Abstract: Background. Given the complexity of lung cancer surgery, this study aims to provide an overview of hospitals authorised to perform lung cancer surgery in France, and assess their performance focusing on severe post-operative complications and 30-day in-hospital mortality based on the Clavien-Dindo classification (grade>2). Methods. We included all patients (N=64,304) who underwent pulmonary resection for lung cancer from the French hospital database (2019–2023). To quantify variations within regions, we used the ratio of the 90th to the 10th decile of the standardised outcome rate of the hospitals. We used a hierarchical logistic regression model to estimate the adjusted odds ratio (aOR) according to the number of annual procedures. We then used the results of this modeling to see how the standardised rate estimate might evolve after simulating a new organisation of hospitals authorised to perform this surgery. Results. A total of 18,151 patients (28%) had severe complications (Clavien-Dindo>2). Compared to hospital performing less than 100 procedures/year, the risk of severe complications was significantly reduced for hospitals performing between 101 and 250 procedures (aOR=0.83[0.77-0.89]) and more than 250 procedures/year (aOR=0.85[0.77-0.93]). A simulation of hospital reorganisation, using 100 procedures/year as the threshold value shows that this would have prevented 477 severe complications over the period. Conclusion. This study shows inequalities in performance indicators between hospitals in each French region. The influence of the volume of activity raises questions about the need to restructure the offer of care for complex surgeries such as lung cancer surgery.

Abstract: Mitochondrial dysfunction and oxidative stress are key contributors to age-related hearing loss (ARHL). Sestrin2, a stress-inducible antioxidant protein, decreases with age, impacting various age-related diseases; however, its role in ARHL remains unclear. In this study, we initially assessed hearing in 8-week-old mice, followed by adeno-associated virus-mediated transfection of Sestrin2 into the posterior semicircular canal. At 26 weeks, hearing was reassessed, and cochlear samples were analysed. Immunofluorescence staining revealed Sestrin2 localization and mitophagy marker PINK1 expression, and TUNEL staining was used to assess hair cell apoptosis rate. We also measured mitochondrial membrane potential and examined AMPKα, mTOR, PINK1, Parkin, and Sestrin2 protein levels. Results showed reduced Sestrin2 in ARHL-affected hair cells, leading to mitochondrial dysfunction and increased apoptosis. Sestrin2 overexpression enhanced mitochondrial membrane potential, ATP levels, and mitochondrial function, delaying hair cell ageing and apoptosis and improving hearing. Furthermore, AMPK activation inhibited mTOR to promote mitophagy as the cells aged, whereas Sestrin2 overexpression inhibited this pathway, directly protecting hair cells. These findings highlight Sestrin2’s critical role in auditory health and its potential as a therapeutic target for delaying ARHL.

Abstract: Fire is a major hazard in hospitals, often caused by flammable liquids and medical gases, and can lead to significant losses due to limited patient mobility. This study simulated the effectiveness of portable and ceiling exhaust systems in reducing smoke, heat, and toxic gases in a hospital Neonatal Intensive Care Unit (NICU) using Computational Fluid Dynamics (CFD).The study began by converting a 2D sketch of the NICU into a 3D model using SketchUp, which was then imported into PyroSim software. Properties of objects and fire scenarios were set in PyroSim, and simulation results for temperature, visibility, and toxic gases (CO, CO2, O2) were generated as 3D cross-sectional views and profiles.In the simulation, the ceiling exhaust contained smoke within the fire room, preserving visibility in other areas, while the portable exhaust spread smoke to corridors, reducing visibility to zero. The ceiling exhaust maintained temperatures between 60–70°C, while the portable exhaust exceeded 80°C. CO concentrations peaked at 700 ppm without exhaust, dropped to 400 ppm with portable exhaust, and 300 ppm with ceiling exhaust. Oxygen levels fell to 18% with either exhaust, but remained at 20% with ceiling exhaust. The ceiling exhaust also reduced CO2 in exit rooms from 18,000 ppm to below 12,000 ppm, while portable exhaust reduced it by only 2,000 ppm. These findings can guide hospital designers and firefighting teams in selecting optimal fire control equipment, enhancing building safety and firefighting strategies.

Abstract: Background/Objectives: Little is known about anemia prevalence and iron reserve status among Chinese women within 2-year postpartum. This study aimed to assess the status of iron deficiency anemia and iron reserve in women within2-year postpartum, and to explore the influencing factors of anemia and the impact on the offspring. Methods: A cross-sectional study was conducted among 977 women within 2 years postpartum in 10 sites from 2016 to 2017 in Zhejiang Province, China. Information on demographics, nutrient supplementation and diet was collected. Whole blood hemoglobin, serum ferritin and transferrin receptor were assessed for all women and whole blood hemoglobin was assessed in offspring. The multivariate logistic regression was used to assess the determinants of anemia and the impact on the offspring. Results: Among 977 participants144, (14.74%) had anemia. The analysis of influence factors of anemia in women within two years postpartum showed that intaking iron supplements during pregnancy (OR（95%CI）:(0.549 (0.350~0.860)), and sufficient intake of red meat (OR（95%CI）:0.647 (0.437~0.958)), were protective factors for anemia in postpartum women. Anemia during pregnancy (OR（95%CI）:Mild anemia: 2.754 (1.844~4.113), Moderate or severe anemia: 3.815 (1.564~9.309)) postpartum age > 7 months (OR（95%CI）:1.717 (1.112~2.650)) and abnormal serum ferritin (OR（95%CI）: 11.931 (4.846~29.379)) and transferrin receptor levels (OR（95%CI）: 1.817 (1.050~3.145)) were risk factors for postpartum anemia. The analysis of influence on offsprings showed that mother intaking iron supplements during pregnancy (OR（95%CI）: 0.602(0.403~0.899))was protective factors for anemia in offsprings. Maternal anemia during pregnancy (OR（95%CI）: Mild anemia: 1.456(0.994~2.133), Moderate or severe anemia: 2.961(1.242~7.058)), age > 6 months (OR（95%CI）: 6~12 month: 7.671(4.291~13.713) , 12~24 month: 6.448(3.205~12.974)), and breastfeeding (OR（95%CI）: Breastfed and weaning: 0.455(0.281~0.736) , Never breastfeed: 0.365(0.135~0.986)) were risk factors for offsprings. Conclusions: The status of anemia in postpartum women was severe and worthy of attention. Meanwhile, its impact on the anemia of their offspring also cannot be ignored. Diagnosis of anemia or lack of iron supplementation in pregnancy might increase the risks of anemia in postpartum women and their offspring. The risk of anemia on t offsprings might increase if their mother suffering anemia or no iron supplementation during pregnancy. The postpartum women whose postpartum age > 9 months or had insufficient intake of red meat, abnormal serum ferritin and transferrin receptor levels were identified as high-risk groups for anemia. Breastfeeding and >6 months after birth were a risk factor for offspring anemia, therefore iron supplementation should be carried out in a timely manner.

Abstract: Objective: To analyze differences in affected upper limb functionality (grip strength, digital pinch grip, sensitivity, and manual dexterity) in a population with breast cancer, and the prediction of these factors in perceived disability. Design: Cross-sectional, quantitative, non-randomized, descriptive study. Setting: Eurovillas Physiotherapy and Pilates Clinic, Specialty Center of Torrejón de Ardoz, in Madrid; and Rosae, an association of women affected by breast cancer, in Valdepeñas, Spain. Participants: A total of 42 women diagnosed with breast cancer, with neuropathic symptoms in the upper limb after receiving chemotherapy, radiotherapy, or hormone therapy. Main Measure: A 40-minute assessment, including the collection of sociodemographic data and administration of the following scales: dynamometry, Spanish Nottingham Somatosensory Assessment Stereognosis Scale, Moberg Pick-up Test, Jebsen & Taylor Hand Function Test, Disability and Shoulder Pain Index (SPADI), pinch dynamometry. The statistical analysis was performed with SPSS 29.0 software. Student's t-tests were used for the group comparison, and the effect size (Cohen's d) was analyzed. An analysis of variance was employed for the linear regression analysis between disability and functionality of the upper limb, considering p50 years (p=0.002). Significant differences were also found in total affected hand disability (F=6.472; D=−0.534) between the group of active and passive women (p=0.015) and in total SPADI time (p=0.026), as well as in mean digital pinch grip (F=5.419; D=.467) between the group of women with surgery ≤4 years and women with surgery >4 years previously (p=0.027). Regression analysis revealed that grip strength, digital pinch strength, hand function, and surface sensitivity are predictor variables in 25.7% of perceived shoulder pain and disability cases. Conclusions: Breast cancer causes motor and sensory disorders in the affected upper limb and in the daily life of those with the disease, triggering disability and reduced quality of life.

Abstract:

Introduction: Infection prevention and control (IPC) measures are essential to minimizing healthcare-associated infections (HAIs), reducing antimicrobial resistance (AMR), and safeguarding the well-being of patients and healthcare workers. Given the significance of IPC in healthcare settings, especially highlighted by the COVID-19 pandemic, this systematic review evaluates the effectiveness of various IPC strategies, including hand hygiene, personal protective equipment (PPE), isolation protocols, and patient education. Methods: This systematic review and meta-analysis adhered to a rigorous methodology, including a comprehensive literature search of PubMed, Embase, and the Cochrane Library for studies published between 2014 and 2024. Studies focusing on the impact of IPC measures on HAIs, AMR, and patient and healthcare worker safety in various healthcare settings were included. Data extraction and quality assessment were performed by two independent reviewers, with disagreements resolved by a third reviewer. Statistical analysis, including heterogeneity assessment using I², was conducted using STATA V.14.0, applying fixed-effect or random-effect models as appropriate. Results: A total of 11 studies met the inclusion criteria, spanning diverse healthcare settings such as hospitals, long-term care facilities, and resource-limited environments. The findings indicate that IPC measures significantly reduce HAIs and improve compliance among healthcare workers. Hand hygiene interventions and PPE use were especially effective in controlling infection transmission, though PPE use was sometimes associated with adverse effects on healthcare workers. Isolation measures, while effective, showed psychological impacts on patients, underscoring the need for supportive interventions. Economic evaluations revealed cost savings through IPC implementation, particularly in long-term care facilities, emphasizing the feasibility of IPC measures even in resource-limited settings. Conclusion: This review demonstrates that IPC measures are effective in reducing infection transmission, though challenges such as compliance, psychological impact, and ethical considerations must be addressed. Tailored strategies that account for specific healthcare settings and include patient education, psychosocial support, and ongoing staff training are recommended to optimize IPC outcomes. Further research should address limitations related to methodological diversity and potential publication bias to enhance the understanding of IPC effectiveness across diverse healthcare environments.

Abstract: Cockroaches serve as mechanical vectors for medically important pathogens, and their presence in hospitals is a common occurrence. Describe the pathogens and their resistance mechanisms carried by cockroaches collected in hospitals in different parts of the world during the period 2000-2023. This will be achieved through a systematic review of the indexed literature. The studies were identified through a search of the Google Scholar search engine and in electronic databases related to health: LILACS, Scielo Regional, and PubMed. The search strategy was conducted in accordance with the principles for systematic reviews and meta-analysis (PRISMA). The review encompassed 22 studies conducted during the specified period. Blattella germanica and Periplaneta americana are referenced in 15 and 13 of the analyzed studies, respectively. A variety of pathogens, including bacteria, fungi, protozoa, helminths, and rotavirus, were isolated and identified from the external and internal body parts of cockroaches. Bacteria represent the most frequently identified group. The species that appear most frequently in the selected articles are Escherichia coli (11 articles), Staphylococcus aureus (9 articles), Klebsiella pneumoniae (7 articles), and Pseudomonas aeruginosa (6 articles). E. coli and S. aureus bacteria were found to be resistant to antibiotics in 19% and 12% of articles, respectively. Conventional techniques, including seeding in culture media, Gram staining (GS), conventional biochemical tests (CBT), direct parasitological methods, and disc diffusion, have historically been the primary methods for identifying microorganisms and determining antibiotic susceptibility profiles in bacteria. However, there is a paucity of studies that use molecular tech-niques for bacterial identification and resistance mechanism detection. The identification of pathogens carried by cockroaches collected in hospitals suggests a potential risk of these insects in the transmission of healthcare-associated infections.

Abstract:

BACKGROUND: Genetic and genomic literacy is pivotal in empowering cancer patients and citizens to navigate the complexities of omics sciences, resolve misconceptions surrounding clinical research and genetic/genomic testing, and make informed decisions about their health. In a fast-evolving scenario where routine testing has become widespread in healthcare, this scoping review aimed to identify current literacy and knowledge gaps among cancer patients and citizens on matters related to genetics and genomics. METHODS: Adhering to the PRISMA framework, the review included 43 studies published between January 2018 and June 2024, which evaluated the understanding of genetics and genomics among cancer patients, caregivers, and citizens. RESULTS: Although the selected studies had significant heterogeneity in populations and evaluation tools, our findings indicate inadequate literacy levels, with citizens displaying lower proficiency than cancer patients and caregivers. The review highlighted consistent knowledge gaps in understanding the genetic and genomic underpinnings of diseases, encompassing misconceptions about mutation types and inheritance patterns, limited awareness of available genetic testing options, and difficulties in interpreting test results. Ethical and privacy concerns and the psychological impact of genetic testing were also common, highlighting the imperative need for effective communication between healthcare providers and patients. CONCLUSIONS: Given the dynamic nature of genomic science, the review underscores the need for continuously evolving educational programs tailored to diverse populations. Our findings could guide the development of educational resources addressed explicitly to cancer patients, caregivers, and the lay public.

Abstract: Background: Chronic diseases are major causes of morbidity, disability, and death worldwide. In many cases, they are potentially preventable and treatable. Glaucoma is one of the leading causes of morbidity and blindness, and its early recognition can help reduce the adverse outcomes of the disease. Health illiteracy among these patients and the absence of self-management of these dis-eases are barriers to effective management worldwide. Therefore, the present study aimed to calculate the level of health literacy and activity level of patients’ activation in self-management, and to explore the link between them among patients with glaucoma in outpatient clinics. Material and methods: Convenience sampling of patients with glaucoma attending the outpatient ophthalmology clinics of a university hospital in Heraklion-Greece was performed. Convenience sampling was used to recruit a total of 312 participants. Data were collected between November 2023 and May 2024. The Patient Activation Measure-13 (PAM-13) questionnaire, in its Greek ver-sion, was used to evaluate patients’ activation level in self-management, whereas the Greek ver-sion of the European Health Literacy Survey Questionnaire 16 (HLS-EU-16) was used to assess health literacy. Results: Participants were classified as level 1(disengaged & overwhelmed) level in self-management (= 40.7, SD: ±29.9) and a sufficient health literacy level (= 10.7, SD ±3.7). However, there was no statistically significant relationship between health literacy levels and patient activation in self-management (p=0.602). Conclusions: Our findings indicate that patients with glaucoma have low to moderate levels of health literacy and self-management activation, further there is no significant association between these two factors. Multifaceted interventions could be essential for enhancing patients’ activation. Further research involving larger sample sizes, multi-center studies, and interventional design is needed.

Abstract: The COVID-19 pandemic disrupted routine child immunization efforts, threatening to reverse progress in controlling vaccine-preventable diseases. We analyzed the impact of COVID-19 on DTP3 vaccination in Europe by comparing trends before and after the pandemic using time series data from 2000 to 2023. Employing Joinpoint regression, chi-square tests, and segmented regression analysis, we assessed DTP3 vaccination trends and coverage changes. The findings revealed significant regional disparities across Europe. Statistical models indicated reductions in DTP3 coverage in countries like Ireland, Sweden, and Switzerland, whereas Ukraine and San Marino showed improvements. These variations indicate the need for targeted public health strategies to address vaccine hesitancy, logistical barriers, and systemic inequities.