Health Consequences Research Articles

The impact of electronic cigarettes on the outcomes of total joint arthroplasty.

Cigarette smoking is known to result in poorer outcomes for patients undergoing total joint arthroplasty. Smoking tobacco cigarettes in the perioperative period is associated with higher analgesia usage, increased mortality, poorer healing, and an increased risk of medical complications. As such, many surgeons advise their patients not to smoke in the perioperative period. Electronic cigarettes are emerging as a popular alternative for usage by patients who would otherwise continue to smoke traditional cigarettes. Importantly, there has been limited investigation into the impact of electronic cigarette usage on the outcomes of total joint arthroplasty. This review investigates the potential detrimental effects caused by the usage of electronic cigarettes on the outcomes of total joint arthroplasty. A systematic review was carried out in accordance with the PRISMA Guidelines. We have drawn from studies that investigated the impact of the constituents of E-cigarette vapour on bone health, wound healing, the immune system and the direct impact of electronic cigarette usage on surgical outcomes. Electronic cigarettes release nicotine in an inconsistent manner, resulting in many negative consequences for bone health. Furthermore, they depress the immune system, impair wound healing and may result in longer hospital stays. Electronic cigarette usage should be monitored in the perioperative period to reduce the risk of complication. There is a pressing need for more comprehensive research in this area to fully understand the implications of EC usage on the outcomes of total joint arthroplasty.

Metapopulations, the inflationary effect, and consequences for public health

Metapopulations, the inflationary effect, and consequences for public health

Evaluation of the Vaginal Panel Realtime PCR kit (Vircell, SL) for diagnosing vaginitis: A comparative study with routinely used diagnostics.

Vaginitis is a prevalent clinical disorder associated with several adverse health consequences, prompting women to seek medical care. In this study we evaluate the Vaginal Panel Real-Time PCR kit (qPCR test) against routinely used diagnostics for detection of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis. A total of 1011 vaginal swab specimens were analyzed. The routinely diagnostic methods for BV was Gram stain-based Nugent score. VVC presence was detected by culture, and Candida species were identified using MALDI-TOF MS. Trichomonas vaginalis was identified by culture in a selective medium. Molecular analyses were conducted on the MagXtract® 3200 System and analyzed using the CFX96™ Real-Time PCR Detection System. The sensitivity, specificity, positive predictive value, and negative predictive value of the qPCR test compared to the reference method for BV diagnosis was 93.1%, 88.8%, 90.1% and 92.2%, respectively, with a Kappa value of 0.82. For Candida species, sensitivity, specificity, positive predictive value, and negative predictive value were 96.0%, 98.4%, 95.3%, and 98.7%, respectively. The qPCR test detected 32 additional positive samples for Candida not reported by the routinely used diagnostics. For trichomoniasis, the qPCR test identified T. vaginalis in fifteen specimens, despite no microscopic detection in cultured specimens. Our results demonstrate that the Vaginal Panel Real-Time PCR kit shows optimal concordance with routinely used diagnostics for diagnosing vaginitis. Furthermore, enhancing detection of T. vaginalis. However, further validation studies are necessary to confirm its full diagnostic accuracy. The use of nucleic acid amplification tests (NAATs) provides rapid and accurate diagnosis, crucial for early detection and treatment of vaginitis.

A comprehensive epidemiological assessment of female rape in São Paulo State, Brazil: trends, patterns, and implications for public health.

Sexual violence against women remains a global challenge, with Brazil exemplifying persistent issues despite legislative advancements. This study examined sexual violence within São Paulo state, Brazil's largest and economically affluent state, focusing on prevalence, patterns, forensic evidence, and health consequences. We analyzed 40,757 medical reports of alleged cases of rape against women available from the São Paulo Medical Legal Institute from 2014 to 2017. An increase in female rape cases was observed, reflecting broader societal trends, but underreporting, prevalent due to fear and stigma, underscored the need for multifaceted interventions. We also explored correlations between rape prevalence and the Human Development Index, highlighting disparities between urban and rural areas. Additionally, the study revealed concerning proportions of cases involving vulnerable victims, emphasizing the imperative for tailored interventions and legislative reforms. Furthermore, we demonstrated that only a small portion of medicolegal examinations were able to find evidence of sexual violence or recent sexual acts, necessary for conducting the criminal investigation of the alleged act. Therefore, despite challenges in forensic evidence collection, efforts to enhance medical examination protocols and awareness among professionals are crucial. Moreover, findings underscored the significant health consequences of rape, including unwanted pregnancies and sexually transmitted infections, necessitating comprehensive healthcare services for survivors. In conclusion, we reinforced that addressing sexual violence demands coordinated action, including legislative reforms, community engagement, and survivor-centered approaches, to create safer and more resilient communities.

The COVID-19 legacy: consequences for the human DNA methylome and therapeutic perspectives.

The COVID-19 pandemic has left a lasting legacy on human health, extending beyond the acute phase of infection. This article explores the evidence suggesting that SARS-CoV-2 infection can induce persistent epigenetic modifications, particularly in DNA methylation patterns, with potential long-term consequences for individuals' health and aging trajectories. The review discusses the potential of DNA methylation-based biomarkers, such as epigenetic clocks, to identify individuals at risk for accelerated aging and tailor personalized interventions. Integrating epigenetic clock analysis into clinical management could mark a new era of personalized treatment for COVID-19, possibly helping clinicians to understand patient susceptibility to severe outcomes and establish preventive strategies. Several valuable reviews address the role of epigenetics in infectious diseases, including the Sars-CoV-2 infection. However, this article provides an original overview of the current understanding of the epigenetic dimensions of COVID-19, offering insights into the long-term health implications of the pandemic. While acknowledging the limitations of current data, we emphasize the need for future research to unravel the precise mechanisms underlying COVID-19-induced epigenetic changes and toexplore potential approaches to target these modifications.

Psychological Responses to Home-Working Practices: A Network Analysis of Relationships with Health Behaviour and Wellbeing

Working at home, rather than in the workplace, has been suggested to affect office-based workers’ health and wellbeing. This exploratory, cross-sectional study sought to identify discrete psychological responses to home-working practices and investigate their relationship with engagement in health-related behaviours and wellbeing. A sample of 491 home-workers completed a survey assessing ten psychological responses to home-working (e.g., the ability to ‘switch off’ from work), ten health behaviour indices (e.g., sleep trouble), and seven wellbeing indices. Network Analysis modelled relationships between these variables. Results showed four clusters of psychological responses to home-working practices (representing ‘home-working independence’, ‘home-work transition’, ‘daily work pressure’, and ‘work-day forecasting’). Variables within these clusters linked to health behaviour and wellbeing: perceptions of workload manageability, ability to switch off from work, homeworking autonomy, and planning and organising a home-working day had cascading influences on indicators of health, health behaviours, and wellbeing. The findings point to a complex system of potential health and wellbeing consequences of working from home. Further evidence is needed to establish truly causal relationships; nonetheless, our findings call for the development of public health initiatives and organisational policies to support the adoption of home-working practices to benefit the health and wellbeing of home-workers.

Digital health intervention for children with ADHD to improve mental health intervention, patient experiences, and outcomes: a study protocol

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition with profound public health, personal, and family consequences. ADHD requires comprehensive treatment; however, lack of communication and integration across multiple points of care is a substantial barrier to progress. Given the chronic and pervasive challenges associated with ADHD, innovative approaches are crucial. We developed the digital health intervention (DHI)—CoolTaCo [Cool Technology Assisting Co-regulation] to address these critical barriers. CoolTaCo uses Patient-Centered Digital Healthcare Technologies (PC-DHT) to promote co-regulation (child/parent), capture patient data, support efficient healthcare delivery, enhance patient engagement, and facilitate shared decision-making, thereby improving access to timely and targeted mental health intervention for children at significant risk for poor outcomes. The present paper will describe our planned protocol to evaluate the efficacy of CoolTaCo via randomized control trial (RCT).Methods/designWe will recruit 60 children (ages 8–12) with ADHD who will be randomized to either immediate (n = 30) or delayed (n = 30) treatment (i.e., a waitlist control group). Among those randomized to immediate treatment, half will be assigned to DHI (delivered via a smartwatch and smartphone application), the other half to an active control treatment as usual (TAU). Unlike the DHI group, the TAU group will receive the smartwatch with no assigned activities, applications, or interventions on the devices. The intervention period will last 16 weeks; after a participant has been in the delayed treatment group for 16 weeks and has completed the post-waiting period assessment, they will be randomly assigned to either the intervention or active control group. Thus, 30 participants will complete the intervention, and 30 will complete the active control, with half of the total sample completing a waitlist period.DiscussionIndividuals with ADHD have complex needs. Despite improvement in outcomes following cognitive behavioral therapies (CBT) and pharmaceutical treatment, long-term maintenance is a challenge often not addressed by traditional medical approaches, and, as we described, ineffective approaches to information sharing across points of care create further barriers to progress. Our research will fill a significant gap in translating early treatment investments and gains into long-term, sustainable outcomes.This study was registered as a clinic trial at ClinicalTrials.gov (Digital Health Intervention for Children With ADHD, ID# NCT06456372) on 06/13/2024.

Biophysics of ACL injuries

Anterior Cruciate Ligament (ACL) injuries rank among the most prevalent and severe types of injuries, significantly impacting both athletes and non-athletes alike. These injuries not only result in immediate physical impairment, such as intense pain, substantial swelling, and a marked loss of mobility, but also carry long-term health consequences that can alter a person’s quality of life. Chronic pain, persistent instability, and an increased risk of developing osteoarthritis are among the lasting effects that can follow an ACL injury. An in-depth understanding of the biophysics behind ACL injuries is paramount for devising effective prevention and treatment protocols. Biophysics, which combines principles from physics with biological systems, provides crucial insights into the mechanical and structural integrity of the ACL and its susceptibility to injury under various conditions. This systematic review aims to collate and synthesize the current knowledge surrounding the biophysical mechanisms that underlie ACL injuries. The review encompasses a range of factors, including the biomechanical forces that place stress on the ligament, anatomical structures that may predispose individuals to injury, and physiological conditions that affect ligament health and resilience. Each of these factors plays a crucial role in the incidence and severity of ACL injuries. Biomechanical forces, for example, can involve sudden changes in direction or impact during physical activity, leading to excessive stress on the ACL. Anatomical factors might include variations in bone structure or ligament alignment that inherently increase the risk of injury. Additionally, physiological conditions such as muscle strength, flexibility, and overall ligament health can influence the likelihood and extent of an ACL injury. The findings of this review underscore the necessity of adopting integrated approaches in both injury prevention and rehabilitation. Such approaches must consider the multifaceted nature of ACL injuries, involving not only mechanical and anatomical aspects but also physiological and possibly even genetic factors. By emphasizing a multi-faceted understanding, interventions can be more effectively tailored to address the complex interplay of elements that contribute to ACL injuries. This holistic approach can lead to better outcomes for those at risk of or recovering from ACL injuries, enhancing the efficacy of prevention strategies and rehabilitation protocols.

Fasting in Judo—Between Healthy Weight Control and Health Hazard: A Narrative Review

Rapid weight loss strategies and weight cycling (losing and gaining weight repeatedly) are acknowledged problems in sports with weight categories, including judo. Extreme fasting, especially if combined with dehydration and intense physical exercise, may harm health and development, particularly those of children and teenagers engaging in judo competitions. However, there is substantial evidence for positive health effects of other forms of fasting. Here, we aim to provide an updated overview of the potential health risks associated with extreme dietary strategies in judo and contrast them with health-promoting fasting approaches. We conclude that the literature on the long-term health consequences of fasting in judo is scarce. This applies specifically to its potential association with eating disorders. Although many reports have highlighted the short-term risks of rapid weight loss, vulnerability and protection factors remain poorly understood. Rigorous scientific studies are needed to disentangle the factors that render fasting in judo healthy or unhealthy, considering both physical and mental health. We argue that a better understanding of weight management in judo is crucial to preventing health risks and designing healthy weight loss strategies, especially for young athletes.

The Perceptions of Overweight and Obese Individuals Regarding Weight-Loss Dietary Supplement Advertisements: A Pilot Cross-Sectional Survey

Introduction: The negative health consequences of overweight and obesity underscore the importance of weight loss in mitigating these issues. Weight-loss dietary supplements (DS) are highly sought-after by overweight or obese individuals, with widespread advertisements promoting their use. This study aimed to investigate the perceptions of overweight and obese individuals regarding weight-loss DS advertisements. Methods: Over a six-week period from 5th April to 17th May 2023, an online pilot cross-sectional study was conducted targeting overweight and obese individuals in Malaysia. The study utilized a convenience sampling method to recruit participants. Results: Of the 146 participants, most were female (82.9%), 53.4% were overweight, and 46.6% were obese. Most respondents believed that weight-loss DS advertisements often contained exaggerated, unverified, and misleading information. Nearly 90% acknowledged that exaggerated advertisement claims might influence consumers, and about 85% believed that people are influenced to buy frequently advertised weight-loss DS. Despite these perceptions, about 40% reported purchasing a weight-loss DS after seeing such a product in an advertisement, while less than 50% of those who purchased weight-loss DS sought information from healthcare professionals. Conclusion: The study found that almost 40% of the respondents had purchased a weight-loss DS after seeing such products being advertised. Individuals with higher income, married people, and older respondents appeared more likely to purchase a weight-loss DS. These findings underscore the necessity for stricter regulatory frameworks and comprehensive consumer education initiatives to protect consumers from misleading information and unethical marketing tactics within the weight-loss DS industry. Implementing targeted public health interventions could further safeguard consumers from the risks associated with exaggerated product claims.

Reported impact of creativity in the Wakakosha ('You're Worth It') internal stigma intervention for young people living with HIV in Harare, Zimbabwe.

Internal stigma (negative judgements towards oneself) continues to be a barrier to HIV treatment, management and care, and has global public health consequences. People living with HIV (PLHIV) who report internal stigma are less likely to seek care, adhere to treatment and can experience increased depression and lower quality of life. The Wakakosha ('You're Worth It') programme sought to reduce internal stigma among young PLHIV using inquiry-based stress reduction (IBSR), a cognitive and awareness-based methodology. This sub-study focused on creativity, exploring how it promotes young PLHIV's well-being. We analysed individual interviews (n = 14), focus groups (n = 3), poems (n = 5), songs (n = 2) and self-compassion letters (n = 38) and 23 activity journals from November 2021 to March 2022, utilising inductive thematic analysis to identify themes across the data. Creativity saturated the Wakakosha intervention through modalities such as drawing, colouring, body mapping, music and letter writing. These engaged participants and gave them a space in which to shift their internal stigmatising beliefs, and helped them in multiple ways including: facilitating emotional regulation, self-acceptance, self-compassion, self-worth and body positivity. Creativity also enhanced participants' self-image and allowed them to see their own abilities. Music improved the therapeutic environment by helping participants focus, emote, retain messages and connect within the group setting. Letters to self/others allowed participants to let go of stigma towards themselves and the circumstances of their infection. Tools such as drawing and body mapping assisted participants with emotional recognition and expression. This sub-study provided insight into the potential of creativity, when integrated into an IBSR intervention, in counteracting internal stigma. Ongoing replication is needed to continue to evolve best practices for internal stigma interventions. Future work should use more structured and specific interviews with participants regarding their creative processes.

Primary Prevention Strategy for Non-Communicable Diseases (NCDs) and Their Risk Factors: The Role of Intestinal Microbiota

Non-communicable diseases (NCDs) are the leading cause of morbidity and mortality worldwide. These conditions have numerous health consequences and significantly impact patients’ lifestyles. Effective long-term treatment is essential since NCDs are irreversible. Therefore, primary healthcare must be both exclusive and of the highest quality, ensuring comprehensive care. The primary goal should be to improve quality of life with a focus on patients, families, and communities, as most of these diseases can be prevented and controlled, although not cured. Several factors have been linked to individual health, including social, cultural, and economic aspects, lifestyle, and certain environmental factors, including work, that can have positive or negative effects. More of these variables may contribute to the onset of NCDs, which are defined by their chronic nature, propensity for prolongation, and generally slow rate of progression. Examples of NCDs include hypertension, type 2 diabetes (T2D), dyslipidemia, and fatty liver disease linked to metabolic dysfunction. The onset of these diseases has been associated with an imbalance in certain microbial niches, such as the gut, which hosts billions of microorganisms performing multiple metabolic functions, such as the production of metabolites like bile acids (BAs), short-chain fatty acids (SCFAs), and trimethylamine N-oxide (TMAO). Therefore, lifestyle changes and personal habits can significantly impact the gut microbiota (GM), potentially preventing chronic diseases associated with metabolism. NCDs are highly prevalent worldwide, prompting increased attention to strategies for modifying the intestinal microbiota (IM). Approaches such as probiotics, prebiotics, synbiotics, and fecal transplantation (FMT) have demonstrated improvements in the quality of life for individuals with these conditions. Additionally, lifestyle changes and the adoption of healthy habits can significantly impact IM and may help prevent chronic diseases related to metabolism. Therefore, the main aim of this review is to analyze and understand the importance of microbiota intervention in the prevention of non-communicable diseases. R3:A1

Optimizing 5-aminosalicylate for moderate ulcerative colitis: expert recommendations from the Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition.

The lack of clear definition and classification for "moderate ulcerative colitis (UC)" creates ambiguity regarding the suitability of step-up versus top-down treatment approaches. In this paper, experts address crucial gaps in assessing and managing moderate UC. The Asia-Pacific, Middle East, and Africa Inflammatory Bowel Disease Coalition comprised 24 experts who convened to share, discuss and vote electronically on management recommendations for moderate UC. Experts emphasized that the goal of treating UC is to attain clinical, biomarker, and endoscopic remission using cost-effective strategies such as 5-aminosalicylates (5-ASAs), well-tolerated therapy that can be optimized to improve outcomes. Experts agreed that 5-ASA therapy could be optimized by maximizing dosage (4 g/day for induction of remission), combining oral and topical administration, extending treatment duration beyond 8 weeks, and enhancing patient adherence through personalized counselling and reduced pill burden. Treatment escalation should ideally be reserved for patients with predictors of aggressive disease or those who do not respond to 5-ASA optimization. Premature treatment escalation to advanced therapies (including biologics and oral small molecules) may have long-term health and financial consequences. This paper provides consensus-based expert recommendations and a treatment algorithm, based on current evidence and practices, to assist decision-making in real-world settings.

RSSDI Expert Consensus for Optimal Glucose Monitoring in Diabetes Mellitus in India and Recommendations for Clinical Practice

Effective management of diabetes warrants accurate and regular monitoring of glucose levels to prevent serious diabetes-associated complications and long-term health consequences. Hence, achieving target glucose levels and maintaining adequate glycemic control is essential in diabetes to prevent episodes of hypoglycemia. Multiple glucose monitoring tools have been developed over time, each with differing degrees of precision, convenience, and real-time input. The management of diabetes has been considerably improved by using these various glucose monitoring devices, both in terms of treatment outcomes and patient quality of life. However, in India, the lack of awareness, patient education, availability, and affordability of glucose monitoring devices poses a significant concern resulting in poor adherence to glucose monitoring and low medication adherence thereby increasing disease burden. Consequently, there is an urgent need for healthcare professionals and policymakers in India to collaborate and address the challenges associated with glucose monitoring in patients with diabetes, while also providing recommendations to overcome these concerns. This recommendation article offers a comprehensive evaluation of various glucose monitoring tools available for use by patients suffering from different types of diabetes, explores the challenges associated with glucose monitoring in India, and also presents expert panel recommendations to enhance diabetes management effectively.

Dissemination in Social Media and Blogs of Public Health Information and Misinformation on Covid-19 Containment in Switzerland

Future epidemics are perceived as inevitable. Dissemination of information can enhance awareness, serving as an initial stride towards fostering desired epidemic-controlling actions among the public. In this study, a qualitative content analysis of Covid-19- and Switzerland-related social media and blog contributions points at a limited adoption of public health key messages and a negative reputation of the informing authorities. The authorities are to a marginal extent the source of information and a controversial sentiment towards vaccination emerges. In addition, we find a large share of disseminated information that is not conducive to pandemic containment. Within this, a substantial volume of misinformation emerges in statements on Covid-19-related issues. The misinformation consists primarily of unsubstantiated health consequences of the Covid-19 vaccination (both efficacy and side effects), and, less often, of trivialisation or denial of the pandemic. Furthermore, in a phase of political campaigning on a Covid-law referendum in Switzerland, social media contributors often portray pandemic containment as an undue, unlawful, or autocratic imposition on individual and collective freedom, and as a tool deployed for political repression. In addition, the pandemic or its containment are embedded in various conspiracies by users and containment measures are contested with religious, naturopathic or esoteric arguments.

Mobile apps for diabetes self-management: An updated review of app features and effectiveness.

Self-management of diabetes is extremely challenging and non-adherence is common. Health consequences are significant for those unable to adhere to the complex treatment regimen, which includes regular oral medication and/or insulin use, frequent blood sugar checks, strict dietary management, and regular physical activity. Mobile applications (apps) present a tremendous opportunity to help patients improve adherence to these behaviors. The availability of commercial diabetes self-management apps is increasing exponentially, making it difficult for patients and providers to stay informed about app options and benefits. Previous reviews have described commercial diabetes apps and their features and usability for patients with diabetes. A smaller number have reviewed the effectiveness of these apps in improving blood glucose as well as other aspects of diabetes management. The aim of this article is to update our 2016 review, summarize the results of new reviews, review outcomes of diabetes apps described in the literature, and offer recommendations for app features, effectiveness research, and marketing in apps for diabetes self-management. Although higher-quality research is needed, current reviews suggest that many diabetes apps are effective in lowering HbA1c. Recommendations for future research include reporting critical details such as patient demographics and intervention elements and designing studies to identify the most effective components of diabetes management apps. Furthermore, clearly labeling apps that have data supporting clinical efficacy in app stores would allow both providers and patients to easily identify apps that might be most beneficial. Future research should explore the use of apps for the prevention of diabetes in individuals diagnosed with prediabetes.

Forecasting atmospheric persistence and implications for the predictability of temperature and temperature extremes

AbstractExtreme temperatures can cause severe disruptions to society, from negative health consequences to infrastructure damage. Accurate and timely weather forecasts contribute to minimising these detrimental effects, by supporting early‐warning systems. In this context, information on the expected performance of the forecasts is valuable. Here, we investigate whether there is a relationship between the persistence of atmospheric circulation patterns in the Euro‐Atlantic sector and forecast skill for temperatures and temperature extremes in Europe. We first apply an objective method to compute the persistence of large‐scale atmospheric patterns in European Centre for Medium‐Range Weather Forecasts (ECMWF) subseasonal retrospective forecasts. We find that the forecasts successfully predict atmospheric persistence up to time‐scales of approximately two weeks. We next investigate the relationship between the persistence of an atmospheric state and the practical predictability of temperature in terms of the error in surface temperature forecasts. The relationship between the two varies depending on season and location. Nonetheless, in a number of cases atmospheric persistence provides potentially valuable information on the practical predictability of temperature. We specifically highlight the cases of wintertime temperature forecasts up to three weeks lead time and wintertime cold spells up to roughly two weeks lead time.

Psychedelic mushroom-containing chocolate exposures: Case series

IntroductionThe recreational use of psilocybin or psilocin-containing products, a chemical found naturally in certain mushroom species, is on the rise across the United States. Several cases of serious clinical effects related to mushroom-containing products have recently been reported to the Food and Drug Administration (FDA). The emergence of these new products and their health consequences are not yet well understood. This case series aims to characterize exposures to mushroom-containing chocolate products, including patient characteristics, clinical effects, treatment(s), and clinical outcome severity, reported to a poison center network. Material and methodsThis was a retrospective case series conducted in patients exposed to mushroom-containing chocolate products across three poison centers between January 2023 to August 2024. Patients were identified via a database search of ToxSentry®. Patients were included if they were exposed to a mushroom-containing chocolate product. Patients were excluded if they ingested an unrelated product or if there was insufficient information documented within ToxSentry®. The primary endpoint was to describe clinical outcome severity after exposure to mushroom-containing chocolate products. ResultsA query of ToxSentry® identified 164 cases; 36 cases met study criteria. The median age of patients in this case series was 17 years old. For most patients (23, 64 %), the reason for the exposure was intentional, with 20 reporting intentional abuse or misuse of the product. Common clinical effects reported included mental status changes (26, 76 %), paranoia/hallucinations (10, 28 %), dysrhythmias (7, 19 %) and gastrointestinal discomfort (6, 17 %). There was one report of seizure. Most clinical effects lasted between 3 and 24 h after ingestion (29, 81 %). Intravenous fluids (18, 50 %) and benzodiazepines (7, 19 %) were the most common treatments given. No fatalities were reported. DiscussionWhile most patients in this series experienced minor clinical effects, some developed serious effects after ingestion of a mushroom-containing chocolate product. Findings from this study further characterize the limited patient demographics, clinical effects, and outcomes published thus far. Further characterization in a larger cohort of patients could expand on our initial findings and is needed to better identify factors that may influence clinical outcomes.

Electronic screening and brief interventions promoting healthy diet and physical activity among adult patients in medical settings: A systematic review

Background & AimsElectronic screening and brief interventions (eSBIs) are promising health promoting approaches but their utilization towards nutrition outcomes has been little documented so far. The aim of this systematic review is to examine the nature and findings of eSBIs targeting diet and/or physical activity (PA) among adult patients in healthcare settings since smartphone technologies emerged. MethodsThree systematic searches in PubMed, ScienceDirect and PsycINFO were conducted from January 2010 to May 2023. We include all studies assessing eSBI towards lifestyle habits (dietary habits and/or PA at least), implemented in healthcare settings and targeting adult participants. ResultsOf 1981 articles identified, 15 studies met inclusion criteria. Most of them documented eSBIs implemented in primary care (n=11), targeting PA (n=11) and diet (n=9) alone or combined (n=5). Some eSBIs targeted additional behaviors (e.g. smoking, drinking). Delivery modes included computer (n=8), printed documents (n=8) or phone (n=2) but only four eSBIs were interactive (or partially automated). In addition to personalized feedback, most common behavior change techniques were “information about social and environmental consequences” (n=9), “goal setting” (n=7), and “information about health consequences” (n=7). Most studies assessing behavior change had a control group (8 in 10), and eight studies found positive changes in behavior. ConclusionsAlthough implementing eSBIs towards PA/diet among adult patients in medical settings seems promising for primary, secondary and tertiary prevention, common conceptual framework, intervention and outcomes are severely lacking, and the extent to which they follow existing SBI guidelines remains unclear. Demonstrating their effectiveness requires fixing these issues before conducting prospective assessment studies in medical settings.

Machine-Learning Approach to Identify Potential Dengue Virus Protease Inhibitors: A Computational Perspective.

The global prevalence of dengue virus (DENV), a widespread flavivirus, has led to varied epidemiological impacts, economic burdens, and health consequences. The alarming increase in infections is exacerbated by the absence of approved antiviral agents against the DENV. Within flaviviruses, the NS3/NS2B serine protease plays a pivotal role in processing the viral polyprotein into distinct components, making it an attractive target for antiviral drug development. In this study, machine-learning (ML) techniques were employed to build predictive models for the screening of a library containing 32,000 protease inhibitors. Utilizing GNINA for structure-based virtual screening, the top potential candidates underwent a subsequent evaluation of their absorption, distribution, metabolism, excretion, and toxicity properties. Selected compounds were subjected to molecular dynamics simulations and binding free energy calculations via MM/GBSA. The results suggest that comp530 possesses binding potential to DENV protease as a noncovalent inhibitor with multiple positions for chemical substitutions, presenting opportunities for optimizing their selectivity and specificity. However, other compounds predicted via ML models may still provide a promising start for covalent inhibitors.