Relationship between the use of smart medical services and mental health status

In this editorial,I comment on the article by Zhang et al.To emphasize the importance of the topic,I discuss the relationship between the use of smart medical devices and mental health.Smart medical services have the potential to positively influence mental health by providing monitoring,insights,and inter-ventions.However,they also come with challenges that need to be addressed.Understanding the primary purpose for which individuals use these smart tech-nologies is essential to tailoring them to specific mental health needs and prefe-rences.

Association between glucose levels of children with type 1 diabetes and parental economic status in mobile health application

BACKGROUND The glycemic control of children with type 1 diabetes(T1D)may be influenced by the economic status of their parents.AIM To investigate the association between parental economic status and blood glucose levels of children with T1D using a mobile health application.METHODS Data from children with T1D in China's largest T1D online community,Tang-TangQuan■.Blood glucose levels were uploaded every three months and parental economic status was evaluated based on annual household income.Children were divided into three groups:Low-income(<30000 Yuan),middle-income(30000-100000 Yuan),and high-income(>100000 yuan)(1 Yuan=0.145 United States Dollar approximately).Blood glucose levels were compared among the groups and associations were explored using Spearman’s correlation analysis and multivariable logistic regression.RESULTS From September 2015 to August 2022,1406 eligible children with T1D were included(779 female,55.4%).Median age was 8.1 years(Q1-Q3:4.6-11.6)and duration of T1D was 0.06 years(0.02-0.44).Participants were divided into three groups:Low-income(n=320),middle-income(n=724),and high-income(n=362).Baseline hemoglobin A1c(HbA1c)levels were comparable among the three groups(P=0.072).However,at month 36,the low-income group had the highest HbA1c levels(P=0.036).Within three years after registration,glucose levels increased significantly in the low-income group but not in the middle-income and high-income groups.Parental economic status was negatively correlated with pre-dinner glucose(r=-0.272,P=0.012).After adjustment for confounders,parental economic status remained a significant factor related to pre-dinner glucose levels(odds ratio=13.02,95%CI:1.99 to 126.05,P=0.002).CONCLUSION The blood glucose levels of children with T1D were negatively associated with parental economic status.It is suggested that parental economic status should be taken into consideration in the management of T1D for children.

Compliance to Medication Management and Mental Health Status of Elderly Hypertensive Patients: Basis of Educational Health Program

Objective:The study aimed to assess medication management compliance and mental health in elderly patients with hypertension.Method:The study evaluated medication compliance and mental health status of elderly hypertensive patients in China using simple random sampling.Data was collected using the Morisky Medication Compliance Questionnaire,Hospital Anxiety and Depression Scale,and a checklist.Ethical practices were strictly observed.Results:A study of 100 elderly hypertensive patients found poor drug management compliance,with female patients showing worse compliance.Female patients were more vulnerable to anxiety and depression.The study also found no significant association between gender,age,education level,marital status,living standards,and medication compliance.Barriers to medication management included food and daily necessities,lack of awareness about the importance of drug treatment,and basic family needs.The lowest-ranked barriers were lack of support from government health clinics,low income,and lack of family support.Conclusion:Based on the results,the study proposes an educational plan for elderly hypertensive patients and their families,to be evaluated and implemented by the hospital and township community service center.The plan aims to improve medication management and lifestyle modification compliance,encourage active participation,and provide access to medical and mental health clinics,support groups,and counseling services.

Investigation of the Oral Health Status of Patients Based on Rehabilitation Nursing

Objective: To investigate the current situation of knowledge, attitude, and practice (KAP) of oral health among rehabilitation nursing patients, and provide some reference for implementing oral health intervention measures for rehabilitation nursing patients. Method: A total of 231 nursing patients in the rehabilitation department of a tertiary hospital in this city from January 2023 to October 2023 were selected as the research subjects. Their oral health knowledge, attitudes, and behaviors were investigated, and the oral health behavior habits of patients with different genders, education levels, and disease situations were compared. Result: The total awareness rate of oral health knowledge among patients was 73.16%, and the average score of oral health knowledge was 6.58 ± 1.25 points. The overall positive rate of oral health attitude among patients is 55.70%, and the average score of oral health attitude is 5.01 ± 1.04 points. The average score for oral health behavior is 16.87 ± 5.23 points. Only 8.48%, 3.3%, 1.3%, 2.6%, and 0.87% of patients seek timely medical treatment for bleeding tooth roots, gum swelling and pain, gum bleeding, tooth pain, and dental calculus, respectively;Only 5.19% of people change their toothbrush every 3 months, and only 10.39% use the vertical brush method to brush their teeth. The scores of oral health knowledge, attitudes, and behaviors of patients are related to age, educational level, disease type, and smoking situation. The oral health knowledge and attitude scores of elderly patients were lower than those of younger patients, and the difference was statistically significant (P P P P P < 0.05). Conclusion: The oral health status of rehabilitation nursing patients is not optimistic, with a moderate level of oral health knowledge, weak awareness of oral health, and a low qualification rate of oral health behaviors. Strengthening oral health education for rehabilitation nursing patients and incorporating oral health care procedures into rehabilitation nursing procedures is of great significance.

Effects of methionine supplementation in a reduced protein diet on growth performance, oxidative status, intestinal health, oocyst shedding, and methionine and folate metabolism in broilers under Eimeria challenge

Background This study investigated effects of different methionine(Met)supplementation levels in a reduced protein diet on growth performance,intestinal health,and different physiological parameters in broilers under Eimeria challenge.A total of 600 fourteen-day-old Cobb500 male broilers were challenged with E.maxima,E.tenella,and E.acervulina,and randomly allocated in a 2×5 factorial arrangement.Birds received normal protein diets(20%crude protein,NCP)or reduced protein diets(17%crude protein,LCP),containing 2.8,4.4,6.0,7.6,and 9.2 g/kg of Met.Results On 6 and 9 days post inoculation(DPI),increasing Met level linearly improved the growth performance(P<0.05).Total oocyst shedding linearly increased as Met level increased(P<0.05).Duodenal villus height(VH):crypt depth(CD)in the LCP groups were higher on 6 DPI(P<0.01)while lower on 9 DPI(P<0.05)compared to the NCP groups.Jejunal CD and duodenal VH:CD changed quadratically as Met level increased(P<0.05).On 6 DPI,liver glutathione(GSH)and glutathione disulfide(GSSG)linearly increased as Met level increased(P<0.05).On 9 DPI,GSSG quadratically increased,whereas GSH:GSSG quadratically decreased as Met levels increased(P<0.05).The expression of amino acid transporters linearly decreased as Met level increased(P<0.05).The expression of zonula occludens 2 and claudin-1 linearly increased on 6 DPI whereas decreased on 9 DPI as Met level increased(P<0.05).The expressions of cytokines were lower in the LCP groups than the NCP groups(P<0.05).Interaction effects were found for the expression of IL-10 and TNFαon 6 DPI(P<0.05),where it only changed quadratically in the NCP group as Met level increased.The expression of Met and folate metabolism genes were lower in the LCP groups than the NCP groups on 9 DPI(P<0.05).The expression of these genes linearly or quadratically decreased as Met level increased(P<0.05).Conclusion These results revealed the regulatory roles of Met in different physiological parameters including oxidative status,intestinal health,and nutrient metabolism in birds fed reduced protein diet and challenged with Eimeria.

An Analysis of the Lifestyle and Mental Health Status of Adult People Living in Dhaka City: A Cross-Sectional Study in Post COVID-19 Era

Introduction: The Novel Coronavirus or COVID-19 affected all the megacities of the world and made the mental health and lifestyle of people paralyzed. According to different studies, such difficulties were different in scale in different cities depending on the demographic attributes of the people. This phenomenon has created the essence of the current study to examine the health conditions in terms of their mental health, lifestyle, and demographic attributes during and immediate past of the COVID-19 era. Method: It was a cross-sectional study covering the people of Dhaka City Corporation. For this purpose, a multistage sampling method was applied, under which the respondents were selected randomly and a self-administered structured questionnaire was used to collect data. The questionnaire was developed based on the DASS 21, as it was suitable to measure the components of mental health in the form of depression, anxiety, and stress. Descriptive analysis and cross-tabulation were applied to find out the association between dependent and independent variables, whereas, a chi-square test was performed to examine the hypothesis. Finally, multivariate analysis was done to find out the risk factors. Three logistic regression models were developed for three dependent variables. Result: The findings of the analysis revealed that the lifestyle of people had severely influenced the components of their mental health conditions during and immediate past of COVID-19 in the Dhaka City Corporation, which varies to some extent depending on the demographic attributes of those. Conclusion: The above findings are statistically significant enough to conclude about the essence of taking preventive measures regarding mental health issues in the future. However, the limitations of this study-keeping it within the urban areas and the educated people, have also created the venue for future researchers to move with their research endeavors in the rural areas nationwide and thus generalize the results.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Influence of the continuing COVID-19 epidemic on sleep quality and psychological status of healthcare workers in private institutions

BACKGROUND On January 22,2020,Macao reported its first case of coronavirus disease 2019(COVID-19)infection.By August 2021,the situation had escalated into a crisis of community transmission.In response,the government launched a recruitment campaign seeking assistance and services of healthcare workers(HCWs)from the private sector throughout Macao.These participants faced concerns about their own health and that of their families,as well as the responsibility of maintaining public health and wellness.This study aims to determine whether the ongoing epidemic has caused them physical and psychological distress.AIM To examine the influence of COVID-19 on the sleep quality and psychological status of HCWs in private institutions in Macao during the pandemic.METHODS Data were collected from December 2020 to January 2022.Two consecutive surveys were conducted.The Pittsburgh Sleep Quality Index(PSQI)scale,Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were employed as investigation tools.RESULTS In the first-stage survey,32%of HCWs experienced a sleep disorder,compared to 28.45%in the second-stage survey.A total of 31.25%of HCWs in the first-stage survey and 28.03%in the second had varying degrees of anxiety.A total of 50.00%of HCWs in the first-stage survey and 50.63%in the second experienced varying degrees of depression.No difference in PSQI scores,SAS scores,or SDS scores were observed between the two surveys,indicating that the COVID-19 epidemic influenced the sleep quality and psychological status of HCWs.The negative influence persisted over both periods but did not increase remarkably for more than a year.However,a positive correlation was observed between the PSQI,SAS,and SDS scores(r=0.428-0.775,P<0.01),indicating that when one of these states deteriorated,the other two tended to deteriorate as well.CONCLUSION The sleep quality,anxiety,and depression of HCWs in private institution in Macao were affected by the COVID-19 epidemic.While these factors did not deteriorate significantly,the negative effects persisted for a year and remained noteworthy.

The Oral Health Status of Person with Special Needs in Kumasi

Background: The most prevalent non-communicable disease worldwide is oral health-related disease, with dental caries and periodontal conditions being common. Oral health status significantly impacts overall health and quality of life. Barriers to dental care affect children with special needs. This study evaluates the oral health status and treatment requirements of people with special needs. Methodology: This descriptive cross-sectional study in Kumasi, Ghana examined oral health status among people, 121 children with special needs over two months, in June-July 2022. Dental caries, periodontal changes, malocclusion, and trauma were assessed. The data was analyzed using SPSS 20.0. Results: The oral health status among people with special needs in this study was generally moderate, with a range from very good to very poor. The prevalence of dental caries was 37%, with a mean DMFT score of 2.82. Periodontal health showed unsatisfactory indicators such as mobile teeth, poor gingival health, high plaque scores, and the presence of halitosis. Conclusion: This descriptive study aimed to provide baseline data on the oral health status of special needs students in Kumasi, addressing the lack of knowledge in this area. It highlighted the importance of dental care in maintaining good oral health and overall well-being in individuals with special needs. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children.

Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,2022.Ocular Surface Disease Index(OSDI),Five-item Dry Eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this study.RESULTS:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.

Analysis of status and influencing factors of mental health in patients with systemic lupus erythematosus

BACKGROUND Systemic lupus erythematosus(SLE)is a heterogeneous autoimmune disorder with varied clinical courses and prognoses,not only did the patients suffer from physical impairment,but also various physical and psychiatric comorbidities.Growing evidence have suggested that mental disorders in SLE patients,can lead to various adverse consequences.AIM To explored the features and influencing factors of mental health in patients with SLE and clarifying the correlations between mental health and personality characteristics and perceived social support.The results would provide a basis for psychological intervention in patients with SLE.METHODS The clinical data of 168 patients with SLE admitted at the First Affiliated Hospital of Hainan Medical University between June 2020 and June 2022 were collected.Psychological assessment and correlation analysis were conducted using the Symptom Checklist-90(SCL-90)and Perceived Social Support Scale,and the collected data were compared with the national norms in China.The relevant factors influencing mental health were identified by statistical analysis.A general information questionnaire,the Revised Life Orientation Test,and Short-Form 36-Item Health Survey were employed to assess optimism level and quality of life(QoL),respectively.RESULTS Patients with SLE obtained higher scores for the somatization,depression,anxiety,and phobic anxiety subscales than national norms(P<0.05).A correlation was identified between total social support and total SCL-90 score or each subscale(P<0.05).The factors significantly affecting patients’mental health were hormone dosage and disease activity index(DAI)(P<0.05).The average optimism score of patients with SLE was 14.36±4.42,and 30 cases were in the middle and lower levels.A positive correlation was found between optimism level and QoL scores.CONCLUSION Patients with SLE develop psychological disorders at varying degrees,which are significantly influenced by hormone dosage and DAI.Patients’mental health should be closely monitored during clinical diagnosis and treatment and provided adequate support in establishing positive,healthy thinking and behavior patterns and improving their optimism level and QoL.

Investigation and analysis of the status of cancer health popularization in China,2023

BACKGROUND Cancer presents a significant public health challenge in China,necessitating broad collaboration across society.The Chinese government has articulated a goal to increase the overall five-year survival rate for cancer by 15%by 2030.Achieving this objective requires not only advances in medical technology,but also an im-provement in the dissemination of knowledge pertaining to cancer prevention and treatment.AIM To provide a comprehensive understanding of the status of cancer prevention and level of popularization in China in 2023.METHODS From January 2023 to May 2023,online questionnaires were distributed to 3000 participants,including medical personnel,patients with cancer,their families,and the general public.There were 2711 valid responses,covering the entire nation.RESULTS A total of 1020 medical personnel and 1691 patients with cancer,their family members,and the general public participated in the survey.Among medical personnel,93.2%had popularized cancer health.Commonly addressed topics included cancer prevention(85.9%)and cancer screening(77.8%).Primary challenges included time constraints(73.9%),insufficient personnel and material support(66.7%),and uncertainty as to where to begin(49.3%).Among patients with cancer,their family members,and the general public,93.4%reported reading or watching cancer science popularization materials and 56.9%expressed a desire for deeper understanding.The most sought-after topics in cancer science popularization included cancer screening(80.2%)and cancer prevention(75.8%).The greatest challenge encountered in accessing cancer health popularization was an abundance of misinformation(67.5%).CONCLUSION Most clinical doctors,patients,family,and the general public wish to participate in cancer education.However,improvement in the quality of content in cancer prevention and treatment education is required.

A study on the cognitive status of human papillomavirus among adult males in Tianjin based on the health belief model

Background:To understand the health beliefs and knowledge of human papillomavirus among adult males in Tianjin.Methods:An online questionnaire survey was conducted from 18 January 2023 to 6 March 2023 using snowball sampling method.Analyze the health belief scores and human papillomavirus(HPV)and HPV vaccine knowledge scores of adult males in Tianjin,and analyze their influencing factors.Results:A total of 388 adult males in Tianjin were surveyed,with an average total score of 3.23±0.04 for their health beliefs.Among them,the average scores for perceived severity,perceived susceptibility,perceived impairment,perceived benefit,and self-efficacy were 3.41±1.05,2.37±1.20,2.96±1.00,3.51±0.90,and 3.36±1.08,respectively.Multiple linear regression analyses showed education was a factor influencing health beliefs.The average total score of knowledge is 64.09±15.62,with 277 people scoring above 60,and a pass rate of 71.4%.Through multiple linear regression analysis,education level,emotional status,whether disease testing has been done,and whether family and friends have been diagnosed with HPV positive are the main influencing factors.Conclusion:The awareness rate of HPV among adult males in Tianjin is still acceptable,but there are still misconceptions.The overall level of health beliefs is moderate,and the perceived susceptibility level is low.It is necessary to strengthen health education on HPV related knowledge for males and improve their cognitive level.

Effects of personalized oral hygiene management on oral health status of pregnant women

BACKGROUND The Cariostat caries activity test(CAT)was used to evaluate the effectiveness of personalized oral hygiene management combining oral health education and professional mechanical tooth cleaning on the oral health status of pregnant women.AIM To investigate whether personalized oral hygiene management enhances the oral health status of pregnant women.METHODS A total of 114 pregnant women who were examined at Dalian Women’s and Children’s Medical Center were divided into four groups:High-risk experimental group(n=29;CAT score≥2;received personalized oral hygiene management training),low-risk experimental group(n=29;CAT score≤1;received oral health education),high-risk control group(n=28;CAT score≥2),and low-risk control group(n=28;CAT score≤1).No hygiene intervention was provided to control groups.CAT scores at different times were compared using independent samples t-test and least significant difference t-test.RESULTS No significant difference in baseline CAT scores was observed between the experimental and control groups,either in the high-risk or low-risk groups.CAT scores were reduced significantly after 3(1.74±0.47 vs 2.50±0.38,P<0.0001)and 6 months(0.53±0.50 vs 2.45±0.42,P<0.0001)of personalized oral hygiene management intervention but not after oral health education alone(0.43±0.39 vs 0.46±0.33,P>0.05 and 0.45±0.36 vs 0.57±0.32,P>0.05,respectively).Within groups,the decrease in CAT scores was significant(2.43±0.44 vs 1.74±0.47 vs 0.53±0.50,P<0.0001)for only the high-risk experimental group.CONCLUSION Personalized oral hygiene management is effective in improving the oral health of pregnant women and can improve pregnancy outcomes and the oral health of the general population.

Progress in Investigating the Current Mental Health Status Among Caregivers for Surgical Oncology Patients

This article aims to discuss the current state and research progress concerning the mental health of caregivers for surgical oncology patients.The goal is to offer insights that can serve as a reference for further enhancements in caregivers’mental well-being.This article conducts a comprehensive review and analysis of recent studies on the mental health of caregivers for patients undergoing oncologic surgery.These studies reveal that caregivers commonly grapple with mental health issues,including anxiety,depression,and stress.These problems are closely linked to the stress of the patient’s condition and treatment,the caregiver’s own mental strain,and a lack of social support.In addition,the mental health status of caregivers significantly influences the patient’s treatment and recovery process.Implementing various interventions,such as mental health education,services,the establishment of mental health support teams,and engagement in mental health promotion activities,can contribute to the improvement of caregivers’mental well-being.This,in turn,has the potential to enhance treatment outcomes and the overall quality of life for patients.

Metaverse for mental health disorders:Opportunities and challenges

Several articles on the mental health impact of the metaverse and the need to balance its potential benefits with the risks of metaverse use has recently published.The metaverse consists of a combination of immersive technologies and artificial intelligence algorithms.The metaverse differs from the preceding digital psychiatric interventions due to its complex structure and interactions between components.The diverse functions of the metaverse ensure that it may have a substantial impact on mental health.However,the evidence for its efficacy in treating mental health disorders is limited to a few trials.The mental health benefits of immersive technologies are well-documented and suggest that metaverse-based psychiatric treatment may be similarly efficacious.The mental health risks of the metaverse are largely unknown,and it is not clear whether they will be greater than other digital psychiatric interventions.Much more research is needed to determine whether metaverse-based psychiatric treatment will meet the standards of appropriate mental healthcare.

Ultra‑High Sensitivity Anisotropic Piezoelectric Sensors for Structural Health Monitoring and Robotic Perception

Monitoring minuscule mechanical signals,both in magnitude and direction,is imperative in many application scenarios,e.g.,structural health monitoring and robotic sensing systems.However,the piezoelectric sensor struggles to satisfy the requirements for directional recognition due to the limited piezoelectric coefficient matrix,and achieving sensitivity for detecting micrometer-scale deformations is also challenging.Herein,we develop a vector sensor composed of lead zirconate titanate-electronic grade glass fiber composite filaments with oriented arrangement,capable of detecting minute anisotropic deformations.The as-prepared vector sensor can identify the deformation directions even when subjected to an unprecedented nominal strain of 0.06%,thereby enabling its utility in accurately discerning the 5μm-height wrinkles in thin films and in monitoring human pulse waves.The ultra-high sensitivity is attributed to the formation of porous ferroelectret and the efficient load transfer efficiency of continuous lead zirconate titanate phase.Additionally,when integrated with machine learning techniques,the sensor’s capability to recognize multi-signals enables it to differentiate between 10 types of fine textures with 100%accuracy.The structural design in piezoelectric devices enables a more comprehensive perception of mechanical stimuli,offering a novel perspective for enhancing recognition accuracy.

Mediating role of health literacy in the relationship between social isolation and psychological distress among pre-frail older adults

BACKGROUND Frailty has become a significant public health issue.The recent increase in the number of frail older adults has led to increased attention being paid to psycho-logical care services in communities.The social isolation of pre-frail older adults can impact their psychological distress.AIM To explore the mediating effect of health literacy between social isolation and psychological distress among communitydwelling older adults with pre-frailty.METHODS This descriptive cross-sectional study was conducted with 254 pre-frail older individuals aged 60 years and over.Social isolation,health literacy,and psycholo-gical distress were comprehensively measured using the Lubben Social Network Scale-6,12-item Short-Form Health Literacy Questionnaire,and the Kessler Psy-chological Distress Scale-10.Data were evaluated using the SPSS 27.0 package program and the PROCESS macro tool.Descriptive statistical analyses,correlation analyses,and bootstrap mediation tests were used to assess associations between the variables.RESULTS The results showed that social isolation had an effect on health literacy among pre-frail older adults(β=0.240,P<0.001),social isolation impact on psycho-logical distress pre-frail older adults(β=-0.415,P<0.001);health literacy was identified effect on psychological distress among pre-frail older persons(β=-0.307,P<0.001).Health literacy partially mediated the relationship between social isolation and psychological distress among community-dwelling older adults with pre-frailty,with a mediation effect of-0.074,accounting for 17.83%of the total effect.

Machine Learning Prediction of Fetal Health Status from Cardiotocography Examination in Developing Healthcare Contexts

Reducing neonatal mortality is a critical global health objective,especially in resource-constrained developing countries.This study employs machine learning(ML)techniques to predict fetal health status based on cardiotocography(CTG)examination findings,utilizing a dataset from the Kaggle repository due to the limited comprehensive healthcare data available in developing nations.Features such as baseline fetal heart rate,uterine contractions,and waveform characteristics were extracted using the RFE wrapper feature engineering technique and scaled with a standard scaler.Six ML models—Logistic Regression(LR),Decision Tree(DT),Random Forest(RF),Gradient Boosting(GB),Categorical Boosting(CB),and Extended Gradient Boosting(XGB)—are trained via cross-validation and evaluated using performance metrics.The developed models were trained via cross-validation and evaluated using ML performance metrics.Eight out of the 21 features selected by GB returned their maximum Matthews Correlation Coefficient(MCC)score of 0.6255,while CB,with 20 of the 21 features,returned the maximum and highest MCC score of 0.6321.The study demonstrated the ability of ML models to predict fetal health conditions from CTG exam results,facilitating early identification of high-risk pregnancies and enabling prompt treatment to prevent severe neonatal outcomes.

Decoding the nexus:branched-chain amino acids and their connection with sleep,circadian rhythms,and cardiometabolic health

The sleep-wake cycle stands as an integrative process essential for sustaining optimal brain function and,either directly or indirectly,overall body health,encompassing metabolic and cardiovascular well-being.Given the heightened metabolic activity of the brain,there exists a considerable demand for nutrients in comparison to other organs.Among these,the branched-chain amino acids,comprising leucine,isoleucine,and valine,display distinctive significance,from their contribution to protein structure to their involvement in overall metabolism,especially in cerebral processes.Among the first amino acids that are released into circulation post-food intake,branched-chain amino acids assume a pivotal role in the regulation of protein synthesis,modulating insulin secretion and the amino acid sensing pathway of target of rapamycin.Branched-chain amino acids are key players in influencing the brain's uptake of monoamine precursors,competing for a shared transporter.Beyond their involvement in protein synthesis,these amino acids contribute to the metabolic cycles ofγ-aminobutyric acid and glutamate,as well as energy metabolism.Notably,they impact GABAergic neurons and the excitation/inhibition balance.The rhythmicity of branchedchain amino acids in plasma concentrations,observed over a 24-hour cycle and conserved in rodent models,is under circadian clock control.The mechanisms underlying those rhythms and the physiological consequences of their disruption are not fully understood.Disturbed sleep,obesity,diabetes,and cardiovascular diseases can elevate branched-chain amino acid concentrations or modify their oscillatory dynamics.The mechanisms driving these effects are currently the focal point of ongoing research efforts,since normalizing branched-chain amino acid levels has the ability to alleviate the severity of these pathologies.In this context,the Drosophila model,though underutilized,holds promise in shedding new light on these mechanisms.Initial findings indicate its potential to introduce novel concepts,particularly in elucidating the intricate connections between the circadian clock,sleep/wake,and metabolism.Consequently,the use and transport of branched-chain amino acids emerge as critical components and orchestrators in the web of interactions across multiple organs throughout the sleep/wake cycle.They could represent one of the so far elusive mechanisms connecting sleep patterns to metabolic and cardiovascular health,paving the way for potential therapeutic interventions.