Search Results (12,200)

Those with intellectual and developmental disabilities (I/DD), especially autism, represent an often misunderstood and underserved population. In order to address health disparities faced by those with I/DD in Washington state, the Extension for Community Healthcare Outcomes (Project ECHO) model was implemented to build capacity to serve these individuals and their families in their home communities. Through this year-long telementorship and learning community, expert teams lead clinics based on interdisciplinary case-based discussion and knowledge sharing with medical, behavioral, and mental healthcare providers. A cornerstone of these expert teams are autistic self-advocates, who provide insight into lived experience. In this paper, we will discuss how the inclusion of six autistic self-advocates across four different ECHO programs has allowed ECHO participants to broaden their horizons and gain new insight into supports for their I/DD clients across multiple aspects of care. In addition to the unique knowledge provided by self-advocates, their participation illustrates the potential for all people with I/DD to live rich and fulfilling lives. The initial implementation and on-going success of including lived experience within the ECHO model can be used as an example of how to create partnerships that meaningfully inform decisions and improve equitable outcomes in service provision. Full article

Perfluoroalkyl and polyfluoroalkyl substances (PFASs), widely utilized in various industries, may pose potential reproductive well-being risks. However, the research on the impact of PFAS exposures on pregnancy and live birth rates remains scarce. To address this gap, we conducted a cross-sectional study using the data from the United States National Health and Nutrition Examination Survey (NHANES) collected between 2013 and 2018. We focused on six PFAS compounds measured in the serum of women aged 20 to 50 years, employing the Poisson regression, Quantile G-composition (Qgcomp), and Weighted Quantile Sum (WQS) regression models. Adjusting for age, racial/ethnic origin, educational level, marital status, family income, body mass index (BMI), menarche age, birth control pill use, and other female hormone consumption, the Poisson regression identified significant negative associations between the individual PFAS exposures and pregnancy and live birth numbers (p < 0.05 for all 24 null hypotheses for which the slope of the trend line is zero). The Qgcomp analysis indicated that a one-quartile increase in the mixed PFAS exposures was associated with reductions of 0.09 (95% CI: −0.15, −0.03) in the pregnancy numbers and 0.12 (95% CI: −0.19, −0.05) in the live birth numbers. Similarly, the WQS analysis revealed that a unit increase in the WQS index corresponded to decreases of 0.14 (95% CI: −0.20, −0.07) in the pregnancy numbers and 0.14 (95% CI: −0.21, −0.06) in the live birth numbers. Among the six specific PFAS compounds we studied, perfluorononanoic acid (PFNA) had the most negative association with the pregnancy and live birth numbers. In conclusion, our findings suggest that PFAS exposures are associated with lower pregnancy and live birth numbers among women of reproductive age. Full article

Reducing environmental pollution, including air pollution, contributes to improving people’s health and quality of life, which is one of the goals of sustainable development. One of the important air pollutants is ammonia, which is mainly emitted from the agriculture sector. This sector is responsible for over 81% of global ammonia emissions. The aim of this research was a preliminary assessment of the implementation status of methods for reducing ammonia emissions on farms and to learn the views and awareness of agricultural producers on reducing emissions of pollutants into the air. The research was conducted using a survey questionnaire that was made available to farmers in various ways. Based on the results, it can be concluded that farmers have knowledge of environmental protection and agree that people have an impact on the environment. Low-emission practices to reduce ammonia emissions from agricultural sources are not widely used. The best situation is considering reduction practices in the storage of natural fertilizers and the use of low-emission fertilizer application techniques. The results of this type of monitoring research may be useful in determining the level of ammonia emission reduction. In the future, the data may be used during air pollution inventories conducted by state institutions. Full article

(1) Background: Playful immunization promotion helps to approach persuasive efforts and raise vaccine acceptance. However, playful promotion in the field of HPV immunization has not been explored. (2) Methods: To address this gap, we analyzed data gleaned from 73 short videos posted by state media and from semi-structured interviews with 37 Chinese stakeholders using thematic analysis. (3) Results: The analysis revealed that state media promoted HPV immunization using celebrity endorsement, anthropomorphism techniques and entertainment performance strategies. Additionally, state media engaged in circle mobilization and livestreamed on Douyin to reach wider audiences. Although playful strategies increased the popularity of HPV vaccine promotion, insufficient multi-stakeholder partnerships and homogeneous message delivery decreased the efficiency of HPV immunization promotion campaigns. (4) Conclusions: The strengthening of multi-stakeholder partnerships and the optimization of the public service provision of HPV vaccination are expected. Our research will not only deepen the global audience’s understanding of Chinese immunization promotion campaigns, but also offer insights for implementing future global health promotion. Full article

Background: This study aimed to identify the specific areas of knowledge gaps regarding lactose intolerance among neonatologists in Chinese outpatient settings as well as to assess the availability of lactose intolerance testing in hospitals. Methods: A total of 278 neonatologists in outpatient settings from 144 hospitals were surveyed. To explore the awareness level, diagnosis, and treatment of neonatal lactose intolerance among neonatologists in outpatient settings, a multicenter cross-sectional survey was designed. Descriptive analysis based on frequency and percent distribution was performed for all variables. Results: Most respondents were senior doctors (256, 92.09%) from general hospitals and maternity/maternal and child health hospitals, had over 10 years of experience, and were dominantly associate chief physicians and chief physicians (211, 75.90%). A significant proportion of the participants (236, 84.89%) believed that neonatal lactose intolerance tends to be overlooked during clinical practice. When the most common symptoms of neonatal lactose intolerance were surveyed, diarrhea was selected by 142 (51.08%) respondents, followed by bloating and milk regurgitation or emesis (71, 25.54%). Other symptoms included unexplained crying (36, 12.85%), stool with milk flap or foam (15, 5.40%), and increased venting (14, 5.04%). Furthermore, the survey results indicated that the most common method for diagnosing neonatal lactose intolerance in the respondents’ hospitals was qualitative test for urinary galactose (78, 28.06%). Of the respondents, 137 (49.28%) stated that their hospital could not test for lactose intolerance. For treating lactose intolerance, the neonatologists primarily opted for exogenous lactase rather than lactose-free formula milk. Conclusions: This study sheds light on Chinese neonatologists’ awareness of neonatal lactose intolerance, revealing some knowledge gaps. The expeditious popularization and conduct of lactose intolerance-related examinations in hospitals will have a positive stimulative effect on the management of lactose intolerance in newborns. Full article

This paper offers a brief insight into predicting the State of Health (SOH) of lithium-ion batteries in EVs using machine learning. Accurate SOH assessment is crucial for optimizing electric vehicles (EVs’) performance and longevity. Employing supervised machine learning on a diverse battery dataset, the research develops a robust SOH estimation method. Various algorithms are compared for efficacy, considering factors like temperature and charging patterns. Feature selection enhances model accuracy and efficiency. The proposed methodology offers promising real-world results, indicating high SOH prediction accuracy. This research contributes to EV battery management, applying machine learning for SOH estimation, which is vital for intelligent battery management systems, and enhancing EVs’ sustainability and efficiency. Full article

Advanced periodontitis poses a significant threat to oral health, causing extensive damage and loss of both hard and soft periodontal tissues. While traditional therapies such as scaling and root planing can effectively halt the disease’s progression, they often fail to fully restore the original architecture and function of periodontal tissues due to the limited capacity for spontaneous regeneration. To address this challenge, periodontal tissue engineering has emerged as a promising approach. This technology centers on the utilization of biomaterial scaffolds, which function as three-dimensional (3D) templates or frameworks, supporting and guiding the regeneration of periodontal tissues, including the periodontal ligament, cementum, alveolar bone, and gingival tissue. These scaffolds mimic the extracellular matrix (ECM) of native periodontal tissues, aiming to foster cell attachment, proliferation, differentiation, and, ultimately, the formation of new, functional periodontal structures. Despite the inherent challenges associated with preclinical testing, the intensification of research on biomaterial scaffolds, coupled with the continuous advancement of fabrication technology, leads us to anticipate a significant expansion in their application for periodontal tissue regeneration. This review comprehensively covers the recent advancements in biomaterial scaffolds engineered specifically for periodontal tissue regeneration, aiming to provide insights into the current state of the field and potential directions for future research. Full article

Preeclampsia is a complex pregnancy-related hypertensive disorder which poses significant risks for both maternal and fetal health. Preeclampsia affects 5–8% of pregnancies in the United States, causing a significant public health and economic burden. Despite extensive research, the etiology and pathogenesis of preeclampsia remain elusive, but have been correlated with maternal conditions such as obesity. In recent decades, the incidence of preeclampsia increased along with the prevalence of obesity among women of reproductive age. Maternal obesity has been shown to negatively affect pregnancy in almost all aspects. However, the precise mechanisms by which obesity influences preeclampsia are unclear. Ankyrin repeat and SOCS Box Containing protein 4 (ASB4) is an E3 ubiquitin ligase that can promote the degradation of a wide range of target proteins. ASB4-null mice display a full spectrum of preeclampsia-like phenotypes during pregnancy including hypertension, proteinuria, and decreased litter size. Furthermore, maternal obesity induced by a high-fat diet aggravates preeclampsia-like phenotypes in pregnant mice lacking ASB4. Variants in the ASB4 gene have been associated with obesity in humans, and a functional connection between the ASB4 gene and obesity has been established in mice. This review discusses the connections between preeclampsia, obesity, and ASB4. Full article

This study presents methods to handle deep learning regressions with input and output sequences of different lengths. We discuss the Autoregressive one-step prediction framework and introduce an innovative one-time multi-step (OTMS) prediction approach, based on a custom loss function, that predicts all future steps in a single shot. The presented methodologies are then applied to simultaneously predict the State of Health (SoH) trajectory and estimate the Remaining Useful Life (RUL) of lithium-ion battery cells. Accurate estimates of SoH trajectory and RUL are essential for Battery Management Systems (BMSs), electronic systems that guarantee safety while maximizing performance and extending battery lifespan. In this context, the studied methodologies were compared using a rigorous cross-validation approach. The OTMS model showed better predictions in early cycles, while the Autoregressive model performed better in later cycles, suggesting a hybrid approach between these two methodologies as an optimal solution. Full article

The incidence of early-onset colorectal cancer (EO-CRC) in individuals under 50 years old is rapidly increasing in the United States. This study aims to evaluate EO-CRC incidence rates using data from the Global Burden of Disease Study (GBD) 2021, providing insights into trends from 1990 to 2021. We employed an age–period–cohort (APC) model analysis to estimate the effects of age, time period, and birth cohort on EO-CRC incidence. Our findings indicate that the number of EO-CRC cases rose from 6256 (95% UI: 6059–6456) in 1990 to 9311 (95% UI: 8859–9744) in 2021, a 49% increase from 1990 to 2021. The age-standardized incidence rate per 100,000 population increased by 34% during this period. The net drift in females (0.22%, 95% CI: 0.20–0.24) was slightly higher than in males (0.21%, 95% CI: 0.19–0.23) (p = 0.45). The APC analysis revealed that being over 25 years old, the period from 2005–2021, and being born after 1983 negatively impacted EO-CRC incidence rates, with a sharp rise after 2000 and a reduction among females from 2017 to 2021. Our study highlights the need for targeted prevention strategies and further research to understand these trends. Full article

From a public health perspective, it is necessary to improve indoor air quality (IAQ) in schools. This study aims to assess the state of perceived IAQ in Slovenian school classrooms and its association with the selected IAQ factors to improve the understanding of perceived IAQ for designing public health interventions aimed to improve IAQ in schools. A national cross-sectional study was performed in all 454 Slovenian primary schools in the school year 2019/2020. The questionnaires were filled out by the 3rd-grade teachers with the support of the caretakers. Teachers rated the IAQ in the classroom as the worst in winter. We found that the teachers’ perceived IAQ in the classroom is statistically significantly associated with the micro location of the school and some of the IAQ factors. Poor IAQ is associated with reduced manual airing of classrooms due to the thermal comfort of the occupants. Interventions should be aimed at improving occupants’ adaptive behaviors to increase the frequency of natural ventilation in classrooms. Full article

Maritime glaciers in the southeastern Tibetan Plateau (SETP) are particularly sensitive to changes in climate, and their changes directly and severely affect regional water security and glacier-related hazards. Given their large societal importance, a better understanding of the mass balance of maritime glaciers in the SETP, a key variable for characterizing the state of glacier health, is of great scientific interest. In this review, we synthesize in situ, satellite-based observations and simulations that present an overall accelerating negative mass balance of maritime glaciers in the SETP in recent decades. We hereby highlight a significant spatiotemporal difference in the mass balance of maritime glaciers across the SETP and investigate the drivers of the accelerated mass loss of these glaciers in recent years. We find that accelerated glacier mass loss agrees with the variabilities in temperatures rising and precipitation decreasing at regional scales, as well as the spatial patterns of widespread melt hotspots (e.g., thin debris, ice cliffs, supraglacial ponds, and surface streams), the expansion of glacial lakes, enlarged ice crevasses, and frequent ice avalanches. Finally, the challenges of the mass balance study of maritime glaciers and future perspectives are proposed. Our review confirms the urgent need to improve the existing glacier inventory and establish comprehensive monitoring networks in data-scarce glacierized catchments, and it suggests paying particular attention to the development of glacier mass-balance models that coupe multiple physical processes at different interfaces to predict the status of maritime glaciers and their responses to climate change. This study can inform the sustainable management of water resources and the assessment of socio-economic vulnerability due to glacier-related hazards in the SETP and its surroundings in the context of marked atmospheric warming. Full article

The operating state of axle box bearings is crucial to the safety of high-speed trains, and the vibration acceleration signal is a commonly used bearing-health-state monitoring signal. In order to extract hidden characteristic frequency information from the vibration acceleration signal of axle box bearings for fault diagnosis, a method for extracting the fault characteristic frequency based on principal component analysis (PCA) fusion and the optimal bandpass filtered denoising signal analytic energy operator (AEO) demodulation spectrum is proposed in this paper. PCA is used to measure the dimension reduction and fusion of three-direction vibration acceleration, reducing the interference of irrelevant noise components. A new type of multi-channel bandpass filter bank is constructed to obtain filtering signals in different frequency intervals. A new, improved average kurtosis index is used to select the optimal filtering signals for different channel filters in a bandpass filter bank. A dimensionless characteristic index characteristic frequency energy concentration coefficient (CFECC) is proposed for the first time to describe the energy prominence ability of characteristic frequency in the spectrum and can be used to determine the bearing fault type. The effectiveness and applicability of the proposed method are verified using the simulation signals and experimental signals of four fault bearing test cases. The results demonstrate the effectiveness of the proposed method for fault diagnosis and its advantages over other methods. Full article

Effects of pre- and probiotics on intestinal health are well researched and microbiome-targeting solutions are commercially available. Even though a trend to appreciate the presence of certain microbes on the skin is seeing an increase in momentum, our understanding is limited as to whether the utilization of skin-resident microbes for beneficial effects holds the same potential as the targeted manipulation of the gut microflora. Here, we present a selection of molecular mechanisms of cross-communication between human skin and the skin microbial community and the impact of these interactions on the host’s cutaneous health with implications for the development of skin cosmetic and therapeutic solutions. Malassezia yeasts, as the main fungal representatives of the skin microfloral community, interact with the human host skin via lipid mediators, of which several are characterized by exhibiting potent anti-inflammatory activities. This review therefore puts a spotlight on Malassezia and provides a comprehensive overview of the current state of knowledge about these fungal-derived lipid mediators and their capability to reduce aesthetical and sensory burdens, such as redness and itching, commonly associated with inflammatory skin conditions. Finally, several examples of current skin microbiome-based interventions for cosmetic solutions are discussed, and models are presented for the use of skin-resident microbes as endogenous bio-manufacturing platforms for the in situ supplementation of the skin with beneficial metabolites. Full article

The emergence of digitalization and artificial intelligence has had a profound impact on society, especially in the field of medicine. Digital health is now a reality, with an increasing number of people using chatbots for prognostic or diagnostic purposes, therapeutic planning, and monitoring, as well as for nutritional and mental health support. Initially designed for various purposes, chatbots have demonstrated significant advantages in the medical field, as indicated by multiple sources. However, there are conflicting views in the current literature, with some sources highlighting their drawbacks and limitations, particularly in their use in oncology. This state-of-the-art review article seeks to present both the benefits and the drawbacks of chatbots in the context of medicine and cancer, while also addressing the challenges in their implementation, offering expert insights on the subject. Full article