Health Assessment Research Articles

Acoustical features as knee health biomarkers: A critical analysis

Acoustical knee health assessment has long promised an alternative to clinically available medical imaging tools, but this modality has yet to be adopted in medical practice. The field is currently led by machine learning models processing acoustical features, which have presented promising diagnostic performances. However, these methods overlook the intricate multi-source nature of audio signals and the underlying mechanisms at play. By addressing this critical gap, the present paper introduces a novel causal framework for validating knee acoustical features. We argue that current machine learning methodologies for acoustical knee diagnosis lack the required assurances and thus cannot be used to classify acoustic features as biomarkers. Our framework establishes a set of essential theoretical guarantees necessary to validate this claim. We apply our methodology to three real-world experiments investigating the effect of researchers’ expectations, the experimental protocol, and the wearable employed sensor. We reveal latent issues such as underlying shortcut learning and performance inflation. This study is the first independent result reproduction study in acoustical knee health evaluation. We conclude by offering actionable insights that address key limitations, providing valuable guidance for future research in knee health acoustics.

Identification of Potential Diagnostic Markers for Depressive Disorders using Urinary Biomarkers of N-Methylnicotinamide and Hippuric Acid

Introduction: The diagnostic methodology for depressive disorders, relying on symptom clusters, has inherent limitations in ensuring heterogeneity levels. Consequently, this presents a notable risk of inevitable diagnostic errors in mental health assessments. Therefore, advocating for objective diagnostic approaches through empirical testing in clinical settings becomes crucial for individuals dealing with depressive disorders. This study aims to identify the effectiveness of urine as a diagnostic support for depressive disorders using the N-Methylnicotinamide and Hippuric Acid biomarkers. Methods: This study used 13 urine samples from patients with depressive disorders and 13 normal urine samples. It used ELISA methods with observational analytic and cross-sectional designs. Results: The results showed that the N-methylnicotinamide biomarker had a relationship with depressive disorders with a correlation value of 0.867, while hippuric acid obtained a correlation value of 0.692. Besides, the N-Methylnicotinamide and Hippuric Acid biomarkers showed differences in the urine of depressive disorder and normal patients with significance values of 0.000 and 0.001 for the N-Methylnicotinamide and Hippuric Acid biomarkers, respectively. In addition, the Relative Operating Characteristics curve analysis showed that these two biomarkers had good sensitivity and specificity values in assisting the diagnosis of depressive disorders. N-methylnicotinamide has a sensitivity of 92.3% and a specificity of 100%, while hippuric acid has a sensitivity of 76.9% and a specificity of 84.6%. Conclusions: Significant differences in the biomarkers of N-methylnicotinamide and hippuric acid in the urine of depressed patients compared to normal patients. Therefore, these biomarkers can be the empirical laboratory methods to support the diagnosis of depressive.

Structural health assessment of existing dams based on non-destructive testing, physics-based models and machine learning tools

Structural health assessment of existing dams based on non-destructive testing, physics-based models and machine learning tools

Automated Assessment of Student Mental Health Through Image Processing Technology

Automated Assessment of Student Mental Health Through Image Processing Technology

Effects of microbial communities during the cultivation of three salt-tolerant plants in saline-alkali land improvement.

Planting vegetation on saline-alkaline land enhances soil fertility and sustainability by improving salt-alkali tolerance. Different salt-tolerant plant species interact with soil microorganisms, enriching bacterial communities and promoting nutrient availability. In this study, mechanisms affecting microbial communities in severely saline-alkaline soils planted with salt-tolerant plants are investigated. Over 4 years, the potential to cultivate three salt-tolerant plant species (tall wheatgrass Agropyron elongatum, chicory Chicorium intybus, and alfalfa Medicago sativa) in severely saline-alkaline soils is compared with a non-cultivated control. Bacterial and fungal communities were characterized through high-throughput sequencing of the 16S rRNA gene V3-V4 region and the V4 region, respectively. Cultivating these three plant species significantly reduces soil electrical conductivity values. Chicory cultivation notably increased soil nutrients, bacterial alpha richness, and fungal alpha diversity and richness. Microbial community structures vary considerably between the control and treatments, significantly correlating with the soil quality index. This index enables an assessment of soil health and fertility by integrating variables such as nutrient content, microbial diversity, and salinity levels. In each plant treatment, particularly alfalfa, the relative abundances of fungal pathogens like Neocosmospora and Gibellulopsis increase, which may pose risks to subsequent crops such as tomatoes, requiring careful consideration in future planting decisions. Conversely, in alfalfa and tall wheatgrass treatments, there was an increase in the relative abundances of fungal genera (e.g., Alternaria and Podospora) that antagonize fungal pathogens, while Paraphoma increased in the chicory treatment. The strong relationship between microorganisms and the rise in pathogen-resistant fungi across different plant treatments highlights robust and beneficial structural characteristics. According to soil quality index scores, each treatment, but especially that of chicory, improved the severely saline-alkaline soil environment.

Integrating oral health in stroke care: a critical necessity.

To highlight the critical role of integrating oral health assessments into routine stroke care for better patient outcomes. The Eto et al. study utilizes the modified oral assessment grade (mOAG) to evaluate the oral health of acute ischemic stroke patients upon admission and its predictive value for functional outcomes and hospital-acquired pneumonia (HAP). Evidence from Eto et al. study shows that mOAG scores at admission significantly predict 3-month functional outcomes and the incidence of HAP, emphasizing the need for comprehensive oral evaluations. Integrating oral health assessments into stroke care protocols can improve recovery outcomes, reduce HAP incidence, and lower healthcare costs through preventive oral care. Routine oral health evaluations for stroke patients are crucial for better recovery and overall health outcomes, advocating for policy changes and multidisciplinary approaches to patient care.

Infiltrations of plasma cells in synovium predict inadequate response to Adalimumab in Rheumatoid Arthritis patients

ObjectiveRheumatoid arthritis (RA) is a clinically heterogeneous and complex autoimmune disease, making the prediction of therapeutic responses a significant challenge. This study aims to assess the role of clinical and synovial biomarkers in predicting poor response to adalimumab treatment in RA patients.MethodsThis single-center prospective study included 56 RA patients who had an inadequate response to methotrexate (MTX). At baseline, comprehensive assessments including complete blood count, liver and kidney function tests, blood glucose levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-citrullinated protein antibody (ACPA), as well as counts of swollen and tender joints, Health Assessment Questionnaire (HAQ) score, pain visual analogue scale (VAS) scores, and DAS28-CRP scores were conducted. Synovial biopsies were performed, followed by an efficacy evaluation at 12 weeks of adalimumab treatment. Patients not meeting the ACR20 criteria were classified into the non-responder group, with the remainder categorized as the responder group.ResultsOut of the participants, 24 (42.9%) failed to achieve ACR20 with adalimumab treatment. Non-responders exhibited higher infiltration of plasma cells in the synovium. Multivariate logistic regression analysis identified the presence of plasma cells as an independent risk factor for inadequate response to adalimumab.ConclusionInadequate responses to adalimumab in RA patients were associated with increased plasma cell infiltrations in the synovium. These findings suggest a promising target for tailored therapies in rheumatoid arthritis.

AI in Soil Health Monitoring: A Data-Driven Approach

Abstract: The sustainability of ecosystems and agricultural productivity depend on healthy soil. However, conventional techniques for evaluating soil health are sometimes time-consuming, labor-intensive, and restricted in their geographic reach. New opportunities for scalable, real-time soil health monitoring have been made possible by recent developments in artificial intelligence (AI) and data-driven methodologies. This study examines a thorough AI-powered system for tracking soil health, emphasizing methods for data collection, processing, and predictive modeling. AI models can provide precise forecasts of soil characteristics, health indicators, and possible crop yields by combining data from multiple sources, such as remote sensing, soil sensors, and historical data. This study offers a comprehensive analysis of recent AI applications in soil health monitoring and suggests a reliable, scalable approach intended to incorporate diverse data sources, guaranteeing precise and effective soil health assessment.

Social Determinants of Successful Smoking Cessation: An Eight-Year Analysis of Population Assessment of Tobacco and Health (PATH) Data.

Smoking cessation is a crucial public health goal due to its substantial impact on reducing the morbidity and mortality associated with tobacco use. However, significant disparities in smoking cessation success persist across socioeconomic groups in the United States. This study aimed to examine differences in smoking cessation rates among daily smokers based on race, ethnicity, and socioeconomic status (SES) using data from the Population Assessment of Tobacco and Health (PATH) study, spanning waves 1 to 6 (eight years). Longitudinal data from PATH were analyzed, focusing on baseline daily cigarette smokers followed over an eight-year period to assess cessation outcomes. SES was measured by education and poverty status. Successful smoking cessation was defined as sustained abstinence from cigarettes for 12 months or more at the final wave. Logistic regression models identified predictors of successful cessation, adjusting for potential confounders, including age, nicotine dependence, and access to cessation resources. The analysis revealed significant disparities in cessation success across racial, ethnic, and SES groups. Smokers living in poverty and those with lower educational attainment were less likely to achieve cessation success than their counterparts. Race (Black) and ethnicity (Latino) were also significantly associated with lower cessation success. This study highlights the social determinants of smoking cessation success among U.S. adult smokers, with lower success rates observed among those in poverty and with less educational attainment. These findings emphasize the need for targeted interventions that address the unique barriers to cessation faced by low-SES groups. Public health strategies should prioritize equitable access to cessation resources and culturally tailored interventions to reduce these disparities and improve cessation outcomes among all smokers.

The impact of gastroesophageal reflux disease on the quality of life of children and adolescents in the Republic of Tyva

Aim of the study was to investigate quality of life indicators in children and adolescents with gastroesophageal reflux disease (GERD) in the Mongoloid and Caucasian populations of the Republic of Tyva. Material and Methods. Schoolchildren aged 7–18 years of the indigenous (25 Mongoloids – Tuvans with GERD and 354 practically healthy) and newcomers population Republic of Tyva (5 Caucasians with GERD and 158 practically healthy) were examined using a cross-sectional method. Gastroenterological complaints and demographic information were recorded. To assess the quality of life of children, adapted Russian parent (CHQ-PF28) and child (CHQ-PF45) versions of the Child Health Questionnaire (CHQ) were used. The questionnaire allows you to assess various areas of a child’s life. Results and discussion. A decrease in the quality of life was established in schoolchildren of both ethnic populations in the presence of GERD on a number of scales as assessed by the children themselves and their parents. However, unlike parents, children’s assessments tended to decrease in the “family cohesion” section (p = 0.068), which, to a certain extent, may reflect the presence of intrafamily problems that can have a traumatic effect on the child. According to parents’ assessments, in schoolchildren with GERD in the Caucasian population, the decrease in indicators concerned only the “physical activity” scale (p = 0.039). In the Tuvan population, more extensive deviations were noted ‒ in sections “general health assessment” (p = 0.041), “physical activity” (p = 0.024), “changes in health status” (p = 0.006), “pain/ discomfort” (p = 0.037). According to the assessment of children, Caucasians with GERD did not show a decrease in indicators, and Tuvans with GERD had fewer deviations on the scales than, according to their parents. Conclusions. Tyva schoolchildren with GERD showed a decrease in quality of life indicators, which was more pronounced among Mongoloids - Tuvans, and there were differences in its assessment by the children themselves and their parents.

From legislation to actual health service: evaluation of health provisions in the disability law of Ghana by adolescents with mobility and visual impairments and their families

BackgroundDespite Ghana’s Persons with Disability Act, 2006 (Act 715) making provisions for access to healthcare services for adolescents with disabilities and their families, a corpus of literature has reported that persons with disabilities continue to face challenges in accessing healthcare services. However, the voices of adolescents with disabilities and their families are very scarce in such discourse. This study explored the experiences of adolescents with disabilities and their families in accessing healthcare services as per the provisions described in Ghana’s Act 715.MethodsThis study involved 45 participants, including 25 adolescents with disabilities and 20 family members from a municipality in Ghana. Employing a qualitative descriptive design, semi-structured interviews were conducted which was then analyzed thematically and interpreted using Critical Disability Theory.ResultsThe study identified two major categories of barriers to healthcare access: environmental (socio-economic difficulties, poor built environment, unavailability of rehabilitation services) and systemic (cultural beliefs, poor support at healthcare facilities and inadequate healthcare legislative provisions for families of children with disabilities). Despite legal provisions for free healthcare, participants faced significant financial barriers, with specialist services often not covered by the National Health Insurance Scheme.ConclusionsThe study calls for policy adjustments to fully cover specialist care under Ghana’s National Health Insurance Scheme, establishment of local-level health assessment and resource centers, educational campaigns to change cultural perceptions, and training of healthcare workers to promote quality access to healthcare.

Impact of the COVID-19 pandemic on university students' psychological distress, well-being, and utilization of mental health services in the United States: populations at greatest risk.

The COVID-19 pandemic led to major disruptions in the lives of university students, which is a population that is already at a greater risk of mental health concerns. Little is known about how the pandemic impacted distress and mental health services utilization among university students across the United States. Using survey data from the National College Health Assessment, both before the COVID-19 pandemic (pre-March 2020, n = 88,986) and during the pandemic (Spring 2021, n = 96,489), the present study examined mental health symptoms and utilization of mental health services among undergraduate students attending four-year universities in the United States. There were notable increases in measures of psychological distress and reductions in well-being from before the pandemic to during the pandemic. However, overall utilization rates of mental health services slightly decreased from pre-pandemic to during the pandemic. Predictors of severe psychological distress included those who experienced loneliness, COVID-19 related stressors, and loss of a loved one from COVID-19. COVID-related stressors and loneliness were associated with higher utilization rates of mental health services, while well-being and resilience were associated with lower utilization rates. Analyses revealed that several demographic groups were at an elevated risk for severe psychological distress, including non-binary, female, and sexual minority students, and especially those who identify as both non-binary and non-heterosexual. Results indicated that students of color, especially female students of color, were less likely to receive mental health services. Future research is needed to increase our understanding of the barriers to mental health service use among high-risk university students.

Exploring The Relationship Between Body Mass Index and Body Fat Percentage Across Age and Gender: A Cross – Sectional Study

Background: In today’s fast-paced world, the prevalence of non- communicable diseases (NCDs) is rising due to work, academic and personal pressures. Obesity, a preventable disease, is often underestimated in clinical settings. The ‘obesity paradox’ where NCDs occur in individuals with normal body mass index (BMI), complicates health assessments. This study evaluates the relationship between BMI and body fat percentage (BFP) by age and gender and assesses if BMI alone is a good predictor of body adiposity. Methods: A cross-sectional observational study was conducted on 385 normal healthy subjects aged 18-67 years, attending an annual temple festival in Kerala during 2016. Subjects were selected based on the inclusion and exclusion criteria, after obtaining the ethical clearance. Using an Omron Body fat analyser, we measured BFP. Statistical analysis was done using Independent T test, ANOVA and Chi square test on SPSS version 20. Results: A significant increase in BMI and BFP with age in both genders, with BFP changes starting at a younger age. Females showed higher increases in both BMI and BFP. Among participants, 34% had normal BMI. 29% had normal BFP and only 20% had both normal. We also found many ‘invisible’ obese individuals within the normal BMI group and some ‘muscle obese’ individuals in the overweight BMI group. Conclusions: To conclude, as BMI and BFP increase with age, the quality of fat free mass likely deteriorates. BFP is a better predictor of adiposity compared to BMI. For early NCD detection, both BMI and BFP should be included in routine clinical screenings.

A Plantar Pressure Detection and Gait Analysis System Based on Flexible Triboelectric Pressure Sensor Array and Deep Learning.

Gait detection is essential for the assessment of human health status and early diagnosis of diseases. The current gait analysis systems are bulky, limited in the scope of use, and cause interference with the movement of the measured person. Hence, it is necessary to develop a wearable gait detection system that is soft, breathable, lightweight, and self-powered. Here, a plantar pressure sensor array and gait analysis system based on a flexible triboelectric pressure sensor (FTPS) array is developed. Soft, breathable, and wearable electrospinning nanofiber film with excellent triboelectric properties is used as the plantar pressure sensor, achieving a high sensitivity of 45.1 mVkPa-1 in the range of 40-200 kPa and 19.4 mVkPa-1 in the range of 200-400 kpa. 32 FTPSs are integrated into an intelligent insole, which has the characteristics of soft, easy production, good air permeability, long-time stability, no external power supply, and etc. Based on the long short-term memory artificial neural network deep learning model, the accuracy of gait judgment can reach 94.23%. This work provides a feasible solution for real-time gait detection, which will have potential applications in human health assessment and early diagnosis of disease.

Emerging Research Trends in River Health Assessment: A Bibliometric Analysis

Emerging Research Trends in River Health Assessment: A Bibliometric Analysis

Evaluating Seismocardiography as a Non-Exercise Method for Estimating Maximal Oxygen Uptake.

The value of maximal oxygen uptake (VO2MAX) is a key health indicator. Usually, VO2MAX is determined with cardiopulmonary exercise testing (CPET), which is cumbersome and time-consuming, making it impractical in many testing scenarios. The aim of this study is to validate a novel seismocardiography sensor (Seismofit®, VentriJect DK, Hellerup, Denmark) for non-exercise estimation of VO2MAX. A cohort of 94 healthy subjects (52% females, 48.2 (8.7) years old) were included in this study. All subjects performed an ergometer CPET. Seismofit® measurements were obtained 10 and 5 min before CPET in resting condition and 5 min after exhaustion. The CPET VO2MAX was 37.2 (8.6) mL/min/kg, which was not different from the two first Seismofit® estimates at 37.5 (8.1) mL/min/kg (p = 0.28) and 37.3 (7.8) mL/min/kg (p = 0.66). Post-exercise Seismofit® was 33.8 (7.1) mL/min/kg (p < 0.001). The correlation between the CPET and the Seismofit® was r = 0.834 and r = 0.832 for the two first estimates, and the mean average percentage error was 11.4% and 11.2%. Intraclass correlation coefficients between the first and second Seismofit® measurement was 0.993, indicating excellent test-retest reliability. The novel Seismofit® VO2MAX estimate correlates well with CPET VO2MAX, and the accuracy is acceptable for general health assessment. The repeatability of Seismofit® estimates obtained at rest was very high.

Depression and associated factors among patients with type 2 diabetic mellitus in Ethiopia: a cross sectional study.

Depression is a significant public health concern in both developed and developing countries. The burden of depression is particularly high among patients with chronic illnesses in developing countries, creating a dual challenge for both patients and the community. However, depression goes undiagnosed in 50%-75% of patients with chronic conditions such as diabetes mellitus. Additionally, there is limited information about the prevalence of depression among diabetic patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among type 2 diabetic patients in Ethiopia. An institution-based cross-sectional study was conducted on 376 randomly selected type 2 diabetic patients. Data were collected through face-to-face interviews and from patients' follow-up records. The data were entered into EpiData version 4.6 and analyzed using STATA 14. Bivariable and multivariate logistic regression analyses were employed to identify associated factors. Variables with a p-value of less than 0.25 in the bivariable analysis were selected for multivariate logistic regression. Model fitness was assessed using Hosmer-Lemeshow's test, and associations were reported using adjusted odds ratios with 95% confidence intervals. In this study, the prevalence of depression among type 2 diabetic patients was found to be 69.72% (95% CI: 64.75, 74.27). Three factors were significantly associated with depression in these patients: the duration of diabetes mellitus since diagnosis [AOR: 1.17; 95% CI (1.02, 1.34)], glycaemic control [AOR: 1.8; 95% CI (1.09, 3.01)] and cigarette smoking [AOR: 2.18; 95% CI (1.07, 4.46)]. The prevalence of depression among type 2 diabetic patients was high. The Federal Ministry of Health, stakeholders, and the Ethiopian Diabetes Association should collaborate to reduce this burden. Mental health assessment and treatment should be integrated into chronic care follow-up services. Additionally, healthcare providers should closely monitor and counsel patients who smoke and those with poor glycemic control.

Impact of Mental Health on Academic Performance: A Study on the Risk of Failure in Higher Education

Building healthy spaces and adequate mental health in the university context is of vital importance for optimal, quality and warm academic development, both for students and teachers. The purpose of the research is to determine the state of mental health of students as a risk factor for academic failure in higher education. For the methodological procedure, the “GHQ-28 Mental Health Assessment Scale and Questionnaire” was applied and a socio-educational form was used to measure academic performance. The level of mental health of students was estimated by applying the principal component factor analysis (PCA). To determine the variance of the factor analysis, Bartlett's sphericity test was used, then the factorization process was carried out by the PCA method with a varimax rotation. They were selected for the sample by the simple random method, resulting in a total of 212 cases. The results obtained revealed that the “mental health status” variable has a significant effect on academic risk, with an estimated coefficient of -0.0878 and an associated p-value of 0.014. This indicates that as the mental health status of students decreases, an increase in the probability of repeating the academic semester is observed.

Impact of Orthopedic Surgical Intervention on Difficult-to-Treat Rheumatoid Arthritis: A Propensity Score Matched Study.

To elucidate the therapeutic effect of orthopedic surgical intervention (OSI) in difficult-to-treat rheumatoid arthritis (D2T RA) compared with non-D2T RA. A total of 534 recent surgeries were analyzed only in patients who had undergone OSI since 2016 and for whom a 12-month post-operative follow-up was available. D2T RA was determined according to the EULAR definition, and patients with D2T RA were matched to patients with non-D2T RA using propensity scores calculated by a logistic regression analysis. The Health Assessment Questionnaire-Disability Index (HAQ-DI), Disease Activity Index 28 (DAS28), face scale, and patient's assessment of general health (GH) were measured repeatedly at baseline and 6 and 12 months and were compared using a two-way analysis of variance. The HAQ-DI, DAS28, face scale, and GH showed significant post-operative improvements, and there were significant differences in the HAQ-DI and face scale scores between D2T RA and non-D2T RA. An additional analysis with DAS28 as a covariate showed no significant interaction for either, suggesting that these improvements in clinical assessment were due to OSI rather than improved disease activity. In the absence of an effective pharmacological treatment strategy, OSI may be an effective treatment modality for the management of D2T RA.

Association of cardiometabolic index with sleep quality in adults: a population‑based study

The Cardiometabolic Index (CMI) represents an innovative metric that encompasses abdominal obesity and lipid levels, offering a comprehensive assessment of cardiometabolic health. It is derived through the multiplication of the waist-to-height ratio by the triglyceride-to-high-density lipoprotein cholesterol ratio. Although obesity and blood lipid levels are known factors affecting sleep quality, the direct correlation between CMI and sleep quality has yet to be elucidated. This study uses NHANES data to explore the potential correlation between CMI and sleep quality. Our research employed a cross-sectional design, utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2011 to 2014. CMI was used as the exposure variable, with sleep quality assessed through three self-reported measures: trouble sleeping, sleep disorders, and sleep duration. We employed multivariate logistic regression models and linear regression model as well as subgroup analyses to explore the independent relationship between CMI and sleep quality. Additionally, interaction tests were conducted to examine differences across various subgroups. The study included 4298 participants, comprising 2134 males and 2164 females. There was a positive correlation between CMI and trouble sleeping (OR = 1.63, 95% CI 1.28–2.08) and sleep disorders (OR = 1.96, 95% CI 1.43–2.67), while there was a negative correlation between CMI and sleep duration (β = − 0.17, 95% CI − 0.31 to − 0.03), indicating that a higher CMI was associated with shorter sleep duration. Subgroup analyses and interaction tests revealed a consistently positive association between CMI and sleep difficulty across various populations, including gender, age, hypertension, diabetes, and cardiovascular disease history. However, the relationship between CMI and sleep disorders was more prominent among participants aged 50 and above. In American adults, a higher CMI is linked to an increased prevalence of sleep disturbances. In clinical practice, CMI can be considered as a supplementary factor in the assessment and management of sleep problems. Our study also provided new insights for improving sleep quality.