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Extracellular vesicles (EVs) are microscopic particles released naturally in biofluids by all cell types. Since EVs inherits genomic and proteomic patterns from the cell of origin, they are emerging as promising liquid biomarkers for human diseases. Flow cytometry is a popular method that is able to detect, characterize and determine the concentration of EVs with minimal sample preparation. However, the limited awareness of the scientific community to utilize standardization and calibration methods of flow cytometers is an important roadblock for data reproducibility and inter-laboratory comparison. A significant collaborative effort by the Extracellular Vesicle Flow Cytometry Working Group has led to the development of guidelines and best practices for using flow cytometry and reporting data in a way to improve rigor and reproducibility in EV research. At first look, standardization and calibration of flow cytometry for EV detection may seem burdensome and technically challenging for non-academic laboratories with limited technical training and knowledge in EV flow cytometry. In this study, we build on prior research efforts and provide a systematic approach to evaluate the performance of a high sensitivity flow cytometer (herein Apogee A60-Micro Plus) and fine-tune settings to improve detection sensitivity for EVs. We performed calibration of our flow cytometer to generate data with comparable units (nanometers, MESF). Finally, we applied our optimized protocol to measure the concentrations of prostate-derived EVs in healthy individuals and prostate cancer patients. In conclusion, our proof-of-feasibility study can serve as a scientific and technical framework for other groups motivated in using flow cytometry for EV research.

Introduction It is important to understand the correlates of different dietary behaviors in a military context in the United Arab Emirates (UAE) to guide intervention development to prevent and treat obesity as it has a significant impact at the country and regional level. This study aimed to assess different dietary behaviors and their association with potential correlates including age, marital status, educational level, smoking status, screen time, dietary knowledge, eating self-efficacy, and general self-efficacy. Materials and Methods The study used a cross-sectional design and included 153 (M = 25.9 years, SD = ± 3.2) military recruits completing their basic training at a single military camp in the UAE. Dietary behaviors of these recruits were measured using the Arab Teens Lifestyle Study. Other potential correlates included dietary knowledge, general self-efficacy, and eating efficacy. The ethical approval was obtained from the research ethics committee in the UAE university. Results Daily intake of fruits, vegetables, and breakfast was reported by 14.4%, 25.5%, and 22.9% of the military recruits, respectively. Almost half of the recruits (46.4%) consumed sugar-sweetened drinks more than 3 times a week, 39.2% consumed fast food more than 3 times a week, and 37.3% consumed sweets/chocolates more than 3 times a week. Bivariate regression analyses revealed that eating self-efficacy was positively associated with breakfast and dairy food consumption, although it was inversely associated with sugar, fast-food, and French fries intake. Age was significantly and inversely associated with sugar, fast-food, and energy drink intake. Moreover, nutrition knowledge was significantly and positively correlated with vegetable intake and negatively correlated with energy drink consumption. Multiple regressions showed that lower age and lower eating self-efficacy were found to be the main predictors for sugar-sweetened drinks (adjusted R2 = 0.112) and fast-food intake (adjusted R2 = 0.084). Also, a higher dietary knowledge score was a predictor of vegetable intake (adjusted R2 = 0.093), although age and smoking predict energy drink intake (adjusted R2 = 0.225). Conclusions The results show that unhealthy eating patterns are common among new recruits in the UAE military. The study suggests that age, eating self-efficacy, and nutrition knowledge are the main correlates of selected dietary behaviors. Interventions are advised to target these correlates to achieve healthier dietary habits inside the military.

Fatigue is a distressing complaint with high detriment to quality of life that persists in one-third of colorectal cancer survivors after cancer treatment. Previous studies in mixed groups of cancer patients have suggested sleep quality is associated with fatigue. We aimed to investigate this association in colorectal cancer survivors up until two years post-treatment. Data on n = 388 stage I–III colorectal cancer patients were utilized from the EnCoRe study. Sleep quality and fatigue were measured at 6 weeks and 6, 12, and 24 months post-treatment. Sleep quality was measured using the Pittsburgh Sleep Quality Index (cross-sectional analysis only) and the single-item insomnia scale from the EORTC QLQ-C30. Fatigue was measured by the Checklist Individual Strength. Linear and mixed-model regression analyses analysed associations between sleep quality and fatigue cross-sectionally and longitudinally. Longitudinal analysis revealed worsening sleep quality over time was significantly associated with increased levels of fatigue over time (β per 0.5 SD increase in the EORTC-insomnia score = 2.56, 95% Cl: 1.91, 3.22). Significant cross-sectional associations were observed between worse sleep quality and higher levels of fatigue at all time points. Worse sleep quality in colorectal cancer patients was associated with higher levels of fatigue during the first two years post-treatment.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, ). The statement is based on current scienti?c evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.

The pulp plays a key role in the treatment of traumatic dental injuries (TDIs) and is strongly associated with the outcome, particularly in severe cases. A correct pulp diagnosis is essential as it forms the basis for developing the appropriate management strategy. However, many TDIs are complex, and their treatment requires a profound knowledge of the physiological and pathological responses of the affected tissues. This comprehensive review will look at the dentine-pulp complex and its interaction with the surrounding tissues following TDIs. The literature up to 2020 was reviewed based on several searches on PubMed and the Cochrane Library using relevant terms. In addition to the recently revised guidelines of the International Association of Dental Traumatology, this article aims to provide background information with a focus on endodontic aspects and to gather evidence on which a clinician can make decisions on the choice of the appropriate endodontic approach for traumatized permanent teeth.

Summary Obesity has increased to an epidemic level in the Gulf States. This systematic review is the first to explore the scientific evidence on correlates and interventions for overweight (body mass index [BMI] ≥ 25) or weight‐related behaviours in the region. A systematic search of peer‐reviewed articles was conducted using PubMed and PsycINFO. Ninety‐one studies were eligible for this review including 84 correlate studies and seven intervention studies. Correlate studies of overweight focused on sociodemographic factors, physical activity, and dietary habits. Low physical activity, sedentary behaviour, and unhealthy dietary habits were associated with overweight. The most‐reported sociodemographic correlates of overweight were increased age, being married, low education, urban residence, and unemployment. Correlate studies of physical activity and dietary behaviours mostly focused on sociodemographic variables. Being female and increased age (the latter less consistently) were associated with low physical activity. Interventions were very heterogeneous with respect to the target group, intensity, and behavioural strategies used. The effectiveness of interventions was difficult to evaluate because of the chosen study design or outcome measure, the small sample size, or high attrition rate. Few studies have investigated sociocognitive and environmental determinants of weight‐related behaviours. Such information is crucial to developing health promotion initiatives that target those weight‐related behaviours.

Sleep is receiving increasing attention in public health. The aim of this umbrella review is to determine what non-pharmacological sleep health interventions have been evaluated among healthy populations, by examining target groups, settings, and effectiveness in improving sleep quality and duration. Comprehensive searches were conducted in five electronic databases (January 1975–February 2019), yielding 6505 records. Thirty-five articles were selected meeting the following eligibility criteria: (1) systematic reviews or meta-analyses of (2) sleep health interventions in (3) primarily healthy populations. Two reviewers independently screened for inclusion, extracted the data, and assessed the review quality. This umbrella review was registered with PROSPERO (CRD42019126291). Eleven intervention types were defined, and their effectiveness discussed. Substantial evidence demonstrated the effectiveness of later school start times, behavior change methods, and mind–body exercise. Other intervention types, including sleep education or relaxation techniques, demonstrated some promising impacts on sleep, but with less consistent evidence. Results were limited by high heterogeneity between studies, mixed results, and variable review quality. Nevertheless, this umbrella review is a first step towards understanding the current state of sleep health promotion and gives an overview of interventions across the lifespan.

This position statement represents a consensus of an expert committee convened by the European Society of Endodontology (ESE) on the endodontic management of traumatized permanent teeth. A recent comprehensive review with detailed background information provides the basis for this position statement (Krastl et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13508). The statement is based on current scientific evidence as well as the expertise of the committee. Complementing the recently revised guidelines of the International Association of Dental Traumatology, this position statement aims to provide clinical guidance for the choice of the appropriate endodontic approach for traumatized permanent teeth. Given the dynamic nature of research in this area, this position statement will be updated at appropriate intervals.

Samoa has been struggling to address the burden of noncommunicable diseases at the health system, community and individual levels.The World Health Organization (WHO) package of essential noncommunicable disease interventions for primary health care in low-resource settings was adopted in seven villages throughout Samoa in 2015. The National Steering Committee Members designed and implemented a screening process, and local facilitators and health-care workers collected health and lifestyle data. The WHO/International Society of Hypertension risk assessment was used on villagers older than 40 years to identify people at high risk of noncommunicable disease.Samoa is a small island developing state with increasing morbidity and mortality due to noncommunicable diseases. A national representative survey indicated that 50.1% (595/1188) of the Samoan adult population is at high risk of such diseases. High numbers of noncommunicable diseases are undiagnosed or untreated, because of shortage of health-care staff and lack of awareness of risk factors.The teams collected data from 2234 adults. For people older than 40 years, 6.7% (54/804) were identified as being at high-risk and were encouraged to seek treatment or manage risk factors. Community members developed an awareness programme to improve understanding of lifestyle risk factors.Engaging community members was crucial in conducting a successful screening campaign. By identifying those villagers at high risk of developing noncommunicable diseases, early intervention was possible. Education improved awareness of the symptom-free nature of early-stage noncommunicable diseases.Les Samoa s'emploient à agir contre la charge que représentent les maladies non transmissibles aux niveaux du système de santé, de la communauté et des individus.L'ensemble d'interventions essentielles de l'Organisation mondiale de la Santé contre les maladies non transmissibles pour les soins de santé primaire dans les structures à faibles ressources a été adopté dans sept villages des Samoa en 2015. Les membres du Comité directeur national ont conçu et mis en œuvre un processus de dépistage, et des facilitateurs et prestataires de soins locaux ont collecté des données sur l'état de santé et le mode de vie. L'évaluation des risques de l'OMS/la Société internationale d'hypertension a été utilisée sur les villageois âgés de plus de 40 ans afin d'identifier les personnes exposées à un risque élevé de développer une maladie non transmissible.Les Samoa sont un petit État insulaire en développement qui affiche des taux croissants de morbidité et de mortalité liés à des maladies non transmissibles. Une enquête représentative à l'échelle nationale a indiqué que 50,1% (595/1188) de la population adulte des Samoa est exposée à un risque élevé de développer une maladie non transmissible. Un grand nombre de maladies non transmissibles ne sont pas diagnostiquées ou ne sont pas traitées en raison d'un manque de personnel de santé et de sensibilisation aux facteurs de risque.Les équipes ont collecté des données auprès de 2234 adultes. Dans les cas des personnes âgées de plus de 40 ans, 6,7% (54/804) ont été identifiées comme étant exposées à un risque élevé et encouragées à se faire soigner ou à maîtriser les facteurs de risque. Les membres de la communauté ont élaboré un programme de sensibilisation afin de mieux faire connaître les facteurs de risque liés au mode de vie.La participation des membres de la communauté s'est avérée essentielle pour mener une campagne de dépistage efficace. L'identification des villageois exposés à un risque élevé de développer une maladie non transmissible a permis une intervention précoce. La sensibilisation a permis de mieux faire connaître la nature asymptomatique des maladies non transmissibles à un stade précoce.Samoa se esfuerza por hacer frente a la carga de las enfermedades no contagiosas a nivel del sistema de salud, la comunidad y los individuos.En 2015 se aprobó en siete aldeas de Samoa el Conjunto de intervenciones esenciales de la Organización Mundial de la Salud (OMS) para las enfermedades no contagiosas para la atención primaria en entornos de bajos recursos. Los miembros del Comité Directivo Nacional diseñaron e implementaron un proceso de evaluación, mientras que los coordinadores locales y los trabajadores de la salud recopilaron datos sobre la salud y el estilo de vida. La evaluación del riesgo de hipertensión de la OMS/Sociedad Internacional de Hipertensión se utilizó en los aldeanos mayores de 40 años para identificar a las personas con un alto riesgo de padecer enfermedades no contagiosas.Samoa es un pequeño Estado insular en desarrollo con una incidencia cada vez mayor de morbilidad y mortalidad por enfermedades no contagiosas. Una encuesta nacional representativa indicó que el 50,1 % (595/1188) de la población adulta de Samoa tiene un alto riesgo de contraer tales enfermedades. Un elevado número de enfermedades no contagiosas no se diagnostican ni se tratan, debido a la escasez de personal médico y la falta de concienciación sobre los factores de riesgo.El equipo ha recopilado datos de 2234 adultos. Para las personas mayores de 40 años, se identificó que el 6,7 % (54/804) tenían un alto riesgo y se les animó a buscar tratamiento o controlar los factores de riesgo. Los miembros de la comunidad desarrollaron un programa de concienciación para mejorar la comprensión de los factores de riesgo en el estilo de vida.Involucrar a los miembros de la comunidad fue crucial para llevar a cabo una campaña de detección de éxito. Al identificar a los aldeanos que corren un mayor riesgo de contraer enfermedades no contagiosas, es posible la intervención temprana. La educación mejoró la concienciación sobre la ausencia de síntomas de las enfermedades no contagiosas en la fase inicial.ظلت ساموا تكافح للتعامل مع عبء الأمراض غير المعدية على مستوى النظام الصحي والمستوى المجتمعي والمستوى الفردي.تم اعتماد مجموعة منظمة الصحة العالمية للتدخلات الأساسية المتعلقة بالأمراض غير المعدية، والخاصة بالرعاية الصحية الأولية في البيئات منخفضة الموارد في سبع قرى في ساموا في عام 2015. وقام أعضاء اللجنة التوجيهية الوطنية بتصميم وتنفيذ عملية فرز، كما قام المسؤولون المحليون وعمال الرعاية الصحية بجمع البيانات الصحية وبيانات نمط الحياة. تم استخدام تقييم المخاطر الخاص بمنظمة الصحة العالمية/الجمعية الدولية لمخاطر ارتفاع ضغط الدم، على القرويين الذين تزيد أعمارهم عن 40 عامًا لتحديد الأشخاص المعرضين لمخاطر عالية من الأمراض غير المعدية.ساموا هي دولة نامية عبارة عن جزيرة صغيرة مع تزايد حالات الإصابة بالأمراض والوفيات الناجمة عن الأمراض غير المعدية. وأظهر مسح تمثيلي وطني أن 50.1٪ (595/1188) من السكان البالغين في ساموا معرضون لمخاطر عالية من مثل هذه الأمراض. هناك عدد كبير من الأمراض غير المعدية غير المشخصة أو غير المعالجة، بسبب نقص العاملين في مجال الرعاية الصحية وقلة الوعي بعوامل الخطر.قامت الفرق بجمع البيانات من 2234 بالغًا. بالنسبة للأشخاص الذين تزيد أعمارهم عن 40 عامًا، تم تحديد 6.7٪ (54/804) منهم على أنهم معرضون في خطر كبير وتم تشجيعهم على طلب العلاج أو إدارة عوامل الخطر. قام أعضاء المجتمع بتطوير برنامج للتوعية لتحسين فهم عوامل مخاطر نمط الحياة.كان إشراك أفراد المجتمع أمرًا حاسمًا في إجراء حملة فرز ناجحة. من خلال التعرف على هؤلاء القرويين المعرضين لخطر كبير للإصابة بالأمراض غير المعدية، كان التدخل المبكر ممكناً. أدى التعليم لتحسين الوعي بطبيعة الأمراض غير المعدية في المراحل المبكرة، والتي تخلو من الأعراض.萨摩亚一直致力于解决非传染性疾病在社区和个体层面的卫生系统中的负担。.针对资源匮乏地区初级卫生保健的世界卫生组织非传染性疾病基本干预服务包于 2015 年在萨摩亚全国范围内的 7 个村庄中应用。国家指导委员会成员设计并实施了筛查过程，当地协调员和医护人员搜集了卫生和生活方式的相关数据。对 40 岁以上的村民进行世界卫生组织/国际高血压协会风险评估，以确定高风险非传染性疾病患者。.萨摩亚是一个小岛国，是发展中国家，其非传染性疾病发病率和死亡率持续增长。一项全国代表性调查表明，萨摩亚 50.1% (595/1188) 的成人患有高风险非传染性疾病。很多非传染性疾病患者由于缺少医护人员且自身缺乏风险因素意识，未能接受诊断或治疗。.团队收集了 2234 名成人的数据。40 岁以上的人群中有 6.7% (54/804) 经确认患有高风险疾病，并鼓励他们寻求治疗或管理风险因素。社区成员开发了一项认知计划，以增强人们对生活方式相关风险因素的理解。.鼓励社区成员的参与对于成功实施筛查活动来说至关重要。确定患高风险非传染性疾病的村民后，早期干预成为可能。教育增强了人们对非传染性疾病早期无症状性质的认知。.Самоа прилагает все усилия для решения проблемы неинфекционных заболеваний на уровне системы здравоохранения, сообществ и отдельных лиц.В 2015 году в семи деревнях на территории Самоа был внедрен пакет основных мероприятий по борьбе с неинфекционными заболеваниями Всемирной организации здравоохранения (ВОЗ) для оказания первичной медико-санитарной помощи в условиях нехватки ресурсов. Члены сообществ разработали и внедрили процесс скринингового обследования, а местные координаторы и работники здравоохранения собрали данные о здоровье и образе жизни. Для выявления среди сельских жителей старше 40 лет людей с высоким риском неинфекционных заболеваний использовалась оценка риска ВОЗ или Международного общества по гипертензии.Самоа — это небольшое островное развивающееся государство с растущей заболеваемостью и смертностью от неинфекционных заболеваний. Национальное репрезентативное исследование показало, что 50,1% (595/1188) взрослого населения Самоа подвергается высокому риску таких заболеваний. Из-за нехватки медицинского персонала и недостаточной осведомленности о факторах риска при большинстве случаев неинфекционных заболеваний не проводится диагностика или лечение.Члены сообществ собрали данные от 2234 взрослых. Среди людей старше 40 лет 6,7% (54/804) были отнесены в группу высокого риска, и им было рекомендовано обратиться за лечением или следить за факторами риска. Члены сообществ разработали программу по повышению осведомленности о факторах риска, связанных с образом жизни.Привлечение членов сообществ имело решающее значение для успешного проведения кампании по использованию скринингового обследования. Выявление среди сельских жителей людей с высоким риском развития неинфекционных заболеваний способствовало более раннему вмешательству. Информирование повысило осведомленность о бессимптомном характере протекания неинфекционных заболеваний на ранней стадии.

Background Samoa is suffering from alarming rates of noncommunicable diseases (NCDs). To address this epidemic, tackling health literacy is important. A qualitative study was conducted with the aim to explore health literacy in Samoa in relation to NCDs. Methods Six focus groups were conducted, with a total sample size of 73 participants aged over 18 years. The semi-structured interview guide was based on the conceptual model of the European Health Literacy project (HLS-EU). Data was translated, transcribed, coded, and categorized as part of the qualitative analysis. Results The analysis resulted in one overarching category and seven sub-categories based on 19 themes. It revealed that health literacy in Samoa is strongly influenced by the culture. Personal responsibility is lacking. The family circle is central to health in a community where support is provided through the church and local groupings. Basic knowledge of NCDs was present in the population, but a deeper understanding of chronic disease implications was lacking. Difficulties with regards to medication adherence for chronic diseases arose as a topic, and traditional healers are still strongly embedded in the local society. Finally, the health system’s performance, especially primary care services at the local level, is suffering from the high burden of NCDs and has been challenged to respond to the needs of the community it serves. Conclusion The findings of this study show how health literacy in Samoa is influenced by culture and suggest employing participatory, culture-sensitive, public health interventions which address the family as a whole, building on health literacy to address major public health problems like NCDs and remove barriers in the health system.

Introduction. The antiphospholipid syndrome (APS) is defined by the occurrence of venous and/or arterial thrombosis and/or pregnancy-related morbidity, combined with the presence of antiphospholipid antibodies (aPL) and/or a lupus anticoagulant (LAC). Large, controlled, intervention trials in APS are limited. This paper aims to provide clinicians with an expert consensus on the management of APS. Methods. Relevant papers were identified by literature search. Statements on diagnostics and treatment were extracted. During two consensus meetings, statements were discussed, followed by a Delphi procedure. Subsequently, a final paper was written. Results. Diagnosis of APS includes the combination of thrombotic events and presence of aPL. Risk stratification on an individual base remains challenging. 'Triple positive' patients have highest risk of recurrent thrombosis. aPL titres > 99th percentile should be considered positive. No gold standard exists for aPL testing; guidance on assay characteristics as formulated by the International Society on Thrombosis and Haemostasis should be followed. Treatment with vitamin K-antagonists (VKA) with INR 2.0 -3.0 is first-line treatment for a first or recurrent APS-related venous thrombotic event. Patients with first arterial thrombosis should be treated with clopidogrel or VKA with target INR 2.0-3.0. Treatment with direct oral anticoagulants is not recommended. Patients with catastrophic APS, recurrent thrombotic events or recurrent pregnancy morbidity should be referred to an expert centre. Conclusion. This consensus paper fills the gap between evidence-based medicine and daily clinical practice for the care of APS patients.

Obesity is a serious public health concern in the Gulf States. Students are exposed to many unhealthy weight-related behaviors due to college life. However, research that gives insight into regional and culture-specific aspects and determinants of weight-related behaviors in students is lacking. The purpose of this study was to explore the potential determinants of weight change, eating behaviors, physical activity, sedentary behaviors, and sleep behaviors in Saudi university students. Five semi-structured focus group discussions guided by Social Cognitive Theory were conducted, consisting of 33 male university students 20 to 22 years old. The data were transcribed, coded, and organized according to themes. The students reported weight gain due to personal, social, and environmental factors related to university lifestyle, such as unhealthy eating behaviors, low physical activity, high sedentary behaviors, and inadequate sleep. Both eating behaviors and physical activity shared similar personal aspects found in other studies, such as knowledge, stress, lack of time, and lack of motivation. However, there were some unique social and environmental factors in the region, such as the social norms, cultural aspects, weather conditions, passive transport dependency, and khat consumption, compared with studies worldwide. Such differences are key factors to developing effective interventions in the future.

A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit attitudes and behaviors. Fifty four papers were identified. The analysis revealed that (primarily European or US) research interest has been relatively recent. Certain food issues were of greater interest to researchers than others, perhaps reflecting the occurrence of a crisis, or policy concern. Three broad themes relevant to the development of best practice in risk (benefit) communication were identified: the characteristics of the target population; the contents of the information; and the characteristics of the information sources. Within these themes, independent and dependent variables differed considerably. Overall, acute risk (benefit) communication will require advances in communication process whereas chronic communication needs to identify audience requirements. Both citizen's risk/benefit perceptions and (if relevant) related behaviors need to be taken into account, and recommendations for behavioral change need to be concrete and actionable. The application of theoretical frameworks to the study of risk (benefit) communication was infrequent, and developing predictive models of effective risk (benefit) communication may be contingent on improved theoretical perspectives., Critical Reviews in Food Science and Nutrition, 56 (10), ISSN:1040-8398, ISSN:1549-7852