Lifestyle Changes Research Articles

Navigating new horizons in inflammatory bowel disease: Integrative approaches and innovations

This editorial offers an updated synthesis of the major advancements in the management and treatment of inflammatory bowel disease (IBD), as documented in the World Journal of Gastroenterology between 2023 and early 2024. This editorial explores substantial developments across key research areas, such as intestinal microecology, computational drug discovery, dual biologic therapy, telemedicine, and the integration of lifestyle changes into patient care. Furthermore, the discussion of emerging topics, including bowel preparation in colonoscopy, the impact of the coronavirus disease 2019 pandemic, and the intersection between IBD and mental health, reflects a shift toward a more holistic approach to IBD research. By integrating these diverse areas of research, this editorial seeks to promote a holistic and multidisciplinary approach to IBD treatment, combining emerging technologies, personalized medicine, and conventional therapies to improve patient outcomes.

Gender differences and mental distress during COVID-19: a cross-sectional study in Japan.

To identify risk factors for mental distress and investigate whether the factors were different between men and women during the coronavirus disease 2019 (COVID-19), using KOKOROBO data, which is an online platform that aims to facilitate access to mental health services. We used baseline data on KOKOROBO users 13 years of age or older in Japan who accessed it from October 11, 2021, to April 6, 2023, excluding those receiving treatment for mental health problems. Global severity, based on the most severe measure on Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI), was analyzed using multivariable logistic regression with baseline characteristics for each gender, and for under 30 and 30 years of age or older in women. We conducted the same analysis of suicidal ideation for each gender. In the 686 men and 1274 women, 117 (17.1%) and 100 (7.8%) had minimal global severity respectively, and the rest suffered from mental distress to some extent. For women, ages under 30 years (adjusted OR (aOR): 0.352, 95%CI: 0.231-0.539, P < 0.001), marriage (aOR: 0.453, 95%CI: 0.274-0.746, P = 0.002), and concerns about COVID-19 infection were associated with global severity, while having children (aOR: 0.509, 95% CI: 0.284-0.909, P = 0.023) and decrease of going out during the COVID-19 pandemic had a protective effect on global severity and suicidal ideation for men, respectively. Living with family was a risk factor for mental distress in unmarried women over 30 years of age. Less communication with family or others and responding to the questionnaire late at night (00:00-05:59) were associated with severe global severity in both genders. Age, living arrangement, marriage, having children, concerns about COVID-19 infection, and lifestyle changes during the COVID-19 pandemic had gender-specific effects on mental distress, while frequent communication and regular life rhythm maintained mental health in both genders. Young women and, unmarried middle-aged women living with their families tended to experience mental distress during the COVID-19 pandemic. The Ethics Committee of the National Center of Neurology and Psychiatry approved this study (approval number B2020141) on April 15, 2021.

An Assessment of the Feasibility, Patient Acceptance, and Performance of Point-of-Care Transient Elastography for Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review and Meta-Analysis

Background: Vibration-Controlled Transient Elastography (VCTE) with FibroScan is a non-invasive, reliable diagnostic tool for Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD), enabling early detection and management to prevent severe liver diseases. VCTE’s ease and portability suit primary care, streamlining referrals, promoting lifestyle changes, reducing costs, and benefiting underserved communities. Methods: Studies on point-of-care VCTE were systematically reviewed, followed by meta-analysis using a random-effects model. Pooled proportions with 95% confidence intervals were reported, and heterogeneity was assessed using I2%. Results: A total of twenty studies from 14 countries, including 6159 patients, were analyzed, with three studies from France, two from the U.S., and four from China. The population had a slight male preponderance, with a mean age range of 35–73 years and a BMI range of 24.4–41.1%. The diagnostic accuracy for detecting any fibrosis (≥F1) was reported in four studies (n = 210) with an AUC of 0.74, sensitivity of 69.5%, and specificity of 70.6%. For significant fibrosis (≥F2), eight studies (n = 650) reported an AUC of 0.69, sensitivity of 81.7%, and specificity of 64.6%. Advanced fibrosis (≥F3) was evaluated in 10 studies (n = 619), with an AUC of 0.84, sensitivity of 88.1%, and specificity of 63.8%. Cirrhosis (F4) was assessed in nine studies (n = 533), with an AUC of 0.65, sensitivity of 87.5%, and specificity of 62.6%. Steatosis diagnoses across stages S1 to S3 showed increasing diagnostic accuracies, with AUCs of 0.85, 0.76, and 0.80, respectively. Probe type and BMI were significant covariates influencing diagnostic performance for both fibrosis and steatosis, while the percentage of male participants also showed significant associations. Conclusions: VCTE shows high diagnostic accuracy for fibrosis and steatosis in MASLD patients at the point of care. Future research should assess its implementation in fibroscan settings.

The Influence of Hyperlipidemia on the Results of Mammography in Postmenopausal Women

Aim: To determine whether hyperlipidemia causes specific or nonspecific changes that can be detected by mammography in postmenopausal women. Materials and Method: This study was conducted retrospectively and designed as a case-control study in the gynecology clinics of Etlik Zubeyde Hanim Women’s Health Education and Training Hospital between January 2017 and January 2020. Healthy postmenopausal women with a total cholesterol (TC) level of 200 mg/dL and above 200 mg/dL, who were examined in our outpatient clinics and whose mammographic controls were performed in our hospital, were included in the study group (Group I). Healthy postmenopausal women with a TC level below 200 mg/dL who were followed up at the same clinic and whose mammographic controls were performed at our clinic were included in the control group (Group II). We analyzed TC, low-density lipoprotein cholesterol, very-low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and triglycerides with mammography findings. Results: There were no significant differences between the groups in terms of age and body mass index. There were no significant differences between smoking status and family history of breast cancer. The BAC and BI-RADS scoring category scores differed significantly (p=0.006 and p=0.042, respectively). Conclusion: Postmenopausal women with hyperlipidemia have mammographic findings that can lead to breast cancer. Considering that hyperlipidemia may also have other causes of morbidity and mortality, such as hypertension, diabetes mellitus and cardiovascular disease, it is necessary to treat it with lifestyle changes and / or medications. As this was a retrospective study with a limited number of patients, it is clear that future randomized controlled trials could provide more reliable data on this topic.

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

Online Lifestyle Medicine Continuing Medical Education (CME) Course Completion Predicts Increases in Clinician Knowledge, Confidence, and Practice of Lifestyle Medicine

Introduction: Despite growing evidence linking lifestyle changes to disease reversal, lifestyle medicine (LM) is not widely practiced. Lack of clinician training and knowledge is cited as a barrier to LM adoption. This study measures changes in LM knowledge, attitudes, confidence, and practice behaviors following completion of a 5.5-h, asynchronous, online continuing medical education (CME) course. Methods: Participants completed a pre- and post-course survey. A repeated-measures linear model tested changes in knowledge, confidence, interest, experience, and practice of LM, after adjusting for age, gender, race, ethnicity, clinical degree/licensure, and presence of a health system value-based care model. Results: Surveys from n = 2954 course participants were analyzed. Overall, statistically significant improvements were observed in self-reported knowledge (+.47 of points) and confidence (+.53 of points) of LM. Participants across the sample reported greater frequency (+.08 of 5 points) and reach (+.10 of 5 points) of LM with their patients (p&lt;.0001 for both). Discussion: This study demonstrated that a brief, scalable, online CME course can improve LM knowledge, confidence, attitudes, and practice. Future research should examine long-term practice changes as well as differences in outcomes across types of healthcare professionals.

Evaluating the Effectiveness of Lifestyle Interventions in Preventing Chronic Diseases: A Systematic Review

This systematic review evaluates the effectiveness of lifestyle interventions, including dietary changes, physical activity, smoking cessation, and alcohol reduction, in preventing chronic diseases such as cardiovascular disease, diabetes, and obesity. Chronic diseases pose a significant burden globally, and lifestyle interventions are increasingly recommended to reduce risk factors. A comprehensive search was conducted in databases like PubMed, Cochrane Library, and Embase, focusing on studies published in the past decade. Included studies assessed adult populations at risk of chronic diseases, using interventions targeting lifestyle modifications with measurable health outcomes. Findings indicate that dietary changes and increased physical activity significantly reduce chronic disease risk, while smoking cessation and alcohol reduction further contribute to improved health outcomes. Combination interventions generally showed the most substantial impact on preventing chronic disease. Although the evidence strongly supports lifestyle changes for disease prevention, variations in intervention type, duration, and adherence remain a limitation. Future research should explore long-term effects and implementation strategies in diverse populations. This review underscores the need for integrating effective lifestyle interventions into healthcare policies to improve public health.

Analyzing Factors Influencing Customer Satisfaction with Organic Coffee in E-Commerce

In recent years, there has been a notable increase in interest in sustainable products, particularly organic goods, driven by the push for sustainable societies. However, Japan’s organic market lags behind the global trend, representing just 0.3% of total farmland in 2021. To tackle this issue, the Ministry of Agriculture, Forestry and Fisheries introduced the “Green Strategy,” with the goal of raising the organic share to 25% by 2050. The COVID-19 pandemic has brought about significant lifestyle changes, such as increased remote work and reduced outdoor activities, leading to a surge in the E-commerce market and an increased need for analyzing consumer satisfaction. To enhance Japan’s organic market, it is crucial to familiarize consumers with organic products like coffee, tea, and snacks. This study proposes a model using E-commerce customer reviews to predict consumer satisfaction. The aim is to improve services and develop new strategies based on customer preferences, promoting sustainable growth and enhancing customer satisfaction. This study delves into the impact of factors derived from latent Dirichlet allocation (LDA) on consumer satisfaction with organic coffee, utilizing three years of data from Rakuten Marketplace customer reviews (2017–2019). A total of 1444 review texts were analyzed, including 154 low-rated reviews (ratings 1–3) and 1290 high-rated reviews (ratings 4–5). To build a satisfaction prediction model using regression analysis, a survey was conducted using question items explored through factor analysis to assess the reliability of items in conveying the consistent meanings of high frequency words extracted by LDA: “taste,” “aroma,” “gift,” “sales/discounts,” “freshness,” and “decaffeinated.” The results of the regression analysis revealed that “gift,” “sales/discounts,” and “decaffeinated” significantly impact consumer satisfaction. Insights derived from these factors illuminate marketing strategies that focus on delivering happiness through products, adding value through pricing strategies, and introducing benefits and consumption methods that effectively meet customer needs. These findings underscore the potential of customer reviews to enhance consumer satisfaction and inform strategic marketing decisions, thereby contributing to the growth and success of the organic coffee market.

The Effect of Fordyce Happiness Training on Life Expectancy and Quality of Life in Hemodialysis Patients: An Intervention Study in Yazd, Iran

Background: Dialysis patients frequently experience issues such as fear, reduced social activity, and hopelessness due to lifestyle changes and treatment requirements. Objectives: This study aimed to determine the effect of Fordyce happiness training on quality of life and life expectancy in hemodialysis patients. Methods: This quasi-experimental intervention study involved 48 hemodialysis patients who were referred to Shahid Rahnemoun Hospital in Yazd, Iran, and selected through simple random sampling. Data collection tools included the Quality-of-Life Questionnaire for Kidney Patients (KDQOL-36) and the Miller Life Examination Questionnaire. Patients participated in ten 60-minute training sessions, held twice weekly. Data were collected at baseline and one month after the intervention and analyzed using SPSS 21 software. Results: Following Fordyce's happiness training, levels of potassium (K), creatinine (Cr), and blood urea nitrogen (BUN) in patients significantly decreased. Before the intervention, the mean scores for quality of life and life expectancy in dialysis patients were 51.9 ±28.27 and 169.75 ±11.95, respectively, which increased to 64.66 ±27.17 and 179.95 ±9.37 after the intervention. Paired t-test results indicated that Fordyce happiness training had a statistically significant positive effect on patients' quality of life (P &lt; 0.05) and life expectancy (P &lt; 0.05). Conclusions: The Fordyce happiness training program can improve quality of life and life expectancy in dialysis patients. In other words, happiness training may serve as a preventive strategy against mental disorders such as depression, anxiety, and life dissatisfaction in dialysis patients.

Attitudes towards geroprotection: measuring willingness, from lifestyle changes to drug use

IntroductionGeroprotection is an emerging field of research focused on devising strategies for combating the mechanisms of ageing. This study held three aims: 1) to explore the willingness to utilise five different geroprotective measures (i.e., exercise, supplements, intermittent fasting, metformin, and rapamycin use), 2) to explore whether the willingness differs based on respondents’ sociodemographic characteristics and 3) to explore the association between trust in medical institutions and willingness to utilise different geroprotective measures.MethodsA questionnaire was used to assess the attitudes of a sample of the Dutch population by way of both convenience and snowball sampling (final N = 178). Descriptive data and bivariate correlations were used in the analyses.ResultsRelatively high social acceptance of both exercise (66%) and supplements (82%) was found, whereas intermittent fasting (30%), metformin (26%), and rapamycin (10%) were less supported. Males were significantly more likely to be open to exercise and women to supplement use. Trust in medical institutions correlated significantly with the willingness to start metformin.DiscussionExploratory research can only provide a first step in understanding the social acceptance of geroprotection measures. Nevertheless, this study clearly illustrates more well-known measures promoted by public health policy are also more accepted and used. Public health campaigns could consider the sex differences in the uptake of exercise and supplements, and future research may want to delve deeper into the role of facilitating trust relations between medical institutions and the public in promoting the use of geroprotective drugs.

Are radical changes to lifestyles necessary for mitigating climate change?

Many policy-makers and commentators propose that technological change alone will solve climate change. In this commentary, we argue that this techno-optimism is unrealistic, risky, and misses opportunities to improve well-being: radical behavioural change is essential for tackling climate change. While some behaviour change involves adopting green technologies, some are about changing how (much) we consume. Change is needed in our travel and dietary habits, material, energy and water use, in how we work and play. But not everyone needs to make radical lifestyle changes – the wealthiest need to change most. Achieving this will require policies that make low-carbon behaviours easier, cheaper, and more attractive. Tackling climate change requires a shift to a more equitable society and one in which happiness is prioritised over consumption.

Exploring Ayurvedic potential in the management of Jirna Pratishaya (Allergic Rhinitis): A Single Case Report

The present era is characterized by chaos, stress, and strain due to lifestyle modifications, dietary changes, urbanization, and industrialization, leading to increased pollution and antibiotic resistance. This has resulted in a rise in diseases, notably Jirna Pratishaya (chronic allergic rhinitis). In India, the prevalence of allergic rhinitis in children is approximately 21.99% and continues to increase. Repeated attacks and inadequate management often escalate the condition to a chronic phase. Additionally, Ajirna (indigestion) can cause Aam (toxins) accumulation, contributing to various disorders. This study evaluates the efficacy of Ayurvedic management - including Shamana Chikitsa (palliative treatment), dietary adjustments, and lifestyle modifications - for Jirna Pratishaya. It focuses on a 13-year-old boy diagnosed with allergic rhinitis for four years, who presented with symptoms aligning with Jirna Pratishaya. Treated at an Ayurvedic hospital, he received Shamana Chikitsa comprising Tribhuvan Kirti Ras, Shwas Kuthar Ras, Gokshuradi Guggul, and Ashtang Lavan Churna, alongside dietary and lifestyle changes over three months. Symptomatic assessments were performed every 15 days, revealing significant improvement in the patient's overall quality of life and a notable reduction in inhaler usage. The therapy provided effective symptomatic relief and highlights the potential of Ayurvedic interventions in managing chronic allergic conditions. This study underscores the importance of a holistic approach to treatment, addressing both physical symptoms and underlying lifestyle factors.

The significant relief of Ayurvedic management for Severe Migraine Episodes: A Case Study

Migraine is a common and debilitating neurological disorder marked by recurrent, severe headaches that are frequently accompanied by nausea, sensitivity to light, and sensitivity to sound. These migraine attacks can profoundly disrupt daily life and overall well-being. The development of migraines is influenced by a complex interaction of genetic, environmental, and neurovascular factors. Recent studies have enhanced our understanding of migraine mechanisms, highlighting the role of cortical spreading depression and neuropeptides such as calcitonin gene-related peptide (CGRP). Managing migraines effectively often involves a combination of lifestyle changes, medications, and, in some cases, alternative treatments. In Ayurveda, migraine is compared with Ardhavbhedaka (half-headache) which belongs to the Shiroroga. Ardhavbhedaka is primarily associated with imbalances in the Pitta and Vata Doshas due to etiological factors such as eating dry food, eating immediately after a meal, exposure to air from the east, dew, excessive sexual activity, preventing the natural urge of bodily waste, excessive physical labor, develop Ardhavbhedaka.

The Effect of Mobile Application Follow-Up on Treatment Compliance and Self-Care Management in Patients With Hypertension: Randomized Controlled Trial.

Hypertension (HT) is a global health problem. Although there are effective treatment protocols, patients have difficulty in adapting to regular use of drugs, diet, and lifestyle changes. Mobile apps can be a potential alternative for managing HT and improving self-care behavior. This study aimed to determine the effect of mobile application follow-up on treatment compliance and self-care management in patients with HT. This randomized controlled trial was conducted in November 2021 and March 2022 with 40 experimental and 40 control group patients with HT. Research data were collected using a patient information form, "Hill-Bone Hypertension Treatment Compliance Scale (HBHTTCS)," "Hypertension Self-Care Profile-Motivation Scale (HTSPMS)," a mobile application program (daily blood pressure, pulse, medication, diet, exercise tracking) uploaded to the mobile phones of the patients, and individual motivational messages. The mean total score of the HBHTTCS at Week 6 was 14.57±1.89 and the mean total score of the HTSPMS was 78.15±2.05.There was a statistically significant difference in mean total HTSPMS (p = 0.000) and HBHTTCS (p = 0.000) scores and mean scores on medical (p = 0.002) and nutrition (p = 0.002) subscales of HBHTTCS between the first interview (1st-week follow-up) and the last interview (6th-week follow-up) of patients in the intervention group. This study showed that mobile application follow-up increased motivation levels and treatment compliance in patients with HT and resulted in better self-care. These positive findings indicate importance of integrating mobile applications in the disease management of HT patients. ClinicalTrials.gov ID: NCT05334446, https://clinicaltrials.gov/ct2/show/NCT05334446.

Euglena Attenuates High-Fat-Diet-Induced Obesity and Especially Glucose Intolerance

Background: Obesity, a global disease, can lead to different chronic diseases and a series of social health problems. Lifestyle changes, especially dietary changes, are the most effective way to treat obesity. Euglena, a novel food, has attracted much attention. Previous studies have shown that Euglena is an important modulator of the host immune response. In this study, the effects of Euglena as a nutritional intervention in high-fat-diet-induced obese C57BL/6J mice were investigated regarding adipose tissue accumulation and lipid and glucose metabolism by gavage at the dose of 100 mg/kg bodyweight for 9 weeks. This study is one of the few to investigate, in detail, the preventive effects of dietary Euglena on obesity. Methods: Five-week-old male C57BL/6J mice were fed with a high-fat diet (HFD) to induce obesity. An obesity model was created by feeding the high-fat diet for a period of 10 weeks. Obese mice were randomized into 2 groups with the same mean body weight, and no significant differences were observed between the groups: (1) the mice in the HEG group were maintained on a high-fat diet and daily gavaged with Euglena (100 mg/kg body weight) dissolved in saline (n = 7); and (2) the mice in the HFD group were maintained on a high-fat diet and daily gavaged with saline with the same volume (n = 7). The experiment finished after a nine-week period. Results: The results showed that Euglena could reduce the accumulation of white body fat, including subcutaneous fat and visceral fat, and mainly targeted subcutaneous fat. Euglena also reduced adipocyte particle size expansion, promoted lipolysis in adipose (adipose triglyceride lipase and hormone-sensitive triglyceride lipase) and liver tissue (reduced non-esterified fatty acid content), and improved obesity-induced ectopic fat deposition and glucose tolerance. Conclusions: Our findings suggest that Euglena, as a nutritional intervention in HFDs, efficiently reduces body weight and white adipose tissue deposition. The mechanism of Euglena is mainly though enhancing lipolysis. It is worth noting that Euglena β-glucan recovers the hyperglycemia and accumulation of ectopic fat within the liver induced by HFD. Our study is one of the few studies to report in detail the preventive effects of dietary Euglena on obesity in vivo. This study revealed that Euglena also has an important ameliorative effect on obesity and metabolic disorders, which laid a theoretical foundation for its future application in functional foods.

Comprehensive Analysis of Allerkhand Tablet: A Novel Ayurvedic Herbal Formulation helps to regulates the Allergic Conditions

The increasing interest in alternative and complementary therapies has spotlighted Ayurveda, an ancient system of medicine, for its holistic approach in managing allergies. Ayurvedic treatments for allergy typically focus on restoring balance of the Vitiated Doshas. This may involve dietary corrections, lifestyle changes, and the use of herbal remedies and rejuvenation therapies. Curcumin, the active component of turmeric, has been extensively studied for its anti-inflammatory, antioxidant, and immunomodulatory properties, which can be beneficial in managing allergic conditions. The current study was conducted for a scientific evaluation of Allerkhand tablet, an Ayurvedic patent medicine used to treat allergy and boost immunity. Allerkhand, a poly-herbal tablet formulation with Curcuma longa as the main ingredient and 18 other constituents, serves to improve immunity by combining anti-allergic and anti-histaminic effects. The product was subjected to qualitative phytochemical HPTLC, HPLC, and anti-microbial studies. Phytochemical analysis of Allerkhand in aqueous and methanolic extracts revealed the presence of 13 and 8 common compounds, respectively. According to HPTLC and HPLC analysis, sufficient quantity of curcuminoids are present in tablets. Significant antimicrobial zones were found against six bacterial strains. These findings support the traditional use of Allerkhand tablets as a natural remedy in regulating allergic conditions.

Unilateral carotid rete mirabile presenting with limb-shaking transient ischemic attack

A rare presentation of unilateral carotid rete mirabile (RM) in a 70-year-old male manifesting as limb-shaking transient ischemic attacks (LS-TIAs), a disorder typically associated with carotid artery stenosis. The patient experienced recurrent left-sided limb shaking and numbness, with angiography revealing an anomalous microarterial collateral network replacing the right internal carotid artery's (ICA) cavernous segment, indicative of RM. Differential diagnoses included recanalization following occlusion, arteriovenous malformation, with carotid canal dysplasia on CT supporting the RM diagnosis. The patient's management involved antiplatelet therapy and lifestyle changes, following which he reported no further cerebrovascular events. This case underscores the importance of considering RM in differential diagnoses of LS-TIA and suggests conservative management as a favorable approach.

Myopia Progression in Children: A Comparative Analysis of Pre-Pandemic and Pandemic Periods

Background: The COVID-19 pandemic brought about significant changes in children's lifestyles, including increased screen time and reduced outdoor activities due to school closures and lockdowns. These changes raised concerns about potential myopia progression in children. Methods: This study compared the spherical equivalent (SE) measurements of children aged 8-17 years from two time visits: one before the pandemic (September 2019 - February 2020) and one during the pandemic (March 2020 - February 2022). Data on family history of myopia, screen time, and outdoor activities were also collected. Paired t-tests were used to analyze the differences in SE between the two visits. Results: A total of 11 children participated in the study. The mean change in SE was -1.55 D, indicating a significant increase in myopia during the pandemic (p = 0.046). The average daily screen time was 201 minutes, while outdoor activity time was 42 minutes. Conclusion: The findings suggest a potential corelation between increased screen time, reduced outdoor activities, and myopia progression in children during the pandemic. It is crucial to encourage healthy visual habits, including limiting screen time and promoting outdoor activities, to mitigate the impact of the pandemic on children's vision.

A Cloud-Based Breast Cancer Detection with Optimized Self-Attenuated Deep CNN

The life of humans faces several disasters that sometimes may be deadly and cause severe effects on future endeavors. One major cause of lifestyle change is the several types of disease among which some are unrecognizable, and some are untreatable. Cancer is one of the chronic diseases that occur due to the uncontrollable cell division and in the category of cancer, breast cancer is the second disease with the lowest survival rate throughout the world. Prediction of breast cancer at its early stage enhances the survival rate. To maximize the survival rate and a healthy environment, researches on various techniques of breast cancer prediction have emerged. Though these researches have paved a better way for prediction, they also had some drawbacks that minimized the efficacy of the research outcomes. To overcome all these drawbacks, the proposed self-attention-based deep Convolutional Neural Network (Self-attention DCNN) is utilized and the classifier’s performance is enhanced with the Smack Echolocation Optimization (SELO). In addition, a better segmentation method called SELO-optimized ensemble masked Region-based CNN (SELO-mask RCNN) is introduced in the research that segments the region of interest to incorporate the fine-grained segmentation as well as the semantic understanding of the image. The performance of research is evaluated with [Formula: see text]-measure, Precision, and Recall that achieved 98.27%, 99.21%, and 98.99%, respectively.

Perceptions about hypertension in an urban population in Pakistan

Background: As the risk factors and prevalence of hypertension continue to increase in Pakistan, it is imperative to understand the perceptions of patients about its prevention, symptoms, diagnosis, treatment, and management to inform the design of programmes to improve management. Objective: To explore patients’ perceptions about the treatment, management and control of hypertension in an urban population in Pakistan. Methods: Using a semi-structured questionnaire, we conducted one-on-one interviews with 30 hypertensive patients at 2 urban government tertiary care hospitals in Lahore and Sargodha. The patients were aged 35–70 years, diagnosed with hypertension by a registered medical doctor, and being treated with anti-hypertensive medication. The interviews were recorded, transcribed and analysed using Quirkos. Results: Almost all the patients recognized the potential long-term consequences of hypertension. Most of them said regular use of prescribed medication was beneficial, including for blood pressure control and relief of symptoms. They understood the benefits of lifestyle modification, such as engaging in physical activity, for the management of blood pressure. They however had inadequate knowledge of their treatment regimens; some of them took their medications irregularly, while some took them only when they felt symptoms. Most patients relied solely on medical management. Conclusion: We identified major challenges with the management of hypertension among the study population. Patients and caregivers relied mostly on medical management, with insufficient follow-up after initiating treatment. There is a need to improve patient follow-up and provide better patient education on the benefits of adhering to treatment regimens and adopting lifestyle changes including dietary and exercise management.