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Smokeless tobacco (SLT) use is widespread across many nations and populations, and India shares more than three-quarters of the global burden of SLT consumption. Tobacco use in India has been largely viewed as a male-dominant behaviour. However, evidence from medical, social and behavioural sciences show significant SLT use among women and young girls. This paper highlights key dimensions of SLT use among women in India including prevalence and determinants, the health effects arising from SLT use and cessation behaviours. The paper concludes by providing recommendations with the aim of setting research priorities and policy agenda to achieve a tobacco-free society. The focus on women and girls is essential to achieve the national targets for tobacco control under the National Health Policy, 2017, and Sustainable Development Goals 3 of ensuring healthy lives and promote well-being for all.

The gut microbiota is recognized as having major impact in health and disease. Sample storage is an important aspect to obtain reliable results. Mostly recommended is immediate freezing, however, this is not always feasible. Faecal occult blood test (FOBT) papers are an appealing solution in such situations, and most studies find these to be applicable, showing no major changes within 7 days storage at room temperature (RT). As fieldwork often requires RT storage for longer periods, evaluation of this is warranted. We performed 16S rRNA gene sequencing of 19 paired faecal samples immediately frozen or kept five weeks and five months at RT on FOBT papers. Alpha-diversity evaluation revealed no effect of FOBT storage, and evaluation of beta-diversity showed that host explained 65% of community variation, while storage method explained 5%. Evaluation of community dispersion and the Firmicutes/Bacteroidetes ratio revealed a larger effect of storage time for fresh-frozen samples. Single taxa evaluation (order-to-genus level) showed significant alterations of four (of 37) genera after five weeks and five genera after five months. When comparing the two timepoints, alterations were only detectable for fresh-frozen samples. Our findings reveal that long term storage on FOBT papers is an applicable approach for microbiota research.

Invasive species can be particularly disruptive when they intersect with organisms of conservation concern. Stabilizing the declining eastern migratory population of monarch butterflies (Danaus plexippus) is projected to require extensive habitat restoration across multiple land use sectors including metropolitan areas. Numerous conservation programs encourage urban citizens to plant gardens with milkweeds, the obligate larval host plants of the monarch. Here, we show that predation by Polistes dominula, an invasive paper wasp that is particularly abundant in urban settings, can turn such sites into ecological traps for monarch larvae. Polistes dominula was the predominant paper wasp seen foraging in central Kentucky pollinator gardens. In 120 observed encounters with monarch larvae on milkweeds in gardens, most second to fourth instars were killed, whereas most fifth instars escaped by thrashing or dropping. The wasps bit and carried off second instars whole, whereas third and fourth instar kills were first gutted, then processed and carried away piecemeal. Predation on sentinel larvae was much higher in urban gardens than in rural settings. The wasps exploited ornamental butterfly “hibernation boxes” in pollinator gardens as nesting habitat. Polistes dominula is an under-recognized predator that may diminish the urban sector’s contributions to monarch habitat restoration.

Background The development of new genetic testing methods and the approval of the first treatments raises questions regarding when and how to perform screening for inherited neuromuscular conditions. Screening directives and access to the different techniques is not uniform across Europe. The patient advisory board of the European reference network for rare neuromuscular diseases (NMD) conducted a qualitative study to understand the state of play of screening for inherited NMD in Europe and patients’ needs. Results We collected answers from 30 patient organisations (POs) from 18 European countries. Fifteen acknowledge the existence of pre-implantation genetic diagnosis in their country. Regarding prenatal screening, we had 25 positive answers and 5 negative ones. Twenty-four POs mentioned that newborn screening was available in their country. We had some contradictory answers from POs from the same country and in some cases; diseases said to be part of the screening programmes were not hereditary disorders. Twenty-eight organisations were in favour of screening tests. The reasons for the two negative answers were lack of reimbursement and treatment, religious beliefs and eventual insurance constrains. Most POs (21) were in favour of systematic screening with the option to opt-out. Regarding the timing for screening, “at birth”, was the most consensual response. The main priority to perform screening for NMDs was early access to treatment, followed by shorter time to diagnostic, preventive care and genetic counselling. Conclusions This is the first study to assess knowledge and needs of POs concerning screening for NMDs. The knowledge of POs regarding screening techniques is quite uneven. This implies that, even in communities highly motivated and knowledgeable of the conditions they advocate for, there is a need for better information. Differences in the responses to the questions “how and when to screen” shows that the screening path depends on the disease and the presence of a disease modifying treatment. The unmet need for screening inherited NMDs should follow an adaptive pathway related to the fast moving medical landscape of NMDs. International coordination leading to a common policy would certainly be a precious asset tending to harmonize the situation amongst European countries.

Smartphone technology has spread rapidly around the globe. According to a report released by the Korea Information Society Development Institute, about 95% of Koreans aged more than 30 years old owned smartphones. Recently, blood pressure (BP) measurement using a photoplethysmography-based smartphone algorithm paired with the smartwatch is continuously evolving. In this document, the Korean Society of Hypertension intends to remark the current results of smartphone / smartwatch-based BP measurement and recommend optimal BP measurement methods using a smartphone device. We aim to increase the likelihood of success in implementing these new technologies into improved hypertension awareness, diagnosis, and control.

Urgent care practice (UCP) is a novel concept for India. Urgent care primarily deals with injuries or illnesses requiring immediate care. Medical emergency and urgency can happen anywhere unannounced. Research has shown that 90% of the morbidities can be resolved within the community by primary care physicians lead teams. Given the changing professional demands, non-specialists tend to refer away far too many cases to specialists, undermining generalist medical care, particularly in Indian settings. The spillover of the patient load from the primary care setting to the tertiary care centers is enormous leading to resource mismatch. Family physicians and other primary care providers are best positioned to develop practices and provide good quality urgent care to society. Family physicians, general practitioners, and medical officers are already functioning as the frontline care providers for any emergency or medical urgency arising within communities. Urgent care is essentially ambulatory care or outpatient care outside of a traditional hospital emergency room. "UCP aims to provide timely support, which is easily accessible with a focus on good clinical outcomes, e.g. survival, recovery, lack of adverse events, and complications. Core interventions of urgent care are centered on the 4Rs - Rescue, Resuscitate, Relate, and Refer. At present, there are no available, established training model for future faculty, residents, and medical students on "UCP" in India.

Family medicine is the internationally recognized nomenclature for the academic discipline, knowledge domain, and medical specialty of primary care doctors, working in the community setting. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences in the community setting. The distinction of family medicine lies in the tradition of medical generalism, promoting whole person care, in a life cycle mode; providing optimal preventive, promotive, and curative healthcare services in a wide spectrum of setting from home to hospital. In 2016, 92nd report of the department-related parliamentary standing committee on health and family welfare on the “Functioning of the Medical Council of India” has emphasized the need for postgraduate in family medicine. The committee report has noted that “the medical education system is designed in a way that the concept of family physicians has been ignored. The committee recommends that the Government of India in coordination with State Governments should establish robust PG Programs in Family Medicine and facilitate introduction of Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous healthcare for the individuals and families. The successive National Health Policies of Government of India–NHP 2002 and 2017 have emphasized the need of family medicine training in India. The recently enacted National Medical Commission Act 2019 has mandated NMC to promote training in family medicine at both undergraduate and postgraduate levels. Therefore, in the background of the stated policies of the Government of India the concept of family doctors, which was earlier neglected should be institutionalized within the mainstream medical education system of India. It is now time to accelerate and upgrade family medicine training and thereby strengthen the concept of comprehensive primary care in India. This white paper presents the review of family medicine training in India and proposes a way forward.

Context: Scientific studies are often presented primarily to a group of colleagues at annual scientific meetings. All year rounds are turned into products in congresses. Aims: The aim of the study is to evaluate the extent of the hand surgery in plastic surgery and plastic surgeons' papers related with hand surgery in national congresses; the past eight plastic surgery congresses were classified and presented. Settings and Design: The abstract books of Turkish National Congresses of Plastic, Reconstructive, and Aesthetic Surgery between 2011 and 2018 have been evaluated retrospectively. Subjects and Methods: Distribution of hand surgery according to the topics was evaluated according to the European White Book rules and standards. Distribution of oral and posters and distribution by years were shown. Results: The ratio of hand surgery reports to all reports was 17.3%. Hand and upper extremity surgery topics were presented at 19.7% in the 38th congress, which is the most hand surgery-included congress. The most frequently presented subjects were tumors, flaps, trauma, congenital anomalies, and replantation. Conclusions: Although there are arguments that plastic surgeons have disregarded hand surgery, there is no similar situation for Turkish plastic surgeons in the national platform. It has been found that the most common topics such as tumor excision and repair of the tissue defect were the most presented issues rather than arthroscopy, paralytic hand, and arthritis, which are specific to the hand surgery. Increasing the number of plastic surgery specialists who have been trained with hand surgery as a subspecialty will bring up the subjects that have not been presented in the hand surgery so far, in the future congresses.

In this study, polyacrylic acid modified filter paper (FP/PAA) was synthesized by in-situ polymerization of acrylic acid, which was used as a matrix to chelate nano-scale zero valent iron (nZVI). The loading content of nZVI in the filter paper reached 24.8%. The fabricated composite FP/PAA/nZVI was characterized by SEM, FT-IR and TGA respectively. Moreover, it was used for the removal of methyl blue and methylene blue as model anionic and cationic dyes. The effect of initial dye concentration on decolorization efficiency was investigated. The results showed that FP/PAA/nZVI enhanced the removal of dye from the simulated dye wastewater and the decolorization efficiency exceeded 95% for the dye solutions lower than 20 mg/L. More importantly, the filter paper supported nZVI realized the continuous treatment of simulated dye wastewater by a simple filtration process. This study hopes to serve as a basis for the application of nZVI in textile wastewater treatment.

Background : E-Learning or web-based technology can be used to train undergraduate medical students’ clinical reasoning skills. Currently, many learning methods are being developed using web-based environment to replace paper-based because they are more efficient in terms of paper usage and are flexible for a student in accessing materials. This study aims to explore student’s working durationaccess time and scores upon the usage of webbased test, to compare students’ scores to paper-based test scores, to explore the advantages anddisadvantages, and suggestions to improve the web-based learning method. Method : This study randomly enlisted 60 medical students of Universitas Gadjah Mada, Yogyakarta, Indonesia and divided them into web-based (n = 30) and paper- based test (n = 30) groups. Students answered 15 disaster management questions and completed a questionnaire. The scores and times needed to answer the questions were compared using the Mann-Whitney and Independent Sample tests. Results : The duration to answer in the web-based group was shorter than in paper- based group (p = 0.001), but the average scores difference was not significant (p = 0.169). In the web-based group, similar numbers of students accessed the website during and after working hours. Survey questionnaire results showed that most students realized the advantages of this program and gave appropriate suggestions. Conclusion : Practicing clinical reasoning skills using web-based learning method is more time-efficient compared to the paper-based test. Its high-accessibility improves the learning interest and motivation of the student, with an equal outcome to the paper-based test.

Metal oxides based graphene nanocomposites were used for ammonia vapour sensing. The self-assembly process was adopted to prepare freestanding flexible pure rGO, CeO2-rGO and SnO2-rGO composite papers. The structural studies confirmed the formation of rGO composite papers. The ammonia vapor sensing was demonstrated using an impedance analyzer at different humidity levels as well as concentration. The CeO2-rGO composite paper achieved a sensitivity of 51.70 ± 1.2%, which was higher than that of pure rGO and SnO2-rGO composite paper. Both the surfaces (top and bottom) of the papers are active in efficiently sensing ammonia, which makes the present work unique. The results reveal that metal oxide/rGO papers can be effectively utilized in real time sensor application.

The world is passing through a global pandemic of COVID 19. The number of positive cases has crossed over twenty thousand as of April 2020. Like everyone else, it is indeed a very challenging situation for family physicians and primary care providers as most of the guidelines presently have focused on screening, quarantine, isolation, and hospital-based management. Limited information or clarity is available on running small private clinics during pandemic times. The key concern is professional obligation versus risks of community transmission. Family physicians see routine flu-like illnesses throughout the year with seasonal variation within their practices. This document is intended to develop consensus and standard practices for the family physicians and other primary care providers during the pandemic, ensuring optimal continuity of care. This document was reviewed by the national executive of the Academy of Family Physicians of India and approved for dissemination among members. However, due to the dynamic status of the pandemic, all practitioners are advised to closely follow the instructions, guidelines, and advisories of national, state and local health authorities as well.

Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.

This position paper has been drafted by experts from the Czech national board of diseases with bronchial obstruction, of the Czech Pneumological and Phthisiological Society. The statements and recommendations are based on both the results of randomized controlled trials and data from cross-sectional and prospective real-life studies to ensure they are as close as possible to the context of daily clinical practice and the current health care system of the Czech Republic. Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable heterogeneous syndrome with a number of pulmonary and extrapulmonary clinical features and concomitant chronic diseases. The disease is associated with significant mortality, morbidity and reduced quality of life. The main characteristics include persistent respiratory symptoms and only partially reversible airflow obstruction developing due to an abnormal inflammatory response of the lungs to noxious particles and gases. Oxidative stress, protease-antiprotease imbalance and increased numbers of pro-inflammatory cells (mainly neutrophils) are the main drivers of primarily non-infectious inflammation in COPD. Besides smoking, household air pollution, occupational exposure, low birth weight, frequent respiratory infections during childhood and also genetic factors are important risk factors of COPD development. Progressive airflow limitation and airway remodelling leads to air trapping, static and dynamic hyperinflation, gas exchange abnormalities and decreased exercise capacity. Various features of the disease are expressed unequally in individual patients, resulting in various types of disease presentation, emerging as the "clinical phenotypes" (for specific clinical characteristics) and "treatable traits" (for treatable characteristics) concept. The estimated prevalence of COPD in Czechia is around 6.7% with 3,200-3,500 deaths reported annually. The elementary requirements for diagnosis of COPD are spirometric confirmation of post-bronchodilator airflow obstruction (post-BD FEV1/VCmax

We present a rapid (

The intersection of art and science is a space useful not only to communicate scientific concepts to the general public but also to allow those of us studying biology in depth to view our work in a different light. I myself enjoy playing with the universality of anatomy, that is its bits and pieces that compose every human being. In mixing these with an array of mediums, colours, and textures, I hope to evoke a multiplicity of emotions in the viewer.

Allergic reactions to stings of Hymenoptera species can have serious or even fatal consequences. If the identification of the culprit insect is possible, venom-specific immunotherapy effectively cures Hymenoptera venom allergies. Although component-resolved diagnostics has strongly evolved in recent years, the differentiation between allergies to closely related species such as Polistes dominula and Vespula spp. is still challenging. In order to generate the basis for new diagnostic and therapeutic strategies, this study aims at resolving the venom proteomes (venomes) of these species. The venoms of P. dominula and Vespula spp. (V. germanica, V. vulgaris) were analyzed by liquid chromatography-mass spectrometry. Resulting proteins were characterized regarding their function, localization and biochemical properties. The analyses yielded 157 proteins in Vespula spp. and 100 in P. dominula venom, 48 proteins, including annotated allergens, were found in both samples. In addition to a variety of venom trace molecules, new allergen candidates such as icarapin-like protein and phospholipase A2 were identified. This study elucidates the venomes of closely related allergy-eliciting Hymenoptera species. The data indicates that relying on marker allergens to differentiate between P. dominula and Vespula spp. venom allergy is probably insufficient and that strategies using cross-reactive major allergens could be more promising.

Highly cited papers in the Essential Science Indicators database refer to papers with citations in the top 1% of all papers in a research field, and they are considered to be symbols of scientific excellence and top performance of the past ten years. This study provided an informetric analysis of 7791 highly cited papers in the environmental sciences category during 2009&ndash, 2019. Informetric indicators and visualization tools were applied to evaluate and present the performances of journals, countries/territories, institutions, top cited papers, and research hotspots. The results showed that the cumulative number of publications has increased exponentially, suggesting strong development of the environmental sciences category. There were 211 journals publishing highly cited papers, with Energy &amp, Environmental Science as the leading journal. The USA ranked first with the highest number of publications and occupied the core position in the collaboration network, while Mainland China took the first place in independent research output. Review articles have an obvious advantage in terms of achieving high citations. &ldquo, Adsorption&rdquo, &ldquo, climate change&rdquo, and &ldquo, heavy metal&rdquo, were the most frequent keywords, with &ldquo, microplastic&rdquo, rising rapidly as a new research frontier in recent years. Five research hotspots were visualized from highly cited papers via cluster analysis.

Here, we follow the stable propagation of a roughening crack using simultaneously Digital Image Correlation and Infra-Red imaging. In a quasi-two-dimensional paper sample, the crack tip and ahead of that the fracture process zone follow the slowly, diffusively moving “hot spot” ahead of the tip. This also holds when the crack starts to roughen during propagation. The well-established intermittency of the crack advancement and the roughening of the crack in paper are thus subject to the dissipation and decohesion in the hot spot zone. They are therefore not only a result of the depinning of the crack in a heterogeneous material.

In the age of Evidence-Based Medicine, Clinical Guidelines (CGs) are recognized to be an indispensable tool to support physicians in their daily clinical practice. Medical Informatics is expected to play a relevant role in facilitating diffusion and adoption of CGs. However, the past pioneering approaches, often fragmented in many disciplines, did not lead to solutions that are actually exploited in hospitals. Process Mining for Healthcare (PM4HC) is an emerging discipline gaining the interest of healthcare experts, and seems able to deal with many important issues in representing CGs. In this position paper, we briefly describe the story and the state-of-the-art of CGs, and the efforts and results of the past approaches of medical informatics. Then, we describe PM4HC, and we answer questions like how can PM4HC cope with this challenge? Which role does PM4HC play and which rules should be employed for the PM4HC scientific community? This research received no external funding

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.

Covid-19 has once again brought into focus our limited preparedness to deal with epidemics. Most nations, across the globe, have responded with a resolve to come stronger out of this crisis and leaderships across the world have shown great commitment to protecting its people from Covid-19. Covid-19 has also taught us a few things for the future. One such learning has been that a strong shift in focus towards non-communicable diseases driving health infrastructure across the globe for the last few decades has come at neglect of communicable diseases. In that sense, therefore, the current pandemic has been a wake-up call. Organised Medicine Academic Guild (OMAG), an umbrella organization of professional associations gathered a group of health experts to develop a policy document on epidemic preparedness to limit the influence of epidemics like Covid-19.

Since Internal Medicine (IM) is the most frequent setting of hospitalization for both patients with advanced liver disease and those with comorbidities and risk factors for infection, through this position paper FADOI aims to promote and disseminates its vision regarding the current and potential role of IM in managing hepatitis C virus (HCV) infection (screening, diagnosis, linkage-to-care, treatment). The Internist plays an important role in identifying new cases, in selecting the appropriate diagnostic work-up for liver disease staging and prognosis, and in initiating antiviral therapy, coordinating care and communication with other specialists, the Hepatology outpatient clinic and General Practitioners. Since the Internist is naturally accustomed to the management of multiple comorbidities, he has a fundamental role in the identification of extrahepatic diseases associated with HCV infection and in the diagnosis of comorbidities, some of which are potential factors of liver disease progression. Moreover, in the prescription of the antiviral therapy, it is important to consider the possible drug interactions, and this ideally fits the role of the Internist who can weigh the risk/benefit ratio of possible alternatives, by considering the patient’s clinical situation, especially in case of multiple comorbidities. Moreover, it seems appropriate that the ability to prescribe antiviral therapy is guaranteed to all IM hepatology clinics, favoring a spread of awareness as well as an increase in national coverage and therefore patient access to therapies. The network of IM can also contribute to homogenizing the management policies of HCV treatment, which sometimes differ between Italian Regions.

Respiratory physiotherapy in patients with COVID-19 infection in acute setting: a Position Paper of the Italian Association of Respiratory Physiotherapists (ARIR) On February 2020, Italy, especially the northern regions, was hit by an epidemic of the new SARS-Cov-2 coronavirus that spread from China between December 2019 and January 2020. The entire healthcare system had to respond promptly in a very short time to an exponential growth of the number of subjects affected by COVID-19 (Coronavirus disease 2019) with the need of semi-intensive and intensive care units.

Orphanet journal of rare diseases: OJRD 15(1), 144 (2020). doi:10.1186/s13023-020-01420-w, Published by BioMed Central, London

Nowadays, due to environmental pollution and natural energy consumption caused by waste paper, many researches are being conducted on the reuse of printed-paper. To recycle the paper, de-inking has to be performed. In this article, in order to reduce the use of the commonly used de-inking chemicals, the effect of an atmospheric pressure helium plasma treatment on the de-inking enhancement of printed-paper is studied. Through colorimeter and UV-visible spectrometer measurements the plasma treatment is shown to speed up the de-inking. While SEM observations and FTIR measurements suggest that the paper quality is retained upon plasma treatment, the increase of surface hydrophilicity measured by water contact angle measurements, compared to non-treated paper, is believed to enhance the fiber swelling of the paper and lead to a faster ink removal.

Objective Stool repositories are a valuable resource for retrospective analyses including quantitative PCR assays to distinguish between asymptomatic shedding and clinical disease. The suitability of archival specimens for this purpose is unclear and requires assessment. We conducted a pilot study to evaluate pathogen detection by TaqMan Array Card (TAC) in travelers’ diarrhea (TD) stool specimens stored for 1–13 years, as well as the impact of transporting specimens on Whatman FTA Elute cards (FTA Cards) on detection. Results The positive percent agreement (PPA) for TAC on stool vs. microbiologic testing was lower than our a priori PPA estimate of 80% for most pathogens: Shigella spp. (100% [95%CI 69–100%]), enterotoxigenic E coli (ETEC) (63% [95%CI 49–75%]), Campylobacter spp. (66% [95%CI 43–85%]) and Norovirus (37% [95%CI 16–61%]). Use of the FTA card resulted in a further reduction of PPA. Our findings suggest that archival specimens may lead to insensitive detection on quantitative PCR assays due to degradation of nucleic acid with prolonged storage, although our limited sample size precluded us from evaluating the impact of storage duration on nucleic acid yield. Additional studies are needed to understand the impact of storage duration on quantitative PCR data.

Introduction: Translational science has gained prominence in medicine, but there is still much work to be done before scientific results are used optimally and incorporated into everyday health practice. As the main focus is still on generating new scientific data with financial resources primarily available for that purpose, other activities that are necessary in the transition from research to community benefit are considered less needy. The European Statistical Office of the European Commission has recently reported that 1.7 million people under 75 years of age died in Europe in 2016, with around 1.2 million of those deaths being avoidable through effective primary prevention and public health intervention. Therefore, Academia Europaea, one of the five Pan-European networks that form SAPEA (Science Advice for Policy by European Academies), a key element of the European Commission&rsquo, s Scientific Advice Mechanism (SAM), has launched a project to develop a model to facilitate and accelerate the utilisation of scientific knowledge for public and community benefit. Methods: During the process, leaders in the field, including prominent basic and clinical researchers, editors-in-chief of high-impact journals publishing translational research articles, translational medicine (TM) centre leaders, media representatives, academics and university leaders, developed the TM cycle, a new model that we believe could significantly advance the development of TM. Results: This model focuses equally on the acquisition of new scientific results healthcare, understandable and digestible summation of results, and their communication to all participants. We have also renewed the definition in TM, identified challenges and recommended solutions. Conclusion: The authors, including senior officers of Academia Europaea, produced this document to serve as a basis for revising thinking on TM with the end result of enabling more efficient and cost-effective healthcare.

We identify useful functions and usability characteristics of a historical cognitive artifact used by nurses working in a hospital unit, the Kardex. By identifying aspects of a widely used artifact, we uncover opportunities to improve the usefulness of current systems for hospital nurses. We conducted semi-structured interviews with registered nurses about their prior experience with the Kardex. Questions included what elements of the Kardex are missing from their current electronic support. Memos were generated iteratively from interview transcript data and grouped into themes. Eighteen nurses from multiple clinical areas participated and had a median of 25–29 years of nursing experience. The themes were: (1) a status at a glance summary for each patient, (2) a prospective memory aid, (3) efficiency and ease of use, (4) updating information required to maintain value, (5) activity management, (6) verbal handover during shift-to-shift report, (7) narrative charting and personalized care, and (8) non-clinical care communication. Implications for digital support are to provide immediate, portable access to a standardized patient summary, support for nurses to manage their planned activities during a series of shifts, provide unstructured text fields for narrative charting, and to support adding informal notes for personalized care.

Point-of-care testing (POCT) for uropathogen detection and chemical screening has great benefits for the diagnosis of urinary tract infections (UTIs). The goal of this study was to develop a portable and inexpensive paper-based analytical device (PAD) for cultivating bacteria in situ and rapidly testing for nitrite on the same device. The PAD was fabricated using a wax printing technique to create a pattern on Whatman No. 1 filter paper, which was then combined with a cotton sheet to support bacterial growth. Nitrite detection was based on the principle of the Griess reaction, and a linear detection range of 0–1.6 mg/dL (R2 = 0.989) was obtained. Scanning electron microscopy (SEM) analysis demonstrated that the bacteria were able to grow and formed a cluster on the cellulose fibres within 2 hours. The enzyme β-glucuronidase, which is specifically produced by Escherichia coli, was able to convert the pre-immobilized 5-bromo-4-chloro-3-indolyl-β-D-glucuronide sodium salt (X-GlcA), a colourless substrate, generating a blue colour. Under optimum conditions, the proposed device allowed bacterial concentrations in the range of 104–107 colony forming units (CFU)/mL to be quantified within 6 hours. Moreover, the use of this device enables the identification of E. coli pathogens with selectivity in real urine samples. In conclusion, the PAD developed in this study for UTI screening provides a rapid, cost-effective diagnostic method for use in remote areas.

Background and Aims: According to the research background and need to print CBCT images in case of emergency, this study has been done to compare the quality and accuracy of the two methods of film and paper printing for CBCT images. Materials and Methods: The study of CBCT images taken from 5 patients was done and the cross-sectional slices on Fotolusio DNP papers and film AGFA were printed. Afterward, the images was exmined by a maxillofacial radiologist. The images’ quality were identified and recorded with anatomical, from 1 to 4 on forms. The accuracy was determined by the diagnosis of alveolar canal area and the comparison with the gold standard. Data were analyzed using independent chi-square and Fisher exact tests’. Results: The images quality in anatomical landmarks consisting PDL (P=0.02), lamina dura (P=0.006), the inferior alveolar canal (P=0.01) and the filling (P=0.006) had a significant difference. There was no significant difference. For the lower border of the mandible landmark, there was no difference between the two methods of printing. In comparing the diagnostic accuracy between the two methods (P=1). Conclusion: The results showed that the diagnostic quality in film printing is better than paper printing and the diagnostic accuracy is the same in both methods.

The amount of Paper Board Mill Effluent Treatment Plant Sludge (PBM-ETPS) dumped from paper mills are huge and its conversion into hydrochar for the purpose of energy has broad prospects. This study investigated the optimum conditions for the production of PBM-ETPS derived hydrochar (PBM-ETPSH) through Reponse Surface Methodology (RSM) for more surface area and pore volume with minimal hydrogen to carbon (H/C) and oxygen to carbon (O/C) ratios. The PBM-ETPSH had higher heating value (HHV) of 18.39 MJ kg−1 with fixed carbon percentage of 15.6. Our results showed a reduction in H/C (35.05%) and O/C (43.7%) ratios confirming the coalification of optimized PBM-ETPSH. Thermogravimetric investigations of blending PBM-ETPSH with coal in 1:1 ratio increased its HHV to 22.25 MJ kg−1 making it suitable as an energy alternative for paper mills.

Objective Electronic data collection (EDC) has become a suitable alternative to paper based data collection (PBDC) in biomedical research even in resource poor settings. During a survey in Nepal, data were collected using both systems and data entry errors compared between both methods. Collected data were checked for completeness, values outside of realistic ranges, internal logic and date variables for reasonable time frames. Variables were grouped into 5 categories and the number of discordant entries were compared between both systems, overall and per variable category. Results Data from 52 variables collected from 358 participants were available. Discrepancies between both data sets were found in 12.6% of all entries (2352/18,616). Differences between data points were identified in 18.0% (643/3580) of continuous variables, 15.8% of time variables (113/716), 13.0% of date variables (140/1074), 12.0% of text variables (86/716), and 10.9% of categorical variables (1370/12,530). Overall 64% (1499/2352) of all discrepancies were due to data omissions, 76.6% (1148/1499) of missing entries were among categorical data. Omissions in PBDC (n = 1002) were twice as frequent as in EDC (n = 497, p

Paper Spray Ionization (PSI) is commonly applied for the analysis of small molecules, including drugs, metabolites, and pesticides in biological fluids, due to its high versatility, simplicity, and low costs. In this study, a new setup called Solvent Assisted Paper Spray Ionization (SAPSI), able to increase data acquisition time, signal stability, and repeatability, is proposed to overcome common PSI drawbacks. The setup relies on an integrated solution to provide ionization potential and constant solvent flow to the paper tip. Specifically, the ion source was connected to the instrument fluidics along with the voltage supply systems, ensuring a close control over the ionization conditions. SAPSI was successfully applied for the analysis of different classes of biomolecules: amyloidogenic peptides, proteins, and N-glycans. The prolonged analysis time allowed real-time monitoring of processes taking places on the paper tip, such as amyloid peptides aggregation and disaggregation phenomena. The enhanced signal stability allowed to discriminate protein species characterized by different post translational modifications and adducts with electrophilic compounds, both in aqueous solutions and in biofluids, such as serum and cerebrospinal fluid, without any sample pretreatment. In the next future, application to clinical relevant modifications, could lead to the development of quick and cost-effective diagnostic tools.

Introduction: Proper orientation of endoscopic mucosal biopsies is crucial for accurate histomorphologic assessment. Aim: To compare the morphology on two different templates, filter paper and gelfoam for orientation of biopsies. Materials and Methods: In this study a total of 21 duodenal biopsies were studied which were taken from the same site, fixed and oriented on wet filter paper and gelfoam in formalin, from patients who presented with malabsorptive symptoms. Histomorphological parameters studied were villous architecture, crypt architecture, intraepithelial lymphocyte (IEL) count per 100 enterocytes, villous tip IEL count per 20 enterocytes, inflammatory cells in lamina propria. Statistical analysis was done using IBM- SPSS software version 21. p-value

Summary The growing number of doctoral graduates in nursing management, together with more focus on qualitative studies, has contributed to the development of qualitative studies. This study aimed to provide a critical appraisal of qualitative research papers in the field of nursing management by Iranian authors, published in national and international journals. In a cross-sectional study, international and Persian electronic databases were used for a systematic search of the relevant literature using the keywords: qualitative studies, nursing management, and Iran. Criteria provided by the Critical Appraisal Skills Program (CASP) for the qualitative studies checklist was used for quality appraisal of the included studies. Of the 22 qualitative studies appraised, 48% had used grounded theory and 22% had adopted the research method of content analysis. The mean score for ethical consideration was 1.66 out of 4. The mean scores for rigor and research credibility were 5.123 out of 9 and 1.66 out of 4, respectively. In terms of research purpose and methodology, mean scores were 3.33 out of 4 and 2.22 out of 3, respectively. Quality of research design obtained the mean score of 2.66 out of 6 and the score for method of data collection was 4.44 out of 7. Results showed that quality of the published qualitative studies in the field of nursing management by Iranian authors seemed not appropriate and the most significant weakness was related to the partial compliance with ethical principles.

Paper degradation on a macroscopic scale is characterised primarily by yellowing, an increase in brittleness, and other destructive changes caused by the hydrolysis of glycoside bonds and oxidation reactions. Until now, lignin has been believed to cause these changes. However, contemporary analysis has not confirmed this assumption and has attributed low paper resistance to ageing with acidification owing to the production in acid environments that involve aluminium sulfate. In view of the common belief this manuscript presents studies on the accelerated ageing of papers with different lignin contents that are produced in neutral environments. To achieve the objective, artificially aged papers under conditions of increased humidity and temperature were investigated using chromatographic (SEC) and spectroscopic (FTIR and UV–Vis spectroscopy) techniques. Mechanical tests were used to determine the decrease in tensile properties of the samples. We observed no effects of the lignin content on the ageing rate of paper produced at neutral pH. This work also reveals the extent to which spectroscopic methods are useful for studying the papers containing lignin.

Background When a journal receives a duplicate publication, the ability to identify the submitted work as previously published, and reject it, is an assay to publication ethics best practices. The aim of this study was to evaluate how three different types of journals, namely open access (OA) journals, subscription-based journals, and presumed predatory journals, responded to receiving a previously published manuscript for review. Methods We performed a quasi-experimental study in which we submitted a previously published article to a random sample of 602 biomedical journals, roughly 200 journals from each journal type sampled: OA journals, subscription-based journals, and presumed predatory journals. Three hundred and three journals received a Word version in manuscript format, while 299 journals received the formatted publisher’s PDF version of the published article. We then recorded responses to the submission received after approximately 1 month. Responses were reviewed, extracted, and coded in duplicate. Our primary outcome was the rate of rejection of the two types of submitted articles (PDF vs Word) within our three journal types. Results We received correspondence back from 308 (51.1%) journals within our study timeline (32 days); (N = 46 predatory journals, N = 127 OA journals, N = 135 subscription-based journals). Of the journals that responded, 153 received the Word version of the paper, while 155 received the PDF version. Four journals (1.3%) accepted our paper, 291 (94.5%) journals rejected the paper, and 13 (4.2%) requested a revision. A chi-square test looking at journal type, and submission type, was significant (χ2 (4) = 23.50, p Conclusion Few journals accepted our submitted paper. However, our findings suggest that all three types of journals may not have adequate safeguards in place to recognize and act on plagiarism or duplicate submissions.

Background Geotagging is the process of attaching geospatial tags to various media data types. In health care, the goal of geotagging is to gain a better understanding of health-related questions applied to populations. Although there has been a prevalence of geographic information in public health, in order to effectively use and expand geotagging across health care there is a requirement to understand other factors such as the disposition, standardization, data sources, technologies, and limitations. Objective The objective of this document is to serve as a resource for new researchers in the field. This report aims to be comprehensive but easy for beginners to understand and adopt in practice. The optimal geocodes, their sources, and a rationale for use are suggested. Geotagging’s issues and limitations are also discussed. Methods A comprehensive review of technical instructions and articles was conducted to evaluate guidelines for geotagging, and online resources were curated to support the implementation of geotagging practices. Summary tables were developed to describe the available geotagging resources (free and for fee) that can be leveraged by researchers and quality improvement personnel to effectively perform geospatial analyses primarily targeting US health care. Results This paper demonstrated steps to develop an initial geotagging and geovisualization project with clear structure and instructions. The geotagging resources were summarized. These resources are essential for geotagging health care projects. The discussion section provides better understanding of geotagging’s limitations and suggests suitable way to approach it. Conclusions We explain how geotagging can be leveraged in health care and offer the necessary initial resources to obtain geocodes, adjustment data, and health-related measures. The resources outlined in this paper can support an individual and/or organization in initiating a geotagging health care project.

Electronic nicotine delivery systems (ENDS) or e-cigarettes or vape pens/vaping devices are battery-powered devices used to smoke or ‘vape’, a flavoured solution containing varying concentrations of nicotine, an addictive chemical found in cigarettes and other forms of tobacco products. Amongst these various types of ENDS devices, e-cigarettes are the most common type. They produce an aerosolized mixture of the flavoured liquids and nicotine, which is inhaled by the user. Nicotine is considered as one of the most addictive substances. The rapidity at which it is introduced into the body, age of first exposure and the dosage administered all add to determine the potential risk of a person being addicted to it throughout life. Nicotine addiction is established more strongly when the exposure occurs in adolescence. The various flavours and attractive designs also add to the allure of these products to the young population. ENDS or e-cigarettes are manufactured in such a way to resemble conventional tobacco products such as cigarettes, pipes and cigars and common gadgets such as flash drives, flashlights or pens (Figs. ​(Figs.11 and ​and22)1. Structurally, most e-cigarettes contain four different components: a cartridge or reservoir, which holds a liquid solution containing varying amounts of nicotine with flavourings, and other chemicals (e-liquid or e-juice), namely a power source (usually a battery), a heating element (atomizer) and a mouthpiece that the person uses to inhale. They date back to 17th August 1965 when the first documented patent for this type of device was issued in Pennsylvania. Since then, it took several decades of additional propagation before mass production was initiated in 2003 in China and some other countries. Currently, there are more than 460 different e-cigarette brands with varied configuration of nicotine delivery available in the market, for example, cigar-likes (first generation), tank systems (second generation) and personal vaporizers (third generation) with over 7700 flavours2. This makes collation of data on health effects more difficult for generation of scientific evidence. Open in a separate window Fig. 1 Various types of electronic nicotine delivery systems devices. Source: Ref. 1

Somatotypic studies and their description of the human morphological configuration allow to appreciate impacts on eating habits and sedentary lifestyle. This study determined the somatotypic difference in Mapuche (NM) and non-Mapuche (NNM) children from Malleco, Chile. Through the ISAK protocol, 160 children with a mean age of 12.5 years, height 145.5 ± 3.5 cm and weight 43.7 ± 3 kg were evaluated, obtaining the following classifications: Group 12 years, Mapuche; mesoendomorphs. Non-Mapuche group 12 years; Endomesomorph. Group 13 years old, Mapuche; Mesoendomorphs. Non Mapuche group 13 years old; endomesomorph. The results indicate that for the age of 12 years, the NM presented lower values of endomorphy and higher values of mesomorphy (p≤0.01) than NNM. The 13-year-old NMs presented lower endomorphy and mesomorphy values (p≤0.01) than NNM. In conclusion, Mapuche schoolchildren present a mesomorphic predominance, however, NNM present a predominance of the endomorphic component.

Microsatellite loci are commonly used markers in population genetic studies. In this study, we present 40 novel and polymorphic microsatellite loci elaborated for the ichneumonid parasitoid Latibulus argiolus (Rossi, 1790). Reaction condition optimisation procedures allowed 14 of these loci to be co-amplified in two PCRs and loaded in two multiplex panels onto a genetic analyser. The assay was tested on 197 individuals of L. argiolus originating from ten natural populations obtained from the host nests of paper wasps. The validated loci were polymorphic with high allele numbers ranging from eight to 27 (average 17.6 alleles per locus). Both observed and expected heterozygosity values were high, ranging between 0.75 and 0.92 for HO (mean 0.83) and from 0.70 to 0.90 for HE (mean 0.85). The optimized assay showed low genotyping error rate and negligible null allele frequency. The designed multiplex panels could be successfully applied in relatedness analyses and genetic variability studies of L. argiolus populations, which would be particularly interesting considering the coevolutionary context of this species with its social host.

The membrane process had been applied for the advanced treatment of pig farm biogas slurry. As studied, this physical pretreatment, with low cost and high efficiency of the suspended solids removal and nutrient retention, is required to control membrane fouling. The combined process of paper filtration and ultrafiltration in a pilot scale was applied in the present study. The main objective was to explore and identify the feasibility of the new process for the pretreatment of the separation liquid of pig farm biogas slurry. A precision identification experiment of paper filtration and the multi-batch repetitive experiments of the combined process were designed. The results showed, at the identified paper filtration precision of 50&mu, m and an operating pressure of 0.3 bar of the ultrafiltration process, that the flux rate at the stable stage of the multi-batch operation was around 295.00 L/h. The combined process achieved an overall processing rate of 345.41 &plusmn, 18.81 L/h and a volume permeation proportion of 82.45% &plusmn, 0.85%. The TSS was removed by 95.71%, but total nitrogen (TN) and ammonia nitrogen (NH3-N) were retained by 76.29% &plusmn, 2.04% and 73.74% &plusmn, 2.10%, respectively. Comprehensively, the requirement for the pretreatment was obtained.

Ovarian cancer is the fifth leading cause of female cancer mortality in the U.S. and accounts for five percent of all cancer deaths among women. No environmental risk factors for ovarian cancer have been confirmed. We previously reported that ovarian cancer incidence rates at the state level were significantly correlated with the extent of pulp and paper manufacturing. We evaluated that association using county-level data and advanced geospatial methods. Specifically, we investigated the relationship of spatial patterns of ovarian cancer incidence rates with toxic emissions from pulp and paper facilities using data from the Environmental Protection Agency&rsquo, s Toxic Release Inventory (TRI). Geospatial analysis identified clusters of counties with high ovarian cancer incidence rates in south-central Iowa, Wisconsin, New York, Pennsylvania, Alabama, and Georgia. A bivariate local indicator of spatial autocorrelation (LISA) analysis confirmed that counties with high ovarian cancer rates were associated with counties with large numbers of pulp and paper mills. Regression analysis of state level data indicated a positive correlation between ovarian cancer and water pollutant emissions. A similar relationship was identified from the analysis of county-level data. These data support a possible role of water-borne pollutants from pulp and paper mills in the etiology of ovarian cancer.

Introduction: Hand hygiene is one of the most effective infection control measures to prevent the spread of healthcare-associated infections (HCAI). Water, soap, paper towel and hand disinfectant must be available and adequate in terms of effective hand hygiene. The adequacy of hand hygiene products or keeping water-soap and paper towel is still a problem for many developing countries like Turkey. In this multicenter study, we analyzed the adequacy in number and availability of hand hygiene products., Materials and Methods: This study was performed in all intensive care units (ICUs) of 41 hospitals (27 tertiary-care educational, 10 state and four private hospitals) from 22 cities located in seven geographical regions of Turkey. We analyzed water, soap, paper towel and alcohol-based hand disinfectant adequacy on four different days, two of which were in summer during the vacation time (August, 27th and 31st 2016) and two in autumn (October, 12th and 15th 2016)., Results: The total number of ICUs and intensive care beds in 41 participating centers were 214 and 2357, respectively. Overall, there was no soap in 3-11% of sinks and no paper towel in 10-18% of sinks while there was no alcohol-based hand disinfectant in 1-4.7% of hand disinfectant units on the observation days. When we compared the number of sinks with soap and/or paper towel on weekdays vs. weekends, there was no significant difference in summer. However, on autumn weekdays, the number of sinks with soap and paper towel was significantly lower on weekend days (p, Conclusion: There should be adequate and accessible hand hygiene materials for effective hand hygiene. In this study, we found that soap and paper towels were inadequate on the observation days in 3-11% and 10-18% of units, respectively. Attention should be paid on soap and paper towel supply at weekends as well.

Amphimeriasis, a fish-borne zoonotic disease caused by the liver fluke Amphimerus spp., has recently been reported as an emerging disease affecting an indigenous Ameridian group, the Chachi, living in Ecuador. The only method for diagnosing amphimeriasis was the microscopic detection of eggs from the parasite in patients' stool samples with very low sensitivity. Our group developed an ELISA technique for detection of anti-Amphimerus IgG in human sera and a molecular method based on LAMP technology (named LAMPhimerus) for specific and sensitive parasite DNA detection. The LAMPhimerus method showed to be much more sensitive than classical parasitological methods for amphimeriasis diagnosis using human stool samples for analysis. The objective of this work is to demonstrate the feasibility of using dried stool samples on filter paper as source of DNA in combination with the effectiveness of our previously designed LAMPhimerus assay for successfully Amphimerus sp. detection in clinical stool samples. A total of 102 untreated and undiluted stool samples collected from Chachi population were spread as thin layer onto common filter paper for easily transportation to our laboratory and stored at room temperature for one year until DNA extraction. When LAMPhimerus method was applied for Amphimerus sp. DNA detection, a higher number of positive results was detected (61/102; 59.80%) in comparison to parasitological methods (38/102; 37.25%), including 28/61 (45.90%) microscopy-confirmed Amphimerus sp. infections. The diagnostic parameters for the sensitivity and specificity werecalculated for our LAMPhimerus assay, which were 79.17% and 65.98%, respectively. We demonstrate, for the first time, that common filter paper is useful for easy collection and long-term storage of human stool samples for later DNA extraction and molecular analysis of human-parasitic trematode eggs. This simple, economic and easily handling method combined with the specific and sensible LAMPhimerus assay has the potential to beused as an effective molecular large-scale screening test for amphimeriasis-endemic areas.

The present work was focused to design a cheap, rapid, portable and easy to use filter paper based assay for the qualitative and quantitate analysis of acetone. Sodium alginate gel was loaded with the acetone specific optical signal probe, and subsequently coated onto filter paper surface to design portable colorimetric assays for acetone monitoring. The color of the paper sensor strip was observed to change from dark yellow to light yellowish in the presence of varying concentrations of acetone. Three different color analyzing models including RGB, HSV, and LAB were employed to probe the output optical signal, and their performance was compared in terms of better interpretation of the generated signal. The LAB model was found to provide better analytical figures of merit with a linear response for the acetone concentration ranging from 2.5 to 1500 ppm, and a limit of detection of 0.5 ppm. Furthermore, the specificity of the designed filter paper based sensor was demonstrated against different common interfering compounds. The results demonstrated the potential of our proposed filter paper based sensor as a novel tool for the analysis of acetone.

As a two-dimensional material, graphene has attracted increasing attention as heat dissipation material owing to its excellent thermal transport property. In this work, we fabricated sisal nanocrystalline cellulose/functionalized graphene papers (NPGs) with high thermal conductivity by vacuum-assisted self-assembly method. The papers exhibit in-plane thermal conductivity as high as 21.05 W m−1 K−1 with a thermal conductivity enhancement of 403% from the pure cellulose paper. The good thermal transport properties of NPGs are attributed to the strong hydrogen-bonding interaction between nanocrystalline cellulose and functionalized graphene and the well alignment structure of NPGs.

Microfluidic paper-based analytical devices (microPADs) are emerging as cost-effective and portable platforms for point-of-care assays. A fundamental limitation of microPAD fabrication is the imprecise nature of most methods for patterning paper. The present work demonstrates that paper patterned via wax printing can be miniaturized by treating it with periodate to produce higher-resolution, high-fidelity microPADs. The optimal miniaturization parameters were determined by immersing microPADs in various concentrations of aqueous sodium periodate (NaIO4) for varying lengths of time. This treatment miniaturized microPADs by up to 80% in surface area, depending on the concentration of periodate and length of the reaction time. By immersing microPADs in 0.5-M NaIO4 for 48 hours, devices were miniaturized by 78% in surface area, and this treatment allowed for the fabrication of functional channels with widths as small as 301 µm and hydrophobic barriers with widths as small as 387 µm. The miniaturized devices were shown to be compatible with redox-based colorimetric assays and enzymatic reactions. This miniaturization technique provides a new option for fabricating sub-millimeter-sized features in paper-based fluidic devices without requiring specialized equipment and could enable new capabilities and applications for microPADs.

Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. The steps followed were: i) a review of the latest international guidelines and position papers; ii) analysis of the evidence-based literature; iii) a qualitative analysis of the psychological services operating in some reference Italian cardiac rehabilitation facilities; iv) classification of the psychological activities in CPR as low or high intensity based on the NICE Guidelines on psychological interventions on anxiety and depression. We confirm the existence of an association between depression, anxiety, social factors, stress, personality and illness onset/outcome and coronary heart disease. Evidence for an association between depression, social factors and disease outcome emerges particularly for chronic heart failure. Some positive psychological variables (e.g., optimism) are associated to illness outcome. Evidence is reported on the impact of psychological activities on ‘new’ conditions which are now indicated for cardiac rehabilitation: pulmonary hypertension, grown-up congenital heart, end-stage heart failure, implantable cardioverter-defribrillator and mechanical ventricular assist devices, frail and oldest-old patients, and end-of-life care. We also report evidence related to caregivers. The Panel divided evidence-based psychological interventions into: i) low intensity (counseling, psycho-education, self-care, self-management, telemedicine, self-help); or ii) high intensity (individual, couples and/or family and group psychotherapy, such as stress management). The results show that psychotherapy is mainly consisting of cognitive-behavior therapy, interpersonal therapy, and short-term psycho-dynamic therapy. The current data further refine the working tools available for psychological activities in CPR, giving clear directions about the choice of interventions, which should be evidence-based and have at least a minimum standard. This document provides a comprehensive update on new knowledge and new paths for psychologists working in the CPR settings.