Health Assessment Research Articles

Factors associated with transitions in tobacco product use states among young adults aged 18-29 years.

This study examined young adults' tobacco use transitions based on their past 30-day use states, and identified factors associated with their transitions. Participants (N = 12377) were young adults aged 18-29 years at Wave 1 of the Population Assessment of Tobacco and Health (PATH) study. Self-reported tobacco use states were categorized by the number of past-month use days (0, 1-4, 5-8, 9-12, 13-30 days) for cigarettes, electronic cigarettes [e-cigarettes], traditional cigars, filtered cigars, cigarillos, smokeless tobacco (SLT), and hookah. Multistate Markov models examined transitions between use states across Waves 1-5 of unweighted PATH data and multinomial logistic regressions examined predictors of transitions. Most young adults remained nonusers across adjacent waves for all products (88%-99%). Collapsed across waves, transitioning from use at any level to nonuse (average 46%-67%) was more common than transitioning from nonuse to use at any level (average 4%-10%). Several factors that predicted riskier patterns of use (i.e., transitioning to use and/or remaining a user across adjacent waves) were similar across most products: male, Black, Hispanic, lower education levels, and lower harm perceptions. In contrast, other factors predicted riskier patterns for only select products (e.g., e-cigarette and SLT use among Whites). Few sampled young adults escalated their tobacco use over time, and escalations for many products were predicted by similar factors. Prevention and regulatory efforts targeted towards adolescents should continue, but also be expanded into young adulthood. These same efforts should consider both shared and unique factors that influence use transitions.

Chikungunya Arthritis Treatment with Methotrexate and Dexamethasone: A Randomized, Double-blind, Placebo-controlled Trial.

Chikungunya fever is a reemerging epidemic disease caused by a single-stranded RNA alphavirus transmitted throughout by Aedes mosquitoes. Chikungunya virus infection is a biphasic disease in which 72% to 95% of affected individuals manifest acute chikungunya fever. Following the acute phase, more than 40% of affected individuals develop arthritis, often lasting more than 3 months, referred to as chronic chikungunya arthritis, which frequently mimics rheumatoid arthritis. This study aimed to evaluate the efficacy and safety of treatment of chronic chikungunya arthritis with methotrexate and dexamethasone in a randomized, double-blind, placebo-controlled clinical trial. The patients were reassessed for treatment response by the DAS28-ESR, tender joint count and swollen joint count, Patient Global Assessment, and for secondary measures, including the Health Assessment Questionnaire Disability Index and Pain Visual Analog Scale. Thirty-one subjects were randomized (placebo, n = 16; methotrexate, n = 15); 27 completed treatment and 4 discontinued during the 8-week blinded period. Among the participants, 96.8% were female, with mean ± SD age was 52.9 ± 13. The mean ± SD disease duration prior to treatment was 220.9 ± 51.2 days. At 8 weeks, methotrexate-treated subjects showed a greater numerical trend towards improvement, but there were no significant differences between methotrexate- dexamethasone group and dexamethasone (placebo) group. In this relatively small cohort, all of whom received background dexamethasone, there was a greater numerical improvement trend in prespecified outcome measures, but methotrexate in combination with dexamethasone was not superior to dexamethasone in chronic chikungunya arthritis.

Evaluation of Cd, Hg, Pb, Zn and Ni in selected cosmetic products: risk assessment for human health

ABSTRACT The ICP-MS method was used to determine the concentrations of five heavy metals: Cadmium (Cd), lead (Pb), zinc (Zn), mercury (Hg), and nickel (Ni). A total of 36 samples of cosmetic products (makeup, eye shadow, and mascara) of various brands were chosen from those available in Riyadh, Saudi Arabia. Several analytical parameters, such as accuracy, precision, linearity, the lower limit of quantification (LOQ), and the lower limit of detection (LOD), were assessed to determine the validity of the proposed method. The determination of Cd, Pb, Zn, Hg, and Ni was verified for accuracy and precision. The results of the determination of studied heavy metals concentration in cosmetic samples reveal that, the concentrations of Cd, Pb, Zn, Hg and Ni ranged from 0.03–0.53, 10.28–107.01, 14.49–867.12, 1.75–6.45 and 4.22–31.36 µg/g, respectively. In all samples of cosmetic products, the concentrations of Cd and Hg were deemed to be within the normal range. However, the concentration of Pb was higher than the recommended value by the World Health Organization (WHO). Nickel concentration was measured with a detection limit lower than the WHO recommended level, but no suggested value for Zn, which is critical for mitochondria, was found. Health risks related to these metal intakes through dermal exposure pathways are assessed using the total hazard quotient (THQs), total hazard index (HI), chronic daily intake (CDI), and hazard quotient (HQ). Despite the low risks of cancer and non-cancer caused by using these cosmetic products, testing results for cancer and non-cancer risks for these products must be regularly examined. Therefore, constant monitoring of cosmetic products, particularly with regard to heavy metal contamination, should be implemented to maintain human safety and security.

АНАЛИЗ КАЧЕСТВА ЖИЗНИ, СВЯЗАННОГО СО ЗДОРОВЬЕМ, У ДЕТЕЙ И ВЗРОСЛЫХ С ПЕРВИЧНЫМИ ИММУНОДЕФИЦИТАМИ В РОССИЙСКОЙ ФЕДЕРАЦИИ

Primary immunodeficiencies (PIDs) accompany patients lifelong therefore assessing the quality of life and developing methods to improving it are of a particular importance. The purpose of this research was to assess the health-related quality of life in patients with PIDs among the Russian population and to compare the results obtained v. worldwide data. Materials and methods used: a single-center cross-sectional survey study was conducted in patients with PIDs in Oct. 2020-Feb. 2021. Patients below the age of 18 y/o had filled the PedsQL 4.0 questionnaire to provide data on psychosocial functioning, a total score was then calculated on the scales of emotional, social and role functioning. Adult patients had completed the EQ-5D-5L questionnaire that included the “mobility, self-care, activities of daily living, pain and discomfort, anxiety and depression” domains. Each question had five answer options and also included a 100-point visual analogue scale for subjective assessment of health. Results: EQ-5D-5L showed significant deviations on the “Anxiety/Depression” scale (Me 2.5). The least affected area was “Self-Care” (1.0 on average). On average, the subjective assessment of one's own health was satisfactory 70.04 points out of 100. On the other hand, PedsQL showed the lowest scores in the “emotional functioning” and “functioning in kindergarten/school” scales, the average ones were in those related to physical functioning and the highest in the social functioning domains.

Assessment of ecosystem health and driving forces in response to landscape pattern dynamics: the Shibing Karst world natural heritage site case study

The Shibing Karst constitutes a pivotal component of the "South China Karst," and its ecosystem health integrity crucially influences the Outstanding Universal Value (OUV) of the corresponding Natural World Heritage (NWH). Consequently, robust ecosystem health assessment (EHA) is imperative for the judicious conservation and management of this heritage, as well as for the sustainable progression of the region. This research assessed the health of the Shibing Karst ecosystem from 2004 to 2020 by employing changes in landscape patterns through the Vigor-Organization-Resilience-Ecosystem Services (VORS) model. Spatial autocorrelation was employed to discern the spatial coherence and evolutionary patterns of ecosystem health, whereas a geo-detector ascertained the pivotal determinants impacting regional ecosystem vitality. The findings revealed that: (1) The landscape patterns distribution in the study area exhibited considerable constancy, primarily comprising forest land, with a rising trajectory in construction land and water, juxtaposed with a recession in shrubland, grassland, paddy land, and dryland expanses. (2) From 2004 to 2020, the ecosystem of the study area maintained its health and remained stable, with mean values of 0.8303, 0.7689, 0.6976, and 0.7824, respectively, showing an evolutionary trend of an initial downtrend trend followed by an upswing, with 2016 marking a pivotal juncture. (3) Spatial clustering analysis highlighted significant clustering characteristics of ecosystem health, with a nominal decrease in the Global Moran's I index from 0.666 to 0.665, which is indicative of a subtle decrease in clustering over time. High-high clustering areas were predominantly located within the World Heritage Site (WHS), while low-low clustering areas were mainly distributed in the southeastern part of buffer zone. (4) Land use and cover change (LUCC) and Ecosystem Services (ESs) were identified as the primary indexes of EHA, with Ecosystem Resilience (ER), Ecosystem Vigor (EV), and Ecosystem Organization (EO) exerting relatively mild influences. This study provides a scientific framework for policymakers in local governance to devise strategies for ecosystem conservation and management, enhances the analytical perspective on the integrity and conservation of Karst Natural World Heritage (KNWH).

The validity, reliability, and responsiveness of a new biopscyhosocial questionnaire for patients with systemic lupus erythematosus

Objective In recent years, the importance of holistic care in individuals with systemic lupus erythematosus (SLE) has been emphasized, and therefore a measurement tool that evaluates biopsychosocial impact is needed. This study was conducted to determine the validity, reliability, and responsiveness of the Cognitive Exercise Therapy Approach-Biopsychosocial Questionnaire (BETY-BQ) in individuals with SLE. Methods Lupus Quality of Life (LupusQoL), Short Form-36 (SF-36), Health Assessment Questionnaire (HAQ), and Hospital Anxiety and Depression Scale (HADS) were used for the validity. For reliability, evaluations were repeated at 1 -week intervals and for responsiveness, the same scales were re-administered at 3-month intervals to 30 patients. Results BETY-BQ showed moderate to high correlations with LupusQoL subparameters (rho = −0.522 to −0.718, p < 0.001), moderate to very high correlations with SF-36 subparameters (r = −0.826 to rho = 0.594, p < 0.001), high correlations with HAQ and HADS-D (rho = 0.735, p < 0.001; rho = 0.622, p < 0.001, respectively) and a moderate correlation with HADS-A (rho = 0.571, p < 0.001). In the test-retest method the correlation between the responses was very high (r = 0.989, p < 0.001). The intraclass correlation coefficient (r = 0.944, p < 0.001) and Cronbach’s alpha value were found to be excellent (0.952). BETY-BQ showed moderate correlations with LupusQoL subparameters (the body image r = −0.443, p = 0.014; planning rho = −0.529, p = 0.003; fatigue r = −0.484, p = 0.007; intimate relationships rho = −0.421, p = 0.02), SF-36 social function subparameter (rho = −0.427, p = 0.019) and anxiety and depression subparameter of HADS (rho = 0.418, p = 0.021; r = 0.507, p = 0.004, respectively). Conclusion BETY-BQ which was found as a valid, reliable, and responsive scale in individuals with SLE, was presented to healthcare professionals for use in clinical and research studies as a scale that can be preferred in the evaluation of biopsychosocial status of individuals with SLE.

Does a specialized assessment improve vocational outcomes for people on sick leave with a suspected common mental disorder? Results from the Mental Health Assessment Study (MeHAS)

Background In Denmark, 50% of those on long-term sick leave are affected by common mental disorders (CMDs), and it has been argued that detection in primary care has been insufficient. The Mental Health Assessment Study (MeHAS) assesses if specialized mental health assessments can enhance return to work for this group. This study aimed to estimate the effect of a specialized mental health assessment for people on sick leave with a mental health disorder, on return to work and mental health care utilization. Methods and findings In this experimental study, sickness absentees were referred from a sick leave benefit management agency. Before intervention allocation, they had already received a standard health assessment in general practice. The intervention group received an additional specialized mental health assessment, while the control group did not. We compared the groups on several vocational outcome measures, the primary being proportion in work after one year. Other outcomes were weeks in work, time to return to work (RTW) and different measures of service utilization. We included 717 in the intervention group and 756 in the control group. On the primary outcome, proportion in work, we observed no differences between the groups at 12 months (53.9% vs. 58.7% in the control group, p = 0.133). Moreover, after one year, the control group showed faster RTW at 12-month follow-up (HR 0.79, p&lt;0.001) and 3.1 more weeks in work (p&lt;0.001). In the intervention group, participants received more hospital-based outpatient mental healthcare. Conclusion Providing a specialized mental health assessment was associated with fewer weeks in work and longer sick leave duration (secondary outcomes), but the proportion in work at 12-month follow-up (primary outcome) did not differ between the groups. The intervention was associated with a higher likelihood of receiving specialized mental healthcare services, perhaps because more needs were met. Given the substantial risk of selection bias, results should be treated with caution.

Burden levels and predictive factors among caregivers of hemodialysis patients: a cross-sectional study in Oman.

Caring for individuals with chronic kidney disease (CKD) is a highly demanding task that can adversely affect the physical and psychological well-being of caregivers. This study aimed to investigate the burden experienced by caregivers of patients undergoing hemodialysis (HD) in Oman and explore the factors associated with this burden, including demographic and medical characteristics. A descriptive cross-sectional was employed. Caregiver burden was assessed, and demographic and medical variables were examined among caregivers of HD patients. A total of 326 unpaid family caregivers completed the Zarit Burden Interview scale, demographics and some medical variables. Linear multiple regression analyses were conducted to identify factors linked to caregiver burden. Of the caregivers, 62.9% reported a minimal burden, 21.8% experienced mild-to-moderate burden, 8.6% faced moderate-to-severe burden, and 6.7% encountered a severe burden. The final multiple regression model demonstrated statistical significance compared to the constant (F = 8.68, p < 0.001), with eight predictors explaining 18% of the variance, and caregivers' satisfaction with health emerged as the only significant predictor. A substantial portion of caregivers reported minimal burden. These findings suggest the need for further in-depth investigations into factors contributing to this favourable outcome. Furthermore, caregivers' satisfaction with health was the only significant predictor of their burden. Healthcare providers need to give special attention to this point and conduct periodic assessments of the primary caregivers' health. Implementing improvements in the healthcare system based on these findings could enhance the overall caregiving experience for HD patients and their caregivers.

Patients with Periprosthetic Femoral Hip Fractures are Commonly Classified as Having Osteoporosis Based on DXA Measurements.

Periprosthetic femoral hipfractures are subject to an increasing incidence and are often considered to be related to osteoporosis. However, there are no available studies that have determined the frequency of osteoporosis in affected patients using gold standard dual-energy X-ray absorptiometry (DXA). In this retrospective comparative study, we analyzed the DXA results of 40 patients with periprostheticfemoral hip fractures who weretreated surgicallyin our department. DXA measurements were performed at the total hip and the lumbar spine to determine bone mineral density T-scores. Data were compared to two age-, sex-, and BMI-matched control groups in which patients underwent DXA prior to aseptic revisionsurgery for other causes or primary THA (consisting of 40 patients each). The mean T-score in the periprosthetic fracture cohort was significantly lower (-1.78 ± 1.78) than that of the aseptic revision (-0.65 ± 1.58, mean difference -1.13 [95% CI -1.88 to -0.37]; p = 0.001) and the primary THA cohort (-0.77 ± 1.34, mean difference -1.01 [95% CI -1.77 to -0.26]; p = 0.005). Accordingly, osteoporosis was detected more frequently (45%) in the fracture cohort compared to patients undergoing aseptic revision (12.5%) and primary THA (10%). In conclusion, almost half of the patients with periprosthetic femoral hipfractures have osteoporosis according to DXA measurements. A regular assessment of bone health in THA enables identification of patients with osteoporosis who likely benefit from initiation of osteoporosis medication and cemented stem fixation.

Automated detection of cognitive impairment in clinical practice.

Cognitive impairment is now recognized as an impending public health crisis. About one-third of adults are concerned about their cognition, and the prevalence of objective cognitive impairment is much higher among those with neurological disorders. Existing screening tools are narrowly focused on detecting dementia in older adults and must be clinician-administeredand scored, making them impractical for many neurology practices. This study examined the utility of a brief, self-administered, computerized cognitive screening tool, the Brief Assessment of Cognitive Health (BACH), in identifying cognitive impairment in adults. 912 adults (ages 18-84) completed BACH and a neuropsychological battery. Multivariable models were developed to provide a BACH index score reflecting the probability of cognitive impairment for individual patients. Predictive accuracy was compared to that of the Montreal Cognitive Assessment (MoCA) in a subset of 160 older adults from a Memory Disorders clinic. The final multivariable model showed good accuracy in identifying cognitively impaired individuals (c = 0·77). Compared to MoCA, BACH had superior predictive accuracy in identifying older patients with cognitive impairment (c = 0·79 vs. 0·67) as well as differentiating those with MCI or dementia from those without cognitive impairment (c = 0·86 vs. c = 0·67). Results suggest that cognitive impairment can be identified in adults using a brief, self-administered, automated cognitive screening tool, and BACH provides several advantages over existing screeners: self-administered; automatic scoring; immediate results in health record; easily interpretable score; utility in wide range of patients; and flags for treatable factors that may contribute to cognitive complaints (i.e., depression, sleep problems, and stress).

A proposed guide to reducing bias and improving assessments of decolonization in global health research

IntroductionThe movement to decolonize global health encompasses efforts to dismantle historically inequitable structures and processes in global health research, education, and practice. However, despite increasing literature on the decolonization of global health, gaps between action and knowledge exist in assessments of knowledge production. In this Perspective, we will outline potential biases in current approaches to assessing knowledge production and propose a systems-focused guide to improve the interrogation of knowledge production in this field.MethodsWe leverage the “Inner Setting” and “Outer Setting” domains of the Consolidated Framework for Implementation Research (CFIR), a well-established, commonly-used implementation science framework to critically assess the status quo of decolonization and to develop criteria to help guide decolonization efforts in academic contexts. We defined the Inner Setting as academic and research institutions leading and participating in global health research collaborations, and the Outer Setting as the funding, editorial, and peer review policies and practices that influence knowledge production in global health. Research institutions in the Inner organizational domain continually interact with the Outer policy domains. We categorize the levels at which decolonization may occur and where action should be focused as follows: (1) North–South, (2) South–South, (3) Local South, and (4) Local North. Using CFIR domains and the levels of action for decolonization, we propose a multi-level guide to improve on the standardization, granularity, and accuracy of decolonization assessments in global health research.Conclusion and expected impactThe proposed guide is informed by our global health research expertise and experiences as African scientists with extensive exposure in both global North and global South research contexts. We expect that the proposed guide will help to identify and address the biases identified and will lead to better knowledge-driven action in the process of decolonizing global health research.

New Mechanism for the Apoptosis of Human Neuroblastoma Cells by the Interaction between Fluorene-9-Bisphenol and the G Protein-Coupled Estrogen Receptor 1.

Fluorene-9-bisphenol (BHPF) is an emerging contaminant. Presently, there is no report on its interaction with G protein-coupled estrogen receptor 1 (GPER). By using an integrated toxicity research scenario that combined theoretical study with experimental methods, BHPF was found to inhibit the GPER-mediated effect via direct receptor binding. Molecular dynamics simulations found that Trp2726.48 and Glu2756.51 be the key amino acids of BHPF binding with GPER. Moreover, the calculation indicated that BHPF was a suspected GPER inhibitor, which neither can activate GPER nor is able to form water channels of GPER. The role of two residues was successfully verified by following gene knockout and site-directed mutagenesis assays. Further in vitro assays showed that BHPF could attenuate the increase in intracellular concentration of free Ca2+ induced by G1-activated GPER. Besides, BHPF showed an enhanced cytotoxicity compared with G15, indicating that BHPF might be a more potent GPER inhibitor than G15. In addition, a statistically significant effect on the mRNA level of GPER was observed for BHPF. In brief, the present study proposes that BHPF be a GPER inhibitor, and its GPER molecular recognition mechanism has been revealed, which is of great significance for the health risk and assessment of BHPF.

Predictive Characteristics of Childhood Emergency Injury Presentations in a Non-Urban Area of Victoria, Australia

Injury is the leading cause of death and disability amongst those between 0 and 16 years of age. Routinely associated with a social gradient of health, childhood injury is reportedly higher in rural and regional areas. A retrospective cross-sectional study collected deidentified emergency injury presentation data from nine health services in regional Victoria for children aged 0–14 years between 2017 and 2022. Emergency injury presentation incidence rates and predictor variables were analysed using hierarchical multiple regression. Significance was determined at p &lt; 0.05. Amongst the 15,884 emergency injury presentations, 35.2% (n = 5597) occurred at health services that did not routinely report data to government datasets. Although some findings are consistent with current research, this study highlights specific factors that are predictive of injury amongst 0–4-year-old children who require deeper investigation, including general practitioner access and health literacy-related elements such as preschool health assessment attendance rates, parent education levels, and overseas birth. These findings provide more comprehensive insights for healthcare workers and policymakers as they seek to support people with injuries and accurately address health inequities.

Railroad missing components detection via cascade region‐based convolutional neural network with predefined proposal templates

AbstractIn the field of railway infrastructure maintenance, timely and accurate detection of component anomalies is crucial for safety and efficiency. This paper presents the Cascade Region‐based convolutional neural network with Predefined Proposal Templates (CR‐PPT), an innovative method for railroad components inspection in complex railway infrastructure using edge‐computing devices. Unlike previous systems, CR‐PPT employs a series of predefined templates that enable it to detect both the presence and missing elements within various fastening systems. Our experimental analysis pinpoints the most effective network configurations for CR‐PPT. Furthermore, the paper examines CR‐PPT's proficiency in zero‐shot learning and fine‐tuning, highlighting its adaptability to new fastening systems. We have developed an optimized inference pipeline on NVIDIA Jetson AGX Orin, significantly enhancing its applicability for railway inspection practices. Field blind tests validate the model's high precision and efficiency, greatly reducing the time and labor required for inspections. The findings highlight CR‐PPT's potential as an efficient and robust tool for track health assessment, marking a notable progression in the integration of AI and computer vision in rail track inspection.

Relationship between hypercholesterolemia and osteoarthritis (preliminary results)

To evaluate the relationship of hypercholesterolemia (HCE) with clinical, instrumental, and laboratory parameters in osteoarthritis (OA) in a multicenter, cross-sectional study. The study included 183 patients aged 40-75 years, with a confirmed diagnosis of stage I-III OA (ACR) of the knee joints, who signed an informed consent. The mean age was 55.6±10.7 years (40 to 75), body mass index was 29.3±6.3 kg/m2, and disease duration was 5 [1; 10] years. For each patient, a case record form was filled out, including anthropometric indicators, medical history, clinical examination data, an assessment of knee joint pain according to VAS, WOMAC, KOOS and comorbidities. All patients underwent standard radiography and ultrasound examination of the knee joints and laboratory tests. HCE was detected in 59% of patients. Depending on its presence or absence, patients were divided into two groups. Patients were comparable in body mass index, waist and hip measurement, and disease duration but differed significantly in age. Individuals with elevated total cholesterol levels had higher VAS pain scores, total WOMAC and its components, an overall assessment of the patient's health, a worse KOOS index, and ultrasound findings (reduced cartilage tissue). HCE patients showed high levels of cholesterol, low-density lipoproteins, triglycerides, STX-II, and COMP (p<0.05). However, after stratification by age, many initial intergroup differences became insignificant, and differences in the WOMAC pain score persisted. The results of the study confirmed the high prevalence of HCE in OA patients (59%). Patients with OA and increased total cholesterol have more intense pain in the knee joints.

Oral status of older adults receiving home medical care: A cross-sectional study.

This study examined the oral status and the presence of teeth requiring treatment among older adults receiving home medical care. This cross-sectional study was conducted at a Japanese dental clinic specializing in geriatric treatment. We recruited older adults receiving home medical care in the community who had begun to receive domiciliary dental care. The Japanese version of the Oral Health Assessment Tool (OHAT-J), as well as the presence of teeth requiring extraction and the need for assistance in maintaining oral hygiene were used to evaluate the participants' oral health and its association with other items. Ninety-three participants (44 male and 49 female, median age: 87.0 years) were surveyed. The median OHAT-J score was 6. The duration since the previous dental visit was 23 months. Sixty-two (73.8%) of 84 participants with ≥1 natural tooth had severe caries or teeth with severe mobility that required extraction. Logistic analysis revealed that requiring assistance in maintaining oral hygiene, mild dementia, severe dementia, and depression were significantly associated with an OHAT score of ≥6. Older adults receiving home medical care had poor oral health, with approximately 70% of them requiring tooth extraction. The need for assistance in maintaining oral hygiene and poor mental status contribute to poor oral health. Geriatr Gerontol Int 2024; ••: ••-••.

Revisiting the global weights of the integrated watershed health assessment framework and Weyib watershed health analysis: Ethiopia's policy prospects

AbstractWatershed health study has been considered as a global issue embodied in the United Nations' 2030 agenda toward sustainable water resources development, paving the way for integrated water resources management (IWRM) application, and visualizing intervention techniques to comprehend existing challenges. The watershed faces tremendous pressure due to erratic rainfall patterns, drastic water demand increase, hydrological extremes, and natural‐anthropogenic activities. This study aims to re‐evaluate the recently developed Integrated Watershed Health Assessment Framework (IWHF) global weights, Weyib watershed health assessment, and Ethiopia's policy implications using the integration of numerous data and multiple tools. The analytic hierarchy process (AHP) was used to estimate aggregate results from experts' survey responses, which depicted 50.89% priority for ecological conditions, followed by economic 23.30%, policy 13.82%, and 12% for socio‐cultural attributes. A slight discrepancy was exhibited when global weights were re‐evaluated, and the variables with substantial effects on IWHF in developing countries like Ethiopia were integrated. The majority of Weyib watershed health index (WWHI) indicators unveiled promising results except for stakeholders' collaboration and social obligation to restoration activities, information and educational campaigns, hydrology, wetland, and natural land‐cover. The water‐quality parameters laboratory findings were depicted as suitable for irrigation purposes. In general, the WWHI was in good health status, and a medium‐level priority was required for intervention activities to address deteriorated variables. Moreover, enhancing IWRM's application will contribute to tackling bottlenecks such as boost community awareness and stakeholder collaboration, legal and administrative gaps, overlapped mandates, and unpermitted water use resulting in undermining downstream demands and environmental low‐flow.

Cardiac Health Assessment Using a Wearable Device Before and After Transcatheter Aortic Valve Implantation: Prospective Study.

Due to aging of the population, the prevalence of aortic valve stenosis will increase drastically in upcoming years. Consequently, transcatheter aortic valve implantation (TAVI) procedures will also expand worldwide. Optimal selection of patients who benefit with improved symptoms and prognoses is key, since TAVI is not without its risks. Currently, we are not able to adequately predict functional outcomes after TAVI. Quality of life measurement tools and traditional functional assessment tests do not always agree and can depend on factors unrelated to heart disease. Activity tracking using wearable devices might provide a more comprehensive assessment. This study aimed to identify objective parameters (eg, change in heart rate) associated with improvement after TAVI for severe aortic stenosis from a wearable device. In total, 100 patients undergoing routine TAVI wore a Philips Health Watch device for 1 week before and after the procedure. Watch data were analyzed offline-before TAVI for 97 patients and after TAVI for 75 patients. Parameters such as the total number of steps and activity time did not change, in contrast to improvements in the 6-minute walking test (6MWT) and physical limitation domain of the transformed WHOQOL-BREF questionnaire. These findings, in an older TAVI population, show that watch-based parameters, such as the number of steps, do not change after TAVI, unlike traditional 6MWT and QoL assessments. Basic wearable device parameters might be less appropriate for measuring treatment effects from TAVI.

Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial.

The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF)compared toSI alone in the treatmentofperiodontitis. Twenty-six participants with Stage III/IV periodontitis requiring nonsurgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3 and 6 months posttreatment.A visual analogue scale was used to evaluatepostoperative participants' perception of pain, swelling, bleeding, bruising, and root sensitivity.The impact of periodontal treatment onquality of lifewas assessed using the General Oral Health Assessment Index (GOHAI) at six months. A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5mm at the 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4±11.9, SI alone:30.1±20.5; P=0.12) and 6 months (SI/EAF: 14.3±9.6, SI alone: 24.5±18.2; P=0.09). A lower percentage of sites with deep PPDs (≥5mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF: 14.3±14.1, SI alone:19.2±20.3; P=0.48) and 6 months (SI/EAF: 8.3±10.0, SI alone: 15.4±17.4; P=0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P=0.03). Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IVperiodontitisdid not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.

Addressing Geographical Inequities and Barriers in Access to Mental Health Care among Youth in a Rural Western Kentucky County.

A Community Health Assessment (CHA) was conducted among community members in a rural Western Kentucky county in 2022-2023 identified mental health as one of the top health issues in the county. The purpose of a CHA is to identify key health needs and issues through data and develop strategies for action. One of the objectives was to identify barriers to accessing mental health care, especially among youth. Secondary data analyses were performed from survey results conducted by the local health department and local public schools. Quantitative data were analyzed using SPSS software. Qualitative data were analyzed using a two-cycle coding process. Access to mental healthcare is an area of great need in this rural Western Kentucky county. Recommendations include working with healthcare providers, especially specialists, to accept Medicaid and it is recommended to cross-train other professionals to address mental health needs in this region.