Appadurai Daniel Reegan, Sam Joy, Purushotham Jambulingam
et al.
Abstract Background Vector-borne diseases remain a major global health problem, mostly in tropical and subtropical areas. Effective vector control is crucial for controlling vector borne diseases (VBDs). Over the years various vector control tools and strategies have been employed globally. However, the recent challenges including insecticide-resistant, alterations in vector behaviour, and non-target effects have highlighted the need for novel vector control tools and alternate strategies. One such tool is the Attractive Targeted Sugar Baits (ATSBs), which uses the sugar-seeking habit of adult mosquitoes. The ATSB strategy operates on an “attract and kill” approach, where mosquitoes are lured to the bait and to feed on sugar combined with an insecticide. For this, a standard methodology needs to be developed for a uniform evaluation of ATSBs. Results The ATSB vector control strategy has shown promising results in studies carried out in various parts of Africa and the Middle East on controlling populations of mosquito species. Although numerous experiments have been conducted and are ongoing in various countries, there remains a lack of standardized guidelines for evaluating ATSBs. In 2023, the ICMR along with partners drafted the 3rd edition of Common Protocols for evaluating public health vector control products. The revised edition included a trial methodology for ATSB. Taking this into consideration, the phase-wise standard methodology is presented in this review for the uniform evaluation of different formulations/products of ATSBs. Conclusions The methodologies, outlined in this article will serve as the standard methodology for testing ATSB formulations/products under laboratory conditions (Phase I), small-phase (Phase II), and large-phase field trial (Phase III) conditions.
Arctic medicine. Tropical medicine, Infectious and parasitic diseases
The development and progression of breast cancer are closely linked to estrogen levels. For patients with estrogen receptor-positive breast cancer, endocrine therapy targeting estrogen pathways remains a cornerstone of postoperative treatment. Aromatase, a critical enzyme in estrogen biosynthesis, exhibits heightened expression in breast tumors and their surrounding tissues. Consequently, aromatase inhibitors (AI) have become widely adopted as a primary endocrine therapy for breast cancer. While AI effectively lower tumor recurrence rates, they are associated with adverse effects such as bone loss, osteoporosis, and increased risk of osteoporotic fractures. These effects are particularly pronounced in elderly breast cancer patients, who are predisposed to accelerated bone mass loss and a higher prevalence of osteoporosis. This review explores the mechanisms of action of AI, the pathways through which they contribute to bone density reduction and osteoporosis, and the risk stratification for osteoporotic fractures. Additionally, it highlights evidence-based strategies for preventing and managing AI-induced osteoporosis in elderly breast cancer patients. By addressing these challenges, the review aims to enhance understanding of the bone health issues faced by this patient population, improve their quality of life, and reduce the incidence of complications.
Abstract Background Children with palliative care conditions and their families have complex care needs. In Norwegian municipalities, designated coordinators facilitate cooperation between health and social care services to ensure a holistic approach to meeting these needs. However, information is limited concerning how coordinators perform their duties and the factors influencing their work performance. Aim To explore coordinators' experiences and perceptions of factors influencing their work performance in relation to children's palliative care (CPC) in municipalities. Methods Semi-structured interviews were conducted with 11 coordinators for children in palliative care and analysed using a reflexive thematic analysis approach. Results Both internal and external factors influenced the coordinator's work performance, and they experienced a range of barriers in their efforts to achieve holistic care. Four themes were generated: ‘random knowledge on children’s palliative care’, ‘the abstract concept of coordination’, ‘striving to unite the fragmented whole’ and ‘aiming for tailored coordination’. A lack of training and experience in CPC is widespread among the coordinators. Additionally, the municipal systems seem inadequately developed to address the needs of children in palliative care and their families. Conclusion Strengthening coordination in municipalities for children in palliative care and their families requires that coordinators receive systematic training in CPC and further development of their support systems.
Ksenia A. Blinova, Irina E. Mishina, Galina E. Ivanova
et al.
INTRODUCTION. The use of antitumor therapy in patients with breast cancer has led not only to an increase in their life expectancy, but also to the need to correct various side effects, including manifestations of cardiotoxicity. Rehabilitation of such patients in Russia is currently lacking.
AIM. To search and analyze the literature on the effectiveness of physical training for the prevention of cardiotoxic complications of antitumor therapy.
MATERIALS AND METHODS. Publications from the PubMed, Scopus, Web of Science, PEDro databases over the past 15 years were collected and analyzed 15 years by keywords in Russian and English: “cardiotoxicity”, “exercise”, “breast cancer”. 126 sources were selected, including systematic reviews and a Cochrane review.
RESULTS AND DISCUSSION. Preclinical studies have shown that physical exercise reduces the accumulation of antitumor drugs in the myocardium and increases the proliferation of cardiomyocyte progenitor cells. Conducting physical training during and after anticancer treatment increases cardiorespiratory endurance and reduces the manifestations of anthracycline cardiotoxicity. This rehabilitation intervention leads to less fatigue, decreased depression, improved physical fitness, cognitive functions, and quality of life. The greatest effectiveness during and after anticancer therapy was shown by aerobic and strength exercises of moderate intensity, performed for 30–40 minutes 3–5 times a week, which provide 150 minutes of physical activity per week. The limitation of the use of physical training in patients is due to the impossibility of predicting the training heart rate by age, as well as the need to take into account concomitant diseases and the patient’s condition.
CONCLUSION. The use of physical training can be used in cancer patients to prevent cardiotoxicity of anticancer therapy. Further research is needed to ensure their successful use in patients with different physical fitness and treatment tolerance.
Pablo Reis de Moraes, Kauã Felipe Kunz, Maiara Helena Rusch
et al.
Introdução: O joelho é a principal articulação acometida pela osteoatrose (OA), com maior prevalência em mulheres idosas. Exercícios multifuncionais são eficazes no tratamento dessa condição, sendo a dança um exercício tolerável e bem aceito. Entretanto, não está claro qual a melhor modalidade de exercício traz maiores benefícios. Objetivo: Comparar a funcionalidade articular entre mulheres com OA de joelhos que participam de um programa de atividade física monitorada de alongamentos e exercícios resistidos para terceira idade e entre participantes de um grupo de dança recreativa. Materiais e Métodos: Estudo transversal, descritivo e analítico. Foram incluídas 47 mulheres acima de 50 anos com OA de joelho. As participantes foram divididas em 2 grupos, um com 25 mulheres que participavam de um grupo de dança recreativa; outro com 22 mulheres que realizavam um programa monitorado de exercícios resistidos e alongamentos. Todas responderam um questionário sociodemográfico e de saúde; a função articular foi avaliada pelo questionário WOMAC. Resultados: As participantes apresentaram características amostrais similares quanto a características sociodemográficas e de saúde. As participantes do grupo de atividade física apresentaram uma maior pontuação no questionário WOMAC em relação as dimensões dor (p<0,001), rigidez (p<0,001) e função física (p<0,001), quando comparadas às do grupo dança. Conclusão: Os resultados demonstram que mulheres com OA de joelho do grupo de dança recreativa apresentaram menos dor, menor rigidez e melhor função física do joelho, quando comparados com o grupo de atividade física monitorada de alongamentos e de exercícios resistidos para terceira idade.
K. Błażejczyk, Yoram Epstein, G. Jendritzky
et al.
Over the past century more than 100 indices have been developed and used to assess bioclimatic conditions for human beings. The majority of these indices are used sporadically or for specific purposes. Some are based on generalized results of measurements (wind chill, cooling power, wet bulb temperature) and some on the empirically observed reactions of the human body to thermal stress (physiological strain, effective temperature). Those indices that are based on human heat balance considerations are referred to as "rational indices". Several simple human heat balance models are known and are used in research and practice. This paper presents a comparative analysis of the newly developed Universal Thermal Climate Index (UTCI), and some of the more prevalent thermal indices. The analysis is based on three groups of data: global data-set, synoptic datasets from Europe, and local scale data from special measurement campaigns of COST Action 730. We found the present indices to express bioclimatic conditions reasonably only under specific meteorological situations, while the UTCI represents specific climates, weather, and locations much better. Furthermore, similar to the human body, the UTCI is very sensitive to changes in ambient stimuli: temperature, solar radiation, wind and humidity. UTCI depicts temporal variability of thermal conditions better than other indices. The UTCI scale is able to express even slight differences in the intensity of meteorological stimuli.
<strong>Background:</strong> accidents constitute chains of events and circumstances that lead to the occurrence of unintentional injuries. They are responsible for numerous deaths every year in the world. In 2019, traffic accidents and falls were among the top 20 causes of death. In Cuba, they stood as the fifth cause of mortality from all causes and ages in the decade 2010-2019. <br /><strong>Objective:</strong> to characterize mortality from accidents in Cuba in the 2010-2019 decade. <br /><strong>Methods:</strong> an ecological, longitudinal, descriptive study of annual mortality due to accidents in Cuba was carried out, throughout the decade from 2010 to 2019. The statistical yearbooks, published from 2012 to 2022, by the Directorate of Medical Records and Health Statistics, from the Ministry of Public Health of Cuba, constituted the main source of information. For its statistical processing, the data obtained were included in a spreadsheet in Microsoft Excel and the results were expressed in figures and tables. <br /><strong>Results:</strong> the gross mortality rates due to accidents in Cuba in the 2010-2019 decade increased from 43 to 49.9 per 100,000 inhabitants, the highest being due to falls: 23.7 in 2018 and 23.4 per 100 000 inhabitants in 2019. The years of potential life lost due to accidents decreased from 5.4 to 4.7 per 1,000 inhabitants between 1 and 74 years of age. <br /><strong>Conclusions:</strong> in Cuba, in the 2010-2019 decade, an increase in mortality from accidents was observed at the expense of accidental falls, these more frequently in the female sex.
Internal medicine, Special situations and conditions
The article is devoted to the expansion of functional devices of the Internet of Things (IoT) in order to increase the safety of the population in emergency situations, in particular in the context of natural disasters and military threats. After analyzing the latest research and publications, a conclusion was made about the relevance of the development of IoT technologies in the context of modern challenges for the safety of citizens. Special emphasis is placed on the use of innovative approaches to solving public safety problems, particularly for persons with disabilities, such as the hearing impaired or the elderly. The article describes the implementation of software in the Python programming language to visually display the status of a missile threat or artillery fire using Yeelight smart lamps, which use colored light to convey information about the presence or absence of danger messages. The proposed solutions include synchronous operation of devices in real time, connection to reliable sources of messages and provision of stable communication between devices and the server. The project demonstrated an innovative approach to solving security problems in crisis situations, in particular martial law, promoting a quick and accurate response to valuable threats and protecting the population.
The observational fact that the present values of the densities of dark energy and dark matter are of the same order of magnitude, $$\rho _{\mathrm{de}0}/\rho _{\mathrm{dm}0} \sim \mathcal {O}(1)$$ρde0/ρdm0∼O(1), seems to indicate that we are currently living in a very special period of the cosmic history. Within the standard model, a density ratio of the order of one just at the present epoch can be seen as coincidental since it requires very special initial conditions in the early Universe. The corresponding “why now” question constitutes the cosmological “coincidence problem”. According to the standard model the equality $$\rho _{\mathrm{de}} = \rho _{\mathrm{dm}}$$ρde=ρdm took place “recently” at a redshift $$z \approx 0.55$$z≈0.55. The meaning of “recently” is, however, parameter dependent. In terms of the cosmic time the situation looks different. We discuss several aspects of the “coincidence problem”, also in its relation to the cosmological constant problem, to issues of structure formation and to cosmic age considerations.
N. Lorenzo Villalba, Yasmine Maouche, M. B. Alonso Ortiz
et al.
We describe two elderly patients evaluated at emergency departments for anosmia/dysgeusia in the absence of any other respiratory symptoms prior to or upon admission. In the current epidemiological context, clinical and biological work-up led to a diagnosis of COVID-19 infection. Unfortunately, one of the patients died during hospitalization, but the other recovered and was discharged. LEARNING POINTS In the current epidemiological situation, anosmia and dysgeusia in the absence of other respiratory conditions should be carefully evaluated. Special attention should be given to patients with non-classic COVID-19 symptoms in order to reduce transmission and protect health providers
Prompted by the weaknesses of standardized risk-management approaches in the aftermath of the 2008 financial crisis, scholars, regulators, and practitioners alike emphasize the importance of creating a risk-aware culture in organizations. Recent insights highlight the special role of tone from the top as a crucial driver of risk awareness. In this study, we take a systems perspective on control system design to investigate the role of tone from the top in creating risk awareness. In particular, we argue that both the interactive and the diagnostic use of budgets and performance measures interact with tone from the top in managing risk awareness. Our results show that interactive control strengthens the effect of tone from the top on risk awareness, whereas tone from the top and diagnostic control are empirically not interrelated with regard to creating risk awareness. To shed light on the boundary conditions of the proposed interdependencies, we further investigate whether the predicted interdependencies are sensitive to the level of perceived environmental uncertainty. We find that the effect of tone from the top and interactive control becomes significantly stronger in a situation of high perceived environmental uncertainty. Most interestingly, tone from the top and diagnostic control are complements with regard to risk awareness in settings of low perceived environmental uncertainty and substitutes at high levels of perceived environmental uncertainty.
Natascha Mojtahedzadeh, Tanja Wirth, A. Nienhaus
et al.
The COVID-19 pandemic has affected health professionals in a special way, as they are responsible for the care of vulnerable groups. Little is known about how outpatient caregivers perceive their working conditions during the pandemic in Germany and about the difficulties they face. The aims of this study were (1) to examine specific job demands of outpatient caregivers in regard to the COVID-19 pandemic, (2) to illuminate their job resources they can rely on and (3) to identify potential strain reactions they experience. Fifteen semi-structured telephone interviews were conducted with outpatient caregivers working in Northern Germany in the period May–June 2020. Interviews were analyzed by using qualitative content analysis. Outpatient caregivers experienced daily mask obligation, lack of personal protection equipment (PPE) and stricter hygiene regulations as demanding during the pandemic. They also described a higher workload and emotional demands such as fear of infection or infecting others. They perceived team spirit and communication as important work-related resources. Depressive symptoms and feelings of stress were described as strain reactions. Outpatient care services need to be better prepared for sudden pandemic situations and provide their employees with sufficient PPE and education to reduce pandemic-related job demands leading to negative strain reactions.
L. V. Simhachalam Kutikuppala, Venkataramana Kandi, Ashish K. Sarangi
et al.
Global public health is significantly challenged due to the continuing COrona VIrus Disease 2019 (COVID-19) outbreak brought forth by the severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) [...]
Abstract COVID-19 pandemic led to an increase in psychological problems; health professionals with higher exposure to risk of infection suffer psychological changes. This study aimed to investigate the level of anxiety, anger, and depression among health professionals in COVID-related special circumstances. A mass COVID-19 outbreak occurred in a general hospital in Korea. In total, 149 frontline and non-frontline health professionals involved in this were surveyed. Their anger, anxiety, and depression were assessed using the State-Trait Anger Expression Inventory, General Anxiety Disorder-7, and the Korean Screening Tool for Depressive disorders. By occupation, health professionals showed relatively higher anxiety and depression than non-health professionals. By type of work, frontline staff showed a higher level of depression than non-frontline staff. The results confirmed that healthcare staff underwent psychological changes during the COVID-19 pandemic. It is important to raise awareness on post-traumatic stress disorder affecting health professionals during the COVID-19 pandemic.
We prove that the posterior distribution of a parameter in misspecified LAN parametric models can be approximated by a random normal distribution. We derive from this that Bayesian credible sets are not valid confidence sets if the model is misspecified. We obtain the result under conditions that are comparable to those in the well-specified situation: uniform testability against fixed alternatives and sufficient prior mass in neighbourhoods of the point of convergence. The rate of convergence is considered in detail, with special attention for the existence and construction of suitable test sequences. We also give a lemma to exclude testable model subsets which implies a misspecified version of Schwartz’ consistency theorem, establishing weak convergence of the posterior to a measure degenerate at the point at minimal Kullback-Leibler divergence with respect to the true distribution.
The article discusses the issues of organizing the educational process in conditions of unforeseen freelance influences, such as accidents, terrorist acts, military or interethnic conflicts, fires, drought, epidemiological situation, etc. It is shown that in a market economy, educational institutions — both state and private ones — reoriented themselves from the planned training of specialists to the customer’s demand for educational services. A new demand-oriented approach to the organization of the educational process is proposed, in which the educational process is presented in the form of a chain “seller — product — consumer”. It is shown that from the point of view of the consumer, the safety and efficiency of educational services are among the important requirements in the face of unforeseen freelance influences. A new structural model of the educational system is proposed, which implies the interaction of two subsystems — the educational infrastructure and the educational process. It is shown that the structural reliability of the educational system is an important indicator for ensuring the psychological and physical safety of participants in the educational process. A new mathematical model based on graphs and hypernets is proposed, which takes into account the mapping of the educational process into the educational infrastructure. The concept of “survivability of the educational system” is introduced as the ability of continuous functioning of this system under the influence of various external destabilizing factors. The task of organizing the educational process in emergency situations from the point of view of the consumer is set as the task of building a hypernet of minimum cost and specified reliability.