The aims of the study are: a) Describe the reactogenicity of WHO-approved two mRNA (Pfizer-BioNTech, Moderna) and two non-RNA vaccines (Oxford-AstraZeneca, Sinovac) among lactating mother and baby pairs; and b) compare and contrast the reactogenicity between mRNA and non-mRNA vaccines. A cross-sectional, self-reported survey was conducted amongst 1784 lactating women who received COVID-19 vaccinations. The most common maternal adverse reaction was a local reaction at the injection site; the largest minority of respondents, 43.7% (780/1784), reported experiencing worse symptoms when receiving the second dose compared to the first dose. There were no major reported adverse effects or behavioural changes in the breastfed infants. Among the respondents who received non-mRNA COVID-19 vaccinations, a majority reported no change in lactation but those who did more commonly reported an increase in milk supply, decrease in milk supply and pain in the breast. The more commonly reported lactation changes (fluctuations in breastmilk supply and pain in the breast) for the non-mRNA vaccines were similar to that of respondents who received mRNA vaccines. Our study, with a large cohort and wide geographical and racial mix, further augments earlier reported findings that COVID-19 vaccines are safe for breastfeeding mothers and her children.

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.

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.

Heavy metal pollution in the aquatic water bodies via the discharge of various toxic heavy metals from industrial effluents has been a major concern in the present era. Various physical and chemical processes are available to solve this problem of heavy metal pollution. Biosorption is considered as a potential alternative for the removal of heavy metals from waste waters as compared to other conventional processes. In the present work, biosorption of Cu(II), Cr(VI), Pb(II) and Zn(II) ions from aqueous solutions was carried out by using peels of Citrus aurantifolia. The peels were found to be efficient in the biosorption of all four metal ions under study. The biosorption process was found to be influenced by factors like contact time, temperature, pH, turbidity as well as biosorbent dose. Further, the change in characteristics of Citrus aurantifolia after biosorption process was studied by using E-SEM, EDAX and FT-IR analysis. The adsorption isotherm studies revealed that Freundlich isotherm model showed better fir to experimental data as compared to Langmuir isotherm model. The results were found to be significant statistically. The regeneration of biosorbent was carried out by desorption study by using certain eluents.

Abstract: Congenital hyperinsulinism (CHI) is a rare disorder of glucose metabolism and is the most common cause of severe and persistent hypoglycemia (hyperinsulinemic hypoglycemia, HH) in the neonatal period and childhood. Most cases are caused by mutations in the ABCC8 and KCNJ11 genes that encode the ATP-sensitive potassium channel (KATP). We present the correlation between genetic heterogeneity and the variable phenotype in patients with early-onset hyperinsulinemic hypoglycemia caused by ABCC8 gene mutations. In the first patients, which presented persistent severe hypoglycemia since the first day of life, molecular genetic testing revealed the presence of a homozygous mutation in the ABCC8 gene [deletion in the ABCC8 gene c.(2390+1_2391-1)_(3329+1_3330- 1)del] correlated with a diffuse form of hyperinsulinism (the parents being healthy heterozygous carriers). In the second patient, the onset was on the third day of life with severe hypoglycemia, and genetic testing identified a heterozygous mutation in the ABCC8 gene c.1792C>T (p.Arg598*) inherited on the paternal line, which led to the diagnosis of focal form of hyperinsulinism. To locate the focal lesions, (18)F-DOPA (3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine) PET/CT was recommended (an investigation that cannot be carried out in the country), but the parents refused to carry out the investigation abroad. In this case, early surgical treatment could have been curative. In addition, the second child also presented secondary adrenal insufficiency requiring replacement therapy. At the same time, she developed early recurrent seizures that required antiepileptic treatment. We emphasize the importance and of molecular genetic testing for diagnosis, management and genetic counseling in patients with HH.

Benefits of baby swimming have been established, but there is limited knowledge about the methodologies used by practitioners. To address this knowledge gap, this study aimed to categorize and classify the equipment and environmental used in baby swimming programs worldwide. A descriptive categorical content analysis approach was employed to analyse videos of baby swimming programs obtained from YouTube. The framework created was validated for interrater reliability, and a pilot study was conducted to classify videos from different countries based on the equipment and environment used. Results indicated that the physical environments observed were pool tanks and swimming pools with and without depth reduction zones, while the equipment used included assistive devices, toys, and clothes. This study represents a significant first step in the development of a comprehensive tool to systematize and characterize the methodologies used in baby swimming programs globally.

Background/Objectives: Endocrine disruptors are ubiquitous agents in the environment and are present in everyday consumer products. These agents can interfere with the endocrine system, and subsequently the reproductive system, especially in pregnancy. Increasing research has been conducted to discover and describe the health effects of these agents on humans, including pregnant women, their fetuses, and the placenta. This review discusses prenatal exposure to various endocrine disruptors focusing on Bisphenols, Phthalates, Organophosphates, and Perfluoroalkyl substances, and their effects on pregnancy and fetal development. Methods: We reviewed the literature via PubMed and EBSCO databases and included the most relevant studies. Results: Our findings reveal that several negative health outcomes were linked to endocrine disruptors. However, despite the seriousness of this topic and the abundance of research on these agents, it remains challenging to draw strong conclusions about their effects from the available studies. This does not allow for strong, universal guidelines and might result in poor patient counseling and heterogeneous approaches to regulating endocrine disruptors. Conclusion: The urgency of the matter calls for urgent efforts, as more studies are needed in this realm, to protect pregnant patients ultimately and in the long term, society.

Ferritin is an indirect marker for total body iron stores. Comparison of the ferritin concentrations in the meconium with the concentrations of proteins regulating iron metabolism could aid better understanding of principles behind the adjustment between the fetal iron pool and newborn body size. Ferritin, transferrin, haptoglobin, ceruloplasmin, lactoferrin, myeloperoxidase, neutrophil gelatinase-associated lipocalin (NGAL) and calprotectin concentrations were measured by ELISA in meconium samples from 122 neonates. The neonates were classified according to the meconium ferritin tertiles and the values were collated with the meconium concentrations of other proteins and newborn body weight and length measurements. Increasing ferritin concentrations in meconium in consecutive tertiles (p < 0.05) were parallel to increased NGAL concentrations (p < 0.05). The interrelationships between the meconium concentrations of transferrin, haptoglobin and NGAL as well as between myeloperoxidase, calprotectin and lactoferrin are maintained in all subsequent tertiles of ferritin concentrations, (p < 0.05). In contrast to ferritin, increasing meconium NGAL concentrations in consecutive tertiles were linked to increased concentrations of transferrin, haptoglobin, lactoferrin and myeloperoxidase (p < 0.05) and of calprotectin, ferritin and ceruloplasmin (p < 0.1). Meconium ceruloplasmin concentrations correlate exclusively with neutrophil granule proteins, i.e. myeloperoxidase, NGAL, lactoferrin and calprotectin (p < 0.05). Meconium ferritin concentrations negatively correlates with birth weight (r= -0.20) and length (r= -0.31) of neonates, whereas NGAL concentrations just with birth length (r= -0.26). The remaining proteins did not show such relationships with the size of the newborn. High meconium concentrations of both ferritin and NGAL may specifically characterize neonates of smaller size. High meconium concentrations of both ferritin and NGAL may specifically characterize neonates with lower body measurements. Correlations between meconium transferrin, haptoglobin and NGAL may confirm the interrelationships of these proteins for proper iron control and transport in the intrauterine environment. Meconium ceruloplasmin concentrations may reflect the control of neutrophil activity in utero.

Forty percent of patients with acute coronary occlusion myocardial infarction (OMI) do not present with STEMI criteria, which delays their treatment and increases morbidity and mor-tality. The need to identify these patients promptly is crucial, and this sets the stage for the pro-posed reclassification. Many of these patients can be identified by other ECG and clinical fea-tures. Background/Objectives: We sought to evaluate STEMI/NSTEMI cases that result in OMI and the consequences of delayed revascularization immediately among NSTEMI patients who have ACO (NSTEMI-OMI). Methods: The study is a retrospective analysis conducted on 334 pa-tients who underwent coronary angiography for acute coronary syndrome at UHC ‘‘Mother Te-resa,’’ Tirana, Albania, during January-May 2023. OMI was defined as an acute culprit lesion with TIMI 0-2 flow, or TIMI 3 flow with highly elevated troponin (cTnI>10.0 ng/mL, hs-cTnI>5000 ng/L). Ejection fraction (EF), total ischemia time, hospital day stay and complications were com-pared between groups. Results: There were 334 patients included of whom NSTEMI-OMI were 98 patients (29.3%) of patients with ACS. 96 patients (40%) of OMI patients did not fulfill the STEMI criteria. Only 11 patients (11%) of STEMI(-)OMI had PCI performed within the first 12 hours vs 76 patients (77%) of STEMI(+)OMI, p<0.001. There was no difference in the percent of patients requiring PCI between the STEMI(+)OMI 98 patients (93%) and STEMI(-)OMI 87 patients (89%) (p<0.001). The overall in-hospital mortality was 19 patients (5.7 %), with subgroup mortality of 14 patients (4.2%) STEMI(+)OMI, two patients (0.6%) STEMI(+) NOMI, three patients (0.9%) STEMI(-)OMI, 0% STEMI(-)NOMI, (p=0.013). Patients with mechanical complications were: 67 patients (46.8%) STEMI(+)OMI and 45 patients (46.4%) STEMI(-)OMI. 26 patients (18.5%) STEMI(+)OMI and 13 patients (13.1%) STEMI(-)OMI developed electrical complications. Conclusions STEMI(-)OMI patients had significant delays in catheterization, yet had angiographic findings, rate of PCI, and complications similar to STEMI(+)OMI. These data add further support to refocusing the paradigm of acute MI to improve recognition and rapid reperfusion of all OMIs, rather than only those with STEMI criteria.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Mediterranean Diet (MD), rich in minimally processed plant foods and in monounsaturated fats, but low in saturated fats, meat and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratio, lipids, and inflammation markers, and even prevents the development of fatal and non-fatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns on its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbioma.

(1) Background: The prediction of cervical lesions evolution is a challenge for clinicians. The prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors for the prediction of progression, regression or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions that underwent follow-up. Descriptive statistics and sensitivity analysis for individual or combined index tests were used for data analysis; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model that comprised a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least 3 clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesions regression or persistence was modest; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction.

The concept of vulnerable carotid plaques is pivotal in understanding the pathophysiology of is-chemic stroke secondary to large-artery atherosclerosis. At the macroscopic evaluation, vulnera-ble plaques are characterized by one or more of the following features: microcalcification, neo-vascularization, lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), thin fibrous caps, plaque surface ulceration, huge dimension determining stenosis, and plaque rupture. Recognizing these macroscopic characteristics is crucial to estimating the risk of cerebrovascular events, also in case of non-significant (less than 50%) stenosis. Inflammatory biomarkers, such as cytokines and adhesion molecules, lipid-related markers like oxidized low-density lipoprotein (LDL), and proteolytic enzymes capable of degrading extracellular matrix components are among the key molecules that will be scrutinized for their associative roles in plaque instability. Through their quantification and evaluation, these biomarkers reveal intricate molecular cross-talking govern-ing plaque inflammation, rupture potential, and thrombogenicity. Current evidence demonstrates that plaque vulnerability phenotypes are multiple and heterogeneous and are associated with as many highly complex molecular pathways that determine the activation of an immune-mediated cascade that culminates in thromboinflammation. This narrative review provides a comprehen-sive analysis of current knowledge on molecular biomarkers expressed by symptomatic carotid plaques. It explores the association of these biomarkers with the structural and compositional at-tributes that characterize vulnerable plaques

The beginning of industrialization human being has observed a variety of environmental troubles in the world. This industrialization has not only brought growth and affluence but ultimately troubled the ecosystem. One of the crashes is visible, in form of water contamination. Here the current study heavy metal contamination of water body has been discussed. Effluents from a great number of industries viz., tannery, textile, pigment & dyes, paint, wood processing, petroleum refining, electroplating, leather etc., have a major amount of heavy metals in their wastewater. The conventional technique of handling heavy metal pollution includes chemical oxidation, chemical precipitation, ion exchange, reverse osmosis, membrane separation, electrodialysis etc. These processes are expensive, energy intensive and frequently related with generation of poisonous by-product. Therefore, the adsorption has been examined as a cost-efficient technique of elimination of heavy metals from wastewater. In the current study different low-cost adsorbent has been a review as an abatement of heavy metal contamination from wastewater. These adsorbent comprise materials of natural origin like peat moss, zeolites, clay, and chitin are found to be an effective agent for removal of deadly heavy metals like Pb, Cd, Zn, Cu, Ni, Hg, Cr etc. Separately from these, a variety of agricultural wastes like rice husk, waste tea, neem bark, black gram; Turkish coffee, walnut shell etc. were also known as a powerful adsorbent for heavy metal removal. at the side of that low-cost industrial byproduct like fly ash, lignin, iron (III) hydroxide and red mud, coffee husks, Areca waste, tea factory waste, sugar beet pulp, battery industry waste, blast furnace sludge, waste slurry, sea nodule remains and grape stalk wastes have been discovered for their technical possibility to eliminate toxic heavy metals from impure water.

Lettuce (Lactuca sativa) is a leafy vegetable that provides a valuable source of phytonutrients for a healthy human diet. Assessment of plant growth and composition is vital for determining crop yield and overall quality, however, classical laboratory analyses are slow and costly. Therefore, new, less expensive, more rapid, and non-destructive approaches are being developed, including those based on (hyper)spectral reflectance. Additionally, it is also important to determine how plant phenotypes respond to fertilizer treatments and whether these differences in response can be detected from analyses of hyperspectral image data. In the current study, we demonstrate the suitability of hyperspectral imaging in combination with machine learning models to estimate the content of chlorophyll (SPAD), anthocyanins (ACI), glucose, fructose, sucrose, vitamin C, β-carotene, N, P, K, dry matter content, and plant fresh weight. The implemented five classification and regression machine learning models showed high accuracy in classifying the lettuces by the applied fertilizers treatments and estimating nutrient concentrations. To reduce the input (predictor data, i.e., hyperspectral data) dimension, 13 principal components were found and applied in models. The implemented artificial neural network models of the machine learning algorithm demonstrated high accuracy (r = 0.85 ... 0.99) in estimating fresh leaf weight, and contents of chlorophyll, anthocyanins, N, P, K, and β-carotene. The four applied classification models of machine learning demonstrated 100% accuracy in classifying the studied baby leaf lettuces by phenotype when certain fertilizer treatments were applied.

Background: breastfeeding is the optimal nourishment for infants and recommends that children commence breastfeeding within the first hour of birth and be exclusively breastfed for the initial 6 months of life. Our objective was to determine which factors related to mothers could influence the degree of exclusive breastfeeding during hospitalization, as well as to assess breastfeeding mothers' attitudes towards breastfeeding. Methods: A multicenter cross-sectional study was undertaken in the healthcare area of Santiago de Compostela, Spain. The reduced Iowa Infant Feeding Attitude Scale (IIFAS-s) was employed to gauge maternal attitudes toward feeding their baby. Results: 64 women were studied. The overall score of IIFAS-s (mean ± standard deviation) was 36.95 ± 5.17. No use of pacifier by the newborn was associated with a positive attitude for breastfeeding. Having previous children (ORa=6,40; IC95% 1,26 – 32,51) and previous experience with breastfeeding (ORa=6,70; IC95% 1,31 – 34,27) increase the likelihood of exclusive breastfeeding during admission. Conclusions: It is important to identify the factors that contribute to increasing the probability that mothers choose exclusive breastfeeding. We must guide our training efforts to these factors.

Background: Fetal overgrowth is related to many perinatal complications including stillbirth, cesarean section, maternal and neonatal injuries, and shoulder dystocia. It is related to maternal diabetes, obesity, and gestational weight gain, but also happens in low-risk pregnancies. There is ongoing discussion regarding definitions, methods of detection, and classification. The method used for detection is of crucial importance as it draws a line between those at risk and low-risk populations. Methods: In this a narrative review of relevant evidence identified through PubMed search with one of the general terms (macrosomia, large-for-gestational-age) combined with the outcome of interest. Results: This revive summarizes evidence on the relation of fetal overgrowth with stillbirth, cesarean sections, shoulder dystocia, anal sphincter injury, and hemorrhage. Customized growth charts help to detect mothers and fetuses at risk of those complications. Relations between fetal overgrowth and diabetes, maternal weight, and gestational weight gain. Conclusions: a substantial proportion of complications are an effect of the fetus growing above its potential and should be recognized as a new dangerous condition of Fetal Growth Acceleration

Plant Growth Promoting Rhizobacteria (PGPR) is beneficial microorganisms that inhabit the rhizosphere of plants and play a crucial role in enhancing plant growth and development. This review provides an overview of the significant role of PGPR in sustainable agriculture. The mechanisms that promote plant growth, such as nitrogen fixation, phosphate solubilization, and growth hormones, are discussed. The potential of PGPR in improving plant tolerance to biotic and abiotic stresses, reducing the use of chemical fertilizers and pesticides, and enhancing nutrient availability, soil fertility, and uptake is also highlighted. Moreover, the ecological and economic benefits of using PGPR for sustainable agriculture include improving crop productivity, reducing environmental pollution, and ensuring food security.

Clinical trials, by contributing to the development of diagnostics and to the search for modern, more effective, and safer therapies, have become one of the most important elements of the healthcare system. The aim of this study was to assess Poles' knowledge and beliefs about clinical trials. Methods: The survey was conducted among Poles aged 18 and over with the help of external company, Ariadna, which is an independent research panel. The questionnaire contained 22 questions, of which 13 questions concerned beliefs and attitudes towards clinical trials. Results: One thousand and seventy-nine participants took part in the study (N = 1079). The mean age of respondents was 44.96 years (SD = 16.30). Slightly more women (N = 568, 52.6%) than men (N = 511, 47.4%) took part in the study. Among the respondents, 86.5% (N = 933) were aware of clinical trials. The main sources of information about clinical trials were the media (53.8%) including the Internet (N= 355, 32.9%), TV (N = 175, 16.2%), press (N = 30, 2.8%) and radio (N = 21, 1.9%). 43.2% (N = 466) of respondents reported little knowledge of clinical trials, while more than three quarters (N = 805, 75.2%) said they would like to learn more about clinical trials. Most respondents (N = 879, 81.4%) agreed with the statement that participation in a clinical trial is completely voluntary, and more than half (N = 580, 53.7%) agreed with the statement that hospitals participating in clinical trials provide better healthcare. The statement that the results of clinical trials are made available to the public was disagreed with by 37.2% (N = 402) of participants. Only 30.3% (N = 327) of participants agreed that clinical trials should be conducted with children. Conclusions: Poles rate their knowledge of clinical trials as low and would like to learn more. To reach the largest possible group of Polish patients, parallel educational activities on multiple levels may have the best effect. Poles' knowledge of clinical trials is mainly based on commercial sources. Further studies in different groups, i.e., clinical trial patients and investigators, are needed.

The study aimed to develop standards for a welfare assessment protocol, by validating potential categorisation thresholds for assessment of beef farms in various beef cow-calf production systems in Namibia. Forty measures combined from a New Zealand-based protocol plus Namibia-specific measures, were applied on 55 beef farms (17 commercial farms, 20 semi-commercial and 18 communal village farms) during pregnancy testing, and a questionnaire guided interview. The categorised measures on a 3-point welfare score of 0: good 1: marginal and 2: poor/unacceptable welfare were subsequently compared with derivation of thresholds based upon the poorest 15% and best 50% of herds for each measure. Overall combined thresholds of continuous measures across the 3 farm types, showed 10/22 measures that posed welfare compromise across Namibia, where commercial farms had 4/22 measures and semi-commercial and communal village farms had 12/22 and 11/22 respectively with high thresholds. Most measures-imposed thresholds were retained because of significant importance to welfare of animals and preventiveness of the traits, while leniency was given to adjust good feeding and mortality measures to signify periods of drought. Handling measures (fearful, falling/lying) and abrasions thresholds were adjusted to reflect the temporary stress caused by infrequent cattle handling, and faulty yard designs/design and possible cattle breed influence on handling. Hence, the country needs prioritised investigation of underlying contributing factors and remediation to reduce the high thresholds.

Abstract Background: Premature babies have a greater risk for having health issues after being discharged from the hospital whilst the mother ability to provide premature baby care still has many issues as well. Interventions are needed to be given to mothers at home to improve the ability of mothers to care their premature babies. Methods: Search for articles used the bolean operator of “or” and “and” with the keywords used were “preterm or premature”, “intervention or program”, and “mother and home”. Data based used were Sciencedirect, Ebscohost, PubMed, SAGE, Proquest and Scopus with inclusion criteria using full text in English from 2018 to 2021. There were 428 articles obtained, the articles were then screened by reading the main focus of articles with paying attention to the topic and the suitability of article content and we obtained 13 suitable articles. Results: The interventions at home carried out for mothers and premature babies were divided into two namely the follow-up interventions from the hospital and the interventions carried out at the patient's home. Seven articles about research of interventions that were as a combination from hospital intervention with follow-up hospital intervention plus five full interventions at the patient's home. Interventions were provided through home visits (12 articles) and by telephone (1 article). The results of the article analysis resulted in 4 main themes of intervention for mothers and premature babies, they were health education, counceling, support, and care for premature babies. Conclusion: Quality care is essential for the best health, growth and development of premature babies. Interventions need to be carried out by health workers to ensure the readiness and ability of mothers to care for their babies. Maternal readiness and abilities can be improved by providing health education, counseling, support and care for premature babies.

Viruses are the most common congenital infections and an important cause of fetal malformations, morbidity, and mortality. The effects of these infections, which are transmitted in-utero (transplacentally), during childbirth or in the puerperium depend on the timing of the infections. These vary from miscarriages (usually with infections in very early pregnancy), congenital malformations (where the infections occur during organogenesis) and morbidity (with infections occurring late in pregnancy, during childbirth or after delivery). The most common of these viruses are cytomegalovirus, hepatitis, parvovirus B-19, rubella, varicella and zika. There are currently very few efficacious antiviral agents licensed for use in pregnancy and therefore for most of these infections, prevention by means of immunisation (where there is a vaccine), administration of immunoglobulins to those exposed to the virus to offer passive immunity or appropriate measures to avoid being infected would be options to minimise the infections and their consequences. In this review, we discuss the current understanding of some of the congenital infections and their consequences on both the mother and fetus and their management focusing mainly on prevention.

Digital technologies have changed the way supply chain operations are structured. In this article, we conduct systematic syntheses of literature on the impact of new technologies on supply chains and the related cyber risks. A taxonomic/cladistic approach is used for the evaluations of progress in the area of supply chain integration in the Industrial Internet of Things and Industry 4.0, with a specific focus on the mitigation of cyber risks. An analytical framework is presented, based on a critical assessment with respect to issues related to new types of cyber risk and the integration of supply chains with new technologies. This paper identifies a dynamic and self-adapting supply chain system supported with Artificial Intelligence and Machine Learning (AI/ML) and real-time intelligence for predictive cyber risk analytics. The system is integrated into a cognition engine that enables predictive cyber risk analytics with real-time intelligence from IoT networks at the edge. This enhances capacities and assist in the creation of a comprehensive understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when AI/ML technologies are migrated to the periphery of IoT networks.

Topological indices are numerical parameters of a graph which characterize its topology and are usually graph invariant. In this paper, bounds for the Randić, general Randić, sum-connectivity, the general sum-connectivity and harmonic indices for tensor product of graphs are determined by using the combinatorial inequalities and combinatorial computing.

Despite the popularity of infant swimming programs, no evidence exists to determine whether they influence infants’ judgements and behavior when confronted with bodies of water. In the current study we examined whether the total number of swimming sessions an infant had participated in predicted whether they avoided a body of water they could enter via an edge (n = 101 infants) or a slope (n = 77 infants). An initial regression analysis revealed no association between the number of sessions and avoidance of the water via either type of entry. However, a secondary analysis of infants who had participated in fewer or more than 10 sessions revealed a significant interaction between number of sessions and type of entry into the water. Infants who participated in more than 10 sessions were more likely to avoid the water if they could access it via an edge but significantly more likely to enter the water if they could access it via a slope. Because we tested the two groups of infants in different countries, further research is warranted to determine if cultural differences in child rearing practices or variations in the content and/or teaching of the swimming programs might explain these intriguing findings.

The use of clays in beauty care comes from ancient times, with therapeutic use since prehistory, and it is considerably relevant in the current cosmetic industry worldwide. In our review, we described types of clay and clay minerals used in cosmetics and dermocosmetics, compositions, usages as active compounds and excipients, and observations about formulation techniques. From this research, we could notice that although many scientific and specialized literature reported the characterization of clays, only some involving efficacy tests when incorporated into cosmetic products, mainly concerning haircare applications. By the exposed, our review could be considered and encouraged in the coming years to provide scientific and technical information for the cosmetic industry regarding the multifunctional use of clays and clay minerals.

Background: Several environmental factors can strongly influence the accumulation of glucosinolates and plant pigments. This study aimed to evaluate the growth and bioactive compounds production of baby leaf kale on colored reflective growing benches with different wavelengths; Methods: In an greenhouse, five types of growing benches were assessed without and with bright reflective colored materials: control and reflective bright (white, yellow, red, and blue); Results: The growing bench with laminated white reflective material increased the photosynthetically active radiation the most. The use of growing benches with laminated reflective material increased the production of baby leaf kale, in which the white, yellow, red, and blue laminates increased the number of leaves by 35.5, 26, 25, and 20.8%, respectively, and the shoot fresh mass by 132, 112, 112, and 109%, respectively. Using the growing bench reflective bright blue laminate increased the bioactive compounds of baby leaf kale plants, increasing chlorophylls A, B, and total by 72, 67, and 70% respectively, and carotenoids by 55%; Conclusions: The use of reflective materials is an alternative method that provides plants with better conditions for assimilating photosynthetically active radiation, increasing the development, yield, and production of bioactive compounds that promote human health.

Background/Objectives: An age-associated increase in serum levels of sex hormone binding globulin (SHBG) is considered to be one of the factors leading to the development of male hy-pogonadism. Aim of the study: to study the relationship between the concentration of sex hor-mone-binding globulin in the blood serum and the age of the man, the level of total and free testosterone. A single-center retrospective cross-sectional study was conducted. The results of laboratory tests of 162 male patients aged from 18 to 56 years (median - 34 years) were analyzed. Methods: The level of total testosterone and sex hormone binding globulin (SHBG) was deter-mined by chemiluminescent immunoassay. The level of free testosterone was determined by the calculation method according to Vermeullen. Statistical analysis was performed using SPSS Sta-tistics v23. Results: Correlation analysis did not reveal a significant relationship between age and SHBG levels, as well as between age and total testosterone levels. Serum SHBG concentration showed a significant (p

Rabies is one of the most significant public and veterinary health problem, causing ap-proximately 59 000 human deaths annually in the developing countries of Asia and Afri-ca. The aetiologic agent, a viral species of the Lyssavirus genus, is highly neurotropic and has a wide host range including terrestrial mammals and several Chiropteran species. The Lyssavirus mokola (MOKV) was first isolated in the late 1960s from organ pools of shrews (Crocidura flavescens manni) in the Mokola forest (Nigeria). To date, at least 30 MOKV isola-tions have been confirmed, all exclusively from Africa, with 73% from southern Africa. There is a limited knowledge about the epidemiology of MOKV and the reservoir host spe-cies is unknown. Here we report on a retrospective identification of a new MOKV from Eswatini, based on molecular characterization of rabies viruses originating from both domestic and African wild cats. A partial region of the lyssavirus genome, encoding the nucleoprotein, was amplified and sequenced. Nucleotide sequence analysis retrospec-tively identified a rare lyssavirus, a Lyssavirus mokola from a domestic cat from Eswatini, whilst the majority of the lyssaviruses were identified as Lyssavirus rabies (98%). Further-more, the nucleotide sequence divergence between the recently identified MOKV isolate, and the historical Lyssavirus mokola isolates ranged from 6.8% and 8.3%. This study further highlights the association between the potential host species of Lyssavirus mokola and the domestic cat as an incidental host. Therefore, continuous vaccination of domestic cats against rabies is crucial even after the elimination of dog-mediated rabies as spill-over re-lated to sylvatic rabies cycles is likely to occur.

A proposed animal welfare assessment protocol for semi-arid rangeland-based cow-calf systems in Namibia combined 40 measures from a protocol developed for beef cattle in New Zealand with additional Namibia-specific measures. Preliminary validation of the protocol had been undertaken with five herds in one semi-commercial village. The aim of the current study was to apply this protocol and compare animal welfare across three cow-calf production systems in Namibia. A total of 2529 beef cows were evaluated during pregnancy testing in the yards of 17 commercial, 20 semi-commercial and 18 communal (total: 55) herds followed by an assessment of farm resources and a questionnaire-guided interview. Non-parametric tests were used to evaluate the difference in the welfare scores between the production systems. The results indicated a discrepancy of animal welfare between the three farm types, with a marked separation of commercial farms from semi-commercial, and communal village farms in the least. The differences in these production systems was mainly driven by economic gains through access to better beef export market for commercial farms and semi-commercial villages, as well as by the differences in the available grazing land, facility designs/quality and traditional customs in the village systems. The results indicate an advantage of commercialisation over communalisation.

One key area where animal welfare may relate to productivity is through reproductive performance. Welfare was assessed on 25 extensively managed pastoral New Zealand beef farms and the relationship between welfare and reproductive performance was explored. Relationships between welfare measures and key reproductive performance indicators (pregnancy rate, weaning rate, mating period and bull: cow ratio) were investigated using an exploratory Principal Components Analysis and linear regression model. Seven welfare measures (thinness, poor rumen fill, dirtiness, blindness, mortality, health checks of pregnant cows and yarding frequency/year) showed potential influence on reproductive performance, and lameness was retained individually as a potential measure. Mean pregnancy rates in both 2018 (PD18) and 2017 (PD17) were ~91% and mean weaning rate was 84%. Of the welfare measures, only lameness had a direct association with pregnancy rate, as well as confounding effect on the association between mating period and pregnancy rate. The bull: cow ration (mean 1:31) and reproductive conditions (dystocia, abortion, vaginal prolapse) did not influence pregnancy and weaning rates. In the study population there was no clear association between welfare and reproductive performance, except for the confounding effects of lameness.

Predicting nurse turnover is a growing challenge within the healthcare sector, profoundly impacting healthcare quality and the nursing profession. This study employs the Synthetic Minority Over-sampling Technique (SMOTE) to address class imbalance issues in the 2018 National Sample Survey of Registered Nurses (NSSRN) dataset and predict nurse turnover using machine learning (ML) algorithms. Four ML algorithms, namely logistic regression (LR), random forests (RF), decision tree (DT), and extreme gradient boosting (XGBoost), are applied to the SMOTE-enhanced dataset. The data is randomly split into an 80% training set and a 20% validation set. Eighteen carefully selected variables from the NSSRN database serve as predictive features, and the machine learning model identifies feature importance concerning nurse turnover. The study includes a performance comparison based on metrics such as Accuracy, Precision, Recall (Sensitivity), F1-score, and AUC. In summary, the results demonstrate that SMOTE-enhanced random forests (SMOTE_RT) exhibit the most robust predictive power, both in the classical approach (with all 18 predictive variables) and an optimized approach (utilizing eight key predictive variables). XGBoost, decision tree, and logistic regression follow in performance. Notably, age emerges as the most influential factor in nurse turnover, with working hours, EHR/EMR usability, individual income, and region also playing significant roles. This research offers valuable insights for healthcare researchers and stakeholders, aiding in selecting suitable ML algorithms for nurse turnover prediction.

The world is currently experiencing the fourth industrial revolution driven by the newest wave of digitisation in the manufacturing sector. The term Industry 4.0 (I4.0) represents at the same time: a paradigm shift in industrial production, a generic designation for sets of strategic initiatives to boost national industries, a technical term to relate to new emerging business assets, processes and services, and a brand to mark a very particular historical and social period. I4.0 is also referred to as Industrie 4.0 the New Industrial France, the Industrial Internet, the Fourth Industrial Revolution and the digital economy. These terms are used interchangeably in this text. The aim of this article is to discuss major developments in this space in relation to the integration of new developments of IoT and cyber physical systems in the digital economy, to better understand cyber risks and economic value and risk impact. The objective of the paper is to map the current evolution and its associated cyber risks for the digital economy sector and to discuss the future developments in the Industrial Internet of Things and Industry 4.0.

This study assesses the impact of nurse-originated changes in central venous catheter (CVC) management on the incidence of central line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI). It is a single-center retrospective cohort study conducted at an urban, tertiary referral, and academic center serving pediatric patients. The study cohort comprised 236 patients and 323 CVCs seen between 2012 and 2022. CLABSI and CRBSI were defined according to the Centers for Disease Control and Prevention definitions. Oncology nurse leaders developed CVC-specific educational modules for CLABSI prevention. All relevant information during the CVC maintenance period was noted in the patient's CVC logbook. 24 (7%) cases of confirmed CLABSI were identified. The incidence of CVC-related infections was 0.32 cases per 1000 catheter days. The incidence decreased by 40% between the first and second three-year study period. Documented exit-site infection was reported in 32 (10%) cases. The correlation between exit-site infection and CLABSI was found in 9 (28%) cases. Our CVC-related infection rates are significantly lower than the incidence reported by the Italian Association of Pediatric Hematology and Oncology, which settles at 3-5 cases per 1000 catheter days. Our data confirm the effectiveness of local CVC management guidelines in preventing CVC-related infectious complications.

Vaccination, particularly against pneumoccus and influenza, is a low-cost primary prevention, useful to avoid hard complications, particularly among frail older people. In this study, we aimed to assess the effect of a strategy for influenza and pneumococcal vaccination for outpatients, never practiced before, evaluating what could stimulate or demotivate vaccination among older people. This study was conducted during the 2023-2024 influenza season at the outpatient clinics of the Geriatrics section, University Hospital of Palermo (Italy). A total of 101 vaccinations were carried out. Half of the patients could be considered as pre-frail and about 20% frail, according to a comprehensive geriatric evaluation. Among participants, 46.3% received only vaccination against Pneumococcus and 26.8% only anti-influenza or the combination of anti-pneumococcus and anti-influenza. Compared with the previous seasons, a 19.5% increase of influenza and 90.2 % of pneumococcal vaccine uptake was observed. Side effects of vaccination were the main reason of the previous rejections, namely 74.8% for influenza and 29.5% for anti-pneumococcal vaccination. In conclusion, our study indicates how a new vaccination strategy in different settings is possible. Proposing influenza and pneumococcal vaccination for outpatients could be an effective instrument to improve immunization coverage that is still low among older people.

The purpose of this study is to determine the relationship between grit and parenting style of mother among Indian rural adolescents. Parental Authority Questionnaire [1] and Short Grit Scale [2] was used to meet objectives of the paper. A sample of 60 adolescents was chosen from private institution located at Bathinda (Punjab) by using convenience sampling technique. Results of correlation analysis revealed that significant (negative) relationship exists between mother’s authoritarian parenting style (only) and grit. This is true for both genders and for adolescents who comes from joint families. Educational implication of the study signifies that the suitable informative and counseling sessions should be organised for the parents to make them conscious of the appropriate parenting style for the development of gritty adolescents.

Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome," linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.

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

In recent years, the management of health systems is a main concern of governments and decision makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders such as nurses for which an increase of their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to a dissatisfaction of the nurses. In addition, skillful nurses have higher salaries and high-level services increase equipment costs and need more expensive trainings and nursing certificates. Therefore, downgrading can enforce hidden huge costs to the managers of a company. To solve the bi-objective model, an -constraint based approach is suggested and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well.

Epstein-Barr virus (EBV)-encoded RNAs (EBERs) are structurally conserved small, noncoding RNAs constitutively expressed in EBV infection. Although primarily localised in the nucleus, EBERs are found in the cytoplasm and exosomes. However, the mechanism(s) of EBERs transport is not known. This study aimed to investigate the structural impact of EBER1 on its transport. EBER1 stem-loop (SL) deletion mutants (ΔSL1, ΔSL3 and ΔSL4) were created and stably transfected into HEK293T cells. The expression of EBER1 was quantified in total cell, nuclear, cytoplasmic and exosomal fractions. The quantification was performed in the presence of physiological expression of RPL22 and La, and after silencing them. These proteins are believed to be involved in EBER1 transport and secretion. Compared to the wildtype EBER1 transfectants, the expression level of EBER1 gene in all mutants was significantly lower in the total cell, cytoplasmic and exosomal fractions. However, ΔSL3 mutant showed significant nuclear retention. Silencing RPL22 resulted in increased nuclear-cytoplasmic trafficking of EBER1. Silencing La protein did not affect EBER1 secretion. Alternatively, the store-operated intracellular Ca2+ was found to correlate with EBER1 expression in exosomes. Taken together, EBER1 structure and its interaction with RPL22 appeared to be important in the nuclear-cytoplasmic transport of the RNA.

Digital technologies have changed the way supply chain operations are structured. In this article, we conduct systematic syntheses of literature on the impact of new technologies on supply chains and the related cyber risks. A taxonomic/cladistic approach is used for the evaluations of progress in the area of supply chain integration in the Industrial Internet of Things and Industry 4.0, with a specific focus on the mitigation of cyber risks. An analytical framework is presented, based on a critical assessment with respect to issues related to new types of cyber risk and the integration of supply chains with new technologies. This paper identifies a dynamic and self-adapting supply chain system supported with Artificial Intelligence and Machine Learning (AI/ML) and real-time intelligence for predictive cyber risk analytics. The system is integrated into a cognition engine that enables predictive cyber risk analytics with real-time intelligence from IoT networks at the edge. This enhances capacities and assist in the creation of a comprehensive understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when AI/ML technologies are migrated to the periphery of IoT networks.

In this paper we present an understanding of cyber risks in the Internet of Things (IoT), we explain why it is important to understand what IoT cyber risks are and how we can use risk assessment and risk management approaches to deal with these challenges. We introduce the most effective ways of doing Risk assessment and Risk Management of IoT risk. As part of our research, we also developed methodologies to assess and manage risk in this emerging environment. This paper will take you through our research and we will explain: what we mean by the IoT; what we mean by risk and risk in the IoT; why risk assessment and risk management are important; the IoT risk management for incident response and recovery; what open questions on IoT risk assessment and risk management remain.

The continuous advancements in healthcare technology have empowered the discovery, diagnosis, and prediction of diseases, revolutionizing the field. Artificial intelligence (AI) is expected to play a pivotal role in achieving the goals of precision medicine, particularly in disease prevention, detection, and personalized treatment. This study aims to determine the optimal combination of the mother wavelet and AI model for the analysis of pediatric electroretinogram (ERG) signals. The dataset, consisting of signals and corresponding diagnoses, undergoes Continuous Wavelet Transform (CWT) using commonly used wavelets to obtain a time-frequency representation. Wavelet images were used for the training of five widely used deep learning models: VGG-11, ResNet-50, DensNet-121, ResNext-50, and Vision Transformer, to evaluate their accuracy in classifying healthy and unhealthy patients. The findings demonstrate that the combination of Ricker Wavelet and Vision Transformer consistently yields the highest median accuracy values for ERG analysis, as evidenced by the upper and lower quartile values. The median balanced accuracy of the obtained combination of the three considered types of ERG signals in the article are 0.83, 0.85, and 0.88. However, other wavelet types also achieved high accuracy levels, indicating the importance of carefully selecting the mother wavelet for accurate classification. The study provides valuable insights into the effectiveness of different combinations of wavelets and models in classifying ERG wavelet scalograms.

The carriage of Candida albicans in children's oral cavities is associated with a higher risk for early childhood caries, so controlling this fungus in early life is essential for preventing caries. In a prospective cohort of 41 mothers and their children from 0-2 years of age, this study addressed 4 main objectives: 1) Evaluate in vitro the antifungal agent susceptibility of oral Candida isolates from the mother-child cohort, 2) Compare Candida susceptibility between isolates from the mothers and children; 3) Assess longitudinal changes in the susceptibility of the isolates collected between 0-2 years; and 4) Detect mutations in C. albicans antifungal resistance genes. Susceptibility to antifungal medications was tested by in vitro broth microdilution and expressed as minimal inhibitory concentration (MIC). C. albicans clinical isolates were sequenced by whole genome sequencing, and the genes related to antifungal resistance, ERG3, ERG11, CDR1, CDR2, MDR1, and FKS1, were assessed. Four Candida spp (n=126) were isolated: C. albicans, C. parapsilosis, C. dubliniensis, and C. lusitaniae. Caspofungin was the most active drug for oral Candida, followed by fluconazole and nystatin. Two missense mutations in the CDR2 gene were shared among C. albicans isolates resistant to nystatin. Most of the children’s C. albicans isolates had MIC values similar to those from their mothers, and 70% remained stable to antifungal medications from 0-2 years. For caspofungin, 29% of the children’s isolates showed an increase in MIC values from 0-2 years. Results of the longitudinal cohort indicated that clinically used oral nystatin was ineffective in reducing the carriage of C. albicans in children; novel antifungal regimens in infants are needed for better oral yeast control.

In 2020, it is estimated that 7.8% of all live births in the United States were complicated with gestational diabetes, with around 10% of all pregnancies in North America involving gestational diabetes. GDM’s prevalence has been increasing over time, likely due to the population’s rising BMI and increasing maternal age. GDM has been long associated with increased complications in pregnancy, from preeclampsia and macrosomia in the short-term, to long term ramifications including the development of type 2 diabetes mellitus, cardiovascular disease, and potential effects on the offspring, including obesity, insulin resistance, hypertension, and increased risk of autism. Additionally, as the field of epigenetics continuously grows, we are able to further elucidate epigenetic mechanisms at play in the development of GDM and how these changes may affect the offspring. In this narrative review, we have compiled recent and relative clinical studies that highlight the role epigenetics may play in the development and perpetuation of GDM, as well as its possible effects on the offspring.

Analysis of non-stationary and nonlinear sound signals obtained from dynamical processes is one of the greatest challenges in signal processing. Turning machine operation is a highly dynamic process persuaded by many events such as dynamical responses, chip formations and operational conditions of machining. Traditional and widely used fast Fourier transformation and spectrogram is not suitable for processing sound signals acquired from dynamical systems as its result have significant deficiencies because of stationary assumptions and having priori basis. The relatively new technique, Discrete Wavelet Transform, which uses Wavelet decomposition and the recently developed technique, Hilbert Huang Transform (HHT) which uses Empirical Mode Decomposition have notably better properties in the analysis of nonlinear and non-stationary sound signals. This paper presents a comparative study on the decomposition of multicomponent sound signals using Empirical Mode Decomposition and Wavelet Decomposition to highlight the suitability found in HHT to analyze tool-emitted sound signals received from turning processes. Apart from the short mathematical and theoretical foundations of the transformations, this paper demonstrates their decomposition strength using an experimental case study of tool flank wear monitoring in turning. It also concludes HHT is more suitable than DWT to analyze tool-emitted sound signals received from turning processes.

Insect behavior is coordinated mainly by smell, through the diverse odor-binding proteins (OBP) that allow them to identify and recognize their environment. Sensory information collected through smell is then analyzed and interpreted in the brain, allowing for correct insect functioning. The behavior of honey bees (Apis mellifera L.) can be affected by different pathogens, such as deformed wing virus (DWV). In particular, DWV variant A (DWV-A) is capable of altering olfactory sensitivity, reducing the gene expression of different OBPs, including those associated with nursing behavior. DWV is also capable of replicating itself in the sensory lobes of the brain, further compromising the processing of sensory information. This study evaluated the behavioral response of nurse honey bees exposed to a pheromone compound and the alterations in the gene expression of pre- and post-synaptic neuronal genes neuroxins-1 and neurogilin-1 in the bee heads and OBP proteins in antennae of nurse bees inoculated with DWV-A. The behavioral response of nurse bees exposed to the larval pheromone compounds benzyl alcohol was analyzed using a Y-tube olfactometer. The viral load, gene expression of OBP5 and OBP11 in antennae and the neuroxins-1 and neurogilin-1 in the bee heads were analyzed by qPCR. High viral loads significantly reduced the ability of 10- and 15-day-old nurse honey bees to choose the correct pheromone compound. Also, the gene expression of OBP5, OBP11, neuroxin-1 and neurogilin-1 in nurse honey bees decreased when they were highly infected with DWV-A. These results suggest that a DWV-A infection can disturb information processing and cause nurse honey bees to reduce their activity inside the hive, altering internal cohesion.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

AI (Artificial Intelligence) chatbots has been widely applied. AI (Artificial Intelligence) chatbots has been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills, facilitate students' understanding of complex concepts in healthcare education: (1) Background: There is currently less emphasis on its application in nursing education. The application of ChatGPT in nursing education needs to be verified; (2) Methods: A descriptive study is used to analyze the scores of ChatGPT on the registered nurse license exam(RNLE) and compare to the pass rate of candidates in Taiwan; (3) Results: The average score of four exams were around 51.6 to 63.75 by ChatGPT, and pass the RNLE in 2022 1st and 2023 2nd. However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucinations; (4) Conclusions: ChatGPT may have potentially to assist with nursing education. Although AI can simulate human behavior in context, it still cannot replace human creativity, critical thinking, and clinical reasoning.

Tawny nurse shark (Nebrius ferrugineus) is a species of carpet shark distributed across the tropical Indo-Pacific region. Tawny nurse shark is listed as “Vulnerable” on IUCN Redlist and rarely seen, recorded and studied in Indonesia. We recorded this species during SCUBA diving activity in Morotai waters in April 2022. Scientific record of the species is highly important for conservation and habitat management, particularly in Morotai, a region in North Maluku famous for shark-based marine tourism.

Background: The coexistence of HIV infection and latent tuberculosis infection (LTBI) presents a significant public health concern due to the increased risk of tuberculosis (TB) reactivation and progression to active disease. The multicenter observational cohort study, TUBHIVIT, conducted in Italy from 2017 to 2023, aimed to assess the prevalence of LTBI among people living with HIV (PLHIV) and their outcomes following LTBI screening and therapy initiation. Methods: We performed a prospective study in 5 referral centers for HIV care in Italy. PLHIV who consented to participate underwent QuantiFERON-TB Gold Plus and clinical, microbiological, and radiological assessments to exclude subclinical tuberculosis, as opportune. PLHIV diagnosed with LTBI that started chemoprophylaxis were followed until the ending of therapy. Results: A total of 1105 PLHIV were screened for LTBI using the QuantiFERON-TB Gold Plus test, revealing a prevalence of 3.4% of positive results (38/1105). Non-Italy-born individuals exhibited a significantly higher likelihood of testing positive. Thirty-one were diagnosed with LTBI, 1 showed active subclinical TB, 6 were lost to follow-up before discriminating between latent and active TB. Among PLHIV diagnosed with LTBI, 83.9% (26/31) started chemoprophylaxis. Most individuals received 6-9 months of isoniazid-based therapy. Of the 26 PLHIV commencing chemoprophylaxis, 18 (69.2%) completed the therapy, while 3 discontinued it and 5 were still on treatment at the time of the analysis. Adverse events were observed in two cases, while in one case the patient refused to continue the treatment.

In Low and Lower-Middle-Income countries, the prevalence of anemia in infancy remains high. In early childhood anemia cause irreversible cognitive deficits and represents a higher risk of child mortality. The consequences of anemia in infancy are a major barrier to overcome poverty traps. The aim of this study was to analyze based on a multi-level approach, different factors associated with anemia in children 6–23 m old based on recent available Standard Demographic Health Surveys (S-DHS). We identified 52 S-DHS that had complete information in all covariates of interest in our analysis between 2005 and 2015. We performed traditional logistic regressions and multilevel logistic regression analyses to study the association between hemoglobin concentrations and household, child, maternal, socio-demographic variables. In our sample, 70 % of the 6–23 m old children were anemic. Child anemia was strongly associated with maternal anemia, household wealth, maternal education and low birth weight. Children fed with fortified foods, potatoes and other tubers had significantly lower rates of anemia. Improving overall household living conditions, increasing maternal education, delaying childbearing and introducing iron rich foods at six months of age may reduce the likelihood of anemia at in toddlerhood.

Maternal gut and breast milk (BM) are key in vertically transmission bacteria to infants, shaping their gut microbiota in early life. Although the establishment of early gut microbiota is known, the role of the combined influence of maternal factors and newborn characteristics are not explored. In this study we aimed to assess the influence of maternal BMI and total body fat, age, delivery mode, and newborn sex on the diversity and composition of the BM and gut microbiota (GM) in mother- newborn dyads. In this cross-sectional study, of the 986 pregnant women candidates, 53 participated, and finally, 40 mother-newborn dyads exclusively breastfeeding at 20-28 days post-partum were included. Metataxonomic profiling of DNA extracted from BM and fecal samples was conducted using 16S rRNA sequencing. Globally, the findings offer valuable insights that excessive adiposity, age and C-section delivery influence on a lower abundance of specific taxa in the BM, maternal gut, and gut newborns. Also, the simultaneous analysis of maternal factors and newborn characteristics shows that maternal age and newborn sex explain an important variation in the microbiota composition. These results add to understanding of the intricate interplay between maternal factors and the microbial communities that influence early-life gut and BM microbiota.

This study aims to examine how the activation of nursing roles and professional identification as a nurse can influence moral judgments in terms of deontological and utilitarian inclinations. In Study 1, a priming technique was used to assess the impact of activating the nursing concept on moral reasoning. Participants were randomly assigned to either a nursing prime or neutral prime condition. By using a scrambled-sentences task, participants were prompted to think about nursing-related or neutral thoughts. Following the priming task, participants were asked to respond to 20 moral dilemmas. The process dissociation approach was employed to measure the degree of deontological and utilitarian tendencies in their moral reasoning. In Study 2, participants completed the nursing profession identification scale and the moral orientation scale before engaging in moral judgments similar to those in Study 1. The findings revealed that priming the concept of nursing roles resulted in an increase in deontological clinical inclinations, while having no significant effect on utilitarian inclinations. Additionally, a positive correlation was observed between identification with the nursing profession and deontological clinical inclinations, whereas a negative correlation was found with utilitarian inclinations. Deliberation orientation acted as a complete mediator in the relationship between nursing professional identification and deontological tendencies, and as a partial mediator for utilitarian tendencies.

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

Background: Patients with Inflammatory Bowel Disease (IBD) believe that diet is a key factor in the pathogenesis of their disease and in worsening their symptoms; they often follow restrictive diets that can lead to malnutrition, anxiety, and stress. Recent studies have found an association between eating disorders and IBD, particularly anorexia nervosa and ARFID (Avoidant Restrictive Food Intake Disorder). None of these studies report the association with orthorexia nervosa, that is the obsession with healthy and natural foods. Aim: to assess the risk of orthorexia nervosa in patients with IBD. Methods: 158 consecutive subjects were recruited, including 113 patients diagnosed with IBD and 45 controls. The Donini standardized questionnaire ORTO-15 was administered to assess the risk of orthorexia; clinical and demographic data were also collected. Results: patients with IBD have a prevalence of orthorexia of 77%, significantly higher than the 47% observed in the control group. In patients with IBD, the risk of orthorexia is associated with lower BMI and history of previous surgery. Conclusion: Many patients with IBD develop orthorexia nervosa that impacts the patient's psychological and social sphere, exposes them to a high risk of nutritional deficiencies, and affects quality of life. Further high quality studies are warranted to evaluate the clinical impact of orthorexia and its correlation with clinical features and frank eating disorders.

There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions of how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. Twenty patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size suggesting, each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) (https://osf.io/9np8v/) prior to recruiting the first participant.

The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive-behavioral outcomes: Change Talk, Resiliency, Self-Efficacy/Independent Agency, Insight & Pattern Recognition, and Building Towards Sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20-minute audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<$20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved Change Talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive-behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

Background Sarcopenia is a state with progressive and generalized loss of skeletal muscle mass and strength. It is a serious complication occurring in chronic kidney disease (CKD) patients which increases morbidity and mortality rate. Sarcopenia is diagnosed when loss of both compartments - muscle strength and skeletal muscle quality or quantity are present. However, there are still numerous patients, also with CKD, diagnosed as pre-sarcopenic individuals with low muscle strength and normal skeletal muscle quality or quantity and conversely, with correct muscle strength and decreased skeletal muscle mass, who are prone to develop sarcopenia in future life. It is crucial to examine numerous variables possibly associated with changes of skeletal muscle mass and muscle strength in terms of preventing the development of sarcopenia. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in advanced stages of CKD. Methods The study sample consisted of 84 non-dialysis dependent patients of both sexes (including 45.2% of women) with eGFR < 45 ml/min/1.73m²: 26.2% with eGFR 30-44 mL/min/1.73 m², 65.5% with eGFR 15-29 mL/min/1.73 m² and 8.3% with eGFR < 15 mL/min/1.73 m². Muscle strength was estimated by measuring hand grip strength (HGS) with the use of handheld hydraulic dynamometer. Muscle quantity was measured by bioimpedance spectroscopy using Body Composition Monitor. Appendicular skeletal muscle mass (ASM) was calculated according to Lin’s formula. Serum creatinine, urea, uric acid and albumin were measured. Results In bivariate analysis we found that ASM significantly and positively correlated with anthropometric variables such as body mass (r=0.903, p<0.001), NH weight (r=0.882, p<0.001), height (r=0.694, p<0.001), body mass index (BMI) (r=0.701, p<0.001), lean tissue mass (LTM) (r=0.664, p<0.001), lean tissue index (LTI) (r=0.433, p<0.001), fat mass (r=0.614, p<0.001) and fat tissue index (FTI) (r=0.449, p<0.001), and was negatively associated with clinical variable such as hydration status (p<0.001). HGS significantly and positively correlated with anthropometric parameters such as body mass (r=0.319, p=0.003), NH weight (r=0.315, p=0.004), height (r=0.666, p<0.001), LTM (r=0.490, p<0.001), LTI (r=0.238, p=0.029), and ASM (r=0.501, p<0.001), and was negatively associated with clinical variables like uric acid (p=0.039) and urea (p<0.001). After adjustment for age, sex and height, HGS remained significantly and negatively related with uric acid (β=-1.078, p=0.041) and hydration status (β=-0.805, p=0.042). Conclusions In CKD patients, ASM is determined mainly by anthropometric parameters but HGS - both by anthropometric and clinical variables specific for CKD.

We present an updated design process for adapting and integrating existing cyber risk assessment approaches for impact assessment for the risk from IoT to the digital economy. The new design process includes a set of changes to the original standards (e.g. NIST) that are adapted for the IoT cyber risk in this paper. This paper also presents a new framework for impact assessment of IoT cyber risk, specific for the digital economy.

This research article reports the results of a qualitative case study that correlates academic literature with five Industry 4.0 cyber trends, seven cyber risk frameworks and two cyber risk models. While there is a strong interest in industry and academia to standardise existing cyber risk frameworks, models and methodologies, an attempt to combine these approaches has not been done until present. We apply the grounded theory approach to derive with integration criteria for the reviewed frameworks, models and methodologies. Then, we propose a new architecture for the integration of the reviewed frameworks, models and methodologies. We therefore advance the efforts of integrating standards and governance into Industry 4.0 and offer a better understanding of a holistic economic impact assessment model for IoT cyber risk.

Congenital heart disease (CHD) is a prevalent congenital disorder diagnosed with high frequency, affecting approximately 0.8% to 1.2% of all live births. Research has demonstrated that the use of pulse oximetry and clinical examination as a screening tool for CHD diagnosis has proven extremely valuable. We conducted a retrospective longitudinal study over a 3-year period that involved screening 1188 newborns admitted to the NICU during the first 72 hours of life within this timeframe. 201 newborns were diagnosed with CHD. Almost all (n=198) had a positive screening test during the 72-hour period, while 3 had a negative screening test, but were later diagnosed using echocardiography. The prevalence rate was 16.67%. A confusion matrix was constructed with 198 true positives (TP), 3 false negatives (FN), no false positives (FP), and 987 true negatives (TN). The sensitivity of the screening test was 98.51%, while the specificity 100%, with no false positives. In our study, a total of 9 deaths occurred. Using the Kaplan-Meier method, the survival probability appeared to be slightly above 0.9 (95.5%), indicating that almost all patients survived past 72 hours after being diagnosed with CHD. Pulse oximetry is an effective, low cost and easy-to-use method and a useful tool to assess and lead to the diagnosis of CHD.

Long-term health consequences are influenced by circumstances that occur during pregnancy. The confluence of the maternal and fetal circulations occurs at the placenta, which is the first or-gan to develop. Placental pathology can provide an accurate diagnosis of inflammation inside the amniotic sac. The pathological alterations of preterm placentas provide evidence for the causes of numerous perinatal pathologies, including spontaneous preterm births. This retrospec-tive study aimed to re-examine placentas regarded as normal by the Obstetrics and Gynecology Department in our institution so that grading and staging of any evident inflammatory response could be evaluated and associated with baby gender. Eighty-four full-term placentas were col-lected after delivery. Placentas that were considered normal and were not sent to the histo-pathology department were taken. Morphological examination of fresh placenta was conducted. Full thicknesses of placenta samples were taken from central and marginal regions of placental disc. Fetal and maternal inflammatory responses syndrome were assessed. Villitis of unknown etiology (VUE) and chronic deciduitis also were evaluated in the placenta. Immunohistochemis-try (IHC) was also performed to evaluate patterns of inflammation in the placenta using an-ti-CD8 and anti-CD68 antibodies. The correlation between the silent pathologies and clinical complications or involvement of developing fetal inflammatory response syndrome was meas-ured. In this study, seventeen (20%) maternal inflammatory samples and ten (12%) fetal inflam-matory samples showed inflammatory responses. The frequency of chronic deciduitis and villi-tis of unknown etiology was more remarkable among Saudi pregnant women than the previ-ously reported findings in the literature of placental pathology. The prevalence of fetal and ma-ternal inflammatory response was greater in the placentas of mothers of males than in placentas of female mothers. Grading placental inflammation usually predict the degree of maternal an-ti-fetal cellular rejection. Fetal inflammatory response syndrome usually goes unnoticed in Sau-di Arabia. There are differences in the inflammatory response in the placenta based on the sex of the newborn. Increasing the number of placental samples that must be sent for microscopic in-spection may be preferable due to their significance in identifying the causes of chronic disor-ders.

A microfinance scheme has emerged as a crucial tool in reducing poverty gaps in many developing countries. A notable player in the arena is Amanah Ikhtiar Malaysia (AIM), a pioneer in microfinancing in Malaysia since 1987. AIM’s microfinance program injects small-scale businesses, particularly benefiting single mother entrepreneurs, contributing to capacity-building and empowerment. However, the advent of the COVID-19 pandemic, coupled with Movement Control Order (MCO), has adversely affected various business sectors and vulnerable groups, including single mothers engaged in microfinancing enterprises. This study employs primary data to assess the impact of AIM’s microfinancing programs on single-mother entrepreneurs during the crisis. Utilizing a quantitative approach with a two-stage sampling process involving 422 respondents in urban areas, the research evaluates the relationship between empowerment indicators (economic, social, digital, and psychological) and management and governance aspects of program effectiveness. The findings reveal that the microfinancing program’s overall effectiveness, economic, digital and psychological empowerment indicators, and program management are at a moderate level, while social empowerment is high. Economic and digital empowerment, along with effective management, positively and significantly influence program effectiveness, whereas social empowerment has a negative and significant impact. The study concludes with recommendations for enhancing AIM’s microfinance program, equipping single mother entrepreneurs to better navigate future challenges, and informing policy formulation related to their empowerment.

The field of human microbiome and gut microbial diversity research has witnessed a profound transformation, driven by advances in omics technologies. These advancements have unveiled essential connections between microbiome alterations and severe conditions, spurring the development of new frameworks through epidemiological studies. Traditionally, each individual was thought to harbor unique microbial communities acquired early in life, but recent research challenges this belief. The neonatal microbiome's onset, influenced by factors like delivery mode and maternal health, remains a subject of intense debate, hinting at potential intrauterine microbial processes. In-depth research reveals associations between microbiome profiles and specific health outcomes, ranging from obesity to neurodevelopmental disorders. Understanding these diverse microbiome profiles is essential for unraveling the intricate relationships between the microbiome and health outcomes.

Background: Exclusively breastfeeding your newborn while in the hospital is imperative for suc-cessful breastfeeding at home. This study will investigate if having a nurse on-site during rooming-in can enhance the proportion of exclusive breastfeeding. Methods: We carried out a prospective cohort study to assess exclusive breastfeeding in the first three months of life among two Neona-tology Units in Southern Italy with different hospital settings. The Ente Ecclesiastico Miulli of Ac-quaviva delle Fonti had on-site nurses available 24/7 (on-site group), while the Policlinico of Bari had nurses available on call 24/7 from the Neonatology Unit (on-call group). Results: Between January 3rd and March 31st, 2018, a total of 564 sets of mothers and babies were admitted - 299 on-site and 265 on-call. The exclusive breastfeeding rate for the entire group was 76.4% at 90 days, demonstrating the positive impact of rooming-in and nursing, regardless of the setting. Infants delivered via ce-sarean section in the on-site group demonstrated higher rates of exclusive breastfeeding at both 30 and 90 days of life. Conclusions: Our research indicates that having a nurse available at all times is crucial for promptly identifying any problems with breastfeeding. We highly suggest having an on-site nurse present during rooming-in for mothers who have had a caesarean delivery. This nurse should continuously promote exclusive breastfeeding until the baby is three months old.

The Internet-of-Things (IoT) enables enterprises to obtain profits from data but triggers data protection questions and new types of cyber risk. Cyber risk regulations for the IoT however do not exist. The IoT risk is not included in the cyber security assessment standards, hence, often not visible to cyber security experts. This is concerning, because companies integrating IoT devices and services need to perform a self-assessment of its IoT cyber security posture. The outcome of such self-assessment needs to define a current and target state, prior to creating a transformation roadmap outlining tasks to achieve the stated target state. In this article, a comparative empirical analysis is performed of multiple cyber risk assessment approaches, to define a high-level potential target state for company integrating IoT devices and/or services. Defining a high-level potential target state represent is followed by a high-level transformation roadmap, describing how company can achieve their target state, based on their current state. The transformation roadmap is used to adapt IoT risk impact assessment with a Goal-Oriented Approach and the Internet of Things Micro Mart model.

The purpose of this study was to evaluate the bioactivity and cell response of a well-characterized Nurse´s A-phase (7CaO•P2O5•2SiO2) ceramic and his effect compared to a control (tissue culture polystyrene-TCPS) on the adhesion, viability, proliferation and osteogenic differentiation of ahMSCs in vitro. Cell proliferation (Alamar Blue Assay), Alizarin Red-S (AR-s) staining, alkaline phosphatase (ALP) activity, osteocalcin (OCN) and collagen I (Col I) were evaluated. Also, field emission scanning electron microscopy (FESEM) images were acquired in order to visualise the cells and the topography of the material. The proliferation of cells growing in a direct contact with the material was slower at early stages of the study because of the new environmental conditions. However, the entire surface was colonized after 28 days of culture in growth medium (GM). Osteoblastic differentiation markers were significantly enhanced in cells growing on Nurse´s A phase ceramic and cultured with osteogenic medium (OM), probably due to the role of silica to stimulate the differentiation of ahMSCs. Moreover, calcium nodules were formed under the influence of ceramic material. Therefore, it is predicted that Nurse´s A-phase ceramic would present high biocompatibility and osteoinductive properties being a good candidate to be used as a biomaterial for bone tissue engineering.

White noise is fundamentally linked to many processes, it has a flat power spectral density and a delta-correlated autocorrelation. Operators acting on white noise can result in coloured noise, whether they operate in the time domain, like fractional calculus, or in the frequency domain, like spectral processing. We investigate whether any of the white noise properties remain in the coloured noises produced by the action of an operator. For a coloured noise, which drives a physical system, we provide evidence to pinpoint the mother process from which it came. We demonstrate the existence of two indices, that is, kurtosis and codifference, whose values can categorise coloured noises according to their mother process. Four different mother processes are used in this study: Gaussian, Laplace, Cauchy, and Uniform white noise distributions. The mother process determines the kurtosis value of the coloured noises that are produced. It maintains its value for Gaussian, never converges for Cauchy, and takes values for Laplace and Uniform that are within a range of its white noise value. In addition, the codifference function maintains its value for zero lag-time essentially constant around the value of the corresponding white noise.

Background: in 2016 an IT system was developed at MUL for the documentation of nursing practice. Preparing nursing students for the implementation of eHealth solutions under simulated conditions is crucially important for achieving digital competencies necessary for the health care systems in the future. Scientific evidence demonstrates that the use of an IT system in clinical practice shortens the time required for preparation of documentation, increases the safety of clinical decisions and provides data for analysis and for creation of predictive models for the purposes of HB HTA. Methods: The system was created by cooperation of an interprofessional team at the Medical University of Łódź. The ADPIECare system was implemented in 2016 at 3 universities in Poland, and in 2017 a study of its usability was conducted using a questionnaire made available by Healthcare Information and Management Systems Society “Defining and Testing EMR Usability MASTER V2 Final” on 78 nurses — students of MA in Nursing at Medical University of Łódź. Findings: Over 50% of the surveyed nurses have indicated the usability of the system for the “effectiveness of documentation” variable. The same group of respondents have confirmed that a positive attitude towards patient care planning with the use of the assessed system. In the opinions of the examined parties positive opinions predominated, such as e.g.: “the system is intuitive,” “the system facilitates work,” “all patient assessments are in one place,” “the time needed for data entry would be shortened.”

The recent SARS-CoV-2 pandemic, which is causing COVID 19 disease, has taught us unexpected lessons about the dangers of human extinction through highly contagious and lethal diseases. As the COVID 19 pandemic is now being controlled by various isolation measures, therapeutics and vaccines, it became clear that our current lifestyle and societal functions may not be sustainable in the long term. We now have to start thinking and planning on how to face the next dangerous pandemic, not just overcoming the one that is upon us now. Is there any evidence that even worse pandemics could strike us in the near future and threaten the existence of the human race? The answer is unequivocally yes. It is not necessary to get infected by viruses of bats, pangolins and other exotic animals that live in remote forests in order to be in danger. Creditable scientific evidence indicates that the human gut microbiota harbor billions of viruses which are capable of affecting the function of vital human organs such as the immune system, lung, brain, liver, kidney, heart etc. It is possible that the development of pathogenic variants in the gut can lead to contagious viruses which can cause pandemics, leading to destruction of vital organs, causing death or various debilitating diseases such as blindness, respiratory, liver, heart and kidney failures. These diseases could result n the complete shutdown of our civilization and probably the extinction of human race. In this essay, I will first provide a few independent pieces of scientific facts and then combine this information to come up with some (but certainly not all) hypothetical scenarios that could cause human race misery, even extinction. I hope that these scary scenarios will trigger preventative measures that could reverse or delay the projected adverse outcomes.

This qualitative exploratory study employs purposeful and maximum variation sampling to explore Mother Ignacia del Espíritu Santo's spiritual journey and the devotion of RVM Sisters. Gathering thirty participants offers a diverse range of perspectives, providing insights into the local community. Thematic analysis highlights their impact during the pandemic in Iligan City. Ignacian spirituality spreads through education, retreat, other ministries and digital adaptation by the RVM Sisters. Through in-depth literature reviews, interviews, and observations, the researcher uncovers Mother Ignacia's journey, resonating with modern spirituality. RVM Sisters adapt during the pandemic, inspiring hope in words and in action. Their humility despite their accomplishments is particularly inspiring. This transformative journey holds significance, illuminating resilience in a post-COVID-19 context. The study contributes to literature and suggests amplifying RVM Sisters' influence. Overall, in a pandemic-stricken world, it emphasizes spirituality's role as a beacon of strength and compassion, inspiring revitalization. The essence of Mother Ignacia and the RVM Sisters' spiritual expedition serves as a celestial inspiration, guiding local residents toward compassion, fortitude, and collective renewal.

At least one ultrasound is recommended to predict fetal growth restriction and low birthweight earlier in pregnancy. However, in low-income countries imaging equipment and trained manpower are scarce. Hence, we developed and validated a model and risk score to predict low birthweight using maternal characteristics during pregnancy, for use in resource limited settings. We conducted a prospective cohort study among 379 pregnant women in South Ethiopia. A step-wise multivariable analysis was done to develop the prediction model. To improve clinical utility, we developed a simplified risk score to classify pregnant women at high- or low-risk of low birthweight. The accuracy of the model was evaluated using the area under the receiver operating characteristics curve (AUC) and calibration plot. We evaluated the clinical impact of the model using a decision curve analysis across various threshold probabilities. Age at pregnancy, underweight, anemia, height, gravidity, and presence of comorbidity remained in the final multivariable prediction model. The area under the receiver operating characteristics curve (AUC) of the model was 0.83 (95% confidence interval: 0.78 to 0.88). The decision curve analysis shows the model provides a higher net benefit across ranges of threshold probabilities. In general, this study showed the possibility of predicting low birthweight using maternal characteristics during pregnancy. The model could help to identify those at higher risk of having a low birthweight baby. This feasible prediction model would offer an opportunity to reduce obstetric-related complications and thus improving the overall maternal and child healthcare in low- and middle-income countries.

Respiratory syncytial virus (RSV) is the most common cause of acute lower respiratory tract infection in young children globally. Following the COVID-19 pandemic, RSV infections have become more prevalent. Consequently, a new vaccine targeting RSV infections in pregnant women has been introduced worldwide. To estimate the effectiveness of this new vaccine for pregnant women, we investigated neutralizing antibodies against RSV in samples taken from 51 mothers and their babies. The prevalence rate of neonatal antibodies, defined as a titer of ≥16, was 39.2%. We found no significant differences in neonatal neutralizing antibodies based on factors, such as sex, gestational age at birth, birth weight, presence of siblings, neonatal problem, and usage of palivizumab. Neonatal neutralizing antibodies were equal to or higher than those of their mother. A new RSV vaccine targeting all pregnant women is promising, as approximately 60% of neonates had low antibody titers against RSV. However, predicting low antibody titer against RSV remains challenging. Moreover, our findings indicate efficient transmission of RSV antibodies from babies to their mothers.

The metaphor of being touched by music is widespread and almost universal. The tactile experience, moreover, has received growing interest in recent years. There is, however, a need to go beyond a mere metaphorical use of the term, by positioning the tactile experience within the broader frame of embodied cognition and the experiential turn in cognitive science. This article explores the possible contribution of a science of touch by defining music as a vibrational art that impinges upon the body and the senses. It takes as a starting point the clinical findings on the psychological and physiological value of tender touch with a special focus on the method of kangaroo mother care, which is a method for holding the baby against the chest of the mother, skin-to-skin. It is seen as one of the most basic affiliative bonding with stimuli that elicit reward. Via an extensive review of the research literature, it is questioned to what extent this rationale can be translated to the realm of music. There are, in fact, many analogies, but a comprehensive theoretical framework is still lacking. This article aims at providing at least some preparatory groundwork to fuel more theorizing about listening and its relation to the sense of touch.

Asthma is a chronic inflammatory disease for which the main anti-inflammatory drugs for better disease control are steroids or corticosteroids. The use of steroids in asthma patients, in particular in uncontrolled asthma patients, is associated with an increased risk of osteoporosis and fragility fractures. A single oral corticosteroids course increases the risk of osteoporosis and continual use of inhaled corticosteroids is correlated over time to an increased risk for both bone conditions. With the use of new, available biologic therapies for asthma, perhaps even anticipating the times of their use in what are the steps of therapeutic management, in the current guidelines and with targeted strategies of prevention it may be possible to improve asthma management, preventing some comorbidities, such as osteoporosis.

The Internet-of-Things (IoT) triggers new types of cyber risks. Therefore, the integration of new IoT devices and services requires a self-assessment of IoT cyber security posture. By security posture this article refers to the cybersecurity strength of an organisation to predict, prevent and respond to cyberthreats. At present, there is a gap in the state-of-the-art, because there are no self-assessment methods for quantifying IoT cyber risk posture. To address this gap, an empirical analysis is performed of 12 cyber risk assessment approaches. The results and the main findings from the analysis is presented as the current and a target risk state for IoT systems, followed by conclusions and recommendations on a transformation roadmap, describing how IoT systems can achieve the target state with a new goal-oriented dependency model. By target state, we refer to the cyber security target that matches the generic security requirements of an organisation. The research paper studies and adapts four alternatives for IoT risk assessment and identifies the goal-oriented dependency modelling as a dominant approach among the risk assessment models studied. The new goal-oriented dependency model in this article enables the assessment of uncontrollable risk states in complex IoT systems and can be used for a quantitative self-assessment of IoT cyber risk posture.

The skin acts as a protective barrier, guarding the body against microorganisms, chemicals, and several environmental factors. Accordingly, this all-important organ must be kept healthy to maintain its optimal functionality. One approach to maintain skin health is the application of multifunction bioactive sunscreens containing antioxidant molecule(s). Rosmarinic acid (RA), a phenolic compound, is known for its antioxidant activity. Herein, the safety and efficacy of a multifunction prototype sunscreen were investigated, aiming to probe putative synergies of this polyphenol with two known and widely used UV filters (bemotrizinol and octyl p-methoxycinnamate). Samples protected the DNA fragmentation compared to UV control, by the comet assay, and showed good skin compatibility in subjects. Formulations F1 and F3 were able to increase skin hydration, and, possibly, the RA interfered with this attribute. An increase in transepidermal water loss was observed for formulations F1, F2 and F4, which may be related to vehicle containing or not the RA. No decreases were observed in the inflammatory reaction caused by the ethyl nicotinate with any of the evaluated formulations. As a perspective, we suggest trials with a greater number of subjects or protocol modifications. Altering the vehicle qualitative and quantitative composition is also a pertinent perspective.

This randomized control trial aims to test the hypothesis that twice-daily nurse-administered saline enema(SE) is comparable to physician-administrated SE in very low birth weight infants (VLBW) with meconium obstruction of prematurity (MOP). MOP is defined as no bowel opening for 48 h, and treatment failure is defined as the need for additional intervention and safety. Twice-daily SE was administered by accredited nurses, surgeons/neonatologists using standardized protocols. The outcomes were comparability of nurse to physician-administered SE in terms of frequency of administration, catheter insertion length and volume of enema, daily maximum meconium output, and treatment failure, defined as the need for additional intervention. Safety outcomes were evaluated. Twenty-eight infants were managed with SE. 389 SE were administered, 96 and 293 in 750-999g and 1000-1500g birth weight groups, respectively. Nurses administered 72.9% and 81.5% of SE in 750-999g and 1000-1500g birth weight groups, respectively. Physicians performed the rest of the SE. Daily meconium output was comparable in nurse and physician-administered SE in both groups. There were no treatment failures or adverse events in both SE group. SE administered by nurses was found to be comparable in terms of safety, efficacy, and frequency of administration to that of physician-administered SE.

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

In Sub-Saharan African Countries such as Nigeria with high prevalence rate, Child HIV/AIDs acquired through Mother-to-Child transmission (MTCT) can be largely prevented by using a well-established prevention programme and scheme. This study examined factors that can enhanced Prevention of Mother-to-Child transmission (PMTCT) in Nasarawa State. To achieve this, structured questionnaire were used to collect data from one hundred and sixteen (116) women attending two (2) primary facilities and two (2) secondary facilities in the State. This study utilized methods of Poisson Regression, Negative Binomial Regression and Logistic Regression Analyses. Results revealed that women with at least a secondary school education, women with husband in military and women with perceived confidentiality of their HIV status significantly enhanced PMTCT of HIV in Nasarawa State while significant proportion of the women attest to the fact that drugs are available in the facilities (p-value=0.0000<0.05) . Other factors include mother income level, willingness to continue with PMTCT programme and women in support group can also enhanced PMTCT though they are not significant. This study recommends that the factors identified should be explored by NGOs, Ministry of Health and, Support groups and other relevant agencies since they have the capacity to enhanced PMTCT of HIV in Nasarawa State, Nigeria.

In January 2019, the French Agency for Food, Environmental and Occupational Health and Safety (ANSES) published an opinion on risks related to the presence of hazardous chemicals in infant diapers. ANSES found that health reference values were largely exceeded for polycyclic aromatic hydrocarbons (PAHs), dioxins (PCCD/Fs) and dioxin-like polychlorobiphenyls (DL-PCBs). The levels of formaldehyde and of some fragrances were also considered potentially unsafe. Therefore, ANSES concluded that actions have to be taken to restrict levels of these contaminants in diapers. Under the exposure scenario deemed the most reliable by ANSES, estimates of cancer risks of the most potent PAHs detected in diapers exceeded 10-3 and hazard quotients for neurobehavioral effects attained values up to 66. Regarding dioxins and DL-PCBs, ANSES derived a hazard quotient of 12 for the risk of decreased sperm count at adult age. The aim of this critical review was to examine whether the exposure and risk assessment conducted by ANSES contained potential flaws that could explain such a high exceedance of health reference values. The review will also put into perspective the exposure from diapers with that from breast milk whose benefits for child’s health are undisputable despite contamination by PAHs, dioxins and DL-PCBS.

The goal of the study is to assess the potential correlation between maternal Sars-cov-2 infection , detected three months before the second trimester anomaly scan, and fetal iperecogenicity in order to determine whether or not this could be considered a predictive factor for maternal-fetal complications . The study included 48 pregnant women who did not have any clear maternal or fetal problems. These individuals had an anomaly scan in the second trimester, as well as amniocentesis and fetal cariotyping, and then RT-PCR testing on their placental tissue after birth to rule out transplacental transmission. There have been no reports of fetal abnormalities via amniocentesis or fetal cariotyping. The patients experienced a high rate of spontaneous births (83%). Fetal development problems (2%) and premature delivery (4%) were uncommon, although placental swabs revealed a possibility of viral transmission across the placenta itself. To the best of our knowledge, this is the first observational study to show that detecting isolated intestinal hyperechogenicity during an abnormality scan in fetuses of women infected with Sars-Cov-2 in the previous three months does not appear to be a predictor of poor maternal-fetal outcomes, but may be linked to transplacental virus transmission.

This report is a narrative of a certified nurse working on a long-term rehabilitation ward for patients with dementia in Japan during the early phase of the COVID-19 pandemic. During this time visitation restrictions had been implemented to prevent the spread of COVID-19 causing psychological distress for patients and their families which nurses had to cope with . The nurse was interviewed twice September–October 2020. The recordings were transcribed verbatim and analysed thematically. Three themes were identified relating to changes in care in response to the pandemic which nurses had to adapt to: the risk of collapse of family members’ roles, anxiety caused by patients forgetting family members and family memories and increased disorientation. During the pandemic, nursing care needs to adapt, ensuring that family attachments and ties continue and minimizing the disruption caused by the pandemic, while ensuring that everyone remains Covid-safe.

Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. Methods: Prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini-Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. Results: The median MNA Short Form (SF) score was 11 (8-12), 39 participants (32.50%) had normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear logistic models showed that the MNA score was associated with dyspnea and respiratory symptoms severity assessed by the Modified British Medical Research Council (mMRC) and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1 and with poorer QoL as assessed by the EQ-5D-3 questionnaire. Cox regression analysis according to nutritional status based on the MNA score showed that COPD participants "at risk of malnutrition" and "malnourished" had a higher risk of moderate to severe acute exacerbations with a hazard ratio (HR) of 3.54 (p=0.002) and 8.20 (p=0.0001), respectively. Conclusion: Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS). Multiple noninvasive respiratory support modes are currently available in Romania, but little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). We aimed to identify the usage extent and clinical application of nHFOV in Romania. A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. The questionnaire was addressed to the leaders of all level III Romanian NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10-17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%), heated, humidified high flow nasal cannula (HHHFNC) (61.9%), and nHFOV (11/21 units; 52.4%); 5/11 units reported frequent nHFOV use (in 2 or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). 10/11 units reported setting a mean airway pressure (MAP) equal to the CPAP level plus 1-2 cmH₂O on rescue nHFOV after CPAP failure. Both dedicated equipment (45.5%) and hybrid ventilators (63.6%) were used for nHFOV delivery, with face/nasal masks and short binasal prongs being the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV; none of the units mentioned pneumothorax as an adverse effect. Only 3 of the NICUs had a written protocol for nHFOV use. Initial, minimum, and maximum amplitude and initial and minimum MAP settings used were significantly higher with hybrid ventilators as compared to dedicated equipment (p<0.05). Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. A need for training for nHFOV use was identified, and efforts are needed at the national level to develop courses and training sessions, including using simulation workshops, to offer more information on optimal nHFOV use in clinical practice.

BACKGROUND&AIMS: Hepatitis B virus (HBV) infection remains a major public health problem. The interaction between HBV and the host inflammatory response is an important factor contributing to liver damage and disease development. We compared the correlation between the subclinical index and PBMCs concentration in two groups of pregnant women (HBsAg positive), which are different in HBV DNA concentration in Vietnam. METHODS: The Hierarchical cluster analysis (HCA) was run with 20 different clustering methods on data collected from 80 Vietnamese pregnant women and their babies (60/80 cord blood). RESULTS: In the high viral load group (HBV DNA ≥ 5x10^7 copies/ml), a strong correlation between CBMCs with serum maternal Haemoglobin concentration and maternal platelet and maternal ALT. Their R values are: -0.88, 0.82, and 0.84 with p=8.97E-03, 2.41E-02 and 1.75E-01, respectively. CONCLUSIONS: We found a significant correlation shift of subclinical index between the two groups, which may be important in diagnosing pregnant women with chronic hepatitis B virus infection.

Recent advancements in gut microbiome research have highlighted the complex interplay between gut microbiota and various physiological and pathological processes, showing that gut microbiota plays a vital role in human health and disease. Imbalances in the gut microbiota, known as dysbiosis, have been associated with a range of health conditions, including gastrointestinal disorders, metabolic diseases, etc. In response to these findings, probiotics, prebiotics, synbiotics, and postbiotics have emerged as a promising therapeutic strategy to modulate gut microbiota composition and functionality. This review paper explores the latest research on how gut microbiota impacts host physiology, immune responses, and overall well-being. Furthermore, the paper delves into the therapeutic potential of probiotics, postbiotics, prebiotics, and synbiotics in therapeutic applications and curing various diseases. The paper also addresses the challenges and opportunities in the field, highlighting the need for personalized approaches to probiotic therapy and the importance of considering factors such as strain specificity, dosing, and safety.Overall, this review aims to provide a comprehensive overview of the evolving landscape of gut microbiota and probiotics, prebiotics, synbiotics, and postbiotics as novel therapeutic agents. It underscores the potential of harnessing the gut microbiome to improve health, prevent diseases, and complement traditional medical interventions. As research in this field continues to expand, a deeper understanding of the gut microbiota and probiotics, prebiotics, synbiotics, and postbiotics promises new avenues for preventive and therapeutic healthcare strategies.

(1) Background: The RDW-CV has predictive value in many pregnancy-related conditions. Re-search question: Can the RDW-CV be utilized predictively in pregnant patients with thrombo-philia? Aim of the study: To carry out a detailed analysis of the RDW-CV in pregnant patients with treated thrombophilia as compared with pregnant patients without thrombophilia who de-livered via cesarean section at term. (2) Methods: We studied 160 pregnant patients, including 80 pregnant patients with treated thrombophilia in the study group, and another 80 patients of a similar age and parity. The patients were referred to our hospital for delivery at term by means of a cesarean section between 1/10/2017 and 1/12/2021. Every patient received a sonogram during the first 1–2 days after the cesarean section, and their uterine evaluation was interpreted using the PUUS (Postpartum Uterine Ultrasonographic Scale). (3) Results: Our PUUS≥1 pregnant and postpartum patients with treated thrombophilia were the only group with an RDW-CV value over 14. No deep vein thrombosis was observed during hospitalization, showing that the antico-agulant treatment was necessary and effective. An RDW-CV of 14.5 was the highest value in the Rh-negative group of pregnant patients with treated thrombophilia. An RDW-CV of 14.48 was the highest level in the Rh-negative postpartum patients with treated thrombophilia. (4) Conclu-sion: An RDW-CV of ≥14 can predict uterine hematometra (PUUS≥1). The RDW-CV values were higher in Rh-negative patients.

(1) Background: Thrombophilia is a tendency towards hypercoagulability, and it is increased by pregnancy, peaking around delivery. Research question: does thrombophilia stimulate the in-flammatory state of the patient, already suppressed by pregnancy? (2) Methods: Eighty thrombo-philia patients admitted for delivery between 1/10/2017 and 1/12/2021 were prospectively stud-ied, together with eighty age- and para-matched control patients. Patients were admitted for de-livery at term by means of cesarean section. The inflammation indexes from the complete blood count values analysis during both the 24 hours before and after labor—extracted from the hospi-tal’s medical records—were calculated and then correlated with uterine involution. (3) Results: Except for the PLR, most of the numerous inflammation indexes studied were not significantly different in treated thrombophilia patients, before and after delivery, compared to non-thrombophilia patients. Only when we split the patients, based on the uterine haematometra in the first 24-48 hours postpartum, we found out that the few treated thrombophilia patients with haematometra (14 with haematometra out of 79 with treated thrombophilia) had elevated SII and AISI antepartum. In pregnant patients treated for thrombophilia, MLR is higher in pa-tients without the Rh factor than in those with the Rh factor. In non-thrombophilia patients, MCVL and NLPR increased with age and before labor, while SII and AISI increased with age postpartum. (4) Conclusions: Thrombophilia did not stimulate the inflammatory state of the pa-tient, already suppressed by pregnancy.

Background: Currently, a Dolutegravir (DTG)-based regimen is administered to women on option B plus to prevent mother-to-child transmission (MTCT) of the virus. However, its effect on reducing MTCT of human immunodeficiency virus (HIV) among exposed infants over the previously used Efavirenz (EFV)-based regimen is unknown. Objective: This study aimed to compare the effects of DTG-based and EFV-based regimens on the MTCT of HIV among exposed infants in southern Ethiopia. Methods: A retrospective before-after study design was employed from March to May 2023 among 958 mother-infant pairs (479 on EFV-based and 479 on DTG-based regimens) enrolled in the prevent mother-to-child transmission (PMTCT) care from September 2015 to February 2023. The outcome variable was the HIV infection status among the exposed infants. A log-binomial model was employed and the proportion was computed to compare the incidence of MTCT of HIV in both groups. The risk ratio (RR) with 95% confidence interval (CI) was calculated to assess the predictor variables. Results: Mothers on a DTG-based regimen were approximately 44% (adjusted risk ratio (aRR): 0.56; 95% CI: 0.44, 0.70) less likely to transmit HIV to their infants than those on an EFV-based regimen. In addition, poor/fair adherence to antiretroviral therapy (ART) (aRR: 5.82; 95% CI: 3.41, 9.93), home delivery (aRR: 3.61; 95% CI: 2.32, 5.62), mixed feeding practice (aRR: 1.83; 95% CI: 1.45, 2.3), and not receiving antiretroviral prophylaxis (aRR: 3.26; 95% CI: 1.6, 6.64) were found to increase the risk of MTCT of HIV infection, whereas older maternal age (aRR: 0.93; 95% CI: 0.9, 0.96) was a protective factor.Conclusion: The Dolutegravir-based regimen significantly reduced MTCT of HIV among exposed infants compared to the EFV-based regimen. Thus, DTG-based first-line ART regimen supplementation should be sustained to achieve global and national targets for zero new infections in HIV-exposed infants.

Mortality in children accounts for 15% of all AIDS-related deaths globally, with a higher burden among Cameroonian children (25%), likely due to poor virological response. We sought to evaluate viral suppression (VS) and its determinants in a nationally representative paediatric and young adult population receiving antiretroviral therapy (ART). A cross-sectional and multicentric study was conducted among Cameroonian children (

ABSTRACT: Background: Virtual Reality (VR) emerges as a promising non-pharmacological intervention for managing symptoms and providing distraction during chemotherapy. This study aims to assess VR's effectiveness on cancer-related symptoms, vital signs, and patients' perception of the chemotherapy in lung cancer patients. Methods: A quasi-experimental study was conducted on 100 patients. Participants were allocated into an intervention group (n = 55), which experienced immersive VR, and a comparison group (n = 45), which received usual care. Data were collected through questionnaires and checklists, including feedback on the VR experience, pain, vital signs, and common cancer symptoms, assessed through the Edmonton Symptom Assessment Scale. Results: VR had a significant impact on reducing the perception of the chemotherapy length. Patients reported high levels of satisfaction and tolerability. No adverse events were observed. VR did not have significant influence on pain intensity and vital signs. The only exceptions were oxygen saturation, where a significant difference (p = 0.02) was reported, and perception of chemotherapy duration. Conclusions: As a non-pharmacological intervention, VR proves beneficial in minimizing the perceived length of chemotherapy session for lung cancer patients, enhancing their overall treatment experience. The intervention showed to be a safe, feasible, and well-accepted distraction technique. Future research should explore VR's potential effects on a wider range of symptoms and evaluate its impact on long-term outcomes.

We investigated the sleep-wake rhythm of nursery school children with the aim of supporting their health and balanced mental/physical development. We analyzed 4881 children from infant to 6 years of age, using 2-week sleep tables recorded by their guardians. The table contains sleep onset times, wake times, nighttime/daytime sleep duration, and the differences in these between weekdays and weekends. The total sleep decrement of children with age is due to a decrease in daytime sleep only, and nighttime sleep duration remains almost unchanged at about 10 hours, and is therefore called the nighttime basic sleep duration (NBSD). While sleep onset time stabilizes at around 9:30 pm by the age of 2, wake-up times to be before 7 am, resulted in weekdays sleep insufficiency. This lack of sleep is compensated by long naps on weekdays and by catching up sleep on weekends morning, which may be the background to future social-jet-lag. Guardians are encouraged to know their children's exact NBSD and set an ap-propriate bedtime to maintain it on weekdays, which prevent sleep dept and form a daily rhythm of waking up at the same time both on weekdays/weekends. These conditions are believed to maintain balance in mental/physical development and school-social-adaptation.

Visceral leishmaniasis (VL) results from infection by the protozoa Leishmania infantum and L. donovani. HIV-coinfected patients may have a relapsing course of VL, even after secondary prophylaxis with amphotericin B. This study investigated whether host factors would explain the relapses. First, susceptibility to amphotericin B of L. infantum isolates was evaluated in vitro. Then, clinical data and the lipid profile of patients with relapsing and non-relapsing VL were assessed. Susceptibility to amphotericin B was similar between the isolates. CD4+ lymphocytes were reduced in both patients in the first episode and with relapsing VL. Still, the strongest blood cell associated with relapses was low total lymphocyte counts. Total plasma cholesterol, high-density lipoprotein, low-density lipoprotein, and, uniquely, triglycerides of the six individuals in the first episode and 23 with relapsing VL were lower in relapsing patients than those in the first episode. Deceased patients had extremely low, low-density lipoprotein. After CD4+ decrease, lymphocyte CD8+ reduction seem to be the final stage of the immunological failure. The lower lipid concentrations appear to be secondary to the depletion of fat stores by inflammation-induced cachexia provoked by the co-occurrence of both diseases, which can finally lead to death.

Background: This study investigated the effect of indirect air-cooling on the variation in intrapulpal temperature (ΔT) during different light-curing protocols of bulk-fill resin composites in molars with class V cavities. Methods: A nonretentive class V cavity was prepared in an upper molar. The intrapulpal temperature changes with and without air-cooling were recorded with type K thermocouple. The cavity was restored with bulk-fill resin composites: Tetric PowerFlow and Filtek Bulk-Fill Flow. The tooth was exposed to different light-curing protocols (n=5) using the Valo Grand light-curing unit: (i) high-intensity light-curing of 3200 mW/cm² (3 and 6 s) and (ii) moderate-intensity light-curing of 1000 mW/cm² (10 and 20 s). The ΔT data were subjected to two-way ANOVA, followed by Bonferroni post hoc test. Results: A significant increase in temperature was observed with the use of the high-intensity light-curing resin composite without indirect air-cooling. In addition, the application of air-cooling significantly decreased the temperature in all the groups except for the Tetric PowerFlow bulk-fill resin composite at 3 s of light-curing. Conclusion: Indirect air-cooling resulted in a lower increase in intrapulpal temperature during the light-curing of bulk-fill resin composites, making it an effective alternative for controlling the temperature rise in class V restorations with 1 mm of remaining dentin.

Rutin, a flavonoid compound found in various plants, has gained attention for its potential applications in the cosmetic industry due to its antioxidant, anti-inflammatory, and potential photoprotective properties. Our review explored the use of rutin (rutoside, 3-O-rutinoside-quercetin) in cosmetics/dermocosmetics, focusing on its physicochemical properties and stability, cutaneous permeability, and efficacy in sunscreen systems, involving in vitro tests and the current state of clinical trials. Rutin's ability to scavenge free radicals, prevent peroxidation, and reduce vascular fragility makes this flavonoid a promising ingredient for photoprotection. Studies have shown that rutin can enhance the sun protection factor (SPF) of sunscreen formulations, especially when combined with organic UV filters. The encapsulation of rutin in nanostructures has also been investigated to improve its applicability. Overall, rutin shows potential as a safe and effective ingredient in cosmetic/dermocosmetic formulations, offering protection against the harmful effects of UV radiation and oxidative stress on the skin.

Background: Early diagnosis of postoperative complications is an urgent task, allowing timely prescribing of appropriate therapy and reducing the cost of patient treatment. Prognostic models based on various data could help in the early diagnosis of postoperative complications after cardiac surgery. Objectives: The purpose of the study was to determine whether an integrated approach based on clinical data along with metabolites and biomarkers had greater predictive value than the models built on less data. Methods: The study included patients (n=62) admitted for planned cardiac surgery (coronary artery bypass grafting with cardiopulmonary bypass), who were retrospectively divided into two groups depending on the presence (n=26) or absence (n=36) of postoperative complications of all types. Clinical and laboratory data on the first day after surgery were analyzed. Additionally, patients' blood samples were collected before and on the first day after surgery to determine biomarkers (interleukin-6, procalcitonin, NT-proBNP, high-sensitivity troponin T) and metabolites (8 aromatic and 2 dicarboxylic acids were detected using gas chromatography-mass spectrometry). Results: Patients before surgery, compared with healthy donors, differed in the concentration of metabolites (p &lt; 0.05), and had concentrations of a number of biomarkers exceeding the corresponding reference values. Multivariate PLS-DA models, predicting the presence or absence of postoperative complications, were built using clinical data (ROC-AUC=0.71), concentrations of metabolites and biomarkers (ROC-AUC=0.60), and the entire data set (ROC-AUC=0.75). For comparison we built univariate models using the EuroScore2 (ROC-AUC=0.59) and SOFA (ROC-AUC=0.76) scales; concentrations of lactate (ROC-AUC=0.71), the dynamic changes of 4-hydroxyphenyllactic acid (ROC-AUC=0.69), and the sum of three sepsis-associated metabolites (ROC-AUC=0.70). The proposed complex model using entire data set was comparable to the SOFA scale, which confirms the expediency of searching for new predictive models based on a variety of factors.

Milk serves as a crucial source of natural bioactive compounds essential for human nutrition and health. The gastrointestinal digestion of milk proteins releases various biologically active peptides that positively impact human health and enhance physiological performance. With the growing production of cheese, Greek yogurt, and other dairy products, the volume of unutilized acid whey is significantly increasing. Acid whey, containing almost all whey proteins and approximately one-quarter of casein, presents a valuable raw material for generating peptides with potential health benefits. These peptides exhibit properties such as antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, antihypertensive, antithrombotic, opioid, mineral-binding, and growth-stimulating activities, contributing to improved human immunity and the treatment of chronic diseases. Enzymatic hydrolysis of milk proteins has been developed as a method to produce these peptides, facilitating their use in food fortification. To incorporate whey into functional beverages, it undergoes fermentation by lactic acid bacteria with proteolytic activity. To specifically enrich these beverages with peptides exhibiting targeted bioactivities, it is essential to select lactic acid bacteria strains possessing the requisite protease profiles. Additionally, the sensory properties of the final product can be enhanced using starter cultures with diverse metabolic capabilities, even in the absence of added flavoring agents. Given the imperative to develop waste-free technologies and enhance the profitability of the dairy industry, there is a growing need to efficiently utilize and transform acid whey into a broad spectrum of valuable products and food additives. This approach is justified not only by the nutritional benefits of the bioactive components in whey but also by the commercial potential of safe and health-enhancing products.