Chronic Non-communicable Diseases Research Articles

Community medical service construction: identifying factors that influence medical choice for patients with non-communicable chronic diseases in the Southwest China

BackgroundCommunity medical institutions play a vital role in China’s healthcare system. While the number of these institutions has increased in recent years, their construction contents remain insufficient. The potential of community medical institutions in preventing, screening, diagnosing, and treating non-communicable chronic diseases (NCDs) has not been fully utilized. This study aims to assess the status of construction contents in community medical institutions in Southwest China and examine how these contents influence the medical choices of NCD patients.MethodsDescriptive statistics were used to evaluate the construction content of community medical institutions. Multiple-sets of multinomial logistic regression were employed to analyze the associations and marginal impacts between construction content and medical choices. Shapley value analysis was applied to determine the contribution and ranking of these impacts.ResultsDescriptive statistics revealed satisfactory construction contents in community medical institutions. Notably, factors such as service attitude, nursing services, expert consultations, charging standards, medical equipment, medical examinations, privacy protection, and referrals significantly influenced medical choices. Among these, service attitude, charging standards, and privacy protection had the most significant marginal improvement effects on NCD patients’ choices, with improvements of 12.7%, 10.2%, and 5.9%, respectively. The combined contribution of privacy protection, medical examinations, service attitude, charging standards, and nursing services to medical choices exceeded 80%.ConclusionOptimizing the service contents of community institutions can encourage NCD patients to seek medical care at grassroots hospitals. This study addresses crucial gaps in existing literature and offers practical insights for implementing new medical reform policies, particularly in underdeveloped regions of Southwest China focusing on hierarchical diagnosis and treatment.

Impact of nutritional risk factors on the development of multiple sclerosis

The literature review considers the data on the assessment of the influence of alimentary factors on the development of a severe neurological disease - multiple sclerosis (MS). MS is a polyetiologic disease, the risk of development of which is influenced by both infectious (Epstein-Barr virus, herpes simplex virus, influenza virus, etc.) and noninfectious factors (genetic predisposition, smoking, geographic region of residence, etc.). MS is a progressive demyelinating disease of the central nervous system (CNS), which leads to neurodegeneration accompanied by a variety of clinical manifestations. The pathogenesis of MS is characterized by immune-mediated damage to the myelin sheaths of nerve fibers, which is manifested by inflammation, neurosynaptic damage, and destruction of white matter, axons, and blood vessels. Rapid non-evolutionary dietary and lifestyle changes, which are driven by urbanization, industrialization and globalization of the food market, are leading to an increase in most chronic non-communicable diseases, including MS. The effects induced by alimentary factors are due to changes in the microbial composition of the gastrointestinal tract (GIT), immune cell function, enzyme systems functioning, etc. The aim of the work is to study the influence of micro/macronutrients, as well as the nature of the diet on the risk of MS development, to assess the role of nutrition in the primary prevention of MS. It has been shown that a diet characterized by a high content of animal fats and trans-isomers of fatty acids (TFA), increased consumption of meat products, but low content of vegetables, fruits and whole-grain products is associated with a higher risk of MS development. Regular inclusion in the diet of sources of polyunsaturated fatty acids (PUFAs) (vegetable oils, seeds, nuts, marine fish) and vitamin D (fatty fish, caviar, butter, egg yolk) leads to lower relapse rates and less new brain lesions among MS patients. The literature review was conducted using open sources posted in electronic databases: PubMed, Medline, Scopus, Google Scholar, World Bank publications, WHO, eLibrary, Cyberleninka, Web of Science.

PREVALENCE OF ASTHENIA IN PATIENTS WITH CHRONIC NONCOMMUNICABLE DISEASES IN REAL CLINICAL PRACTICE

The aim of the research. Examine the features of prevalence of asthenia in patients with chronic noncommunicable diseases in real clinical practice.Materials and methods. Research includes 2 373 patients, who are under the general practitioner’s care for chronic noncommunicable diseases. These patients are 1 337 (56,3%) women and 1 036 (43,7%) men. The average age of them is 56,3±15,0 year. We asked about complains, took anamnesis, examined the organs’ systems, and reviewed patients’ cards. According these data we confirmed the diagnosis of chronic noncommunicable disease. We diagnosed asthenia thanks to Multidimensional Fatigue Inventory – 20, MFI-20 and Fatigue Severity Scale, FSS. Statistic data processing was made with applying of Mann–Whitney U testResults. The largest amount of patients, who we examined, have cardiovascular diseases (1 474 patients, 62,1%). More than one half of all examined patients are from 18 to 60 years (1349 patients). According MFI-20, 847 patients have asthenia (35,7%). According FSS, 701 patients have it (29,5%). 57,1% patients with asthenia are people elder 61 year (484 patients). Moreover, 334 citizens among elderly patients have polymorbidity (69,1%). The level of severity of asthenia is utterly higher in patients who elder 61 year (p < 0,001). Patients with multimorbidity have more sever asthenia that patients who have only one disease (p < 0,001).Conclusion. Results of large spread of asthenia in patients with chronic noncommunicable diseases underline the necessity of awareness of general practitioners about right assessment of asthenia in real clinical practice, especially in elderly patients with multimorbidity.

Type 2 Diabetes in the Elderly in Obuasi: Management Strategies and Effect on Nutrition and Health

Type 2 Diabetes Mellitus (DM) is a chronic non-communicable disease which requires effective management strategies, especially in the elderly, in order to maintain good nutrition and ensure optimal health. The main objective of the study was to assess the management strategies of Type 2 DM in the elderly as well as the effects of Type 2 Diabetes Mellitus on the nutrition and health of persons aged 60 years and above in Obuasi Municipality. Using a cross sectional study design 100 respondents comprising Type 2 diabetic patients were selected purposively to respond to the research instruments. Questionnaire and a mini nutritional assessment tool were the main instruments for the study. The findings of the study indicated that majority of the respondents were within the age range of 60-65 years and were females. Also, most of the respondents had pharmacotherapy and diet therapy as their treatment options for the management of the type 2 diabetes. Again, majority of the patients were on anti- diabetic medications while few were on insulin. Furthermore, half of the respondents had physical activities as part of their management. About half (45%) of the respondents had hypertension as additional chronic disease. Most (52.7%) of the respondents aged 60-65 years had normal nutritional status. Also, majority (45.8%) of the female respondents were malnourished. There is the need for health authorities to develop local- specific diabetes management guidelines for the patients. Dietitians/Doctors should intensify awareness and education diabetes to reduce the prevalence of diabetes and improve outcomes for the persons with the disease.

Weight loss treatment for COVID-19 in patients with NCDs: a pilot prospective clinical trial

COVID-19 comorbid with noncommunicable chronic diseases (NCDs) complicates the diagnosis, treatment, and prognosis, and increases the mortality rate. The aim is to evaluate the effects of a restricted diet on clinical/laboratory inflammation and metabolic profile, reactive oxygen species (ROS), and body composition in patients with COVID-19 comorbid with NCDs. We conducted a 6-week open, pilot prospective controlled clinical trial. The study included 70 adult patients with COVID-19 comorbid with type 2 diabetes (T2D), hypertension, or nonalcoholic steatohepatitis (NASH). Interventions: a restricted diet including calorie restriction, hot water drinking, walking, and sexual self-restraint. Primary endpoints: COVID-19 diagnosis by detecting SARS-CoV-2 genome by RT-PCR; weight loss in Main group; body temperature; C-reactive protein. Secondary endpoints: the number of white blood cells; erythrocyte sedimentation rate; adverse effects during treatment; fasting blood glucose, glycosylated hemoglobin A1c (HbA1c), systolic/diastolic blood pressure (BP); blood lipids; ALT/AST, chest CT-scan. In Main group, patients with overweight lost weight from baseline (− 12.4%; P < 0.0001); 2.9% in Main group and 7.2% in Controls were positive for COVID-19 (RR: 0.41, CI: 0.04–4.31; P = 0.22) on the 14th day of treatment. Body temperature and C-reactive protein decreased significantly in Main group compared to Controls on day 14th of treatment (P < 0.025). Systolic/diastolic BP normalized (P < 0.025), glucose/lipids metabolism (P < 0.025); ALT/AST normalized (P < 0.025), platelets increased from baseline (P < 0.025), chest CT (P < 0.025) in Main group at 14 day of treatment. The previous antidiabetic, antihypertensive, anti-inflammatory, hepatoprotective, and other symptomatic medications were adequately decreased to completely stop during the weight loss treatment. Thus, the fast weight loss treatment may be beneficial for the COVID-19 patients with comorbid T2D, hypertension, and NASH over traditional medical treatment because, it improved clinical and laboratory/instrumental data on inflammation; glucose/lipid metabolism, systolic/diastolic BPs, and NASH biochemical outcomes, reactive oxygen species; and allowed patients to stop taking medications.Trial Registration: ClinicalTrials.gov NCT05635539 (02/12/2022): https://clinicaltrials.gov/ct2/show/NCT05635539?term=NCT05635539&draw=2&rank=1.

Role and molecular mechanism of NOD2 in chronic non-communicable diseases.

Nucleotide-binding oligomerization domain containing 2 (NOD2), located in the cell cytoplasm, is a pattern recognition receptor belonging to the innate immune receptor family. It mediates the innate immune response by identifying conserved sequences in bacterial peptide glycans and plays an essential role in maintaining immune system homeostasis. Gene mutations of NOD2 lead to the development of autoimmune diseases such as Crohn's disease and Blau syndrome. Recently, NOD2 has been shown to be associated with the pathogenesis of diabetes, cardiac-cerebral diseases, and cancers. However, the function of NOD2 in these non-communicable diseases (CNCDs) is not well summarized in reviews. Our report mainly discusses the primary function and molecular mechanism of NOD2 as well as its potential clinical significance in CNCDs.

Prevalence of hypertension and diabetes mellitus in Peruvian patients with chronic kidney disease: a systematic review and meta-analysis

BackgroundChronic Kidney Disease (CKD) represents a major challenge for public health, with hypertension and diabetes being the main causes of its occurrence. Therefore, this study aims to determine the prevalence of hypertension (HTN) and diabetes mellitus (DM) in Peruvian patients with CKD.MethodsA systematic search for studies about CKD in Peru was carried out in PubMed, Scopus, Embase, Web of Science, ScienceDirect, Google Scholar, Virtual Health Library (VHL), and Scielo from 2011 to December 2023. The protocol of this research was registered in the international registry of systematic reviews, the Prospective International Registry of Systematic Reviews (PROSPERO), with registration number CRD42023425118. Study selection, quality assessment, and data extraction were performed independently by two authors. Study quality was assessed using the Joanna Briggs Institute Statistical Meta-Analysis Assessment and Review Instrument. A random-effects model with inverse variance weighting was used to estimate the combined prevalence of HTN and DM in Peruvian patients with CKD. To analyze data heterogeneity, the I2 statistical test was used. Statistical analysis was performed with R version 4.2.3.ResultsA total of 1425 studies were retrieved, of which 23 were included in the final meta-analysis. A total of 43,321 patients with CKD were evaluated, of whom 52.22% were male and 47.78% were female. The combined prevalence of HTN in Peruvian patients with CKD was 38% (95% CI: 30–46%; 41,131 participants; 21 studies, I2 = 99%, p = 0), while the combined prevalence of DM in Peruvian patients with CKD was 33% (95% CI: 26–40%; 43,321 participants; 23 studies, I2 = 99%, p = 0).ConclusionApproximately one-third of Peruvian patients with CKD have HTN and DM. These findings highlight the importance of implementing prevention and control measures for these chronic noncommunicable diseases in the Peruvian population, such as promoting healthy lifestyles, encouraging early detection and proper management of hypertension and diabetes, and improving access to medical care and health services.

Evaluation of Knowledge, Attitudes and Behaviors of Physicians Working in a University Hospital About Smoking Cessation Treatment

Introduction and Objective: Tobacco use is one of the most important risk factors for chronic non-communicable diseases, a preventable cause of morbidity and mortality and a global public health problem affecting the whole world. It is clear that all physicians, especially primary care physicians who provide various health services to the community, need to increase their awareness, increase their level of knowledge, and change their negative attitudes and behaviours about smoking, which is a risk factor for many preventable diseases in the world. This study was planned to evaluate the knowledge, attitudes and behaviours of physicians working in a university hospital regarding smoking cessation treatments. Materials and Method: This study was a descriptive and cross-sectional study. The study included 203 physicians who agreed to participate. A printed questionnaire form was used to collect data. Nicotine dependence of the participants who smoked cigarettes was evaluated by Fagerström nicotine dependence test (FNBT). Data were analyzed using SPSS 23.0 statistical package form. A value of p

Antioxidant and anti-inflammatory function of Eupatorium adenophora Spreng leaves (EASL) on human intestinal Caco-2 cells treated with tert-butyl hydroperoxide

Chronic non-communicable diseases (CNCDs) pose a significant public health challenge. Addressing this issue, there has been a notable breakthrough in the prevention and mitigation of NCDs through the use of antioxidants and anti-inflammatory agents. In this study, we aim to explore the effectiveness of Eupatorium adenophora Spreng leaves (EASL) as an antioxidant and anti-inflammatory agent, and its potential applications. To construct a cellular model of oxidative damage and inflammation, Caco-2 cells were treated with tert-butyl hydroperoxide (t-BHP). The biocompatibility of EASL-AE with Caco-2 cells was assessed using the MTT assay, while compatibility was further verified by measuring LDH release and the protective effect against oxidative damage was also assessed using the MTT assay. Additionally, we measured intracellular oxidative stress indicators such as ROS and 8-OHdG, as well as inflammatory pathway signalling protein NFκB and inflammatory factors TNF-α and IL-1β using ELISA, to evaluate the antioxidant and anti-inflammatory capacity of EASL-AE. The scavenging capacity of EASL-AE against free radicals was determined through the DPPH Assay and ABTS Assay. Furthermore, we measured the total phenolic, total flavonoid, and total polysaccharide contents using common chemical methods. The chemical composition of EASL-AE was analyzed using the LC–MS/MS technique. Our findings demonstrate that EASL-AE is biocompatible with Caco-2 cells and non-toxic at experimental levels. Moreover, EASL-AE exhibits a significant protective effect on Caco-2 cells subjected to oxidative damage. The antioxidant effect of EASL-AE involves the scavenging of intracellular ROS, while its anti-inflammatory effect is achieved by down-regulation of the NFκB pathway. Which in turn reduces the release of inflammatory factors TNF-α and IL-1β. Through LC–MS/MS analysis, we identified 222 compounds in EASL-AE, among which gentianic acid, procaine and L-tyrosine were the compounds with high antioxidant capacity and may be the effective constituent for EASL-AE with antioxidant activity. These results suggest that EASL-AE is a natural and high-quality antioxidant and anti-inflammatory biomaterial that warrants further investigation. It holds great potential for applications in healthcare and other related fields.

Lifestyle, meal times, and sleep patterns changes in higher education professors during COVID-19: Association with non-communicable chronic diseases.

In response to the COVID-19 pandemic, educational institutions had to swiftly adapt and transition to remote teaching in order to maintain academic activities. However, these changes presented a number of challenges for professors, which could have negative effects on their health. To analyze the association between changes in dietary and sleep habits, physical activity level, and sedentary behavior with the development of non-communicable diseases (NCDs) among Brazilian higher education professors during the pandemic period. This is a cross-sectional and retrospective study conducted using an online form. Generalized linear models, adjusted for age, sex, and body mass index, were used to verify the difference between pre-pandemic and pandemic periods. Logistic regression models were used to predict the odds ratio (OR) for the development of NCDs according to physical activity time, sedentary behavior time, dietary and sleep patterns. A total of 936 professors residing across Brazil participated in the survey. The duration of sedentary behavior increased, sleep duration slightly decreased, and meal times shifted to earlier during the pandemic. A total of 22.9%of the participants reported the diagnosis of some NCDs during this period. Physical activity practice was associated with a lower risk of diseases during the pandemic, regardless of the intensity performed. On the other hand, late eating habits and excessive food consumption during the pandemic were associated with a higher risk. The results provide data that can help in the development of public policies that promote health actions to minimize the consequences associated with the pandemic period.

Effectiveness of different antioxidants in suppressing the evolution of thermally induced peroxidation products in hemp seed oil

Several scientific studies have warned that the ingestion of dietary lipid oxidation products (LOPs) may initiate or exacerbate the development of several chronic non-communicable diseases in humans. Indeed, the constantly increasing consumption of culinary oils by larger global populations indicates the need for scientific techniques to suppress the evolution of LOPs in thermo-oxidised oils. This study employed a 600.13 MHz frequency NMR spectrometer in evaluating the effect of 10, 50, and 100 ppm concentrations of chemical compounds reported to have antioxidant properties in continuously-stirred and thermally stressed polyunsaturated fatty acid (PUFA)-rich hemp seed oil at a frying temperature of 180℃ for 180 min. Research data acquired showed that the antioxidants α- and γ-tocopherol, γ-oryzanol, β-carotene, eugenol, resveratrol, ascorbyl palmitate, gentisic acid, and L-ascorbic acid all played a vital role in suppressing the evolution of secondary aldehydic lipid oxidation products in hemp seed oil. However, the most ineffective LOP-suppressing agent was L-lysine, an observation which may be accountable by its poor oil solubility. Nonetheless, trends deduced for compounds acting as antioxidants were mainly unique for each class of agent tested. Conversely, the antioxidant capacity of resveratrol was consistently higher, and this effect was found to be independent of its added amounts. This report provides a direct approach in developing scientific methods for the suppression of LOPs in thermo-oxidatively susceptible PUFA-rich cooking oils.

Abstract PO5-27-11: A COMPARATIVE STUDY OF DIAGNOSTICS MADE BY FINE NEEDLE ASPIRATION (FNA) BIOPSY VERSUS TRU-CUT FOR BREAST PATHOLOGY IN A ONE STOP CLINIC PROGRAM IN MEDELLIN, COLOMBIA

Abstract Breast cancer is the leading cause of morbidity and mortality among women in Colombia due to non-communicable chronic diseases. This has prompted health insurance companies to develop innovative initiatives to mitigate these negative outcomes. Since September 2018, Ayudas Diagnósticas SURA, in alliance with the Gustave Roussy Hospital and General Electric Healthcare has promoted a “One-stop clinic” program called: “TIEMPO PARA TI”. One of the primary challenges was to demonstrate that breast cytology, based on the Yokohama guidelines approved by The International Academy of Cytology has a high sensitivity, specificity, and diagnostic accuracy. The Yokohama system for classifying breast cytology is comprised of five categories: C1 not satisfactory, C2 benign, C3 atypical, C4 malignancy suspected, and C5 malignant. From September 2018 to December 2022, consecutive patients referred for breast biopsy and suspected of having breast cancer underwent triple assessment of breast tumor and were included in this retrospective study. Descriptive analysis was made using STATA v17 software to compare fine needle aspiration (FNA) biopsy versus Tru-cut. A total of 14,501 patients were included, 14.398 FNA and 14.401 trucut biopsies were performed. The comparative analysis showed a 99% concordance between categories 2, which correspond to benign lesions and 96.7% between categories 5, which correspond to malignant lesions. Our findings demonstrate that a well-executed FNA biopsy is not inferior to a trucut biopsy, as revealed by the Yokohama system, and offers significant advantages, such as cost-effectiveness and prompt diagnosis. Both techniques should be used with caution, considering their advantages and disadvantages. Citation Format: Sara Gil, Carlos Agudelo, Jorge Castaño, Melissa Naranjo, Clara Piedrahita, Daniel Wilches, Kelly Corredor. A COMPARATIVE STUDY OF DIAGNOSTICS MADE BY FINE NEEDLE ASPIRATION (FNA) BIOPSY VERSUS TRU-CUT FOR BREAST PATHOLOGY IN A ONE STOP CLINIC PROGRAM IN MEDELLIN, COLOMBIA [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-27-11.

Prevalence of non-communicable chronic diseases in rural India amongst peri- and post-menopausal women: Can artificial intelligence help in early identification?

AimsTo identify peri- and post-menopausal women at risk of non-communicable diseases in rural India and to assess their prevalence amongst these groups via the use of artificial intelligence. Settings and designAn observational study conducted by the Indian Menopause Society in collaboration with the Government of Maharashtra. The study included rural women resident in three villages in the Latur district of Maharashtra, India. Materials and methodsAccredited social health activist workers identified 400 peri- and post-menopausal women aged 45–60 years. Specific symptoms able to predict the presence of a non-communicable disease were identified through the use of artificial intelligence. Statistical analysis usedDescriptive statistics and predictive network charts analysis. ResultsThe mean age of 316 women included in the analysis was 50.4 years and the majority of them were illiterate (68 %). The prevalence of dyslipidaemia, osteopenia, diabetes mellitus, obesity and hypertension were 58 %, 50 %, 25 %, 25 %, and 20 % respectively. None of their symptoms or laboratory reports could be significantly correlated directly with any of these non-communicable diseases. Hence, we used a cluster of symptoms to suggest the presence of hypertension, diabetes mellitus, osteoporosis and hypothyroidism via predictive network analysis charts. ConclusionsScreening of at-risk women can be done using an artificial intelligence-based screening tool for early diagnosis, timely referral and treatment of non-communicable diseases with the support of community health workers.

The Impact of a Nutritional Intervention on Glycemic Control and Cardiovascular Risk Markers in Type 2 Diabetes.

Nutritional management plays a crucial role in treating patients with type 2 diabetes (T2D), working to prevent and control the progression of chronic non-communicable diseases. To evaluate the effects of individualized nutritional interventions on weight, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), triglycerides (TGs), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR)} over 12 months and subsequently at follow-up (15 months). This longitudinal experimental study (without randomization and blinding) enrolled 84 sedentary participants with T2D (both sexes, aged 18-80 years). They were divided into a control group of 40 participants who received only medical consultations, and an intervention group of 44 participants who received the same medical care along with a nutritional assessment. Consultations occurred quarterly from August 2020 to November 2022 (first-twelfth month), with six to nine patients per session. Subsequently, a follow-up was conducted from December 2022 to November 2023, during which the intervention group had only medical care (during the 12th-15th months). Personalized dietary planning was inspired by the Mediterranean/DASH diets adapted to Brazilian foods and socioeconomic cultures. Normal variables were compared between groups for each time point and also within each group across different time points using a two-way ANOVA (repeated measures for intragroup) followed by the Šídák post hoc test. Non-normal variables were compared between groups for each time point using Kruskal-Wallis followed by the Dunn post hoc test, and within each group across different time points using Friedman followed by the Dunn post hoc test. Data with a Gaussian distribution were presented as mean ± standard deviation (SD), and data with a non-Gaussian distribution were presented as median ± interquartile range (IQR). For all cases, α < 0.05 and p < 0.05 were adopted. In the intervention group, significant reductions were observed between the first and twelfth month for all parameters (p < 0.05), (except for TC), along with an increase in HDL-C (p = 0.0105). Conversely, in the control group, there was a significant increase in HbA1c, weight, BMI, FBG, and WHR (p < 0.05) between the first and twelfth months. Regarding the comparison between groups, there was a significant difference for all analyzed parameters (p < 0.05) from the first to the twelfth month. In the follow-up, differences were also observed (p < 0.05), except for BMI (p > 0.05). The individualized nutritional intervention improved eating habits, anthropometric, biochemical, and cardiovascular markers in T2D over 12 months, with sustained results during follow-up. The dietary plan inspired by the Mediterranean and DASH diets demonstrated good adaptation to the Brazilian food culture and the patients' socioeconomic contexts. Consistent monitoring and personalized nutritional management are essential for optimizing long-term outcomes. However, more clinical trials are necessary in order to optimize the level of evidence for longitudinal interventions.

A hybrid 1D CNN-BiLSTM model for epileptic seizure detection using multichannel EEG feature fusion

Epilepsy, a chronic non-communicable disease is characterized by repeated unprovoked seizures, which are transient episodes of abnormal electrical activity in the brain. While Electroencephalography (EEG) is considered as the gold standard for diagnosis in current clinical practice, manual inspection of EEG is time consuming and biased. This paper presents a novel hybrid 1D CNN-Bi LSTM feature fusion model for automatically detecting seizures. The proposed model leverages spatial features extracted by one dimensional convolutional neural network and temporal features extracted by bi directional long short-term memory network. Ictal and inter ictal data is first acquired from the long multichannel EEG record. The acquired data is segmented and labelled using small fixed windows. Signal features are then extracted from the segments concurrently by the parallel combination of CNN and Bi-LSTM. The spatial and temporal features thus captured are then fused to enhance classification accuracy of model. The approach is validated using benchmark CHB-MIT dataset and 5-fold cross validation which resulted in an average accuracy of 95.90%, with precision 94.78%, F1 score 95.95%. Notably model achieved average sensitivity of 97.18% with false positivity rate at 0.05/hr. The significantly lower false positivity and false negativity rates indicate that the proposed model is a promising tool for detecting seizures in epilepsy patients. The employed parallel path network benefits from memory function of Bi-LSTM and strong feature extraction capabilities of CNN. Moreover, eliminating the need for any domain transformation or additional preprocessing steps, model effectively reduces complexity and enhances efficiency, making it suitable for use by clinicians during the epilepsy diagnostic process.

Inflammageing in patients with idiopathic pulmonary fibrosis (IPF)

We took Peripheral blood samples from adult patients over 60 years of age with a confirmed diagnosis of IPF through biopsy or clinical criteria. Plasma separation was performed, and proinflammatory cytokines were measured using CBA. This study received approval from the ethics and research committee of the Colombian Pulmonological Foundation. Patients with IPF exhibited an increase in cytokines such as IL-4, INFy, and IL-6 compared to healthy older adults. Inflammatory disease has been associated with the development and coexistence of multiple chronic non-communicable diseases that have a higher incidence after 65 years of age. The involvement of adaptive immunity in the pathogenesis of IPF has been described as an imbalance in the Th1/Th2 lymphocyte response. Further studies are required to identify additional markers of immunosenescence that correlate with IPF.

IL-10 and IL-1β Serum Levels, Genetic Variants, and Metabolic Syndrome: Insights into Older Adults' Clinical Characteristics.

Populational aging is marked by chronic noncommunicable diseases, such as metabolic syndrome (MetS). IL-10 and IL-1β are pleiotropic cytokines with multiple biological effects linked to metabolic disorders. This cross-sectional study assessed 193 participants' IL-10 and IL-1β serum levels regarding their role in developing MetS, clinical characteristics, and their IL1B rs1143627 and IL10 rs1800890 variants' genotype frequencies in a population over 60. IL-10 levels correlated weakly with HDL levels and fat mass and inversely with triglycerides, glucose, glycated hemoglobin, and estimated average blood glucose levels. IL-10 levels were also indirectly influenced by the patient's T2DM duration, lean mass amount, and bone mineral content. Participants with altered HDL, elevated serum glucose, raised HbA1c levels, or those over 80 had reduced serum IL-10 levels compared to those with normal levels or other age groups, respectively. Women also had higher serum IL-10 levels than men. Dissimilarly, IL-1β levels correlated directly only with the number of total leukocytes and segmented neutrophils, showing only significant variations with self-reported alcohol consumption. Our study also found that those with the IL10 AA genotype (lower IL-10 levels) had a significantly higher risk of developing MetS. These findings may help direct future research and more targeted therapeutic approaches in older adults.

Let the records speak: an exploration of rehabilitation services offered in primary healthcare, Johannesburg metropolitan district

BackgroundPrimary healthcare in South Africa aims to transform the national health system by emphasising community-based care and preventive strategies. However, rehabilitation services, particularly for individuals with disabilities and chronic non-communicable diseases, are often overlooked in primary healthcare. This study aimed to investigate the provision of primary healthcare rehabilitation services in the Johannesburg Metropolitan District by exploring client sociodemographics and variations in services provided by rehabilitation professionals.MethodsA retrospective review of clinic rehabilitation records from 2011 to 2020 was conducted at nine provincially funded community health centres (CHCs) offering rehabilitation services. Stratified sampling facilitated record selection based on rehabilitation service type and year. A specifically designed data extraction tool captured demographics, disabilities, rehabilitation received, and referral sources. Descriptive analysis used means, standard deviations, and frequencies.ResultsThe findings show a diverse client population with a wide age range, with a significant proportion falling into the < 5 years and 30–49 years age groups. Neuromusculoskeletal and movement-related disabilities were most prevalent, affecting approximately two-thirds of clients. Referral sources were often undocumented, and inconsistent discharge information with no record of patient follow up, highlighted the need for improved documentation practices. Clinic visits were the primary service delivery mode, followed by limited home visits and outreach services. Occupational therapy and physiotherapy were the most used services. Speech and language therapy services were underused, and some CHCs lacked audiology services. There were variations in the number of individual and group sessions provided by the different rehabilitation services, and there were age- and disability-specific differences in service use.ConclusionThis study offers insights into rehabilitation service provision in the Johannesburg Metropolitan District and enhances our understanding of rehabilitation services in primary healthcare settings. It underscores the importance of a multidisciplinary rehabilitation team to address diverse rehabilitation needs, improving documentation and discharge practices, expanding service delivery models, and reducing disparities in service use. The findings inform strategies for optimising service delivery, workforce, resource allocation, and intersectoral collaboration to ultimately enhance the quality and accessibility of integrated rehabilitation services.

Evaluator's alignment as an important indicator of adequacy of the criteria and assessment procedure for recognizing the good practice in public health.

Public health interventions aim to reduce the burden of chronic non-communicable diseases. Implementing evidence-based interventions that are proven to be successful and effective is widely recognized as the best approach to addressing public health challenges. To avoid the development and implementation of less effective or successful or even harmful practices, clear criteria for the assessment of practices, that consider different dimensions of the interventions in public health, are needed. The main aim of the research was to test our Criteria and assessment procedure for recognizing good practices in the field of public health by estimating the consistency between the evaluators and thereby gaining insight into the adequacy and reliability of the criteria as well as to check how the evaluators understand the criteria and methodology and if it is properly used in assessing the interventions. The assessment of the interventions took place from 2021 to 2022. The individual evaluator's scores on the scale from 1 to 5 for each specific sub-criterion were collected, which was followed by a panel discussion to reach a final score for each sub-criterion. The inter-rater agreement was measured using percent overall agreement and Fleiss' kappa coefficient. We found moderate inter-rater agreement on the level of the assessment criteria group. The lowest agreement was observed for the effectiveness and efficiency sub-criteria group, which also received the lowest scores from the evaluators. Challenges identified with the scoring process were due to the descriptive 1 to 5 scale and the varying specificity of the criteria. The results showed that studying consistency between evaluators can highlight areas for improvement or adjustment in the assessment criteria and enhance the quality of the assessment instrument. Therefore, such analysis would be useful part of both newly and well-established health promotion and prevention program registries.

Improving the effectiveness of screening for chronic noncommunicable diseases using artificial intelligence-based technologies

Improving the effectiveness of screening for chronic noncommunicable diseases using artificial intelligence-based technologies