Search results for: cardiovascular health

Authors: Dil Ware Alam, Faiza Zebeen, Sumaya Binte Masud

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COVID-19) has impacted the whole world, including Bangladesh. The epidemic has reduced access to health care, particularly for women, creating challenges for an increasingly disadvantaged population. Women's health and well-being in Bangladesh are susceptible to a rise in domestic violence and need to be addressed quickly. The planet has been greatly influenced by Coronavirus disease 2019 (COVID-19), and Bangladesh is no difference. The pandemic has resulted in a decline in the availability of health care, notably for women's health problems, leading to an increase in difficulties for an increasingly marginalized group. Maternity care, maternal health programs, medical interventions, nutritional counseling and mental health care, are not discussed, and women's health and well-being in Bangladesh is vulnerable with a spike in domestic violence and needs to be resolved urgently.

Keywords: Covid-19, mental health, reproductive health, Bangladesh

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Authors: Marina Shargorodsky

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Aim: Gestational weight gain (GWG) has been related to altering future weight-gain curves and increased risks of obesity later in life. Obesity may contribute to vascular atherosclerotic changes as well as excess cardiovascular morbidity and mortality observed in these patients. Noninvasive arterial testing, such as ultrasonographic measurement of carotid IMT, is considered a surrogate for systemic atherosclerotic disease burden and is predictive of cardiovascular events in asymptomatic individuals as well as recurrent events in patients with known cardiovascular disease. Currently, there is no consistent evidence regarding the vascular impact of excessive GWG. The present study was designed to investigate the impact of GWG on early atherosclerotic changes during late pregnancy, using intima-media thickness, as well as placental vascular circulation and inflammatory lesions and pregnancy outcomes. Methods: The study group consisted of 59 pregnant women who gave birth and underwent a placental histopathological examination at the Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Israel, in 2019. According to the IOM guidelines the study group has been divided into two groups: Group 1 included 32 women with pregnancy weight gain within recommended range; Group 2 included 27 women with excessive weight gain during pregnancy. The IMT was measured from non-diseased intimal and medial wall layers of the carotid artery on both sides, visualized by high-resolution 7.5 MHz ultrasound (Apogee CX Color, ATL). Placental histology subdivided placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion according to the criteria of the Society for Pediatric Pathology, subdividing placental findings to lesions consistent with maternal vascular and fetal vascular malperfusion, as well as the inflammatory response of maternal and fetal origin. Results: IMT levels differed between groups and were significantly higher in Group 1 compared to Group 2 (0.7+/-0.1 vs 0.6+/-0/1, p=0.028). Multiple linear regression analysis of IMT included variables based on their associations in univariate analyses with a backward approach. Included in the model were pre-gestational BMI, HDL cholesterol and fasting glucose. The model was significant (p=0.001) and correctly classified 64.7% of study patients. In this model, pre-pregnancy BMI remained a significant independent predictor of subclinical atherosclerosis assessed by IMT (OR 4.314, 95% CI 0.0599-0.674, p=0.044). Among placental lesions related to fetal vascular malperfusion, villous changes consistent with fetal thrombo-occlusive disease (FTOD) were significantly higher in Group 1 than in Group 2, p=0.034). In Conclusion, the present study demonstrated that excessive weight gain during pregnancy is associated with an adverse effect on early stages of subclinical atherosclerosis, placental vascular circulation and neonatal complications. The precise mechanism for these vascular changes, as well as the overall clinical impact of weight control during pregnancy on IMT, placental vascular circulation as well as pregnancy outcomes, deserves further investigation.

Keywords: obesity, pregnancy, complications, weight gain

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Authors: Yasmina Bendaali, Cristian Vaquero, Carlos Escott, Carmen González, Antonio Morata

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Consumer tendencies to healthy eating habits and request for organic beverages led to the production of new drinks from fruit juices as a source of nutrients and bioactive compounds. Grape juice is a rich source of sugars, organic acids, and phenolic compounds, which define its beneficial effect on health and the attractive sensory profile for consumers' choices (color, taste, flavor). Thus, grape juice was used as a source of sugars, avoiding the addition of sweeteners by diluting it with mineral water to obtain the sugar concentration recommended for isotonic drinks (6% to 8%) to provide energy during physical activities. In addition, phenolic compounds of grape juice are associated with many human health benefits, mainly antioxidant activity, which helps to prevent different diseases associated with oxidative stress, including cancers and cardiovascular and neurodegenerative diseases. Furthermore, physical exercise has been shown to increase the production of free radicals and other reactive oxygen species. Thus, athletes need to improve their antioxidant defense systems to prevent oxidative damage. Different studies have demonstrated the positive effect of grape juice consumption during physical activities, which improves antioxidant activity and performance, protects against oxidative damage, and reduces inflammation. Thus, the use of grape juice to develop isotonic drinks can provide isotonic drinks with antioxidant and biological activities in addition to their principal role of rehydration and replacement of minerals and carbohydrates during physical exercises. Moreover, attractive sensory characteristics, mainly color, which is provided by anthocyanin content, have a great contribution to making the drinks more natural and help to dispense the use of synthetic dyes in addition to the health benefits which will be a novel product in the field of healthy beverages responding on the demand of consumers for new, innovative, and healthy products.

Keywords: grape juice, isotonic, antioxidants, anthocyanins, natural, sport

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Antonio J. Melendez-Martinez

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Beyond their role as natural colorants, some carotenoids are provitamins A and may be involved in health-promoting biological actions and contribute to reducing the risk of developing non-communicable diseases, including several types of cancer, cardiovascular disease, eye conditions, skin disorders or metabolic disorders. Given the versatility of carotenoids, the COST-funded European network to advance carotenoid research and applications in agro-food and health (EUROCAROTEN) is aimed at promoting health through the diet and increasing well-being by means. Stakeholders from 38 countries participate in this network, and one of its main objectives is to promote research on little-studied carotenoids. In this contribution, recent advances of our research group and collaborators in the study of two such understudied carotenoids, namely phytoene and phytofluene, the colorless carotenoids, are outlined. The study of these carotenoids is important as they have been largely neglected despite they are present in our diets, fluids, and tissues, and evidence is accumulating that they may be involved in health-promoting actions. More specifically, studies on their levels in diverse tomato and orange varieties were carried out as well as on their potential bioavailability from different dietary sources. Furthermore, the potential effect of these carotenoids on an animal model subjected to oxidative stress was evaluated. The tomatoes were grown in research greenhouses, and some of them were subjected to regulated deficit irrigation, a sustainable agronomic practice. The citrus samples were obtained from an experimental field. The levels of carotenoids were assessed using HPLC according to routine methodologies followed in our lab. Regarding the potential bioavailability (bioaccessibility) studies, different products containing colorless carotenoids, like fruits, juices, were subjected to simulated in vitro digestions, and their incorporation into mixed micelles was assessed. The effect of the carotenoids on oxidative stress was evaluated on the Caenorhabditis elegans model. For that purpose, the worms were subjected to oxidative stress by means of a hydrogen peroxide challenge. In relation to the presence of colorless carotenoids in tomatoes and orange varieties, it was observed that they are widespread in such products and that there are mutants with very high quantities of them, for instance, the Cara Cara or Pinalate mutant oranges. The studies on their bioaccessibility revealed that, in general, phytoene and phytofluene are more bioaccessible than other common dietary carotenoids, probably due to their distinctive chemical structure. About the in vivo antioxidant capacity of phytoene and phytofluene, it was observed that they both exerted antioxidant effects at certain doses. In conclusion, evidence on the importance of phytoene and phytofluene as dietary easily bioavailable and antioxidant carotenoids has been obtained in recent studies from our group, which can be important shortly to innovate in health-promotion through the development of functional foods and related products.

Keywords: carotenoids, health, functional foods, nutrition, phytoene, phytofluene

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Authors: Vanessa H. S. Zago, Ana Maria H. de Avila, Paula P. Costa, Welington Corozolla, Liriam S. Teixeira, Eliana C. de Faria

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Objectives: The outcome of cardiovascular disease is affected by environment and climate. This study evaluated the possible relationships between climatic and environmental changes and the occurrence of biological rhythms in serum lipids and lipoproteins in a large population sample in the city of Campinas, State of Sao Paulo, Brazil. In addition, it determined the temporal variations of death due to atherosclerotic events in Campinas during the time window examined. Methods: A large 8-year retrospective study was carried out to evaluate the lipid profiles of individuals attended at the University of Campinas (Unicamp). The study population comprised 27.543 individuals of both sexes and of all ages. Normolipidemic and dyslipidemic individuals classified according to Brazilian guidelines on dyslipidemias, participated in the study. For the same period, the temperature, relative humidity and daily brightness records were obtained from the Centro de Pesquisas Meteorologicas e Climaticas Aplicadas a Agricultura/Unicamp and frequencies of death due to atherosclerotic events in Campinas were acquired from the Brazilian official database DATASUS, according to the International Classification of Diseases. Statistical analyses were performed using both Cosinor and ARIMA temporal analysis methods. For cross-correlation analysis between climatic and lipid parameters, cross-correlation functions were used. Results: Preliminary results indicated that rhythmicity was significant for LDL-C and HDL-C in the cases of both normolipidemic and dyslipidemic subjects (n =respectively 11.892 and 15.651 both measures increasing in the winter and decreasing in the summer). On the other hand, for dyslipidemic subjects triglycerides increased in summer and decreased in winter, in contrast to normolipidemic ones, in which triglycerides did not show rhythmicity. The number of deaths due to atherosclerotic events showed significant rhythmicity, with maximum and minimum frequencies in winter and summer, respectively. Cross-correlation analyzes showed that low humidity and temperature, higher thermal amplitude and dark cycles are associated with increased levels of LDL-C and HDL-C during winter. In contrast, TG showed moderate cross-correlations with temperature and minimum humidity in an inverse way: maximum temperature and humidity increased TG during the summer. Conclusions: This study showed a coincident rhythmicity between low temperatures and high concentrations of LDL-C and HDL-C and the number of deaths due to atherosclerotic cardiovascular events in individuals from the city of Campinas. The opposite behavior of cholesterol and TG suggest different physiological mechanisms in their metabolic modulation by climate parameters change. Thus, new analyses are underway to better elucidate these mechanisms, as well as variations in lipid concentrations in relation to climatic variations and their associations with atherosclerotic disease and death outcomes in Campinas.

Keywords: atherosclerosis, climatic variations, lipids and lipoproteins, associations

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Authors: Yao Huang, Hongjie Yu, Fangrong Xu, Longbiao Cai, Qiqiang He

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The Klotho gene has been found to be involved in cardiovascular health, and epigenetic mechanism has risen as good candidates to understand the role of lifestyle factors in obesity. The aim of this study was to investigate the effect of exercise intervention on the expression and DNA methylation of Klotho gene in high-fat diet induced obese mice. C57BL/6 male mice were fed a normal diet (ND) or a high-fat diet (HFD) for 12 weeks. HFD induced obese mice were divided into secondary group (SED) and exercise group (EX) randomly. The treadmill exercise was performed in EX group for 8 weeks. The expression and DNA methylation of Klotho were evaluated by Western blot, RT-PCR, and Methylation-specific PCR. Results indicated that Klotho protein and mRNA expression were significantly lower in the SED group than those in the ND and EX groups (P<0.01), whereas no significant difference, was found between ND group and EX group (P>0.05). Furthermore, mice in the ND group and SED group showed significantly lower levels of completely methylated Klotho DNA in ND group (0%) and SED group (50%) compared with the EX group (90%), and unmethylated Klotho DNA level in ND group (80%) was significantly higher than those in the SED (0%) and EX (0%) groups. These results suggested that exercise leads to increased Klotho expression and reduced Klotho DNA methylation level in HFD induced obese mice.

Keywords: DNA methylation, exercise intervention, klotho, obese mice

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Authors: Ryan Adams

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Introduction: Major trauma is the leading cause of death in 15-45 year olds and a significant human, social and economic costs. Resuscitation is a stalwart of trauma management, especially in the pre-hospital environment and packed red blood cells (pRBC) are being increasingly used with the advent of permissive hypotension. The evidence in this area is lacking and further research is required to determine its efficacy. Aim: The aim of this retrospective, matched cohort study was to determine if major trauma patients, who received pre-hospital pRBC, have a difference in their initial emergency department cardiovascular status; when compared with injury-profile matched controls. Methods: The trauma databases of the Royal Brisbane and Women's Hospital, Royal Children's Hospital (Herston) and Queensland Ambulance Service were accessed and major trauma patient (ISS>12) data, who received pre-hospital pRBC, from January 2011 to August 2014 was collected. Patients were then matched against control patients that had not received pRBC, by their injury profile. The primary outcomes was cardiovascular status; defined as shock index and Revised Trauma Score. Results: Data for 25 patients who received pre-hospital pRBC was accessed and the injury profiles matched against suitable controls. On admittance to the emergency department, a statistically significant difference was seen in the blood group (Blood = 1.42 and Control = 0.97, p-value = 0.0449). However, the same was not seen with the RTS (Blood = 4.15 and Control 5.56, p-value = 0.291). Discussion: A worsening shock index and revised trauma score was associated with pre-hospital administration of pRBC. However, due to the small sample size, limited matching protocol and associated confounding factors it is difficult to draw any solid conclusions. Further studies, with larger patient numbers, are required to enable adequate conclusions to be drawn on the efficacy of pre-hospital packed red blood cell transfusion.

Keywords: pre-hospital, packed red blood cells, severe trauma, emergency medicine

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Authors: Muhamad Hafiz Ismail, Ahmad H., Nelfianty M. R.

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The longitudinal study is conducted to identify predictive factors of soccer talent among male players aged 14 to 17 years. Convenience sampling involving elite respondents (n=20) and sub-elite respondents (n=20) male soccer players. Descriptive statistics were reported as frequencies and percentages. The inferential statistical analysis is used to report the status of reliability, independent samples t-test, paired samples t-test, and multiple regression analysis. Generally, there are differences in mean of height, muscular strength, muscular endurance, cardiovascular endurance, task orientation, cognitive anxiety, self-confidence, juggling skills, short pass skills, long pass skills, dribbling skills, and shooting skills for 20 elite players and sub-elite players. Accordingly, there was a significant difference between pre and post-test for thirteen variables of height, weight, fat percentage, muscle strength, muscle endurance, cardiovascular endurance, flexibility, BMI, task orientation, juggling skills, short pass skills, a long pass skills, and dribbling skills. Based on the first predictive factors (physical), second predictive factors (fitness), third predictive factors (psychological), and fourth predictive factors (skills in playing football) pledged to the soccer talent; four multiple regression models were produced. The first predictive factor (physical) contributed 53.5 percent, supported by height and percentage of fat in soccer talents. The second predictive factor (fitness) contributed 63.2 percent and the third predictive factors (psychology) contributed 66.4 percent of soccer talent. The fourth predictive factors (skills) contributed 59.0 percent of soccer talent. The four multiple regression models could be used as a guide for talent scouting for soccer players of the future.

Keywords: soccer talent identification, fitness and physical test, soccer skills test, psychological test

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Authors: Angkrit Phitchayangkoon, Ar-Aishah Dadeh

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Background: A key aim of triage is to identify the patients with high risk of cardiac arrest because they require intensive monitoring, resuscitation facilities, and early intervention. We aimed to identify the predicting factors such as initial vital signs, serum pH, serum lactate level, initial capillary blood glucose, and Modified Early Warning Score (MEWS) which affect the occurrence of cardiac arrest in an emergency department (ED). Methods: We conducted a retrospective data review of ED patients in an emergency department (ED) from 1 August 2014 to 31 July 2016. Significant variables in univariate analysis were used to create a multivariate analysis. Differentiation of predicting factors between cardiac arrest patient and non-cardiac arrest patients for occurrence of cardiac arrest in an emergency department (ED) was the primary outcome. Results: The data of 527 non-trauma patients with Emergency Severity Index (ESI) 1-3 were collected. The factors found to have a significant association (P < 0.05) in the non-cardiac arrest group versus the cardiac arrest group at the ED were systolic BP (mean [IQR] 135 [114,158] vs 120 [90,140] mmHg), oxygen saturation (mean [IQR] 97 [89,98] vs 82.5 [78,95]%), GCS (mean [IQR] 15 [15,15] vs 11.5 [8.815]), normal sinus rhythm (mean 59.8 vs 30%), sinus tachycardia (mean 46.7 vs 21.7%), pH (mean [IQR] 7.4 [7.3,7.4] vs 7.2 [7,7.3]), serum lactate (mean [IQR] 2 [1.1,4.2] vs 7 [5,10.8]), and MEWS score (mean [IQR] 3 [2,5] vs 5 [3,6]). A multivariate analysis was then performed. After adjusting for multiple factors, ESI level 2 patients were more likely to have cardiac arrest in the ER compared with ESI 1 (odds ratio [OR], 1.66; P < 0.001). Furthermore, ESI 2 patients were more likely than ESI 1 patients to have cardiovascular disease (OR, 1.89; P = 0.01), heart rate < 55 (OR, 6.83; P = 0.18), SBP < 90 (OR, 3.41; P = 0.006), SpO2 < 94 (OR, 4.76; P = 0.012), sinus tachycardia (OR, 4.32; P = 0.002), lactate > 4 (OR, 10.66; P = < 0.001), and MEWS > 4 (OR, 4.86; P = 0.028). These factors remained predictive of cardiac arrest at the ED. Conclusion: The factors related to cardiac arrest in the ED are ESI 1 patients, ESI 2 patients, patients diagnosed with cardiovascular disease, SpO2 < 94, lactate > 4, and a MEWS > 4. These factors can be used as markers in the event of simultaneous arrival of many patients and can help as a pre-state for patients who have a tendency to develop cardiac arrest. The hemodynamic status and vital signs of these patients should be closely monitored. Early detection of potentially critical conditions to prevent critical medical intervention is mandatory.

Keywords: cardiac arrest, predicting factor, emergency department, emergency patient

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Authors: Hanieh Sakha, Nader Nader, Haleh Farzin

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Introduction: Throughout history, pain theories have been supposed by biomedicine, especially regarding its diagnosis and treatment aspects. Therefore, the feeling of pain is not only a personal experience and is affected by social background; therefore, it involves extensive systems of signals. The challenges in emotional and sentimental dimensions of pain originate from scientific medicine (i.e., the dominant theory is also referred to as the specificity theory); however, this theory has accepted some alterations by emerging physiology. Then, Von Frey suggested the theory of cutaneous senses (i.e., Muller’s concept: the common sensation of combined four major skin receptors leading to a proper sensation) 50 years after the specificity theory. The pain pathway was composed of spinothalamic tracts and thalamus with an inhibitory effect on the cortex. Pain is referred to as a series of unique experiences with various reasons and qualities. Despite the gate control theory, the biological aspect overcomes the social aspect. Vrancken provided a more extensive definition of pain and found five approaches: Somatico-technical, dualistic body-oriented, behaviorist, phenomenological, and consciousness approaches. The Western model combined physical, emotional, and existential aspects of the human body. On the other hand, Kotarba felt confused about the basic origins of chronic pain. Freund demonstrated and argued with Durkhemian about the sociological approach to emotions. Lynch provided a piece of evidence about the correlation between cardiovascular disease and emotionally life-threatening occurrences. Helman supposed a distinction between private and public pain. Conclusion: The consideration of the emotional aspect of pain could lead to effective, emotional, and social responses to pain. On the contrary, the theory of embodiment is based on the sociological view of health and illness. Social epidemiology shows an imbalanced distribution of health, illness, and disability among various social groups. The social support and socio-cultural level can result in several types of pain. It means the status of athletes might define their pain experiences. Gender is one of the important contributing factors affecting the type of pain (i.e., females are more likely to seek health services for pain relief.) Chronic non-cancer pain (CNCP) has become a serious public health issue affecting more than 70 million people globally. CNCP is a serious public health issue which is caused by the lack of awareness about chronic pain management among the general population.

Keywords: pain, sociology, sociological, body

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Authors: Mutaz Shurahabeel Ahmed Ombada

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This paper investigates potential health and financial settlement of health information technology, this paper evaluates health care with the use of IT and other associated industries. It assesses prospective savings and costs of extensive acceptance of Electronic Medical Record Systems (EMRS), models significant to health as well as safety remuneration, and conclude that efficient EMRS execution and networking could ultimately save more than US $55 billion annually through recuperating health care effectiveness and that Health Information Technology -enabled prevention and administration of chronic disease could eventually double those savings while rising health and other social remuneration. On the contrary, this is improbable to be realized without related to significant modifications to the health care system.

Keywords: electronic medical record systems, health care economics, EMRS

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Authors: Maria Luisa Barcena De Arellano, Sofya Pozdniakova, Pavelas Karkacas, Anja Kuhl, Istvan Baczko, Yury Ladilov, Vera Regitz-Zagrosek

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Introduction: Aging is associated with deterioration of the physiological function, leading to systemic inflammation and mitochondrial dysfunction that promote the development of cardiovascular diseases. Sex differences in aging-related cardiovascular diseases have been postulated. However, their precise mechanisms remain unclear. In the current study, we aimed to investigate the sex difference in the age-related alteration in Sirt1-AMPK signaling and its relation to the mitochondrial biogenesis and inflammation. Methods: Male and female human non-disease lateral left ventricular wall tissue (young (17–40 years; n= 7 male and 7 female) and old (50–68 years; n= 9 male and 8 female)) were used. qRT-PCR, western blot and immunohistochemistry assays were performed for expression analyses of Sirt1, AMPK, pAMPK, ac-Ku70, TFAM, PGC-1α, Sirt3, SOD2 and catalase. CD68 was used as a marker for macrophages and the ratio of IL-12:IL10 (pro-inflammatory phenotype (high IL-12/low IL-10) and anti-inflammatory phenotype (low IL-12/high IL-10) was used to examine the inflammatory stage in the heart. Results: Sirt1 expression was significantly higher in young females compared to young males, whereas in aged hearts Sirt1 expression was significantly downregulated in females, but not in males. In line with the Sirt1 downregulation in aged females, acetylation of nuclear Ku70, a direct target of Sirt1, in aged female hearts was significantly elevated. The activity of AMPK was significantly decreased in aged individuals, however no sex differences in the AMPK expression or activity were found in young or old individuals. The expression of mitochondrial proteins TOM40, SOD2 and Sirt3 was significantly higher in young females compared to young males, while in aged female hearts SOD2 and TOM40 were downregulated. In addition, the expression of catalase, a key cytosolic and mitochondrial anti-oxidative enzyme was significantly higher in young females and this female sex benefit was lost in aged hearts. In addition, the number of cardiac macrophages was significantly increased in old female, but not in male hearts. Consistently, the pro-inflammatory shift in old females was further confirmed by differences in the IL12/IL10 ratio in young female cardiac tissue in a favour of the anti-inflammatory mediator IL-10 (ratio 1:4) compared to young males (ratio 1:1). The anti-inflammatory environment in the heart was lost in aged females (ratio 1:1). Conclusion: Aging leads to the significant downregulation of Sirt1 expression and elevated acetylation of Ku70 in female, but not in male hearts. Furthermore, a beneficial upregulation of mitochondrial and anti-oxidative proteins in young females is lost with aging. Moreover, the malfunctions in the expression of Sirt1 and mitochondrial proteins in aged female hearts is accompanied by a significant pro-inflammatory shift. The study provides a molecular basis for the increased incidence of cardiovascular diseases in old women.

Keywords: inflammation, mitochondrial dysfunction, aging, Sirt1-AMPK axis

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Authors: Kehinde Joseph Awosan, Balarabe Adami Isah, Edzu Usman Yunusa, Sarafadeen Adeniyi Arisegi, Izuchukwu Obasi, Oluchi Solomon-Anucha

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Background: Metabolic syndrome (MetS) is prevalent in patients with diabetes mellitus and a significant risk for major cardiovascular events. Identifying its burden and peculiarities is crucial to preventing complications among those at risk. Aim: This study was conducted to determine the prevalence and predictors of metabolic syndrome among diabetes clinic attendees in Sokoto, Nigeria. Materials and Methods: A cross-sectional study was conducted among 365 patients with type 2 diabetes attending the diabetes clinic of Specialist Hospital, Sokoto, Nigeria. A structured questionnaire was used to obtain data on the respondents’ socio-demographic variables, treatment history, and lifestyle. Blood pressure and anthropometric measurements (including weight, height, and waist circumference) were done for the patients. Likewise, biochemical assessment (including fasting plasma glucose, high-density lipoprotein cholesterol (HDL-c), and triglyceride (TG) was done. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III). Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 25. Results: The ages of the patients ranged from 30 to 78 (mean = 50.9 ±11.7) years. The overall prevalence of MetS was 57.3%, with a higher prevalence in females (68.1%) than males (43.0%). The most common components of MetS observed were hypertension (69.2%), and elevated fasting plasma glucose (65.7%); while the predictors of MetS were age > 50 years (OR 6.960, 95% CI: 3.836-12.628, p < 0.001), female sex (OR 2.300, 95% CI: 1.355-3.903, p = 0.002), physical activity (OR 0.214, 95% CI: 0.126-0.363, p < 0.001), and overweight/obesity (OR 3.356, 95% CI: 1.838-6.127, p < 0.001). Conclusion: Metabolic syndrome is prevalent among patients with type 2 diabetes in Sokoto, Nigeria, and the predictors were age > 50 years, female sex, physical activity, and overweight/obesity. Diabetes care providers should screen their patients for MetS to prevent adverse cardiovascular events.

Keywords: prevalence, predictors, metabolic syndrome, diabetes

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Authors: Boitumelo Ditshwane, Zelda Janse van Rensburg, Wanda Jacobs,

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Health literacy is defined as competencies and skills that individuals need to find, comprehend, evaluate, and use to make knowledgeable choices to improve their health and well-being. Low health literacy has been found to affect people’s ability to take care of their own health. Incomprehension of health education and health care instructions due to low health literacy is often due to information given at a level that is above the patient’s level of understanding. The study aimed to test the health literacy levels of South African PHC patients using a previously developed health literacy assessment tool. Determining health literacy levels may assist PHC nurses in providing health education and health care instructions to the patient on the patient’s level of understanding and, therefore, ensuring positive health outcomes for the patient. A health literacy assessment tool, translated into ten official South African languages, was used to quantitatively determine the health literacy levels of 400 PHC patients in five clinics in Gauteng, South Africa. Patients’ health literacy levels were tested in English, and nine other official languages spoken in South Africa and were compared. The results revealed that patients understand information better when given in their preferred language. Giving health education in a language and level that is better understood by the patient may lead to better health outcomes and prevent adverse health. Patients may better understand instructions provided, be more likely to follow the correct route of medication, honor appointments, comply with medication, and thus have better treatment outcomes.

Keywords: health literacy, primary health care, South Africa, patients

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Authors: Armaghan Moravej Aleali, Hajieh Shahbazian, Seyed Mahmoud Latifi, Leila Yazdanpanah

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Objective: Metabolic syndrome or insulin resistance syndrome or syndrome X is a collection of abdominal obesity, hypertension, glucose intolerance and lipid abnormalities (elevated triglycerides, elevated LDL, and decrease the amount of HDL). That increases the incidence of diabetes and risk of cardiovascular disease. The aim of this study is to investigate the prevalence of metabolic syndrome in people over 20 years of Ahvaz according to IDF, ATPIII, Harmonized I and Harmonized II. Material & Methods: A cross-sectional study with a random cluster sampling in six health centers in Ahvaz was done. After obtaining informed consent, questionnaire for each person filled up including demographic data and examinations, including blood pressure in sitting position, weight, height, waist circumference, and waist circumference measurement. Results: From all participating 912 people, (434 (2/47%) male and 478 (2/52%) female) were evaluated. Mean age was 42/27± 14years (44/2±14/26 for male and 40/5±13/5 for female). Prevalence of metabolic syndrome was 22/8%, 28/4%, 30/9% and 16/9% according to ATPIII, IDF, Harmonized I and Harmonized II criteria respectively and increased with age in both sexes. IDF and Harmonized I had most kappa coordination (0/94). Conclusion: The results show a high prevalence of metabolic syndrome in Ahvaz. So, identification of the risk factors should be attempted to prevent metabolic syndrome.

Keywords: metabolic syndrome, IDF, ATP III, prevalence

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Authors: Shu-Hsi Ho

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The problems of aging and number of widowed peers gradually rise in Taiwan. It is worth to concern the related issues for elderly after the death of a spouse. Hence, this study is to examine the impact of spousal death on the surviving spouse’s self-perceived health and mental health for the elderly in Taiwan. A cross section data design and ordered logistic regression models are applied to investigate whether marriage is associated significantly to self-perceived health and mental health for the widowed older Taiwanese. The results indicate that widowed marriage shows significant negative effects on self-perceived health and mental health regardless of widows or widowers. Among them, widows might be more likely to show worse mental health than widowers. The belief confirms that marriage provides effective sources to promote self-perceived health and mental health, particularly for females. In addition, since the social welfare system is not perfect in Taiwan, the findings also suggest that family and social support reveal strongly association with the self-perceived health and mental health for the widows and widowers elderly.

Keywords: logistic regression models, self-perceived health, widow, widower

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Authors: Nevruz Zogu, Shpetim Rezniqi

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In the framework of transformational economic development social pluralism and the free, market health systems operating in the countries of our region are naturally involved in a process of profound change and reform. Health systems actually represent complex ensembles centers and public and private institutions (domestic and foreign), who administer substantial amounts of human, technological, material, financial, information and scientific facts • The goal of health systems is much more than medical care. It includes the promotion, protection, treatment and rehabilitation of health of the population. • Meeting the needs of increasingly diverse broader health services efficient, secure the quality and affordability of their increasing cost of unstoppable, requires the necessary reform of health systems and implementing policies and new management methods, to ensure effectiveness and health benefits as higher population.

Keywords: health, management, economy, finance

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Authors: Marisol Warthon-Medina, Jenny Plumb, Ayoub Aljawaldeh, Mark Roe, Ailsa Welch, Maria Glibetic, Paul M. Finglas

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Similar to Western Countries, the Eastern Mediterranean Region (EMR) also presents major public health issues associated with the increased consumption of sugar, fat, and salt. Therefore, one of the policies of the World Health Organization’s (WHO) EMR is to reduce the intake of salt, sugar, and fat (Saturated fatty acids, trans fatty acids) to address the risk of non-communicable diseases (i.e. diabetes, cardiovascular disease, cancer) and obesity. The project objective is to assess status and provide training and capacity development in the use of improved standardized methodologies for updated food composition data, dietary intake methods, use of suitable biomarkers of nutritional value and determine health outcomes in low and middle-income countries (LMIC). Training exchanges have been developed with clusters of countries created resulting from regional needs including Sudan, Egypt and Jordan; Tunisia, Morocco, and Mauritania; and other Middle Eastern countries. This capacity building will lead to the development and sustainability of up-to-date national and regional food composition databases in LMIC for use in dietary monitoring assessment in food and nutrient intakes. Workshops were organized to provide training and capacity development in the use of improved standardized methodologies for food composition and food intake. Training needs identified and short-term scientific missions organized for LMIC researchers including (1) training and knowledge exchange workshops, (2) short-term exchange of researchers, (3) development and application of protocols and (4) development of strategies to reduce sugar and fat intake. An initial training workshop, Morocco 2018 was attended by 25 participants from 10 EMR countries to review status and support development of regional food composition. 4 training exchanges are in progress. The use of improved standardized methodologies for food composition and dietary intake will produce robust measurements that will reinforce dietary monitoring and policy in LMIC. The capacity building from this project will lead to the development and sustainability of up-to-date national and regional food composition databases in EMR countries. Supported by the UK Medical Research Council, Global Challenges Research Fund, (MR/R019576/1), and the World Health Organization’s Eastern Mediterranean Region.

Keywords: dietary intake, food composition, low and middle-income countries, status.

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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The COVID-19 pandemic has presented an opportune time for China to deploy its health diplomacy around the world. This paper focused on China’s health diplomacy along the path of its Health Silk Road, with particular emphasis on the Middle East and Europe amid COVID-19. This paper employed a retrospective literature review, analyzed China’s health diplomacy in such regions to cultivate bilateral and multilateral relationships. And findings argued that such health diplomacy is a success, and Beijing has assumed a leadership role in the world’s health governance. This research contributes to the literature in health diplomacy and suggests that amid the ever changing international order, China has exerted great effort in its health diplomacy and established itself as a responsible world power.

Keywords: china’s health silk road, COVID-19, europe, middle east

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Authors: Ha Hai Duong, Amnon Levy Livermore, Kankesu Jayanthakumaran, Oleg Yerokhin

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The issues of economic development, the environment and human health have been investigated since 1990s. Previous researchers have found different empirical evidences of the relationship between income and environmental pollution, health as determinant of economic growth, and the effects of income and environmental pollution on health in various regions of the world. This paper concentrates on integrative relationship analysis of GDP, carbon dioxide emissions, and health services and population health in context of Vietnam. We applied the dynamic generalized method of moments (GMM) estimation on datasets of Vietnam’s sixty-three provinces for the years 2000-2010. Our results show the significant positive effect of GDP on emissions and the dependence of population health on emissions and health services. We find the significant relationship between population health and GDP. Additionally, health services are significantly affected by population health and GDP. Finally, the population size too is other important determinant of both emissions and GDP.

Keywords: economic development, emissions, environmental pollution, health

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Authors: Tsai Su Hui

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Background: Hyperphosphatemia in patients receiving dialysis can cause hyperparathyroidism, which can lead to renal osteodystrophy, cardiovascular disease and mortality. Data showed that 26% of patients receiving dialysis had blood phosphate levels of >6.0 mg/dl at this unit from January to March 2017, higher than the Taiwan Society of Nephrology evaluation criteria of < 20%. After analysis, possible reasons included: 1. Incomprehensive education for nurse and lack of relevant training. 2. Insufficient assistive aids for nursing health education instruction. 3. Patients were unsure which foods are high or low in phosphate. 4. Patients did not have habits of taking medicine with them and how to correctly administer the medication. Purpose: To reduce the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl to less than 20% at this unit. Method: (1) Improve understanding of hyperphosphatemia and food for patients receiving dialysis and their families, (2) Acquire more nursing instruction assistive aids and improve knowledge of hyperphosphatemia for nurse. Results: After implementing the project, the percentage of patients receiving dialysis with blood phosphate levels of >6.0 mg/dl decreased from 26.0% to 18.8% at this unit. By implementing the project, the professional skills of nurse improved, blood phosphate levels of patients receiving dialysis were reduced, and the quality of care for patients receiving dialysis at this unit was enhanced.

Keywords: hemodialysis, hyperphosphatemia, incidence, reducing

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

Abstract:

The outbreak of the COVID-19 epidemic has caused great difficulties for South-South cooperation, but there are also opportunities. China’s health diplomacy has changed from dispatching medical teams, assisting in the construction of hospitals, and encouraging medical investment in the Africa health sector. This paper adopted a retrospective review of China’s health diplomacy in Africa from 1963 to 2020. Findings suggested that China has a preference for aiding Africa health infrastructure and sending medical teams to African countries. China’s health diplomacy in Africa is a success and has established secure diplomatic relations with African countries, thanks to the medical and health assistance to Africa over 60 years. This research contributes to the literature of health diplomacy and foreign relations and indicates that China’s health aid has fostered cooperation at the medical and diplomatic levels.

Keywords: Africa, china’s health diplomacy, COVID-19, bilateral relations

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Authors: Jackson Ishara, Ariel Buzera, Gustave N. Mushagalusa, Ahmed R. A. Hammam, Judith Munga, Paul Karanja, John Kinyuru

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Numerous mushroom bioactive metabolites, including polysaccharides, eritadenine, lignin, chitosan, mevinolin, and astrakurkurone have been studied in life-threatening conditions and diseases such as diabetes, cardiovascular, hypertension, cancer, DNA damage, hypercholesterolemia, and obesity attempting to identify natural therapies. These bioactive metabolites have shown potential as antiviral and immune system strengthener natural agents through diverse cellular and physiological pathways modulation with no toxicity evidence, widely available, and affordable. In light of the emerging literature, this paper compiles the most recent information describing the molecular mechanisms that underlie the nutraceutical potentials of these mushroom metabolites suggesting their effectiveness if combined with existing drug therapies. The findings raise hope that these mushroom bioactive metabolites may be utilized as natural therapies considering their therapeutic potential while anticipating further research designing clinical trials and developing new drug therapies while encouraging their consumption as a natural adjuvant in preventing and controlling life-threatening conditions and diseases.

Keywords: bioactive metabolites, food functionality, health-threatening conditions, mushrooms, nutraceutical

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Authors: Ladislas Havugimana, Véronique Zinnen, Mary Hadley, Jean Claude Mwumvaneza, Francois Régis Habarugira, Silas Rudasingwa, Victor Ndaruhutse, Evelyne Bocquet

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Rwanda's health systems face various challenges, including low health infrastructure coverage (the objective is to have at least one health center per administrative sector) and insufficient qualified human resources for infrastructure maintenance and financing. Moreover, there is no policy for the preventive maintenance of infrastructures for the health sector. This paper presents action research conducted in seven districts, focusing on the impact of health infrastructure's quality on maternal and neonatal care, with the support of the Belgian cooperation agency through Enable Barame project.

Keywords: health infrastructure, maintenance, maternity, neonatology

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Authors: Elizabeth Waleola Afolabi-Soyemi

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As the population of older adults continues to grow, improving health outcomes for this demographic has become an increasingly important public health goal. Health promotion interventions have been developed to address the unique health needs and challenges faced by older adults. This abstract reviews the literature on health promotion interventions for older adults and their effectiveness in improving health outcomes. Various interventions have been found to be effective, including physical activity programs, nutrition education, medication management, and social support programs. These interventions have been shown to improve outcomes such as functional status, quality of life, and disease management. Despite the success of these interventions, there are still barriers to their implementation, such as a lack of access to resources and inadequate funding. Further research is needed to identify effective strategies for overcoming these barriers and to develop more tailored interventions for specific populations of older adults. Overall, health promotion interventions have great potential to improve the health outcomes and quality of life of older adults and should be a priority for public health efforts.

Keywords: health, humanity, health promotion, older adults

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Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi

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Introduction: Identifying sexual health needs, developing appropriate plans, and delivering services to meet those needs is an essential component of health programs for women, men, and children all over the world, especially in poor countries. Main Subject: The aim of this study was to describe the needs of sexual health from the viewpoint of health policymakers in Iran. Methods: A qualitative study using thematic content analysis was designed and conducted. Data gathering was conducted through semi-structured, in-depth interviews with 25 key informants within the healthcare system. Key informants were selected through both purposive and snowball sampling. MAXQUDA software (version 10) was used to facilitate transcription, classification of codes, and conversion of data into meaningful units, by the process of reduction and compression. Results: The analysis of narratives and information categorized sexual health needs into five categories: culturalization of sexual health discourse, sexual health care services, sexual health educational needs, sexual health research needs, and organizational needs. Conclusion: Identifying and explaining sexual health needs is an important factor in determining the priority of sexual health programs and identification of barriers to meet these needs. This can help other policymakers and health planners to develop appropriate programs to promote sexual and reproductive health.

Keywords: sexual health, sexual health needs, policy makers, health system, qualitative study

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Authors: Samiullah Paracha, Sania Jehanzeb, M. H. Gharanai, A. R. Ahmadi, H.Sokout, Toshiro Takahara

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The purpose of this study is to examine how health consumers utilize pictures when developing an understanding of multimedia health documents, and whether attentional processes, measured by eye-tracking, relate to differences in health-related cognitive resources and passage comprehension. To investigate these issues, we will present health-related text-picture passages to elders and collect eye movement data to measure readers’ looking behaviors.

Keywords: multimedia, eye-tracking, consumer health informatics, human-computer interaction

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Authors: Rachel Tambyah, Katarzyna Olcoń, Julaine Allan, Pete Destry, Thomas Astell-Burt

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The rising social and financial burden of mental illness indicates an urgent need to explore interventions that can be used as well as or instead of traditional treatments. Although there is growing evidence of the positive mental health outcomes of spending time in nature, the implementation of nature-based interventions (NBIs) within mental health services remains minimal. Based on interviews with mental health clinicians in Australia, this study demonstrated that clinicians supported the use of NBIs and would promote them to their clients.

Keywords: nature, nature-based interventions, mental health, mental health services, mental health clinicians

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Authors: Anna Paola Micheli, Carmelo Intrisano, Anna Maria Calce

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This research focused on the capability of health tourism to improve the economic and financial performance of healthcare companies. It is assumed that health tourism companies have better profitability and financial efficiency because they can also count on cross-border demand differently from no health tourism companies. A three-level gap analysis was conducted: the first concerns health tourism companies located in Italy and in the other EU28 states; in the second Italian and EU28, no health tourism companies were compared; the third level is about the Italian system with a comparison between health tourism and no health tourism companies. Findings highlighted that Italian healthcare companies have better profitability performance if compared to European ones, but they present weaknesses in the financial position given the illiquidity and excessive leverage. Furthermore, studying the Italian system, we found that health tourism companies are more profitable than no health tourism companies.

Keywords: financial performance, gap analysis, health tourism, profitability performance, value creation

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