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With the rise of Internet of Things (IoT) technology, the seamless connection between the physical and digital worlds has been realized. This review paper aims to conduct a science mapping review of IoT applications in industrial management and to identify mainstream research topics, research gaps, and future research directions. Using VOSviewer as a visualization tool, 142 articles retrieved from the Scopus database were quantitatively discussed using scientometric analysis. Additionally, a follow-up qualitative discussion was focused on mainstream research topics, existing research gaps, and future research directions as the main research goals. The results revealed influential findings for the co-occurrence of keywords, journals, countries, authors, and documents analyses. Moreover, it was found that the existing research mainly focused on four main research topics including (1) application of IoT in manufacturing based on cyber-physical systems, (2) IoT-related technologies on logistics and supply chain management, (3) The impact of IoT on business models, and (4) Industrial IoT (IIoT) in the context of Industry 4.0. On this basis, the existing research gaps and future research directions are proposed. This review paper would help relevant practitioners and researchers to better understand the existing body of knowledge and lay the foundation for further research. [ABSTRACT FROM AUTHOR]

Society has shifted to bandwidth intensive internet use to protect public health, sustain economic participation and educational attainment, and support critical infrastructure services. This shift made robust, open, broad-based internet network (ROBIN) access essential to public safety and societal resilience. This Article examines Internet Service Provider (ISP) throttling policies, an underexplored area of the digital divide, net neutrality, and consumer protection legal and policy debate. Many ISPs use contract terms and software to slow users to 2G speeds, more commonly used in the early 1990s, after internet use commensurate with a few days or a week or two of digital work or school. The difference between open internet access and throttled access is the ability to access school, work, or a telemedicine appointment through videoconferencing platforms and other applications. This Article theorizes infrastructure law and policy as a legal superstructure that either reifies vulnerability and inequity or, if constructed differently, supports equity and technology justice. To build the legal architecture necessary to foster ROBIN access critical to education, health, economic, and civic opportunities, this Article calls for Federal Communications Commission (FCC) and Federal Trade Commission (FTC) examination of ISP throttling policies and disclosures. It calls on ISPs, as part of their commitments to diversity, inclusion, and equity, to drop the practice of throttling users to speeds that make contemporary internet uses unavailable. It argues that stemming ISP throttling is critical to equity, opportunity, public health, and public safety. [ABSTRACT FROM AUTHOR]

Smart transportation relies on data collection, transmission, processing, and release, involving various terminal devices, control systems, central platforms, and communication links, so its control process is more complicated. In order to improve the operation efficiency of the intelligent traffic control system, based on the open Internet of Things and machine learning, this paper builds an intelligent three-way intelligent traffic control system, sets various parameters, and builds a simulation model using cellular automata as a platform. Moreover, in order to study the performance of the model, the model constructed in this paper is compared with the model of the traditional road traffic control system. In addition, this paper analyzes the model constructed in this paper through the statistics of the highest vehicle flow on the road and the relationship between road occupancy and vehicle speed. The research results show that the model constructed in this paper has good performance and can be applied to intelligent traffic control. [ABSTRACT FROM AUTHOR]

This study seeks to explain how Chinese state media bolster the use of visions in global internet governance. The empirical data for the article consist of 1,158 internet-related articles published in the Global Times between 2009 and 2018. I develop a theoretical perspective that distinguishes between grand and strategic narratives. Based on a mixed-methods approach, I show that "internet sovereignty" has qualified as a grand narrative since the second half of 2013. State media facilitate this shift with strategic narratives that push the content and context of "internet sovereignty" from domestic political rationales towards a matter of global affairs. The article contributes to theoretical and methodological advancement in textual analysis. [ABSTRACT FROM AUTHOR]

Copyright of Cuadernos Europeos de Deusto is the property of Universidad de Deusto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Sprachreport is the property of Institut fuer Deutsche Sprache and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Has net neutrality been institutionalized as a fundamental right in the digital constitution? Empirical evidence shows that statutory embedding of net neutrality has recently been taking shape in certain jurisdictions. The unfolding of constitutional structures and processes--the next step to be expected according to the theory of societal constitutionalism--is still pending. What would the scope of protection of net neutrality be if institutionalized as a fundamental right? To answer this normative question, two theoretically challenging issues must be addressed as a preliminary: First, what should be the adequate conceptualization of the relationship between the social and the technological? The perspective adopted by this paper is a combination between science and technology studies scholarship and legal sociology literature. Second, as net neutrality involves relationships between private parties, the question is how fundamental rights should be conceived beyond state-centrism. Methodologically, the sociological reflection of fundamental rights as institutions of society will serve as a benchmark for evaluating future developments of constitutional legal doctrine. [ABSTRACT FROM AUTHOR]

This lacklustre performance belies a history of significant internet entrepreneurs who pioneered UK ecommerce (Archives IT, [3]) and UK internet engineers whose fundamental contributions help make the internet that we know today (Kirstein, [12]). NN regulation is frequently proffered as a notion that all internet data is equal and, as such, flat-rate broadband packages based on internet speed are the most fair and equitable way to offer broadband to consumers, presumably to maximise the data from all possible points of the internet. HOW NN REGULATION HARMED INNOVATORS The largest US internet companies were founded well before NN regulation was framed and had already globalised by the time rules were imposed in 2015. [Extracted from the article]

The modern internet is vast, with more than 2.5 quintillion bytes of data created every day. Content is created, uploaded, downloaded, and shared across an increasingly large number of platforms. Most of this content is legal; however, some is illegal, including hate speech, child sexual abuse material, and content that violates intellectual property rights. Section 230 of the Communications Decency Act ("CDA") provides that websites are not liable for content posted to their platform by third parties. Instead, websites determine their own content moderation policies, and the law assumes that they will do just that (given that exposure to graphic or otherwise upsetting content deters the average user). This approach has been largely successful, but there are growing concerns about a proliferation of child sexual abuse material and sex trafficking content, and whether platforms are doing enough to prevent the spread of illegal content online. Adult content websites such as Pornhub and OnlyFans, which are hosts to legal pornography in addition to illegal content, have been a primary target of this concern. Congress's attempts to legislate the issue have been ineffective: FOSTA-SESTA, passed in 2018, created an exception to § 230's blanket grant of immunity for sex trafficking content, but has not been used in any prosecutions to date. Instead, private companies--most frequently, payment processors like Visa, Mastercard, and PayPal--are making decisions regarding vice and illegal content. In practice, this has involved shutting down payments to a website until the platform agrees to comply with the payment processor's policies regarding content moderation and verification. While technically effective for victims of illegal content, this approach entails the mass disenfranchisement of legal sex workers. This Note proposes a reconsideration of § 230's blanket grant of immunity through a statutory revision resembling the Digital Millennium Copyright Act. The Act implements a notice-and-takedown model for copyright infringement, and a statutory revision to § 230 could do the same for illegal content. The notice-and-takedown model creates a content moderation strategy that prevents the rapid dissemination of illegal content. This Note argues that a notice-and-takedown model of liability for illegal content would respond to the needs of both victims and platforms without undermining the foundations of the free and open internet or disenfranchising legal sex workers. [ABSTRACT FROM AUTHOR]

Crowdsourcing is a relatively inexpensive and efficient mechanism to collect annotations of data from the open Internet. Crowdsourcing workers are paid for the provided annotations, but the task requester usually has a limited budget. It is desirable to wisely assign the appropriate task to the right workers, so the overall annotation quality is maximized while the cost is reduced. In this article, we propose a novel task assignment strategy (CrowdWT) to capture the complex interactions between tasks and workers, and properly assign tasks to workers. CrowdWT first develops a Worker Bias Model (WBM) to jointly model the worker's bias, the ground truths of tasks, and the task features. WBM constructs a mapping between task features and worker annotations to dynamically assign the task to a group of workers, who are more likely to give correct annotations for the task. CrowdWT further introduces a Task Difficulty Model (TDM), which builds a Kernel ridge regressor based on task features to quantify the intrinsic difficulty of tasks and thus to assign the difficult tasks to more reliable workers. Finally, CrowdWT combines WBM and TDM into a unified model to dynamically assign tasks to a group of workers and recall more reliable and even expert workers to annotate the difficult tasks. Our experimental results on two real-world datasets and two semi-synthetic datasets show that CrowdWT achieves high-quality answers within a limited budget, and has the best performance against competitive methods. [ABSTRACT FROM AUTHOR]

The history of relations between the European Union and China represents an endless source of diverse analytic approaches and possibilities of creating appropriate evaluations and projections based on historical and actual happenings that concerns both analyzed subjects. Various literature depending on the sources and affiliation of the authors points out to the different approach in the analysis of the historical retrospective of the relations between the European Union and China which covers different scientific fields from politics, geopolitics, geostrategic to possibly the most important economic premises on their continuous process of cooperation. The main thesis in the whole research efforts divided in two papers is related with the question could EU and China be strategic partners and contribute in the creation of a constructive world order? The research in this paper is done based on the overall available literature which the authors could gather. Initially, accessing to the open Internet resources and as well as the official websites of the European Union and China. Consequently, sources of official media portals and analytical centers were used in the research. The entire material is analyzed with an appropriate methodological framework whereupon the obtained results represent an original scientific effort. [ABSTRACT FROM AUTHOR]

To successfully learn using open Internet resources, students must be able to critically search, evaluate and select online information , and verify sources. Defined as critical online reasoning (COR), this construct is operationalized on two levels in our study: (1) the student level using the newly developed Critical Online Reasoning Assessment (CORA), and (2) the online information processing level using event log data, including gaze durations and fixations. The written responses of 32 students for one CORA task were scored by three independent raters. The resulting score was operationalized as "task performance," whereas the gaze fixations and durations were defined as indicators of "process performance." Following a person-oriented approach, we conducted a process mining (PM) analysis, as well as a latent class analysis (LCA) to test whether—following the dual-process theory—the undergraduates could be distinguished into two groups based on both their process and task performance. Using PM, the process performance of all 32 students was visualized and compared, indicating two distinct response process patterns. One group of students (11), defined as "strategic information processers," processed online information more comprehensively, as well as more efficiently, which was also reflected in their higher task scores. In contrast, the distributions of the process performance variables for the other group (21), defined as "avoidance information processers," indicated a poorer process performance, which was also reflected in their lower task scores. In the LCA, where two student groups were empirically distinguished by combining the process performance indicators and the task score as a joint discriminant criterion, we confirmed these two COR profiles, which were reflected in high vs. low process and task performances. The estimated parameters indicated that high-performing students were significantly more efficient at conducting strategic information processing, as reflected in their higher process performance. These findings are so far based on quantitative analyses using event log data. To enable a more differentiated analysis of students' visual attention dynamics, more in-depth qualitative research of the identified student profiles in terms of COR will be required. [ABSTRACT FROM AUTHOR]

With more and more color images are spread and shared in the untrusted cloud server remotely over the open Internet, some private or confidential information may be contained, it is necessary to develop cryptosystem for these images to free from serious threats. This paper investigates a secure and robust cryptosystem for color image based on discrete trinion Fourier transform and random-multiresolution singular value decomposition. Firstly, a color image is represented into a trinion matrix by precoding and followed by block-wise discrete trinion Fourier transform. Then a mapping from trinion number domain to real number domain is implemented to facilitate random-multiresolution singular value decomposition. To further enhance the randomness of the transformed data, the scrambling based on chaotic sequence is applied to obtain the cipherimage. Experimental results have demonstrated that the proposed color image encryption algorithm is feasible. The adoption of logistic map ensures that the proposed cryptosystem attains high level security. Furthermore, the quality of the retrieved image is better than that of the algorithm based on single color channel processing separately and quaternion matrix based algorithms when it is decrypted correctly or under Gaussian noise and shear attacks. Moreover, employing a trinion matrix to represent a color image is more compact than using quaternion matrix. It would have potential applications in digital image protection. [ABSTRACT FROM AUTHOR]

The article offers information on regulation of the European Parliament and of the Council on November 25, 2015 laying down measures concerning open internet access and amending Directive on universal service and users' rights relating to electronic communications networks. Topics include roaming on public mobile communications networks within the Union must be interpreted as meaning that packages, and the purchase a tariff entitling them to use a specific volume of data without restriction.

This article tackles the problem of detecting and solving potential conflicts among independently developed apps that are to be installed into an open Internet-of-Things (IoT) environment. It provides a new set of definitions and categorizations of the conflicts to more precisely characterize the nature of the problem, and it proposes a representation named "IA Graphs" for formally representing IoT controls and inter-app interplays. Based on the definitions and representation, it then describes an efficient conflict detection algorithm. Combining conflict categories, seriousness indicator, and conflict frequency, an innovative solution policy for solving various detected conflicts is developed, which also takes into account user preference and interest by providing interactive process. It implements a compiler and runtime software system that integrates all the proposed techniques together into a comprehensive solution. Experiments on SmartThings apps validate its significantly better detection efficacy over prior methods and effectiveness of conflict solution with user preference. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to define the main success factors of distance learning at high education institutions and explaining some of the challenges that students are faced with distance learning at Al-Aqsa University. Design/methodology/approach: A qualitative study was applied involving interviews and focus group discussion with students with analysing of documents of learning management system at Al-Aqsa University. Findings & Recommendations: This research is exploratory in nature. Findings of the study expects to improve our understanding of student to support in distance learning, in which analysis is based on good practices and challenges for improvement of Al-Aqsa University. From the interview results, the key success factors of distance learning at high education institutions during COVID-19 pandemic are (1-Course Design 2- The Quality of E-learning 3- Interaction & Communication 4- Diversity of Learning Sources 5- Supporting The learners). The study recommended to 1) obtaining qualification to deal with e-learning environments.2) Adjust recorded lectures in terms of reducing time, reducing knowledge and focusing on what is important. 3) Support students with open internet packages in consideration of their financial circumstances and using SMS in e-learning Practical implications: Findings of this study will reveal success factors and challenges based on practices and lessons learnt which is useful as reference to universities, taking into considerations the fact that each university has not been established to address specific challenges in its own unique circumstances as COVID 19. Originality/value: This research is adopted as baseline framework for analysis of student support for universities. Further in-depth study is needed to understand how various aspects of student support contribute to success in distance learning. [ABSTRACT FROM AUTHOR]

Copyright of Veterinaria is the property of University of Sarajevo, Veterinary Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Digital dissemination of public-domain works of historic, literary, and artistic value increases the intellectual value of those materials; repositories that license digitization rights to commercial agencies should seek the greatest possible availability for these works on the open Internet. As with copyright law, a balance must be struck between society's legitimate interest in maximizing access to and use of the work and society's equally legitimate interest in encouraging capital investment in digitization, dissemination, and long-term sustainability. This paper proposes that the open-access movement and efforts to "reclaim the public domain" provide a theoretical framework for evaluating prospective partnerships between non-profit repositories and commercial digital publishers, and recommends practical guidelines for developing digitization contracts that both uphold the value of the public domain and meet the needs of the marketplace. [ABSTRACT FROM AUTHOR]

What can we tell library funders who believe subscriptions can be cancelled because everything is on the Web for free? Specifically, how does the open Internet compare with proprietary online services as a research tool? Tenopir presents answers offered by representatives of Lexis-Nexis and Factiva (Dow Jones & Reuters), and cites the results of the “Internet Search-Off.” She concludes that both Internet and traditional online services must be used to offer complete information services. [ABSTRACT FROM PUBLISHER]

A new open-source, web-based, configurable data visualization platform is presented that is specifically designed to support large-scale transportation simulations including MATSim and ActivitySim. It produces a wide array of interactive charts, maps, animations and analysis dashboards that are generally useful in the transportation domain. Interactive visualizations can be created and viewed locally on an analyst's laptop, or public web-based dashboards can be published for viewing on the open Internet. The details of software design are provided along with several examples of implementation at public agencies. User feedback shows the platform is found to be very flexible, while the straightforward configuration approach enables efficient development and deployment of web-based interactive visualizations. While it is not intended to replace geographic information systems or commercial software packages, the smaller curated set of capabilities is found by users to warrant its current adoption at several public agencies. Further work is needed to add more useful features, improve the platform's quality and user experience, and extend documentation. [ABSTRACT FROM AUTHOR]

The article discusess the net neutrality rules enacted by the Federal Communications Commission in the U.S. Topics discussed include engagement of companies in zero rating model by broadband provides; distorting competition through the exercise of monopoly power, along with ongoing debate on consumer benefit; and enactment of Communications Act for addressing the same.

Background: It is now recognized that many patients have persistent symptoms after recovery from acute COVID-19 infection, an infection caused by the coronavirus SARS-CoV-2. This constellation of symptoms known as 'Long COVID' may manifest with a wide range of physical and cognitive/psychological symptoms. Few data are available on the prevalence, attributes, and factors associated with Long COVID in Africa. Method: This was a retrospective review of patients' electronic medical records from Hallelujah General Hospital (one of the first private hospitals to treat COVID-19 patients). The hospital's database was searched for patients hospitalized for acute COVID-19 infection from March 2020 to December 2022. Two hundred and forty-seven participants who underwent follow-up beginning four weeks after symptom onset were assessed for Long COVID. Admission and follow-up data were collected using Kobo Toolbox and exported into SPSS 27 for analysis. The relationship between the independent and dependent variables was explored through binary logistic regression. Results: One hundred seventy-eight (72.1%) participants had at least one persisting symptom 4 weeks post-symptom onset, at a median follow-up time of 35 (IQR 32–40) days. The most frequently reported symptoms were fatigue (41.7%), shortness of breath (31.2%), cough (27.1%), and sleep disturbances (15%). Duration of symptoms more than 7 days before admission [aOR = 1.97; CI95% = 1.04 to 3.75; P = 0.038] and length of stay more than 10 days in the hospital [aOR = 2.62; CI95% = 1.20 to 5.72; P = 0.016] were found to be significantly associated with Long COVID. Conclusion: There is a high prevalence of Long COVID among patients hospitalized for acute COVID-19. Those who had a longer duration of symptoms before admission and a longer stay in the hospital appear to have a higher risk. [ABSTRACT FROM AUTHOR]

Time-restricted eating (TRE) is a promising and cost-effective dietary approach for weight management. This study aimed to evaluate the effects of TRE on weight loss in three adult populations using pre- and post-intervention analyses while also investigating its underlying mechanism. A systematic search was conducted across four databases (PubMed, Web of Science, Scopus, and the CENTRAL) up until January 28, 2024, specifically focusing on prospective studies that examined the efficacy of TRE in achieving weight loss. A random effects model was employed to conduct meta-analyses, while heterogeneity was assessed using the I2 statistic (PROSPERO: CRD42023439317). The study encompassed 36 selected studies involving 44 effect sizes and 914 participants. The effectiveness of the TRE was found to vary across health conditions, with modest weight loss observed in healthy individuals (pooled effect size -1.04 Kg, 95% CI: -1.42 to -0.65) and more significant weight reduction seen in participants with chronic diseases (pooled effect size -3.33 Kg, 95% CI: -5.05 to -1.62) and overweight/obesity (pooled effect size -4.21 Kg, 95% CI: -5.23 to -3.10). The observed decrease in body weight could be partially attributed to factors influencing energy balance, as evidenced by the significantly lower mean calorie intake at the end of the intervention (1694.71 kcal/day, 95% CI: 1498.57–1890.85) compared to the baseline intake (2000.64 kcal/day, 95% CI: 1830–2172.98), despite the absence of intentional efforts to restrict energy intake by the participants. These findings support the efficacy of this lifestyle intervention for weight loss maintenance and guide the development of its clinical guidelines. [ABSTRACT FROM AUTHOR]

Aim: Chronic Kidney Disease (CKD) has emerged as a global public health concern. People with the most advanced stage of CKD require renal replacement therapies, either dialysis (the focus of this study) or a kidney transplant. Research on CKD has primarily focused on its clinical, epidemiological, and public health aspects. However, studies exploring the lived experiences of individuals on dialysis and the key factors influencing these experiences are limited, particularly in low- and middle-income settings. Therefore, this study aims to synthesize the existing literature on the illness experience of people living with CKD who are on maintenance dialysis across different country contexts. Methods: Adhering to PRISMA and PiCO guidelines for systematic review, we identified original studies published between 2000 and 2024, focusing on the lived experience of patients with CKD on dialysis, across PubMed, Web of Science, and Scopus databases. A thematic analysis was conducted based on two frameworks: Michael Bury's biographical disruption model of chronic illness, and the framework on internal and external factors affecting self-care. Results: A total of 59 studies were included, and the following key themes were identified: 1) disrupted biographies among people on dialysis, which included: (a) diagnosis and initiation of dialysis, (b) disabling physical symptoms and functional limitations, (c) impaired socio-occupational functioning, (d) uncertainty and psychological distress, and (e) changes in self-image and identity; and 2) biographical repair, which included: (a) coping with CKD and dialysis, (b) coping styles, and (c) coping strategies. The key internal factors influencing the lived experiences were personal beliefs and misconceptions about CKD, feelings of shame and guilt, financial constraints, and spirituality. The external factors included family and social support, information and treatment received from the clinical team, social stigma, availability and quality of dialysis services, and access to health insurance. Conclusions: This review deepens our understanding of the lived experiences of individuals undergoing maintenance dialysis across diverse settings and illuminates the internal and external factors that shape these experiences. Our findings emphasize the necessity of a holistic and person-centred approach to dialysis care and highlight the need to make dialysis services more accessible and affordable in low- and lower-middle-income countries. [ABSTRACT FROM AUTHOR]

Background: Historically, eating disorder (ED) research has largely focused on White girls and women, with minority ethnic populations underrepresented. Most research exploring EDs in minority ethnic populations has been conducted in the United States (US). The aim of this scoping review, the first of its kind, was to systematically examine research on disordered eating and EDs among minority ethnic populations in Australia, Canada, Aotearoa New Zealand and the United Kingdom (UK), four countries with shared sociocultural and healthcare characteristics. An inequity lens was applied to highlight gaps in research, access, and treatment experiences. Method: Five databases (Medline, Embase, PsycINFO, CINHAL and Web of Science) were searched up to March 7, 2024. Two independent reviewers screened titles and abstracts and full texts against eligibility criteria resulting in the inclusion of 87 records (76 peer-reviewed articles and 11 theses). Included studies were charted according to their focus, study design, sample characteristics and findings, with a particular focus placed on prevalence, access to treatment and treatment experience. Results: The majority of identified studies were conducted in the UK (61%, 53 studies). There was a notable lack of studies investigating assessment, diagnosis and intervention. Methodologies varied, though most studies utilised cross-sectional survey designs. Most samples were non-clinical, exclusively or predominantly girls and women, and focused on adolescents and young adults. Asian populations were the most frequently studied minority ethnic group. Understanding of prevalence and treatment experience amongst minority ethnic groups was limited. Conclusion: There is a need for further research addressing inequities in ED prevalence, service access, and treatment experiences among minority ethnic and Indigenous groups, especially in Australia, Canada and Aotearoa New Zealand. Improved ethnicity data collection and culturally sensitive approaches to assessment, diagnosis and treatment are essential. Recommendations for future research and clinical practice are provided. Plain English Summary: More research exploring disordered eating and eating disorders (EDs) in minority ethnic groups is needed outside of the United States (US), where most research has been conducted. We conducted a scoping review to identify studies examining disordered eating and EDs in minority ethnic individuals in Australia, Canada, Aotearoa New Zealand and the United Kingdom (UK). A particular focus was placed on studies which explored prevalence, access to treatment and treatment experiences. We searched five academic databases and screened resulted against inclusion criteria, identifying 87 records (76 peer-reviewed articles and 11 theses). Data on the study focus, design, methods, sample characteristics and findings were extracted. Most studies (61%) were conducted in the UK. The topics covered by studies varied and a wide range of methods were used. Samples were typically non-clinical populations and mostly young girls and women. Asian populations were the minority ethnic group most frequently included in studies. Understanding of prevalence and treatment experience amongst minority ethnic groups was limited. There is a need for further research with underrepresented groups, especially to better understand how these groups access ED services and experience the treatment delivered by services. Efforts to improve the collection and reporting of ethnicity data are also required. [ABSTRACT FROM AUTHOR]

Cataracts are significant causes of blindness, closely linked to prolonged hypercholesterolemia. While saffron has the potential for eye health, its effects on lens lesions remain understudied. This study aimed to investigate the effect of saffron on the lens changes in atherosclerotic-induced New Zealand white rabbits (NZWR). Thirty-five NZWRs were subjected to four to eight weeks of high-cholesterol diet to induce atherosclerosis, resulting in cataractous lens changes. The rabbits were categorised randomly into three groups: normal diet group, pre-treated group and treated group. The pre-treated group was divided into early atherosclerosis(HC4) and established atherosclerosis (HC8). The saffron-treated group was fed with the HCD diet followed by saffron treatment of 50mg/kg/day (TG450, TG840) and 100mg/kg/day (TG4100, TG8100) of saffron ethanolic extract (SEE) respectively. The normal diet group was given a normal diet over the 8 weeks. After completing the 16-week experimental protocol, the NZWR were euthanized, and their lenses were extracted for histopathological evaluation. The pre-treated group exhibited cataractous lens changes of grade 2, characterized by increased homogenisation, swollen lens fibers, and intracellular vacuolisation. Interestingly, these cataract changes showed a positive trend from grade 2 to grade 1 post-treatment with SEE. In the saffron-treated group, vacuoles and pinkish homogenised areas were reduced. Additionally, a uniform layer of anterior epithelium and decreased non-swollen lens fibers indicated significant cataract lesion improvement. The normal diet group displayed minimal to zero cataractous changes (Grade 0). HPLC analysis demonstrated the presence of crocin, crocetin, and picocrocin in the saffron ethanolic extract, with peak absorptions at 440nm (12.817min), 440nm (1.620min), and 254nm (6.553min) respectively. The phytochemical screening of saffron ethanolic extract was conducted and showed the presence of phytochemical compounds including saponins, flavonoids, tannins, and steroids. The positive effects on lenses in the TG groups could be due to crocin and crocetin, bioactive components of saffron, and its phytochemical compounds. This study highlights saffron's potential in managing cataract-induced conditions, emphasizing the importance of further research for its full therapeutic potential in cataract management. [ABSTRACT FROM AUTHOR]

Background: Rigorous population-based assessments of the use of specialty palliative care (SPC) in the US are rare. Settings/subjects: This study examined SPC use among cancer patients in a mid-sized metropolitan area in Southeast US. Measurements: In this cancer decedent cohort study, data were acquired and linked from the state-wide cancer registry; state-wide hospital discharge dataset; and local SPC providers. Results: 12,030 individuals with cancer were included in this study; only 2,958 (24.6%) used SPC. Of the 9,072 persons who did not use SPC, 3,877 (42.7%) went only to hospitals that did not offer SPC; and 3,517 (38.8%) went to hospitals that offered SPC but did not use it. About half of SPC recipients (1493; 50.5%) first received SPC in the final 30 days of life, including 768 (26.0%) in the final week of life. Characteristics associated with using SPC use included being in an socio-economic status quintile other than the lowest; being younger; being Black; having a solid (versus hematological) cancer; having a shorter survival with cancer; dying in the latter two years of the study; being from an area of low or complete rurality; having a hospital admission in the final 60 days prior to initiation of PC or death; having more days in hospital; and living within 15 miles of a hospital offering SPC. Conclusions: In this population-based study, only one-quarter of cancer patients used SPC, and for half who did so, it came in the final 30 days of life. [ABSTRACT FROM AUTHOR]

Introduction: Effective antimicrobial stewardship programs require data on antimicrobial consumption (AMC) and utilization (AMU) to guide interventions. However, such data is often scarce in low-resource settings. We describe the consumption and utilization of antibiotics at a large tertiary-level hospital in Uganda. Methods: In this cross-sectional study at Kiruddu National Referral Hospital, we analyzed medicine delivery records for the period July 2021 to June 2022, accessed on 12/08/2022, to extract AMC data expressed as defined daily doses (DDDs) per 1000 inhabitants per day (DID). We used the WHO point prevalence survey (PPS) to analyze AMU data with a systematic sampling of outpatient department (OPD) for a period between June and August 2022 and selected all inpatient department (IPD) patients admitted before 8:00 AM on 27/11/2022. AMU data was analyzed as the proportion of individual antibiotic prescriptions, indications for prescriptions, and compliance with the national treatment guidelines. Both AMC and AMU data were categorized by the WHO AWaRe (access, watch, and reserve) criteria. Results: In the year 2021–2022, a total of 6.05 DID of antibiotics were consumed comprising 3.61 DID (59.6%) access, 2.44 DID (40.3%) watch, and 0.003 (0.1%) reserve antibiotics. The most consumed antibiotics comprised penicillin (1.61 DID, 26.7%), cephalosporins (1.51, 25%), and imidazole (1.10 DID, 18.1%). A total of 119/211 (56%) patients in the OPD and 99/172 (57.5%) patients in the IPD were prescribed antibiotics. Of the 158 OPD antibiotic prescriptions, 73 (46.2%) were access, 72 (45.6%) were watch, 0 (0%) were reserve, and 13 (8.2%) were unclassified antibiotics. Of the 162 IPD antibiotic prescriptions, 62 (38.3%) were access, 88 (54.3%) were watch, 01 (0.6%) was reserve, and 11 (6.8%) were unclassified antibiotics. Indications for antibiotic prescriptions in the OPD comprised respiratory tract infections (53, 38.1%), urinary tract infections (34, 26.6%), gastrointestinal infections (20, 14.4%), sepsis (17, 12.2%), and medical prophylaxis (12, 8.7%). The indications for antibiotic prescriptions in the IPD comprised sepsis (28.2%), respiratory tract infections (18.3%), burn wounds (14.1%), and gastrointestinal infections (14.1%). Conclusion: Prescription of watch antibiotics in both OPD and IPD hospital settings was high. Establishment of robust antimicrobial stewardship measures could help improve the rational prescription of antibiotics. [ABSTRACT FROM AUTHOR]

Background: Rich data on diverse patients and their treatments and outcomes within Electronic Health Record (EHR) systems can be used to generate real world evidence. A health recommender system (HRS) framework can be applied to a decision support system application to generate data summaries for similar patients during the clinical encounter to assist physicians and patients in making evidence-based shared treatment decisions. Objective: A human-centered design (HCD) process was used to develop a HRS for treatment decision support in orthopaedic medicine, the Informatics Consult for Individualized Treatment (I-C-IT). We also evaluate the usability and utility of the system from the physician's perspective, focusing on elements of utility and shared decision-making in orthopaedic medicine. Methods: The HCD process for I-C-IT included 6 steps across three phases of analysis, design, and evaluation. A team of health informatics and comparative effectiveness researchers directly engaged with orthopaedic surgeon subject matter experts in a collaborative I-C-IT prototype design process. Ten orthopaedic surgeons participated in a mixed methods evaluation of the I-C-IT prototype that was produced. Results: The HCD process resulted in a prototype system, I-C-IT, with 14 data visualization elements and a set of design principles crucial for HRS for decision support. The overall standard system usability scale (SUS) score for the I-C-IT Webapp prototype was 88.75 indicating high usability. In addition, utility questions addressing shared decision-making found that 90% of orthopaedic surgeon respondents either strongly agreed or agreed that I-C-IT would help them make data informed decisions with their patients. Conclusion: The HCD process produced an HRS prototype that is capable of supporting orthopaedic surgeons and patients in their information needs during clinical encounters. Future research should focus on refining I-C-IT by incorporating patient feedback in future iterative cycles of system design and evaluation. [ABSTRACT FROM AUTHOR]

Background: Following UK approval of the Pfizer-BioNTech and Oxford-AstraZeneca vaccines on 2/12/20 and 30/12/20 respectively, discussions about them emerged on the social media platform Twitter, (now 'X'). Previous research has shown that Twitter/ X is used by the UK public to engage with public health announcements and that social media influences public opinions of vaccines, including COVID-19 vaccines, globally. This study explored discussions on Twitter posted in response to the UK government's posts introducing the Pfizer-BioNTech and Oxford-AstraZeneca vaccines. The aim was to investigate vaccine hesitant views, and thereby identify barriers and facilitators to COVID-19 vaccine uptake in the UK. Methods: Online ethnography was used to collect responses ('tweet replies') to 14 Twitter posts published by officials or departments of the UK government on the dates the Pfizer-BioNTech and Oxford-AstraZeneca vaccines received approval from the Medicines and Healthcare products Regulatory Agency (2/12/20 and 30/12/20, respectively). 16,508 responses were collected and those expressing vaccine hesitancy were analysed using reflexive thematic analysis. Results: Three themes that underpinned Twitter posters' vaccine hesitancy were identified: (1) Concerns about vaccine development and safety, (2) Information, misinformation and disinformation, (3) Distrust: Politics and 'Big Pharma'. From these themes, eight barriers and eight facilitators to UK COVID-19 vaccine uptake were identified. Conclusion: This paper highlights key obstacles to COVID-19 vaccine acceptance in the UK based on views from Twitter and contributes to the emerging literature on the relationship between social media and the public response to COVID-19 vaccines. In so doing, this analysis offers insights that are useful for the development of vaccine communication strategies more broadly, both in and beyond future pandemics, to ensure that public concerns are addressed, and misinformation and disinformation are appropriately countered. [ABSTRACT FROM AUTHOR]

Breast cancer remains one of the most prevalent malignancies among women globally. Despite advances in therapeutic options, the prognosis often remains challenging. Breast cancer typically originates in the epithelial lining of glandular tissue ducts (85%) or lobules (15%). Initially confined to these areas (in situ), it generally remains asymptomatic and poses little risk of metastasis. The primary treatments for breast cancer include surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Although these interventions have advanced significantly and have improved patient survival rates, they are connected with numerous im mediate and long-term side effects. Effective breast cancer treatment aims to maximize efficacy while minimizing adverse effects. Given that many breast cancers are specific to the breast, developing safe and targeted therapeutic strategies will be of benefit. This review examined the current literature on the effectiveness of topical therapies for breast cancer. Studies and clinical trials were evaluated that have investigated these treatments, focusing on their safety, ease of application, and patient acceptance. Recently, topical drug delivery is transforming breast cancer therapy, offering precision and reduced systemic toxicity. Emu oil-enhanced tamoxifen showed superior transdermal effectiveness, while raloxifene gel achieved 2.77 times greater bioavailability than oral forms. Tamoxifen nanoemulgels and microneedle arrays with resveratrol further enhanced localized delivery, These therapies have gained patient acceptance due to their non-invasive nature, lack of gastrointestinal side effects, ease of application, and favourable safety and therapeutic profiles and setting a new benchmark for innovative and patient-friendly treatments. This review summarizes the findings from various studies, highlighting the benefits and limitations of topical therapies. Topical therapies offer a promising noninvasive option for breast cancer treatment with fewer side effects. These treatments have shown favorable therapeutic and safety profiles, making them an attractive option for patients. Keywords:Breast cancer, topical treatment, breast skin, local transdermal therapy, nanoformulation: [ABSTRACT FROM AUTHOR]

Oropouche fever is an increasingly significant health concern in tropical and subtropical areas of South and Central America, and is primarily spread by midge vectors. The Oropouche virus (OROV) was first identified in 1955 and has been responsible for numerous outbreaks, particularly in urban environments. Despite its prevalence, the disease is often under-reported, making it difficult to fully understand its impact. OROV typically causes febrile illness characterized by symptoms such as headaches, muscle pain, and, occasionally, neurological issues such as meningitis. The ability of the virus to thrive in both forested and urban areas has raised concerns regarding its potential spread to new regions, particularly in the context of climate change. This paper delves into the epidemiology, clinical features, and transmission patterns of OROV, shedding light on the difficulties in diagnosing and managing the disease. The absence of specific treatments and vaccines highlights the urgent need for continued research and development of targeted public health strategies. Advancements in molecular diagnostics and vector control strategies can mitigate Oropouche fever's impact. However, a comprehensive public health approach involving increased surveillance, public education, and cross-border collaboration is needed, especially as the global climate crisis may expand vector habitats, posing risks to previously unaffected regions. [ABSTRACT FROM AUTHOR]

Background: A Caesarean Section (CS) is a life saving procedure. It has a beneficial effect on maternal and child health as an alternative to difficult vaginal delivery. Adverse outcomes are postpartum hemorrhage (PPH), surgical site infection, puerperal sepsis, and maternal mortality, and fetal complications like neonatal sepsis, neonatal death, stillbirth, neonatal respiratory distress, a low Apgar score, and preterm birth. In past few decades a remarkable increase has been observed in delivery by caesarean section. This study aimed to find the indications of caesareansection in a private hospital. Method: A retrospective study was carried out for a period of six months at AMRI Hospital, Mukundapur, Kolkata. This includes 359 pregnant women, who underwent caesarean sections, both elective and emergency. Conclusion: Out of 359 pregnant women, 91% (328) were elective caesareans and 9% (31) were emergency caesarean sections. Previous caesarean section 16.15% (58) was found to be the most common indication of caesarean sections. A reduction of primary CS should be given priority. Following labor care guidelines, use of cardiotocography, partography, and patient education will contribute to the reduction of caesarean sections and related complications. [ABSTRACT FROM AUTHOR]

Background: Exercise training (ET) is a promising rehabilitation approach for long-term negative consequences of traumatic brain injury (TBI). However, little is known regarding overall rates of attrition, adherence, and compliance to ET in TBI. Objective: The purpose of this systematic review was to estimate average attrition, adherence, and compliance rates in ET studies in persons with TBI. Methods: Databases were searched from inception to April 15, 2024. Two authors independently extracted data related to attrition, adherence, compliance, and possible moderators identified a priori. Results: The average rate of attrition from 45 studies was 14.4%, although the majority of studies had small sample sizes (i.e. n < 42). Based on hierarchical linear regression, the most influential predictors of attrition were sample size and study design. A minority of studies reported adherence (44.4%) or compliance (22.2%) but those that did reported good average adherence (85.1%) and compliance (77.7%). These studies support the ability of persons with TBI to complete an ET intervention as prescribed. Conclusions: Researchers can use this information to ensure adequate power to detect a true effect of ET in persons with TBI. Researchers conducting ET studies in persons with TBI should clearly and thoroughly report data on attrition, adherence, and compliance. [ABSTRACT FROM AUTHOR]

Campaigns to scale up Voluntary Medical Male Circumcision (VMMC) for the prevention of HIV transmission has been going on for years in selected Southern African countries, following recommendations from the World Health Organisations. Despite significant strides made in the initiative and its proven benefits, controversies surrounding the strategy have never ceased, and its future remains uncertain especially as some countries near their initial targets. Over the years, as the campaigns unfolded, a lot of insights have been generated in favour of continuing the VMMC campaigns, although some insights portray the impression that the strategy is not worthy of the risks and effort required, or that enough has been done, as the targets have now been achieved. This article proposes a scoping review that aims at synthesizing and consolidating that evidence into a baseline for a further systematic review aimed at developing sound recommendations for the future of the VMMC strategy for HIV prevention. The scoping review will target all scientific literature published on the Web of Science, Cochrane Library, Scopus, Science Direct, PubMed as well as grey literature from Google Scholar and WHO Institutional Repository for Information Sharing (IRIS) from the inception of the campaigns. The review shall be guided by Arksey and O'Malley's (2005) framework for scoping reviews, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist shall be followed. Discussion of the findings is envisioned to yield evidence that can be further analysed to give insights about risk/cost-benefits ratios of the strategy at this point in time as well as best clinical practices for the VMMC procedure, to inform the future of the strategy. This protocol is registered with the Open Science Framework, registration ID https://doi.org/10.17605/OSF.IO/SFZC9. [ABSTRACT FROM AUTHOR]

In Canada, the ongoing fatal overdose crisis remains driven by the unpredictable potency and content of the illicit drug supply. From August 2022 until October 2023, the Drug User Liberation Front [DULF] operated a drug compassion club [CC], which sells drugs of known composition and purity without medical oversight. The present study is a qualitative evaluation of this project. From December 2022 to February 2023, we interviewed 16 CC members about their experiences with DULF's CC. Using a semi-structured interview guide, participants were interviewed in a private space to ensure confidentiality. Thematic analysis was used to code for a priori and unexpected themes. Participants spoke positively of their experiences with the CC, which ranged from lower overdose risk, health improvements, preference for the drug purchasing process, and mutual respect and trust among CC members, founders, and staff. No participants reported overdosing on CC-sourced drugs, and drugs were described as safe and reliable. For opioid users, the tolerance developed for opioid-potent fentanyl hampered the transition to CC heroin. Suggestions for CC improvements were also identified. Despite political backlash to the project, the CC appears to be a novel and promising approach to reducing overdose morbidity in high needs communities. By promoting participant autonomy, regulating an unstable drug supply, and creating community, this intervention has reduced self-reported overdose risk and improved the health and social wellbeing of members. No overdoses reported from CC-sourced drugs suggests that authorizing, expanding and continually evaluating the CC model is warranted. [ABSTRACT FROM AUTHOR]

Objective: Health Inequalities refer to disparities in healthcare access and outcomes based on social determinants of health. These inequalities disproportionately affect Black, Asian, Minority Ethnic (BAME) groups, particularly pregnant women, who face increased risks and limited access to care due to low health literacy. Maternal mortality rates for BAME women can be up to four times higher than for white women. This scoping review aimed to assess the impact of health literacy on BAME pregnant women's health outcomes and experiences. Objectives included evaluating health literacy improvement tools, engaging stakeholders through co-production, and identifying persisting health inequalities. Data sources: A scoping review using the Arksey and O'Malley's framework was conducted. A specific search strategy was developed with a research librarian across three databases: EMBASE, Medline, and the Maternity and Infant Care (MIC) database. Patient, Public Involvement, and Engagement (PPIE) members were consulted from the outset to co-design the research question and to provide feedback on the findings. Study appraisal and synthesis methods: Out of 1958 articles, 19 were included in the study, with 47% from the US and 21% from Denmark. Articles were published from EMBASE. 47% of the articles measured health literacy, while 53% implemented health literacy interventions, such as digital or community-based approaches. Results: All 19 articles highlighted lower health literacy in BAME women compared to other groups. Ten proposed recommendations, while others emphasized the impact of social determinants of health, collectively underscoring the need for more research on BAME health. Conclusions: The review underscores the inadequate health literacy and patient experience of BAME pregnant women. It also highlights the potential of digital health interventions to improve health literacy and health outcomes. The findings call for increased research into health literacy tools for BAME pregnant women. Healthcare systems, including the NHS, should allocate resources to enhance digital health interventions and address health inequalities in BAME groups during pregnancy. [ABSTRACT FROM AUTHOR]

Interventions designed to improve medication adherence, and blood pressure control have not been effective globally. There is limited comprehensive understanding regarding the level of drug adherence to antihypertensive medications in Ethiopia, particularly in the study area. This study aimed to assess adherence to antihypertensive medication and associated factors among patients with hypertension on follow-up at public health facilities of Adama town, Oromia, Ethiopia. A multicenter cross-sectional study was conducted among 402 patients with hypertension from January 1 to February 30, 2022. The objectives of the study were explained to participants in the local language and written informed consent was obtained. The level of adherence was measured by Morisky Medication Adherence Scale. Data were entered into Epidata and exported to Statistical Package for the Social Science for analysis. Bivariable and multivariable logistic regression analyses were conducted to determine associations between independent variables and medication adherence. Adjusted Odds ratios with 95% confidence interval were estimated to assess the strength of associations. Statistical significance was declared at a P-value < 0.05. The proportion of adherence to antihypertensive medication was 63.4% (95% CI: 59.1–66.9). Respondents under the age of 49 years ((AOR = 2.3, 95% CI: 1.009–5.459), ages 49–59 years (AOR = 3.2, 95% CI: 1.452–7.396), and ages 60–71 years (AOR = 2.7,95% CI: 1.207–6.066), who were married (AOR = 2.1, 95% CI: 1.056–4.19), urban residents (AOR = 3.9, 95% CI: 1.486–10.949), and patients with a monthly income between 5500 and 8249 Ethiopian Birr (AOR = 4.150, CI: 1.083–15.097) were more likely to be adherent to antihypertensive medications. : The adherence to the antihypertensive drug in this study was lower compared to the expected index, 80%. Education and counseling should focus on older age, rural residents, single, and patients with higher monthly incomes. [ABSTRACT FROM AUTHOR]

With the continuous development of network technology, cryptographic protocols are facing diverse and complex security challenges. Blockchain technology, as a solution incorporating decentralization, traceability, programmability, and immutability, effectively enhances the security, trustworthiness, operational efficiency, and ensures the security and integrity of data storage in traditional cryptographic protocols. Consequently, it has gradually emerged as a focal point of research in cryptographic protocols. This manuscript delves into the ongoing research concerning the application of blockchain technology in cryptographic protocols. First, this manuscript introduces the background of blockchain research in cryptographic protocols and the corresponding basic knowledge. Secondly, we delve into the main concerns of traditional cryptographic protocols, with a particular focus on security and performance. Thirdly, according to the main classification of cryptographic protocols, the latest research results of blockchain in authentication protocols, authentication and key agreement protocols, and e-commerce protocols are presented. Finally, the research directions of blockchain technology in cryptographic protocols are summarized based on the existing research, and the future development trend is also prospected. [ABSTRACT FROM AUTHOR]

Background: Despite declining COVID-19 incidence, healthcare workers (HCWs) still face an elevated risk of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. We developed a diagnostic multivariate model to predict positive reverse transcription polymerase chain reaction (RT-PCR) results in HCWs with suspected SARS-CoV-2 infection. Methods: We conducted a cross-sectional study on episodes involving suspected SARS-CoV-2 symptoms or close contact among HCWs in Bogotá, Colombia. Potential predictors were chosen based on clinical relevance, expert knowledge, and literature review. Logistic regression was used, and the best model was selected by evaluating model fit with Akaike Information Criterion (AIC), deviance, and maximum likelihood. Results: The study included 2498 episodes occurring between March 6, 2020, to February 2, 2022. The selected variables were age, socioeconomic status, occupation, service, symptoms (fever, cough, fatigue/weakness, diarrhea, anosmia or dysgeusia), asthma, history of SARS-CoV-2, vaccination status, and population-level RT-PCR positivity. The model achieved an AUC of 0.79 (95% CI 0.77–0.81), with 93% specificity, 36% sensitivity, and satisfactory calibration. Conclusions: We present an innovative diagnostic prediction model that as a special feature includes a variable that represents SARS-CoV-2 epidemiological situation. Given its performance, we suggest using the model differently based on the level of viral circulation in the population. In low SARS-CoV-2 circulation periods, the model could serve as a replacement diagnostic test to classify HCWs as infected or not, potentially reducing the need for RT-PCR. Conversely, in high viral circulation periods, the model could be used as a triage test due to its high specificity. If the model predicts a high probability of a positive RT-PCR result, the HCW may be considered infected, and no further testing is performed. If the model indicates a low probability, the HCW should undergo a COVID-19 test. In resource-limited settings, this model can help prioritize testing and reduce expenses. [ABSTRACT FROM AUTHOR]

Background: Mucormycosis, is a rare yet potentially life-threatening fungal infection common in immunocompromised patients. Despite optimal care, mucormycosis in haemato-oncological patients often results in poor outcomes. This case series details the presentations and unique challenges faced during the management of patients with acute myeloid leukemia who developed rhino-cerebral mucormycosis. Case presentation: We present three cases of rhino-cerebral mucormycosis in patients with acute myeloid leukemia: two females aged 35 and 29, and one male aged 42. Symptoms manifested during chemotherapy induction, with all patients experiencing symptoms suggestive of rhino, orbital, or cerebral infection in a background of severe neutropenia (ANC < 0.5). Nasal endoscopy revealed necrotic tissue in all cases, with contrast-enhanced computer tomography (CECT) confirming invasive fungal infection. Rhizopus species were isolated in cultures from the two female patients, and histopathological evidence of fungal invasion was noted in one. Prompt treatment with liposomal Amphotericin B combined with surgical debridement with functional endoscopic sinus surgery (FESS) and treatment of neutropenic sepsis resulted in the survival of two patients, though one succumbed during treatment. Conclusions: This case series highlights the importance of early clinical suspicion and treatment of mucormycosis in hematological malignancies. Due to mild and atypical presentations and lack of confirmation by microbiological and histological methods, a multifaceted diagnostic approach combining clinical, laboratory, and imaging modalities is essential. A multidisciplinary treatment approach with the management of concomitant complications like neutropenic sepsis is crucial for better outcomes. [ABSTRACT FROM AUTHOR]

Background: Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population. Methods: A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. Patients ≥ 18 years old with a primary diagnosis of acute MI (ICD-9 codes: 410.0-410.9 and ICD-10 codes: 121.0-121.9) discharged from the Cardiology Service from January 2019 to December 2020 who could be contacted and consented to participate were included. Data was collected from electronic records, and patients were interviewed via phone calls using a validated Urdu version of the WHOQOL-BREF questionnaire. Statistical analysis was performed using non-parametric tests via RStudio (Version 1.4.1717). Results: The final study cohort was 440 patients with a median age of 63.0 (IQR: 56.0,72.0) years, with a male predominance (68.2%). Physical health was the most affected domain. Females, lower-income individuals, and those with lower levels of education had lower HRQoL scores in all domains. Diabetes and the presence of multiple co-morbidities were associated with lower HRQoL. Marital and socioeconomic status, along with psychosocial factors were significantly associated with HRQoL scores. Notably, 62.0% of post-MI patients rated their overall HRQoL as good (4–5 on a Likert scale of 1–5). Cronbach's alpha values indicated good internal consistency, with an overall Cronbach's alpha of 0.902. Conclusion: Although a significant proportion of patients in our cohort reported good HRQoL post-MI, several social factors were associated with lower HRQoL. These factors must be investigated further in discharge planning and post-discharge of patients with MI. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization has recognized maternal mental illness as an emerging issue. Previous studies have indicated that maternal mental illness is associated with socioeconomic status (SES). However, there is a lack of research concerning the mental health of pregnant people with low SES in Ontario, Canada. In this study, we examined associations between mental health conditions during pregnancy and two SES indicators: the pregnant person's residential neighbourhood income and education level. Methods: A population-based retrospective cohort study was conducted, consisting of all singleton pregnancies resulting in stillbirths or live births in Ontario hospitals from April 1, 2012, to March 31, 2021. Data were linked from the BORN Information System database, Canadian Institute for Health Information Discharge Abstract Database, and Canadian Census. Poisson regression with robust error variance models was performed to estimate the relative risks of anxiety, depression, anxiety and/or depression, or any mental health condition during pregnancy, by SES indicator. We adjusted for maternal age, obesity status in pre-pregnancy, certain pre-existing maternal health conditions, substance use during pregnancy, race, and rural or urban residence. Results: Within the cohort (n = 1,202,292), 10.5% (126,076) and 8.1% (97,135) of pregnant individuals experienced anxiety and depression, respectively, and 15.8% (189,616) had at least one mental health condition during pregnancy. The trend test (p < 0.0001) showed a significant downward trend in the total rates of mental health conditions by increasing SES quintiles. Pregnant individuals in the lowest neighbourhood income quintile tended to have a higher risk of anxiety (aRR: 1.24, 95%CI: 1.22–1.27), depression (aRR: 1.56, 95%CI: 1.52–1.59), anxiety and/or depression (aRR: 1.13, 95%CI: 1.11–1.15), or any mental health condition (aRR: 1.18, 95%CI: 1.16–1.19). Similarly, pregnant people living in the lowest education level neighbourhoods had higher likelihoods of anxiety (aRR: 1.66, 95%CI: 1.62–1.69), depression (aRR: 2.09, 95%CI: 2.04–2.14), anxiety and/or depression (aRR: 1.42, 95%CI: 1.39–1.44), and any mental health condition (aRR: 1.41, 95%CI: 1.38–1.43). Conclusions: Despite a universal healthcare system, the variations in mental health prevalence and risk during pregnancy based on SES suggest health inequity in Ontario, Canada. Future studies are needed to examine the mechanisms of this health inequity to guide policy makers in reducing disparities in Ontario. [ABSTRACT FROM AUTHOR]

Background: Clusters of health behaviours could impact changes in adiposity among adolescents over time. This study examines the clustering of screen time, physical activity, dietary behaviours and sleep, and the associations with 3-year changes in indicators of adiposity. Methods: Data from the UK's Millennium Cohort Study were utilised when participants were aged 14 and 17 years respectively. At age 14, demographics, screen time, dietary behaviours and sleep duration were measured via self-report, and physical activity using wrist worn accelerometers. Height, weight, and percent body fat were measured at age 14 and 17 years. Behavioural clusters were determined using k-means clustering analysis, and associations with change in indicators of adiposity between age 14 and 17 years were examined using multivariate regression models. Results: Three clusters were identified at age 14, a 'healthy cluster', a 'mixed cluster', and an 'unhealthy cluster' in the analytical sample of 3,065 participants (52.5% girls). The 'unhealthy' cluster was the most prevalent cluster among boys (53%), while the 'healthy cluster' was most prevalent among girls (55.9%). Adolescents in healthy clusters had a lower BMI z-score and percent body fat at age 14 compared to those in the unhealthy and mixed clusters, and maintained lower scores at age 17. Boys in the mixed and unhealthy clusters at 14 years had a lower change in BMI z-score between 14 and 17 compared to boys in the healthy cluster. Conclusion: Adolescents in the healthy cluster had lower BMI z-scores and percent body fat at age 14 years than those in the unhealthy cluster, and they maintained this lower level at age 17. Given the upward trend in BMI during this period, this maintenance could be interpreted as a positive outcome. Further prospective research is needed to better understand these associations as well as research examining the stability of cluster membership over time. [ABSTRACT FROM AUTHOR]

Background: Continuity of care is a core principle of family medicine associated with improved outcomes. However, fragmentation challenges sustaining continuous relationships. This review aimed to provide timely and critical insights into the benefits of continuity and sustainability of care for older adults. Methods: PubMed, EMBASE, CINAHL, Cochrane Library were systematically searched for studies on continuity/sustainability models in family medicine and effects on older adults. 14 studies met inclusion criteria for final synthesis. Quality was assessed using ROBINS-I. Outcomes were narratively and thematically synthesized. Results: Greater continuity of care was consistently associated with reduced healthcare utilization including lower emergency department visits and hospitalizations. Continuity also correlated with improved chronic disease management, care coordination, patient-reported experiences, and quality of life. Patient-centered medical homes and care coordination models showed potential to strengthen continuity and sustainability. Thoughtful telehealth integration and technology tools augmented continuity. Conclusion: Continuous healing relationships are vital for patient-centered care of older adults. While current fragmentation challenges sustainability, innovations in primary care teaming, coordination, telehealth, and health information technology can extend continuity's benefits. Realizing improvements requires system-wide reorientation toward relationships and whole-person care. [ABSTRACT FROM AUTHOR]

Background: Chikungunya (CHIK) is a viral disease spread by Aedes mosquitoes in tropical and subtropical countries, including Ethiopia. It is important to educate communities and implement behavioral and social interventions to prevent and control the spread of disease. This study assessed the community's knowledge, attitude, and practices (KAP) about CHIK disease in the Afar Region, Northeast Ethiopia. Methods: A community-based quantitative and qualitative cross-sectional study was conducted between September 2022 and January 2023 in two districts in the Afar Region, Ethiopia. A household survey (HHS) using a structured questionnaire was conducted through face-to-face interviews for the quantitative study. For the qualitative research, focus group discussions (FGDs) were conducted using a semi-structured questionnaire. Data was analyzed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regressions. Results: The study included 296 and 116 adult community members for quantitative and qualitative studies, respectively. Of 296 respondents, 67.3% had previously heard of CHIK, and of those who heard of it, 44.7% knew that CHIK is caused by a virus. While a majority (68.8%) of participants believed that CHIK could be prevented, only 45.6% considered it a serious illness. Additionally, over half (56.8%) of the respondents knew that not all mosquitoes transmit CHIK. About 48.7% were able to identify the Aedes mosquito, but only 16.5% of those knew that Aedes mosquitoes bite during the daytime. The overall mean correct/positive response scores for knowledge, attitudes, and practices were 63.2%, 60.0%, and 60.0%, respectively. Being a student and having educational levels of grade 9-12th and college or above were associated with good knowledge while being single, having an educational level of 9-12th, and being within the age group of 45–59 years old were found to be associated with positive attitude scores. Conclusion: The study revealed a limited understanding of CHIK and the role of the Aedes mosquito in the study area. The community had uncertainty about the disease, its transmission, and prevention measures. The lack of understanding may affect attitudes towards the disease and risk perceptions, leading to less practice in prevention and control measures. The findings suggest the need for community-based educational initiatives to improve awareness and promote prevention and control measures. [ABSTRACT FROM AUTHOR]