control efforts thus brought the prevalence of O. volvulus to a level where the disease was no longer a public health problem and a national onchocerciasis control program was set up in 1991 to ensure surveillance and maintain the gains made. A resurgence of onchocerciasis cases has been observed in two regions (Comoé, South West) located around several river basins in the 2010-2011. In accordance with WHO guidelines, for the management of resurgent cases, CDTI was implemented in the affected areas of Comoé and Sud-Ouest regions. Methodology: We conducted an extensive analysis to determine the effects of CDTI on parasitological indices of onchocerciasis in these two areas and we also analyzed the data in relation to the location of the village in relation to the river to see if this was a factor in the decrease in prevalence. Results: A total of 43 villages in 6 health districts, i.e., 100% of the villages that participated in the epidemiological surveys before and after the implementation of CDTI in the Southwest and Cascade regions were included in the study. The key findings were that standardized microfilaria prevalence and CMFL decreased significantly after the implementation of CDTI in both regions. For the average of the two regions, the results for standardized microfilaria prevalence were -5.91 with a 95% confidence interval of (-9.67; -2.16) and for CMFL were -0.29 with a 95% confidence interval of (-0.57; -0.01). Our results showed also a decline in standardized microfilaria prevalence and CMFL in all villages involved in the study. Moreover, the drop in the trajectory of the curve representing the predicted standardized microfilaria prevalence of villages located within 5 km of the streams was greater than that of villages located more than 5 km from the streams. Conclusion: Our results thus show that the implementation of effective CDTI could stop the transmission of O. volvulus in these two regions. The main challenge for stopping transmission could be the migration of populations to neighboring countries and migration of the vector from one country to another, as Burkina Faso shares some river basins with neighboring countries.

Objective: To explore the hot spots and development trends of community public health research. Methods: The literature related to this topic was searched in CNKI and PubMed databases, and the trend map of the number of articles was drawn according to the obtained data. The included literature were analyzed with Vosviewer software for keyword and author co-occurrence, and CiteSpace 6.3.R1 Basic software was used for mechanism co-occurrence, key emergence and clustering analysis, and timeline distribution map drawing. Results: 189 Chinese literature and 77 English literature were selected. The Chinese literature focused on “community public health service, emergency management, and community governance”, and the research trend was “community public health emergency management and community governance”; English literature focuses on “nursing education, health education, human qualitative research”. Conclusion: Although the Chinese and English literature shows that scholars in this field have different emphases, the primary community health is the key and difficult point to realize the national public health service project, and improving the basic public health service in the primary community is related to the health of all the people, so it is very important.

Medical datasets may be imbalanced and contain errors due to subjective test results and clinical variability. The poor quality of original data affects classification accuracy and reliability. Hence, detecting abnormal samples in the dataset can help clinicians make better decisions. In this study, we propose an unsupervised error detection method using patterns discovered by the Pattern Discovery and Disentanglement (PDD) model, developed in our earlier work. Applied to the large data, the eICU Collaborative Research Database for sepsis risk assessment, the proposed algorithm can effectively discover statistically significant association patterns, generate an interpretable knowledge base for interpretability, cluster samples in an unsupervised learning manner, and detect abnormal samples from the dataset. As shown in the experimental result, our method outperformed K-Means by 38% on the full dataset and 47% on the reduced dataset for unsupervised clustering. Multiple supervised classifiers improve accuracy by an average of 4% after removing abnormal samples by the proposed error detection approach. Therefore, the proposed algorithm provides a robust and practical solution for unsupervised clustering and error detection in healthcare data.

To accurately determine the refractive error of the eye, sufficient relaxation of eye accommodation is essential, either through the fogging technique or pharmacological cycloplegia. This study aimed to evaluate the clinical information revealed after cycloplegia and assess how age and non-cycloplegic refractive status influence the classification of eye refractive error. We analyzed the records of 472 non-population-based subjects aged 3–28 years (mean ± SD: 9.1 ± 4.6) who attended a private ophthalmology practice from January 2018 to December 2020. Cycloplegia was induced with one drop of cyclopentolate 1% in each eye, and refraction was measured 30 ± 5 min later using an objective autorefractometer. The average spherical equivalent (SE) difference (mean ± SD) induced by cycloplegia was 0.72 ± 0.73 D, with the highest difference observed in the 3-5 years age group (1.18 ± 0.85 D). Gender had no significant effect on the SE values before or after cycloplegia (p &gt; 0.05). Cycloplegia caused a hyperopic refractive shift in 83% of participants, no shift in 12%, and a myopic refractive shift in 6%. This study highlights the importance of cycloplegia use in children and young adults.

This narrative review examines the crucial role of physical activity in managing long COVID, characterized by persistent symptoms such as fatigue, breathlessness, and cognitive impairments following SARS-CoV-2 infection. The methodology involved a comprehensive literature search across PubMed, EBSCO (EDS), and Google Scholar, selecting peer-reviewed articles from December 2019 focusing on long-term COVID physical activity interventions. The review highlights that tailored exercise programs, adjusted to individual health status and abilities, significantly alleviate symptoms and enhance psychological well-being. Key findings emphasize the importance of personalized exercise prescriptions due to the variability in patient responses and the need for a multidisciplinary approach in developing and monitoring interventions. Despite promising outcomes, the review identifies research gaps, including the need for long-term studies, randomized controlled trials, and deeper mechanistic insights. It suggests that standardized reporting, templates like CERT, and integrating digital health tools are essential for optimizing interventions. Overall, the review advocates including personalized physical activity programs in standard care for long COVID to improve patient outcomes and quality of life.

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers—DNA methylation age (DNAmAge) and telomere length (TL)—in blood leukocytes, nasal cells (NC), and induced sputum (IS) one-year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February-May 2020), compared to COPD patients, model for "aged lung". Data by questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male gender, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p&lt;0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p&lt;0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p≤0.05) and NC (p&lt;0.001), and were biologically older than COPD patients (p&lt;0.05). These findings suggest the need for monitoring aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population.

Sudden cardiac arrest (SAC) is a leading cause of mortality. In recent years, though, many lives have been saved through the use of defibrillators by random bystanders. As a result, defibrillators have been popping up in various locations. In this work we propose a state mandate demanding the presence of a defibrillator at every pharmacy store and argue that it could greatly enhance and augment the impact of the defibrillator network. We support our claim via detailed calculations of the immediate (a defibrillator readily available) and partial (a defibrillator available at a reasonable distance) population coverage achievable by the implementation of our proposal, taking the Argolis area in Peloponnese Greece as a case study. Our findings indicate that, in addition to other benefits, the use of pharmacies to establish a defibrillator network could bring an eight-fold increase in the immediate population coverage of defibrillators and would provide immediate / partial access to a defibrillator to 18 / 24 incidents of SCA per year that would otherwise lead to death, potentially leading to the saving of numerous lives. Alternative scenaria are also discussed.

Penile cancer (PeCa) is a rare urological malignancy characterized by significant geographic variations in both incidence and mortality rates. Due to its rarity and the consequent lack of randomized trials, current management is based on retrospective studies and small prospective trials. In addition, the diagnostic pathways and treatment strategies exhibit substantial heterogeneity, differing significantly between less developed and well-developed countries. The prognosis of PeCa is determined by the presence and extent of regional lymph node (LN) involvement. Therefore, early detection and treatment of LN metastasis is paramount to ensure better outcomes. In recent decades, the overall survival for PeCa has increased, mainly due to advancements in imaging techniques and risk stratification. We aim to provide an overview of the current role of PET CT imaging in the management of patients with PeCa.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

(1) Background: São Paulo, Brazil, exhibits high mortality rates from pediatric solid tumors. This study analyzed the survival trends of patients aged 0-19 diagnosed with the state's five most prevalent solid tumors between 2000-2022. (2) Methods: An epidemiological, descriptive study utilized data from the Oncocentro Foundation of São Paulo, classified according to the International Classification of Childhood Cancer. The time between the first consultation and diagnosis, between diagnosis and treatment initiation, and patient survival were assessed using the Pe-to-Peto test. (3) Results: Analysis involved 11,067 cases: 53.5% male, with 89.6% diagnosed via microscopic confirmation. Tumor distribution comprised 34.3% central nervous system, 21.1% bone, 18.6% soft tissue, 14.2% germ cell, and 11.9% retinoblastomas. Main treatments included surgery with chemotherapy (26.5%), surgery alone (20.5%), and chemotherapy alone (15.6%). The average time between consultation and diagnosis was 22.94 ± 69.93 days, significant for treatments and recurrences, except for germ cell tumors (p=0.0178). The time between diagnosis and treatment was 25.46 ± 39.71 days, not significant for germ cell tumor treatments (p=0.0793). (4) Conclusions: Survival curves varied among neoplasm groups, with patients experiencing delays beyond recommended times, despite advanced healthcare services in the state.

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted between 2006 and 2017. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas generally exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need and their low intention to use FP services and preference for family size (&gt;3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts.

This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, for college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study's end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over three weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. Activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and three weeks post-program. The experimental group showed significant improvements in stress, anxiety, depression, self-efficacy, resilience, and the K-PPC total score compared to the control group. These improvements were maintained at the three-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times like the COVID-19 pandemic.

Background: Burns are a common and severe medical emergency requiring immediate specialized care to minimize damage and prevent complications. Burn severity depends on depth, extent, and location, with more complex care needed for burns on critical areas or extensive burns. Nursing is essential in burn management, providing immediate care, adapting treatments, managing pain, preventing infections, and offering emotional support for recovery. Methods: Retrospective, observational study that analyzed burn cases treated at the Hospital Complex of Cáceres (Spain) 2018-2022. Inclusion criteria were based on ICD-10 codes for burns, excluding severe cases not treated in this service. Data were analyzed using descriptive statistics, Student's t-tests, Chi-square tests, and ANOVA. Results: 220 patients, with a mean age of 47 years and 60.9% male. Most burns (95.5%) affected the external body surface, with a mean hospital stay of 7.86 days. Medical treatment was provided to 75.5% of patients, and 24.5% required surgical intervention. Significant differences in treatment procedures were observed according to age, skin thickness, and burn degree. Older patients had more procedures and longer hospital stays. Excision and transfer procedures were more common in full-thickness and severe burns. Conclusions: The findings align with previous research on burn demographics and treatment approaches. Treatment differences by age and burn severity highlight the need for tailored interventions. The study underscores the importance of comprehensive burn management, including psychological support for improved long-term outcomes. Further research could explore the impact of socio-economic factors on burn incidence and treatment.

This study investigated the relationship between fundamental movement skills (FMSs) and health-related fitness (HRF) among first and second graders in South Korean elementary schools. It aimed to provide foundational data for developing physical education programs tailored to the motor development stages and fitness levels of younger elementary school students. In October 2023, FMSs (jumping, running, hopping, static balance, dynamic balance, overhand throwing, and kicking) and HRF (muscular strength, cardiorespiratory endurance, and flexibility) were evaluated among 291 first and second graders. The collected data were analyzed through frequency and multiple regression analyses performed using the SPSS software. The results revealed that higher scores in jumping and hopping are associated with greater muscular strength, cardiorespiratory endurance, and flexibility. Running had no significant effect on HRF elements. Higher scores in static balance (single-leg stance) were associated with increased muscular strength, cardiorespiratory endurance, and flexibility, but dynamic balance (balance beam walking) did not have a significant effect. Higher scores in overhand throwing were associated with greater muscular strength and cardiorespiratory endurance, but kicking did not show a significant association. Overall, these findings emphasize the importance of prioritizing jumping and static balance in physical education for the well-rounded health development of first and second graders.

Individuals have different rumination patterns after experiencing traumatic events in different cultural backgrounds and situations. This study was aimed to explore the experience of Chinese young and middle-aged patients with acute coronary syndrome (ACS) to understand the content and nature of their rumination. Fourteen participants were selected using the purposive sampling method in XXX hospital from May 2023 to December 2023. Data were collected using semi-structured interviews and analyzed using Colaizzi’ s 7-step phenomenological method. The content of rumination in young and middle-aged patients with ACS can be summarized into 2 categories: non-adaptive rumination and adaptive rumination. Non-adaptive rumination included 3 themes: worry or anxiety, scare, and depression. Adaptive rumination included 4 themes: tracing of disease processes, enhancement of disease cognition, improvement of health awareness, and adjustment of lifestyle cognition. In conclusion, although Chinese young and middle-aged patients with ACS experience negative emotions after a traumatic cardiac event, they gradually make positive changes, and optimism and information support play important roles in this transition, which provide a fundamental understanding of rumination experiences in Chinese young and middle-aged patients with ACS and provide new data for healthcare providers when designing intervention programs to enhance post-traumatic growth in these patients.

Keywords: Artificial Intelligence in Implantology; AI in Dental Implantology; Machine Learning in Dental Implantology; Deep Learning in Implant Dentistry; Robotics in Dental Implantology; AI-Based Implant Planning.

The global antibiotic resistance crisis, driven by antibiotic overuse and misuse, is multifaceted. This study aimed to assess the microbiological and genetic characteristics of raw retail pork meat, including the isolation, antibiotic susceptibility testing (AST), whole genome sequencing (WGS) of selected indicator bacteria, antibiotic residue testing, and metagenomic sequencing. Samples were purchased from 10 randomly selected retail stores in Gauteng, South Africa. Samples were aseptically separated, with a portion sent to an external laboratory for isolating indicator bacteria and antibiotic residue testing. Identification of the isolated bacteria was reconfirmed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). AST was performed using the Microscan Walkaway system. WGS and metagenomic sequencing were performed using the Illumina NextSeq 550 instrument. The isolated E. coli and enterococci exhibited little phenotypic resistance, with WGS revealing tetracycline resistance genes. Isolated bacteria and meat samples all harboured tetracycline resistance genes, and the antibiotic residue concentrations were within acceptable limits for human consumption. In the metagenomic context, most identified bacteria were of food/meat spoilage and environmental origin, with the resistome analysis primarily indicating beta-lactam, tetracycline and multidrug resistance genes. Further research is needed to understand the broader implications of these findings on environmental health and antibiotic resistance.

State-of-the-art augmented-reality (AR) glasses record their position and orientation in space, enabling measurements and analyses of clinical gait-and-balance tests. This study’s objective was to evaluate concurrent validity and test-retest reliability for common clinical gait-and-balance tests in people with Parkinson’s disease: the Five Times Sit-To-Stand (FTSTS) and Timed Up-and-Go (TUG) tests. Position and orientation data was collected in 22 participants with Parkinson's disease using HoloLens 2 and Magic Leap 2 AR glasses, from which test-completion durations and durations of distinct sub-parts (e.g., sit-to-stand, turning) were derived and compared to reference systems and over test repetitions. Regarding concurrent validity, for both tests an excellent between-systems agreement was found for position and orientation time series and test-completion durations. Between-systems agreement for FTSTS (sub-)durations were all excellent, while TUG turning sub-durations were excellent (turn 1) and moderate (turn 2). Regarding test-retest reliability, the within-system test-retest variation in test-completion times and sub-durations was always much greater than the between-systems variation, implying that these (sub-)durations may be derived interchangeably from AR and reference-system data. In conclusion, AR data are of sufficient quality to evaluate gait and balance in people with Parkinson's disease, with valid quantification of test-completion durations and sub-durations of distinct FTSTS and TUG sub-parts.

This longitudinal study aimed to analyze the effects of a team rowing-based training program on physical fitness and anthropometric parameters in female breast cancer survivors (n=40; 56.78±6.38 years). Participants were divided into two groups: one rowed in fixed seat rowing (FSR) boats (n=20; 56.35±4.89 years) and the other in sliding seat rowing (SSR) boats (n=20; 57.20±7.7 years). Both groups engaged in two 75-minute sessions per week for 24 weeks. Significant improvements were observed in both groups in resting heart rate (FSR: -10.65 bpm; SSR: -8.45 bpm), heart rate at the beginning of the 6-minute walk test (6MWT) (FSR: -10.7 bpm; SSR: -11.25 bpm), and heart rate at the end of the test (FSR: -13.85 bpm; SSR: -20.35 bpm). Blood pressure improved significantly in both diastolic blood pressure (FSR: -12.35 mmHg; SSR: -19.25 mmHg) and systolic blood pressure (FSR: -13 mmHg; SSR: -16.95 mmHg). Additionally, both groups increased the distance covered in the 6MWT (FSR: +63.05 m; SSR: +93.65 m). These results suggest that a rowing training program is a viable and safe activity for female breast cancer survivors, improving cardiac function, blood pressure, and cardiorespiratory capacity, particularly in sliding seat boats.

Healthcare leaders are faced with many financial challenges in the contemporary environment, leading to many bankruptcies in recent years. What is not well understood are the specific conditions that lead to organizational economic failure. Ideally, hospital leaders could examine the literature for guidance to predict bankruptcy before it occurs. However, existing regression methods have proven inadequate, especially when the finance variables follow a nonnormal frequency pattern. Furthermore, the regression approach encounters difficulties due to multicollinearity and nonnormality issues. Therefore, an alternate stochastic approach for predicting the probability of hospital bankruptcy is warranted. This new method includes computing and interpreting the correlations between the hospital’s revenue and expenses for bivariate lognormal data, calculating the risk of bankruptcy due to the mismatch between revenues and expenses, determining the likelihood of a hospital’s expense exceeding the state’s median expense level, and evaluating a hospital’s financial memory level. Ultimately in our research, we demonstrate a novel approach to anticipate hospital bankruptcy, which can be particularly useful for health policy analysts and hospital leaders in making informed financial decisions and proactively managing risks to ensure the sustainability and stability of their institutions.

Background: Positive person-centered attributes of inpatient rehabilitation need to be identified from the patient perspective to be further developed and sustained. Purpose: To identify which attributes patients openly evoke as being great care experiences, using an open appreciative inquiry during the inpatient rehabilitation stay. Methods: Qualitative secondary analysis of appreciative patient comments during a bedside patient experience rounding, facilitated by a neutral party. Two independent analysts employed an inductive, summative form of content analysis. Results: Among 150 patients rounded, 122 provided categorizable appreciative accounts. Over two thirds of the patients (67.2%) focused on “staff attributes” in their great-experience accounts. Those attributes were mostly interpersonal such as being “attentive & caring - beyond clinical duty” and being “encouraging (but not too hard) & reassuring”. These interpersonal staff attributes were reported with words showing deep levels of personal significance or patient appreciation. Beyond staff attributes, the perceived quality of the “patient care” (31.1%) and opportunities for “leisure and social activities” (9.0%) were also frequently evoked. Amenities like food or costumer service were the least evoked, rarely so as an exclusive attribute (0.8% for each). Conclusions: The human(e) factor, especially the interpersonal qualities of staff, emerged as greatly appreciated from the patient experience perspective during inpatient rehabilitation. These experiences help identify which person-centered attributes of care might be further developed and sustained.

Introduction:The high interest in sports among young people has contributed to the growing importance of the phenomenon of sports specialization in recent years. It refers to players who train a particular sport for more than 80h per month. This is particularly noticeable in the group of young soccer players, in whom such a high training volume, is an important factor predisposing to the development of injuries. An important risk factor is the common lower limb muscle imbalance in the soccer player population between the extensors and flexors of the knee joint, showing a maximum isometric force ratio as low as 1:2. To compensate for this imbalance, it is important that eccentric exercises have a positive effect by improving the strength of the knee joint flexor muscles, especially the well-studied Nordic hamstring exercise(NHE). However, many studies only evaluate the effect of modified NHE exercise training volume, without isolating the effects of performing a single exercise session. It is worth noting that, there are warm-up protocols that incorporate the aforementioned exercise and enjoy high utility and effectiveness for sports injury prevention. Objective: Given the emerging imbalance in the strength of the knee stabilizing muscles, the aim of the study was to determine whether performing a single NHE intervention would alter the isometric strength of the knee flexor muscles (HAM). Methods: A group of 56 players of a youth soccer team (age range 13-16), were recruited for the pilot study. In doing so, the players constituted a group of healthy, training soccer players at the central junior level. After meeting the inclusion criteria, 32 players were entered into the study. Participants were randomly assigned to a study group (A) and a control group (B). In the study group, the intervention consisted of a single NHE exercise in the form of two series of trunk slumps in a kneeling position, eight repetitions each. The control group performed one series of forward trunk bends, five repetitions each. Participants (group A and B) were tested on the ` platform before the experimental procedure and immediately after the intervention. Maximum isometric strength of the knee joint extensors (QUAD) and knee joint flexors (HAM) were measured. Results: Statistical analysis of the obtained results indicated that the maximum muscle strength of the HAM increased after the performed, single intervention NHE (p=0.04) relative to the control group. At the same time, no increase in the strength of the quadriceps muscles of the thigh (extensors of the knee joint) was shown after the intervention, relative to the control group. Conclusions:The results obtained indicate that a single performance of the NHE exercise has an effect on increasing the maximum isometric strength of the HAM muscles. This increase, although not statistically significant, correlated with no change in quadriceps muscle strength. The work is a pilot study and further research may benefit in maintaining the balance between the two muscle groups, namely HAM and QAD, which contributes to the prevention of joint-muscle injuries. At the same time, the study supports the previously stated thesis that a single performed Nordic Eccentric Exercise is an important element in the prevention of muscle injuries in the lower limb, thus confirming the effectiveness of its use in football warm-ups. Nonetheless, implementation of the exercise into long-term training is necessary to achieve significant effects of muscle balance compensation in the lower limb, as confirmed by numerous training protocols.

In the context of modern healthcare, the concept of patient-centered care (PCC) has emerged as a crucial aspect, prompting the need for innovative frameworks to empower patients and enhance healthcare outcomes. This paper introduces the Patient-Oriented Medical Ontology Conceptual Framework (POMOCF), a powerful framework aimed at giving patients control over their personal and healthcare information. It prioritizes patient independence by allowing for direct control of electronic health records (EHRs) and facilitates the gathering of information through document upload or scanning. In the POMOCF front-end framework, we propose to maintain scalability, along with robust authorization, authentication, and secure data protocols, all of which are detailed within the framework. This approach enhances data accuracy and security, improving data management efficiency. As part of our ongoing development, we are planning to implement an innovative inference system that will automatically analyze and extract relevant details from the uploaded authorized document, provide real-time updates, and maintain data accuracy. This approach further strengthens data accuracy and prevents unauthorized modifications, thereby making the data management process more efficient. POMOCF leverages medical ontology principles to ensure standardized clinical concepts and improved semantic interoperability. Our integration plans involve integrating genotypic data for personalized medicine initiatives and strengthening the front-end infrastructure. By linking front-end interfaces with advanced technological solutions, we aim to provide effective healthcare delivery, promoting personalized care and enhancing patient outcomes.

Background: School nursing plays a crucial role in promoting the health and well-being of students in educational settings. Previous research has highlighted its protective effect across various health domains, including substance use, mental health, violence, and sexual health. Despite its importance, the job satisfaction of school nurses and the factors influencing it have been insufficiently addressed in scientific research, underscoring the need to better understand their challenges and barriers. Therefore, the objective of this research is to evaluate the perceived job satisfaction and professional quality of life of school nurses at a national level in Spain. Methods: A descriptive cross-sectional study was conducted using the Font-Roja Job Satisfaction Questionnaire and the CPV-35 Professional Quality of Life Questionnaire. The sample included 553 school nurses from different geographical regions in Spain, selected through school nursing groups and associations. Data were collected from November 2023 to February 2024. Results: The majority of the nurses were women (68%), with a median age of around 40 years and predominantly less than 5 years of work experience (56%). Significant differences were observed in job satisfaction and professional quality of life depending on the employing entity (healthcare and educational settings). Factors such as workload, institutional support, and work experience influenced the perception of job satisfaction. Conclusions: We affirm that this study, being one of the first of its kind at a national level in Spain, highlights the need to develop effective strategies to improve the job satisfaction and professional quality of life of school nurses. School nurses in Spain present a moderately high level of job satisfaction, although there are significant differences in factors such as status and job monotony depending on the sector of employment (Healthcare, Education, Others). Nurses in educational contexts report lower levels of job satisfaction, influenced by the nature of the work, interpersonal relationships, opportunities for professional development, and institutional support. Additionally, work experience impacts satisfaction, being more positive for nurses with greater experience. We also affirm that the professional quality of life of school nurses is homogeneous, with an average score of 6.000 on the CPV-35. Although professional competence is uniformly perceived, work pressure is a common concern. Working more than 37.5 hours per week is associated with higher professional quality of life, although also with lower job satisfaction. Only half of the schools have a school nurse, highlighting the need for policies that ensure equity in service provision. There is also a recognized need for health training for teachers, which could improve support for nurses and student health. Active interaction with the educational community reinforces the integral role of school nurses and emphasizes the importance of the socioeconomic context in interventions and resource allocation.

Previous studies have reported that clinical walk tests could not predict development of frailty. With advancements in wearable technology, it may be possible to predict the development of frailty using loading asymmetry parameters during clinical walk test. This prospective cohort study aimed to test the hypothesis that increased limb loading asymmetry predicts frailty risk in community-living older adults. Sixty-two independently ambulant community-living adults aged ≥ 65 years were recruited, and forty-seven subjects completed the one-year follow-up after baseline. Loading asymmetry index of net and regional (forefoot, midfoot, and rearfoot) plantar forces were collected using force sensing insoles (100 Hz) during a 10-m walk test with their maximum speed. Development of frailty was defined if the participant progressed from baseline at least one grading group of frailty at follow-up period using the Kihon Checklist. Fourteen subjects developed frailty at follow-up period. Increased risk of frailty was associated with each 1% increase in loading asymmetry of net impulse (Odds ratio 1.153, 95% CI 1.001 to 1.329). Loading asymmetry of net impulse significantly correlated with asymmetry of peak force in midfoot force. These results indicate the feasibility of measuring plantar forces of gait during clinical walking tests, and underscore the potential of using load asymmetry as a tool to augment frailty risk assessment in community-dwelling older adults.

The aim of this article is to identify the best available evidences analyzing liver samples, normall and pathological. In the study were used liver samples, collected during necropsy, from healthy patients and from patients diagnosed with cirrhosis .This mentioned, are known as routinally practice for hepatitis C diagnosis, which conduct to hepatic cirrhosis. Were made permanent preparations and used Hematoxylin–Eosin staining and other special stainings for structural observations at optical microscope using lens with differents magnifications, such us x10 and x40.

Geographic information systems (GIS) are critical for mapping the geographical distribution of illness prevalence, disease transmission patterns, and spatially modeling environmental elements of disease occurrence. This study was purposively to map and cluster five diseases such as cholera, diabetes, malaria, asthma and hypertension using GIS techniques in Southern Malawi. Getis-Ord Gi* statistic was used to determine spatial distribution of diseases. Data were acquired from Malawi Demographic Health Survey (DHS) and assessed geographically using spa-tial-statistical analytical techniques, including the kernel and hotspot models. These models were developed to investigate and exhibit the dissimilar patterns of the selected diseases, as well as to depict places of high concentration, and they may be useful in understanding local patterns of diseases and their geographical correlations. The study found that asthma is high in Mangochi, Balaka, Blantyre, Thyolo, Mulanje, Chikwawa and Nsanje districts. It was also revealed that hypertension patients were highly concentrated in Blantyre, Thyolo, Chikwawa, Zomba, Mangochi and Nsanje Districts. Mangochi, Phalombe, Nsanje and Chikwawa are high risk areas of Malaria and diabetes is highest in Blantyre. Cholera is high in Mangochi, Balaka, Blantyre, Thyolo, Mu-lanje, Chikwawa and Nsanje districts.

Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, there is currently no evidence to counter the widespread concern that these services enable large numbers of unsuitable patients to obtain Glucagon-like peptide-1 receptor agonists (GLP-1 RA). This study retrospectively analysed the rate at which the partner pharmacy network of Australia’s largest DWLS provider committed GLP-1 RA dispensing errors over a 6-month period. The analysis found that 191 (0.14%) of the 135131 dispensed Semaglutide orders contained an error. Non-compliant dose escalation (44.5%) and dispatch errors (32.5%) were the two most common error types. Most errors (89%) were deemed to have been of medium urgency, with 6.8% considered high urgency. A disproportionate number of high urgency cases were from wrong medication (31%) and general complaint errors (15%). A Chi-square test revealed a statistically higher dispensing error rate among orders to female patients (0.16%) compared to males (0.076%). The results lay an important foundation in digital pharmacy literature and suggest that comprehensive DWLSs have the potential to safely collaborate with third-party pharmacies in dispensing GLP-1 RAs.

Deep inhalation breath hold (DIBH) has become a valuable technique in left breast cancer radiotherapy, offering the possibility to reduce radiation exposure to organs at risk (OARs) and minimize the risk of cardiac complications. The treatment method involves patients stopping breathing during irradiation to temporarily distance the heart from the radiation field, reducing potential cardiac and other complications. Research shows that DIBH reduces the radiation dose to the heart and lungs. However, the effectiveness of DIBH is determined by a variety of factors, including the patient's training, cooperation, anatomical features, age and choice of radiotherapy technique. Additionally, cardiovascular risk factors: diabetes, smoking, hypertension can affect the effectiveness and potential complications of DIBH. Moreover, lack of consent, fear, anxiety, depression and comorbid psychiatric disorders disqualify some patients from the DIBH treatment method. Careful patient selection, comprehensive training and optimization of treatment parameters are essential to maximize the benefits of DIBH while minimizing potential side effects. DIBH enhancement techniques, such as IMRT or VMAT, also have an important role to play. The purpose of this review article is to summarize the factors affecting the efficacy and side effects of DIBH in radiation therapy for left breast cancer, with the aim of optimizing its clinical application while minimizing side effects.

This study compares the Melbourne Decision-Making Questionnaire (MDMQ) and the General Decision-Making Style (GDMS), two of the most widely used decision-making questionnaires in the literature, in a large age- and sex-weighted general population sample of 714 men (45.7%) and 848 women (54.3%) between 18 and 90 years old. The objective was to evaluate the convergent and construct validity between several aspects of decision-making styles questionnaires. The results indicate that the two questionnaires replicate the factorial structure of four and five factors reported in the original studies respectively, through exploratory and confirmatory procedures in our cross-cultural context. The domains of both questionnaires that represent a strong or large correlation are Vigilance with Rational (.50), Hypervigilance, Buck-passing, and Procrastination with Avoidant (.45, .52 and .60). A Structural Equations Model (SEM) between both questionnaires indicates that both latent factors formed by the domains of the MDMQ and the GDMS obtain a correlation of .96. It is concluded that the two questionnaires measure similar aspects of the decision-making construct.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A literature search was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, between 1980 and 2024. Titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

Purpose: To explore how race and residential zip codes' socioeconomic index (SES) influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City. The study included 16,915 individual tests from 30 residential zip codes. Results: The overall testing rate in St. Louis was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indian/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher testing rates were observed in low and middle SES zip codes compared to high SES zip codes. Adjusted for SES, testing rates were 1.68% higher among Blacks and 0.43% higher among American Indian/Alaskan Natives compared to Whites, and 0.033% lower among Asians. Geographical mapping showed higher testing rates in the inner core and lower rates in the periphery of St. Louis. Conclusion: Race and SES influence testing rates. Areas with low testing rates should be targeted for intervention in St. Louis.

Obesity is associated with chronic low-grade inflammation. Polyunsaturated fatty ac-ids such as omega-3 (n-3), are essential in the pro-resolution of inflammation. An 8-week double-blind randomized clinical trial was conducted with a n-6:n-3, 5:1 ratio, along with daily 1.8 g of n-3 supplementation vs. placebo. A total of 40 subjects were included, 21 in omega 3 group and 19 in placebo group. The n-3 supplementation had a superior effect compared to placebo increasing levels of Resolvin D1 [129.3 (-90.1 - 193.5) vs. -16.8 (-237.8 - 92.5) pg/mL, p=0.041], IL-10 [1.4 (-0.7 - 4.6) vs. -2.0 (-5 - 0.05) pg/mL, p=0.001], and decreasing IL-6 [-0.67 (2.72 - -0.59) vs. 0.03 (-0.59 - 1.84) pg/mL p=0.015], and MCP-1 [-29.6 (-94.9 - 5.50) vs. 18.3 (-97.3 - 66.35) pg/mL, p=0.040]. In con-clusion, n-3 supplementation promoted resolution of inflammation by increasing sys-temic levels of Resolvin D1, IL-10, and decreasing IL-6 and MCP-1.

Mental Disorders are an important public health problem. The main of this study was to analyze the prevalence of Mental Disorders and Environmental Quality. Data on the Prevalence of Mental Disorders, Gross Domestic Product, and Median Years of Schooling from 178 countries were used. A positive association was observed and was independent of Gross Domestic Product and Median Years of Schooling.

Myasthenia Gravis (MG) is a chronic autoimmune neuromuscular disorder characterized by muscle weakness and fatigue, which can significantly impact various facets of daily life, including physical capabilities, emotional well-being, and social interactions. The prognosis, when supported by optimal symptomatic, immunosuppressive, and supportive treatment, is generally favorable. However, compelling evidence underscores the presence of diminished quality of life among patients with MG. Notably, cognitive impairment, depressive symptoms, and sleep disorders emerge as clinically pertinent dimensions in affected individuals, warranting careful scrutiny and investigation. Individuals with this condition often encounter challenges stemming from a lack of knowledge about effective coping strategies. The core objective of our research is to delve into the coping strategies adopted by patients with MG. To this end, we conducted an extensive inquiry, administering a series of personalized questions and utilizing the short version of the Coping Orientation to Problems Experienced questionnaire, (COPE-NVI-25) survey. Generative Artificial Intelligence was also employed to gain a better understanding of patient responses. The outcomes of our study hold the potential to steer the development of targeted interventions, strategic approaches, and valuable resources designed to assist patients with MG in proficiently managing their condition and enhancing their overall well-being.

Although many physical activity (PA) interventions for older adults have proven ef-fective in controlled research settings, optimal implementation in real life remains challenging. This study identifies determinants perceived by stakeholders when im-plementing community-based PA interventions for older adults. We interviewed 31 stakeholders guided by the Consolidated Framework for Implementation Research (CFIR). Results showed that stakeholders are very specific about the role they can play in implementation making collaboration between stakeholders crucial. Barriers and motivators were identified in the CFIR intervention characteristics domain (relative advantage, complexity and costs, evidence quality and strength, and adaptability and trialability), in the outer setting domain (cosmopolitism, patient needs, and external policy and incentives), in the inner setting domain (implementation climate, relative priority, compatibility and organizational incentives and rewards) and in the individ-ual characteristics domain (knowledge and beliefs, and other personal attributes). An overarching theme was the stakeholders' emphasis on aiming for broad health goals in interventions, as they perceive PA as a means to reach these goals rather than an end in itself. Another overarching theme requiring attention in future implementation ef-forts is the need to tailor implementation efforts to the specific needs of older adults as the end users of the intervention.

Background: Our previous study highlighted important healthcare access and utilization concerns among new immigrants. Hence, in this study, we aimed to explore the role of public and patient involvement (PPI) may have in enhancing the accessibility and their contribution to migration health studies. Method: An open and in-depth interactive consecutive virtual discussion was conducted among volunteer asylum seekers and refugees from Eritrea and Syria in Switzerland. The novel PPI establishment had three phases; inception, training phase, and contribution phase. Result: At the beginning, the concept of PPI was apprehensive to grasp, as it was a new approach. After training and consecutive discussions, volunteers were ardent to engage actively. Hence, among the prime findings were the PPI's role and effect in raising awareness, PPI's role in exploring and communicating the healthcare system accessibilities and utilization among their community, the impact of PPI in echoing the healthcare needs of their fellow migrants, and PPI's contribution in enhancing and strengthening migration health researches. Conclusion: The PPI volunteers in the study were keen to raise their community's awareness through their networks, and bridge the research gap between researchers and the public.

Paediatric supraventricular tachycardia (SVT) is a common arrhythmia of great clinical significance. If not treated promptly, it can cause heart failure and cardiogenic shock. Depending on the patient’s condition SVT treatment involves vagal manoeuvres, pharmacological or direct current cardioversion. The goal of acute SVT management is to immediately convert SVT to normal sinus rhythm (NSR) and prevent its recurrence. Adenosine is recommended as first-line treatment for stable SVT by the European Resuscitation Council (ERC) and American Heart Association (AHA) guidelines when vagal manoeuvres have proven ineffective. ERC and AHA guidelines recommend the intravenous route of administration. Intraosseous (IO) administration technique is also possible, but still relatively unknown. The aim of this paper is to describe a 3.5-year old child with SVT which was converted to NSR following IO administration of adenosine. Successful conversion was achieved in the second attempt with the adenosine dose. In the described case, there was no recurrence of SVT.

As the global population faces an increasing prevalence of physical disabilities, the challenge of motor rehabilitation has become increasingly urgent. Considering that approximately 15% of the global population lives with some form of disability, with a significant number having motor disa-bilities that greatly impact their quality of life, the integration of robotic technologies into rehabili-tation processes offers an opportunity for significant improvement in functional recovery and pa-tient autonomy. This analysis aims to evaluate the progress and challenges encountered in imple-menting robotic technology for the rehabilitation of patients with physical disabilities, highlighting the potential of emerging technologies such as exoskeletons, assisted training devices, and brain-computer interface systems in facilitating motor recovery. By examining relevant clinical studies, the analysis demonstrates the varied effectiveness of robotic therapies compared to traditional re-habilitation methods, while also highlighting the need for ongoing research to optimize care prac-tices and address challenges related to cost, accessibility, and treatment personalization. In con-clusion, robotic technologies represent a promising direction in motor rehabilitation, with the po-tential to revolutionize the care of patients with physical disabilities, significantly improving quali-ty of life and social integration.

Introduction: Rural Americans face significant health disparities due to limited access to healthcare services. Telehealth has emerged as a promising solution to mitigate these disparities by facilitating remote access to medical care. This paper comprehensively reviews the advantages, challenges, and implementation strategies of telehealth in rural areas.Method: A narrative review methodology was employed to synthesize existing literature and case studies on telehealth in rural settings. Databases such as PubMed, Google Scholar, and JSTOR were searched for relevant studies published in the last three decades. Keywords such as "telehealth," "rural health," and "healthcare disparities" guided the search process. The review focused on studies assessing the impact of telehealth on healthcare access, cost-effectiveness, and quality of care in rural areas.Results: The review findings indicate that telehealth significantly enhances healthcare access by reducing travel distances, increasing availability of specialist consultations, and promoting patient engagement. It improves chronic disease management and patient satisfaction by enabling convenient access to healthcare services at home. Despite initial setup costs and challenges such as broadband access and regulatory issues, telehealth demonstrates long-term cost savings through reduced travel expenses and improved healthcare efficiency. Quality of care is enhanced through improved communication between healthcare providers and patients, leading to better treatment adherence and health outcomes.Conclusion: Telehealth represents a transformative approach to address healthcare disparities in rural areas. It offers a cost-effective solution to improve access to healthcare services, enhance patient outcomes, and reduce healthcare costs in the long run. However, successful implementation requires addressing infrastructure challenges, refining reimbursement policies, and ensuring regulatory support. Future efforts should focus on expanding broadband infrastructure, refining policy frameworks, and conducting further research to optimize telehealth's impact on rural healthcare delivery.

Future healthcare professionals can play a significant role in managing those with thoughts of suicide. This scoping review aims to determine healthcare students’ knowledge and attitude towards suicide. A systematic search was conducted across five databases: PubMed, CINAHL, EMBASE, PsycINFO, Cochrane, and DARE. Only primary studies written in English, from database inception until 31st December 2023 were included. A total of 44 studies were included. Overall, healthcare students demonstrated low to moderate confidence in managing patients with thoughts of suicide and low levels of relevant education despite acknowledging their importance in preventing suicide. Increased personal exposure to suicide was associated with increased suicide literacy, confidence in managing patients with thoughts of suicide, and reduced stigma. Demographics and culture were shown to affect knowledge and attitude as well. Further research is needed to better understand various contributing factors to healthcare students’ knowledge and attitude regarding suicide. Evaluating healthcare curricula should be considered to implement effective suicide training program.

Causation concepts for work-related musculoskeletal disorders vary among authors and academic disciplines. Major causation concepts are single-event and repetitive motion. The aim of this short communication is to share findings from a recent survey, conducted by the U.S. Bureau of Labor Statistics of United States employers about work-related musculoskeletal cases, and more specifically, about whether the employers regard the cause of their employee’s musculoskeletal problem as being from a single exposure or from multiple exposures. Recommendations are offered for using terminology consistent with employer understandings.

The detection, characterization, and monitoring of SARS-CoV-2 recombinant variants is a challenge to public health authorities worldwide. Recombinant variants, composed of two or more SARS-CoV-2 lineages, often have unknown impacts on transmission, immune escape, and virulence in the early stages of emergence. We examined 4,213 SARS-CoV-2 recombinant SARS-CoV-2 genomes collected between 2020 and 2022 from California to describe regional and statewide trends in prevalence. Many of these recombinant genomes, such as those belonging to the XZ lineage, or novel recombinant lineages, likely originated within the state of California. We discuss the challenges and limitations surrounding Pango lineage assignments, the use of publicly available sequence data, and adequate sample sizes for epidemiologic analyses. Although these challenges will continue as SARS-CoV-2 sequencing volumes decrease globally, this study enhances our understanding of SARS-CoV-2 recombinant genomes to date while providing a foundation for future insights into emerging recombinant lineages.

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

Jamaica has one of the highest teenage pregnancy rate and therefore identifying the context of adolescent sexual and reproductive health is important, especially since there is paucity of research on preadolescents in the Jamaican context. The study was a nationally representative cross-sectional, interviewer administered, school-based survey of 10 -15 year olds. Summary statistics of the demographics and bivariate analyses were performed to assess the association of sexual initiation and given risk and resiliency factors. 1,422(47.4%) males, 1,581 (52.6%) females, mean age (SD) 12.5 (1.6) years were surveyed. Mean age of first sex was 11.0 (±2.5) years. Factors significantly with sexual initiation were, female sex (OR 0.17; 95% CI 0.12-0.23), caring relationships inside the home (OR 0.85; 95%CI 0.83-0.97) rare church attendance (OR1.36; 95%CI1.0-1.8), age (OR 1.75; 95%CI1.6-1.9) and community disorganization (OR 1.02 95% CI 1.01-1.07). Sexual initiation of early adolescents is positively influenced by environmental factors such as family connectedness and religious involvement. The negative correlates are societal risk factors such as community disorganization. Empowerment through learned sexual negotiation skills, should be incorporated into the education programme of pre-adolescents to facilitate adolescents embracing their intrinsic power to delay sexual debut and if sexually active to insist on condom use.

Knowing the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many places during the first wave of COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana (Valencia Community, Spain), during “Falles” mass gathering events in March 2020, a cross-sectional study was performed in June 2020 querying public health register. Logistic regression models were used. From a total of 468 symptomatic COVID-19 cases diagnosed in the outbreak by anti-SARS-CoV-2 serology, 36 cases were reported (7.7%), thus an underreporting of 92.3% (95% Confidence Interval [CI] 89.5%-94.6%), 13 unreported cases for every reported case. Only positive SARS-CoV-2 polymerase chain reaction cases were predominantly reported due to a limited testing capacity and following a national protocol. Significant factors associated with underreporting were no medical assistance for COVID-19 disease, adjusted odds ratio [aOR] 10.83 (95% CI 2.49-47.11), no chronic illness, aOR=2.81 (95% CI 1.28-6.17), middle and lower social classes, aOR=3.12 (95% CI 1.42-6.85), younger age, aOR=0.97 (95% CI 0.94-0.99), shorter duration of illness, aOR=0.98 (95% CI 0.97-0.99). To improve surveillance, studies of representative population samples are necessary to estimate the magnitude of future epidemics, and novel approaches are recommended.

Background This study aimed to examine the acute effects of different pre-ST strategies on muscular performance and blood pressure (BP) responses in recreationally strength-trained women. Methods: Twelve overweight women with normal-to-elevated BP were recruited and performed six exper-imental protocols in a randomized order: 1) control protocol (CC) – BP assessed without exercises performed, 2) strength training (ST), 3) foam rolling warm-up followed by strength training (FR+ST), 4) specific warm-up followed by strength training (SW+ST), 5) aerobic exercise followed by strength training (AE+ST), and 6) stretching exercises followed by strength training (SE+ST). Strength training consisted of three sets at 80% of 10RM with a self-suggested rest interval between sets for bench press, back squat, bench press 45º, front squat, lat pull-down, leg press, shoulder press, and leg extension. Results: All experimental protocol had a lower total training volume, fa-tigue index, and repetitions performance in relation to ST (p

In a world where physical activity and social participation are fundamental pillars for a full, healthy, and quality life, confidence in walking emerges as a fundamental aspect to be assessed, especially in older adults. The purpose of this study was therefore to develop a Portuguese (Euro-pean) version, linguistically and psychometrically adapted, of the Ambulatory Self-Confidence Questionnaire (ASCQ); A translation method was used followed by an assessment of its validity and reliability. The Portuguese version was completed by 173 older adults. To assess reliability was used Cronbach’s Alpha and Intraclass Correlation Coefficients (ICC). For sociodemographic and clinical characterization, as well as for the questionnaire scoring was used descriptive statistical analysis. Pearson's correlation (r), Student´s t-test and ANOVA were used to analyse the criterion and con-struction validity; The Portuguese interactions of ASCQ was effectively translated and adjusted, revealing exceptional internal consistency and test-retest reliability, as reflected in Cronbach's alpha and ICC values of 0.95. No Floor Effect was observed, however, a Celling Effect was identified (3.5%). Criterion and construct validity were verified because all the correlations established were statistically significant; The adaptation of the ASCQ to Portuguese culture is adequate, making it valid for use within the Portuguese population of Portugal.

Mortality rates in sub-Saharan Africa remains unacceptably high, and disproportionately affecting economically disadvantaged communities. And healthcare delivery which is considered a major contributor to this is challenged by the limited resources and high service costs, prompting many patients to opt for outpatient department services. This study addresses the need for a data-driven approach to healthcare policy formulation by proposing a model for the implementation of a data warehousing system that integrates outpatients into the national healthcare framework. By leveraging data warehousing, healthcare delivery can be made more efficient through a robust repository that supports decision-making and policy formulation. The research focuses on the outpatient department in resource-scarce settings, proposing a novel multidimensional data model and practical framework implementation. The benefits include improved patient experiences, cost-effective service delivery, and enhanced patient management through electronic health records. Additionally, mobile apps are explored for patient navigation and reminders to enhance treatment adherence. The study’s results indicate that data warehousing can significantly improve healthcare delivery by consolidating critical data and facilitating better planning, resource allocation, and policy formulation. Ultimately, this approach offers valuable insights for optimizing healthcare systems in resource-constrained environments, enabling data-driven policies, and improving health outcomes across sub-Saharan Africa.

Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, predominantly affecting older adults. Understanding the multifaceted factors contributing to AD is crucial for developing effective prevention and intervention strategies. This narrative review synthesizes current literature on the various factors influencing the development and progression of AD in older adult populations.Methods: A comprehensive search was conducted across electronic databases including PubMed, Web of Science, and PsycINFO using relevant keywords such as "Alzheimer's disease," "risk factors," "genetics," "environmental factors," and "lifestyle." Studies published between 2000 and 2023 were included, focusing on factors associated with AD in individuals aged 65 years and older.Results: The review identified several key factors contributing to AD in older adults. Genetic predisposition, particularly the presence of apolipoprotein E (APOE) ε4 allele, emerged as a significant risk factor. Environmental factors such as air pollution, pesticides, and heavy metals were also implicated. Furthermore, lifestyle factors including physical inactivity, poor diet, and smoking were associated with increased AD risk. Chronic conditions such as diabetes and cardiovascular diseases were found to exacerbate cognitive decline in older adults.Conclusion: This narrative review highlights the complex interplay of genetic, environmental, and lifestyle factors in the development and progression of Alzheimer's disease among older adults. Understanding these factors is crucial for targeted interventions aimed at reducing AD risk and improving cognitive health outcomes in aging populations. Future research should focus on longitudinal studies and personalized medicine approaches to elucidate specific mechanisms underlying AD pathogenesis and to develop effective preventive strategies.

Despite many calls to reduce or eliminate the use of mechanical restraint, it is still widely used in many countries. Studies using patient interviews have a very clear message: Patients experience mechanical restraint as the most humiliating intervention. There seems to be a lack of alternatives with violent patients. We developed a method using 30 kg bags, originally designed for fitness purposes, to be attached to a patient's wrist or ankle under 1:1 supervision. The method was tested with 10 experienced nurses and de-escalation trainers. A video was made and presented to six outpatients who had previously experienced mechanical restraint. All participants were interviewed. Transcribed interviews were analysed using qualitative content analysis. All participants approved of the method as a milder and less humiliating alternative to mechanical restraint. Nurses' main concerns were the risk of falls and the use of the bags as a weapon. The latter could be controlled by using an additional bag. Patients were generally positive, especially if there was a history of abuse. The method should be further developed to replace at least part of mechanical restraints. As with all ‘milder means‘, care should be taken to really replace restraint and not to introduce additional coercion.

Knee osteoarthritis is a prevalent joint disease affecting millions of individuals globally. While total knee arthroplasty is an effective treatment for advanced stages of KOA, it may not be suitable for earlier stages or younger patients. Supervised exercise therapy has proven to be the first line treatment of preference in tackling pain and disability caused by KOA. However, the high intensities required to induce positive muscle adaptations are not indicated in this population as this is often accompanied by pain, discomfort, and frustration; leaving low load resistance training as the only feasible method of treatment. Recently, the use of blood flow restriction training began to emerge as a substitute for high load resistance training. With BFRT, a cuff is applied around the proximal aspect of the affected limb, causing partial arterial and full venous occlusion, thereby inducing localized hypoxia and accumulation of metabolites, mimicking the effects of high load resistance training, albeit with low loads. Consequently, BFRT might offer a suitable and more effective alternative for KOA patients who are not (yet) eligible for TKA, compared to the traditional exercise therapy. This review aims to summarize the current evidence as regards the application of Blood Flow Restriction in exercise therapy of knee osteoarthritis patients, with particular consideration of the underlying mechanisms and its safety, as well as general guidelines for practical implementation into clinical practice. In doing so, this narrative review aims to create a framework allowing the translation from theory to practice.

Integrating optical coherence tomography (OCT) into the pre-surgical stage of cataract management holds significant clinical and economic potential, particularly in low-to-middle-income countries like Kazakhstan. This study aimed to evaluate these impacts by prospectively recruiting 124 patients, aged 70±8 years, from two ophthalmology surgical centers in Almaty, Kazakhstan. Patients undergoing phacoemulsification of cataracts with monofocal intraocular lens (IOL) implantation between January and December 2022 were divided into two groups: the OCT group (n=75) received pre-operative OCT, while the Control group (n=49) did not. Visual acuity (VA) was measured pre- and post-surgery, and the cost-effectiveness of the surgical strategies was analyzed. The OCT group experienced a significantly greater improvement in VA (-0.647±0.232 logMAR) compared to the Control group (-0.543±0.244 logMAR), with a notable interaction between time and group (F(df) = 217.2, p &lt; 0.001). Additionally, pre-existing concomitant diseases were diagnosed in 25.3% of cases in the OCT group and 28.6% in the Control group. The economic analysis revealed that the integration of OCT facilitated multiple surgeries in one appointment, thereby reducing overall costs. These findings suggest that implementing OCT in the pre-surgical stage of cataract management can significantly enhance visual outcomes and decrease the cost of ophthalmology services in Kazakhstan.

: Fluoride toxicity has become a global public health concern, and its significant source of exposure is drinking water. This study aimed to determine groundwater fluoride level and assess its related human health risks. Its level was measured from groundwater samples using an ion-selective electrode. The total hazard index was assessed based on the chronic daily oral intake and dermal absorbed dose of groundwater fluoride. Analyses were conducted using ArcGIS and SPSS. This study reported groundwater fluoride ranged from 0.3 mg/L to 38 mg/L, with a mean annual level of 15 mg/L. Groundwater fluoride level above 5 mg/L was reported in 60 % of the water samples. Total hazard index values among sampled locations varied from 0.18 to 22.56. Half (51.5 %) of infants, 85.5 % of children, 82.5 % of adolescents, and 67.5 % of adults had a risk of developing a non-carcinogenic health effect. This study demonstrated that the fluoride level of the groundwater sources was high, and the water was not suitable for drinking, a result that is of special importance for children and adults since they are a hypersensitive subgroup of the population.

Background: Breastfeeding is essential for optimal infant health, offering numerous benefits such as infection prevention and enhanced bonding. Despite its importance, challenges exist, particularly for mothers of preterm and very low birth weight (VLBW) infants, necessitating effective lactation support strategies. Initiatives like the Baby Friendly Hospital Initiative (BFHI) and Kangaroo Mother Care (KMC) aim to promote breastfeeding success, while donor human milk (DHM) serves as an alternative bridge while the mother is supported to build up her supply. Adequate lactation support, counseling, and education are vital antenatally, during NICU stays and after discharge to improve breastfeeding rates and infant health outcomes, ultimately contributing to global efforts to reduce neonatal mortality and achieve sustainable development goals. This study explores existing research on factors influencing mothers’ ability to produce breast milk and sustain breastfeeding, with the aim of enhancing lactation support and improving infant health outcomes.Methods/Design: A systematic review will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. Searches will be performed in the following databases: PubMed, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE Ovid via EBSCOhost, Google Scholar, and WILEY online Library) to identify and incorporate primary research articles related to the topic published between 2014 and 2024. Authors will search peer-reviewed articles, gray literature sources, and reference lists to identify eligible studies. Independent abstract and full-text screening by two reviewers will follow the title screening. The analysis of data will be carried out using Review Manager software (version 5.3.5). The I² test will be used to quantify the amount of unexplained heterogeneity. Potential biases related to study size (such as publication bias) will be examined through the application of several techniques, including funnel plots, Egger’s test, Begg’s test, and Trim and Fill analysis.Discussion: Our review represents a singular exploration into exclusive breastfeeding among very low birth weight (VLBW) infants in low- and middle-income countries (LMICs), focusing on breastfeeding assistance methods. With VLBW defined as less than 1500 g, and most low birth weight (LBW) babies born in LMICs, there is a critical need to address feeding challenges and promote optimal nutrition. Despite updated WHO guidelines in 2022, there is still a lack of comprehensive advice for this vulnerable population. Peer support interventions and health worker counseling have shown promise in increasing breastfeeding continuation rates in LMICs, but challenges persist due to workforce shortages and inadequate documentation. Promoting early postpartum milk expression is crucial for milk production and infant health. Our review aims to fill the gap in understanding VLBW mothers’ breastfeeding experiences in LMICs, shedding light on the effectiveness of breastfeeding support methods and identifying areas for further research. Systematic review registration: CRD42024547864

Carbonaceous materials have gained significant attention in recent years for their various applications in the field of medicine and biotechnology. This comprehensive review explores the synthesis and characterization of carbon-based materials and their potentials in various medical applications. The paper delves into the methods of fabrication of carbon-based nanoparticles, such as carbon nanotubes, biochar, and graphene, while highlighting their unique properties. Characterization techniques, such as microscopy, spectroscopy, and surface analysis, are discussed to provide insights into the chemical and structural properties of these materials. Furthermore, the review examined their wide-ranging medical applications, encompassing tissue engineering, drug delivery, biosensing, and imaging, showcasing the versatility and promising contributions of carbonaceous materials in the healthcare industry. The review outlines the current challenges and prospects in the field, emphasizing the growing significance of carbon-based materials as valuable tools in advancing medical science and technology, as well as public health.

Interoperable multilayer networks are pivotal and transformative in public digital health. They not only enhance the delivery of healthcare services but also contribute significantly to improving public health outcomes. Through better accessibility, efficiency, and data-driven decision-making, these networks are revolutionizing how we approach public health. The seamless data exchange and integration they facilitate across different healthcare systems and providers can lead to substantial cost savings for public healthcare systems. These networks pave the way for a more efficient and effective healthcare system by reducing redundancies, optimizing resource allocation, and minimizing unnecessary procedures. This study combines the pressing issues of public digital health with the innovative interpretation of multilayer network theory, proposing practical solutions that inspire academics and practitioners alike.Public digital health is not just about improving care access and patient engagement. It is also about ensuring the financial sustainability of our healthcare systems. Innovative multilayer network analysis is critical in this game, improving interoperability and reducing spatial and temporal constraints. These networks streamline processes and improve efficiency by easing complex interactions within healthcare systems. This process, in turn, allows healthcare providers to deliver high-quality care at a lower cost, transforming, whenever possible, in-patients and out-patients into home-patients. Networks are a cornerstone and a beacon of hope for transforming public digital health. They are increasing the Value for Money and enhancing a patient-centric approach, making us optimistic about the future of healthcare.This study shows that revolutionizing digital healthcare methodologies has a profound impact on crucial elements like resilience, interoperability, and patient well-being within public health. The enhancement of interoperability facilitates the smooth flow of data exchange across various platforms and healthcare providers, fostering improved collaboration and decision-making processes and elevating the safety of patients.

Breast cancer (BC) is the most common invasive neoplasm and affects many women of working age. The return to work (RTW) of female survivors (BCSs) is associated with a better quality of life and longer survival. A tailored intervention to promote RTW was launched in 2022. A year later, the women were contacted to find out if RTW had occurred regularly and what their health conditions were compared to baseline. BCSs reported excessive fatigue, poor sleep quality, anxiety, depression and reduced work ability; these parameters had not improved significantly compared to baseline. Thematic analysis of the interviews confirmed the presence of personal, company and societal factors that could hinder or favor RTW. The interviews demonstrated that, even in an economically developed country that has provided numerous benefits for BCSs, protection is not always effective. Personalized intervention seems necessary to complete the process of reintegrating BCSs into their future working careers.

Background: In 2023, ChatGPT-4 has been impactful across several sectors including healthcare, where it aids in medical information analysis and education. Electronic Patient-Reported Outcomes (ePROs) play a crucial role in monitoring cancer patients’ post-treatment symptoms, enabling early in-terventions. However, managing the voluminous ePRO data presents significant challenges. This study assesses the feasibility of utilizing ChatGPT-4 for analyzing side effect data from ePROs. Methods: Thirty cancer patients were consecutively collected via a web-based ePRO platform, reporting side effects over 4 weeks. ChatGPT-4, simulating oncologists, dietitians, and nurses, analyzed this data and offered improvement suggestions, which were then reviewed by professionals in those fields. Results: Two oncologists, two dieticians and two nurses evaluated the AI’s performance across roles with 540 reviews. ChatGPT-4 excelled in data accuracy and completeness, and was noted for its empathy and support, enhancing communication and reducing caregiver stress. It was particularly effective as a dietician. Discussion: ChatGPT-4 shows promise in processing ePRO data with high accuracy, suggesting that AI can enhance clinical decision-making. Nevertheless, its limitations in emotional engagement highlight the need for AI to supplement, not replace, human care. Emphasizing the role of dietitians underscores the importance of nutritional advice in cancer care. Future studies will further explore the feasible application of AI and ePRO in cancer care clinical processes.

As the global overprovisioning of electronic devices continues to rise, the management of electronic waste (e-waste) has developed as a significant challenge. E-waste is comprised of hazardous materials; moreover, the toxic constituents in them can impact the environment and public health through improper disposal. On the beneficial side, this e-waste also contains some valuable materials. If the valuable materials are recovered, they can reduce the dependence on new, raw materials. Conventional linear models of production and consumption have led to a momentous buildup of e-waste, posing environmental and economic risks. This paper examines how the adoption of a circular economy approach can improve e-waste recycling in Nairobi by evaluating its economic recovery potential and e-waste residuals. It introduces metrics to assess the development of circular economy practices to help in the handling of e-waste residuals and examines the economic consequences associated with the adoption of circular strategies.

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

In the context of healthcare technology management (HTM) in Saudi Arabia and the Gulf region, this study addresses a significant gap by exploring both external and internal risk factors affecting HTM performance. Previous research has primarily focused on modeling or predicting failures in medical devices, mostly examining internal (endogenous) factors that impact device performance and the development of optimal service strategies. However, a comprehensive investigation of external (exogenous) factors has been notably absent. This research introduces a novel hierarchical risk management framework, designed to accommodate the broad array of healthcare technologies, not limited to medical devices. It significantly advances the field by thoroughly investigating and validating a comprehensive set of 53 risk factors and assessing their influence on HTM. Additionally, this study embraces the perspective of enterprise risk management (ERM) and expands it to identify and incorporate a wider range of risk factors, offering a more holistic and strategic approach to risk assessment in healthcare technology management. The findings reveal that several external and internal factors previously underexplored significantly impact HTM performance. Notably, the Fuzzy AHP survey identified “design risk” under facility and environmental risks as the highest risk for HTM in the region. Furthermore, the study reveals that three out of the top ten risks are related to “facility and internal environmental” factors, six are related to technological endogenous factors, and only one is related to managerial factors. This distribution underscores the critical areas for intervention and the need for robust facility and technology management strategies. In conclusion, this research not only fills a critical void by providing a robust framework for healthcare technology risk assessment but also broadens the scope of risk analysis to include a wider array of technologies, thereby enhancing the efficacy and safety of healthcare interventions in the region. Additionally, the proposed hierarchy provides insights into the underlying risk factors for healthcare technology management, with potential applications extending beyond the regional context to a global scale. Moreover, the equation we propose offers a novel perspective on the key risk factors involved in healthcare technology management, presenting insights with far-reaching implications applicable not only regionally but also on a global level. This framework also supports sustainability goals by encouraging the efficient and responsible utilization and management of healthcare technologies, essential for ensuring the long-term economic and environmental sustainability of medical technology use.

(1) Background: Emotional resilience is defined as the capacity of individuals to cultivate positive emotions and effectively navigate through negative emotions in terms of stress or adversity. Recent research has focused on the significant impact of adolescents’ negative emotions, as opposed to positive emotions, on mental health. The examination of positive emotion provides a distinct viewpoint on the relationship between emotional resilience and mental health in adolescents. Consequently, the current research conducted two separate investigations to examine the impact of adolescent emotional resilience on mental health, as well as the mediating influence of positive emotion. (2) Methods: Study 1 comprised a cross-sectional analysis of 3086 Chinese adolescents, while Study 2 involved a longitudinal examination of 266 Chinese adolescents. (3) Results: Results indicated that emotional resilience was associated with enhanced levels of life satisfaction, self-esteem, and overall mental health, while also demonstrating a negative correlation with symptoms of depression and anxiety. Positive emotions were found to have a partial mediating effect on the relationship between emotional resilience and mental health. These results indicate that emotional resilience not only has a direct impact on mental health but also influences mental health indirectly through positive emotions. (4) Conclusions: The findings highlighted the role of emotional resilience in mitigating psychological problems and enhancing mental health in Chinese adolescents. The implications and limitations were discussed.