Lifestyle Changes Research Articles

Decoding Urinary Stones: Compositional Insights and Recurrence Patterns from a Tertiary Care Hospital in Eastern India.

Background and objective Urinary stones are a prevalent medical condition entailing significant health burdens and substantial financial ramifications. Its global prevalence is expected to rise notably, particularly in low-middle-income nations. Understanding the spectrum of diverse urinary stone types is crucial for effective management and prevention. This study aims to elucidate the demographic profiles, clinical types, and recurrence of urinary stone cases at a tertiary care hospital in Eastern India. Methods and materials The clinical data from the electronic medical record of 1,231 patients with urolithiasis who underwent surgery in a tertiary care center in eastern India from January 2015 to November 2022 were retrospectively analyzed. Patient data, including demographic information, clinical records, dietary habits, water intake, and stone recurrence history, were collected. A thorough statistical analysis was conducted to elucidate the associations between patient characteristics, urinary stone composition, and recurrence. Results Among the 1,231 participants, the majority of cases (343 (27.9%)) were in the 31-40 age group, with a higher prevalence in males (876 (71.2%)) than in females (355 (28.8%)). Flank pain or abdominal pain (593 (48.1%)) was the primary complaint, followed by nausea/vomiting (227 (18.5%)). Most stones (922 (74.9%)) were located in the kidney, and calcium oxalate was the predominant stone component (773 (62.8%)). The highest stone recurrence rates were in patients aged between 21-30 years (21 (36.8%)) and 31-40 years (16 (28.0%)). A low non-vegetarian diet and adequate hydration may reduce the likelihood of stone recurrences. Conclusion This study provides insights into the compositional analysis of urinary stones in the eastern Indian population, addressing the causes of their recurrence and management strategies, which are crucial for prevention and effective management. The findings indicate that the early middle-aged group exhibited the highest incidence of urinary stones. We also observed that strict adherence to a low animal protein, along with proper hydration and lifestyle changes, significantly reduced urinary stone recurrence.

Causal relationship between fertility nutrients supplementation and PCOS risk: a Mendelian randomization study.

Polycystic ovary syndrome (PCOS), a prevalent endocrine disorder in women of reproductive age, is mainly ameliorated through drugs or lifestyle changes, with limited treatment options. To date, numerous researchers have found that fertility nutrient supplements may benefit female reproductive health, but their direct impact on polycystic ovary syndrome risk remains unclear. Our research employs Mendelian Randomization to assess how fertility nutrients affect PCOS risk. Initially, we reviewed 49 nutrients and focused on 10: omega-3 fatty acids, calcium, dehydroepiandrosterone, vitamin D, betaine, D-Inositol, berberine, curcumin, epigallocatechin gallate, and metformin. Using methodologies of Inverse Variance Weighting and Mendelian Randomization-Egger regression, we examined their potential causal relationships with PCOS risk. Our findings indicate omega-3 fatty acids reduced PCOS risk (OR=0.73, 95% CI: 0.57-0.94, P=0.016), whereas betaine increased it (OR=2.60, 95% CI: 1.09-6.17, P=0.031). No definitive causal relations were observed for calcium, dehydroepiandrosterone, vitamin D, D-Inositol, and metformin (P>0.05). Drug target Mendelian Randomization analysis suggested that increased expression of the berberine target gene BIRC5 in various tissues may raise PCOS risk (OR: 3.00-4.88; P: 0.014-0.018), while elevated expressions of curcumin target gene CBR1 in Stomach and epigallocatechin gallate target gene AHR in Adrenal Gland were associated with reduced PCOS risk (OR=0.48, P=0.048; OR=0.02, P=0.018, respectively). Our research reveals that specific fertility nutrients supplementation, such as omega-3 fatty acids, berberine, and curcumin, may reduce the risk of PCOS by improving metabolic and reproductive abnormalities associated with it.

Photocatalytic applications of metal oxide-based nanocomposites for sustainable environmental remediation

Change in human lifestyle and excessive use of commercial products have caused an ecological deterioration. A major contribution towards this comes from the mixing of toxins and persistent organic pollutants into water bodies, which poses a serious risk to the ecosystem. In the above context, materials scientists are involved in the search for sustainable solutions to address the above environmental challenges by the development of advanced materials. In this study, we prepared nanocomposite materials such as; ZnO-SnO2 and ZnO-MoS2 by wet-chemical approach to degrade dye pollutants like Rhodamine B (RhB) and Congo red (CR) towards achieving environmental remediation. Powder X-ray diffraction (PXRD) measurement was done for structural characterization of the samples and the formation of the nanocomposite phase was validated by the above study. The goal of the field emission scanning electron microscopy (FESEM) study was to examine the morphology of the composites which was accompanied by the energy dispersive analysis of x-rays (EDAX) and electron mapping experiments which verified the presence of Zn, Sn, O, Mo, S elements in the respective samples. Fourier transformed infrared spectroscopy (FTIR) meas urement was conducted to investigate the vibrational properties of the samples. Photocatalytic measurement showed improved degradation efficiency of the composites as compared to the pristine samples. The degradation efficiency was found to increase with irradiation time and attained saturation after 180 min. ZnO-SnO2 nanocomposite show 91.23 % and 88.11 % of degradation for RhB and CR dyes respectively whereas 89.29 % and 83.25 % degradation have been obtained for ZnO-MoS2 for the same dyes. Several aspects of the experiment were varied, including the amount of catalyst employed, the initial dye concentration, and the pH levels, in order to assess the efficacy of the photocatalysts. Both the photocatalysts degraded CR dye most effectively at acidic pH, although RhB dye gets degraded more at neutral and alkaline pH. ZnO-SnO2 was found to be an effective photocatalyst for degrading RhB dye at neutral pH and CR dye at acidic pH. After multiple iterations of experimentation, the photocatalytic mechanism has been extensively described, and the stability and reusability of the photocatalysts have been ensured for effective environmental cleanup.

Promoting Mental Health of City Residents: Stress Management and The Role of Salutogenic Design

Introduction. Salutogenic, or health-promoting design, suggests that the designed environment should not only provide comfortable living space but also support the health and well-being of individuals. However, the rapid process of urbanization is accompanied by significant changes in people's lifestyles and negatively affects mental health. Thus, it is necessary to study the impact of urban environment on the citizens mental health, as well as to summarize and analyze technologies of health-promoting design in urban environment. Objective. To justify the problem of high prevalence of chronic stress among citizens and to summarize the best practices of applying the principles of salutogenic design in the urban environment to overcome stress and prevent psychological problems. Materials and methods. We conducted a non-systematic narrative literature review in the following databases: PubMed, Google Scholar, eLibrary.ru. Search request depth covered 20 years from 2003 to 2023. Results. Urban planning based on the principles of salutogenic design is one of the important tools for ensuring the health of citizens, extending beyond the scope of healthcare system. Moreover, addressing chronic stress, referred to as the «epidemic of the 21st century», can be considered a key direction in implementing salutogenic design in urban planning. The main focus areas of salutogenic design in the urban environment are regulating the density of urban development, creating public spaces, providing landscape design and greenery, offering convenient and safe urban navigation and using arts. Conclusions. Stress levels in cities are influenced by various factors. Effective urban planning that incorporates salutogenic design principles can contribute to improving public health and creating a supportive urban environment.

Integrating health screening for non-communicable diseases into dental services: what do we know?

This narrative review describes the impetus for health screening for non-communicable diseases in dental settings and highlights important considerations for evaluating such interventions. Real world cases are presented that showcase health screening interventions implemented in the UK. Non-communicable diseases including diabetes and cardiovascular disease are a global public health challenge. They are largely preventable by implementing lifestyle changes such as healthy eating and participation in physical activity, regular health screening for disease prevention, and/or early initiation of treatment. Hypertension case finding and control is one of the key five areas of focus for adult health, and oral health and diabetes are two of five key clinical areas for children and young people where efforts should be focused to intervene, improve outcomes and reduce inequalities. Links between oral and chronic diseases have been discussed in recent years. Therefore, screening for diabetes and cardiovascular disease has become of greater relevance to the dental profession. There is emerging evidence indicating that screening for the risk factors of cardiovascular diseases and diabetes in dental settings shows promise for improving health outcomes and may offer a cost-effective preventive approach for the detection of diabetes. Real-world services implementing health screening in dental settings have highlighted possibilities for the future and highlight the potential for the role of the dental team in detecting chronic diseases.

Reversal of Bone Mineral Density Loss Through Lifestyle Changes: A Case Report

Approximately 10 million individuals in the United States have osteoporosis and 44 million have low bone mineral density which puts them at risk for bone breaks. This presents a large burden on our health care system since about one-quarter of hip fracture patients never regain full function, need nursing care, and, for those over age 50, 24% die within one year. Oral bisphosphonates are often used as first-line therapy for the treatment of osteoporosis; however, patients frequently experience significant side effects. In addition, bisphosphonates inhibit bone loss by initiating apoptosis in osteoclasts that remove old bone, thus allowing old bone to accumulate and slowing the activity of osteoblasts that create new bone, thereby affecting bone quality. As an alternative, a bone-friendly lifestyle, including calcium and vitamin D consumption, exercise, smoking cessation, and a decrease in alcohol intake, may reduce bone loss. This case report describes lifestyle changes that included diet and exercise that increased bone mineral density in two years in a post-menopausal woman with no negative side effects.

Metabolic adverse drug reactions related to psychotropic drugs

Metabolic adverse drug reactions (mADR) related to psychotropic drugs have significant health-related effects including weight gain, impaired glucose tolerance, diabetes mellitus and dyslipidemia as well as economic relevance. Nearly all antipsychotics (AP) and many antidepressants (AD) and mood stabilisers may induce weight gain. Weight development in the first weeks or months after the beginning of the therapy is the strongest predictor for weight gain related to AP and AD. The most important risk factors for mADR are antagonistic effects at H1-, 5-HT2C- und M3-receptors and antidopaminergic effects. However, several other systems are also relevant. Systematic monitoring of metabolic parameters is recommended in all patients treated with substances that are associated with an increased risk of mADR. Lifestyle modification, dietary measures, exercise therapy, dose reduction, change and discontinuation of the substance, and additional treatment with metformin and topiramate are evidence-based treatment options for AP-associated weight gain. GLP-1 receptor agonists such as liraglutide are also promising.

Efficacy of Homoeopathic Medicine in Treating Gastritis: A Retrospective Case Series Study

Background:Gastritis is one of the commonest disease which affects all ages and sex. The prevalence rate also increases with the change in lifestyle. Aim: To analyse the effectiveness of homoeopathic medicine in treating gastritis. Methodology: Cases diagnosed to have gastritis visited OPD and IPD of Sarada Krishna Homoeopathic Medical College were considered in the study. Sample size selected was 40. Cases were selected based on inclusion and exclusion criteria. Pre structured case records of Sarada Krishna Homoeopathic Medical College were used in the study. Details were collected about age, sex, occupation, medicine selected and potency used. Follow up is added to assess the improvement of the patient. Result: Out of 44 patients, 23 were females and 17 were males. Majority comes between 48 and 58 years. 10 patients comes between 37 and 47 years,7 between 59 and 69 years. 5 each is seen between 15 to 25 years and 26 to 36 years and 2 patients are there between 70 and 80 years. 9 patients were treated with Lycopodium , 6 patients with Nux vomica, pulsatilla and sulphur has been used in 5 patients.3 patients were treated with silicea and 2 patients with cundurango., the other medicines used were Ignatia, Anacardium, Argentum nitricum,Calcarea Carbonicum, Sepia, Thuja, Arsenicum album, Bryonia, Ferrum Metallicum, Chelidonium. Most commonly used potencies is 200 by 23 patients.8 patients were treated with LM potency. 7 patients has taken 30 potency.1M potency was used in 2 patients. Conclusion: Homoeopathy has a better scope in treating such cases as long term use of modern medicine has shown an adverse effect in the health of patients.

Abstract B087: Inflammation and breast cancer: Understanding the interplay and implications for prevention and treatment

Abstract Breast cancer continues to be a major global health issue, affecting millions and posing challenges for researchers and healthcare workers. Recent research has revealed the importance of inflammation in the development and progression of a variety of malignancies, including breast cancer. The aim of this study is to investigate the complex association between inflammation and breast cancer in order to improve treatment and preventative techniques. A mixed-methods approach was used, with both quantitative and qualitative studies. The study included 580 breast cancer patients and 2,573 control participants. Patient records, hospital databases, and publicly available datasets were all used as data sources. Statistical methods, including univariate and multivariate logistic regression models, were employed to discover breast cancer predictors associated with inflammation. Breast cancer growth is strongly linked to chronic inflammation and specific inflammatory markers (CRP, IL-6, and TNF-α). Breast cancer incidence is correlated with geographical, demographic, and lifestyle characteristics such as region, age, gender, race, education level, and overall health condition. Comorbidities like hypertension, diabetes, and arthritis, as well as BMI, smoking, and physical activity levels, all have a role in risk. Anti-inflammatory drugs and lifestyle changes show promise for lowering the risk of breast cancer and improving patient outcomes. The study reveals significant relationships between breast cancer incidence and a variety of demographic, lifestyle, and health-related variables. Chronic inflammation is important in the development of breast cancer; therefore, inflammatory indicators could be used as diagnostic or therapeutic tools. The study suggests that tailored anti-inflammatory medications and lifestyle changes could have a significant impact on breast cancer prevention and therapy. This study emphasizes the necessity of knowing the relationship between inflammation and breast cancer. The insights revealed can lead to novel methods for breast cancer management, stressing the importance of ongoing research to fully understand the connection between inflammation and breast cancer and to implement these discoveries in clinical practice. Citation Format: Opeyemi O. Ogungbola, Samuel O. Ejeh, Jane Odeh, Olajumoke R. Omoniyi, Abayomi A. Akomolafe, Emmanuel K. Abudu. Inflammation and breast cancer: Understanding the interplay and implications for prevention and treatment [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B087.

Development of a scale to measure successful aging in late middle-aged women

This study was conducted in two stages, the tool development stage and the tool verification stage, and was based on DeVellis' tool development guidelines. A total of 18 questions were confirmed as a result of developing a successful aging measurement tool for middle-aged women and verifying the validity. It consisted of a total of 5 factors, and in consideration of the characteristics of the items included in each factor, factor 1 was named 'inconvenience of aging', factor 2 was named 'inconvenience of female hormone deficiency', factor 3 was named 'family success', factor 4 was named 'appearance due to aging', and factor 5 was named 'aging and lifestyle change'. It is measured on a 5-point Likert scale, and the score is 18 points to 90 points, which means that the higher the score, the higher the successful aging. The tool developed in this study will be used to measure successful aging status tailored to middle-aged women.

Abstract B068: Physical function and fitness of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program

Abstract Background: Prostate cancer (PC) is the most commonly diagnosed cancer in American men with 1 in 8 men diagnosed in their lifetime. African American men have the highest rates of incidence and mortality for PC in the USA, due to a myriad of socio-biological factors. Fortunately, given advances in screening and treatment options the survival rate of PC is high with a 97% 5-year survival rate. However, PC treatments can cause muscle atrophy and reduced physical functioning and quality of life (QoL). Physical function and strength can serve as proxy measurements for cellular aging, longevity, and QoL. Handgrip is related to overall strength, upper limb function, bone mineral density, and mortality. Sit-to-stand measures leg strength and endurance and is used to evaluate fall risk. The 6-minute walk test (6MW) is used to assess aerobic capacity. Men Moving Forward (MMF) is one of the first community-based lifestyle programs developed with and for African American Prostate Cancer Survivors (AAPCS). This study examines objective and subjective physical function of MMF participants at baseline. Methods: MMF is a randomized, wait-list control trial with a 16-week group-based lifestyle intervention focused on physical activity, nutrition and QoL, led by local health coaches. Participants complete physical assessments and surveys at baseline, post-intervention and 12 months. Physical assessments consist of a blood draw, DXA scan, anthropometric measurements, handgrip strength, 30-second sit-to-stand, and 6MW (added with second cohort). Participants also answer surveys on their health and physical function. Pearson’s correlation was used to assess linear correlation between fitness measures and self-reported physical function. Results: At baseline, 100 AAPCS completed both the physical assessment and survey. Participants had a mean age of 65.8 ± 7.26 years, 49% were married/living with a partner, 47.6% were retired, and education levels varied. Top comorbidities include hypertension, obesity, diabetes, and hypercholesterolemia. Mean hand grip scores were 39.8 ± 7.5kg for right and 38.4 ± 7.7kg for left. Handgrip scores 28.2-44.0kg for men aged 64-69 are considered normal. Mean sit-to-stand (n=96) was 12.2 ± 4.3 reps in 30 seconds. Since 6MW was added later in the study, 68 men completed with a mean score of 0.42 ± 0.10 km. Normal ranges for men aged 65-69 is 15 reps for sit-to-stand and 0.572km for 6MW. 50% of participants rated their overall health as “good”, 21% as “very good”, and 20% as “fair” on a five-point Likert scale. PROMIS physical function measures had an average of 50.3 ± 7.3 for men at baseline. PROMIS physical function was weakly correlated with 6MW and sit-to-stand with r = 0.34, p-value=0.004 and r = 0.27, p- value=0.009, respectively. Conclusion: Data reflect the value of supporting AAPCS in lifestyle changes to improve physical function. Few efforts have addressed lifestyle among AAPCS, despite high prostate cancer burden. Future reports will examine the efficacy of MMF in improving physical function, overall health, and QoL. Citation Format: Margaret Y. Tovar, Iwalola Awoyinka, Patricia Sheean, Paula Papanek, Toni Uhrich, Sandra Contreras, Meheret Gebreegziabher, Estefania Alonso, Jayme Ewens, Shannon Reed, Diana Navarro Suarez, Kathleen O'Connell, Kathryn Flynn, Kathryn Bylow, Deepak Kilari, Melinda Stolley. Physical function and fitness of African American prostate cancer survivors at baseline of Men Moving Forward, a lifestyle intervention program [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B068.

Excess glucose alone induces hepatocyte damage due to oxidative stress and endoplasmic reticulum stress

Type 2 diabetes mellitus (DM) is a significant risk factor for metabolic dysfunction-associated steatotic liver disease (MASLD) and hepatocellular carcinoma (HCC). With the increasing prevalence of type 2 DM and MASLD due to lifestyle changes, understanding their impact on liver health is crucial. However, the hepatocellular damage caused by glucose alone is unknown. This study investigates the effect of excess glucose on hepatocytes, focusing on oxidative stress, endoplasmic reticulum stress (ER stress), apoptosis, autophagy, and cell proliferation. We treated an immortalized-human hepatocyte cell line with excess glucose and analyzed. Excess glucose induced oxidative stress and ER stress in a time- and concentration-dependent manner, leading to apoptosis. Oxidative stress and ER stress were independently induced by excess glucose. Proteasome inhibitors and palmitic acid exacerbated glucose-induced stress, leading to the formation of Mallory-Denk body-like inclusion bodies. Despite these stresses, autophagic flux was not altered. Excess glucose also caused DNA damage but did not affect cell proliferation. This suggests that glucose itself can contribute to the progression of metabolic dysfunction-associated steatohepatitis (MASH) and carcinogenesis of HCC in patients with type 2 DM. Managing blood glucose levels is crucial to prevent hepatocyte damage and associated complications.

Abstract A088: Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors

Abstract Background. Racial disparities in prostate cancer survivorship persist despite clinical advancements. Stress has been implicated as a potential driver of these disparities, with both chronic and perceived stress found to be associated with adverse cancer survivorship. Allostatic load (AL), one such marker of chronic stress, has been associated with decreased survivorship and worse quality of life (QoL) in cancer survivors. Perceived stress has also been associated with outcomes in cancer survivorship including increased symptom burden and worse quality of life. Despite this, few studies incorporate direct measures of stress or examine how these measures contribute to AL This study examines the relationship between AL, objective stress (as measured by occurrence of stressful life events), and self-reported perceived stress in a subset of African American prostate cancer survivors (N=59) enrolled in Men Moving Forward, a randomized trial to improve body composition through lifestyle change. Methods. At baseline, participants completed an adapted version of the Crisis in the Family Systems (CRISYS) survey, an instrument designed to measure recent (past 4 months) contemporary life stressors. The survey was tailored for AAPCS via feedback from the community advisory board. 41 items reflective of 11 domains were included. Overall CRISYS scores and scores by domain were calculated. Feelings of perceived stress in the past month were measured via the 10-item perceived stress scale, with higher scores reflecting higher perceived stress. AL scores used 15 criterion reflecting neuroendocrine, cardiovascular, immune, and metabolic systems. Each criterion was assigned a score of 0 or 1: 1 if in the high-risk range based on clinical guidelines. An index score was generated by summing high-risk indicators. Pearson correlations were used to explore the relationship between stress measures. Logistic regression comparing the those with highest quartile AL to lower AL was also performed. Results. The mean AL score was 5.6 (SD ± 2.4) of a maximum score of 15. The mean summative score for CRISYS was 4.8 (SD ± 3.3). The most common domains of stress experienced were safety in the community (67%), relationships (66%), and medical issues of loved ones (44%). The Mean PSS was 11.5 (SD ± 6.0), with 64% of men reporting low stress and 36% moderate stress levels. Significant correlations were found between CRISYS and PSS, however no correlations with AL were detected. No significant findings were identified in the regression analysis. Conclusions. Objective and perceived stress measures were correlated, but no associations were found between the perceived or objective stress measure and AL in this sample.. Given AL is meant to reflect the physiological impact of cumulative and chronic stress burdens, it is possible that the shorter-term context of the objective (past 4 months) and perceived stress (past month) measures were not sufficiently aligned with the longer-term context of AL. Citation Format: Iwalola Awoyinka, Deepak Kilari, Kathryn Bylow, Jennifer Knight, Alexis Visotcky, Anjishnu Banerjee, Patricia Sheean, Paula Papanek, Melinda Stolley. Examining associations between objective and perceived stress and allostatic load in African American prostate cancer survivors [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A088.

Research on the digital inheritance and development of Weixian paper-cutting from the perspective of intangible cultural heritage

As a traditional folk art in northern China, Weixian paper-cutting has been listed in the national intangible cultural heritage list and has rich cultural connotations and artistic value. However, with the acceleration of modernization and changes in lifestyle, the inheritance of Weixian paper-cutting faces severe challenges, including a decrease in the number of inheritors, shrinking market demand, and a decline in the younger generation's attention to traditional culture. The rapid development of digital technology has provided a new opportunity for the inheritance and development of Weixian paper-cutting. This study aims to explore the application and practice of digital technology in the inheritance of Weixian paper-cutting from the perspective of intangible cultural heritage protection. The study found that digital technology can not only enhance the cultural communication power of Weixian paper-cutting, but also bring it the possibility of innovative design and broaden its marketization path. Through the analysis of the digital practice of Weixian paper-cutting, this paper puts forward countermeasures and suggestions in the future in terms of digital platform construction, policy support and inheritor training, providing a theoretical basis and practical reference for the sustainable inheritance of Weixian paper-cutting.

Pain in chronic pancreatitis: What can we do today?

The aim of this study is to illustrate the complexity of pain management in chronic pancreatitis (CP). In this context, pain represents the most common and debilitating symptom, and it deeply affects patient's quality of life. Multiple rating scales (unidimensional, bidimensional and multidimensional) have been proposed to quantify CP pain. However, it represents the result of complex mechanisms, involving genetic, neuropathic and neurogenic factors. Considering all these aspects, the treatment should be discussed in a multidisciplinary setting and it should be approached in a stepwise manner. First, a lifestyle change is recommended and nonsteroidal anti-inflammatory drugs represent the gold standard among medical treatments for CP patients. The second step, after medical approach, is endoscopic therapy, especially for complicated CP. In case of failure, tailored surgery represents the third step and decompressive or resection procedures can be chosen. In conclusion, CP pain's management is challenging considering all these complex aspects and the lack of international protocols.

Questioning Sustainable Environmental Policies and Practices in Indonesia: Would Durkheim’s Structural Functionalism Theory Have a Relevance?

Indonesia, as a signatory to the UNFCCC and the Paris Agreement, is committed to reducing greenhouse gas (GHG) emissions. These commitments, outlined in Law Number 16 of 2016, include limiting global temperature rise, setting Nationally Determined Contributions (NDC) targets, and developing a long-term strategy for net zero emissions by 2050. To meet these obligations, the Indonesian government has introduced Carbon Economic Value (CEV) policies through Presidential Regulation Number 98 of 2021. These policies aim to reduce GHG emissions by implementing carbon pricing mechanisms such as carbon trading, levies, and performance-based payments. However, the implementation of CEV policies has faced various reactions, including criticism and resistance. Despite these challenges, it's imperative not to hinder the policy's implementation, given its potential to drive significant societal and lifestyle changes towards a greener future. This study analyzes Indonesia's progress in reducing GHG emissions through CEV policies. Using normative legal research and qualitative analysis, it explores the positive impacts of these policies, including their alignment with structural functionalism theory. The study highlights that the implementation of CEV policies as an effort to reduce greenhouse gas emissions in Indonesia through carbon trading mechanisms, carbon taxes, and funding partnerships with developed countries aligns with structural functionalism theory according to Emile Durkheim. This is evidenced by the existence of a clear system (legal and governance) in implementing CEV policies, including regulators (Government), implementers (SOEs, private sector, and society), supervisors (UNFCCC), and program donors (World Bank, IMF), where each entity cooperates in an organized manner in accordance with the provisions of the Paris Agreement 2015 and Presidential Regulation 98 of 2021 continuously according to their respective tasks. This policy also brings about functional social change by promoting a harmonious balance to shift dependence away from fossil fuels towards more environmentally friendly Renewable Energy sources.

Risk of developing Type 2 Diabetes Mellitus in a vulnerable community in northern Argentina

Introduction: Prevention of diabetes requires sustained lifestyle changes as well as identification of groups at higher risk. Objective: The aim of this research was to estimate the risk of diabetes in vulnerable subjects from a primary care center in northern Argentina, with no known glucose abnormalities, using the FINDRISC questionnaire, investigate the relationship between survey variables and the final score, and explore its association with metabolic risk factors and body composition. Methodology: This cross-sectional design included 498 patients without type 2 diabetes or known glycemic abnormalities. All subjects underwent a complete medical history and completed the FINDRISC questionnaire. Results: The predominant age group was 18-45 years old. Around 64% were physically active and 44% reported daily consumption of fruit and vegetables. Most of them had a BMI higher than 25 kg/m2. Regarding the risk of developing type 2 diabetes in the next 10 years, 24.3% were at low risk and the remaining fraction was distributed in slightly elevated, moderate, high and very high risk. All variables influenced the individuals' variance (p < 0.05). The hierarchical clustering and principal component analysis (PCA) revealed that elevated FINDRISC score was strongly associated with: age > 65 years, fasting blood glucose, BMI ? 30 kg/m2 and antihypertensives use. CONCLUTION: We found a high percentage of obesity and overweight, as well as a high risk of cardiometabolic disease and of developing T2D. In addition, in the population studied, the variables that compose the FINDRISC did not influence the highest score in the same way.

Neural Conversational Agent for Weight Loss Counseling: Protocol for an Implementation and Feasibility Study.

Obesity is a common, serious and costly chronic disease. Current clinical practice guidelines recommend that providers augment the longitudinal care of people living with obesity with consistent support for the development of self-efficacy and motivation to modify their lifestyle behaviors. Lifestyle behavior change aligns with the goals of motivational interviewing (MI), a client-centered yet directive counseling modality. However, training health care providers to be proficient in MI is expensive and time-consuming, resulting in a lack of trained counselors and limiting the widespread adoption of MI in clinical practice. Artificial intelligence (AI) counselors accessible via the internet can help circumvent these barriers. The primary objective is to explore the feasibility of conducting unscripted MI-consistent counseling using Neural Agent for Obesity Motivational Interviewing (NAOMI), a large language model (LLM)-based web app for weight loss counseling. The secondary objectives are to test the acceptability and usability of NAOMI's counseling and examine its ability to shift motivational precursors in a sample of patients with overweight and obesity recruited from primary care clinics. NAOMI will be developed based on recent advances in deep learning in four stages. In stages 1 and 2, NAOMI will be implemented using an open-source foundation LLM and (1) few-shot learning based on a prompt with task-specific instructions and (2) domain adaptation strategy based on fine-tuning LLM using a large corpus of general psychotherapy and MI treatment transcripts. In stages 3 and 4, we will refine the best of these 2 approaches. Each NAOMI version will be evaluated using a mixed methods approach in which 10 adults (18-65 years) meeting the criteria for overweight or obesity (25.0≥BMI≤39.9) interact with NAOMI and provide feedback. NAOMI's fidelity to the MI framework will be assessed using the Motivational Interviewing Treatment Integrity scale. Participants' general perceptions of AI conversational agents and NAOMI specifically will be assessed via Pre- and Post-Interaction Questionnaires. Motivational precursors, such as participants' confidence, importance, and readiness for changing lifestyle behaviors (eg, diet and activity), will be measured before and after the interaction, and 1 week later. A qualitative analysis of changes in the measures of perceptions of AI agents and counselors and motivational precursors will be performed. Participants will rate NAOMI's usability and empathic skills post interaction via questionnaire-based assessments along with providing feedback about their experience with NAOMI via a qualitative interview. NAOMI (version 1.0) has been developed. Participant recruitment will commence in September 2024. Data collection activities are expected to conclude in May 2025. If proven effective, LLM-based counseling agents can become a cost-effective approach for addressing the obesity epidemic at a public health level. They can also have a broad, transformative impact on the delivery of MI and other psychotherapeutic treatment modalities extending their reach and broadening access. PRR1-10.2196/60361.

The Benefits of Lifestyle Changes in the Management of Hypertension: A Review of the Literature

Introduction: Hypertension has been identified as an important health problem worldwide. It is a major factor in cardiovascular diseases with a resultant high mortality rate. Understanding the role of lifestyle modification in the management of hypertension is important in improving the health of the population, especially in middle-aged adults. Aim: The aim of this research is to identify and evaluate the positive effects of lifestyle changes, specifically dietary modifications and physical activities in the management of hypertension. Methods: This study employed a systematically structured literature review, with emphasis on important studies that focused on lifestyle changes and their effect on hypertension. The review focused on peer-reviewed articles that addressed dietary interventions and physical activity levels among middle-aged adults with hypertension. Results: The research revealed that changes in the lifestyle if properly implemented would have a positive impact on the management of high blood pressure. A more personalized dietary regimen and regular exercise are the strategies that were singled out as efficient for reducing blood pressure Conclusion: The findings of this study underscore the importance of lifestyle modifications in the management of hypertension. When applied correctly, these changes can significantly contribute to better health outcomes and reduced risks associated with high blood pressure.

Positive impact of nutrition in the prevention of peripheral vascular disease and severe acute respiratory syndrome coronavirus 2: review.

Recent research has shown that there is a link between the trend of cardiovascular disease (CVD), chronic symptoms of SARS-CoV-2 (COVID-19), and medical nutrition therapy. Making positive changes to an individual's lifestyle can help to reduce the symptoms that follow exposure to CVD and COVID-19. Sustainable nutrition and lifestyle changes can positively impact an individual's health. Studies have considered the risk factors associated with the disease, medical history, the link between nutrition and peripheral vascular disease (PVD), symptom management, and the interrelationship between nutrition, COVID-19, and PVD. One study has demonstrated that Western Dietary intake can boost the innate immune system while suppressing humoral response, causing chronic inflammation and poor host defense against viruses. However, further investigation is needed to confirm. Patients with PVD and COVID-19 have experienced a reduction in side effects when prescribed a regimen of medical nutrition therapy, heart-healthy diets, and adequate physical activity before and after symptoms of both diseases appear. This approach has proven to be a protective factor during the combination of both illnesses. Our findings indicate that balanced diet and lifestyle are essential in supporting an optimal immune system that can reduce the risk of virus load in individuals at risk of infection and symptoms from COVID-19 and PVD.