Exploratory Cross-sectional Study Research Articles

The Diet Quality of Ultramarathon Runners Taking Part in an Australian Event: A Cross-Sectional Explorative Study

Background/Objectives: Ultramarathon runners exceed the physical activity guidelines and in doing so are constantly exposed to physical and metabolic demands, requiring strategic dietary practices to support training, performance, and recovery. This study aimed to assess the diet quality and nutrient intake in runners enrolled in an Australian-based ultramarathon. Methods: A 3-day food diary was collected using the Australian smartphone application ‘Easy Diet Diary’ during both peak and taper periods. Macronutrient and micronutrient intakes were analysed using the AUSNUT 2011–2013 food composition database within the Foodworks professional software, and diet quality was evaluated using the Healthy Eating Index for Australians (HEIFA-2013). Results: A total of 26 runners participated in the study. The results revealed that, although runners met or exceeded protein recommendations, their carbohydrate intake fell short of endurance-specific guidelines, whilst total dietary fat intake exceeded recommendations (excluding long-chain polyunsaturated fatty acids). Diet quality scores averaged 63.1 out of 100, reflecting moderate alignment with dietary recommendations. Fruit, vegetable, and wholegrain food groups were inadequately consumed. Conclusions: The findings indicate that ultramarathon runners who easily exceed physical activity recommendations, may paradoxically consume suboptimal diets, characterized by insufficient intake of core food groups such as whole grains and fruits, alongside excessive consumption of discretionary items. This dietary pattern may not only elevate their risk of chronic disease but also impair optimal performance by compromising recovery and adaptation to training. Further research is warranted to better understand the dietary behaviors and nutritional needs of this population.

Evaluation of the association between thyroid-stimulating hormone with handgrip strength and dynapenia in euthyroid postmenopausal women.

To examine the association between serum thyroid-stimulating hormone (TSH) levels with handgrip strength (HGS) and dynapenia in euthyroid postmenopausal women. This was an exploratory cross-sectional study among 385 participants from the Department of Obstetrics, Gynecology, and Reproduction of the Dexeus Women's University Hospital, Barcelona, Spain. Age, age at menopause, adiposity, alcohol consumption, body mass index (BMI), and smoking status were recorded. TSH was determined by electrochemiluminescence immunoassay. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Dynapenia was considered when HGS was <20 kg. A directed acyclic graph was designed to identify confounding variables. Multivariable linear and logistic regression models were adjusted by age, age at menopause, adiposity, BMI, glomerular filtration rate, glycated hemoglobin, physical activity, and smoking status. Multivariable linear regression model showed that age ( β = -0.22; 95% CI, -0.28 to -0.16), adiposity ( β = -0.15; 95% CI, -0.22 to -0.07), BMI ( β = 0.15; 95% CI, 0.04-0.25), glomerular filtration rate ( β = -0.04; 95% CI, -0.07 to -0.01), and physical activity ( β = 0.79; 95% CI, 0.07-1.5) were significantly associated with HGS. Instead, serum TSH levels were not significantly associated ( β = 0.21; 95% CI, -0.10 to 0.51). Multivariable logistic regression model showed that dynapenia was associated with age (OR, 1.20; 95% CI, 1.12-1.31) and glomerular filtration rate (OR, 1.03; 95% CI, 1.00-1.05). No significant association between TSH and dynapenia was observed (OR, 0.98; 95% CI, 0.78-1.23). In this study of postmenopausal women, normal TSH levels were not associated with low HGS or dynapenia.

Nursing Knowledge and Skills in Hidradenitis Suppurativa: A Multi-Centre Exploratory Study

Background/Objectives: Hidradenitis suppurativa (HS) is an under-treated chronic inflammatory disease that affects approximately 0.40–2% of the population. Despite the competences nurses have in wound care, little is known about their management of HS lesions. The objectives of this study were to determine the knowledge and skills of primary care nurses regarding HS as well as to analyse the aspects in which these nurses need to strengthen their competences. Methods: A multicentre exploratory cross-sectional study was carried out in all seven healthcare areas of the Galician Health Service (N-W Spain) during 2021–2022. A questionnaire was developed for the project and subsequently piloted; from it, four dimensions were established. Additionally, sociodemographic data were collected. A total of 211 primary care nurses participated. Results: Both total and dimension scores were lower than 5 out of 10 points. The participants showed more knowledge in the Diagnosis and Clinical Course dimension (M = 4.59 out of 10). An older age correlated with greater knowledge regarding Diagnosis and Clinical Course (rho = 0.196; p = 0.006). Conclusions: These findings highlight the importance of developing evidence-based continuous training in the management and detection of the disease, while reducing the consequences of HS on patients’ quality of life.

The Association of Family and Friend Networks with Appetite: Structural Equation Modeling of the Indirect Effects of Depression among Community-Dwelling Older Adults.

Appetite loss in older adults raises the risk of malnutrition and frailty. The recent emphasis on psychological and social support for appetite loss reveals the importance of robust social networks. Depression is linked to a decline in appetite and social networks. Social networks may influence appetite directly and indirectly through depression. This exploratory cross-sectional study categorizes social networks into family and friend networks to elucidate their direct and indirect effects. The study analyzed 193 community-dwelling older adults (women 78.2%; mean age 77.1±5.3 years) who participated in health-checkup events in two cities in Japan. Appetite was assessed using the Japanese version of the Simplified Nutritional Appetite Questionnaire, and family and friend networks were assessed using the Lubben Social Network Scale-6. Depression was assessed using the Geriatric Depression Scale-15. Based on previous research, we constructed a causal model examining the impacts of family and friend social networks and depression on appetite and calculated the direct and indirect effects through structural equation modeling. The family network had a direct effect on appetite (path coefficient=0.18) and an indirect effect via depression (path coefficient=0.0608). Conversely, the friend network was not directly associated with appetite but had an indirect effect through depression (path coefficient=0.0905). The model exhibited a good fit. The mechanism of influence on appetite varied between the networks. To prevent appetite loss, social networks with family and friends should be assessed separately, and tailored support should be provided for each.

Commentary: Psychological distress among healthcare students in Poland from COVID-19 to war on Ukraine: a cross-sectional exploratory study.

Commentary: Psychological distress among healthcare students in Poland from COVID-19 to war on Ukraine: a cross-sectional exploratory study.

Psychological Empowerment as a Mediator of Effort-Reward Imbalance Effects on Burnout, Anxiety and Depression Among Nursing Home Professionals: A Cross-Sectional Study.

Few studies have explored empowerment as a predictor of mental health outcomes in geriatric healthcare professionals. This research addresses this gap by using the 'effort-reward imbalance' theory of work-related stress to develop a comprehensive model, examining the role of psychological empowerment in the psychological outcomes of nursing home professionals. This cross-sectional exploratory study used structural equation modelling (SEM) to test a model on the mediating role of psychological empowerment in the relationship between effort-reward ratio and burnout, anxiety and depression. From 2021 to 2023, we used convenience sampling to enrol 280 physicians, nurses and other healthcare workers from 13 nursing homes in France. Self-administered measurements included Psychological Empowerments Scale, Effort-Reward Imbalance Questionnaire, Maslach burnout inventory-Human Services Survey and Hospital Anxiety and Depression Scale. Of the 280 healthcare professionals included, 245 had complete data. Findings confirmed direct predictive paths from the effort-reward ratio to burnout, anxiety and depression. The negative direct path between effort-reward ratio and psychological empowerment was significant, as was burnout and depression prediction by psychological empowerment. Anxiety was not explained by psychological empowerment. Mediation effects were confirmed. Model fit indices indicated a good fit, supporting the role of psychological empowerment in reducing the negative impact of effort-reward imbalance on psychological outcomes, except for anxiety. Psychological empowerment appears to be a promising way to enhance and protect psychological work-related health of nursing home healthcare professionals. Understanding the impact of psychological empowerment on healthcare is a first step towards implementing interventions for healthcare professionals to enhance the quality of care and work conditions.

Navigating Cancer: Mental Adjustment as Predictor of Somatic Symptoms in Romanian Patients- A Cross-Sectional Study

Objective: This study aimed to examine the relationship between mental adjustment mechanisms and somatic symptoms in cancer survivors, a topic with limited research in Psycho-oncology. Methods: In this exploratory cross-sectional study, 88 cancer patients were surveyed using the Somatic Symptoms Scale (SSS-8), the Somatic Symptom Disorder Scale (SSD-12), and the Mini-Mental Adjustment to Cancer Scale (MINI-MAC). Additional questions were asked regarding cancer stage, treatment, and illness relapses. Data collection occurred over one month at a local oncology unit. Results: Several significant correlations were observed between the scales and subscales of the instruments applied during this study. The most important results showed that maladaptive adjustment mechanisms were significantly associated with somatic symptoms, while adaptive mechanisms were not. However, "fighting spirit," an adaptive mechanism, acted as a moderator between somatic symptoms and their psychological impact (effect size t = 0.157, p 0.05). Lower "fighting spirit" scores correlated with higher SSS-8 and SSD-12 scores, indicating its potential protective role. Conclusion: A more specific assessment of somatic symptoms and their link to mental adaptation to cancer is needed. Psycho-oncological interventions should address both adaptive and maladaptive adjustment mechanisms due to their significant influence on patient outcomes.

Management of Psychosis and Schizophrenia by Primary Care GPs: A Cross-Sectional Study in Spain.

To investigate the detection and initial management of first psychotic episodes, as well as established schizophrenia, within the primary care of the Andalusian Health System. Delay in detecting and treating psychosis is associated with slower recovery, higher relapse risk, and poorer long-term outcomes. Often, psychotic episodes go unnoticed for years before a diagnosis is established. Primary care physicians are crucial for early recognition of psychosis and schizophrenia, especially in Spain, where primary care is the main entry point to healthcare services. Cross-sectional exploratory study. All active primary care physicians in the Malaga Guadalhorce Health District were invited to participate. Due to the COVID-19 pandemic, the survey was conducted online. The survey, adapted and validated for the local context, included 22 items and 5 sociodemographic questions covering early detection, treatment options, physical health monitoring, and management challenges. Descriptive and bivariate analyses summarized the data and explored correlations between key variables. The study included 142 primary care physicians (response rate 35.5%), with 28.9% men and 71.1% women, primarily from urban areas (83.1%). Most had completed residency training (86.6%), with 79.6% receiving psychiatric training. However, only 5.6% had participated in training sessions in the last 5 years, with all such sessions lasting less than 30 h. Physicians typically managed 0-10 patients with diagnosed schizophrenia and saw these patients 2 to 3 times annually. They often felt capable of managing these patients, especially with mental health consultancy support. Physical health monitoring was common, though some relied on mental health services to do this. Collaboration with mental health services was moderate, with high utility perceived for having a list of patients with severe mental disorders in their care panel. Family physicians are generally confident in managing psychosis and schizophrenia but lack recent specialized training. Mental health consultancy services are valued, but collaboration with these services needs improvement. Clear guidelines and enhanced training are essential to ensure comprehensive care, addressing both mental and physical health needs of these patients.

Quality of life in cutaneous leishmaniasis patients in Khyber Pakhtunkhwa, Pakistan.

To determine the impact of leishmaniasis on the quality of life of patients visiting the district headquarter hospital in District Khyber, Khyber Pakhtunkhwa, Pakistan. A cross-sectional exploratory study was conducted in District Headquarter Hospital of Khyber District, Khyber Pakhtunkhwa from November 2019 to April 2020. In this study, 349 participants who consented were included by using a non-probability consecutive sampling technique. A validated questionnaire "Dermatology Life Quality Index" (DLQI) was used for data collection. Independent sample t-test and one-way ANOVA were used for mean scores comparison. The mean DLQI score of cutaneous leishmania patients was 11.83 ± 3.94. Cutaneous leishmaniasis (CL) patients experienced a huge impact on their quality of life. The highest effect was observed for symptoms and feelings while the least impact was for the treatment. Statistically, no significant difference in mean DLQI score was found for gender, age, marital status, lesion activity, lesion appearance, and treatment history (p > 0.05). However, statistically, a significant difference was observed for the education, occupation, lesion location, and lesion type (p < 0.05). CL had a significant impact on the patient's quality of life and mental health. Further research is required to assess the impact of the treatment on QOL in CL patients. and for a better understanding of the issue and its mechanistic basis.

Self-reported injury in ultra-endurance participants with a focus on knee injuries: An exploratory cross-sectional comparative study of running, cycling, and triathlon.

To investigate the frequency and location of reported injuries among ultra-endurance participants competing in different sports. Cross-sectional. Ultra-endurance runners, cyclists and triathletes were recruited via a social media advertisement to participate in a web-based questionnaire. The questionnaire asked for information on demographics, competition history, training characteristics, and self-reported injury. Descriptive analyses and prevalence rates were calculated to determine differences between sports. Of the 258 participants (age:46±11 years; 33% female), 129 (50%) self-reported an injury within the past 12 months. Despite high frequency of reported injury, only 10% of injuries resulted in 'severe' pain and 7% resulted in stopping participation. The lower extremity, and specifically the knee, ankle and foot, were the most common injury locations. Prevalence ratios for injury over the past 12 months was similar across running, cycling, and triathlon, with no statistically significant differences. However, cyclists demonstrated a significantly higher prevalence of knee injuries since starting ultra-endurance participant compared to runners after adjusting for covariates (PR: 1.62; 95% CI: 1.15-2.28, p=0.006). Ultra-endurance participants self-report a considerable number of lower extremity injuries, yet this is similar across sports, and both the level of pain and impact on performance impact is generally low.

Hyperproteinemia, Hematuria, and Squamous Cell Shedding in Elderly Cervical Cancer Patients and the Potential Alternative Screening Tool.

In Saudi Arabia, cervical cancer, frequently caused by human papillomavirus (HPV) infection, is a common cancer. The usual procedures for screening and diagnosing cervical cancer include Pap smears and HPV tests, even though they have considerable drawbacks, particularly for older women (> 60 years) who have limited access to or compliance with these tests. Urinalysis is a simple, noninvasive test that has been suggested as an alternative procedure. This study aimed to investigate the change in urinalysis characteristics in cervical cancer patients in elderly females and the possible use of urinalysis as a screening or diagnostic tool for cervical cancer in older women. This was an exploratory cross-sectional study of 190 cervical cancer patients diagnosed between January 2018 and August 2021. Based on age, the study included two groups, < 60 years and ≥ 60 years. Urinalysis characteristics, including bacterial count, blood level, protein level, and squamous epithelial cell shedding, were compared between the age groups by using the chi-squared and Kruskal-Walli tests. The results showed a significant difference between aged females and younger females with cervical cancer at the blood level, protein level, and squamous epithelial cell shedding in the urine. The older women (≥ 60 years) had higher incidences of increased bacterial count, blood levels, protein levels, and squamous epithelial cell shedding than the younger women (< 60 years). The main finding of the study implies that there are significant changes in urine characteristics in cervical cancer patients including hyperproteinemia, hematuria, and squamous cell shedding in elderly patients compared to younger patients, and it proposes a potential role for urinalysis as a screening tool for cervical cancer in older women. Urinalysis could be a potential screening tool for cervical cancer in older women who have not been screened or have no screening access. Further studies are needed to validate these findings.

Clinicians’ adherence to low back pain guidelines in the Czech Republic is low – an exploratory cross-sectional study

Clinicians’ adherence to low back pain guidelines in the Czech Republic is low – an exploratory cross-sectional study

A cross-sectional exploratory study on the clinico-demographic profile, co-morbidities and treatment of children with tic disorder

Introduction: Tic disorders encompass a spectrum of involuntary, repetitive movements or sounds, varying in complexity and severity, affecting individuals across different age groups. Tourette's disorder specifically presents as a neurological condition characterized by multiplemotor and vocal tics lasting for more than a year, often accompanied by other behavioral or mental health conditions. Methods: The study examines tic disorders in a group of 10 children under 14 at the child and adolescent mental health unit of Kanti Children’s Hospital. It utilized the Yale Global Tic Severity Scale- Revised (YGTSS-R) to comprehensively analyse this neuro-developmental disorder, exploring various tic manifestations, complexities, and their impact. Further Rutter’s multi-axial diagnoses was used for multidimensional assessment in understanding tic disorders comprehensively. Results: The children in our study had both simple and complex motor tics, with a contrast between the types of motor and vocal tic symptoms. Using multi-axial diagnosis specific co-morbidities were also identified in our study cohort. Correlations between socio-demographicfactors and clinical profiles were inconclusive in this limited sample. Conclusion: The detailed assessment provided insights into tic characteristics, advocating for tailored treatment modalities like pharmacological interventions, psychoeducation, habit reversal therapy, and cognitive behavioral interventions. The study emphasizes the necessity for comprehensive assessments and individualized interventions to address the varied manifestations and impacts of tic disorders in affected children.

Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease.

Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and traditional CV risk factors, indicators of atherosclerotic burden, and cardiac geometry and dysfunction in outpatients with peripheral arterial disease (PAD). An explorative cross-sectional study (Study of Atherosclerosis in Vastmanland, Västerås, Sweden) included 439 outpatients with carotid or lower extremity PAD. The mean age was 70 years (standard deviation [SD] 7), and 59% of the patients were men. Plasma levels of GDF-15 were obtained along with potential determinants, including medical history, biochemical data, echocardiographic measures of cardiac geometry and function, ankle-brachial index (ABI), and carotid ultrasonographic data on intima-media thickness (IMT) and occurrence of carotid stenosis. The relations between GDF-15 concentrations (transformed with the natural logarithm) and the different determinants were evaluated using uni- and multivariable linear regression models. All pre-specified variables were included in the multivariable models. The multivariable analysis identified independent relations of GDF-15 with several of the included variables (adjusted R 2 = 0.48). Diabetes (beta coefficient [β] of 0.37, 95% confidence interval [95% CI] 0.25 to 0.50), low-density lipoprotein (LDL) cholesterol (β = -0.22, 95% confidence interval [CI]: -0.34 to -0.09), and physical activity (β = -0.16, 95% CI: -0.25 to -0.06) had the strongest associations. In contrast, no significant independent associations with GDF-15 level were observed for cardiac geometry and function, ABI, IMT, or carotid stenosis. Circulating GDF-15 is more strongly associated with traditional CV risk factors, especially diabetes, LDL cholesterol, and physical activity than with specific indicators of atherosclerotic burden or cardiac dysfunction. To better understand the pathophysiological role of GDF-15 and its link to clinical outcomes in patients with PAD, future studies should focus on the metabolic processes involved in atherosclerotic disease.

Do adolescents with different types and degrees of idiopathic scoliosis curves differ in postural control compared to their healthy peers? a cross-sectional study

BackgroundNumerous scoliosis research studies have investigated postural control changes in adolescents with idiopathic scoliosis and compared them to healthy controls. However, the results have been controversial. Therefore, the present study aimed to compare whether postural control in adolescent idiopathic scoliosis (AIS) patients is different from their age-matched healthy counterparts.MethodsAn exploratory cross-sectional study was conducted comprising 121 adolescents (11 to 17 years) divided into five groups, including those diagnosed with idiopathic scoliosis (n = 95) and healthy control peers (n = 26). According to the type (single or double), location (thoracic or lumbar), and severity (mild = Cobb's angle ≤ 25°, moderate = 26° ≤ Cobb's angle ≥ 45°) of AIS, the groups included: group 1: mild single curve in the thoracic region, group 2: mild single curve in the lumbar region, group 3: mild double curves, group 4: moderate double curves, and group 5: healthy control. Computerized Dynamic Posturography (CDP)/ /NeuroCom International, Inc., Clackamas, OR, USA was used to assess the postural control parameters. The assessment included the Sensory Organization Test (SOT), the Adaptation Test (ADT), the Motor Control Test (MCT), the Weight-Bearing Squat test (WBS), and finally the Unilateral Stance Test (UST).ResultsThe study analyzed data from 121 participants (36 boys, 85 girls) across five groups. No significant differences were found between the AIS and control groups concerning the type of curve or when comparing single and double curves. A one-way ANOVA indicated that variables related to the SOT were normally distributed, while other tests did not show normal distribution. Comparisons controlled for BMI, curve type (single or double), and severity of the major curve revealed no significant differences in postural control variables between AIS and control groups. Notable p-values include SOT 1 (p = 0.964), SOTstrategy 1 (p = 0.192), SOT 2 (p = 0.733), SOTstrategy 2 (p = 0.497), SOT 3 (p = 0.057), SOTstrategy 3 (p = 0.693), MCT (p = 0.089), USleftOpen (p = 0.087), and USrightOpen (p = 0.057).ConclusionThis study's findings indicated that there were no statistically significant differences in postural control when performing activities of daily living among adolescents with idiopathic scoliosis compared to their healthy aged-matched peers. Therefore, there is no need for additional training to improve postural control in these adolescents with idiopathic scoliosis. However, the importance of identifying the postural control mechanisms in these populations is considerable for treating scoliosis.

Cardiovascular Risk Biomarkers in Women with and Without Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is a prevalent metabolic disorder with an increased risk for cardiovascular disease (CVD) that is enhanced by obesity. This study sought to determine whether a panel of cardiovascular risk proteins (CVRPs) would be dysregulated in overweight/obese PCOS patients, highlighting potential biomarkers for CVD in PCOS. In this exploratory cross-sectional study, plasma levels of 54 CVRPs were analyzed in women with PCOS (n = 147) and controls (n = 97). CVRPs were measured using the SOMAscan proteomic platform (version 3.1), with significant proteins identified through linear models, regression analysis, and receiver operating characteristic (ROC) analysis. Analysis on BMI-matched subsets of the cohort were undertaken. Functional enrichment and protein-protein interaction analyses elucidated the pathways involved. Eleven CVRPs were dysregulated in PCOS (whole set, without matching for body mass index (BMI) or insulin resistance (IR)): leptin, Interleukin-1 receptor antagonist protein (IL-1Ra), polymeric immunoglobulin receptor (PIGR), interleukin-18 receptor (IL-18Ra), C-C motif chemokine 3 (MIP-1a), and angiopoietin-1 (ANGPT1) were upregulated whilst advanced glycosylation end product-specific receptor, soluble (sRAGE), bone morphogenetic protein 6 (BMP6); growth/differentiation factor 2 (GDF2), superoxide dismutase [Mn] mitochondrial (MnSOD), and SLAM family member 5 (SLAF5) were downregulated versus the controls. In BMI-matched (overweight/obese, BMI ≥ 26 kg/m2) subset analysis, six CVRPs were common to the whole set: ANGPT1 and IL-1Ra were upregulated; and sRAGE, BMP6, GDF2, and Mn-SOD were downregulated. In addition, lymphotactin (XCL1) was upregulated and placenta growth factor (PIGF), alpha-L-iduronidase (IDUA), angiopoietin-1 receptor, and soluble (sTie-2) and macrophage metalloelastase (MMP12) were downregulated. A subset analysis of BMI-matched plus insulin resistance (IR)-matched women revealed only upregulation of tissue factor (TF) and renin in PCOS, potentially serving as biomarkers for cardiovascular risk in overweight/obese women with PCOS. A combination of upregulated obesity-related CVRPs (ANGPT1/IL/1Ra/XCL1) and downregulated cardioprotective proteins (sRAGE/BMP6/Mn-SOD/GDF2) in overweight/obese PCOS women may contribute to the increased risk for CVD. TF and renin upregulation observed in the BMI- and IR-matched limited sample PCOS subgroup indicates their potential risk of CVD.

Validation of a Wearable Sensor Prototype for Measuring Heart Rate to Prescribe Physical Activity: Cross-Sectional Exploratory Study.

Wearable sensors are rapidly evolving, particularly in health care, due to their ability to facilitate continuous or on-demand physiological monitoring. This study aimed to design and validate a wearable sensor prototype incorporating photoplethysmography (PPG) and long-range wide area network technology for heart rate (HR) measurement during a functional test. We conducted a transversal exploratory study involving 20 healthy participants aged between 20 and 30 years without contraindications for physical exercise. Initially, our laboratory developed a pulse wearable sensor prototype for HR monitoring. Following this, the participants were instructed to perform the Incremental Shuttle Walk Test while wearing the Polar H10 HR chest strap sensor (the reference for HR measurement) and the wearable sensor. This test allowed for real-time comparison of HR responses between the 2 devices. Agreement between these measurements was determined using the intraclass correlation coefficient (ICC3.1) and Lin concordance correlation coefficient. The mean absolute percentage error was calculated to evaluate reliability or validity. Cohen d was used to calculate the agreement's effect size. The mean differences between the Polar H10 and the wearable sensor during the test were -2.6 (95% CI -3.5 to -1.8) for rest HR, -4.1 (95% CI -5.3 to -3) for maximum HR, -2.4 (95% CI -3.5 to -1.4) for mean test HR, and -2.5 (95% CI -3.6 to -1.5) for mean recovery HR. The mean absolute percentage errors were -3% for rest HR, -2.2% for maximum HR, -1.8% for mean test HR, and -1.6% for recovery HR. Excellent agreement was observed between the Polar H10 and the wearable sensor for rest HR (ICC3.1=0.96), mean test HR (ICC3.1=0.92), and mean recovery HR (ICC3.1=0.96). The agreement for maximum HR (ICC3.1=0.78) was considered good. By the Lin concordance correlation coefficient, the agreement was found to be substantial for rest HR (rc=0.96) and recovery HR (rc=0.96), moderate for mean test HR (rc=0.92), and poor for maximum HR (rc=0.78). The power of agreement between the Polar H10 and the wearable sensor prototype was large for baseline HR (Cohen d=0.97), maximum HR (Cohen d=1.18), and mean recovery HR (Cohen d=0.8) and medium for mean test HR (Cohen d= 0.76). The pulse-wearable sensor prototype tested in this study proves to be a valid tool for monitoring HR at rest, during functional tests, and during recovery compared with the Polar H10 reference device used in the laboratory setting.

EEG Oscillations as Neuroplastic Markers of Neural Compensation in Spinal Cord Injury Rehabilitation: The Role of Slow-Frequency Bands.

Spinal cord injury (SCI) affects approximately 250,000 to 500,000 individuals annually. Current therapeutic interventions predominantly focus on mitigating the impact of physical and neurological impairments, with limited functional recovery observed in many patients. Electroencephalogram (EEG) oscillations have been investigated in this context of rehabilitation to identify effective markers for optimizing rehabilitation treatments. We performed an exploratory cross-sectional study assessing the baseline EEG resting state of 86 participants with SCI as part of the Deficit of Inhibitory as a Marker of Neuroplasticity in Rehabilitation Cohort Study (DEFINE). Our multivariate models demonstrated a positive correlation between frontal delta asymmetry and depression symptoms, while the frontal alpha asymmetry band and anxiety symptoms were negatively correlated. Theta oscillations were negatively associated with motor-evoked potential (MEP), whereas alpha oscillations were positively associated with MEP in all regions of interest and with CPM response as a negative correlation. Based on the potential role of lower-frequency oscillations in exerting a salutogenic compensatory effect, detrimental clinical and neurophysiological markers, such as depression and lower ME, likely induce slow oscillatory rhythms. Alpha oscillations may indicate a more salutogenic state, often associated with various cognitive functions, such as attention and memory processing. These results show an attempt by the CNS to reorganize and restore function despite the disruption caused by SCI. Indeed, this finding also challenges the notion that low-frequency EEG rhythms are associated with cortical lesions. These results may contribute to the development of rehabilitation strategies and potentially improve the clinical outcomes of patients with SCI.

Examining the Correlation Between Clinical Presentations of Coronavirus Disease 2019 (COVID-2019) Infected Pneumonia and the Utilisation of Natural Remedies for Alleviation

Background: The COVID-19 pandemic has exposed various clinical presentations, including respiratory, gastrointestinal, musculoskeletal and neurological symptoms. In this scenario, natural remedies have notably increased popularity due to their perceived therapeutic advantages. However, these remedies remain untested in terms of their effectiveness and role in mitigating COVID-19 symptoms. Aim: This study aims to examine how natural remedies can help manage COVID-19 symptoms and explore the complex relationship between symptomatology and consumption. Methods: An exploratory cross-sectional study with 215 Jordanians was conducted. A structured questionnaire was used to collect information about symptoms and natural remedies used by COVID-19 patients. Statistical analysis was conducted to identify relationships between symptoms and natural remedies used. Results: Natural remedies were used to treat mild symptoms (58.1%) and to help patients recover from their symptoms (40.5%). The use of natural remedies is associated with symptoms such as indigestion, coughing, shortness of breath, chest pain, nasal congestion, nausea, stomachache, diarrhoea and loss of smell. For headaches, 31.3% of participants used fenugreek, black seeds and sesame oil. Sore throats and coughs were treated with honey, turmeric, cinnamon, chamomile, lemon, olive oil, rosemary, sage, anise, sesame oil, parsley and cardamom. To treat nasal congestion, honey, garlic and anise were used. Severe loss of taste and smell were treated with onions and garlic. Each region offers unique natural remedies and preferences that reflect its distinct culture and environment. Conclusions: During the COVID-19 pandemic, natural remedies were found to be effective in treating upper respiratory infections among the adult Jordanian population. Individuals use natural remedies during health crises for a variety of purposes, emphasising the importance of a personalised approach.

Understanding the Public's Viewpoint on Organ Donation Among Adults in Bangladesh: An Exploratory Cross-Sectional Study.

Organ donation is the last option for patients with end-stage organ failure, but the number of people in need of transplantation outweighs the supply of donor organs. A thorough analysis of public understanding is required to design educational programs that increase public commitment to organ donation. Therefore, the present study aimed to explore Bangladeshi adults' understanding, attitudes, and willingness towards organ donation, while also investigating the sources of information, gender-specific knowledge, intentions, and the factors influencing their decisions. A cross-sectional survey was conducted between October 15 and November 25, 2021, using a non-probability convenience sampling technique. Data were analysed using both descriptive and inferential statistics. Among 592 participants, only 35.8% were knowledgeable about organ donation. Internet/online sources were the most reported source of knowledge (37.8%), followed by social media (36%). Despite having limited knowledge, 63.7% had a positive attitude, with females demonstrating a more positive attitude than males (β = 0.09, p = 0.024). Males were significantly more likely than females to follow Bangladesh's specific organ donation laws (29.3% vs. 25%, p = 0.004). Besides, 48.6% of females, compared to 40.4% of males, believe that the health service related to organ donation in Bangladesh is ineffective (p = 0.016). More than one-third (35.1%) of the participants indicated a willingness to donate their organs after death. The participants' significant barriers to organ donation were found to be family objections (40.4%), health complications (34.4%), fear of disfigurement (31.1%), and religious barriers (26.8%). Although Bangladeshi adults have a positive attitude regarding organ donation, they lack adequate knowledge, which renders them unlikely to be eager to donate organs. Therefore, it is crucial to update policy within a sociocultural framework to boost organ donation for transplantation. National education campaigns and awareness-raising events should be held in Bangladesh to increase public knowledge of organ donation and transplants.