To assess the community health workers’ (CHWs) knowledge, attitude, and practices (KAP) in type-2 diabetes (T2D) and hypertension (HTN) management. We thus also sought to assess the potential health system barriers for incorporating CHWs in T2D and HTN management. Mixed-method study comprised (1) a survey among 153 active CHWs to assess their KAP of T2D and HTN, and (2) semi-structured interviews with key informants to understand challenges of the health system and proposed solutions in incorporating CHWs in T2D and HTN management. The majority of CHWs correctly answered general knowledge questions on NCDs, risk factors, and prevention; however, only one-quarter correctly answered questions on smoking, family history, or tobacco use as risk factors. Most respondents appeared to have positive attitudes and have been practicing some activities related to T2D and HTN. Both financial and non-financial resource constraints were cited as challenges of the health system; therefore, re-structuring the role definition of CHWs and task of responsibilities, and assessment the need and workload have been proposed as ways forwards to effectively incorporate CHWs in T2D and HTN care. CHWs in Cambodia have shown their potential in T2D and HTN management; however, a well-designed strategy including technical training, clearly defined roles and responsibilities, and strong supporting structure are important to maximize their potential in the health system.

ABSTRACT Background: To date, the COVID-19 pandemic has been the foremost health concern for humankind in the new millennia. This paper aims to describe the related hospitalizations in Italy during the first two years of the health emergency. Design and methods: This is a retrospective, population-based study of Italian hospitalizations for patients diagnosed with COVID-19 during the 2020-2021 period, extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay, among other hospitalization-level variables. Costs were estimated through the charges associated with the Diagnosis-Related Group and Major Diagnostic Categories coding system, plus an additional cost attributed to COVID-19 admissions. To these charges was added an extra cost defined by the ministry of health. Results: In Italy, there were 357,354 hospitalizations for COVID-19 attributed to 298,856 patients in 2020 and 399,043 hospitalizations for COVID-19 attributed to 333,447 patients in 2021. COVID-19 patients faced a transfer rate thrice that of other patients. Hospitalizations were concentrated predominantly in the northern regions, particularly in the first year. Hospitalization rates varied by age in a sine wave pattern, peaking in the youngest and oldest age groups, with mortality rates escalating with age— tending to remain below 3% for those under 44 but surging to 40% in individuals over 75. The financial impact of COVID-19 hospitalizations was substantial, with total costs reaching €3.97 billion in 2020 and €4.99 billion in 2021. Costs per admission and per day also rose, from €11,112 and €807 in 2020 to €12,503 and €844 in 2021, respectively. Excluding the added financial burden of COVID-19, costs would have been notably lower. Hospitalizations involving continuous invasive mechanical ventilation were particularly costly (about 24.000 euros x admission), reflecting the significant resources required for these treatments. Conclusion: Implementing a protective pad around the entire health system that leverages networks of family doctors and nurses, connected in real time to the entire health system, can be crucial. Such a network, tasked with monitoring the local epidemiological situation, protecting vulnerable individuals also through telehealth visits, and establishing a triage system for infections in the initial phase, may effectively help in managing virus spread and protecting hospitals from unpredictable waves of admission demand. Strengthening primary health care could be a decisive factor for the future and enhance the system's resilience in facing new challenges.

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<0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p<0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p≤0.05) and NC (p<0.001), and were biologically older than COPD patients (p<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.

Despite the importance of influenza vaccination for healthcare workers (HCWs), their uptake remains challenging. This study aimed to measure influenza vaccine hesitancy among HCWs in Nakhon Phanom province, Thailand. A representative cross-sectional survey was conducted at six hospitals during August – September 2020 using a self-administered questionnaire. HCWs delaying getting influenza vaccines, accepting but unsure, or refusing with doubts were categorized as hesitant. Those accepting without any doubts were classified as non-hesitant. Vaccine hesitancy determinants were identified by multivariable logistic regression analysis. A total of 338 participants (97%) completed the questionnaires; most were female nurses working at district hospitals without pre-existing chronic medical conditions. Nearly 60% of participants (197/338) exhibited influenza vaccine hesitancy, and significant factors included age above 50 years adjusted odds ratio [aOR] 3.2, 95% CI 1.3-8.5), fair knowledge of influenza/vaccination (aOR 0.4, 95% CI 0.2-0.8), and negative influence of other HCW (High level– aOR 2.3, 95% CI 1.1-4.8; Moderate level- aOR 2.1, 95% CI 1.1-4.4). Imparting updated information to the HCW combined with positive guidance from influential peers may help reduce this hesitancy.

Under the dual background of underemployment and health inequality, this paper empirically analyzes the impact of education level on underemployed workers’ health based on CLDS2016 data. The results show that underemployment is significantly related to the decline of self-rated health, increased depression tendency, and morbidity in a certain period. The results indicate that underemployment can significantly reduce the health level of workers in the low education level group and the high education level group. However, it has no significant impact on workers’ health in the middle education level group; even if we change the measurement method of indicators and consider endogeneity, the research conclusion is still robust. Moreover, this kind of health inequality mainly comes from the difference in economic effect and leisure effect of underemployment to workers with different educational levels. This paper provides empirical support for increasing the labor protection mechanism of underemployed people and reducing the health inequality caused by educational level differences.

Migrants are mainly employed in "3D Jobs" dirty, dangerous, difficult, characterized by monotony, intense rhythms, in sectors at higher risk as construction, heavy industry, agriculture. Aim of this study is to elaborate a systematic review, in order to identify the main occupational risks and occupational diseases of this category. Research included articles published from 2013 to 2018 on the major online databases (PubMed, Cochrane Library and Scopus), using a combination of some keywords (migrant workers, expatriates, physical health, diseases, illnesses, travel, travelers, work and occupational). The online search indicated 1.109 references. We excluded 977 studies, because unrelated to physical health and 64 due to duplication. They were analyzed 68 articles, including 6 reviews and 62 original article. The main risk emerged are to developing infectious diseases, metabolic cardiovascular diseases and to manifesting a lower quality of life, in particular due to difficulties in accessing local health services. It will be crucial to implement the role of occupational medicine in order to introduce multilevel interventions designed to prevent work-related injuries and illnesses and to promote healthier working environments.

In Pakistan, 2018 National Nutrition Survey reported 40% of under five children were stunted. This study assesses the effectiveness of nutritional supplementation in reducing stunting among under-five children in two rural districts in Sindh, Pakistan. This was a mixed-method quasi-experimental study with intervention and control population. 3397 and 3277 under-five children participated in the baseline and end-line surveys. Both study areas were matched for demographic and economic circumstances. The participants received nutrient supplements underpinned by nutrition behaviour change communication for appropriate complementary feeding practices and hand hygiene targeted at primary caregivers during the first 1000 days of an infant's life. The impact was assessed using the difference in difference analysis with kernel propensity score matching to adjust the differences among control and intervention populations.

Smoking is a major risk factor for non-communicable diseases and remains a significant public health challenge in many lower- and middle-income countries (LMIC) including Namibia. The purpose of the study was to estimate the prevalence of smoking and its associated risk factors among HCWs and non-HCWs in Zambezi region. An exploratory cross-sectional survey was conducted between March and October 2020 among residents of the eight (8) constituencies of Zambezi region. Four hundred and sixty-one (461) respondents who had been residents of the selected constituencies for over five years and aged between 17-60 years were selected for the study. The main outcome measure was current cigarette smoking status. Descriptive statistics were used to summarize the socio-demographic characteristics of the respondents. We stratified data analysis by individual being health workers or non-health workers. A bivariate Pearson Chi-square test was used to determine the association between socio-demographic characteristics and the smoking status. Statistically significant variables in the bivariate analysis were used as predictors in the univariate and multivariate models. The response rate of potential participants was 95% (n=434). The mean (±SD) age of participant’s was 32.5 (± 11.34 years). Significant relationships were observed between smoking status and area of residency (constituency), gender, age category, level of education, age of onset of smoking and the daily smoking frequency. The majority of smokers (n=108) were none-HCWs with males being the majority (n=62). Age (p=0.001), education levels (p=0.001) and area of residency (p=0.022) were highly associated with smoking among none-HCW while marital status was associated with smoking among HCWs (p=0.013). In the final multivariate model, the odds of smoking among female non-HCWs were significantly lower (OR: 0.386; 95% CI: 0.228 – 0.655). Furthermore, the odds of smoking among this same group were lower among those who had secondary level education (OR: 0.178; 95% CI: 0.0659 – 0.483), post-secondary (OR: 0.117, 95% CI: 0.0412 – 0.330) and first stage tertiary (OR: 0.306: 95% CI: 0.106 – 0.881) compared to those who had primary school education. In conclusion, smoking prevalence among none HCWs and HCWs working in Zambezi included in the study was similar to that of the general Namibian population but higher than other neighboring countries within SADC. The results showed a need for the establishment of specific smoking related strategies that target HCWs to address smoking use parallel to the running of none HCWs which would ultimately decrease the smoking prevalence and improve health.

Background: The workplace burnout syndrome is often associated with particular aspects of certain job positions, especially those which entail working with people with special needs. The burnout syndrome in healthcare jobs is a serious problem which has grown into an epidemic among healthcare workers and associates. Objectives: The aim of this research is to assess the presence of stress and burnout syndrome at work with healthcare workers, expert workers, professional associates and associates in social service institutions in Belgrade. Material and Methods: This research has been conducted in the form of a cross-sectional study of a representative sample in social institutions in Belgrade. It has been conducted from March to the end of June of 2023. The sample of the study had 491 participants. The questionnaires used were a structured instrument with social-demographic and social-economic characteristics, workplace characteristics, life style characteristics, and the following questionnaires: DASS-21, Copenhagen, Brief Resilience Scale, and Brief Resilient Coping Scale. Results: The end results indicate the following to be significant risk factors for the occurrence of workplace burnout syndrome: overtime (OR=2.62; CI=1.50-4.56), BRS average score (OR=0.28; CI=0.17-0.44), DASS21 D heightened depression (OR=2.09; CI=1.1-4.04), DASS21 A heightened anxiety (OR=2.38; CI=1.34-4.21), DASS21 S heightened stress (OR=2.08; CI=1.11-3.89). The only protective risk factor which stood out was the self-assessment of health levels (OR=0.60; CI=0.42-0.85). Conclusion: Overtime is a significant predictor of workplace burnout. Apart from it, other significant predictors of workplace burnout were heightened depression, anxiety, and stress levels.

Type 2 diabetes (T2DM) presents an enormous global healthcare challenge, especially among rural communities due to limited access. To overcome this, many low- and middle-income countries are resorting to task shifting, using community health workers (CHWs) for diabetes management. However, its successful implementation depends on the practice behaviours and knowledge of these workers. This cross-sectional study from rural South India aimed to evaluate the proficiency of 275 CHWs in diabetes screening and management. A customized questionnaire, developed through experts and government was used to evaluate the practice behaviours and knowledge. Analytical methodologies consisted of descriptive statistics, logistic regression, and mosaic plots for comprehensive data interpretation. Results showed significant deficiencies of mean correct practice behaviours at 48 and 50% respectively. The identified gaps included diabetes diagnosis, HbA1c testing, diet, self-management, complications screening and risk assessment. In several areas, correct practice behaviour was reported by a relatively large number of CHWs despite incorrect answers to the related knowledge questions such as referral to the health centres, self-management and calculation of diabetes risk assessment. Addressing these deficiencies requires a thorough needs assessment and tailored training for improved diabetes management by CHWs. Training of CHWs, should not only identify prior knowledge and/or behaviour but also their interrelationship to help create a robust and flexible set of practice behaviours.

Background: Since 2010, Burkina Faso has developed and initiated community-based management of childhood illnesses. Following the increased presence of community health workers and the adoption of free community health care, this study aims to assess community satisfaction with curative care administered by community health workers. Methodology: It was a descriptive and analytical cross-sectional study. Data were collected in the health districts of Boussé and Boussouma from 20 February to 30 March 2023 for quantitative data and from 12 to 30 January 2024 for qualitative data using a questionnaire (household survey) and an interview grid (focus groups). Analyses were conducted using SPSS IBM 25 and Nvivo 14. Results: Households benefit from oral curative care when using CHWs, but are not satisfied with the temporal accessibility of these community health workers. Temporal accessibility and awareness during care have a significant influence on household satisfaction. Conclusion: Curative care by community health workers is effective, but its use could be improved by addressing the unavailability of community health workers, inputs and better communication during care.

Self-perceived health is an important indicator of occupational health. This research explores the relationship between poor self-perceived health and exposure to psychosocial risk factors, taking into account potential socio-demographic, occupational and employment determinants. Using data from the First Survey of Occupational Safety and Health Conditions covering 1049 salaried workers in Guayaquil, Ecuador descriptive and stratified binary logistic regression analyses (Odds Ratios with corresponding 95% confidence intervals) were carried out. No significant relationship was found between exposure to psychosocial risk factors and the probability of presenting poor self-perceived health by socio-demographic, occupational and employment characteristics. Occupational exposure factors to psychosocial risks are predictors of self-perceived ill health and are related to the variables analyzed; the most frequently expressed factors among the respondents were Cognitive Demands (DGOG) and Job Insecurity (IL). The results have implications in terms of designing effective workplace interventions pursuant of ensuring the health and wellbeing of employee.

Little research has been done on occupational health ramifications of informal electronic waste (e-waste) recycling work, which is increasingly common in low- and middle-income countries, and very little is known about this in high-income countries. Our study evaluated informal and formal e-waste recycling workers in Chile, which was recently recognized as a high-income country. In 2017 we recruited 78 informal recycling workers from two cities, and 15 formal e-waste recycling workers from one recycling facility. Participants completed a questionnaire and health assessment regarding their involvement in, and potential impacts of, e-waste recycling, among other measures. Participants were primarily male, middle-aged, married with children, and had worked in e-waste recycling for an average of 12 years. Participants generally reported good health status, and chronic disease prevalence was similar to the national prevalence. Workers commonly reported exposures to several occupational stressors, including mental health stressors and noise, as well as insufficient income. Occupational injuries were common and use of safety equipment was low. No significant differences were found between informal and formal workers. Informal e-waste workers in Chile face occupational health challenges. The extent to which these issues impact the health of informal Chilean e-waste workers is unclear and warrants further research.

Personal protective equipment (P PE) rules must be respected and followed to the letter of healthcare professionals in Cameroon to avoid the transmission of infectious diseases. This research proposes solutions to the problems of non-adherence and non-compliance among healthcare workers in Cameroon towards PPE rules. Inadequate access to suitable PPE, discomfort when wearing PPE during poor quality, and a lack of training on correct PPE use are just a few of these obstacles amongst HCWs in Cameroon. Hospitals and healthcare facilities should prioritize offering thorough instruction on PPE use and pinpoint the need to adhere consistently to PPE rules to remove these obstacles. They should also ensure that all healthcare personnel have access to and a sufficient supply of the proper PPE. Through the organization of impromptu visits by surveillance teams to identify areas of support and training, there is a need for assistance from government bodies and public health groups in creating awareness of the security value of PPE use among healthcare professionals. There is a lack of PPE in health care settings in rural areas in Cameroon, thus a need for an adequate supply. Then can we put appropriate PPE policies and practices for HCWs in Cameroon, as they will keep to it.Healthcare professionals in Cameroon must comprehend that following PPE standards protects not just their selves from diseases but also their patients, coworkers, and communities. We are accountable for ensuring everyone's safety and well-being, and adhering to PPE regulations is an essential first step.

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

Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

Beta thalassemia is an inherited blood disorder that results in inefficient erythropoiesis due to genetic mutation that leads to reduction or absence of the hemoglobin beta-globulin protein. Approximately 8.5% of UAE residents suffer from β-thalassemia, a significant health and financial problem. The treatment options available for β-Thalassemia major are limited and associated with a wide range of complications. β-thalassemia gene therapy is emerging as a potential novel treatment option that eliminates the complications caused by the current long-term treatment modalities and the associated economic burden. This paper reviews the scientific literature related to emerging gene-therapy for β-Thalassemia by analyzing all the articles published from January 2010 to December 2023 in the English language on Databases like PubMed, Scopus, ProQuest, and CINAHL. The use of gene therapy has demonstrated promising outcomes for a permanent cure of β-Thalassemia. ZYNTEGLO (Betibeglogene autotemcel) is the only cell-based gene therapy which was approved by the FDA on 19th August, 2018. To conclude, Gene therapy is an innovative solution. It demonstrates a promising future, but does come with its own set-backs and is something that must be tackled in-order to revolutionize it in the medical world. FDA approved ZYNTEGLO is a potentially one-time curative treatment for β-Thalassemia. Although cutting-edge, its use is limited because of the high cost; a price of $2.8million per patient.

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

Polycystic ovary syndrome (PCOS) is a common condition in reproductive-age women. Women with PCOS are at higher risk of pregnancy complications including gestational diabetes (GDM). The prevalence of PCOS and GDM varies according to the diagnostic criteria used. The mechanism for the occurrence of GDM in women with PCOS is still unclear. Materials & Methods- A systematic search of the electronic database was done using keywords like PCOS, and GDM to include studies between April 2008 and March 2023 where uniform diagnostic criteria were used. Studies were excluded with high-risk of bias after the assessment of bias, and meta-analysis was done with relative risks and confidence intervals. Results & Discussion-Out of 1896 search results, 95 were selected for full-text. The quality of the studies was scrutinized and a total of 28 studies were included as they fulfilled the inclusion criteria. The incidence of GDM in women with PCOS was found to be 10.55 % (2.9- 54.9%) from pooled data involving 1,280,245. The prevalence of PCOS in women diagnosed with GDM was found from pooled data of 36,351 women in retrospective studies to be 2.47% (1.5- 50.1%). Selection predominantly included cohort studies, most commonly from China. The meta-analysis reported the risk of GDM is higher in women with PCOS than in those without PCOS (HR: 1.59, 95% CI: 1.27–1.91, p < 0.001). Family history of diabetes, ethnicity, pre-pregnancy BMI, insulin resistance, gestational weight gain, use of assisted reproductive techniques, and multifetal gestation were the risk factors for GDM in women with PCOS. Conclusion- The prevalence of GDM in patients with PCOS is high, but the causality is complex. The newer predictive models are promising in clarifying the causative relationships, yet use various parameters at different cut-offs. There is a need for the development of universally acceptable parameters for the early prediction of GDM in women with PCOS.

Social biases may concentrate attention of researchers on a small number of well-known molecules/mechanisms leaving others underexplored. In accordance with this view, central to mechanistic toxicology is a narrow range of molecular pathways that are assumed to be involved in significant part of responses to toxicity. It is unclear, however, if there are other molecular mechanisms which play important role in toxicity events but are overlooked by toxicology. To identify overlooked genes sensitive to chemical exposures we used publicly available databases. First, we used data on published chemical-gene interactions for 17,338 genes to estimate their sensitivity to chemical exposures. Next, we extracted data on publication numbers per gene for 19,243 human genes from Find My Understudied Genes database. Threshold were applied to both datasets using our algorithm to identify chemically sensitive and chemically insensitive genes and well-studied and underexplored genes. 1,110 underexplored genes highly sensitive to chemical exposures were used in GSEA and Shiny GO analyses to identify enriched biological categories. Metabolism of fatty acids, amino acids, and glucose were identified as underexplored molecular mechanisms sensitive to chemical exposures. These findings suggest that future effort is needed to uncover the role of xenobiotics in the current epidemics of metabolic diseases.

Brown rice is a familiar whole grain in Japan. We examined national trends in brown rice consumption among Japanese adults aged ≥ 20 years old, using individual-level data from the National Health and Nutrition Surveys conducted between 2012 and 2019. We employed multivariable logistic regression to identify factors associated with brown rice consumption. The 95th percentile of daily brown rice intake remained at 0.0 grams throughout the study period. The percentage of brown rice consumers increased from 1.8% (95% confidence interval: 1.6–2.1) in 2012 to 2.3% (95% confidence interval: 1.8–3.0) in 2019. Compared with individuals who consumed only white rice, brown rice consumers had significantly higher mean intake levels of macronutrients, legumes, vegetables, fruits, and nuts. Brown rice consumption was positively associated with certain sociodemographic characteristics (being female, older age, residing in a major city, living without very young children, and having higher education levels) and health behaviors (lower body mass index, engaging in regular exercise, and being a former or never smoker). Despite its potential nutritional benefits in balanced diets, only a small fraction of adults in Japan consume brown rice, indicating a need for further promotion, particularly among individuals with characteristics associated with brown rice consumption.

The relationship between antitumor response and tumor marker changes was evaluated in patients with advanced hepatocellular carcinoma treated with durvalumab plus tremelimumab (Dur/Tre). Thirty-two patients were enrolled in this retrospective evaluation of treatment outcomes. According to Response Evaluation Criteria for Solid Tumors at 8 weeks, the objective response rate (OR) was 25% and the disease control rate (DC) was 56.3%. Median alpha-fetoprotein (AFP) ratio at 4 weeks was 0.310 in patients who achieved OR at 8 weeks (8W-OR group), significantly lower than the 1.105 in the non-8W-OR group (p=0.0020), but was 1.210 in patients who did not achieve DC at 8 weeks (non-8W-DC group), significantly higher than the 0.470 in the 8W-DC group (p=0.0006). Similarly, median des-γ-carboxy-prothrombin (DCP) ratio at 4 weeks was 0.125 in the 8W-OR group, significantly lower than the 1.225 in the non-8W-OR group (p=0.0001), but was 1.120 in the non-8W-DC group, significantly higher than the 0.480 in the 8W-DC group (p=0.0255). Early changes in tumor markers after Dur/Tre initiation were associated with antitumor response. In particular, changes in AFP and DCP at 4 weeks may offer useful biomarkers for early prediction of both response and progressive disease following Dur/Tre.

The ageing of workers is one of the most important issues for occupational health and safety in Europe. A number of intervention studies on health promotion for older workers were conducted in European workplaces between 2000 and 2015. This review gives an overview of these studies and considers perspectives for workplace health promotion.

The literature study delves into novel therapeutic strategies in transplantation medicine, highlighting unique approaches that could revolutionize current practices. It emphasizes novel patterns that have the potential to transform the current landscape. Commencing with a thorough examination of the historical environment, it traces crucial advances and changes in transplantation. The focus is on traditional techniques, emphasizing their limitations and challenges. An extensive examination of contemporary transplantation therapies offers valuable insights into the most recent progress in organ, cellular, and tissue transplantation. This analysis examines the immunological obstacles and outlines the current advancements and constraints. The exploration further navigates into novel models and concepts such as immunomodulation, developments in organ preservation techniques, gene editing, biomaterials, scaffold-based solutions, and the integration of precision medicine, artificial intelligence, and machine learning applications. Each section analyzes the potential for change and current progress in various areas, backed by relevant scientific sources up to 2023. The subsequent sections delve into innovative cellular therapies, biotechnological progress, current clinical trials, and case studies demonstrating effective applications. This examination delves into the ethical and regulatory considerations of innovative therapeutic procedures, emphasizing ethical implications, regulatory frameworks, and the importance of balancing innovation with patient welfare. The literature review concludes by offering a forward-looking perspective, emphasizing potential progress, anticipated challenges, and advocating for collaboration and interdisciplinary approaches to overcome limitations in the field of transplantation medicine.

Objectives: 1) To describe the cardiovascular health of the construction workers in Hong Kong, 2) to examine the demographic differences in cardiovascular health, and 3) to examine the association between modifiable lifestyle behaviors and cardiovascular conditions. Methods: 626 registered construction workers were included in the analysis. Blood chemistry, blood pressure, weight and height were measured. Face-to-face questionnaire interview was conducted. T-tests and One-way ANOVAs were used to compare the cardiovascular health score, cardiovascular outcomes, and lifestyle behaviors by demographic characteristics. Logistic regressions were performed to assess the cardiovascular outcomes by lifestyle behaviors. Results: Two-thirds of the construction workers failed to achieve three out of the seven “ideal” cardiovascular health indicators. The younger, more educated, and female subjects had better cardiovascular health scores than their counterparts. The ideal fish and seafood consumption was associated with 1) ideal weight status and 2) ideal cholesterol level, whereas less soft drink consumption was associated with ideal cholesterol level. Conclusions: The findings highlighted the importance of promoting cardiovascular health in the construction industry. This study provided insights for future interventions, which should include increasing fish and seafood intake, decreasing soft drink consumption, and enhancing the health literacy amongst older, less educated, and male construction workers.

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.

The study assessed the trapping efficacy of locally-modified 1) Gravid Aedes Trap(GAT) lined with insecticide-treated net (ITN) as a killing agent, 2) Autocidal Gravid Ovitrap(AGO) with sticky board in the semi-field system (SFS) and field setting. Fully-balanced Latin square experiments were conducted to compare GAT lined with ITN vs AGO, both with either yeast or grass infusion. Biogents-Sentinel (BGS) with BG-Lure and no CO2 was used as standard trap for Aedes mosquitoes. In the SFS, GAT outperformed AGO in collecting both nulliparous (65% vs 49%,OR=2.22,[95%CI:1.89-2.60],p

Diarrhoea is a serious cause of mortality worldwide that can lead to dehydration, gut barrier function impairment, nutrient malabsorption, and alterations of the gut microbiota (dysbiosis). Current solutions for its management, such as oral rehydration salts (ORS), inhibitors of the gut motility, antibiotics, and living probiotics only partially counteract the mechanisms of the disease and do not provide a full coverage of the problem. Potential risks of the use of living probiotic strains, particularly in immunocompromised patients, can be eliminated with the use of tyndallized (heat-killed) postbiotic bacteria and yeast. ABB C22® is a postbiotic combination of three tyndallized yeasts, namely Saccharomyces boulardii, Saccharomyces cerevisiae, and Kluyveromyces marxianus. To assess the action of the postbiotic combination on diarrhoea, immune and gut epithelial cell signaling assays, gut barrier formation assay and rotavirus gene expression assay were performed. ABB C22® showed a strong anti-inflammatory effect, an induction of the build-up of the gut epithelium, and a degree of protection against rotavirus infection. These experimental studies support the use of the postbiotic ABB C22® as a solution for the management of diarrhoea and gastrointestinal conditions, alone or in combination with existing but incomplete treatments.

Safe water is a global public health concern amid increasing scarcity and pollution. Bottled water production and consumption contribute to these problems. This study examines tap water consumption in Italy, assessing associated sociodemographic factors and related health outcomes such as obesity and self-perceived health status. Data from the Italian National Statistics Institute's "Aspects of daily life" survey (N=45,597) were analyzed. Covariates included education, age, gender, economic status, region, concerns about waste and climate change, consumption of carbonated drinks excluding water, alcohol consumption, consumption of vegetables, consumption of snacks, body mass index, and self-perceived health status. Bivariate analyses and mixed-effect logistic regression models explored the associations. People who drink tap water were 19,674 with a higher prevalence in people aged 45 to 59 old, people with a graduate/post-graduate degree diploma, with optimal economic resources, and concerned about waste production and climate change, coming from the North-East regions of Italy. Underweight people showed a higher prevalence of TW assumption as well as those who drink less than occasionally carbonated drinks, drink alcohol, consume vegetables more than once a day, and snacks less than once a week with a satisfying level perceived health status. Regressions showed that all age classes are less likely to drink tap water than people younger than 20 years old. The category with “inadequate” economic resources is more likely to consume tap water. Low educational classes show a low likelihood of consuming tap water as well as Islands. A concern about waste production and climate change is associated with an increased likelihood of assuming tap water. Tap water consumption was negatively associate with obesity but not with a satisfactory Self-perceived health status. Insights from this study can inform public health strategies.

Stress is a natural yet potentially harmful aspect of human life, necessitating effective management, particularly during overwhelming experiences. This paper presents a scoping review of personalized stress detection models using wearable technology. Employing the PRISMA-ScR framework for rigorous methodological structuring, we systematically analyzed literature from key databases including Scopus, IEEE Xplore, and PubMed. Our focus was on biosignals, AI methodologies, datasets, wearable devices, and real-world implementation challenges. The review presents an overview of stress and its biological mechanisms, details the methodology for the literature search, and synthesizes the findings. It shows that biosignals, especially EDA and PPG, are frequently utilized for stress detection and demonstrate potential reliability in multimodal settings. Evidence for a trend towards deep learning models was found, although the limited comparison with traditional methods calls for further research. Concerns arise regarding the representativeness of datasets and practical challenges in deploying wearable technologies, which include issues related to data quality and privacy. Future research should aim to develop comprehensive datasets and explore AI techniques that are not only accurate but also computationally efficient and user-centric, thereby closing the gap between theoretical models and practical applications to improve the effectiveness of stress detection systems in real scenarios.

Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. It suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.

Objective: Mechanical bowel preparation is essential for the visualisation of the colon during colonoscopy, and previous studies have identified changes in gut microbiota composition after bowel preparation and colonoscopy. Considering the gut microbiota is increasingly implicated in mood, we aimed to explore the potential impact of this intervention on mood and the microbiota-gut-brain axis. Methods: We conducted a pre-post intervention study, with timepoints of one week before and one month after bowel preparation and colonoscopy, in community-dwelling adults referred for colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores using generalised estimating equations. We also examined changes in average anxiety, stress, and quality of life scores, and faecal microbiota composition and potential function using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and the gut microbiota and conducted post-hoc analyses to explore potential effect modifiers. Key Results: 59 participants were included in the analyses. Depressive symptoms decreased one-month post-procedure compared to baseline (adjusted β=−0.64; 95%CI: −1.18, −0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (1.78; 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Changes in gut microbiome composition included reduced alpha diversity, modest effects on beta-diversity, and increases in genera associated with potential health benefits, one-month post-procedure compared to baseline. Increases in the CLR-transformed abundance of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. Conclusions: There is preliminary evidence of a potential mental health effect of bowel preparation and colonoscopy, which may be associated with changes to the gut microbiota. There may also be a differential mental health impact of this procedure for those with and without IBS. Considering the limitations of our study, further research is required to confirm these findings and their clinical relevance.

Non-Vitamin K Oral Anticoagulants (NOACs) have revolutionized anticoagulant therapy, offering improved safety and efficacy over traditional agents like warfarin. This review comprehensively examines the dual roles of NOACs—Apixaban, Rivaroxaban, Edoxaban, and Dabigatran—not only as anticoagulants but also as modulators of inflammation via Protease-Activated Receptor (PAR) signaling. We highlight the unique pharmacotherapeutic properties of each NOAC, supported by key clinical trials demonstrating their effectiveness in preventing thromboembolic events. Beyond their established anticoagulant roles, emerging research suggests that NOACs influence inflammation through PAR signaling pathways, implicating factors such as FXa and Thrombin in the modulation of inflammatory responses. This review synthesizes current evidence on the anti-inflammatory potential of NOACs, exploring their impact on inflammatory markers and conditions like atherosclerosis and diabetes. By delineating the mechanisms by which NOACs mediate anti-inflammatory effects, this work aims to expand their therapeutic utility, offering new perspectives for managing inflammatory diseases. Our findings underscore the broader clinical implications of NOACs, advocating for their consideration in therapeutic strategies aimed at addressing inflammation-related pathologies. This comprehensive synthesis not only enhances understanding of NOACs' multifaceted roles but also paves the way for future research and clinical applications in inflammation and cardiovascular health

The COVID-19 pandemic has caused significant medical and psychological challenges worldwide, and not only exceeded the capacity of hospitals and intensive care units but also an individuals’ ability to cope with life. Health-care workers have continued to provide care for patients despite exhaustion, fear of transmission to themselves and their family, illness or death of friends and colleagues, and losing many patients. They have also faced additional stress and anxiety due to long shifts combined with unprecedented population restrictions, including personal isolation. In this study, we study the effect of an app-based Yoga of Immortals (YOI) intervention on mental health of healthcare workers. In this study, the health care workers were digitally recruited, and their psychological parameters were measured using validated questionaries. The participants were randomly grouped into control and test groups. The validated psychological measures were the Patient Health Questionnaire-8 (PHQ-8), Insomnia Severity Index (ISI) and generalized anxiety disorder (GAD-7) scales. The digital YOI intervention significantly reduced the anxiety, depression symptoms, and insomnia in healthcare workers of all age groups. In contrast, there was no improvement in the control group. This study details the effectiveness of an app-based YOI intervention in healthcare workers.

Dust inhalation is a huge concern in the mining environment and within all its operations. In fact, dust to be one of the most serious occupational hazards in the mining industry. Coal and crystalline silica dust are the causes of serious, sometimes fatal lung diseases such as pneumoconiosis, which affects coal miners, as well as silicosis, tuberculosis, chronic bronchitis, emphysema, chronic obstructive pulmonary disease, and chronic renal disease, which affect coal and other types of miners. The resulting effects both affect workers and nearby communities. The mining industry has in the past, employed several approaches to reduce effects of dust. But these strategies have often been ineffective because the grass withers during the dry season and sprayed water is rapidly absorbed or evaporates. This paper endeavors to review information on dust in the mining environment and how it is a nuisance to workers and communities and establish what strategies exist for this.

Lyme disease, the leading vector-borne ailment in the U.S., annually affects an estimated 476,000 individuals, predominantly in the Northeast and Upper Midwest. Despite its increasing incidence, the evaluation of risk within U.S. cities, including natural public lands, remains inadequate. This study focuses on blacklegged tick occurrences and Borrelia burgdorferi infection prevalence in 24 Staten Island parks, aiming to assess Lyme disease exposure risk. Monthly acarological risk index (ARI) calculations from 2019 to 2022 revealed elevated values (0.16-0.53) in specific parks, notably Wolfe’s Pond Park, High Rock Park, Clay Pit Pond Park, Clove Lake Park, and Fair View Park. June (0.36) and November (0.21) consistently exhibited heightened ARIs, aligning with peak tick collection months. Despite stable yearly infection rates at 28.97%, tick densities varied significantly between parks and years. Identifying a high transmission risk in specific parks in Staten Island, a highly urbanized part of New York City, emphasizes the continuous necessity for Lyme disease risk management, even within the greenspaces of large cities.

Background: Sudden changes in clinical practice and the altered ability to care for patients due to the COVID-19 pandemic have been associated with moral distress and mental health concerns in healthcare workers internationally. This study aimed to investigate the severity, prevalence, and predictors of moral distress experienced by Australian healthcare workers during the COVID-19 pandemic. Methods: A nationwide, voluntary, anonymous, single time-point, online survey of self-identified frontline healthcare workers was conducted between 27th August and 23rd October 2020. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts, and national media. Results: 7846 complete responses were received from nurses (39.4%), doctors (31.1%), allied health staff (16.7%) or other roles (6.7%). Many participants reported moral distress related to resource scarcity (58.3%), wearing PPE (31.7%) limiting their ability to care for patients, exclusion of family going against their values (60.2%), and fear of letting co-workers down if they were infected (55.0%). Many personal and workplace predictors of moral distress were identified, with those working in certain frontline areas, metropolitan locations, and with prior mental health diagnoses at particular risk of distress. Moral distress was associated with an increased risk of adverse mental health outcomes. Feeling appreciated by the community mitigated this risk in healthcare workers. Conclusions: Safeguarding healthcare workforces during crises is important for both patient safety and workforce longevity. Targeted interventions are required to prevent or minimise moral distress and associated mental health concerns in healthcare workers during COVID-19 and other crises.

Gestational trophoblastic diseases (GTDs) encompass a spectrum of conditions characterized by abnormal trophoblastic cell growth, ranging from benign molar pregnancies to malignant trophoblastic neoplasms. This systematic review explores the molecular underpinnings of GTDs, focusing on genetic and epigenetic factors that influence disease progression and clinical outcomes. Based on 65 studies identified through systematic search and selection criteria, key findings include dysregulations in tumor suppressor genes such as p53, aberrant apoptotic pathways involving BCL-2, and altered expression of growth factor receptors and microRNAs. These molecular alterations not only differentiate molar pregnancies from normal placental development but also contribute to their clinical behavior, from benign moles to potentially malignant forms. The review synthesizes insights from immunohistochemical studies and molecular analyses to provide a comprehensive understanding of GTD pathogenesis and implications for personalized care strategies.

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

Diarrhoea is a serious cause of mortality worldwide that can lead to dehydration, gut barrier function impairment, nutrient malabsorption, and alterations of the gut microbiota (dysbiosis). Current solutions for its management, such as oral rehydration salts (ORS), inhibitors of the gut motility, antibiotics, and living probiotics only partially counteract the mechanisms of the disease and do not provide a full coverage of the problem. Potential risks of the use of living probiotic strains, particularly in immunocompromised patients, can be eliminated with the use of tyndallized (heat-killed) postbiotic bacteria and yeast. ABB C22® is a postbiotic combination of three tyndallized yeasts, namely Saccharomyces boulardii, Saccharomyces cerevisiae, and Kluyveromyces marxianus. To assess the action of the postbiotic combination on diarrhoea, immune and gut epithelial cell signaling assays, gut barrier formation assay and rotavirus gene expression assay were performed. ABB C22® showed a strong anti-inflammatory effect, an induction of the build-up of the gut epithelium, and a degree of protection against rotavirus infection. These experimental studies support the use of the postbiotic ABB C22® as a solution for the management of diarrhoea and gastrointestinal conditions, alone or in combination with existing but incomplete treatments.

The main objective of this review is to determine the main risks that agricultural workers are exposed to during pesticide application, which may have a harmful effect on their health and on public health. This systematic review was based on the PRISMA guidelines. A search for articles was conducted in the Medline/PubMed, ScienceDirect, and Web of Science databases. Fifteen articles were selected considering their assessment of agricultural workers' knowledge, perceptions, attitudes, practices, and behaviours, identifying the main risks and risk factors for disease associated with the unsafe handling of pesticides. The main risk factors identified were age, education, pesticide safety training, farming experience, and contact with other farmers/intermediaries resulting in pesticide access. The most frequent risk behaviours were: application of pesticides without personal protective equipment (PPE), incorrect disposal of empty packaging and waste, and undervaluation of label information, as well as other unsafe practices. A multidisciplinary and more effective training must be delivered in order to enhance pesticide safe usage. This will empower workers to adopt more conscious and safer behaviours while using pesticides.

AbstractBackground: In digitalization era, health care system was conditioned with the health worker’s ability to adapt media of digital technology. Digital technology media was used to strengthening and fasted the health care for patient and community. Aims: This study aimed to explore the accurate information of health professional utilization digital technology during doing the job at the health facilities in Timor-Leste. Methods: This study was used correctional study with 56 respondents was participated in the study. Was collected the data from 1 to 30 February 2023. Was used questioner of google form based for data collection. Data collection was distributed via online with google form to social media as WhatsApp’s, email and face book and twitter to completed by respondents. The inclusive Criteria are: health professional living in Timor-Leste, to able response the questioner. Was used descriptive analysis in this study. Finding: This study was indicated that majority of health professional was participated in the study as 54,2% man then women have 45,8%. About 100% health professional used hand phone to facilitate their daily activities including related with their work activities. Other side indicated in digital technology tools use are able to use Microsoft word is 78,3%, able to use Microsoft Excel is 76,7% and able to use Power Point is 81,7%. E-mail use about 89,2%, WhatsApp’s use 81,7%, About 74,2% was used zoom/webinars/Google meet application, about 72,5% sad that they were used computer in the work place until now. Around 96.4% need to improve or deepen their knowledge and skills in using ICT in the future to facilitate they are activity. Conclusion: Majority of health professional in Timor-Leste was used the computer, internet, hand phone in daily activities. Majority need to gate the training to improve their knowledge, attitude and psychomotor in the future.

Background This study aimed to identify the prominent risk factors that may trigger danger signals of early onset of vascular deregulation in T1D. The risk factors we have identified may serve as dual-purpose biomarkers of rapid diagnosis that offer prospective tailor-made resolution therapeutics. Methods The healthy control (HC) was compared with individuals diagnosed with T1D for the risk factors of vascular deregulation in published research studies from year 2013 to 2023. The PubMed, Web of Science and Google Scholar databases were searched from 1/1/2013 to 1/9/2023. The risk of bias was assessed with the Cochrane (ROBINS-I ) tool, which is relevant to clinical subjects. A random effect model for continuous data was followed and analysed by RevMan 5.4 and GraphPad Prism software. Results 80 relevant case-control studies having 5293 HC and 7492 T1D patients were included. The age and sex-matched HC consisted of persons free of disease and not under any medication while clinical subjects of all age groups were included. 28 risk factors were grouped into six primary outcome models, all of which favoured the T1D synonymous with a high risk of CVD. Conclusions Our findings have strong implications for improving the quality of life and health economics related to vascular disease in T1D. HbA1c% is the most effective biomarker, followed by FBG, LDL-C, and AI% which the clinicians could evaluate using a simple blood test or non-invasive techniques. (Protocol registered at https://www.crd.york.ac.uk/prospero/ CRD42022384636).

A new quinazolinone alkaloid, named peniquinazolinone A (1), as well as eleven known com-pounds, 2-(2-hydroxy-3-phenylpropionamido)-N-methylbenzamide (2), viridicatin (3), viridicatol (4), (±)-cyclopeptin (5a/5b), dehydrocyclopeptin (6), cyclopenin (7), cyclopenol (8), methyl-indole-3-carboxylate (9), 2,5-dihydroxyphenyl acetate (10), methyl m-hydroxyphenylacetate (11), conidiogenone B (12), was isolated from the endophytic Penicillium sp. HJT-A-6. The chemical structures of all compounds were elucidated by comprehensive spectroscopic analysis, including 1D, 2D NMR, and HRESIMS. The absolute configuration at C-13 of peniquinazolinone A (1) was established by applying the modified Mosher’s method. Compounds 2, 3, and 7 exhibited an op-timal promoting effect on the seed germination of Rhodiola tibetica at a concentration of 0.01 mg/mL, while the optimal concentration for compounds 4 and 9 to promote Rhodiola tibetica seed germination was 0.001 mg/mL. Compound 12 showed optimal seed-germination-promoting activity at a concentration of 0.1 mg/mL. Compared with the positive drug 6-benzyladenine (6-BA), compounds 2, 3, 4, 7, 9, and 12 could extend the seed-germination period of Rhodiola tibetica up to the 11th day.

Few studies have examined the dietary protein intake and sources in combination with the longitudinal changes in brain structure markers. Our study aimed to examine the association between dietary protein intake and different sources of dietary protein with the longitudinal rate of change in brain structural markers. A total of 2723 and 2679 participants from the UK Biobank were included in the analysis. The relative and absolute amounts of dietary protein intake were calculated through a 24-hour dietary recall questionnaire. The longitudinal change rates of brain structural biomarkers were computed using two waves of brain imaging data. We utilized multiple linear regression to examine the association between dietary protein and different sources and the longitudinal changes in brain structural biomarkers. Restrictive cubic splines were used to explore nonlinear relationships, and stratified and sensitivity analyses were conducted. Increasing the proportion of animal protein in dietary protein intake is associated with a slower reduction in the total hippocampus volume (THV, β: -0.02524, P<0.05), left hippocampus volume (LHV, β: -0.02435, P<0.01) and right hippocampus volume (RHV, β: -0.02544, P<0.05).Higher intake of animal protein relative to plant protein is linked to a lower atrophy rate in THV (β: -0.01249, P<0.05) and LHV (β: -0.01173, P<0.05) and RHV (β: -0.01193, P<0.05). Individuals with higher intake of seafood exhibit lower longitudinal rate of change in HV compared to those with no consume (THV, β: -0.004514; P<0.05; RHV, β: -0.005527, P<0.05). In subgroup and sensitivity analyses, there was not a significantly alteration. A moderate increase in the intake and proportion of animal protein in the diet, especially from seafood, is associated with a lower longitudinal change rate in hippocampus volume.

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.

1) Background: Several studies have shown the benefit of drawing when learning anatomy. Virtual Reality (VR) also appears to be useful to increase the understanding of the location of anatomical structures. This study aims to describe how students in an Operating Room Nursing (OR nursing) master study program perceive the benefit of active learning methods, including drawing and the use of VR. 2) Methods: We combined these two methods in a class of 29 students. 38 half-finished drawings of anatomical structures were made. The students were to complete these during lectures with guidance from the teacher. The students also attended a two-hour VR session where they were to find various anatomical structures. A paper questionnaire was applied to evaluate the teaching program. Data were analyzed statistically. 3) Results: The students highly appreciated these learning methods. They reported that drawing made them work more actively during lectures and increased their learning outcome. They also perceived that the use of VR technology increased their understanding of the location of anatomical structures. 4) Conclusion: The combination of drawing and VR technology may be of benefit to OR Nursing students when learning anatomy by both increasing student activity and learning outcomes.

In this paper, we introduce a specialized, fully automated experimental arrangement designed for assessing the effectiveness of augmented and virtual reality technologies in healthcare setting and explore its design principles focusing on depth sensor characterization. The main goal of this project is to establish a robust benchtop platform for the quantitative evaluation of extended reality technologies in a controlled environment, emphasizing the practical assessment of augmented reality head-mounted devices. We outline a design concept and considerations for an experimental configuration aimed at creating a realistic testing environment. This apparatus comprises an observation platform mounted on a three-degree-of-freedom motorized system and a test phantom stage. Focusing on real-case scenarios, we utilized a range of sensors, including readily available range-sensing cameras and commercial augmented reality headsets, such as the Intel RealSense L515 LiDAR camera, mounted on the motion control system. The setup enabled automated data collection and facilitates controlled assessments and validation of various facets of augmented reality technologies, including object, hand, and head tracking, as well as static and dynamic image registration. This paper describes the system architecture, the process of automated data collection, and presents several evaluation studies conducted with this setup, providing insights into the quality and temporal noise associated with static or moving objects or observers in augmented reality applications.

Background. Transferrin receptor 1 (TfR1), glucose transporter 1 (GLUT1), and CD98hc are candidates for targeted therapy at the blood-brain barrier (BBB). Our objective was to challenge the expression of TfR1, GLUT1, and CD98hc in brain capillaries by the histone deacetylase inhibitor (HDACi) valproic acid (VPA). Methods. Primary mouse brain capillary endothelial cells (BCECs) and brain capillaries isolated from mice injected intraperitoneally with VPA were examined using RT-qPCR and ELISA. Targeting to the BBB was performed by injecting monoclonal anti-TfR1 (Ri7217)-conjugated gold nanoparticles measured using ICP-MS. Results. In BCECs co-cultured with glial cells, Tfrc mRNA expression was significantly higher after 6 h VPA returning to baseline after 24 h. In vivo Glut1 mRNA expression was significantly higher in males, but not females', receiving VPA, whereas Cd98hc mRNA expression was unaffected by VPA. TfR1 increased significantly in vivo after VPA, whereas GLUT1 and CD98hc were unchanged. Uptake of anti-TfR1-conjugated nanoparticles was unaltered by VPA in spite upregulated TfR expression. Conclusions. VPA upregulates TfR1 in brain endothelium in vivo and in vitro. VPA does not increase GLUT1 and CD98hc proteins. The increase in TfR1 does not result in higher anti-TfR1 antibody targetability, suggesting targeting sufficiently occurs with available transferrin receptors without further contribution from accessory VPA-induced TfR1.

The COVID-19 pandemic halted progress in global vaccine coverage and disrupted routine childhood vaccination practices worldwide. While there is ample evidence of vaccination declines experienced during the pandemic, it is less clear how low-income countries were affected. We executed a systematic review to synthesize the current literature on impacts to routine childhood vaccinations in low-income countries from January 1, 2020 to February 8, 2023. We collected data using an extraction form on Covidence and assessed the quality of studies included in the review using the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool. Effect estimates for changes in vaccination during the pandemic were reported and summarized. Factors that influenced changes were grouped into descriptive themes. Thirteen studies, encompassing 18 low-income countries and evaluating 15 vaccines at varying doses, were included in the final review. We found that routine childhood vaccinations during the COVID-19 pandemic varied considerably by vaccine type, location, and phase of the pandemic. Nine different themes were identified as factors that influenced changes in vaccination. Documenting past experiences and lessons learned is crucial for informing preparedness efforts in anticipation of future public health emergencies. Failure to effectively address these things in the next public health emergency could result in a recurrence of declining routine childhood vaccinations.

Proper Post-Activation Performance Enhancement helps to improve athletic performance. This study aimed to investigate the effects of two different velocity loss (VL), 10%VL and 20%VL, on post-activation performance enhancement (PAPE) in 20m sprint performance among sprint athletes. Twenty-four male sprint athletes (100m sprint time: 10.96±0.15 s) were recruited. A randomized crossover experimental design was used for traditional group (TG), 10%VL, and 20%VL interventions. Sprint tests were conducted at the 4th, 8th, 12th, and 16th minutes after the intervention. Two-way repeated measures ANOVA revealed an interaction effect between group and time on 20m sprint performance (F=2.817, p=0.037, partial η²=0.585). Simple effect analyses showed significant differences compared to baseline at the 4th minute for the 20%VL group (P<0.05). Cohen's d values indicated improvement in 10m sprint times at the 8th minute of the rest interval for all three intervention groups (TG: ES=-0.270, 10%VL: ES=-0.038, 20%VL: ES=-0.279). Improvement in 20m sprint times was observed at the 4th minute for the 20%VL group (ES=-0.296) and at the 16th minute for the 10%VL group (ES=-0.276). Compared to traditional PAPE schemes based on 1RM, PAPE schemes based on velocity loss (20%VL) can better induce PAPE effects in sprint athletes.

Coxsackievirus A6 (CV-A6) has emerged as the predominant causative agent of hand, foot, and mouth disease (HFMD) in young children. Since the declaration of coronavirus disease 2019 (COVID-19) as a global pandemic, the incidence of infectious diseases, including HFMD, has decreased markedly. When social mitigation was relaxed during the COVID-19 pandemic in 2022, re-emergence of HFMD was observed in Gwangju, South Korea, and seasonal characteristics of the disease appeared to have changed. To investigate the molecular characteristics of enterovirus (EV) associated with HFMD during 2022, 277 specimens were collected. Children aged under 5 years accounted for the majority of affected individuals. EV detection and genotyping were performed using real-time RT-PCR and nested RT-PCR followed by sequence analysis. EV detection rate was found to be 82.3%, and the main genotype identified was CV-A6. Sixteen CV-A6 samples were selected for whole genome sequencing. According to phylogenetic analysis, all CV-A6 strains from this study belonged to the sub-genotype D3 clade based on VP1 sequences. Analysis of 3D polymerase phylogeny showed that only the recombinant RF-A group was identified. In conclusion, circulating EV types should be continuously monitored to understand pathogen emergence and evolution during the post-pandemic era.

Button batteries pose a significant threat to young children and are found in many household items and children’s toys. Along with product manufacturers and retailers, parents and caregivers have a role in button battery ingestion prevention through vigilance regarding items containing button batteries in the home, and knowledge of button battery ingestion symptoms. There is limited information available about parent and caregiver perspectives towards button battery safety. Identifying the areas where increased education is required is important for informing safety campaigns and delivering targeted education. This study aimed to examine parent and caregiver elemental perspectives on button battery safety. One hundred and seventy-four parents and caregivers of children aged 0 to 5 completed a cross-sectional online survey. Distribution occurred via social media. The survey contained multiple-choice questions pertaining to button battery perspectives, and one open-ended question. Respondents recognized the dangers of button battery ingestion, yet only 37% reported being familiar with button battery ingestion symptoms. While 68% knew of household items containing button batteries, only 21% were aware of product recall information sources. Approximately 64% understood immediate post-ingestion steps and 17% found current safety labels unsatisfactory. In an open-ended question, parents and caregivers provided comments about button battery safety that revealed five broad themes; supervision and education; safe storage of button batteries in the home; ensuring children cannot access button batteries; disposing of button batteries safely; and avoiding purchasing items containing button batteries. This study provides a foundation for ongoing investigation of parent and caregiver perspectives on button battery home safety.

Human papillomavirus (HPV) can potentially compromise both unassisted conception and success rates with assisted reproductive technology (ART). We aimed to evaluate the rates of HPV vaccination among women presenting for fertility care. This was a prospective study analyzing a self-reported intake form completed by all new patients presenting to a fertility clinic. The primary outcome was HPV vaccination status. Among the 523 new patients included in this study 172 (32.9%) were fully vaccinated, 237 (45.3%) were unvaccinated, and 95 (18.2%) patients didn’t respond. There was a significant age difference between fully vaccinated patients (33.1 years) compared to unvaccinated patients (37.4 years) p<0.001 and a significant difference in gravidity between fully vaccinated patients (average 0.65) and unvaccinated patients (average 1.11) p=0.0005. No significant association was found between HPV vaccination status and history of abnormal Pap smears or relationship status (single vs. married). Less than half of patients presenting to our fertility center were vaccinated against HPV, despite being eligible to receive the vaccine. Younger patients with lower gravidity were more likely to be vaccinated against HPV than older patients with higher gravidity. Reproductive Endocrinologists have the opportunity to recommend HPV vaccination for eligible patients presenting for fertility care.

Background: Complementary and alternative medicines (CAM) are widely used, with pharmacies accounting for a significant share of the distribution market. Despite their popularity, many CAMs lack scientific evidence for effectiveness, and some can cause adverse health effects. Limited research exists on CAM-related adverse events and the effectiveness of CAM labels in conveying crucial information. Methods: This cross-sectional study aimed to investigate CAM utilization, consumer perspectives, and the influence of labels on CAM usage in Melbourne, Australia. Data were collected through an online questionnaire and analysed using descriptive statistics, Pearson's correlation, MANOVA, and regression analyses. Results: The study enrolled 125 current CAM users, primarily recruited from pharmacy and supermarket customers (age: predominantly 31-50; gender: 20.8% male, 79.2% female). Participants' perceptions of effectiveness and safety were positively correlated. Label warnings prompted information-seeking, but consultation with healthcare professionals (HCPs), particularly pharmacists, was infrequent (24%). Adverse reactions were reported by 18.5% of participants, with 8.3% experiencing severe reactions. The analysis revealed relationships between CAM usage and demographics. Ordinal logistic regression showed a significant association between calcium consumption and higher age groups (coefficient = 1.658, p = 0.006), while binary logistic regression identified higher iron consumption among females (coefficient = 2.177, p = 0.007). Conclusions: Label warnings significantly prompted consumers to seek more information about CAMs. However, a limited engagement of HCPs, especially pharmacists, suggests an opportunity for improved consumer education and pharmacist involvement in CAMs-related discussions. The findings highlight demographic influences on CAM usage being essential for developing targeted health interventions and policies. Addressing these aspects may lead to safer CAM practices and informed consumer decision-making.

Amitriptyline is a tricyclic antidepressant commonly used for depressive disorders and pre-scribed off-label for several neurological conditions like neuropathic pain, migraine and anxiety. Amitriptyline potentiates the monoaminergic transmission by blocking the reuptake of norepi-nephrine and serotonin. However, antidepressants also act on additional targets that contribute to either therapeutic or adverse effects and may suggest new indications for their repurposing. Furthermore, since depression is often a co-morbidity in patients with chronic conditions (i.e. cancer, neurodegenerative diseases) the use of antidepressants interfering with pathways in-volved in cell homeostasis may affect the progression and outcome of these pathologies. Here we investigate the effects of amitriptyline on proliferation and autophagy in human SH-SY5Y neuroblastoma cells. Dose and time-dependent upregulation of the autophagy markers LC3II and autophagy receptor p62, with accumulation of LAMP1 positive compartments, were observed in SH-SY5Y cells exposed to amitriptyline. Alteration of autophagy was accompanied by reduced cell viability and decreased clonogenic capacity, without a significant induction of apoptosis. Decrease viability and clonogenic activity were still observed in autophagy deficient Atg5 -/- MEF and following pre-treatment of SH-SY5Y culture with the autophagy inhibitor chloroquine suggesting that the amitriptyline’s effects on cell proliferation were not caused by the modulation of autophagy. Our findings demonstrate that amitriptyline acts on pathways that are crucial for cell and tissue homeostasis and pose the basis for further studies on the potential application of these effects and the consequences during long-term antidepressant treatment.

While disrespectful treatment of pregnant women attending health care facilities occurs globally, it is more prevalent in low resource countries. In Kenya, a large body of research studies or has studied disrespectful maternity care (DMC) from the perspective of the service users. This paper examines the perspective of health care workers (HWCs) on factors that influence DMC experienced by pregnant women at health care facilities in rural Kisii and Kilifi counties in Kenya. We conducted 24 in-depth interviews with health care workers (HCWs) in these two sites. Data were analyzed deductively and inductively using NVIVO 12. Findings from HCWs reflective narratives identify four areas connected to the delivery of disrespectful care including poor infrastructure, understaffing, service users’ socio–cultural beliefs, and health care workers’ attitudes toward marginalized women. Investments are needed to address health systems influences on DMC including poor health infrastructure and understaffing. Additionally, it is important to reduce cultural barriers through training on HCWs interpersonal communication skills. Further, strategies are needed to affect positive behavior changes among HCWs directed at addressing stigma and discrimination of pregnant women due to socio-economic standing. To develop evidence-informed strategies to address DMC, a holistic understanding of the factors associated with pregnant women’s poor experiences of facility based maternity care is needed. This may best be achieved through an intersectional approach to address DMC by identifying systemic, cultural, and socio-economic inequities as well as the structural and policy features that contribute and determine peoples’ behaviors and choices.

Healthcare personnel must face two problems of growing importance: violence in the workplace and the loss of work ability due to ageing of the workforce. Studying the relationship between these two phenomena can help to prepare effective prevention measures. In a public health company, we asked nurses to self-assess their work ability using the Work Ability Index (WAI) and we analysed the relationship between this indicator and the violence experienced in the previous and following years. 321 out of 344 nurses (99.3%) participated. In a logistic regression model, the WAI score was a significant protective factor for violence experienced in the previous year (OR=0.94 CI95%=0.90; 0.98 p<0.01) and in the following year (OR=0.88 CI95%=0.84; 0.92 p<0.01). In a hierarchical logistic regression model, social support acted as a protective factor (OR = 0.87 CI95% = 0.79; 0.95 for violence experienced in the previous year), while occupational stress was a significant determinant of the risk of aggression (OR=3.65 CI95%=1.90; 7.03 in the previous year, OR=3.54 CI95%=1.801; 6.947 in the following year). The difficulties that nurses encounter in carrying out their growing work demands in an environment that is not promptly adapted to their changing physical and mental conditions can lead to an increased risk of violence. Prevention of workplace violence should include organizational and ergonomic measures that reduce stress and increase staff support and work ability.

Neurological involvement following COronaVIrus Disease 19 (COVID-19) is thought to have a neuroinflammatory etiology. Co-ultraPEALut (an antiinflammatory molecule) and luteolin (an antioxidant) yielded promising results as neuroinflammation antagonists. This study aimed at describing cognitive impairment in post-COVID patient treated with co-ultraPEALut. Montreal Cognitive Assessment (MoCA), Prospective-Retrospective Memory Questionnaire (PRMQ), Fatigue Severity Scale (FSS) and a subjective evaluation were administered at baseline and after 10 months. Co-ultraPEALut-treated patients were retrospectively compared with controls. 26 co-ultraPEALut-treated patients showed significant improvement in PRMQ (T0: 51.94±10.55, T1: 39.67±13.02, p

Automobile industries worldwide extensively use organic solvents. Yet, limited evidence examined the health and safety in handling these solvents, which can only be assured if workers have appropriate knowledge and demonstrate safe practices. A cross-sectional study was conducted to explore the knowledge and practice among workers who are involved with handling organic solvents in the automobile industry in the largest most urban district in Brunei Darussalam. Qualitative data were sought from open-ended questions; observations and pictorial evidence through still photographs. Quantitative analysis showed that 75% of the workers practice reading labels, 94.1% use fully covered clothes, 82.4% wear gloves and 98.5% practice proper hand washing as well as 98.5% cover container lids. The qualitative analysis illustrated workers have general knowledge of materials containing solvents but did not identify the exact solvents, the harmful effects of the solvents, pathophysiology and harmful effects on specific body systems. Health and safety were practiced albeit not consistent. Health and Safety Authorities in Brunei Darussalam must review and enforce specific policies on use of organic solvents so that they can be practiced consistently and safely in automobile industries. Cooperation and collaboration in adhering to the policies are mandatory to ensure health and safety at work.

In recent experimental studies, we reported the aggravating effects of Asian sand dust (ASD) on male reproductive function in mice. However, the effects of fetal ASD exposure on male reproductive function have not been investigated. The present study investigated the effects of fetal ASD exposure on reproductive function in male offspring. Using pregnant CD-1 mice, ASD was administered intratracheally on days 7 and 14 of gestation, and the reproductive function of male offspring was determined at 5, 10, and 15 weeks after birth. The secondary sex ratio was significantly lower in the fetal ASD-exposed mice than in the controls. Histologic examination showed partial vacuolation of seminiferous tubules in immature mice. Moreover, daily sperm production (DSP) was significantly less in the fetal ASD-exposed mice than in the controls. DSP in the fetal ASD-exposed mice was approximately 10% less than the controls at both 5 and 10 weeks. However, both the histologic changes and the DSP decrease were reversed as the mice matured. These findings suggest that ASD exposure affects both the fetal development and the reproductive function of male offspring. In the future, it will be necessary to clarify the onset mechanisms of ASD-induced male fetus death and male reproductive disorders.

BACKGROUND AND OBJECTIVE: The use of biomass for cooking carries significant health implications and can lead to adverse environmental issues such as deforestation, greenhouse gas emissions, and erosion. Despite these concerns, there is a lack of information about the nature and extent of cooking emissions in many developing countries. To address this gap, a study was conducted to assess cooking emission levels and their associated health effects among households in Dodoma City, Tanzania. METHODS: A descriptive cross-sectional design was conducted, involving 285 households in the peri-urban area of Dodoma City, Tanzania. A combination of questionnaires, observational checklists, and sampling devices (Aeroqual series 500 for Carbon Monoxide and Temptop PMD 351 for Particulate Matters) were employed for data collection, adhering to established protocols. Additionally, lung function tests were conducted with consent from the primary household cooks. Collected data were entered into an Excel spreadsheet and analyzed using STATA 17 software. FINDINGS: Out of 285 participants, 74.7% predominantly use charcoal for cooking, with 68.4% having outdoor kitchen setups. Significant differences in pollutant concentrations were observed across various fuel types (P=0.0001), with firewood emitting higher levels of particulate matter and carbon monoxide. Carbon monoxide concentrations during cooking were 6 times higher for firewood, 5 times higher for charcoal-gas, and 3 times higher for charcoal compared to WHO daily average limits. Additionally, a positive correlation between pollutant concentrations was noted (P-value = 0.0000). Lung problems 17.8% followed by eye irritation 15.7% were mentioned by those who claimed to know the health effects associated with cooking emissions. In addition, the spirometry test indicated that the majority of the participants had % predicted >80 while only 19% had % predicted below 50. CONCLUSION: Charcoal and firewood remain the primary cooking fuels in the study area despite their significant negative impacts. Our findings highlight a lack of awareness among community members regarding the health effects of biomass cooking emissions and insufficient guidance on constructing healthy kitchens. To address this, enforcing building standards, raising health awareness, and ensuring affordable access to modern fuels are crucial steps. These measures are essential for promoting healthier cooking practices and mitigating the adverse effects on households.

HIV early detection (CD4 counts ≥350 cells/μL) is correlated with higher life expectancy among people living with HIV (PLHIV). Several factors including physical, cultural, structural, and financial barriers have contributed to HIV late detection. This is the first-of-its-kind study on the regional differences in early detection of HIV within Tajikistan and any country in the Central Asia region. Utilizing Tajikistan Ministry of Health's national HIV data (N=10,700) spanning 2010 to 2023, we developed median regression models with median CD4 cell count as the outcome and as predictors: time (years), region, age, gender, and area (urban/rural status). Individuals younger than 19 years old are more likely to be detected early for HIV, whereas those older than 39 years are more prone to late detection. Given their active engagement in age-related and sexual activities, those older than 39 years face a higher risk of HIV transmission to others if diagnosed late. Therefore, they require further attention and targeted interventions. Females are detected earlier compared to their male counterparts, regardless of region of residence. Rural populations are detected earlier in most years compared to their urban counterparts. The COVID-19 pandemic accelerated HIV early detection in 2021 but most regions have returned to near pre-pandemic levels of detection in 2022 and 2023. These fluctuations in early detection may signify a shift in attention and resource allocation, potentially affecting efforts to address access gaps during the initial year of the COVID-19 pandemic. There are significant health inequities among different demographic and geographic groups which warrant further attention.

Three autonomous communities have been the ones that, in the 2022-2023 season, anticipated the document approved by the Public Health Commission, recommending influenza vaccination for all children aged 6 to 59 months. The main objective of this work is to evaluate the attitude of healthcare professionals towards the first universal vaccination campaign in our region, as well as the acceptability of the vaccines used and the attitude towards the piloting of school vaccination. Cross-sectional, survey-based, descriptive study. All healthcare professionals involved in the campaign were invited to participate. The 91.9% of surveyed professionals thought that flu vaccination from 6 to 59 months was important or very important. 89.8% had previous experience regarding the intramuscular vaccine. The professionals valued the intranasal vaccine significantly more positively; however, there were no differences when asking for each of the vaccines without comparison. The inhaled vaccine was preferred by 97.5% for the following campaign. Piloted school vaccination showed 75% acceptance. The inhaled vaccine was preferred by most professionals and the piloted school vaccination was highly accepted, and independently associated to the importance of vaccination as considered by physicians, being a medical doctor, and participation in the pilot program.

Background: high-altitude work exposes individuals to reduced oxygen levels, imposing physi-ological adaptations. These conditions can induce alterations in the cardiovascular system, po-tentially exacerbating pre-existing health issues and impacting overall well-being of workers in such environments. This study has investigated the cardiovascular challenges for the high-altitude worker on Etna volcano. Methods: Through an observational study, ten healthy, non-smoking male participants underwent cardiovascular and pulmonary function tests at alti-tudes below 500m and above 3000m, simulating work conditions on the volcano. Results: signif-icant findings include elevated systemic blood pressure and heart rate, indicating an increased cardiovascular workload necessary for adaptation to hypoxia. Conclusions: the study highlights the importance of acclimatization to high altitude for minimizing cardiovascular risks among workers. It calls for the development of safety protocols, underlining the critical role of preven-tative measures and specific safety protocols for high-altitude workers.

Angiogenesis is a critical physiological response to ischemia but becomes pathological when dysregulated and driven excessively by inflammation. We recently identified a novel angiogenic role for tripartite-motif-containing protein 2 (TRIM2) whereby lentiviral shRNA-mediated TRIM2 knockdown impaired endothelial angiogenic functions in vitro. This study sought to determine whether these effects could be translated in vivo and to determine the molecular mechanisms involved. CRISPR/Cas9-generated Trim2–/– mice that underwent a periarterial collar model of inflammation-induced angiogenesis exhibited significantly less adventitial macrophage infiltration relative to wildtype (WT) littermates, concomitant with decreased mRNA expression of macrophage marker Cd68 and reduced adventitial proliferating neovessels. Mechanistically, TRIM2 knockdown in endothelial cells in vitro attenuated inflammation-driven induction of critical angiogenic mediators, including nuclear HIF-1α, and curbed the phosphorylation of downstream effector eNOS. Conversely, in a hindlimb ischemia model of hypoxia-mediated angiogenesis, there were no differences in blood flow reperfusion to the ischemic hindlimbs of Trim2–/– and WT mice despite a decrease in proliferating neovessels and arterioles. TRIM2 knockdown in vitro attenuated hypoxia-driven induction of nuclear HIF-1α but had no further downstream effects on other angiogenic proteins. Our study has implications for understanding the role of TRIM2 in the regulation of angiogenesis in both pathophysiological contexts.

Background Praziquantel is the commonly used conventional treatment recommended for schistosomiasis in the mainstream healthcare system. Although Praziquantel may be free in healthcare facilities, many individuals may resort to the use of traditional medicine. This study aimed to assess perceptions of participants on the availability of Praziquantel and to ascertain whether individuals infected with schistosomiasis used concurrently African traditional medicines with this treatment. Methods A cross–sectional descriptive study, using face-to-face interviews, was conducted from January to April 2023 among healthcare workers (HCWs) and patients. A review of medical chart records of patients was further carried out to triangulate the information from interviews. Ddescriptive statistics including frequency and percentage were used; categorical data were represented as tables. Chi-squared tests were performed for the association between continuous variables. A p value ≤ 0.05 was estimated as statistically significant. Results Most of HCWs (114/124; 91.9%) reported that Praziquantel was available in healthcare facilities. Majority of HCWs (76/124; 61.3%) did not know whether patients seen by them used concurrently traditional medicine and Praziquantel for schistosomiasis. There was no significant relationship between the availability of Praziquantel and the concurrent use of TM by patients for schistosomiasis (X2 = 3.042, p = 0.551). Patients seen by THPs (8/20, 40%) did not use Praziquantel for schistosomiasis. Those patients (8/15, 53.3%) who crossed from TM to the mainstream healthcare system did not disclose their use of TM to HCWs. Their main reason was that concurrent use of TM and Praziquantel could destroy organs or make Praziquantel not to work properly. None of the medical chart records analysed documented the concurrent use of TM and Praziquantel. Conclusion Most of HCWs were not aware of the concurrent use of TM and Praziquantel by patients for the treatment of schistosomiasis. Patients seen by THPs relied solely on TM for schistosomiasis. Although patients indicated crossing from TM to the mainstream healthcare system, there was no evidence of documented use of TM in medical chart records of patients. Further studies are needed to contribute to the knowledge of medicinal plants used by THPs for schistosomiasis.

Background: This study aimed to identify the association between occupational stress and depression-well-being by proposing a comprehensive and flexible job burden-capital model with its corresponding hypotheses. Methods: For this research, 1618 valid samples were gathered from the electronic manufacturing service industry in Hunan Province, China; self-rated questionnaires were administered to participants for data collection after obtaining their written consent. The proposed model was fitted and tested through structural equation model analysis. Results: Single-factor correlation analysis results indicated that coefficients between all items and dimensions had statistical significance. The final model demonstrated satisfactory global goodness of fit (CMIN/DF=5.37, AGFI=0.915, NNFI=0.945, IFI=0.952, RMSEA=0.052). Both the measurement and structural models showed acceptable path loadings. Job burden and capital were directly associated with depression and well-being or indirectly related to them through personality. Multi-group structural equation model analyses indicated general applicability of the proposed model to basic features of such a population. Gender, marriage and education led to differences in the relation between occupational stress and health outcomes. Conclusions: The job burden-capital model of occupational stress-depression and well-being was found to be more systematic and comprehensive than previous models.

Malaria parasites increase their host erythrocyte’s permeability to obtain essential nutrients from plasma and facilitate intracellular growth. In the human P. falciparum pathogen, this increase is mediated by the plasmodial surface anion channel (PSAC) and has been linked to CLAG3, as encoded by one member of the conserved clag multigene family. Whether paralogs encoded by other clag genes also contribute to PSAC formation or serve unrelated roles remains unknown. Here, we generated transfectant lines carrying epitope-tagged versions of each CLAG. Each paralog colocalized with CLAG3, with concordant trafficking via merozoite rhoptries to the host erythrocyte membrane of newly-invaded erythrocytes. Each also exists within infected cells in at least two forms: an alkaline-extractable soluble form and a form integral to the host membrane. Like CLAG3, CLAG2 has a variant region cleaved by extracellular protease but CLAG8 and CLAG9 are protease-resistant. Paralog knockout lines, generated through CRISPR/Cas9 transfection, exhibited uncompromised growth in PGIM, a modified medium with more physiological nutrient levels; this finding is in marked contrast to a recently reported CLAG3 knockout parasite. CLAG2 and CLAG8 knockout lines exhibited compensatory increases in transcription of remaining clags and associated rhoph genes, yielding increased PSAC-mediated uptake to specific solutes. We also report distinct transport properties of these knockout lines, suggesting partially overlapping roles of CLAG paralogs in PSAC activity. We propose that the nutrient channel pore is formed by a higher order assembly of CLAG proteins at the host membrane.

Background Community health workers (CHWs) drawn from the general population are an important human resource in health care systems, preventing non-communicable diseases (NCDs) and contributing to an increase in healthy life expectancy in Japan. Thus, we have developed the COmmunity health workers perceptual and behavioral Competency Scale for preventing Non-communicable diseases (COCS-N) to measure CHWs’ competence in preventing NCDs. The purpose of this study is to examine individual and community factors affecting CHWs’ COCS-N scores. Methods Municipal public health nurses and other public health professionals are responsible for training and supporting CHWs in Japan. Therefore, the existence of CHWs and their willingness to participate in the study were confirmed with the municipalities, who were asked to distribute the self-administered questionnaire to CHWs where consent was obtained (N = 6,480). Variables used included demographic characteristics, COCS-N scores, and individual- and community-related factors. Logistic regression analysis was used to assess associations between variables. Results A total of 3,120 people completed the questionnaire, a valid response rate of 48.1%. The respondents’ mean age was 67.0 years (standard deviation = 9.0), and 88.0% were female. Comparison of the high- and low- competence groups in terms of NCD prevention based on COCS-N scores identified 13 factors associated with significant differences, including years spent working as a CHW (p < 0.001), subjective sense of health (p = 0.005), European Health Literacy Survey Questionnaire (HLS-EU-Q47) scores (p < 0.001), and community commitment scale (CCS) scores (p < 0.001). Logistic regression analysis revealed that HLS-EU-Q47 scores (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.02–1.03) were a significant individual factor, while CCS scores (OR: 1.14, 95% CI: 1.11–1.16) were a significant community factor. Conclusions We found that the COCS-N score was associated with the individual factors overall health literacy (HL), perceptions of HL, and subjective sense of health, and with the community factor CCS scores. These results suggest that strengthening individual factors such as HL and subjective sense of health, and community factors such as sense of community is an effective strategy for increasing CHWs’ competence in preventing NCDs.

Background: Work experience is a key factor that influences safety awareness among workers. This study investigated the influence of work experience on the level of awareness on adverse health effects of silica dust exposure among stone quarry workers in Ghana while controlling for theoretically relevant compositional and contextual factors, evaluated the magnitude and order of association between the predictors and the predicted variable. Method: A cross-sectional survey data of 524 randomly selected stone quarry workers were subjected to multivariate statistical analyses. Results: Stone quarry workers who had 6 to10 years and more than 10 years of work experience were 48% (OR = 1.475, P = 0.021) and 82% (OR = 1.816, P = 0.003) respectively more likely to be aware of the adverse health effects of silica dust exposure compared to their counterparts who had 1 to 5 years work experience. Workers who had secondary or higher education were 32% (OR = 1.320, P = 0.036) more likely to be aware of the adverse health effects of silica dust exposure compared to their counterparts who had no education. Conclusion: These findings provide relevant information for managers and policymakers to plan and maximize awareness on silica dust health hazards among silica exposed workers.

Health-Related Quality of Life (HRQoL) encompasses the comprehensive evaluation of an indi-vidual's health and well-being across multiple dimensions. Mindfulness, recognized as a scientifi-cally supported strategy for anxiety management, plays a role in enhancing both physical and mental health. The Gut-Brain Axis (GBA) serves as the bidirectional communication link between the gastrointestinal system and the central nervous system. This study aims to explore the associa-tion between Mindfulness and factors influencing the GBA in both healthy individuals and those with Inflammatory Bowel Diseases (IBD). A cross-sectional investigation involved 338 adults, in-cluding 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterra-nean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, an-thropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate cor-relation with the MAAS-15 scale (r=0.389, p

Background: Cell proliferation and the cell cycle are fundamental to tumor development, with mitosis playing a crucial role in cell division. Understanding the complexities of the cell cycle and mitosis is critical for cancer research, especially in the context of developing therapeutic strategies. Objective: This review highlights mitotic poisons as potential anti-cancer pharmacotherapeutics, particularly their structural and functional group diversity presenting opportunity for semi-synthesis of new derivatives with multi-target mechanisms relevant for cancer pharmacotherapeutics. Also, the review explores naturally occurring mitotic poisons and inhibitors of microtubule-dependent molecular motors as promising cancer pharmacotherapeutics. Methods: A comprehensive review of literature from 2004 to 2023 was conducted, covering studies on cell proliferation, mechanism of cell cycle regulation, mitosis, cytokinesis, and anti-cancer drug development. The published literature was collected primarily from PubMed, Scopus, Medline, Web of Science Core Collections, Google Scholar and other relevant scientific databases using keywords including but not limited to mitotic poisons and cancer, sources of mitotic poisons, mechanism of mitotic poisons, targets of mitotic poisons and structural diversity of mitotic poisons. The efficacy and limitations of various mitotic poisons and their impact on different cancer types were examined. Recent advancements in targeted therapeutic interventions for various cancers were also explored. Results: The effectiveness and limitations of mitotic poisons, including Taxanes, Epothilones, Colchicine, Vinca alkaloids, Berberine, Laulimalide, and Pseudolaric acid B, were highlighted. Drugs targeting mitotic kinases such as CDKs, Aurora kinases, PLK1, and WEE1 inhibitors were reported. Inhibiting kinesin motor proteins such as Eg5 and KIF15 to interfere with spindle formation and cell division were discussed, along with specific genomic alterations in KIF genes and the discovery of KIFC1 as potential for future research and drug development. Conclusion: Targeting microtubules and mitotic kinases, along with inhibiting kinesin motor proteins, show promise for cancer pharmacotherapeutics. The combination of targeted therapies, patient stratification based on biomarkers (such as low alpha-1 acid glycoprotein and high p63 expression), and exploration of alternative natural sources of mitotic poisons and analogues can significantly advance cancer pharmacotherapy to improve patient outcomes.

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

This cross-sectional study evaluated the validity of three alternative methods compared to the gold standard 24-h urine collection for estimating dietary sodium intake, a modifiable risk factor for hypertension, among middle-aged and older adults with elevated blood pressure. These included spot urine collection (using Kawasaki, Tanaka, and INTERSALT equations), 24-h dietary recall, and food frequency questionnaire responses, compared against 24-h urine collection in a subset of 65 participants (aged 50–75 years, 58.5 % women, 61.6 % hypertensive) from the DePEC-Nutrition trial. The validity of the methods was assessed using bias, Spearman correlation coefficient (SCC), intraclass correlation coefficient (ICC), and Bland-Altman analysis. Among the alternative methods, spot urine collection using the Kawasaki equation showed the strongest correlation (SCC 0.238; ICC 0.119, 95 % CI -0.079 to 0.323) but it exhibited a significant bias (1414 mg/day, p-value < 0.001) relative to 24-h urine collection. Conversely, dietary surveys had a smaller bias but wider limits of agreement. These findings underscore the complexities of accurately estimating dietary sodium intake using spot urine collection or dietary surveys in this specific population, suggesting that a combination or refinement of existing methodologies might improve accuracy. Further research with larger samples is necessary to develop more reliable methods for assessing sodium intake in this high-risk group.

The growth of the wind power sector has been marked by environmental, economic, and political drivers. Its starring role is also visible in the emergence of the so-called “green jobs”. Notwithstanding, its evolution ought not to compromise issues related to occupational risks. This exploratory study examines psychosocial risks in the operation and maintenance of onshore wind turbines in a leading Portuguese company. We conducted interviews with main stakeholders (Human Resources, OHS professionals, and team leaders); developed an “activity diary” for the operation and maintenance technicians to describe their activity and perceived impacts on health, complemented with collective interviews; and applied the Work and Health Survey. The results revealed particular risks and health impacts: working under adverse weather conditions; working at heights and in confined spaces; spending long work hours inside of the nacelles to achieve an optimum balance between favorable wind slots to intervene and avoiding additional trips up and down the wind turbines without lifts (70m-120m); and the feeling of early ageing. At a time when these workers are striving for recognition of their profession as a “rapid wear profession”, it is a key moment to discuss these results to guarantee sustainable conditions for future generations of workers.

Our results demonstrated that SWT stimulates osteoblastogenesis and increase the cell number of osteoblasts, suggesting positive regulatory effects on osteoblast differentiation. However, the effect of SWT on bone formation need further examination, since the expression of alp gene is downregulated. On the other hand, SWT appears to negatively regulate osteoclast differentiation and bone resorption, as number of osteoclasts and the expression of critical bone resorptive genes are all downregulated. Collectively, SWT might change the equilibrium of bone remodeling and increase the bone mass. Our data provided supportive evidences that this medicine formulation can be applied to treat osteoporosis or bone destructive diseases.

Occupational accidents, despite continuous safety updates, are still a scourge in the occupational and forensic spheres, constituting, among other things, the subject of a large share of litigation. Demographic data can help to understand the areas where the application of health surveillance is lacking. This meta-analysis sets out to analyze data from studies on accidents at work, focusing on the correlation between the areas in which accidents occur and whether or not personal safety equipment is used, about the different regulations in force. For the selection of the data, a systematic review was carried out according to the PRISMA guidelines, with the primary objective of identifying the trend of occupational accidents in specific geographical areas, which differ in terms of the attention paid to preventive aspects. The data we highlighted showed, regarding the type of accident, substantial differences between low-income countries and industrialized countries (stratified according to the Human Development Index) and, an overall indifference as to whether or not individual safety devices were used, revealing that, despite the continuous normative evolution in the field of safety at work, even today, the investigative data on the actual application of the regulations, during accidents at work, is underestimated and little researched.

Apis mellifera, especially weak ones, are highly vulnerable to Carpoglyphus lactis mites, which can rapidly infest and consume stored pollen, leading to weakened colonies and potentially colony collapse. This study aimed to ascertain and investigate the prevalence of this mite in honeybee colonies across 9 provinces in the Republic of Korea (ROK). A total of 615 honeybee colonies were collected, from 66 apiaries during the spring and 58 apiaries during the summer of 2023. A 1,242 bp segment of the the Cytochrome c oxidase subunit 1 (COI) gene was amplified using the polymerase chain reaction method. The detection levels of C. lactis in the honeybees were compared between winter and summer. Based on the COI sequence analysis, the nucleotide sequence similarity of C. lactis mites isolated in the ROK with those from China (NC048990.1) was found to be 99.5%, and with those from the United Kingdom (KY922482.1) was 99.3%. This study is the first report of C. lactis in Korean apiaries. The findings in this study demonstrate a significantly higher detection rate in winter, which is 4.1 times greater than that in summer (p &lt; 0.001). Furthermore, the results underscore the usefulness of molecular diagnostic techniques for detecting C. lactis mites.

Parental labour migration, either one or both parents, has been associated with various challenges among left-behind children (LBC). However, there is a limited understanding of the LBC’s own views and experiences of social and mental wellbeing and how the new daily life circumstances they encounter following their parents’ migration impact them. This study aimed to understand the influence of parental migration and its aftermath on the social and mental wellbeing of children and adolescents (referred to as LBC) in two rural districts in Indonesia. Employing a qualitative design, data were collected through individual in-depth interviews with LBC (n=24) aged 14 to 18 years, recruited using the snowball sampling technique. Data were thematically analysed, guided by a qualitative data analysis framework. The findings showed that parental migration negatively impacted the social wellbeing of LBC. This impact was reflected in negative labelling from friends and changes in familial roles which influenced their social interactions and activities with peers. Parental migration also caused challenges to the mental wellbeing of LBC. These manifested in the LBC experiencing fractured emotional bonds, leading to negative emotions, including stress, anxiety, sadness, depression, frustration, loss of motivation, and self-imposed isolation, which were associated with their parents’ migration and abrupt disruptions in parent-child communication. The transition to new life situations with caregivers after parental migration and the dynamics within the caregivers’ households were additional factors that detrimentally affected their mental well-being. Unmet basic needs and educational needs due to financial hardships faced by mothers and caregivers, further exacerbated mental health challenges for the children. The findings indicate the importance and improvement of policies and interventions in Indonesia (e.g., counselling services, non-cash food assistance, family hope program, direct cash assistance) that cover and address the diverse needs of mothers or caregivers and the LBC.

Background: Endometriosis is a female chronic inflammatory disease in which endometrial tissue develops outside the uterine cavity. It is a complex pathology, that significantly contributes to morbidity in premenopausal women, leading to chronic pain, infertility, and subfertility negatively impacting the physical, and emotional well-being and overall quality of life. The public health burden of endometriosis remains elusive and challenging to determine, and this uncertainty can lead to inadequate healthcare services and treatments. Objective: To estimate the incidence and prevalence of endometriosis in Italy using the hospital discharge records database. Population-based retrospective study. Nationwide between 2011 and 2020. Methods: From the National Hospital Discharge Database were selected all admissions with a diagnosis of endometriosis (ICD-9-CM, codes 617.x), supported by the presence of a procedure code of laparoscopy or any other surgical procedure allowing direct visualisation of the lesions. Main outcomes measures Incidence and prevalence of endometriosis were estimated for the entire 2010-2020 period and by individual year, analysing the time trend and variability in different geographical areas of Italy. Results: A total of 134,667,646 women aged 15–50 years with one or more hospitalisations for endometriosis in all Italian hospitals. The incidence of endometriosis in Italy during this period was 0.839 per 1000 women (CI95% 0.834-0.844), exhibiting a statistically significant decreasing trend over the years. A discernible north-south gradient was observed, with higher rates documented in the northern regions. The prevalence rate stood at 14.0 per 1000 during the same period, and a similar north-south geographical gradient was identifiable in the prevalence rates as well. Conclusions: The utilization of national-level hospital data enables the generation of incidence and prevalence data for endometriosis without variations in methods and definitions, facilitating the evaluation of temporal trends and regional comparisons. Understanding and quantifying this phenomenon is essential for appropriate healthcare planning in various Italian regions.

Background: Learning arrangements in health care profession education are increasingly taking place in digital environments. VR in nursing education, as one of the digital elements, is the subject of controversial debate. On the one hand it supports the authenticity of case studies by adding realistic perspectives and information. On the other hand, the costs of developing and maintaining software and hardware hinder long-term implementation. Methods: In this paper, we describe our findings and insights from two different research projects focused on the incorporation of digital tools, particularly virtual reality (VR), into nursing education. Based on the German context, our aim is to promote the adoption of innovative digital methods in nursing education and to offer invaluable experiences from the field. Results: Starting with a brief recapitulation of the projects, we then elucidate the pedagogical strategies for embedding VR-driven scenarios in nursing education. Based on our experiences during the projects we identify various positive aspects, such as change of perspective and simulating acute situations. Key findings: Although potential drawbacks remain, we advocate long-term implementation and specific use of VR at the interface between theory and practice. Nevertheless it is crucial to establish regular evaluation observing the value of digitalisation, especially VR; for nursing education.

Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

The health status of Hungary's population is unfavorable, with significant differences in health indicators not only compared to the EU15 but also to the Visegrad countries. Unfavorable health indicators can be disproportionate and particularly affect vulnerable groups, such as people with disabilities. The aim of the present study is to compare the health behaviour and indicators of adolescents with disabilities in Hungary with those of the HBSC survey in the Visegrad countries, and to compare the results of the Hungarian special needs adolescent population with those of the Visegrad countries. Eating habits are unfavourable for both the Visegrad countries and the young people we studied. Children with disabilities have significantly higher rates of schoolwork stress compared to other countries. Significantly higher prevalence of somatic complaints and worse mental well-being parameters higher in Hungary than in the other Visegrad countries. The results suggest that further interventions are needed in Hungary and that differentiated, professionalised health promotion is needed for young people with disabilities. The researchers propose to extend the research to adolescents with disabilities living in the Visegrad countries, on the basis of which a methodology for injury-specific health promotion could be developed, including through interna-tional interprofessional cooperation.

The global SARS-Cov-2 which caused the coronavirus disease 2019 (COVID-19) pandemic has had a significant impact over the last 3.5 years, especially among healthcare workers (HCWs) who were constantly in the forefront of the pandemic. Due to the nature of their work, HCWs faced a potential risk of exposure. Therefore, this study investigated the individual-level factors associated with perceived COVID-19 risk among South African HCWs. We used an analytical cross-sectional study design to analyse data from the South African Health Care workers’ response to the Coronavirus (COVID-19) pandemic online survey conducted by the Human Sciences Research Council across the nine provinces in South Africa, from 11th April to 7th May 2020. In this study, only data (n= 5 579) with non-missing values for COVID-19 risk and individual-level factors (age, gender, educational level, occupational category, and race) was analysed. Univariate and Multivariate binomial logistic regression analyses were conducted. The crude and adjusted odds ratio and p-value ≤ 0.05, were used to describe the association between the individual-level factors and perceived COVID-19 risk, from low-medium to high. The binomial logistic regression was used to assess the factors associated with high perceived risk. Perceived COVID-19 risk among HCWs in South Africa was significantly associated with age, race, educational level and occupational category. Being 60 years and older, being “White”, having a Master’s and Doctorate degrees and being a healthcare worker other than a nurse practitioner and medical practitioner, all had higher odds of having high perceived COVID-19 risk. The findings may be used to guide policies and programs aimed at mitigating the impacts of COVID-19 and other similar pandemics.

Despite the effectiveness of insulin injections in managing hyperglycemia in Type 1 Diabetes, they fall short in addressing autoimmunity and regenerating damaged islets. This review aims to explore the potential of various treatment modalities for T1DM, including mesenchymal stem cells (MSCs), MSC-derived exosomes, gene therapy, islet allotransplantation, and pancreatic islet cell transplantation. Results: MSCs demonstrate efficacy in T1DM treatment through immunomodulation and tissue regeneration, although further research is warranted to optimize their therapeutic potential. Gene therapy presents a promising approach despite challenges such as donor shortage and immune rejection. Pancreatic islet cell transplantation emerges as a viable option, albeit with associated risks including graft rejection and the need for immunosuppression. Teplizumab, an FDA-approved humanized monoclonal antibody, revolutionizes the treatment landscape of Type 1 Diabetes by significantly delaying its onset, offering a paradigm shift since the discovery of insulin Conclusion: Ongoing studies and technological advancements in T1DM management offer a promising outlook for improved treatments and possibly even eradication on a global scale. MSCs, MSC-derived exosomes, gene therapy, and pancreatic islet transplantation hold considerable potential.

In the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data was collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p&lt;0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p&lt;0.05, low vs. high sleep quality), and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p&lt;0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest insomnia as a predictive factor for both poor mental well-being and disordered eating habits. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study.

The aim of the present study was to investigate the incidence of breast (females), prostate, testicular and thyroid cancer in the Italian National Priority Contaminated Sites (NPCSs), served by cancer registries, where the presence of endocrine disruptors (EDs), reported to be linked to these tumors, was documented. Evidence of carcinogenicity of EDs present in NPCs was assessed based on evaluation by international scientific institutions/committees. Standardized Incidence Ratios (SIRs) were computed for each NPCS and cancer site with reference to the time window 1996-2005. Excess incidence of one or more cancer site at study was found in twelve out of fourteen NPCSs. Significantly increased SIRs were found for breast cancer in eight NPCSs, for prostate cancer in six, for thyroid cancer (both gender) in four and for testicular cancer in two. Non significantly increased SIRs were found in five NPCSs for testicular cancer and in two for thyroid cancer (males). Even if increased incidence of one or more cancer sites at study were found in several NPCSs, the ecological study design and the multifactorial etiology of the considered tumors do not allow reaching conclusions in terms of causal links with environmental contamination. In light of the observation of some excesses in SIRs, continuing epidemiological surveillance is warranted.

Long COVID, a name often given to the persistent symptoms following acute SARS-CoV-2 infection, poses a multifaceted challenge for health. This review explores the intrinsic relationship between comorbidities and autoimmune responses in shaping the trajectory of long COVID. Autoantibodies have emerged as significant players in COVID-19 pathophysiology, with implications for disease severity and progression. Studies show immune dysregulation persisting months after infection, marked by activated innate immune cells and high cytokine levels. The presence of autoantibodies against various autoantigens suggests their potential as comorbid factors in long COVID. Additionally, the formation of immune complexes may lead to severe disease progression, highlighting the urgency for early detection and intervention. Furthermore, long COVID is highly linked to cardiovascular complications and neurological symptoms, posing challenges in diagnosis and management. Multidisciplinary approaches, including vaccination, tailored rehabilitation, and pharmacological interventions, are used for mitigating long COVID's burden. However, numerous challenges persist, from evolving diagnostic criteria to addressing the psychosocial impact and predicting disease outcomes. Leveraging AI-based applications holds promise in enhancing patient management and improving our understanding of long COVID. As research continues to unfold, unravelling the complexities of long COVID remains paramount for effective intervention and patient care.

Keywords: pelvic ultrasound, follicle number per ovary, FNPO, ovarian volume, PCOM, upper normal limits, referral population

Opuntia ficus-indica (L.) Mill. belongs to the Cactaceae family and the genus Opuntia; it is a succulent plant that adapts to extreme climatic conditions. The aerial part of the plant consists of the cladodes, morphological changes of branches that appear green, are covered with thorns, and are essential to reduce excessive perspiration of water. The composition of cladodes is very varied, and the main constituents are water, fibers, polysaccharides, proteins, fatty acids, vitamins, sterols, minerals, and polyphenols. Polyphenols are responsible for many beneficial activities for human health, such as antioxidant, anti-inflammatory, antitumor, and nutritional properties. The purpose of this manuscript was to compare the properties of cladodes belonging to the same plant but with different stages of maturity. Relative extracts were tested both in vitro and on a cell line and antioxidant and anti-apoptotic properties were found. The antioxidant activity was tested by the ORAC test, the DPPH test, and the measurement of cellular accumulation of ROS. Anti-apoptotic activity was evaluated by the annexin/PI assay and measurement of caspases 9 and 3 expression. The results obtained have shown that the extracts considered possess antioxidant and anti-apoptotic properties. However, the different stages of maturity of cladodes are essential for the performance of both functions. In addition, important variations have been made in the dissolution of extracts that have brought greater safety in their use. In conclusion, this manuscript provides further information on cladodes of Opuntia ficus-indica, which can be used as adjuvants in many human pathologies.

Background: Gluten and casein-containing foods could aggravate the symptoms of children and adolescents with autism spectrum disorder (ASD), and subsequently impact their quality of life. However, there is a mixed opinion among researchers concerning the impact of alternative diet on reducing ASD symptoms. Objective: This scoping review aimed at examining the impact of the ‘’gluten-free, casein-free’’ (GFCF) diet on health outcomes and the quality of life among autistic children and adolescents. Methods: A scoping review of the literature was performed following the Joanna Briggs Institute (JBI) guidelines. Four databases including EbscoHost, Medline, CINAHL and ProQuest were used to obtain subject-specific studies relevant to the research question and published between July 2013 and March 2024. A comprehensive search using keywords such as “autism spectrum disorder”, “gluten-free diet”, and “casein-free diet” was conducted to obtain articles related to the research focus area. Only full-text, peer-reviewed, written in English articles were selected. Data extraction and data analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- extension to Scoping Review (PRISMA-ScR) protocol. Results: From the initial 586 studies a total of 27 articles were included in the final analysis of the review. The thematic analysis included ‘GFCF diet and improvement of the core autistic symptoms’’, “the gut-brain link’’, ‘’dietary interventions and autism’’, ‘’possible side effects due to the GCFC diet’’, and ‘’ inconclusive studies and mixed opinions’’. Majority of the studies showed positive effect of the GFCF diet on a variety of autistic symptoms including positive changes in cognitive skills, behaviour, and gastrointestinal symptoms while some showed conflicting evidence. Conclusion: The currently available evidence on the impact of ‘GFCF’’ diet on the quality of life of autistic children and adolescents may warrant potentially effective interventions for alleviating symptoms of autism spectrum disorders. However, this scoping review highlighted the need for more research to provide more reliable evidence on the health outcomes and quality of life of ASD sufferers to guide practice.

The intelligent elderly care model places new demands on the skills of aging caregivers. The identification and development of forward-thinking, high-potential nursing talent is essential for advancing the intelligent elderly care sector. Multi-benchmarking selection and competitive analysis is used to evaluate and identify nursing personnel in the rehabilitation treatment center of a hospital in Hefei City. Using proxy evaluation and democratic evaluation model, three types of benchmarks such as single item benchmark, individual benchmark and group benchmark were identified and selected, and the professional nursing team was constructed based on the evaluation results. Different from the traditional other-directed evaluation, multi-benchmarking selection and competitive analysis is self-directed evaluation, this method is more conducive to the identification of high-potential and digital nursing talents by intelligent elderly service organizations, and facilitates the formation of professional nursing teams with complementary strengths and cross-fertilization, so as to satisfy the diversified and multi-level needs of the elderly for intelligent elderly services.

This comprehensive review has systematically examined the use of heterogeneous solid acid catalysts in the production of biodiesel from wastewater-derived sludge by using the PRISMA methodology. The manuscript highlighted the composition and characteristics of wastewater-derived sludge, presenting both the opportunities and challenges associated with its use as a feedstock for biodiesel production. Various types of catalysts were dis-cussed, with a detailed exploration of heterogeneous solid acid catalysts, including zeolites, hetero-polyacid (HPA), mixed metal oxides, and sulphonic acid group catalysts. The advantages and limitations of these catalysts were critically analyzed, providing a balanced view of their potential in industrial applications. The application section delved into the catalytic transesterification reaction, mechanisms of biodiesel production, and the effects of catalyst loading on yield. Performance metrics such as catalytic activity, stability, recyclability, cost-effectiveness, and environ-mental impact were thoroughly evaluated, offering a clear understanding of the efficacy of these catalysts. Synthesis and characterization techniques were also reviewed, shedding light on the latest preparation methods and characterization techniques. Recent advances in catalyst development were presented, showcasing the innovative strides made in enhancing catalyst performance. The environmental and economic implications of using solid acid catalysts for bio-diesel production were assessed, emphasizing the importance of sustainability and economic viability.

The mortality of birds resulting from collisions and electrocutions with overhead lines, such as power lines, and phone line among others, has been implicated in the decline of various avian species globally. Specifically, overhead line collisions pose a significant threat to the conserva-tion of the Canarian houbara bustard (Chlamydotis undulata fuertaventurae), an endangered sub-species endemic to the Canary Islands. This study centres on the postmortem findings of Canarian houbara bustards that have collided with overhead lines, providing insights into the post-collision outcomes for these birds. A com-plete standardized necropsy of nine Canarian houbara bustards revealed that polytrauma was the cause of death in all cases. The most notable gross lesions associated with trauma included bone fractures, soft tissue lacerations, haemorrhages, luxations, and hemocoelom, with certain body regions being more frequently affected. Histopathology, immunohistochemistry, and en-tomology analysis confirmed that numerous birds survived the initial trauma, exhibiting varia-ble survival intervals before succumbing to their injuries. We concluded that when a houbara bustard collide with an overhead line it frequently survives the initial trauma. The histopathology, immunohistochemistry, or entomologic analysis may be helpful to approximate the timing interval between trauma and death.

Melioidosis is an endemic infectious disease caused by Burkholderia pseudomallei bacteria, which contaminates soil and water. To better understand the environmental changes that have contributed to melioidosis outbreaks, this study used spatiotemporal analyses to clarify the distribution pattern of melioidosis and the relationship between melioidosis morbidity rate and local environmental indicators (land surface temperature, normalised difference vegetation index, normalised difference water index) and rainfall. A retrospective study was conducted from January 2013 to December 2022, covering data from 219 sub-districts, with each exhibiting varying morbidity rate of melioidosis on a monthly basis. Spatial autocorrelation was determined using local Moran’s I, and the relationship between melioidosis morbidity rate and the environmental indicators was evaluated using geographically weighted Poisson regression. The results revealed clustered spatiotemporal patterns of melioidosis morbidity rate across sub-districts, with hotspots predominantly observed in the northern region. Furthermore, we observed a range of coefficients for the environmental indicators, varying from negative to positive, which provided insights into their relative contributions to melioidosis in each local area and month. These findings highlight the presence of spatial heterogeneity driven by environmental indicators and underscore the importance of public health offices implementing targeted monitoring and surveillance strategies for melioidosis in different locations.

Hepatitis C virus (HCV) is a major public health threat associated with serious clinical consequences worldwide. The WHO reports an estimated 58 million people globally living with chronic hepatitis C virus (HCV) infection, with 1.5 million new cases and over 350,000 deaths annually due to HCV-related diseases. Despite the existence of multiple diagnostic methods, the accessibility of diagnosis and treatment is often hindered across the continent by limited resources, insufficient healthcare infrastructure, and low public awareness of Hepatitis C virus Hepatitis C virus infection is a major public health concern in African countries, which have the highest prevalence rates of HCV in the world (1–26%). Egypt, African country which had the highest prevalence of Hepatitis C virus infection in the world. Its national hepatitis C elimination initiative emerges as an exemplary case of success an having screened over 60 million individuals, and treated more than 4 million, thereby markedly diminishing both the prevalence and incidence of the disease. The strategies employed by Egypt offer critical insights and adaptable frameworks for other African Countries facing analogous challenges. The Aim of this Review is to highlight the triumphs and hurdles of Egypt's approach, while also providing strategic guidance for African Countries to accelerate the journey towards the eradication of hepatitis C.

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

We present a case of adult-onset systemic chronic active EBV disease (CAEBV) in a 40-year-old woman with chronic HBV hepatitis. Initial symptoms resembled a viral illness, progressing to recurrent fever, transaminitis, and anasarca. Investigations revealed high-level EBV viremia and an abnormal T-cell population in liver and bone marrow, indicative of CAEBV. Liver biopsy showed CD3+ T-cells lacking TCRbeta and displaying dim/negative CD5, with elevated EBV-infected T-cells. Next-generation sequencing identified rare variants in CREBBP, SPEN, TP73, and PLCG2, suggesting potential contributions to disease pathogenesis. This case underscores diagnostic challenges and management complexities of adult-onset CAEBV, particularly with underlying chronic HBV infection. Genomic profiling offers crucial insights into the molecular landscape of rare lymphoid malignancies, highlighting the importance of personalized treatment strategies. The distinct immunophenotypic features underscore the heterogeneity in EBV-associated T-cell LPDs, urging further research for optimized clinical management

Although vitamin D deficiency has been correlated with an increased risk of cardiovascular disease (CVD), there are few data on the association between 25-hydroxyvitamin D (25(OH) D) and atherogenic indices predictive of CVD. This study aimed to investigate the relationship of vitamin D status with lipid profile and atherogenic indices in adult women in Morocco. Three hundred healthy women, aged 18 to 50 years, from Meknes were included. Fasting 25(OH) D and lipid concentrations were determined using a one-step electrochemiluminescence-based immunoassay and an enzymatic method, respectively. Atherogenic indices (Atherogenic index of plasma (AIP), non-HDL cholesterol (Non-HDL-C), Atherogenic coefficient (AC), Castelli risk indices I and II (CRI-I and II), and CHOLIndex (CI)) were calculated using conventional lipid parameters. Logistic regression models and operating characteristic curve (ROC) analysis were used to assess the relationship of the variables and estimate the threshold of 25(OH) D levels associated with high atherogenic indices. 25(OH) D below 20 ng/ml was significantly associated with an enhanced risk of hypertriglyceridemia and elevated values of AIP, AC, Non-HDL-C, and CRI-I with an OR (95% CI) of 4.904 (1.856-12.959); 3.637(2.149-6.158); 3.589(1.673-7.700); 2.074(1.215-3.540), and 2.481(1.481-4.123), respectively. According to ROC analysis, the likelihood of hypertriglyceridemia and high values of AIP, AC, Non-HDL-C, and CRI-I were associated with 25(OH)D thresholds ≤15.15 ng/ml, ≤ 17.5 ng/ml, ≤ 19.8 ng/ml, ≤ 20.1 ng/ml and ≤ 19.5 ng/ml, respectively, all p &lt; 0.01. Based on atherogenic indices, this study indicates that vitamin D below 20 ng/ml may increase the risk of cardiovascular disease in adult women. Additional health efforts are needed to raise awareness among women and healthcare providers in preventing and controlling cardiovascular risk factors.