Search

Olajumoke Arinola Oyebode, Nicolette Nadene Houreld Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, Gauteng, South AfricaCorrespondence: Olajumoke Arinola Oyebode, Laser Research Centre, Faculty of Health Sciences, University of Johannesburg, Doornfontein, Gauteng, South Africa, Tel + 27781519058, Email daramzjay09@gmail.comPurpose: Photobiomodulation (PBM) promotes diabetic wound healing by favoring cell survival and proliferation. This study aimed to investigate the potential of PBM in stimulating cellular migration, viability, and proliferation using the transforming growth factor-β 1 (TGF-β 1)/Smad signaling pathway.Methods: The study explored the in vitro effects of near infrared (NIR) light on cell viability (survival) and proliferation as well as the presence of TGF-β 1, phosphorylated TGF‐β receptor type I (pTGF-βR1) and phosphorylated mothers against decapentaplegic‐homolog (Smad)‐2/3 (p-Smad2/3) in different fibroblast cell models.Results: Results show a significant increase in cellular migration in wounded models, and increased viability and proliferation in irradiated cells compared to their respective controls. An increase in the presence of TGF-β 1 in the culture media, a reduction in pTGF-βR1 and a slight presence of p-Smad2/3 was observed in the cells.Conclusion: These findings show that PBM at 830 nm using a fluence of 5 J/cm2 could induce cell viability, migration and proliferation to favor successful healing of diabetic wounds. This study contributes to the growing body of knowledge on the molecular and cellular effect of PBM and showcases the suitability of PBM at 830 nm in managing diabetic wounds.Keywords: diabetic wound, photobiomodulation, wound healing, hyperglycemia, NIR light

Summary: Background: Current UK guidance recommends that adolescents with obesity attend a family‐based multi‐component obesity intervention. However, these programmes suffer from low recruitment and high rates of attrition. Understanding the views of adolescents is necessary for developing future interventions. The aim of this systematic review was to synthesize and explore the views of adolescents who have attended an obesity intervention. Methods: Published literature was identified by searching six databases. Studies of adolescents (12–17 years) who attended an obesity intervention were examined. Only studies that collected and analysed data qualitatively were included. Full texts were analysed using thematic synthesis. Results: Twenty‐eight studies were included. Thirty‐five analytical themes were developed that were broadly divided into seven domains. Key themes included ensuring adolescents receive a 'tailored intervention' that involves 'active engagement'. Support from professionals, family and peers were valued highly. Adolescents expressed 'prior fears of attending interventions' and wanted 'longer term support'. 'Enjoyment of sport and physical activity' was evident, and adolescents were strongly motivated by improving body image and social desirability. Discussion Considering the views of adolescents attending obesity interventions may help to inform policy makers in the development of future interventions. This may lead to an improvement in recruitment and attrition rates. [ABSTRACT FROM AUTHOR]

This study involved the development of a nanofluid and its experimental use during a machining operation for enhancement of the surface profile of a mild steel rod. Silica nanoparticles were made from coconut shell and rice husk using a chemical process, and then disseminated into distilled water to create the hybrid nanofluid. A control sample was used to compare the performance of the created nano machining fluid. The mild steel samples had a better surface roughness when nano machining fluids were used.

This research created a cutting tool made of recycled steel, palm kernel shell and alloy additives. Scrapped crankshaft and rod (100 kg) containing 0.5607% carbon were charged into an electric induction furnace with a maximum temperature of 3000℃ for melting. Before and after melting, the chemical composition of the charged components was determined using a UV-VIS spectrometer. Alloy additives were added in order to meet the carbon and other elements content of high Speed Steel materials. Samples were pulverized with carbon and heat treated. The performance of developed tool was evaluated using wear rate, toughness and micro structural analysis respectively. High proportion of carbide and strengthened martensite were obtained from the microstructure. The tool’s surface hardness and micro-hardness were 76.8 and 47.9 HB, respectively, while that of the control sample’s were 76.3 and 46.1 HB. Minimum wear rate and toughness of the 1ool were 1095x10-8m2/N and 15.01 J, while those of the control sample were 1.127x10-8 Cm2/N and 17 J respectively.

In this study, we identified bioactive compounds from the ethanolic extracts of the leaves, stem bark and root bark of Acalypha wilkesiana through GC-MS analysis and investigated the effects of these extracts on some of the enzymes linked to type 2 diabetes. Plant parts were extracted sequentially with ethyl acetate, ethanol and water. GC-MS analysis revealed the presence of long-chain alkyl acids, esters, ketones and alcohols including phytol and phytol acetate along with some secondary metabolites such as xanthone, vitamin E and various types of sterols including stigmasterol, campesterol and sitosterol. Ethanolic extracts of all the parts showed a dose- -dependent inhibition of α-glucosidase and α-amylase activity. The extracts also demonstrated anti-lipase activity. The ethanolic extract of root bark showed the highest inhibition of enzymes compared to other extracts. The EC50 values (concentrations for 50 % inhibition) of α-glucosidase, α-amylase and lipase inhibition were 35.75 ± 1.95, 6.25 ± 1.05 and 101.33 ± 5.21 μg mL-1, resp. The study suggests that A. wilkesiana ethanolic extracts have the ability to inhibit the activity of enzymes linked to type 2 diabetes. Further studies are needed to confirm the responsible bioactive compounds in this regard.

The aim of this paper is to contribute technical arguments to the debate about the importance of health examination surveys and their continued use during the post-pandemic health financing crisis, and in the context of a technological innovation boom that offers new ways of collecting and analysing individual health data (e.g. artificial intelligence). Technical considerations demonstrate that health examination surveys make an irreplaceable contribution to the local availability of primary health data that can be used in a range of further studies (e.g. normative, burden-of-disease, care cascade, cost and policy impact studies) essential for informing several phases of the health planning cycle (e.g. surveillance, prioritization, resource mobilization and policy development). Examples of the use of health examination survey data in the World Health Organization (WHO) European Region (i.e. Finland, Italy, Malta and the United Kingdom of Great Britain and Northern Ireland) and the WHO Region of the Americas (i.e. Chile, Mexico, Peru and the United States of America) are presented, and reasons why health provider-led data cannot replace health examination survey data are discussed (e.g. underestimation of morbidity and susceptibility to bias). In addition, the importance of having nationally representative random samples of the general population is highlighted and we argue that health examination surveys make a critical contribution to external quality control for a country's health system by increasing the transparency and accountability of health spending. Finally, we consider future technological advances that can improve survey fieldwork and suggest ways of ensuring health examination surveys are sustainable in low-resource settings., ((c) 2024 The authors; licensee World Health Organization.)

Background: Perinatal outcomes are poor among migrant women in vulnerable situations, but little is known about their health preconception. We investigated preconception health inequalities between migrant women in vulnerable situations and non-migrant women., Methods: This national cross-sectional study used data from the NHS Maternity Services Data Set (MSDS) version 1.5, incorporating NHS maternity services in England. All 652,880 women with an antenatal booking appointment between 1/4/2018 and 31/3/2019 were included. Migration category data were available for 66.2 % ( n = 432,022). Odds ratios were calculated comparing preconception indicators among probable migrants in vulnerable situations (English not their first language with complex social factors (CSF)), probable migrants not in vulnerable situations (English not their first language without CSF), probable non-migrants in vulnerable situations (English their first language with CSF) and probable non-migrants not in vulnerable situations (English their first language without CSF). CSF include recent migrants, asylum seekers, refugees, difficulty reading/speaking English; alcohol and/or drugs misuse; aged under 20; and/or experiencing domestic abuse., Findings: We identified 3.8 % (25,070 women) of the study population as probable migrants in vulnerable situations, 10.2 % (66,783 women) as probable migrants not in vulnerable situations, 5.6 % (36,433 women) as probable non-migrants in vulnerable situations, 46.5 % (303,737 women) as probable non-migrants not in vulnerable situations, and 33.8 % as having missing migration category data. Probable migrants in vulnerable situations ( n = 25,070) had over twice the odds of not taking folic acid preconception compared to probable non-migrants not in vulnerable situations (odds ratio 2.15, 95 % confidence interval 2.06-2.25). They had increased odds of previous obstetric complications and being underweight, but lower odds of physical and mental health conditions (apart from diabetes and hepatitis b), smoking and overweight or obesity., Interpretation: Inequalities exist across many preconception indicators, highlighting opportunities to improve preconception health in this population to reduce health inequalities and improve perinatal and neonatal outcomes., Funding: Medical Research Council., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Majel McGranahan reports financial support was provided by UKRI Medical Research Council. Danielle Schoenaker reports financial support was provided by NIHR Southampton Biomedical Research Centre. Helen Duncan reports a relationship with Office for Health Improvement and Disparities that includes: employment. Debra Bick reports a relationship with MASIC foundation that includes: board membership. HD is National lead for lifecourse intelligence at the Office for Health Improvement and Disparities, Department of Health and Social Care If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Background: Typical adolescent diets do not meet current dietary recommendations. There is a need to address these dietary patterns to reduce the risk of obesity and other diet-related diseases. Schools provide an opportune setting to do so, as students consume a substantial proportion of their daily dietary intake whilst at school. There is a developing evidence base on the use of choice architecture (food choice cues) to promote healthy eating in school contexts. It is necessary to understand the acceptability and feasibility of implementing such interventions. We aimed to explore these factors from the perspectives of secondary school caterers., Methods: We conducted qualitative interviews with caterers from secondary schools across the West Midlands, UK and national/regional catering representatives. A semi-structured topic guide and visual aid were used to guide interviews. Interviews were recorded and transcribed. Framework analysis was conducted in NVivo v12., Results: Twelve participants took part. Seven themes were identified and grouped into three categories: Acceptability (Suitability; Salient cues; Student engagement), Barriers (Catering decision drivers; Limits of influence), and Enablers (Perceived role; Opportunities). Caterers considered healthy food cues to be suited to adolescents as they require minimal reflective motivation. Salient cues included enhancing the placement, presentation and portability of healthy items, improving the dining environment and focusing pricing/incentive strategies on increased quantity. Student engagement was considered important. Some catering decision drivers conflicted with healthy food cues, and many felt that their role in healthy eating was limited due to the overwhelming influence of external food environments, adolescent resistance, and features of the secondary school canteen setting e.g. short duration of lunchtime, lack of space. However, caterers appeared motivated to implement healthy food cues and identified key opportunities for implementation, including integration into whole-school approaches to healthy eating., Conclusions: Interventions using healthy food cues appeared acceptable to secondary school caterers, key potential implementers of these strategies. Future interventions could incorporate strategies relating to placement, presentation and pricing to prompt healthy selections, and actions to engage the student body and improve the dining environment. Evaluations should consider potential impacts upon food purchasing, consumption and waste to address caterers' concerns about these issues., (© 2024. The Author(s).)

Problem: Although social media can be an accessible option for women to receive support, there is increasing awareness of the negative mental health impacts of social media use during the postpartum period. Idealistic portrayals on social media have been shown to lead to body dissatisfaction and low mood., Background: The beginning of a child's life is a period of significant physical, mental and social adjustment for a mother. Women often resort to online sources of information to navigate this time period., Aim: This study explored the content featured in prominent health and exercise Instagram account posts targeting pregnant and postpartum women., Methods: Popular individual health and exercise focused accounts targeting pregnant and post-partum women were identified on Instagram. Data about the account holder and content of posts were extracted. Data were analysed using inductive content analysis., Findings: Most included accounts belonged to American women aged 35-44 who were slim. Content analysis of 317 posts from 43 Instagram accounts unveiled six themes: reasons to exercise, weight management, guidance on doing exercise, eating well or not so well, fitting it all in, and comparison of body image., Discussion /conclusion: Content analysed was not representative of the general population. Included posts could shape beliefs that may lead to intrapersonal weight stigma. Consideration must be given to actions that could promote individuals of all body sizes being represented in the media relating to pregnancy and the postpartum period., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Neighbourhood effect on health outcomes is well established, but little is known about its effect on access to essential health services (EHS). Therefore, this study aimed to assess the contributing factors to access to EHS in slum versus non-slum settings., Methodology: The most recent data from 58 Demographic and Health Surveys (DHS) conducted between 2011 and 2018 were used, including a total of 157,000 pairs of currently married women aged 15-49 and their children aged 12-23 months. We used meta-analysis techniques to examine the inequality gaps in suboptimal access to EHS between mother-children pairs living in slums and non-slums. Blinder-Oaxaca decomposition technique was used to identify the factors contributing to the inequality gaps in each low- and middle-income country (LMIC) included., Result: The percentage of mother-child pairs living in slums ranged from 0.5% in Egypt to 63.7% in Congo. Meta-analysis of proportions for the pooled sample revealed that 31.2% [27.1, 35.5] of slum residents and 20.0% [15.3, 25.2] among non-slum residents had suboptimal access to EHS. We observed significant pro-slum inequalities in suboptimal access to EHS in 28 of the 52 LMICs with sufficient data. Of the 34 African countries included, 16 showed statistically significant pro-slum inequality in suboptimal access to EHS, with the highest in Egypt and Mali (2.64 [0.84-4.44] and 1.76 [1.65, 1.87] respectively). Findings from the decomposition analysis showed that, on average, household wealth, neighbourhood education level, access to media, and neighbourhood-level illiteracy contributed mostly to slum & non-slum inequality gaps in suboptimal access to EHS., Conclusion: The study showed evidence of inequality in access to EHS due to neighbourhood effects in 26 LMICs. This evidence suggests that increased focus on the urban poor might be a important for increasing access to EHS and achieving the universal health coverage (UHC) goals., (© 2024. The Author(s).)

Cardiovascular disease (CVD) is the leading cause of mortality globally, and is the second main cause of mortality in the UK. Four key modifiable behaviours are known to increase CVD risk, namely: tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol. Behaviours that increase the risk of CVD can spread through social networks because individuals consciously and unconsciously mimic the behaviour of others they relate to and admire. Exploiting these social influences may lead to effective and efficient public health interventions to prevent CVD. This project aimed to construct and validate an agent-based model (ABM) of how the four major behavioural risk-factors for CVD spread through social networks in a population, and examine whether the model could be used to identify targets for public health intervention and to test intervention strategies. Previous ABMs have typically focused on a single risk factor or considered very small populations. We created a city-scale ABM to model the behavioural risk-factors of individuals, their social networks (spousal, household, friendship and workplace), the spread of behaviours through these social networks, and the subsequent impact on the development of CVD. We compared the model output (predicted CVD events over a ten year period) to observed data, demonstrating that the model output is realistic. The model output is stable up to at least a population size of 1.2M agents (the maximum tested). We found that there is scope for the modelled interventions targeting the spread of these behaviours to change the number of CVD events experienced by the agents over ten years. Specifically, we modelled the impact of workplace interventions to show that the ABM could be useful for identifying targets for public health intervention. The model itself is Open Source and is available for use or extension by other researchers., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Archbold et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Oxidative stress, an imbalance between pro-oxidant and antioxidant status, favouring the pro-oxidant state is a result of increased production of reactive oxygen species (ROS) or inadequate antioxidant protection. ROS are produced through several mechanisms in cells including during mitochondrial oxidative phosphorylation. Increased mitochondrial-derived ROS are associated with mitochondrial dysfunction, an early event in age-related diseases such as Alzheimer's diseases (ADs) and in metabolic disorders including diabetes. AD post-mortem investigations of affected brain regions have shown the accumulation of oxidative damage to macromolecules, and oxidative stress has been considered an important contributor to disease pathology. An increase in oxidative stress, which leads to increased levels of superoxide, hydrogen peroxide and other ROS in a potentially vicious cycle is both causative and a consequence of mitochondrial dysfunction. Mitochondrial dysfunction may be ameliorated by molecules with antioxidant capacities that accumulate in mitochondria such as carotenoids. However, the role of carotenoids in mitigating mitochondrial dysfunction is not fully understood. A better understanding of the role of antioxidants in mitochondrial function is a promising lead towards the development of novel and effective treatment strategies for age-related diseases. This review evaluates and summarises some of the latest developments and insights into the effects of carotenoids on mitochondrial dysfunction with a focus on the antioxidant properties of carotenoids. The mitochondria-protective role of carotenoids may be key in therapeutic strategies and targeting the mitochondria ROS is emerging in drug development for age-related diseases., (© 2024 The Author(s).)

Background: The prevalence of obesity is rising globally and effective strategies to treat obesity are needed. Intermittent fasting, a dietary intervention for weight management, has received growing interest from the general public, as well as healthcare professionals, as a form of lifestyle intervention., Methods: We executed a rapid review using PUBMED database to identify systematic reviews that examined the impact of intermittent fasting on metabolic indices, published between 2011 and 2022., Results: Intermittent fasting leads to weight loss of a similar magnitude to continuous energy restriction. Most of the evidence shows that intermittent fasting leads to greater fat loss as measured by fat mass (kg) or body fat percentage compared to an ad libitum diet, but fat loss attained during intermittent fasting is not significantly different to continuous energy restriction, although recent evidence shows intermittent fasting to be superior. There is mixed evidence for the impact of intermittent fasting on insulin resistance, fasting glucose and lipid profile. Some studies focused on populations of Muslim people, which showed that Ramadan fasting may lead to weight loss and improvement of metabolic parameters during fasting, although the effects are reversed when fasting is finished., Conclusions: Intermittent fasting is more effective than an ad libitum dietary intake, and equally or more effective as continuous energy restriction, for weight management. However, there is inconclusive evidence on whether intermittent fasting has a clinically beneficial effect on glucose and lipid metabolism., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Background: Poor diets lead to negative health outcomes, including increased risk of noncommunicable diseases. Food systems, most notably agriculture, contribute to greenhouse gas emissions (GHGE) that lead to climate change. Meat consumption plays a role in both health and environmental burden. Consumption of meat alternatives may reduce these harms. The aim was to compare meat products and their plant-based alternatives on nutritional parameters, GHGE and price to examine if it is feasible and beneficial for policymakers and health professionals to recommend meat alternatives., Methods: Data on nutritional information and cost for 99 selected products were collected from five UK supermarkets. Estimates for GHGEs for 97 of these products were found through secondary articles. Median values for nutritional value, GHGE (kgCO 2 e) and price per 100 g were calculated to allow comparisons between meat products and their alternatives. Mann-Whitney U tests were used to look for significant differences for each nutrient, emissions and price., Results: Meat alternatives contained significantly more fibre and sugar and were significantly higher in price compared to the equivalent meat products. Meat alternatives had a significantly lower number of calories, saturated fat, protein and kgCO 2 e than meat products. There was no significant difference in the amount of salt between meat and meat alternatives., Conclusions: Overall, this paper found that meat alternatives are likely to be better for health according to most parameters, while also being more environmentally friendly, with lower GHGEs. However, the higher price of these products may be a barrier to switching to meat alternatives for the poorest in society., (© 2023 The Authors. Journal of Human Nutrition and Dietetics published by John Wiley & Sons Ltd on behalf of British Dietetic Association.)

Introduction: Tobacco taxation remains a poorly used intervention to control tobacco use in many low- and middle-income countries (LMICs) including Pakistan even after two decades of FCTC adoption. This study identifies gaps and implementation challenges in the current Tobacco Taxation and Pricing Policies (TTPP) in Pakistan, and highlights key policy implications and lessons for LMICs to strengthen tobacco control measures., Methods: We used qualitative document analysis to examine the policy documents to assess the TTPP against the WHO Framework Convention on Tobacco Control (FCTC) guidelines for the implementation of Article 6 of the FCTC. In addition, we used secondary data on tobacco tax and prices to assess the impact of TTPP on tobacco affordability in the country., Results: Although Pakistan taxes raw tobacco, cigarettes and other tobacco products (cigarillos, cigars, cheroots), the existing TTPP falls below the WHO FCTC requirements of: uniform tax level, simple tax structure and 70% share of excise tax in the price of a product's pack; among others. There are also multiple issues in tobacco tax administration such as lack of monitoring. This is leading to the availability of highly affordable tobacco products in the country., Conclusions: Pakistan does not have a clear strategy on using tobacco taxation and prices as a public health tool in the country. Existing TTPP face dual issues of flawed structure and poor administration translating into highly affordable tobacco products and low revenues in the country. There is a need to introduce multisectoral tobacco control policies in countries like Pakistan in the context of the tobacco sector political economy., Competing Interests: The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2023 Masud H. et al.)

Background: A team of volunteers, known as City Hosts, were recruited to support UK City of Culture 2021 awarded to Coventry. City Hosts held various roles facilitating cultural event delivery and promoting a positive experience for visitors. This study aimed to (i) understand how and to what extent the volunteering programme impacted volunteer subjective wellbeing, and (ii) explore the mechanisms of change and intermediate outcomes between volunteering and subjective wellbeing., Methods: This qualitative study comprised inductive and deductive analysis of data collected through semi-structured interviews, conducted between December 2021-May 2022 with City Hosts. This was complimented with secondary qualitative analysis of free text responses within Monitoring and Evaluation data collected from City Hosts in surveys conducted in August and November 2021, and April 2022., Results: Approximately 180 City Hosts responded to the free text questions in each survey and 27 completed interviews. Analysis of data collected from City Hosts suggested positive wellbeing impacts from volunteering and supported theorised pathways to improved wellbeing. Strengths of the City Host programme included (i) facilitating the full range of mechanisms of change that mediate improved volunteer wellbeing, particularly promoting social connections and developing a strong role and group identity and (ii) flexibility around what volunteers do, how much, and how often., Conclusions: This study offers lessons for others designing volunteering programmes who wish to promote wellbeing among associated volunteers. We also offer evidence that exposure to culture may be one mechanism by which volunteering can improve wellbeing., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Previous studies have shown that those in lower socioeconomic positions (SEPs) generally have higher levels of behavioural non-communicable disease (NCD) risk factors. However, there are limited studies examining recent trends in inequalities. This study examined trends in socioeconomic inequalities in NCD behavioural risk factors and their co-occurrence in England from 2003-19., Methods: This time-trend analysis of repeated cross-sectional data from the Health Survey for England examined the relative index of inequalities (RII) and slope index of inequalities (SII) in four NCD behavioural risk factors: smoking; drinking above recommended limits; insufficient fruit and vegetables consumption; and physical inactivity., Findings: Prevalence of risk factors has reduced over time, however, this has not been consistent across SEPs. Absolute and relative inequalities increased for physical inactivity; relative inequalities also increased for smoking; for insufficient fruit and vegetable consumption, the trends in inequalities depended on SEPs measure. Those in lower SEPs experienced persistent socioeconomic inequalities and clustering of behavioural risk factors. In contrast, those in higher SEPs had higher prevalence of excessive alcohol consumption; this inequality widened over the study period., Interpretation: Inequalities in smoking and physical inactivity are persisting or widening. The pattern of higher drinking in higher SEPs obscure the fact that the greatest burden of alcohol-related harm falls on lower SEPs. Policy attention is required to tackle increasing inequalities in smoking prevalence, low fruit and vegetable consumption and physical inactivity, and to reduce alcohol harm., (© 2023. The Author(s).)

The antidiabetic potentials of the dichloromethene, ethyl acetate, butanol and aqueous fractions of Bridelia ferruginea leaves were investigated using in vitro , ex vivo and in vivo models. In vitro and ex vivo antidiabetic activities revealed the butanol (BFBF) to be the most active of the fractions, and thus selected for in vivo study. Diabetes was induced using the fructose-streptozotocin model. Treatments with BFBF significantly reduced blood glucose level and improved glucose tolerance, serum insulin level and sensitivity as well as suppressed hyperlipidaemia and serum nephropathy markers. Histopathological analysis revealed the ability of BFBF to protect and regenerate pancreatic β-cells. BFBF significantly elevated glutathione level, catalase and superoxide dismutase activities, while depleting MDA level in serums and kidney of diabetic rats. Phenols, steroids, terpenoids, aliphatic and aromatic compounds were identified in the fractions following GC-MS analysis. Overall, results from this study propose that BFBF possess potent antidiabetic activity.

Multiple waves of COVID-19 have significantly impacted the emotional well-being of all, but many were subject to additional risks associated with forced regulations. The objective of this research was to assess the immediate emotional impact, expressed by Canadian Twitter users, and to estimate the linear relationship, with the vicissitudes of COVID caseloads, using ARIMA time-series regression. We developed two Artificial Intelligence-based algorithms to extract tweets using 18 semantic terms related to social confinement and locked down and then geocoded them to tag Canadian provinces. Tweets (n = 64,732) were classified as positive, negative, and neutral sentiments using a word-based Emotion Lexicon. Our results indicated: that Tweeters were expressing a higher daily percentage of negative sentiments representing, negative anticipation (30.1%), fear (28.1%), and anger (25.3%), than positive sentiments comprising positive anticipation (43.7%), trust (41.4%), and joy (14.9%), and neutral sentiments with mostly no emotions, when hash-tagged social confinement and locked down. In most provinces, negative sentiments took on average two to three days after caseloads increase to emerge, whereas positive sentiments took a slightly longer period of six to seven days to submerge. As daily caseloads increase, negative sentiment percentage increases in Manitoba (by 68% for 100 caseloads increase) and Atlantic Canada (by 89% with 100 caseloads increase) in wave 1(with 30% variations explained), while other provinces showed resilience. The opposite was noted in the positive sentiments. The daily percentage of emotional expression variations explained by daily caseloads in wave one were 30% for negative, 42% for neutral, and 2.1% for positive indicating that the emotional impact is multifactorial. These provincial-level impact differences with varying latency periods should be considered when planning geographically targeted, time-sensitive, confinement-related psychological health promotion efforts. Artificial Intelligence-based Geo-coded sentiment analysis of Twitter data opens possibilities for targeted rapid emotion sentiment detection opportunities., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)

Background: The Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) is validated for measuring mental wellbeing in populations aged 11 + and has been translated into 30 + languages. The aims of this study were a) to translate and validate WEMWBS for use in Swahili-speaking populations to facilitate measurement and understanding of wellbeing, evaluation of policy and practice, and enable international comparisons; and b) to examine sociodemographic characteristics associated with higher and lower mental wellbeing in participants in the Girls' Education Challenge (GEC) project in Tanzania., Methods: A short questionnaire including WEMWBS and similar scales for comparison, socio-demographic information, and self-reported health was translated into Swahili using gold standard methodology. This questionnaire was used to collect data from secondary school students, learner guides, teacher mentors and teachers taking part in the GEC project in Tanzania. Focus groups were used to assess acceptability and comprehensibility of WEMWBS and conceptual understanding of mental wellbeing. These were audio-taped, transcribed and analysed thematically. Internal consistency of WEMWBS, correlation with comparator scales and confirmatory factor analysis were completed as quantitative validation. Finally, multivariable logistic regression was used to explore associations between individual characteristics and 'high' and 'low' mental wellbeing, defined as the highest and lowest quartile of WEMWBS scores., Results: 3052 students and 574 adults were recruited into the study. Participants reported that WEMWBS was understandable and relevant to their lives. Both WEMWBS and its short form met quantitative standards of reliability and validity, were correlated with comparator scales and met the criteria to determine a single factor structure. For students in the GEC supported government schools: mental wellbeing was higher in students in the final two 'forms' of school compared with the first two. In addition: being male, urban residence, the absence of markers of social marginality and better self-reported health were all significantly associated with better mental wellbeing. For adults, urban residence and better self-reported health were associated with better mental wellbeing., Conclusions: The Swahili translation of WEMWBS is available for use. Further work to explore how to intervene to increase mental wellbeing in vulnerable GEC participants is needed., (© 2023. The Author(s).)

Introduction: Excess body weight causes 4 million deaths annually across the world. The number of people affected by humanitarian crises stands at a record high level with 1 in 95 people being forcibly displaced. These epidemics overlap. Addressing obesity is a post-acute phase activity in non-communicable disease management in humanitarian settings. Information is needed to inform guidelines and timing of interventions. The objective of this review was to explore the prevalence of overweight and obesity in populations directly affected by humanitarian crises; the cascade of care in these populations and perceptions of patients with overweight and obesity., Methods: Literature searches were carried out in five databases. Grey literature was identified. The population of interest was non-pregnant, civilian adults who had experience of humanitarian crises (armed conflict, complex emergencies and natural disasters). All study types published from January 1st, 2011, were included. Screening, data extraction and quality appraisal were carried out in duplicate. A narrative synthesis is presented., Results: Fifty-six reports from forty-five studies were included. Prevalence estimates varied widely across the studies and by subgroups. Estimates of overweight and obesity combined ranged from 6.4% to 82.8%. Studies were heterogenous. Global distribution was skewed. Increasing adiposity was seen over time, in older adults and in women. Only six studies were at low risk of bias. Body mass index was the predominant measure used. There were no studies reporting cascade of care. No qualitative studies were identified., Conclusion: Overweight and obesity varied in crisis affected populations but were rarely absent. Improved reporting of existing data could provide more accurate estimates. Worsening obesity may be prevented by acting earlier in long-term crises and targeting risk groups. The use of waist circumference would provide useful additional information. Gaps remain in understanding the existing cascade of care. Cultural norms around diet and ideal body size vary., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Shortland et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: The aim of this systematic overview of reviews was to synthesise available evidence on inequalities in infectious disease based on three dimensions of inequalities; inclusion health groups, protected characteristics and socioeconomic inequalities., Methods: We searched MEDLINE, Embase, Web of Science and OpenGrey databases in November 2021. We included reviews published from the year 2000 which examined inequalities in the incidence, prevalence or consequences of infectious diseases based on the dimensions of interest. Our search focused on tuberculosis, HIV, sexually transmitted infections, hepatitis C, vaccination and antimicrobial resistance. However, we also included eligible reviews of any other infectious diseases. We appraised the quality of reviews using the Assessment of Multiple Systematic Reviews V.2 (AMSTAR2) checklist. We conducted a narrative data synthesis., Results: We included 108 reviews in our synthesis covering all the dimensions of inequalities for most of the infectious disease topics of interest, however the quality and volume of review evidence and consistency of their findings varied. The existing literature reviews provide strong evidence that people in inclusion health groups and lower socioeconomic status are consistently at higher risk of infectious diseases, antimicrobial resistance and incomplete/delayed vaccination. In the protected characteristics dimension, ethnicity, and sexual orientation are important factors contributing to inequalities across the various infectious disease topics included in this overview of reviews., Conclusion: We identified many reviews that provide evidence of various types of health inequalities in different infectious diseases, vaccination, and antimicrobial resistance. We also highlight areas where reviews may be lacking. The commonalities in the associations and their directions suggest it might be worth targeting interventions for some high risk-groups that may have benefits across multiple infectious disease outcomes rather than operating purely in infectious disease siloes., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

There is lack of literature on international comparison of gender differences in the use of active travel modes. We used population-representative travel surveys for 19 major cities across 13 countries and 6 continents, representing a mix of cites from low-and-middle income (n = 8) and high-income countries (n = 11). In all the cities, females are more likely than males to walk and, in most cities, more likely to use public transport. This relationship reverses in cycling, with females often less likely users than males. In high cycling cities, both genders are equally likely to cycle. Active travel to access public transport contributes 30-50% of total active travel time. The gender differences in active travel metrics are age dependent. Among children (< 16 years), these metrics are often equal for girls and boys, while gender disparity increases with age. On average, active travel enables one in every four people in the population to achieve at least 30 min of physical activity in a day, though there is large variation across the cities. In general, females are more likely to achieve this level than males. The results highlight the importance of a gendered approach towards active transport policies. Such an approach necessitates reducing road traffic danger and male violence, as well as overcoming social norms that restrict women from cycling., Competing Interests: Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest.