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Introducción: La posibilidad de ofrecer la atención odontológica bajo sedación o anestesia general es cada vez más solicitada por los padres o tutores, particularmente en pacientes pediátricos o con necesidades especiales, debido a las dificultades en la comunicación y escasa colaboración con el tratamiento. Objetivos: Se ha realizado esta revisión narrativa de la literatura con los objetivos de determinar las indicaciones de sedación y/o anestesia general para el tratamiento odontológico en niños, además de describir las diferentes opciones de sedación o anestesia general, y de establecer unos criterios para el alta del paciente tratado bajo sedación o anestesia general. Métodos: Se ha realizado una búsqueda bibliográfica en la base de datos Pubmed con las palabras clave “pediatric dentistry”, “conscious sedation” y “general anesthesia” y el filtro “publicados en los últimos 10 años”, incluyendo publicaciones relevantes para el tema a tratar, que fueran trabajos de revisión o con un diseño observacional o transversal. Se excluyeron publicaciones acerca de pacientes adultos, así como reportes de casos. Resultados: 29 publicaciones fueron incluidas en la presente revisión. Conclusiones: La indicación de un determinado grado de sedación, o de anestesia general, vendrá dada por el grado de colaboración del paciente, su historia médica y la extensión del tratamiento odontológico que requiera. Los principales riesgos de estos procedimientos serán las alteraciones respiratorias y las reacciones alérgicas, entre otras. Tras la intervención, se esperará a que el paciente cumpla con los criterios para el alta antes de interrumpir su monitorización.

Introduction: Periodontal diseases (PDs) pose a significant challenge to dental health, leading to a growing interest in probiotics as potential therapeutic and prophylactic agents. Literature evidence has shown conflicting results on the use of probiotics in the management of PDs. Hence, this systematic review was performed to explore the effectiveness of probiotics in both the prevention and treatment of PDs by synthesizing data from relevant studies. Methodology: Various databases were searched using appropriate MeSH keywords as per the PRISMA protocol. Studies were included only if they met certain criteria. Two reviewers independently extracted data variables from the included literature. The risk of bias 2.0 tool was employed to assess the methodological quality of the included studies. Results: In total, 21 studies were considered eligible and included in the review. It was observed that 17 studies reported a statistically significant improvement in both periodontitis and gingivitis among the probiotic group compared to control cohorts. The synthesized evidence from the review suggests that probiotics play a favourable role in both the prevention and treatment of PDs. Conclusion: It also supports the incorporation of probiotics as a potential adjunctive therapy in PD management. However, further research is warranted to explore the specific probiotic strains, dosages, and treatment durations for optimized outcomes.

IntroductionNarrative skills are crucial for academic success and social interaction. To date, few studies have looked at the specific impact of hearing loss on higher-level language skills, like narrative skills, especially in German-speaking children. This study is the first to analyze the narrative skills of German-speaking children who are hard of hearing.MethodSpecifically, we assessed and compared the narrative skills of two groups of school-aged children – children who are hard of hearing (n = 22; Mage = 10;5) and children with typical hearing (n = 28; Mage = 9;0) – at the macro- and microstructural level using a standardized storytelling task. In addition, the relationship between spoken narrative skills, receptive vocabulary, and phonological working memory was investigated to determine which factors best predict oral narrative performance.ResultsChildren who are hard of hearing produced adequate narratives at the macrostructural level, but used less diverse vocabulary than their peers without hearing loss. Furthermore, children who are hard of hearing demonstrated lower receptive vocabulary and phonological working memory skills than children with typical hearing. Receptive vocabulary emerged as the most important factor in predicting narrative skills at the microstructural level.DiscussionThe heterogeneity observed in the narratives of children who are hard of hearing emphasizes the need to investigate additional factors that may influence the development and expression of spoken narrative skills in this group.

BackgroundShared micromobility programs (SMPs) are integral to urban transport in US cities, providing sustainable transit options. Increased use has raised safety concerns, notably about helmet usage among e-scooter and e-bicycle riders. Prior studies have shown that head and upper extremity injuries have risen with SMP adoption, yet data on helmet use remains sparse.MethodsThis cross-sectional observational study evaluated helmet use among 5,365 riders (e-bicycles, conventional bicycles, and e-scooters) in San Francisco during February and March 2019. Observations were made at seven key intersections during peak commute hours on clear days.ResultsThe majority rode conventional bicycles (77.1%), followed by e-bicycles (19.0%) and e-scooters (3.9%). Most vehicles (82.2%) were personally owned, with the remainder shared via SMPs. Helmet usage was substantially lower among SMP riders, with shared e-scooter users showing the lowest compliance. Specifically, shared e-scooter riders wore helmets 70% less frequently than personal e-scooter riders and 59% less than shared e-bike riders. Dockless e-bike riders used helmets 42% less than those on docked e-bikes.ConclusionThis study exposes significant gaps in helmet usage among SMP riders, highlighting a pressing need for public health interventions and policy adjustments to improve safety and reduce head injury risks. The findings suggest that helmet use is notably deficient among e-scooter and dockless e-bicycle riders, underscoring the urgent need for targeted safety regulations as cities continue to integrate SMPs into their transportation frameworks.

IntroductionThere has been a significant increase in global energy usage due to urbanization and population growth. The built environment is responsible for over one third of global energy consumption, carbon dioxide emissions, and over a quarter of greenhouse gas emissions. The United Arab Emirates building, and construction sector consumes 70% of the entire country’s electricity demand and uses large amounts of raw materials, accelerating resource scarcity. The tiny house offers several environmental and sustainability benefits that have contributed to its growing popularity.MethodsIn this study, the environmental impacts of a tiny house, built on the American University of Sharjah campus will be evaluated using life cycle impact assessment. A cradle-to-grave evaluation was conducted for the life cycle assessment of the tiny house, with a functional unit of 1 m2, using the ReCiPe 2016 V1.03 midpoint method.ResultsThe environmental impact associated with the production and operational phases was most severe, aligning with similar studies on residential buildings. In the material production phase, concrete and steel had the most significant environmental impacts, particularly in the climate change category. These results highlight the importance of focusing on sustainable innovations in material production and recycling to mitigate environmental impacts. The operational phase contributed to approximately 77% of the total carbon dioxide emissions over the 50-year lifespan of the tiny house, primarily due to energy consumption for heating and cooling.DiscussionWhile the findings align with previous studies on residential buildings, it is important to consider the context of a tiny house; its small size results in a significantly lower overall environmental impact compared to larger homes.

Mung beans are promising for protein ingredient production, but their benefits are hindered by potential antinutritional factors and coloring compounds in the hull, resulting in darker-colored products. To address this issue, this study aims to identify a germination period that enhances dehulling efficiency while minimizing mass losses and chemical alterations. Mung bean seeds were soaked overnight and germinated in the dark for 4, 8, 12, 24, 32, and 48 h, with the effects on dehulling efficiency, enzymatic activities, and chemical composition, including antinutritional factors, examined.After 48 h of germination, a substantial increase in enzyme activities was observed: lipolytic activities increased by 644 %, amylolytic activities by 200 %, and polyphenol oxidase activity by 280 %. A decline in protein (21.02–25.77 %), starch (41.83–56.65 %), and fat (0.35–1.03 %) content was detectable after 48 h of germination. SDS-PAGE analysis revealed a reduction in globulins and structural changes with prolonged germination. Total phenolic content was particularly reduced by 20 % due to dehulling. Short-term germination within 12 to 24 h was found to be an effective strategy to facilitate dehulling of mung bean seeds while reducing antinutritional factors and preserving their chemical composition, thus improving their potential as a high-quality raw material for plant-based foods.

ABSTRACT Objective To describe the prevalence of hormone use, sociodemographic profile, and access to health services among the transgender, transvestite, and nonbinary population in Porto Alegre, capital city of Rio Grande do Sul state. Methods A cross-sectional study was conducted between September and November 2021, using a snowball sampling method (n=65). Data were collected through a self-administered questionnaire with transgender people aged 18 years or older. Results High hormone use was observed (n=47), with a higher occurrence of self-medication among transgender women, transvestites, and transfeminine people (n=10). Health monitoring predominantly occurs in gender identity outpatient clinics (n=56). Episodes of transphobia when accessing health services were reported by 28 individuals. Conclusion This study demonstrated high prevalence of hormone use, highlighted specific patterns of use across different gender identities, and the need for improvements in access to healthcare services.

Abstract Objective: Yellow September (YS) (Setembro Amarelo) is a Brazilian suicide prevention campaign launched in 2015, however, its effectiveness at reducing mortality is still unknown. This is an ecologically interrupted time series study that analyzed the trend in suicide rates in Brazil between 2011 and 2019 and its association with the implementation of YS at a national level. Methods: A segmented interrupted series regression analysis was performed, using a generalized linear Poisson model, with correction for seasonal trends. Data were provided by the Mortality Information System (Sistema de Informações Sobre Mortalidade [SIM]). Results: There was an increase in the annual rates of suicide deaths between 2011 and 2019, with 4.99 and 6.41 suicides per 100,000 inhabitants, respectively. The null hypothesis, that the YS did not change the historical trend of growth in suicides in Brazil after its implementation, was confirmed. However, there was a significant increase of 6.2% in the risk of mortality in 2017 and a significant increase of 8.6% in 2019. Conclusion: The results are consistent with the literature, which proposes that campaigns focused solely on publicity in the media generate unsound findings regarding the effective reduction in the number of deaths by suicide. The lack of initiatives involving multisectoral actions may explain the failure of YS to change rates of death by suicide. Therefore, implementation of new lines of action focused on training professionals and expanding the care network could make it an effective instrument for reducing mortality from suicide.

ABSTRACT Objective: To evaluate the association between burden of disease and multimorbidity and absenteeism in Brazil. Methods: This is a cross-sectional study using data from the National Survey of Health 2019. The assessed outcome was absenteeism from work. The burden of disease was assessed by simply counting a list of 14 morbidities and multimorbidity was defined as: ≥two chronic diseases. Poisson regression models stratified by sex were used to estimate crude and adjusted prevalence ratios and their respective 95% confidence intervals. Results: Of the 96,131,029 employed individuals, 38.5% reported absenteeism (95%CI 32.9–44.3). The most prevalent morbidities among women who reported absenteeism were back problems (50.8%), depression (42.9%), and hypertension (41.6%); and among men, hypertension (39.7%), chronic back pain (34.1%), and dyslipidemia (19.9%), among those who reported absenteeism. Having multimorbidity increased the report of absenteeism among women by 73% (95%CI 1.01–2.96); among men, there was no association after progressive adjustment for sociodemographic and health factors [PR 1.27 (95%CI 0.96–1.71)]. Conclusion: The burden of disease and multimorbidity are highly prevalent among employed individuals and are strongly related to absenteeism from work, especially among women. In this sense, workers must be the target of interventions to reduce the impact of chronic noncommunicable diseases.

Background Digital adherence technologies (DATs) with associated differentiated care are potential tools to improve tuberculosis (TB) treatment outcomes and reduce associated costs for both patients and healthcare providers. However, the balance between epidemiological and economic benefits remains unclear. Here, we used data from the ASCENT trial to estimate the potential long-term epidemiological and economic impact of DAT interventions in Ethiopia.Methods We developed a compartmental transmission model for TB, calibrated to Ethiopia and parameterised with patient and provider costs. We compared the epidemiological and economic impact of two DAT interventions, a digital pillbox and medication labels, to the current standard of care, assuming each was introduced at scale in 2023. We projected long-term TB incidence, mortality and costs to 2035 and conducted a threshold analysis to identify the maximum possible epidemiological impact of a DAT intervention by assuming 100% treatment completion for patients on DAT.Findings We estimated small and uncertain epidemiological benefits of the pillbox intervention compared with the standard of care in Ethiopia, with a difference of −0.4% (95% uncertainty interval (UI) −1.1%; +2.0%) incident TB episodes and −0.7% (95% UI −2.2%; +3.6%) TB deaths. However, our analysis also found large total provider and patient cost savings (US$163 (95% UI US$118; US$211) and US$3 (95%UI: US$1; US$5), respectively, over 2023–2035), translating to a 50.2% (95% UI 35.9%; 65.2%) reduction in total cost of treatment. Results were similar for the medication label intervention. The maximum possible epidemiological impact a theoretical DAT intervention could achieve over the same timescale would be a 3% (95% UI 1.4%; 5.5%) reduction in incident TB and an 8.2% (95% UI 4.4%; 12.8%) reduction in TB deaths.Interpretation DAT interventions, while showing limited epidemiological impact, could substantially reduce TB treatment costs for both patients and the healthcare provider.

Objectives Access to healthcare and accurate health information is a persistent issue for people experiencing homelessness (PEH), one heightened by the COVID-19 pandemic and exacerbated by issues of health literacy and mistrust. Strategies involving community health workers (CHWs) have the potential to improve education and service delivery for PEH. The objective of this study is to assess PEH knowledge, attitudes and barriers to COVID-19 testing and vaccination, and the impact of CHW-led education within a homeless shelter in Indiana.Design/setting Between November 2021 and April 2022, 15 sessions were held at a homeless shelter that combined focus group discussions with COVID-19-related education. Pre-/post-tests measured knowledge gains and attitude shifts among PEH. Guided by the socioecological model, thematic analysis of focus group transcripts identified key motivators and barriers to COVID-19 vaccination and testing.Participants 78 PEH (73% male, 74% white, mean age=48).Outcome measures COVID-19-related knowledge gains and willingness to receive testing and vaccination among PEH.Results Completion of an educational session was associated with a significant increase in knowledge scores (mean pre-test score=10.76/15, SD=2.16; mean post-test score=13.58/15, SD=1.72; p

Objetivos: Investigar la fotobiomodulación vascular en el control de la ansiedad en niños durante la atención odontológica. Métodos: Participaron 90 niños entre 6 y 12 años de la Clínica Universitaria de Salud de la Universidad Católica del Uruguay. Fueron divididos aleatoriamente en dos grupos: PBM(G1)8.3años; Sham(G0)9.12 años la media. Se utilizó el equipo Therapy EC, DMC Brasil. Para el tratamiento de fotobiomodulación (FBM) se aplicó láser continuo, dirigido a la arteria radial de la mano izquierda, en contacto directo, con 60J de energía, longitud de onda 660nm y 100mW/cm2 de potencia durante 10 minutos en G1. Para G0 la FBM fue simulada, anulando la emisión de luz, niño con tapaojos. Un investigador externo fue responsable de aplicar la FBM. Se evaluaron los niveles de ansiedad mediante la Escala de Imagen Facial (FIS) y Test de Imagen de Venham (VPT), antes y después de la atención odontológica. También fueron medidos parámetros fisiológicos: presión arterial (PA), oximetría(O), y frecuencia cardíaca (FC). Resultados: VPT disminuyo de 4,41 a 3,63 en el G1, permaneciendo constantes en el G0. FIS se mantuvo constante en ambos grupos. O y PA sin diferencia estadisticamente significativa. FC disminuyo de 86 a 84 y de 93 a 86 l/s en el G1 y G0; aunque en G1 (p=0,333), la disminución no fue estadísticamente significativa, la caída en G0 sí fue significativa (p=0,001). Conclusiones: No hubo diferencias estadísticamente significativas con el uso de fotobiomodulación para controlar la ansiedad de los niños durante la atención odontológica en los grupos estudiados.

Objetivos: Este ensayo clínico tiene como objetivo verificar si el uso de fotobiomodulación vascular (FBMV) es capaz por su efecto sistémico de disminuir los signos y la sintomatología de los niños con TMD, si la FBMV influye en la reducción del dolor y aumenta la amplitud de movimiento en la apertura y cierre bucal en niños y adolescentes con DTM. Métodos: Este ensayo que es ciego, randomizado controlado se realizó a niños entre 6 y 9 años que ingresaron a la Universidad Católica del Uruguay Facultad de Ciencias de la Salud, Escuela de Posgrado y escuelas con convenio con la Universidad Católica del Uruguay, que presentaron TMD, basados en los Criterios Diagnóstico para Trastornos Temporomandibulares modificado para niños y adolescentes (DC/TMD) y usando la escala visual analógica que es un buen instrumento para medir la intensidad de dolor en niños, siendo el más usado. El láser que se usó es de la marca DMC Therapy Ec potencia 100 mW ±20%, longitud de onda 660nm ±10 nm, rojo, el parámetro de energía 120J, de aplicación continua. La técnica no es invasiva, el punto de irradiación es por aplicación transcutánea continua y directa a la arteria radial por medio de pulsera en la que se aplica el haz del láser. Esto se realizó en una única sesión de 20 minutos en dos grupos, grupo 1 FBMV y grupo 2 placebo. Los participantes de los 2 grupos fueron reevaluados inmediatamente después de la sesión, siguiendo los mismos procedimientos de evaluación utilizados inicialmente. Resultados: El tamaño de la muestra fue menor, se mostró una disminución del dolor tanto en el grupo FBMV como en el grupo placebo, siendo la diferencia estadística mayor en el grupo FBMV. No se registraron cambios en la variable de movimiento de apertura y cierre bucal ni en el patrón de movimiento. Se concluye que la FBMV, en relación con el dolor, disminuye tanto en el grupo FBMV como en el grupo placebo en una única sesión.

Objective: We assessed the global distribution and academic, administrative and research outcomes of international fellows (IFs) trained in Canadian gynecologic oncology (GO) programs. Methods: A web-based survey was sent to IFs who completed GO training in Canada. Using the Web of science database, we identified the publication list, citation record and H-index of IFs and classified them according to their region of practice: high-income countries (HIC), middle income countries (MIC), and low-income countries (LIC). Results: From 1996 to 2020, 81 IFs from 23 countries were trained in English-speaking (62,9%) and French-speaking Canadian universities (37,1%). Most IFs came from HIC (87,6%) and none from LIC. Only 12 IFs (14,8%) are now practicing in Canada. Of the 55 IFs who completed the survey (response rate: 67,9%), the majority (58,2%) reported working in an academic hospital and 29,1% were holding an executive position in a national scholar organization. IFs participated in mentoring residents (96.4 %) and medical students (83,6%) and 36,3% initiated a GO fellowship program in their home country. 67,3% of IFs were involved in international research collaboration and 52,7% participated in international clinical trials. The mean number of publications (22,36 vs 7,75, p = 0.007), citations (369,15 vs 45,12 p = 0.0006) and H-Index (6,88 vs 2,37 p = 0.0001) were significantly higher among IFs working in HIC compared to those in MIC. Most IFs (98,2%) recommended their Canadian GO fellowship program to a colleague from their home country. Conclusion: Most IFs trained in Canadian GO fellowship programs returned to their home countries and achieved important milestones in terms of academic, clinical and research accomplishments.

A retrospective cohort study was conducted in Malta to assess the prevalence of threatened miscarriage. The study focuses on cases managed at a local state hospital over a 12-month period. Currently, data on pregnancies prior to 22 weeks’ gestation are not publicly available, which hampers understanding of the frequency and impact of threatened miscarriage. This research provides the basis for a potential prospective study which analysis the epidemiology and outcomes of threatened miscarriage and advocates for early intervention and appropriate patient counselling. The study included females who visited the Accident and Emergency Department in a local state hospital in 2019 with first trimester vaginal bleeding. It excluded patients with incomplete medical records. Data from various hospital departments were collected, anonymised and analysed to track outcomes such as miscarriage, ongoing pregnancy, ectopic or molar pregnancy. The research aimed to create a comprehensive local registry of pregnancy outcomes following threatened miscarriage, reflecting the national situation. In 2019, 711 pregnant women in Malta experienced first-trimester vaginal bleeding. Of these, 241 had successful births beyond 22 weeks’ gestation, while 412 experienced miscarriages, with other outcomes including ectopic and molar pregnancies and 58 women had an unknown pregnancy outcome. A significant association was found between maternal age and risk of miscarriage, particularly higher for women aged 35–46 and those under 19. Birthweight data revealed that threatened miscarriage complications likely led to low birthweights in a significant proportion of newborns. This study analysed pregnancy outcomes which were preceded by first trimester vaginal bleeding in pregnant women in Malta. Establishing a local register of pregnancy outcomes following first trimester vaginal bleeding provides clinicians with enhanced insights into the current local context. This resource may improve patient counselling and informed policy decisions and lay the groundwork for future research in the field.

Anxiety is a common reaction to the threat of nuclear war, and there is a need for a reliable and valid measure to assess it. Existing questionnaires on the specific anxiety due to the danger of nuclear war only measure some of the four clusters of anxiety symptoms (cognitive, emotional, somatic, behavioural), or they measure coping strategies or attitudes toward nuclear weapons. Therefore, the main aim was to develop a new Anxiety due to the Nuclear War Threat Scale (ANWTS) and to determine its psychometric characteristics. In a cross-sectional online study, 287 participants from a community setting (64.8% women) filled out the ANWTS, Depression, Anxiety, and Stress Scale (DASS-21), the Nuclear War Anxiety Questionnaire, and the Nuclear Coping Strategies scale. Exploratory factor analysis showed a two-factor structure with Cognitive and Emotional Symptoms Subscale (11 items, ⍵ = .96) and Somatic Symptoms Subscale (6 items, ⍵ = .93). High convergent and divergent validity was demonstrated. Known-group differences validity showed that women reported higher anxiety symptoms on both subscales and total scale than men. A new 17-item ANWTS is reliable and valid in measuring cognitive, emotional, and somatic anxiety symptoms due to possible nuclear war threats.

In recent years, there has been a surge of interest in violence as a public health issue. Preventing violence before it occurs and developing effective response strategies are key to achieving the United Nations Sustainable Development Goals and improving health and well-being. This systematic scoping review explores the role of public health frameworks in the primary prevention of interpersonal violence. A systematic literature search was undertaken to identify frameworks from both academic and grey literature. Extracted records (n = 17) were thematically analyzed to explore themes, divergences, and theoretical underpinnings. Most frameworks were published in the last decade by national and international public health bodies. The majority were from high-income countries and explored a range of interpersonal violence types. Nine themes were identified, which provide opportunities for violence prevention across the socio-ecological model, including: families, caregivers, and early years; early identification and support; schools, education, and skill development; safe community environments; safe activities and trusted adults; social norms and values; empowerment and equality; policy and legislation; and poverty reduction. These frameworks evidence the leadership role played by public health in the development and implementation of the primary prevention of violence. However, to effectively embed a public health approach, the review identified several areas which warrant further attention. These included redressing disparities in evidence, particularly from low income countries; building the evidence base for addressing community and structural determinants of violence such as gender, poverty, and inequality; and investing in research which explores the implementation of primary prevention approaches.

Abstract Arid and semiarid regions cover more than one‐third of the land surface, where the interplay between water, land use, and management strongly influences carbon (C) sequestration. Yet, information on the C management practices and how local biophysical conditions affect the C sequestration potential is limited. We explored the opportunities, research gaps, and future directions of land C sequestration in arid and semiarid regions, using New Mexico as an example. We also identified the major land use types and their potential for C storage and sequestration. Our results showed that innovations in cropland and rangeland management, protection of existing forests, and restoration of degraded forest lands after drought and wildfire enhanced C sequestration in arid and semiarid lands. Landscape‐scale C balance studies with fine‐scale mapping, improving water and nutrient use efficiency, and policy incentives to support farms will unlock the full potential of C sequestration in croplands, rangelands, and forest lands. Future research should focus on the response of land management practices to climate anomalies and their potential to sequester C and offset greenhouse gas emissions as a natural climate solution in arid and semiarid regions.

Background: The integration of work coaches (WCs) and disability employment advisors (DEAs) into General Practitioner (GP) practices in the UK aims to address the interplay between health and employment by facilitating access to employment support, especially to people with disabilities and health conditions affecting their ability to work. This study seeks to explore the perspectives and perceptions of WCs, DEAs and GPs regarding the benefits and challenges of embedding WCs and DEAs in GP practices. Methods: Data was collected between May and July 2023 through semi-structured interviews with four GPs, four WCs and four DEAs working in NHS GP practices. The interviews were audio-recorded, transcribed verbatim and thematically analysed using the Thematic Framework method. Emergent themes were pre-structured and classified as perceived benefits, barriers and challenges or drivers and strategies. Results: The integration of WCs & DEAs within GP practices was perceived by respondents as fostering a direct collaboration between professionals as well as a greater openness of patients which benefited patients, WCs/DEAs and GPs. While all respondents emphasised the various benefits, they also identified several barriers and challenges. The implementation stage was perceived as particularly challenging, especially by WCs and DEAs, whereas the lack of human, financial and logistical resources hindered the service beyond this stage. Several strategies and drivers to support the service were identified, including the importance of receiving support from all professionals involved as well as making the service visible to both healthcare professionals and patients. Conclusion: Embedding WCs and DEAs in GP practices emerges as a promising approach which can benefit patients, GPs and WCs/DEAs. Exploring patients' perspectives directly is crucial to fully assess this type of service and identify any additional challenges and benefits.

ObjectiveThis pilot study aims to assess the diet quality amongst Lebanese male university students using the Global Diet Quality Score (GDQS), identify its association with obesity, and determine the key drivers of consumption of foods associated with higher NCDs risk.MethodsA cross-sectional survey was conducted using a convenience sampling approach, comprising 385 male students aged between 18 and 24 years at the American University of Beirut. Dietary data was collected using 24-h recall, where participants detailed all foods and beverages consumed in the past 24 h, including portion sizes. Sociodemographic, anthropometric, lifestyle factors and drivers of food consumption data were also collected. GDQS scores were categorized as high (≥23), moderate (15–23), or low (< 15) indicating low, moderate and high NCD risk, respectively. A multiple logistic regression was applied to assess association of GDQS with sociodemographic and anthropometric variables.ResultsThe results showed that the majority of male university students had low (47%) or moderate (47%) GDQS scores, with only a small proportion (4%) showing high scores. Foods contributing to low GDQS scores were determined, with taste emerging as the primary factor influencing food group consumption. Additionally, individuals in health-related majors and higher academic year of study had higher GDQS scores, and those with higher GDQS scores had a lower risk of obesity. The study findings suggest that a high proportion of the study sample are at a higher risk of NCDs given their dietary quality, demonstrated an association between low GDQS scores and obesity risk, and identified education as a predictor of diet quality.ConclusionThis study calls for larger studies assessing dietary habits and quality amongst Lebanese university students to provide context-specific evidence for the development of targeted interventions aimed at the promotion of healthier eating habits in this population group and curbing the NCDs epidemic in the country.

A concretização do currículo integrado é fundamental para que ocorram avanços nos processos de aprendizagem do ensino técnico integrado ao ensino médio. Com o intuito de contribuir com a discussão sobre a temática da educação profissional científica e tecnológica, propõe-se no presente trabalho apresentar e refletir sobre a experiência inovadora de integração propiciada pela implementação das Unidades Curriculares Politécnicas (UCPs) no campus Uberlândia Centro do Instituto Federal do Triângulo Mineiro. As UCPs são unidades curriculares flexíveis, planejadas por docentes de diferentes áreas técnicas do conhecimento assumindo vertente interdisciplinar e transdisciplinar. A implementação das UCPs exige um planejamento constante, experimental e coletivo, estimula o protagonismo relacional entre professores e estudantes e aproxima o conhecimento de diferentes áreas do conhecimento possibilitando um rompimento com os padrões educacionais disciplinares (Foucault, 1987).

A edição especial n.º 50 da Revista Dialogia tem como foco temático EDUCAÇÃO STEAM: FORMAÇÃO, PERCEPÇÕES E PRÁTICAS SOB OLHARES DE BRASIL E PORTUGAL, e reúne artigos resultantes de pesquisas e experiências realizadas sob a abordagem STEAM, que integra as áreas de Ciências, Tecnologia, Engenharia, Artes e Matemática. Essa abordagem tem se tornado cada vez mais relevante no contexto educacional contemporâneo, especialmente na Educação Básica, estendendo-se também ao Ensino Superior, uma vez que busca desenvolver nos estudantes não apenas habilidades, mas também competências criativas e críticas, essenciais para enfrentar os desafios do século XXI. Ao integrar essas áreas do conhecimento, a educação STEAM promove uma aprendizagem mais holística, conectando o conhecimento teórico e prático de forma interdisciplinar. Nesse sentido, cada uma das áreas que compõem o STEAM oferece contribuições valiosas para a formação dos estudantes. A Ciência estimula o pensamento lógico e a curiosidade ao buscar explicações e compreender o mundo natural. A Tecnologia prepara os estudantes para lidar com as ferramentas e inovações que dominam a sociedade atual, além de promover o desenvolvimento de habilidades de resolução de problemas e inovação. A Engenharia oferece uma abordagem prática para solucionar questões complexas, incentivando os estudantes a aplicar o conhecimento científico na criação de soluções viáveis. A Matemática, por sua vez, proporciona uma base sólida para a análise e interpretação de dados, sendo fundamental para a tomada de decisões informadas em diversas áreas. Por fim, as Artes desempenham um papel crucial ao incentivar a criatividade, a expressão pessoal e a capacidade de pensar fora da caixa. Além disso, ao incluir as Artes no currículo, a educação STEAM contribui para a formação de cidadãos mais empáticos, éticos e conscientes, capazes de usar sua criatividade para melhorar o mundo ao seu redor. Ao integrar essas áreas, a educação STEAM promove uma aprendizagem mais global, estimulando os estudantes a desenvolver habilidades cognitivas, socioemocionais e atitudes essenciais para o sucesso acadêmico e profissional, equipando-os para lidar com as rápidas mudanças tecnológicas e sociais. Em um mundo onde a inovação é constante e as profissões estão em transformação, os estudantes precisam estar preparados para se adaptar e colaborar de forma multidisciplinar. O modelo STEAM fomenta a interdisciplinaridade, incentivando a resolução de problemas complexos por meio de abordagens criativas e colaborativas. Vale ainda destacar que a educação STEAM é fundamental para promover a inclusão e a equidade no ensino, permitindo que todos os estudantes, independentemente de sua origem ou condições sociais, tenham acesso a um currículo que favoreça o desenvolvimento de habilidades essenciais para a vida moderna, como o pensamento crítico. Quando desafiados a trabalhar em projetos que envolvem múltiplas disciplinas, os estudantes precisam analisar problemas sob diversas perspectivas, pensar de forma independente e tomar decisões baseadas em evidências e dados, fortalecendo, assim, sua capacidade de resolução de problemas — uma habilidade crucial não apenas para a vida acadêmica, mas também para a carreira profissional e o cotidiano. A transição de um modelo tradicional para uma abordagem STEAM, no entanto, enfrenta desafios significativos. Muitos professores ainda estão inseridos em sistemas educacionais que priorizam a especialização disciplinar e os métodos de ensino convencionais. Essa mudança exige um esforço coletivo para a reformulação do currículo, das práticas pedagógicas e da formação docente. É necessário que as políticas educacionais incentivem a integração entre as áreas do conhecimento e ofereçam apoio concreto para que os professores desenvolvam as competências necessárias à abordagem STEAM. Isso pode ser realizado por meio de programas de capacitação, oficinas, workshops e espaços de troca de experiências entre educadores de diferentes áreas. Diante desse cenário, o número especial da Dialogia foi idealizado a partir do evento TRILHAS FORMATIVAS: A FORMAÇÃO DE PROFESSORES EM TEMPOS DE EDUCAÇÃO STEAM[1], realizado em 10 de abril de 2024, fruto da parceria entre o GRUPETEC (Grupo de Pesquisa em Educação, Tecnologias e Cultura Digital), vinculado ao CNPq e à Universidade Nove de Julho (São Paulo/Brasil), e a Universidade Aberta de Portugal (UAb-PT) — Unidade de Missão dos Centros Locais de Aprendizagem de Coruche e de Montijo. Esse evento contou com participantes de Portugal, Angola, Moçambique e Brasil. Como palestrantes, houve a colaboração de três pesquisadoras da UAb-PT e de cinco pesquisadores brasileiros, cujas apresentações abordaram temáticas relacionadas à Educação STEAM e alguns de seus desdobramentos, como: Universidade, Escola e Pesquisa; Internacionalização Pedagógica; Educação STEAM: Princípios e Práticas; Panorama sobre a Formação de Professores em Tempos de Educação STEAM no Brasil; Formação de Professores e os Projetos STEAM com uso de Tecnologias em Portugal; Robótica Educacional; Pensamento Computacional e Inovação; Criatividade e Empreendedorismo na Formação Acadêmica com ABP e STEAM. Essas temáticas permitiram uma discussão sobre as potencialidades da educação STEAM e sobre como trilhas formativas podem ser estruturadas para preparar os professores para esse contexto, promovendo uma prática educativa mais conectada e inovadora. Após o evento, os palestrantes foram convidados a contribuir para a construção desta edição especial n.º 50 da Dialogia. Como resultado desse convite, obtivemos os seguintes artigos: Trilhas formativas: mobilizando conhecimentos e interações docentes além Brasil/Portugal, de Adriana Aparecida de Lima Terçariol, Fernanda Pereira da Silva, João Barnabé e Lara Caeiro; Educação STEAM: conceito, breve histórico, diretrizes e prática, de Stephani Vilela Ferreira Custodio e Thais de Almeida Rosa; ePortfólios como recursos de carreira – programa online com estudantes do ensino superior, de Susana Henriques, Maria de Fátima Goulão e Daniela Barros; · Robótica educacional, avanços e desafios para o ensino médio integrado ao técnico, de Romeu Afecto, Andressa Algayer da Silva Moretti e Lucimara de Sousa Teixeira; · Educação STEAM e a formação inicial de Professores: perspectivas e desafios para escolas brasileiras, de Ronaldo Lasakoswitsck; · Criatividade, inovação e empreendedorismo na formação acadêmica com aprendizagem baseada em projetos integrada ao STEAM, de Lilian Amatucci Gazoti e Dalva Célia Henriques Rocha Guazzelli. Os demais textos, relacionados abaixo, foram elaborados por convidados externos, devido aos seus temas de estudo estarem alinhados à temática geral proposta para o evento e para esta edição especial. O radioamadorismo como ferramenta inovadora na Educação STEM: uma revisão bibliográfica, de Moisés Figueiredo da Silva, Luciano Henrique Trindade e Antonio Pires Barbosa; Uma nova abordagem usando simulação de modelos físicos com realidade aumentada para o ensino em engenharia elétrica: um estudo de caso usando eletromagnetismo, de Natan Menegasse e Cleber Dias; Contribuição de oficinas sobre metodologias ativas para o desenvolvimento profissional de professores em uma rede municipal catarinense, de Valdir Lamim-Guedes; Os impactos do CO2 em plantas: cultivando a consciência ambiental em estudantes por meio de uma atividade investigativa, de Daniel Bastos Souza Filho e Fabrício Bonfim Sudério; A cultura e metodologia maker na formação de professores: uma proposta criativa, interdisciplinar, inovadora, sustentável e inclusiva, de Katia Valeria Pereira Gonzaga, Vania Gabriela Dias Graça e Paula Quadros-Flores. É com imensa alegria que apresentamos a vocês, queridos leitores, a edição mais recente da Revista Dialogia. Nosso desejo é que esta publicação contribua para o avanço da inovação e do conhecimento em Educação, fortalecendo as redes de formação e expandindo as oportunidades de internacionalização entre pesquisadores, educadores e todos os interessados nos temas aqui tratados. Por fim, agradecemos ao interesse e à contribuição de cada autor (a)! Acreditamos que os artigos compartilhados poderão inspirar novas pesquisas e experiências articuladas à Educação STEAM em territórios luso-brasileiros. Excelente leitura! [1] Esse evento constitui-se como uma das ações previstas para oportunizar a formação continuada de professores nos seguintes projetos de pesquisa: (1) “A Robótica Criativa e Sustentável no Desenvolvimento de uma Educação Profissional e Tecnológica Integrada ao Ensino Médio: Potencializando Projetos em uma Abordagem STEAM”, em desenvolvimento desde fevereiro de 2023, com o apoio da Chamada do Programa de Pesquisa em Educação Básica – PROEDUCA – FAPESP/SEDUC e Universidade Nove de Julho (UNINOVE/SP/BRASIL); (2) "Educação STEAM: Uma Construção Colaborativa com a Robótica Educacional Sustentável", em curso desde março de 2023, com apoio do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), conforme a Chamada CNPq Nº 09/2022 - Produtividade em Pesquisa, em parceria com a Universidade Nove de Julho (Uninove/SP/BRASIL).

Abstract The study examines the connection between the geopotential height (Z850 hPa) and the temperature (°C) and precipitation (mm) in Iraq. The observation data for climatological parameters that are currently available from the Iraqi meteorological organization are used. The temporal analysis of precipitation had a homogeneous data with a single mean for the period but temperatures throughout the research period exhibit a fluctuating tendency, with most stations showing a rising trend after 1993. The northern mountain area of Iraq has the highest amounts of precipitation, while the southern portion of the country records the lowest amounts. The distribution of temperature is characterized in reverse by the precipitation pattern. A correlation map is used for investigating the link between Z850 hPa and the two Iraqi climatological factors. According to the research, cold air descending from the Polar Regions is the primary mechanism responsible for bringing cold air mass over the Iraqi region during winter precipitation. Iraq receives precipitation in the springtime mostly due to the advection of moist air from the Mediterranean Sea and North Africa. Additionally, during summer and autumn, the hot air advection from India and eastern Africa through the Arabian Peninsula is associated with Iraqi temperature patterns.

BackgroundPortable spirometers are increasingly used to measure lung function at home, but doubts about the accuracy of these devices persist. These doubts stand in the way of the digital transition of chronic respiratory disease care, hence there is a need to address the accuracy of home spirometry in routine care across multiple settings and ages. ObjectiveThis study aimed to assess the accuracy, reproducibility, and responsiveness to the treatment of home spirometry in long-term pediatric and adult cystic fibrosis care. MethodsThis retrospective observational study was carried out in 5 Dutch cystic fibrosis centers. Home spirometry outcomes (forced expiratory volume in one second [FEV1], and forced vital capacity [FVC]) for 601 anonymized users were collected during 3 years. For 81 users, data on clinic spirometry and elexacaftor/tezacaftor/ivacaftor (ETI) use were available. Accuracy was assessed using Bland-Altman plots for paired clinic-home measurements on the same day and within 7 days of each other (nearest neighbor). Intratest reproducibility was assessed using the American Thoracic Society/European Respiratory Society repeatability criteria, the coefficient of variation, and spirometry quality grades. Responsiveness was measured by the percentage change in home spirometry outcomes after the start of ETI. ResultsBland-Altman analysis was performed for 86 same-day clinic-home spirometry pairs and for 263 nearest neighbor clinic-home spirometry pairs (n=81). For both sets and for both FEV1 and FVC, no heteroscedasticity was present and hence the mean bias was expressed as an absolute value. Overall, home spirometry was significantly lower than clinic spirometry (mean ΔFEV1clinic-home 0.13 L, 95% CI 0.10 to 0.19; mean ΔFVCclinic-home 0.20 L, 95% CI 0.14 to 0.25) and remained lower than clinic spirometry independent of age and experience. One-way ANOVA with post hoc comparisons showed significantly lower differences in clinic-home spirometry in adults than in children (Δmean 0.11, 95% CI –0.20 to –0.01) and teenagers (Δmean 0.14, 95% CI –0.25 to –0.02). For reproducibility analyses, 2669 unique measurement days of 311 individuals were included. Overall, 87.3% (2331/2669) of FEV1 measurements and 74.3% (1985/2669) of FVC measurements met reproducibility criteria. Kruskal-Wallis with pairwise comparison demonstrated that for both FVC and FEV1, coefficient of variation was significantly lower in adults than in children and teenagers. A total of 5104 unique home measurements were graded. Grade E was given to 2435 tests as only one home measurement was performed. Of the remaining 2669 tests, 43.8% (1168/2669) and 43.6% (1163/2669) received grade A and B, respectively. The median percentage change in FEV1 from baseline after initiation of ETI was 19.2% after 7-14 days and remained stable thereafter (n=33). ConclusionsHome spirometry is feasible but not equal to clinic spirometry. Home spirometry can confirm whether lung functions remain stable, but the context of measurement and personal trends are more relevant than absolute outcomes.

IntroductionThis study examines inmates' perspectives on the effectiveness of sports coaches in prison. According to the integrative definition of effective coaching, coaches require professional, interpersonal, and intrapersonal knowledge to enhance athletes' outcomes within a specific context.MethodsFive male inmates of a German prison were interviewed after they participated in sports programs. The data were analyzed using directed content analysis.ResultsThe inmates recognized professional knowledge in coaches who demonstrated clear training structures and spoke in an educated manner. Interpersonal knowledge was highly valued, with inmates expressing a preference for coaches who showed closeness, truthfulness, and responsiveness, while intrapersonal knowledge was attributed through coaches' adaptability. Inmates identified all four possible outcomes and emphasized that sensitivity, authenticity, energetic demeanor, physical appearance, and athletic skills are crucial qualities for an effective coach in a prison.DiscussionThe balance between an authentic and energetic demeanor, including a certain degree of strictness, emerges as a key factor in effective coaching within the prison context.

Proline-rich antimicrobial peptides (PrAMPs) have gained attention due to their antimicrobial properties and low cytotoxicity. B7-005, a small optimized PrAMP, exhibits a broader spectrum of activity than native PrAMPs, due to an antimicrobial mechanism based on inhibiting prokaryotic protein synthesis and destabilizing bacterial membranes. However, the toxicity and the in vivo efficacy of B7-005 remain poorly understood, so in vitro and in vivo microbiology and toxicology experiments were used to assess its suitability as an anti-infective agent. The incidence of resistance towards B7-005 by E. coli was lower than for other PrAMPs and antibiotics; moreover, it maintained antimicrobial activity in the presence of human serum. B7-005 exerted its antimicrobial effect at a much lower concentration than those causing harmful effects on four different cell types, such as membrane permeabilization or non-lytic depolarization of mitochondria. The latter effect may be related to the inhibition of eukaryotic protein synthesis by B7-005 observed in vitro. In a zebrafish embryo model, B7-005 was well tolerated and reduced mortality from pre-existing E. coli bacteraemia. Overall, B7-005 was safe for human cells and effective against systemic infection in vivo, making it a promising lead for developing new antibiotics.

Successfully implementing care technology to enhance people's health-related quality of life poses several challenges. Although many technological tools are available, we lack consensus on values and principles, regulatory systems, and quality labels. This article describes the FIDE process of the Belgian ‘Teckno 2030' project: Future-thinking Interdisciplinary workshops for the Development of Effectiveness principles, resulting in a framework of eight Caring Technology principles. These principles are built on three overarching values: autonomy, justice, and trust. The framework enables responsible health technology innovation by focusing on the needs of users and society, data security, equity, participatory governance, and quality control. A learning community was established to support the framework’s implementation in projects, organizations, and the broader innovation community. We also discuss the barriers, facilitators, and practical tools developed within this learning community. The FIDE process, caring technology principles, and learning community provide a case study for responsible innovation in care technology.

Microglia represent the main resident immune cells of the brain. The interplay between microglia and other cells in the central nervous system, such as neurons or other glial cells, influences the function and ability of microglia to respond to various stimuli. These cellular communications, when disrupted, can affect the structure and function of the brain, and the initiation and progression of neurodegenerative diseases including Alzheimer's disease and Parkinson's disease, as well as the progression of other brain diseases like glioblastoma. Due to the difficult access to patient brain tissue and the differences reported in the murine models, the available models to study the role of microglia in disease progression are limited. Pluripotent stem cell technology has facilitated the generation of highly complex models, allowing the study of control and patient-derived microglia in vitro. Moreover, the ability to generate brain organoids that can mimic the 3D tissue environment and intercellular interactions in the brain provide powerful tools to study cellular pathways under homeostatic conditions and various disease pathologies. In this review, we summarise the most recent developments in modelling degenerative diseases and glioblastoma, with a focus on brain organoids with integrated microglia. We provide an overview of the most relevant research on intercellular interactions of microglia to evaluate their potential to study brain pathologies.

Diabetes mellitus (DM) is one of the most prevalent cardiovascular risk factors in the general population, being associated with high morbidity and socioeconomic burden. Diabetic cardiomyopathy (DCM) is a non-negligible complication of DM, whose pathophysiological fundaments are the altered cardiac metabolism, the hyperglycemia-triggered formation of advanced glycation end-products (AGEs) and the inflammatory milieu which are typical in diabetic patients. These metabolic abnormalities lead to cardiomyocytes apoptosis, interstitial fibrosis and mechanical cardiac dysfunction, which can be identified with non-invasive imaging techniques, like echocardiography and cardiac magnetic resonance. This review aims to: 1) describe the major imaging features of DCM; 2) highlight how early identification of DCM-related anatomical and functional remodeling might allow patients’ therapy optimization and prognosis improvement.

Purpose: The impact of dietary counseling on body composition in early breast cancer patients (EBC) treated with aromatase inhibitors (AIs) is uncertain. The aim of this study was to assess the effects of a diet counseling program on weight, BMI, total and regional body composition in patients treated with AIs. Methods: This observational study involved 194 EBC patients, of which 97 attended a 6-month personalized counseling program, based on Mediterranean diet principles (cohort A) and 97 did not (cohort B). Dual-energy X-ray absorptiometry (DXA) scan was used to measure the total and regional fat and lean body mass, before (baseline) and after at least 18 months of AI-therapy. Results: Weight and BMI increased significantly, on the average, in cohort B, but not in cohort A. In the cohorts A and B, fat mass increased by 10 % and 7.7 % respectively, while lean mass decreased by 3.3 % and 2.6 % from before to after AI therapy, without statistically significant differences between them using the Mann-Whitney test. The changes in body composition were greater in premenopausal than in postmenopausal women at cancer diagnosis. The proportion of patients with sarcopenia, obesity and sarcopenic obesity increased from before to after AI therapy, similarly in both cohorts. Conclusions: Patients treated with AIs reported an increase in fat mass and a decrease in lean mass, and consequently an increase in sarcopenia and obesity, regardless of the participation in a dietary counseling program. A combined dietary counseling and physical exercise program may be necessary for preventing these unfavourable changes in these patients.

Background: Depression that occurs in pregnancy or postpartum (perinatal depression) impacts 1 in 5 mothers, yet access to effective and high-quality preventative interventions remains elusive for most. Digital interventions are a promising solution to this treatment gap because of the ubiquity of mobile devices and internet access. The Mothers and Babies Online Course (eMB) is an online adaptation of Mothers and Babies, an evidence-based preventative program for postpartum depression. Preliminary studies of eMB point to its potential efficacy, but low engagement with eMB was a major limitation. Leveraging home visitors as coaches to guide clients through eMB may be a way to increase uptake and engagement, and ultimately improve outcomes when implemented in home visiting programs. Objective: The aim of this study was to implement user-centered design methods to develop a coaching manual for home visitors to implement eMB. Methods: 10 parents and 10 home visitors were interviewed individually. Measures included a “think aloud” activity and a semi-structured interview focused on gaining insight into parent and home visitor needs and preferences regarding eMB coaching in the context of home visiting. Thematic analysis was used to derive themes and sub-themes from interview transcripts. Results: Parents were enthusiastic about eMB, but noted barriers including limited time and forgetfulness. Parents also thought that their home visitor would be the ideal eMB coach because of the existing close relationship. Home visitors shared that eMB would fit seamlessly into their home visiting workflow. They also thought that home visitors could address challenges that parents encounter in using eMB and leverage their relationship with parents to crystalize learning. Home visitors also noted that a coaching manual would be a key part of successful eMB implementation. Thus, valuable insights from parents and home visitors were used to create a coaching manual. Conclusions: Parents and home visitors were both enthusiastic about eMB with adjunctive coaching, and home visitors agreed that a coaching manual would be vital in guiding them to help parents through eMB. Results highlight the importance of engaging end-users in all aspects of online intervention design, including the coaching manual. The effectiveness of the intervention and utility of the coaching protocol will be evaluated in a future pilot trial.

ABSTRACTThere is mounting evidence regarding the role of gut microbiota in anorexia nervosa (AN). Previous studies have reported that patients with AN show dysbiosis compared to healthy controls (HCs); however, the underlying mechanisms are unclear, and data on influencing factors and longitudinal course of microbiome changes are scarce. Here, we present longitudinal data of 57 adolescent inpatients diagnosed with AN at up to nine time points (including a 1-year follow-up examination) and compare these to up to six time points in 34 HCs. 16S rRNA gene sequencing was used to investigate the microbiome composition of fecal samples, and data on food intake, weight change, hormonal recovery (leptin levels), and clinical outcomes were recorded. Differences in microbiome composition compared to HCs were greatest during acute starvation and in the low-weight group, while diminishing with weight gain and especially weight recovery at the 1-year follow-up. Illness duration and prior weight loss were strongly associated with microbiome composition at hospital admission, whereas microbial changes during treatment were associated with kilocalories consumed, weight gain, and hormonal recovery. The microbiome at admission was prognostic for hospital readmission, and a higher abundance of Sutterella was associated with a higher body weight at the 1-year follow-up. Identifying these clinically important factors further underlines the potential relevance of gut microbial changes and may help elucidate the underlying pathophysiology of gut-brain interactions in AN. The characterization of prognostically relevant taxa could be useful to stratify patients at admission and to potentially identify candidate taxa for future supplementation studies aimed at improving AN treatment.

Remote Arctic communities have often been depicted as being particularly vulnerable to the challenges of disasters, with their location and lack of infrastructure exacerbating risk. This study explores the characteristics of local resilience in the Arctic using the case study of the communities of the north-western Westfjords. A total of 42 semi-structured interviews were carried out with various community members, seeking to uncover the features of inbuilt resilience that contribute to successes and vulnerabilities. These were transcribed, coded, and categorised in relation to an integrated framework for assessing community resilience in disaster management, which groups topics via the themes of environmental, social, governance, economic, and infrastructure. All themes played a role in the success of local coping strategies, with easy access to the natural environment central to physical and mental well-being. Despite this, vulnerabilities of the community were evident, including insufficient local healthcare workers during a severe COVID-19 outbreak in a care home, the absence of a local quarantine hotel, and insufficient information in foreign languages for non-natives of Iceland. The general trend of following rules and expert advice was demonstrative of strong social capital, with locals trusting those in charge, nationally and locally, to manage the pandemic.

Despite the progress of anti-cancer treatment, the prognosis of many patients with solid tumors is still dismal. Reliable noninvasive biomarkers are needed to predict patient survival and therapy response. Here, we propose a Humoral Complementomics approach: a work-up of assays to comprehensively evaluate complement proteins, activation fragments, and autoantibodies targeting complement proteins in plasma, which we correlated with the intratumoral complement activation, and/or local production, focusing on localized and metastatic clear cell renal cell carcinoma (ccRCC). In two prospective ccRCC cohorts, plasma C2, C5, Factor D and properdin were elevated compared to healthy controls, reflecting an inflammatory phenotype that correlated with plasma calprotectin levels but did not associate with CRP or with patient prognosis. Conversely, autoantibodies against the complement C3 and the reduced form of FH (a tumor neo-epitope reported in lung cancer) correlated with a favorable outcome. Our findings pointed to a specific group of patients with elevated plasma C4d and C1s-C1INH complexes, indicating the initiation of the classical pathway, along with elevated Ba and Bb, indicating alternative pathway activation. Boostrapped Lasso regularized Cox regression revealed that the most predictive complement biomarkers were elevated plasma C4d and Bb levels at the time of surgery, which correlated with poor prognosis. In conclusion, we propose Humoral Complementomics as an unbiased approach to study the global state of the complement system in any pathological plasma sample and disease context. Its implementation for ccRCC revealed that elevated C4d and Bb in plasma are promising prognostic biomarkers, correlating with shorter progression-free survival.

Objective: HPV vaccination is recommended for children beginning at age 9 to prevent several types of cancer. Many parents turn to Facebook for health information. This study describes changes in HPV vaccine-related articles shared on Facebook amidst the COVID-19 pandemic. Methods: HPV-related articles shared on Facebook (2019–2021) were collected using Buzzsumo, a social media analytics tool and analyzed using content analysis. Articles were categorized by valence, misinformation, evidence types, persuasive tactics, and framing. We quantified these data and tested for difference by article year. Results: Of the 138 included articles, 51% had positive valence towards the vaccine and 36% had negative valence. In 2021, there was a significant increase in positive messaging (72% vs. 44% in 2019/2020; p

Introduction: Drinking motives and neurocognition play significant roles in predicting alcohol use. There is limited research examining how relief-driven drinking motives interact with neurocognition in alcohol use, which would help to elucidate the neurocognitive-motivational profiles most susceptible to harmful drinking. This study investigated the interactions between neurocognition (response inhibition and cognitive flexibility) and relief-driven drinking, in predicting problem drinking. Methods: Participants completed the Alcohol Use Disorders Identification Test – Consumption items (AUDIT-C) to measure drinking behaviour, and online cognitive tasks, including the Value-Modulated Attentional Capture and Reversal Task (VMAC-R) and the Stop Signal Task (SST). The sample (N = 368) were individuals who drink alcohol, which included a subsample (N = 52) with problematic drinking, as defined by self-identifying as having a primary drinking problem. Drinking motives were assessed using a binary coping question in the overall sample, and the Habit, Reward, and Fear Scale (HRFS) in the subsample. Moderation analyses were conducted to investigate whether cognitive flexibility and response inhibition moderated relationships between relief-driven motives and drinking. Results: Cognitive flexibility moderated the relationship between relief-driven motives and drinking (overall sample: β = 13.69, p = 0.017; subsample: β = 1.45, p = 0.013). Greater relief-driven motives were associated with heavier drinking for individuals with low cognitive flexibility. There was no significant interaction between response inhibition and relief-driven motives. Conclusions: Relief-driven drinking motives interact with cognitive inflexibility to drive heavier drinking. Greater understanding of these neurocognitive-motivational mechanisms may help to develop more targeted and effective interventions for reducing harmful drinking.

Background To determine the association of trainees involvement with surgical outcomes of abdominal and laparoscopic myomectomy including operative time, rate of transfusion, and complications.Methods A retrospective cohort study of 1145 patients who underwent an abdominal or laparoscopic myomectomy from 2008–2012 using the American College of Surgeons National Surgical Quality Improvement Program database (Canadian Task Force Classification II-2).Results Overall, 64% of myomectomies involved trainees. Trainees involvement was associated with a longer operative time for abdominal myomectomies (mean difference 20.17 minutes, 95% Confidence Interval (CI) [11.37,28.97], p

Background: Risk factors for cardiovascular disease (CVD) and sleep health are well-known to be sex- and race-specific. To build on the established relationship between sleep duration and CVD risk, this cross-sectional study aimed to describe sex-specific associations between CVD risk and other sleep characteristics (sleep quality, sleep timing and sleep onset latency) in low-income adults of African descent. Methods: Self-reported sleep (Pittsburgh Sleep Quality Index [PSQI], Epworth Sleepiness Scale [ESS], Insomnia Severity Index [ISI]), demographic and lifestyle data were collected in 412 adults (56 % women, 35.0 ± 7.6y, 40 % employed) living in an informal settlement in South Africa. CVD risk was determined using the BMI-modified Framingham 10-year CVD risk formula. Results: Logistic regression analyses, adjusted for employment, alcohol use and physical activity, indicated that men reporting poor sleep quality (OR: 1.95[95 %CI: 1.07–3.51], p=0.025) and earlier bedtimes (0.54[0.39–0.74], p

Most aging populations report chronic illnesses, which are usually permanent or recurrent, significantly affect well-being and quality of life, require daily and consistent healthcare management, and last more than three months. Improved health outcomes and reduced healthcare costs are associated with self-care in treating chronic illnesses. The aim is to describe a protocol using a self-care intervention in a person with a chronic disease. A longitudinal study will be conducted with 40 patients. This article describes a protocol for a self-care intervention in a person with a chronic disease. The outcome measures will be compared with measures after the intervention in three different chronologic times. Randomization will be used to assign participants to the intervention group. The present study is expected to generate significant information about the role of self-care intervention in persons with chronic disease.

Monoclonal neutralizing antibodies (mAbs) are considered an important prophylactic against SARS-CoV-2 infection in at-risk populations and a strategy to counteract future sarbecovirus-induced disease. However, most mAbs isolated so far neutralize only a few sarbecovirus strains. Therefore, there is a growing interest in bispecific antibodies (bsAbs) which can simultaneously target different spike epitopes and thereby increase neutralizing breadth and prevent viral escape. Here, we generate and characterize a panel of 30 novel broadly reactive bsAbs using an efficient controlled Fab-arm exchange protocol. We specifically combine some of the broadest mAbs described so far, which target conserved epitopes on the receptor binding domain (RBD). Several bsAbs show superior cross-binding and neutralization compared to the parental mAbs and cocktails against sarbecoviruses from diverse clades, including recent SARS-CoV-2 variants. BsAbs which include mAb COVA2–02 are among the most potent and broad combinations. As a result, we study the unknown epitope of COVA2–02 and show that this mAb targets a distinct conserved region at the base of the RBD, which could be of interest when designing next-generation bsAb constructs to contribute to a better pandemic preparedness.

Chikungunya virus (CHIKV) is a mosquito-transmitted, RNA virus that causes an often-severe musculoskeletal illness characterized by fever, joint pain, and a range of debilitating symptoms. The virus has re-emerged as a global health threat in recent decades, spreading from its origin in Africa across Asia and the Americas, leading to widespread outbreaks impacting millions of people. Despite more than 50 years of research into the pathogenesis of CHIKV, there is still no curative treatment available. Current management of CHIKV infections primarily involves providing supportive care to alleviate symptoms and improve the patient’s quality of life. Given the ongoing threat of CHIKV, there is an urgent need to better understand its pathogenesis. This understanding is crucial for deciphering the mechanisms underlying the disease and for developing effective strategies for both prevention and management. This review aims to provide a comprehensive overview of CHIKV and its pathogenesis, shedding light on the complex interactions of viral genetics, host factors, immune responses, and vector-related factors. By exploring these intricate connections, the review seeks to contribute to the knowledge base surrounding CHIKV, offering insights that may ultimately lead to more effective prevention and management strategies for this re-emerging global health threat.

Managing migratory game species is challenging and often leads to conflicts across areas or stakeholders. The European Turtle-dove Streptopelia turtur (TD), a declining migratory game bird, is currently subject to an adaptive harvest management plan in the European Union (EU), which has led to a temporary hunting moratorium in western Europe. We used Q-methodology to identify the discourses of hunters, hunting lobbyists and members of governmental agencies in Spain, the country with the largest TD hunting bags within EU, regarding the role of hunting and its regulation, including the moratorium, on species recovery prospects. Three discourses were identified: one that denies any involvement of hunting in the species population decline and thus considers the moratorium unnecessary; one that advocates for a moratorium but highlights the need for global strategies for it to be effective; and one that disputes the population decline, attributing the moratorium purely to environmentalists’ pressures and false data. Larger differences were observed among hunters from areas with varying levels of TD hunting than among hunters that hunt or not TD, suggesting that discourses may be socially constructed and maintained. Hunting lobbyists’ discourse was more uniformly against the moratorium than that of hunters as a whole, while governmental agencies had more nuanced perspectives. A point of consensus among discourses was the agreement on the need for transboundary coordination and a global conservation strategy incorporating habitat and hunting management approaches. These results emphasize the importance of increased transborder collaboration and effective communication strategies to mitigate conflicts about migratory game management.

Background Abortion is a public health problem in Latin America and is more common among women living with HIV. Objective to verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil. Methods Prospective cohort during the period 1996–2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome “induced abortion” using a generalized linear mixed model. Results 753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10–0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02–0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02–0.70). Conclusions We showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.

The implementation of rewilding initiatives is crucial for biodiversity recovery, particularly in biodiversity hotspots such as the Brazilian Atlantic Forest. Long-term monitoring of rewilding initiatives is critical for assessing progress and informing management choices. This study assesses the efficiency of different reforestation practices for biodiversity recovery, including passive restoration, active reforestation with different native seedlings, and plantations of exotic species. We applied an ecosystem approach to estimate the tree and mammal diversity, collected through forest plots and camera traps. We selected differently managed areas and included the oldest forest patches as reference points for the assessment of biodiversity; a naturally disturbed montane forest in the area was included as a control category for the disturbance analysis. Moreover, we investigated the influence of ecological variables, such as biodiversity, aboveground biomass, and altitude, on rewilding processes. Our results suggest that Eucalyptus plantations, a simplified ecosystem made up of monocultures of exotic species, support lower biodiversity. On the contrary, active reforestation with different native species resulted in an ecological status comparable to naturally regrown secondary forests. We show that active reforestation can reduce the time required for rewilding. We also found a positive correlation between tree and mammal species richness. These results underscore the importance and potential of responsible restoration efforts in recovering local biodiversity, contributing to the vision of a future where the Brazilian Atlantic Forest can be acknowledged not only as a biodiversity hotspot but also as a “hopespot.”

Fabry disease is a rare X-linked lysosomal condition that leads to the accumulation of glycosphingolipids in various tissues, causing cellular dysfunction, tissue remodeling, progressive fibrosis, and organ failure. The disease results from a deficiency in the human α-galactosidase A enzyme, responsible for breaking down glycosphingolipids like globotriaosylceramide (GL-3 or Gb3) into galactose and dihexose ceramides. In individuals diagnosed with Fabry disease, treatment from 2 years of age onwards typically involves agalsidase beta, the normal recombinant form of the defective enzyme. Agalsidase beta from Biosidus has been developed as a biosimilar to Sanofi-Genzyme's Fabrazyme®. In the molecule's clinical journey, a phase I trial was designed to establish its similarity in terms of pharmacokinetics, pharmacodynamics, and immunogenicity compared to the reference medication. The study was conducted on 24 healthy male volunteers, aged between 18 and 40 years. All volunteers received a single 1 mg/kg bw dose of Fabrazyme® or Biosidus Agalsidase beta by continuous intravenous (IV) infusion over 5 h. The 90 % confidence interval (CI) of the maximum concentration (Cmax), area under the plasma concentration-time curve from time 0 to 12 h (AUC0-12 h) and area under the plasma concentration-time curve extrapolated from time 0 to infinity (AUC0-∞) ratios fell within the accepted range of 80–125 %. No differences were detected in adverse effects or antibody induction. This indicates that Biosidus agalsidase beta meets the criteria for being considered similar to the reference formulation Sanofi Genzyme's Fabrazyme®.

Introduction: Adverse childhood experiences (ACEs) associate with various mental disorders, including personality features. Our understanding of how ACEs influence alexithymia features in the general population is limited. In a prospective population setting, we studied whether ACEs associate with alexithymia, and the role of sex and emotional symptoms in this association.Methods: In a Finnish population-based prospective study, 3,142 individuals aged between 30 and 64 years completed eleven ACE questions and the Toronto Alexithymia Scale in 2000 and 2011, and the Hopkins Symptoms Checklist in 2011. The effect of ACEs on alexithymia and its subdomains – difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally oriented thinking (EOT) in 2000 and 2011 – was analysed using repeated measures ANOVA.Results: The number of ACEs and their main component, childhood social disadvantage, associated positively with total alexithymia scores and its subdomains DIF and DDF, and negatively with EOT. After controlling for the effect of depression and anxiety, the strength of these associations was reduced, but the effect of social disadvantage on DIF and EOT remained significant in females. Childhood family conflicts associated positively with DIF in males and negatively with EOT in females. Additionally, maternal mental problems associated positively with DIF and DDF in females.Discussion: In the general population, ACEs, particularly social disadvantage, are associated with adult alexithymia features. Alexithymia features, detectable from youth, may predispose individuals to emotional disturbances caused by childhood adversities. The effect of family conflicts and maternal mental problems on alexithymia features varies between sexes.

This article focuses on the UK’s pre-COVID 19 pandemic preparedness and its early response to the COVID-19 pandemic (January ‘20 – March ‘20). The aim of this article is to explain the high excess mortality the UK experienced compared to many of its international and European peers in the first wave, which is contrary to the country’s high ranking in pre-COVID-19 preparedness rankings. The article assesses the various components of pre-COVID-19 pandemic preparedness such as pandemic strategy, exercises, and stockpiles, and it covers government decision making processes on the early response, including questions around post-travel quarantining, test and trace, and mobility restrictions. The article concludes that there were important deficiencies in the UK's pandemic preparedness and early response in the COVID-19 pandemic. These include the centrality of the ‘inevitability of spread’-assumption underpinning the UK’s pandemic planning pre-COVID, the insufficient implementation of pandemic exercise recommendations, the lack of early and ‘live learning’ from other countries’ experiences, the lack of adoption of public health advice of the World Health Organisation early on, the late implementation of internal mobility restrictions, the lack of timely consideration of alternative early pandemic response models, and fragilities in the SAGE/governmental interplay.