Uncertain Health Research Articles

Resilience-oriented passenger subsidy design for taxi travel under pandemic control

Summarizing historical pandemic control experience can help the government better cope with the impact of uncertain public health events on taxi industry. This paper presents a summary of the relationship between various pandemic control measures and taxi system from the perspective of travel resilience. Additionally, we investigate the effectiveness of passenger subsidy schemes in improving the taxi travel resilience. To achieve these objectives, our research follows these steps: Firstly, we analyze the impact of different pandemic control measures on the performance variation curves of the taxi travel system. Secondly, using the travel resilience calculation formula, we evaluate the taxi travel resilience levels under different pandemic control measures and analyze other factors (such as virus characteristics) on taxi travel resilience through regression models. Finally, we construct a taxi travel resilience improvement model. Aiming at maximizing the social benefits which consider taxi travel resilience, we search for the optimal passenger subsidy result. And then make a comparison for two distinct subsidy types: fixed-amount and fare subsidy rate. Taking Ningbo city, China as a case study, the research findings demonstrate: (1) The ranking order of each pandemic control measure based on taxi travel resilience performance from low to high are as follows: city-wide lockdown control measure, district-wide lockdown control measure, targeted epidemic control measure, and fully lifted control measure. These findings suggest that a reduction in the scope and duration of pandemic control measures can maintain a high level of taxi travel resilience. (2) In addition to pandemic control measures, the virus’s incubation period and infectivity have a significant impact on travel resilience. (3) Model results show that increasing passenger subsidies can quickly improve taxi travel resilience, but it cannot guarantee a consistent increase in social benefits. When the weight of travel resilience in the objective function is small, social benefits will initially increase and then decrease with higher passenger subsidy amounts. In such cases, the extreme value method can help determine the optimal passenger subsidy amount. (4) When decision-makers focus on improving taxi travel resilience, they can adopt the fixed amount subsidy scheme. When the focus is on maximizing social benefits, the fare subsidy rate scheme should be chosen.

The role of health shocks after age 70 on housing and wealth profiles.

We conduct a novel investigation into the effects of uncertain health shocks and medical costs on the life cycle consumption, housing, and saving decisions. Our model aids in understanding the role of health shocks and medical costs after age 70 in explaining the lack of wealth and housing decumulation during retirement. We utilize a comprehensive life-cycle model that includes housing, as well as shocks to house price, labor income, and health. Our model could be useful for policy evaluation and future studies concerning older adults. Our first contribution to the previous literature is modeling the whole adult life-cycle. This enables us to determine whether decisions in youth and middle age are influenced by anticipated health shocks in old age. Our second contribution is modeling housing explicitly with health shocks. Conclusions regarding the savings puzzle may be significantly influenced by the explicit modeling of housing. We develop a more realistic model by relaxing some of the assumptions made in previous studies. We find that health shocks motivate the household to accumulate higher wealth before retirement. Moreover, as health shocks become more severe, individuals reduce their consumption and decumulate less wealth in old age. Health shocks help explain the flat trends observed in the housing and wealth profiles of older adults. The possible health shocks after age 70 affect the decisions in young and middle ages only marginally. The wealth profile in middle and old age is affected by health shocks.

Alleviation of ulcerative colitis via curcumin-fortified orange juice: Utilization of orange-derived extracellular vesicles as active nanocarrier

There is evidence that consumption of fruit and vegetable juices may alleviate ulcerative colitis. However, their application is limited because of their relatively weak and uncertain health benefits. In this study, curcumin-fortified orange juice (Cur-OJ) was produced using orange extracellular vesicles as natural active nanocarriers. The concentration, composition, morphology and size of extracellular vesicles were first determined. It was shown that curcumin was incorporated into the lipid bilayer of extracellular vesicles in an amorphous form. The influences of oral administration of Cur-OJ on DSS-triggered colitis mice was evaluated. Cur-OJ reduced the pathological symptoms in mice, affected the expression of inflammatory cytokine, and improved the integrity of the colon tissue through enhancing the levels of three tight junction proteins. The gut microflora and colonic metabolites of colitis mice in Cur-OJ group were close to those in control group. Noticeably, the treatment of colitis was better in the Cur-OJ group than those in curcumin or orange juice groups, suggesting that curcumin and orange juice can work together to relieve colitis symptoms. In summary, this study showed that Cur-OJ can reduce colitis, which may be useful for the progress of novel functional fruit or vegetable juice and foods designed to improve body health and human wellbeing.

Participation in eHealth Communication Interventions Among Patients Undergoing Hemodialysis: Scoping Review.

eHealth communication interventions have been shown to offer individuals with chronic kidney disease the opportunity to embrace dialysis therapies with greater confidence, the potential to obtain better clinical outcomes, and an increased quality of life. eHealth is an emerging field that offers diverse, flexible designs and delivery options. However, existing evidence on eHealth communication among patients undergoing hemodialysis is sparse and scattered and lacks systematization. This scoping review aims to identify and map the current evidence on patient participation in eHealth communication interventions. We aimed to map the associations between interventions and electronic health records, the participative role of individuals living with chronic kidney disease and undergoing hemodialysis, and the barriers to and facilitators of patient involvement in eHealth communication with health care professionals. This study used the Joanna Briggs Institute methodology for conducting a scoping review. Studies eligible for inclusion were those that included adult patients (aged >18 y) undergoing all types of hemodialysis, including prescheduled in-center hemodialysis and conventional home-based hemodialysis. Systematic searches were completed in Ovid MEDLINE, Ovid Embase, EBSCOhost CINAHL with Full Text, Scopus, and ProQuest Dissertations and Theses. Extracted data from the included studies were presented in figures and tables along with descriptions that responded to the research questions. This review was reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. In total, 9 peer-reviewed studies were included. The main result was a low participative patient role and a vaguely described link to electronic health records. The key participative facilitators were availability of and access to the intervention; security, trust, and confidence; patient knowledge of their health situation and use of self-care; and patient preparedness for an uncertain future health situation and the ability to relate to family and friends about it. The key participative barriers were lack of availability of and access to information, mistrust and lack of safety, lack of knowledge of health situation and self-care, and relational issues. All barriers and facilitators were related to health literacy. This scoping review summarizes 4 specific and 3 nonspecific eHealth communication interventions developed and evaluated in various studies involving patients receiving hemodialysis. A knowledge gap exists between low levels of patient participation in eHealth communication and patients' limited access to electronic health records. eHealth communication interventions should implement patient participation and focus on the fact that different modalities of eHealth communication can complement face-to-face communication. RR2-10.2196/38615.

Intelligent prediction for remaining life of aero-engine --A Study on CNN-BiLSTM Model Based on Scores Loss Function

With the advent of the era of big data and artificial intelligence, predicting and managing the remaining service life of aero-engines has become a key challenge, which has a direct impact on the enhancement of autonomous control capabilities. In this paper, a new deep learning model combining a one-dimensional convolutional neural network (1D-CNN) and a bidirectional long and short-term memory network (BiLSTM) is proposed to efficiently handle dynamic and uncertain engine health state data. The concurrent model takes full advantage of 1D-CNN in extracting local features and BiLSTM in capturing time-dependence, avoiding the loss in the information transfer process in conventional models. Empirical studies on NASA's C-MAPSS dataset show that the model significantly improves the accuracy and robustness in predicting the remaining service life, reducing the RMSE by up to 5.05% and the Scores by up to 54.89% compared to the conventional model. Especially in the short-term prediction task, the model shows higher stability and accuracy, which provides strong support for advance warning in the field of aviation safety.

Experiences and Understanding of Well-Being in Lung Transplant Recipients in China: A Phenomenological Qualitative Study.

To explore lung transplant recipients' perceptions of well-being when they are facing uncertain health outcomes, including identifying the factors to enhance well-being. A qualitative descriptive study. A purposive sample of 11 lung transplantation recipients who were hospitalised in the Department of Organ Transplantation of a tertiary university hospital was recruited in China. A descriptive qualitative study using thematic analysis of semistructured interviews. Themes were organised within a PERMA model. Colaizzi's qualitative analysis was used to analyse the data. Five major themes and 11 categories were generated: (1) mindset shift [optimism and hope and living in the moment]; (2) meaning in life [self-care, priority change and value realisation]; (3) health benefits [improved health and behavioural changes]; (4) perceived support [support from family, the health care team and others]; (5) unmet support needs. Lung transplant recipients could perceive well-being from five aspects that caused significantly favourable transformation across a variety of aspects in patients' lives. These findings may support nursing staff when caring for this patient group, making them aware of multifaceted nature of well-being. They could offer insight into potential pathways for the development of nurse-led tailored interventions, based on specific elements of PERMA model. This work adds to a growing body of knowledge about well-being amongst lung transplant patients. These findings may support nursing staff when caring for this patient group, making them aware of multifaceted nature of well-being and illustrating factors that promote positive well-being in this group, based on specific elements of PERMA model. This study followed the Consolidated Criteria for Reporting Qualitative Research checklist. Two lung transplant recipients were involved in the early phases of this study. They helped in formulating the interview outline.

A novel sodium caseinate lipid-based auto-emulsifying delivery system to increase resveratrol intestinal permeation: Characterization and in vitro assessment

In recent years, nutraceuticals have emerged as a promising strategy for maintaining health and represent a high-growth market in Italy and across Europe. However, the lack of strict regulations regarding formulation requirements and proof of efficacy raises serious concerns about their poor bioavailability and, consequently, their uncertain health benefits. An emblematic example is t-resveratrol (RES), a cardioprotective stilbene polyphenol that undergoes extensive metabolism in the intestine and liver, resulting in a bioavailability of <1 %.This manuscript describes a novel technological matrix developed with the primary goal of improving RES oral bioavailability. This technology can be classified as a lipid-based autoemulsifying drug delivery system (LIBADDS), in which RES is thoroughly solubilized in a hot liquid phase composed of lipids and surfactants, and the mixture is further adsorbed onto a powder composed of polysaccharides and sodium caseinate (NaC), along with inert excipients, and then compressed.In this study, NaC was used for the first time to trigger pancreatin-mediated hydrolysis of an enteric-coated tablet, allowing micellar delivery of RES to the small intestine. The RES-containing tablets were characterized via differential scanning calorimetry (DSC) and X-ray diffraction (PXRD). The digested formulation, with simulated gastric and enteric fluids, was dimensionally assessed via dynamic light scattering (DLS). Finally, calculations of the bioaccessible fraction, dissolution tests, and in vitro permeability experiments using Caco-2 cell monolayers were carried out to preliminarily define the overall efficiency and applicability of this new technology in improving RES intestinal permeability.

Immunomodulatory Effects of Statins in the Treatment and Prophylaxis of Influenza Viruses

Background and aim: Influenza, commonly referred to as "the flu," is an infectious illness caused by influenza viruses (IV). Despite the availability of efficient antiviral drugs, the IV still significantly increases mortality. Antiviral drugs swiftly remove these viruses from pulmonary secretions, suggesting that a prolonged inflammatory response may be to blame for the poor result. Therefore, using immunomodulatory medications looks advantageous. Numerous anti-inflammatory effects are produced by statins. Numerous retrospective studies recommended that statins be considered for IV therapy. This study set out to comprehensively examine the immunomodulatory potential of statins in IV prophylaxis and therapy. Methods: From the beginning until 25 March 2022, a number of electronic databases (Scopus, EMBASE, PubMed, Web of Science, ProQuest, OVID, EBSCO, and CINAHL) were searched for cohort studies and randomized trials assessing the association between outcomes or risk of infections and statin therapy. Data were gathered on the investigated characteristics, measuring statin usage, quality evaluation, and results (set for potential confounders). Results: Finding additional therapeutic agents for influenza prevention and management is crucial since there are uncertain public health issues regarding the clinical efficacy of conventional medications. Pro-inflammatory cytokines are released as a result of influenza. According to the results, by using anti inflammatory medications, severe influenza infections can be prevented along with pleiotropic effects. As a result, statins, which are cardioprotective medications with immunomodulatory and anti-inflammatory properties, may be beneficial for individuals with IV. Conclusion: Based on the positive immunomodulatory effects of statin administration, our systematic review's findings suggested that IVs may be prevented and treated.

Smoking Cessation Tools in the Urological Context: Considering the Genitourinary Impacts of Smoking Cessation Tools

Electronic cigarette use is rising globally. Although it may represent a potential smoking cessation tool, amidst misinformation and social media promotion, there is a growing concern regarding the health risks associated with its usage. These risks include adverse effects on the genitourinary system. This commentary investigates the genitourinary effects of approved smoking cessation tools versus electronic cigarettes, urging urologists to prioritize established methods over electronic cigarettes due to their potential for multisystem toxicity and uncertain long-term health implications. Further research is warranted to evaluate comprehensively the genitourinary effects of these interventions.

Integrated optimization of facility location, casualty allocation and medical staff planning for post-disaster emergency response

PurposeDisaster management and humanitarian logistics (HT) play crucial roles in large-scale events such as earthquakes, floods, hurricanes and tsunamis. Well-organized disaster response is crucial for effectively managing medical centres, staff allocation and casualty distribution during emergencies. To address this issue, this study aims to introduce a multi-objective stochastic programming model to enhance disaster preparedness and response, focusing on the critical first 72 h after earthquakes. The purpose is to optimize the allocation of resources, temporary medical centres and medical staff to save lives effectively.Design/methodology/approachThis study uses stochastic programming-based dynamic modelling and a discrete-time Markov Chain to address uncertainty. The model considers potential road and hospital damage and distance limits and introduces an a-reliability level for untreated casualties. It divides the initial 72 h into four periods to capture earthquake dynamics.FindingsUsing a real case study in Istanbul’s Kartal district, the model’s effectiveness is demonstrated for earthquake scenarios. Key insights include optimal medical centre locations, required capacities, necessary medical staff and casualty allocation strategies, all vital for efficient disaster response within the critical first 72 h.Originality/valueThis study innovates by integrating stochastic programming and dynamic modelling to tackle post-disaster medical response. The use of a Markov Chain for uncertain health conditions and focus on the immediate aftermath of earthquakes offer practical value. By optimizing resource allocation amid uncertainties, the study contributes significantly to disaster management and HT research.

4.F. Workshop: Supporting present policy making to address future challenges: foresight and public health policies

Abstract The COVID-19 pandemic and its impact on health showed that we were not prepared for uncertain health events and its uncertain consequences and impact in society. To be prepared for the uncertainty of the future, foresight provides a systematic, participatory, and vision-building process that explores the future to anticipate trends and support present-day actions. Foresight explores possible futures and their impact on society and population health. Foresight can enable better informed present-day decision-making and thereby better short-term and long-term preparedness in European Union (EU) Member States (MS) and the European region for possible future health crises. With foresight, experts and policy makers can explore long-term decisions that need to be made in the present to be prepared for the future. Using foresight to formulate long-term decisions can allow setting priorities, planning budgets and spending to address health threats and challenges, and learning how to cope with challenges while keeping resilient and sustainable health systems. In this workshop, we will focus on how foresight can be integrated into the policy cycle to support policy makers to be prepared for the future. It will provide an outlook on how a foresight exercise can provide insights into future challenges to provide recommendations and explore policy implications. The workshop will start with an interactive Mentimeter session to get a better view on how the audience is familiar with foresight in the policy cycle. Then, a brief presentation is given as introduction to foresight and its role in policy making. This is followed by a presentation of a Foresight study that provides recommendations for policy makers to address present and future challenges related to mental health. The second foresight study provides an example on how digitalization in primary healthcare can address present and future challenges. The last presentation gives an overview on the role that foresight can play in the policy cycle at different stages of the foresight exercise when discussing the use of personalized medicine in cancer prevention. The workshop will be concluded by a discussion with the four presenters on the lessons learned regarding foresight and policy making. Key messages • Foresight provides a systematic and participatory process to support policy making towards sustainable and resilient health systems. • Foresight can enable better informed present-day decision-making towards better short- and long-term preparedness in the European region and its Member States for possible future health challenges.

"Too Many Jobs and Not Enough Hands": Immigrant and Refugee Community Health Workers at the Frontlines of the COVID-19 Pandemic.

Refugees and immigrants have experienced heightened health inequities related to COVID-19. As community-embedded frontline health personnel, refugee and immigrant community health workers (riCHWs) played essential roles in the provision of informational, instrumental, and emotional support during the unprecedented first year of the pandemic. Despite the importance of this workforce, riCHWs are at high risk for burnout due to low recognition and demanding workloads. This was exacerbated as riCHWs navigated a new and uncertain health delivery landscape. We sought to glean insight into riCHWs' stressors, coping strategies and resources, and self-efficacy to identify ways to support their work and wellbeing. Using a narrative inquiry approach, we conducted semi-structured, in-depth interviews with 11 riCHWs working in a midsized city in the midwestern United States. We generated three distinct yet interrelated themes: (1) Rapid and trustworthy information is key, (2) Creativity and perseverance are good … structural support is better, and (3) Integrating riCHW expertise into health promotion programming and decision-making. Although riCHWs were deeply committed to enhancing community wellbeing, quickly shifting responsibilities in tandem with structural-level health inequities diminished their self-efficacy and mental health. riCHWs relied on work-based friends/colleagues for informational and emotional support to enhance their capacity to deliver services. Findings suggest increasing opportunities for peer support and idea-exchange, professional development, and integration of riCHW expertise in health promotion decision-making are effective strategies to enhance riCHWs' professional self-efficacy and personal wellbeing.

Macroeconomic consequences of alternative reforms to the health insurance system in the United States

AbstractThis paper presents a dynamic general equilibrium model designed to examine the macroeconomic effects and welfare implications of alternative reforms to the US health insurance system. Specifically, it scrutinizes the extent to which health care reform can mitigate inefficiencies stemming from market imperfections in the health insurance industry. The model considers a stochastic overlapping generations framework, incorporating heterogeneous agents who are subject to uncertain health shocks. These individuals make optimal decisions regarding labor supply, health insurance, and medical services. Given that the optimal levels of medical consumption and hours worked are endogenous, this setting encapsulates general equilibrium effects. The model is calibrated to US data, and numerical simulations suggest that suitable adjustments to the present health insurance system can broaden coverage and enhance welfare. This improvement is achieved by reducing adverse selection, improving overall health status, and lessening tax distortions on labor supply.

Exposure and Health Risk Assessment of Heavy Metal in Crayfish from the Middle and Lower Reaches of the Yangtze River.

Red swamp crayfish (Procambarus clarkia) is an exposed species to heavy metals due to their lifestyle of direct contact with sediments. Based on the complete crayfish industry, we focus on the presence of heavy metals in crayfish from different circulation links, which provides a new idea for the investigation of heavy metals in food. To analyze the exposure levels of heavy metals in crayfish during aquaculture and circulation, the five elements (Cd, Pb, Hg, Cr, Cu) in crayfish from 126 sampling sites were investigated. Cultured environmental samples were collected for Spearman correlation analysis. Monte Carlo simulation was used to analyze the uncertain health risks of heavy metals in crayfish. The results indicated that the average heavy metal concentrations in crayfish were all below the limit threshold values. The hepatopancreas was the main target organ for heavy metal accumulation (Cd: 0.3132mg/kg; Pb: 0.0258mg/kg; Hg: 0.0072mg/kg; Cr: 0.1720mg/kg; Cu: 10.6816mg/kg). The positive correlation of heavy metal content between crayfish and sediments was not significant under the crayfish-rice coculture model. The 95th HI values for adults and children ranged from 0.022 to 0.042 and 0.071 to 0.137, well below 1, indicating that heavy metals do not pose a noncarcinogenic risk to humans. The potential carcinogenic risk of Cd and Cr in crayfish should be taken seriously, as the 95th CR values for children have reached 4.299 × 10-5 and 6.509 × 10-5, respectively.

The Use of a Single-Time Sit-To-Stand Test in Ambulatory Individuals With Spinal Cord Injury by Primary Health Care Providers.

The uncertain health care situations, such as that created by the COVID-19 pandemic, has limited hospital access and facilitated a paradigm shift in health care toward an increased demand for standard home visits and community-based rehabilitation services, including by ambulatory individuals with spinal cord injury (SCI). This 6-month prospective study explored the validity and reliability of a single-time sit-to-stand (STSTS) test when used by primary health care (PHC) providers, including a village health volunteer, caregiver, individual with SCI, and health professional. Eighty-two participants were assessed for the STSTS using four arm placement conditions (arms on a walking device, arms on knees, arms free by the sides, and arms crossed over the chest) and standard measures, with prospective fall data follow-up over 6 months. Thirty participants involved in the reliability study were also assessed and reassessed for the ability to complete the STSTS conditions by PHC providers. Outcomes of the STSTS test, except the condition with arms on a walking device, could significantly discriminate lower extremity muscle strength (LEMS) and mobility of the participants (rpb = -0.58 to 0.69) with moderate concurrent validity. Outcomes of the tests without using the arms also showed moderate to almost-perfect reliability (kappa = 0.754-1.000) when assessed by PHC raters. The findings suggest the use of an STSTS with arms free by the sides as a standard practical measure by PHC providers to reflect LEMS and mobility of ambulatory individuals with SCI in various clinical, community, and home-based settings.

Pollution Characteristics and Risk Assessment of Polycyclic Aromatic Hydrocarbons in Agricultural Soils of Different Land Use Types in Nanjing Suburbs

In order to clarify the pollution characteristics of PAHs in suburban agricultural soils, the content of 16 types of PAHs was measured in agricultural soils with different land use types (paddy fields, vegetable fields, and forest land) in the suburbs of Nanjing. The results showed that acenaphthene (Acy) was not detected in any soil samples. The concentration of 15 PAHs in agricultural soil in suburban Nanjing ranged from 24.49 to 925.54 μg·kg-1, with an average concentration of 259.88 μg·kg-1. In different land use types, the order of PAHs concentration in soil from high to low was:forest land>paddy fields>vegetable fields, and the high-ring PAHs content was dominant in general. The effects of different soil physicochemical properties on PAHs showed that there was a certain correlation between soil organic carbon (TOC) and clay (clay) content and PAHs, whereas pH and total nitrogen (TN) had no significant correlation with PAHs. The toxic equivalence method and CSI index method were used for ecological risk assessment, which showed that the ecological risk of PAHs in agricultural soils in suburban Nanjing was relatively small; however, the ecological risk of PAHs in forest land should be given some attention, and supervision should be strengthened. Health risk assessment using incremental lifetime cancer risk (ILCR) showed that the threat to the health of children was slightly greater than that of adults, and the CR of forest land was significantly higher than that of vegetable and paddy fields, though still within an acceptable range. Uncertain health assessments were performed in adults, showing that risk analyses of deterministic health risks underestimated the health risks of PAHs. The results of sensitivity analysis showed that the input parameter that had the greatest impact on the total variance of the total carcinogenic risk CR was the exposure frequency EF (50.7%), followed by the pollutant concentration CS (43.3%).

Indoor and outdoor air quality impacts of cooking and cleaning emissions from a commercial kitchen.

Gas and particulate emissions from commercial kitchens are important contributors to urban air quality. Not only are these emissions important for occupational exposure of kitchen staff, but they can also be vented to outdoors, causing uncertain health and environmental impacts. In this study, we chemically speciated volatile organic compounds and measured particulate matter mass concentrations in a well-ventilated commercial kitchen for two weeks, including during typical cooking and cleaning operations. From cooking, we observed a complex mixture of volatile organic gases dominated by oxygenated compounds commonly associated with the thermal degradation of cooking oils. Gas-phase chemicals existed at concentrations 2-7 orders of magnitude lower than their exposure limits, due to the high ventilation in the room (mean air change rate of 28 h-1 during operating hours). During evening kitchen cleaning, we observed an increase in the signal of chlorinated gases from 1.1-9.0 times their values during daytime cooking. Particulate matter mass loadings tripled at these times. While exposure to cooking emissions in this indoor environment was reduced effectively by the high ventilation rate, exposure to particulate matter and chlorinated gases was elevated during evening cleaning periods. This emphasizes the need for careful consideration of ventilation rates and methods in commercial kitchen environments during all hours of kitchen operation.

Fast-screening flow cytometry method for detecting nanoplastics in human peripheral blood

Plastic pollution is a global problem. Animals and humans can ingest and inhale plastic particles, with uncertain health consequences. Nanoplastics (NPs) are particles ranging from 1 nm to 1000 nm that result from the erosion or breakage of larger plastic debris, and can be highly polydisperse in physical properties and heterogeneous in composition. Potential effects of NPs exposure may be associated with alterations in the xenobiotic metabolism, nutrients absorption, energy metabolism, cytotoxicity, and behavior. In humans, no data on NPs absorptions has been reported previously. Given that their detection relies significantly on environmental exposure, we have prospectively studied the presence of NPs in human peripheral blood (PB). Specifically, we have used fluorescence techniques and nanocytometry, together with the staining of the lipophilic dye Nile Red (NR), to demonstrate that NPs can be accurately detected using flow cytometry.•Potential effects of nanoplastics exposure.•Fluorescence techniques and nanocytometry.•Accurate detection using flow cytometry.

Patient care after heart transplantation - a case study

Heart transplantation is a recognized and effective method of treating end-stage heart failure. Complicated heart transplant surgery carries a high surgical risk as well as complications that are dangerous to life and health. Transplantation is a life-saving opportunity for patients who have run out of alternative treatments. Patients with heart transplants face many physical and psychological problems every day.&#x0D; The aim of the work was to discuss the care problems of a patient 3.5 years after the heart transplantation procedure.&#x0D; Material and methods: The study used a research method - an individual case study, in which the interview technique, observation, analysis of medical documentation and measurement of vital parameters were used.&#x0D; Results: After the interview, observation and analysis of medical records and as a result of the measurements made, the patient was diagnosed with nursing problems, including such as: increased susceptibility to infections that may pose a serious threat to the life and health of the patient caused by the weakening of the immune system by immunosuppression, anxiety and fear related to the risk of rejection of a transplanted organ and mood instability resulting from uncertain health situation and the effects of immunosuppressive drugs, physical limitations related to with previous operations.&#x0D; Conclusions: Despite the passage of time, the patient after heart transplantation still feels the fear of a sudden deterioration of his health, the occurrence of side effects of the implemented treatment, and to the greatest extent his organism rejects the transplanted organ. Educating the patient, caring for it and keeping track of his health condition makes him feel more confident and at ease. The quality of life of the patient after transplantation can be significantly improved thanks to discipline and properly conducted self-care and self-care.

Utilizing the Internet of Things (IoT) to address uncertain home health care supply chain network

Generally, Home Health Care (HHC) consists of a medical team that serves patients in their own homes and carries out various medical services, such as taking biological samples and administering medicine. Aging trends in developing countries, and the growing tendency of the elderly to receive healthcare services in their own homes, leads to increasing demand for such services that outgrow those available in hospitals, healthcare personnel, and other resources. Therefore, HHC services and their associate demand rates are increasing dramatically. A major opportunity normally ignored in this regard is the applicability of the Internet of Things (IoT) systems to facilitate this practice. In this work, a two-phased approach is proposed to 1) identify the potential patients and 2) collect their biological samples and send them to be analyzed. Green Split Pick-up Vehicle Routing Problem (GSPVRP) and IoT concept are employed to address the patients in both sub-models. The proposed model is investigated by data from a real-world case study in Montreal, Canada, and solved using four multi-objective metaheuristic algorithms. An extensive analysis of the results revealed that utilizing the IoT system contributes to maximizing the overall occupancy rate of the vehicles and can effectively optimize the number of trips, hence minimizing total costs and greenhouse gas emissions.