Tool For Prevention Research Articles

From Pandemic to Heatwave: Digital Strategies for Health Resilience

Abstract Heatwaves threaten public health in the EU, as evidenced by the high heat-related mortality in the summer of 2022. Despite their frequency, European heat-health action plans (HHAPs) largely exclude digital solutions. The COVID-19 pandemic shifted perceptions and use of digital health tools, demonstrating their effectiveness in responding to health crises and providing insights for heatwave management. This work explores the potential of further including digital health interventions into European HHAPs. The objective is to identify adaptable digital strategies to mitigate heatwave health impacts. We started by analyzing WHO’s guidance on the creation of HHAPs, as well as the European Observatory on Health Systems and Policies’ assessment of the four main areas supported by digital health tools during the pandemic. Later, we proposed four main areas where digital health solutions could be efficiently integrated. Each area underwent a rapid literature review to identify digital solutions used during COVID-19, followed by a critical analysis for applicability in heat-health action planning. We identified four areas where the implementation of digital tools should be explored: Communication and Information Dissemination (focusing on raising awareness among vulnerable groups, caregivers, and organizations); Modeling and Forecasting (developing precise forecasts for proactive planning); Health services coordination (among services delivering immediate care during heatwaves); Monitoring and Population Surveillance (implementing strategies to identify and mitigate heat-related risks e.g. among vulnerable populations). Results indicate that digital health solutions from COVID-19 can enhance national HHAPs. Tools for pandemic prevention and response are applicable to extreme weather events. The pandemic’s increased digital usage resulted from policy changes and infrastructure investment - leveraging these advancements could prepare Europe for extreme heat threats. Key messages • Results indicate that digital health solutions from COVID-19 can enhance national HHAPs. Tools for pandemic prevention and response are applicable to extreme weather events. • The pandemic’s increased digital usage resulted from policy changes and infrastructure investment - leveraging these advancements could prepare Europe for extreme heat threats.

Asbestos is still paid for dearly

Abstract Background In Italy, asbestos is a current and important problem in terms of health effects due to the long latency of diseases related to its exposure. The aim of the study is to analyze the case history of malignant pleural mesothelioma (MPM) in the University Hospital of Siena in the period 2019-2023, comparing the type of exposure (occupational/non-occupational), the mean conventional latencies (MCL) of diagnosis, the histotype and the most exposed categories. Methods The study was conducted from January to April 2024, on 69 patients (79.7% male and 20.3% female) with a diagnosis of pleural mesothelioma between 2019 and 2023. 48 patients lived in Tuscany and 21 outside the region. The data were collected by consulting the medical surveillance records and radiological images through the VuePacs platform, then organized in a filtered database. Results Of 69 patients, exposure was occupational in 54 cases and non-occupational in the remaining 15. In patients with occupational exposure, the MCL was 55.9 years and the mean age at diagnosis was 73.66 years; in the other group, the MCL was 47.3 years and the mean age at diagnosis was 66.8. The study revealed the prevalence of epithelioid histotype in 76.81% of cases, biphasic in 15.94% of cases and sarcomatoid in 7.25%. The most at-risk categories were: metalworking (10 cases), construction (8), electricity/gas production (6) and shipyards (4). The study also identified two cases of atypical occupational exposure. Conclusions The shorter average latency in cases with non-occupational exposure is in accordance with the current scientific literature, as well as the prevalence of epithelioid histotype. Are hereby confirmed the primary role of health surveillance in the in-depth investigation of occupational anamnesis and of the environmental sites’ survey as prevention tool, especially in those cases of MPM whose evaluation, deviating from the exposure standards, could lead to the assignment of a misdiagnosed exposure. Key messages • The effects of asbestos exposure are a current and important problem in our country, even after its disposal, due to the long latency of disease onset. • In-Department investigation of occupational anamnesis and survey of environmental sites as prevention tool play an essential role in MPM evaluation, especially in those cases of atypical exposure.

The collaborative cross mouse for studying the effect of host genetic background on memory impairments due to obesity and diabetes.

Over the past few decades, a threefold increase in obesity and type 2 diabetes (T2D) has placed a heavy burden on the health-care system and society. Previous studies have shown correlations between obesity, T2D, and neurodegenerative diseases, including dementia. It is imperative to further understand the relationship between obesity, T2D, and cognitive deficits. This investigation tested and evaluated the cognitive impact of obesity and T2D induced by high-fat diet (HFD) and the effect of the host genetic background on the severity of cognitive decline caused by obesity and T2D in collaborative cross (CC) mice. The CC mice are a genetically diverse panel derived from eight inbred strains. Our findings demonstrated significant variations in the recorded phenotypes across different CC lines compared to the reference mouse line, C57BL/6J. CC037 line exhibited a substantial increase in body weight on HFD, whereas line CC005 exhibited differing responses based on sex. Glucose tolerance tests revealed significant variations, with some lines like CC005 showing a marked increase in area under the curve (AUC) values on HFD. Organ weights, including brain, spleen, liver, and kidney, varied significantly among the lines and sexes in response to HFD. Behavioral tests using the Morris water maze indicated that cognitive performance was differentially affected by diet and genetic background. Our study establishes a foundation for future quantitative trait loci mapping using CC lines and identifying genes underlying the comorbidity of Alzheimer's disease (AD), caused by obesity and T2D. The genetic components may offer new tools for early prediction and prevention.

Prediction of mental health risk in adolescents via a smartphone app: a feasibility pilot study

Abstract Background The prevalence of mental health problems in adolescents is a global public health concern. Machine learning (ML) can analyse multidimensional data collected by phone sensors (passive tracking) and symptom self-reporting (active tracking) to model and predict mental health states. However, research in adolescents is lacking. This study investigated the feasibility of using ML to predict mental health in a non-clinical population of adolescents from active and passive data collected through the Mindcraft mobile app. Methods We recruited 103 secondary students (aged 14-18) who first completed the Strengths and Difficulties Questionnaire (SDQ) and then used the Mindcraft app for two weeks. The app integrates sensor data (location, steps, noise, light, battery, app usage) and self-reports. We extracted 85 sensor-based features and 19 from questionnaires to develop a gradient-boosted ensemble ML model. This model identifies students with abnormal SDQ scores and was evaluated using leave-one-out cross-validation. Results All students completed the active questionnaires; 67 also provided passive sensor data. 31 had abnormal SDQ scores. Using passive data, the ML model reached a balanced accuracy of 0.64 and an AUC score of 0.57. Incorporating both data types improved accuracy to 0.67 and AUC to 0.70. Feature importance scores showed step count and questionnaire on racing thoughts and hopefulness as most significant. Conclusions Our findings affirm the potential of integrating passive and active data collection to monitor mental health in real-world settings. Our ML model demonstrated moderate accuracy in predicting adolescents’ mental health risk measured with a behavioural screening questionnaire. This study will guide the development of a ML-driven, personalised mobile intervention for early symptom detection and mental health self-management, which might constitute an innovative and scalable tool for mental health prevention and intervention in adolescents. Key messages • This study shows the feasibility of using active and passive data to predict mental health risk in adolescents. • This study informs the development of a personalised machine learning-driven mobile intervention.

Compliance of eating model of individuals with metabolic syndrome with Bulgarian dietary guidelines

Abstract Background The incidence of metabolic syndrome progressively increases among the urban population of Europe. About 1/3 of the Bulgarian adults have metabolic syndrome. Changing the dietary pattern can be a modern approach to control it. The aim of the study is to investigate the eating model of people with metabolic syndrome according to the Bulgarian dietary guidelines. Methods Two hundred individuals with metabolic syndrome aged 54.6±10.5 y. were randomly selected from general practitioners’ practices in Pleven region, Bulgaria. A Food Frequency Questionnaire method was applied to assess the eating pattern of the respondents. The frequency of food consumption of different foods was compared with the dietary guidelines for the Bulgarian population over 18 years of age. Data were processed with IBM SPSS v. 25. Results Grain consumption met the recommendations in almost all respondents. Only 29% consumed fresh fruits and 42% had intake of milk and milk products according to the requirements. Women ate more fresh vegetables and fruits and dairy products than men (p = 0,032). Risk meat consumption, 2-4 times a week, was found: men preferring more red meat (45%) and women - chicken and poultry (56%). Fish consumption met recommendation (once a week) in only 14.7% of the respondents. The food intake of eggs, vegetables, legumes and nuts were low. The preferred oils were sunflower and olive (once a day by 86% and 15% respectively), and butter (21% - 2-4 times a week). The intake of table salt corresponds to the recommendations in two thirds of the participants. One third consumed confectionery every day. Half did not drink alcohol, but 16% used concentrates once a day. Conclusions Foods that increase the nutritional risk for the development of metabolic syndrome and type 2 diabetes - high consumption of confectionery and red meat, low consumption of vegetables, fish and legumes were found. Unbalanced eating model requires new public initiatives to prevent metabolic syndrome. Key messages • Men with metabolic syndrome have a higher consumption of unhealthy foods than women. • Modern Bulgarian dietary guidelines are an important tool for prevention of metabolic syndrome.

Living with a chronic disease: tertiary prevention tools in asbestos-exposed patients

Abstract Background The main asbestos-related pathology is asbestosis, frequently associated with pleural plaques. The spirometric pattern is mainly restrictive, with reduction in all lung volumes (FEV1, FVC, TLC). Also a reduction in alveolus-capillary diffusion of carbon monoxide (DLCO) may be added, related to the fibrotic process. The aim of the study is to analyze the health surveillance data, correlating the spirometric finding and its variation over time with the clinical and radiological picture. Methods The study is conducted on 372 patients with asbestosis from occupational exposure diagnosed in the period 2017-2023, as part of the Tuscany Region’s program for former asbestos exposures (DGR 396/2016). The investigation is at the second level of surveillance, which includes chest CT and Respiratory Functionality Testing (RFT). Data are obtained from patients’ medical records and processed through a database. Results Out of 372 patients with asbestosis, 213 had pleural plaques (57.25%). Out of those, there is a progressive worsening of RFTs in a restrictive direction (TLC <80%, FEV1/FVC >70%) in 71 patients (33.3%), with a mean TLC loss of 8.7 ± 5.9 mL over subsequent follow-ups on a yearly basis. The FEV1/FVC ratio also declines, with a mean reduction of 5 ± 2.4%. Out of those 71 patients, 14 (19.7%) also show a mean reduction in DLCO of 6.7 ± 5 mL/min/mmHg. The negative trend in RFTs correlates with the worsening clinical and radiological picture attributable to the occurrence of plaques on a fibrotic framework. Conclusions The health surveillance protocol that we adopted has as objective the ascertainment of pulmonary pleura-parenchymal alterations correlated with occupational exposure, investigating their evolution over time through the analysis of spirometric data, and to optimize the management of the functional disability, with a view to the tertiary prevention of patients with asbestos-related disease. Key messages • The negative trend in asbestosis PFRs correlates with the worsening of the clinical and radiological picture attributable to the appearance of pleural plaques on an interstitial fibrosis. • Health surveillance is essential in order to optimize the management of functional disability, with a view to tertiary prevention of patients with asbestos-related disease.

Perceptions of MSM on targeted sexual healthcare about HPV vaccination: a French qualitative study

Abstract Background To improve the effectiveness of public health policies, HPV vaccination campaigns target “high-risk groups”, such as men who have sex with men (MSM). In France, HPV vaccination is recommended for MSM up to the age of 26, rather than 19 for the general population. It’s crucial to assess the impact of such targeting policies on MSM who are eligible for HPV vaccination. Methods A qualitative study was conducted between April and July 2022 among MSM participating in the “Vaccigay” electronic survey in France (Brosset et al. 2023). Participants were selected based on age and declared HPV vaccination status. Semi-structured interviews were conducted by telephone using a thematic grid on the barriers and facilitators influencing the uptake of the vaccine against HPV. The interviews lasted on average 40 minutes. The audio-recorded verbatims were transcribed and thematically analysed using NVivo software. Results A total of 22 viewpoints were analysed. Two opinions emerged without differences in terms of individuals’ profile. The reasons MSM advocated for targeted sexual healthcare stemmed from the recognition of epidemiological factors, as well as the need for greater listening and understanding from healthcare workers. MSM who didn’t support targeted sexual healthcare did so because they felt stigmatised and because sexual orientation might not always be clear. Among them, some advocated for sexual healthcare based on sexual practices rather than sexual orientation. Others emphasized the necessity of extending prevention tools for sexual risks existing for MSM to the general population. Conclusions The findings of this study prompt reflection on universal versus targeted public health policies, as well as sexual and gender discrimination within the healthcare system. We recommend improving healthcare workers’ education on sexual healthcare, and that HPV vaccination guidelines could be extended to all adults up to 26, regardless of their sexual orientation. Key messages • Improving knowledge among healthcare workers and MSM about HPV and sexual health is important. • It is important to extend the age for the HPV vaccination, regardless of sexual orientation.

A single immunization of Borreliella burgdorferi-infected mice with Vanguard crLyme elicits robust antibody responses to diverse strains and variants of outer surface protein C.

Lyme disease, caused by Borreliella burgdorferi and related species, is a growing health threat to companion animals across North America and Europe. Vaccination is an important preventive tool used widely in dogs living in, or near, endemic regions. In this report, we assessed anti-outer surface protein (Osp) A and anti-OspC antibody responses in B. burgdorferi-infected and -naïve mice (C3H/HeN) after immunization with a murine-optimized single dose of the Lyme disease subunit vaccine, Vanguard crLyme. crLyme is comprised of OspA and an OspC chimeritope-based immunogen designated as CH14. Mice that were infected and immunized developed higher levels of anti-OspC antibodies (Abs) than those infected only or that received one vaccine dose. The anti-OspC Abs that developed in the infected/immunized mice bound to all OspC variants tested (n = 22), whereas OspC Abs in serum from infected mice bound predominantly to the OspC variant (type A) produced by the infecting B. burgdorferi strain. Consistent with the absence of OspA expression in infected mammals, none of the infected mice developed Abs to OspA and did not develop anti-OspA Abs after single dose immunization. Lastly, serum from infected/immunized mice displayed significantly higher and broader killing activity than serum from non-immunized infected mice. The results of this study demonstrate that a single vaccination of actively infected mice results in strong anti-OspC Ab responses. This study contributes to our understanding of Ab responses to vaccination in actively infected mammals.

A human model of Buruli ulcer: Provisional protocol for a Mycobacterium ulcerans controlled human infection study.

Critical knowledge gaps have impeded progress towards reducing the global burden of disease due to Mycobacterium ulcerans, the cause of the neglected tropical disease Buruli ulcer (BU). Development of a controlled human infection model of BU has been proposed as an experimental platform to explore host-pathogen interactions and evaluate tools for prevention, diagnosis, and treatment. We have previously introduced the use case for a new human model and identified M. ulcerans JKD8049 as a suitable challenge strain. Here, we present a provisional protocol for an initial study, for transparent peer review during the earliest stages of protocol development. Following simultaneous scientific peer review and community/stakeholder consultation of this provisional protocol, we aim to present a refined protocol for institutional review board (IRB) evaluation.

Seasonal Variability of Human Enteric Viruses Discovered in Food Production Mussels (Mytilus galloprovincialis) Farmed in the Central Adriatic Sea (Italy).

Among the different naked and quasi-enveloped viruses, the hepatitis A virus (HAV), hepatitis E virus (HEV), and norovirus genogroups I and II (NoV GI and NoV GII) are considered the main microbiological noxae involved in foodborne outbreaks. Mussels can harbor pathogens in their tissues. In addition to epidemiological attention, marine water temperature changes are considered a crucial variable influencing viral loads. This study aimed to biomolecularly screen 1775 farmed mussels (Mytilus galloprovincialis) for viral ribonucleic acid (RNA) sequence detection (belonging to the HAV, HEV, and NoV GI and GII genogroups) in three different sampling periods (spring, summer, and winter), with the mussels collected from three farms located in the Central Adriatic Sea (Italy). The results showed that 10.42% of the screened animals harbored at least one type of pathogen RNA, more specifically, 5.35% HEV, 4.51% NoV GI, and 0.56% HAV. The highest genetic equivalent (GE) amounts were majorly observed in the winter season (NoV GI 1.0 × 103 GE/g and HEV 1.0 × 102 GE/g), resulting in statistical differences when compared to summer and spring (p-value: <0.001). The original data obtained serve to bring scientific attention to the possible influence of environmental and climatic aspects on viral loads, highlighting the crucial role played by biomolecular assays as preventive medicine tools.

Comparing ‘fair’ machine learning models for detecting at-risk online gamblers

ABSTRACT Researchers have worked to develop machine learning models that detect at-risk online gamblers, enabling personalized harm prevention tools. However, existing research has not evaluated these models’ potential to reinforce or amplify sociodemographic biases leading to treatment disparity, a recognized issue in the machine learning field. We sought to develop and compare three examples of potentially fair models using online gambling data. In two large samples of transaction data from a provincially owned Canadian gambling website (N1 = 9,145, N2 = 10,716), we developed three machine learning models based on competing concepts of fairness: fairness via unawareness, classification parity, and outcome calibration. We hypothesized that significant relationships existed between reporting a high risk of past-year gambling problems (the dependent variable) and participants’ age and sex. Further, we hypothesized that the three ‘fair’ models would show differing levels of classification performance both in aggregate and within sociodemographic groups. Significant age and sex effects were found, refuting the fairness via unawareness modeling strategy. Superiority across all performance metrics was not present for either of the remaining models. For the fairest practices in any jurisdiction, classification parity and outcome calibration models should be tested in situ, and incorporate the perspectives and preferences of end users who will be affected.

Predictive value of triglyceride glucose index in acute kidney injury in patients with severe traumatic brain injury

Background At present, the relationship between the Triglyceride-glucose index (TyG index) and Acute kidney injury (AKI) in traumatic brain injury patients in the Intensive Care Unit (ICU) is still unclear. Currently, the relationship between TyG index and AKI occurred within 7 days in the ICU is a highly researched and trending topic. Objective In this study, we conducted in-depth exploration of the relationship between the development of AKI in traumatic brain injury (TBI) patients in the ICU and changes in TyG index, as well as its relevance. Methods A cross-sectional study was conducted with a total of 492 individuals enrolled in the Medical Information Mart for Intensive Care IV(MIMIC-IV) database. Multivariate model logistic regression, smoothed curve fitting and forest plots were utilized to confirm the study objectives. The predictive power of the TyG index for outcome indicators was assessed using subject work characteristics (ROC) curves. As well as comparing the Integrated Discriminant Improvement Index and the Net Reclassification Index of the traditional forecasting model with the addition of the TyG index. Results Of all eligible subjects, 55.9% were male and the incidence of AKI was 59.3%. There was a statistically significant difference in the incidence of AKI within 7 days in the ICU between the different TyG index groups. The difference between TyG index and the risk of AKI within 7 days in the ICU remained significant after adjustment for logistic multifactorial modeling (OR = 2.07, 95% CI = 1.41–3.05, P < 0.001). A similar pattern of associations was observed in subgroup analyses (P values for all interactions were greater than 0.05). The addition of TyG index to the traditional risk factor model improved the predictive power of the risk of AKI within 7 days in ICU (P < 0.05). Conclusion The findings of this study demonstrate a strong association between the TyG index and the occurrence of AKI within 7 days in ICU patients. The TyG index can potentially be used as a risk stratification tool for early identification and prevention of AKI. Implementing preventive strategies targeting patients with a high TyG index may help reduce the burden of AKI in the ICU. Further prospective studies are warranted to validate these findings and explore the clinical utility of the TyG index in AKI prevention.

Analysis of Mannose-Binding Lectin Protein and mRNA Levels on Selected Chicken Breeds in South Africa.

Mannose-binding lectin (MBL) is a key component of the innate immune system that plays a crucial role in binding to the microbial sugar surface to recognize and eliminate pathogens by activating the complement system. To detect and quantify the MBL protein concentration and chicken MBL expression in selected chicken breeds in South Africa. Forty-five blood samples from three indigenous chicken breeds, Ovambo (OV=9), Venda (VD=9) and Potchefstroom Koekoek (PK=9), and two exotic chicken breeds, Rhode Island Red (RIR=9) and Lohmann Brown (LB=9), were used for MBL protein concentration using enzyme-linked immunosorbent assay (ELISA) techniques. Also 20 liver samples from symptomatic two indigenous chicken breeds, OV (5) and PK (5), and two exotic chicken breeds, RIR (5) and LB (5), were used for MBL expression using quantitative polymerase chain reaction (qPCR) techniques. A general linear model was done using Tukey's multiple comparison post hoc test. The findings revealed MBL protein concentration from 5.26 to 18.56µg/mL. The LB breed had the lowest mean 6.40±0.80µg/mL, whereas the PK breed had the highest mean MBL concentration of 17.70±0.24µg/mL of MBL protein concentration. At 12, 25 and 35 weeks, the MBL proteins of OV, VD, PK, RIR and LB varied significantly at p≤0.05. The mRNA MBL expression of OV and LB breeds showed a 1-fold decrease in MBL expression, while RIR showed a 2-fold increase in MBL expression, and the PK showed more than a 3-fold increase in MBL expression relative to the control. The least-squares means for OV, LB, PK and RIR mRNA MBL expression were 0.54±0.19, 0.68±0.30, 4.46±2.76 and 2.89±0.19µg/mL, respectively. MBL protein was detected and quantified with distinct differences in concentration and expression levels at the presence of mycoplasma gallisepticum among the sampled South African chicken breeds. This highlights the genetic diversity of MBL as a tool for disease prevention in South African chicken breeds.

EPIZOOTIC LYMPHANGITIS - THE FORGOTTEN DISEASE OF UNGULATES

Epizootic lymphangitis, as a forgotten disease of ungulates, again attracts the attention of veterinarians and zoologists. This infection, caused by pathogenic microorganisms, leads to inflammation of the lymphatic vessels, which can cause serious complications and even death of the animal. Despite the rarity of cases in recent decades, epizootic lymphangitis leaves a significant mark on the history of veterinary medicine, causing alertness among specialists. The purpose of the review. To summarize current scientific data on the etiology, pathogenesis, diagnosis and prevention of equine epizootic lymphangitis in order to assess the risk of introduction and spread of the disease to disease-free territories. Results. The review presents the epidemiological characteristics of the etiological agent of the disease, possible main and intermediate reservoirs of the pathogen in nature, mechanisms of transmission of infection, promising directions for the development of prevention and treatment tools. Conclusion. The causes of epidemics remain a mystery, but the factors contributing to the spread of the disease range from lack of vaccinations to unfavorable conditions of detention. The fight against this disease should be carried out through vaccination, isolation and quarantine of sick animals, disinfection of animal housing and equipment, as well as surveillance.

The Saudi thoracic society guidelines for vaccinations in adult patients with chronic respiratory diseases

Abstract: Adult patients with chronic respiratory diseases (CRDs) are considered high risk group who are more likely to experience worse clinical outcomes if they acquire viral or bacterial infections. Vaccination is the best preventive tool to reduce the risk of infection and disease occurrence and to reduce the level of severity of complications associated with the various vaccine-preventable infections. These guidelines were developed by the Saudi Thoracic Society task force to emphasize the critical importance of improving the vaccine coverage rates in adult patients with CRD. They are intended to serve as a reference for healthcare practitioners managing CRD patients. The guidelines aimed to review the current knowledge related to vaccination efficacy in adult patients with CRD, based on the recent evidence and recommendations. Integrating the administration of the recommended vaccines in routine healthcare, such as during outpatient visits or before hospital discharge, is crucial for improving the vaccination rates in high-risk patients. The key strategies to address this public health priority include simplifying vaccination guidelines to enhance their accessibility and implementation by healthcare providers, increasing awareness in both the patients and healthcare providers that vaccines are not only intended for children. Additional strategies include maintaining continuous surveillance and advance research to discover novel vaccines. This approach aims to expand the range of preventable diseases and improve overall health and well-being. Vaccine hesitancy remains a significant challenge that necessitates a clear understanding of the community concerns. Providing appropriate education and communication, as well as addressing these concerns, are the crucial steps toward improving vaccine acceptance and uptake. By implementing these guidelines and multifaceted strategies, healthcare systems can optimize vaccine coverage and protection for patients with CRD, reduce the burden of vaccine-preventable complications, and improve the clinical outcomes in this vulnerable population.

“Validation of three scales for enhanced suicide prevention in Spanish-speaking populations: Suicidal ideation, stigma, and literacy”

BackgroundEscalating suicide rates in Spain and Latin America underscore the critical need for accurate assessment and prevention tools tailored to these populations. This study aimed to culturally adapt and validate three essential scales: the Suicidal Ideation Attributes Scale (SIDAS), the Suicide Stigma Scale - Short Form (SOSS-SF), and the Suicide Literacy Scale - Short Form (LOSS-SF). MethodA total of 678 participants (including 150 with suicidal ideation) completed an online survey. The scales underwent rigorous back-translation and adaptation by native speakers from Spain and Latin America. SIDAS and SOSS-SF were validated using Confirmatory Factor Analysis (CFA), with criteria including fit indices (e.g., RMSEA, CFI). LOSS-SF underwent validation through Item Response Theory (IRT). Additionally, gender invariance was assessed across all scales. ResultsCFA confirmed the original factor structures of SIDAS and SOSS-SF, demonstrating good fit indices and internal consistency. The analysis of LOSS-SF required excluding two items, resulting in a final Spanish version with 10 items and an unifactorial structure. Gender invariance was established across all scales. ConclusionsThe culturally adapted and validated scales in this study demonstrate robust reliability and validity for assessing suicidal ideation, suicide stigma, and suicide literacy among Spanish-speaking populations. These validated tools have the potential to enhance clinical assessment, inform personalized interventions, monitor public health initiatives, educate communities about suicide, and advance research in suicide prevention and treatment.

Human Trafficking Dynamics and Prevention Efforts as an Outcome of Russia’s War on Ukraine

Abstract Debates on the connection between human trafficking and war have been discussed in wars and conflicts across the globe. Russia’s war on Ukraine has brought this relationship to the forefront again, questioning whether trafficking flows have increased, examining the types of trafficking in war, and determining the conditions (if any) that make it flourish. This article examines human trafficking in Ukraine before the war and during limited and total war to determine how governments with robust anti-trafficking institutions negotiate anti-trafficking responses over different stages of war. The main research question of this study aims to determine how different stages of the war in Ukraine have changed human trafficking dynamics and responses over time. Using data from interviews and participant observations from Ukraine, I analyze the different types of human trafficking characteristics and flows, conditions that create vulnerabilities, and prevention tools that have been used in different periods. I theorize that war fundamentally alters human trafficking prevention but a foundation of prevention tools before war means that governments are better able to respond to human trafficking dynamics and flows when war occurs. Ukraine offers a unique and important perspective from which to examine human trafficking dynamics and the consequences of war due to a stable government, external aggressor, and clear path for those fleeing the violence to the European Union. The results show that Ukraine’s strong prevention efforts before the war helped shape responses after the war and full-scale invasion began. The data revealed that human trafficking is a longer-term form of gender-based violence in war because the exploitation is prolonged and there is a delay in identifying victims.

Identifying and supporting vaccine champions in pediatric primary care: a qualitative interview study.

Implementation science research identifies clinical champions as instrumental in aligning healthcare professionals' (HCPs) behavior with practice guidelines for delivering health services, including vaccinations. However, we know relatively little about identifying or supporting champions. To characterize who vaccine champions are, what they do, and how to support their work in pediatric primary care. In 2022, we interviewed a purposive sample of peer-nominated or self-identified vaccine champions (n=20) and HCPs who worked with vaccine champions (n=4). We thematically analyzed qualitative data. Vaccine champions' defining characteristics were firsthand primary care experience, whether as providers or nursing staff, and a strong belief in vaccinations as uniquely effective tools for primary prevention. Participants noted these beliefs were "part of the DNA" of specialties like pediatrics and infectious disease, where they perceived champions as especially common. Being "insatiable in their quest for knowledge," champions primarily conceptualized their role as understanding and sharing complex information and performance metric data related to vaccine administration. Champions' role in leading other implementation strategies, such as communication training, was more peripheral. Champions reported that dedicated time and staff support helped them "go above and beyond" to improve vaccination rates. Our findings suggest that vaccine champions can be found among providers and nursing staff with deep clinical experience and commitment to primary prevention through vaccination, including through providing vaccine education to colleagues. Healthcare systems can allocate resources to support champions as educators, while exploring opportunities to extend their role in other implementation strategies to improve vaccination rates.

Human Fall Motion Prediction: Fall Motion Forecasting and Detection with GRU

The human fall motion prediction system is a preventive tool aimed at reducing the risk of falls. In our research, we developed a deep learning model that utilizes pose estimation to track human body posture and integrated this with a Gated Recurrent Unit (GRU) to forecast human motion and predict falls. GRU, an enhancement of Recurrent Neural Network (RNN) and Long Short-Term Memory (LSTM) models offers improved memorization and more efficient memory usage and performance. Our study presents the human fall motion prediction, which combines the forecasting and classification of potential falls.The CAUCAFall dataset is used as the benchmark of this study, which contains the image sequences of single human motion with ten actions conducted by ten actors. We employed the YOLOv8 Pose model to track the 2D human body pose as the input in our system. A thorough evaluation of the CAUCAFall dataset highlights the effectiveness of our proposed system. Evaluation using the CAUCAFall dataset demonstrates that the model achieved a Mean Per Joint Position Error (MPJPE) of 4.65 pixels from the ground truth, with a 70% accuracy rate in fall prediction. However, the model also exhibited a Mean Relative Error (MRE) of 0.3, indicating that 30% of the predictions were incorrect. These findings underscore the potential of the GRU-based system in fall prevention

Potential association between mobile phone usage duration and postpartum depression risk: Evidence from a Mendelian randomization study

The widespread adoption of mobile phones in daily life has raised concerns regarding their impact on mental health, including among postpartum women. Considering the rising prevalence of postpartum depression (PPD) and the pervasive use of mobile phones in modern society, this study aimed to rigorously investigate the causal relationship between mobile phone use duration and the risk of developing PPD. Data were collected through an online survey assessing mobile phone usage and mental health among postpartum women. The survey’s reliability and validity were evaluated using Statistical Package for the Social Sciences software. In total, 2015 participants completed the survey. To explore causal relationships, genetic data were sourced from open-access databases, and two-sample Mendelian randomization (MR) techniques were employed. Statistical analysis, including chi-square tests, revealed a significant association between higher mobile phone use and lower incidence of PPD. MR analysis supported these findings, indicating a protective effect of mobile phone use against PPD (P &lt; .05 based on inverse variance weighting and the weighted median method). This MR-based study provides evidence that increased mobile phone use is associated with a decreased risk of PPD, suggesting that mobile phones could serve as an effective tool for PPD prevention. These findings highlight the importance of evidence-based evaluations of lifestyle factors in mental health research.