Search Results (29)

Background/Objectives: Iran carries a significant burden of mental health disorders. This study aimed to describe the status of mental health and mental health care in Iran between 2012 and 2023, addressing inequalities and mapping existing challenges in the mental health care system. Methods: A systematic literature review was conducted. Databases including Medline, CINAHL, APA PsycINFO, Scopus, Web of Science, and the Cochrane Library, as well as local databases such as SID, Magiran, and Noormags, were searched to identify studies related to mental health care in Iran. A total of 59 studies met the inclusion criteria. An inductive approach and thematic analysis were used to synthesize themes from the data. Results: Lower socioeconomic status (SES) was associated with higher rates of mental disorders due to poverty-related stressors and limited access to quality care. Gender disparities revealed that women are more vulnerable to mental health problems, exacerbated by perceived gender inequality. Ethnic minorities and undocumented migrant populations faced inadequate healthcare services, resulting in poorer mental health outcomes. Children and older adults also experienced mental health challenges influenced by sociodemographic factors. The main challenge for mental health care is establishing mechanisms to ensure more equitable access for all citizens. Additional challenges include limited awareness among policymakers, insufficient budget allocation, weak prevention programs, and poor intra- and inter-sectoral coordination and collaboration. A shortage of mental health care providers, as well as deficiencies in structure, system processes, and resources, further hinder progress. Conclusions: Socioeconomic factors exacerbate the challenges of Iran’s under-resourced mental health system. To address these issues, equity considerations must be integrated into mental health policies. Key interventions include the routine monitoring of mental health indicators, expanding insurance coverage for mental health services, and establishing dedicated services for children. Full article

Sudden Infant Death Syndrome (SIDS) is one of the leading causes of postnatal mortality, with the prone sleeping position identified as a critical risk factor. This article presents the design, implementation, and validation of a low-cost embedded system for unobtrusive, real-time monitoring of infant posture. The system acquires data from a pressure mat on which the infant rests, converting the pressure matrix into an image representing the postural imprint. A Convolutional Neural Network (CNN) has been trained to classify these images and distinguish between prone and supine positions with high accuracy. The trained model was optimized and deployed in a data acquisition and processing system (DAQ) based on the Raspberry Pi platform, enabling local and autonomous inference. To prevent false positives, the system activates a visual and audible alarm upon detection of a sustained risk position, alongside remote notifications via the MQTT protocol. The results demonstrate that the prototype is capable of reliably and continuously identifying the infant’s posture when used by people who are not technology experts. We conclude that it is feasible to develop an autonomous, accessible, and effective monitoring system that can serve as a support tool for caregivers and as a technological basis for new strategies in SIDS prevention. Full article

Affordable public housing has been identified as a key programme initiative towards social infrastructural development. Scholarship has shown that sustainable affordable public housing (SAPH) aids in achieving the UN Sustainable Development Goals (SDGs), especially SDG 1 (No Poverty), SDG 9 (Industry, Innovation and Infrastructure) and SDG 11 (Sustainable Cities and Communities). There exists a dire need for sustainable and affordable housing initiatives in Small Island Developing States (SIDS). The purpose of this research paper is to investigate the relationship between sustainability and affordable public housing development by extracting and ranking critical success factors (CSFs) associated with SAPH in Caribbean SIDS. By adopting a quantitative methodology, a closed-ended questionnaire was administered to relevant personnel associated with the construction industry to rank the risk impact of various success factors relating to SAPH and produce a Structural Equation Model (SEM). The findings revealed that CSFs for SAPH in SIDS are context specific and deviated from the general literature. CSFs were broadly grouped into economic, energy efficiency and transparency, and construction execution categories. The most pertinent CSF was the implementation of risk reduction inputs into the planning stages of construction projects. These risk reduction inputs are important preventive measures for disasters and contribute to achieving social, economic and environmental sustainability within Caribbean SIDS. This research aims to bridge the gap between academic research and praxis to advance a sustainable construction industry within SIDS while contributing to the critically limited body of knowledge on SAPH within developing nations. It also aims to form the foundation of sustainable housing within SIDS based on the Triple Bottom Line (TBL) theory. Full article

Myocarditis, an inflammatory disease of the myocardium, is increasingly recognized as a potential contributor to sudden infant death syndrome (SIDS), though often underdiagnosed. This study reviews the current literature on the association between myocarditis and sudden death in infants, with a focus on autopsy and histopathological findings. A comprehensive search of the PubMed database yielded 64 studies published between 1960 and 2024; after applying specific inclusion criteria—such as patient age (0–6 years), presence of autopsy data, and forensic investigation—40 studies were analyzed in detail. The review identified myocarditis—especially lymphocytic—as an underrecognized but critical cause of sudden death in infants and children. Histological, molecular, and immunohistochemical findings highlighted viral infections, immune dysregulation, and structural anomalies as frequent etiological factors. Several SIDS cases were reclassified as myocarditis upon in-depth examination. These findings underscore the value of standardized autopsy protocols and integrated diagnostic approaches. Advanced postmortem diagnostic techniques, including polymerase chain reaction (PCR) and immunohistochemistry, have enhanced the detection of viral myocarditis. In addition, structural cardiac anomalies, such as cardiomyopathies and coronary abnormalities, may co-exist and contribute to sudden cardiac death. These findings emphasize the need for standardized autopsy protocols and the integration of molecular diagnostics in forensic investigations of SIDS. Further research is essential to improve early detection, refine diagnostic criteria, and develop preventive strategies to reduce the incidence of sudden infant death related to myocarditis. Full article

Background: Effective prevention of SIDS/SUID requires a multidimensional approach. It is essential to provide targeted support for marginalized families, improve access to healthcare services, and implement policies aimed at reducing social and economic inequalities. The parallel effective way to reduce the risk of sudden unexpected infant death is through increased awareness of proper infant care. Despite the guidelines available in many countries, the risk of infant death from non-medical causes is still reported. The aim of the study was to assess awareness regarding an infant’s sleep environment and safe sleep practices among Polish caregivers. Methods: The survey was conducted among 451 mothers of infants under 18 months of age. The survey questionnaire was prepared, which consisted of single- and multiple-choice questions with closed and open answers assessing safe sleep practices. Results: Analysis of the survey responses showed that most mothers in the sample (88.9%) were aware that the supine position is the safest. According to the survey, 74.5% of respondents believed that infants should not sleep in the same bed as parents or siblings. In addition, 78.3% of those women stated that infants should sleep separately in their own bed. Despite this knowledge, almost 37.76% of female respondents still put their infants to sleep in their parents’ bed. As many as 98.4% of respondents knew that any items should not be placed in an infant’s crib. Despite this knowledge, a third of respondents still placed additional items in their baby’s crib. In the study 90.7% of women believed that breastfeeding should begin within the first hour after birth. Conclusions: Knowledge of safe sleep recommendations, including sleep environment, sleep position, and spatial organization, does not always translate into proper caregiving practices. Understanding caregivers’ motivations and how they perceive medical information is critical to effective prevention of infant sleep safety. Full article

This paper investigates the ultimate socioeconomic causes underlying the termination of parental investment in humans by analyzing the relationship between socioeconomic status and various forms of child mortality, including live births, stillbirths, infant deaths, and infanticide. Utilizing theoretical foundations from human behavioral ecology, the study illustrates how different forms of termination of parental investment can be viewed as points along a continuum of adaptive strategies aimed at optimizing reproductive fitness. The research emphasizes that technical and cognitive limitations lead to many instances of infanticide being concealed as natural child deaths, such as Sudden Infant Death Syndrome (SIDS), thus complicating the accurate detection of true causes of death. However, addressing common ultimate causes—specifically socioeconomic factors such as healthcare accessibility, nutritional quality, social support, and stress reduction—can simultaneously prevent or reduce all forms of investment termination. The paper further analyzes demographic data from Zagreb and surrounding municipalities. Ultimately, the study advocates a holistic approach to public health interventions and policies aimed at improving socioeconomic conditions as a crucial step toward reducing all forms of child mortality. Full article

Accurate identification of surgical instruments is crucial for efficient workflows and patient safety within the operating room, particularly in preventing complications such as retained surgical instruments. Artificial Intelligence (AI) models have shown the potential to automate this process. This study evaluates the accuracy of publicly available Large Language Models (LLMs)—ChatGPT-4, ChatGPT-4o, and Gemini—and a specialized commercial mobile application, Surgical-Instrument Directory (SID 2.0), in identifying surgical instruments from images. The study utilized a dataset of 92 high-resolution images of 25 surgical instruments (retractors, forceps, scissors, and trocars) photographed from multiple angles. Model performance was evaluated using accuracy, weighted precision, recall, and F1 score. ChatGPT-4o exhibited the highest accuracy (89.1%) in categorizing instruments (e.g., scissors, forceps). SID 2.0 (77.2%) and ChatGPT-4 (76.1%) achieved comparable accuracy, while Gemini (44.6%) demonstrated lower accuracy in this task. For precise subtype identification of instrument names (like “Mayo scissors” or “Kelly forceps”), all models had low accuracy, with SID 2.0 having an accuracy of 39.1%, followed by ChatGPT-4o (33.69%). Subgroup analysis revealed ChatGPT-4 and 4o recognized trocars in all instances. Similarly, Gemini identified surgical scissors in all instances. In conclusion, publicly available LLMs can reliably identify surgical instruments at the category level, with ChatGPT-4o demonstrating an overall edge. However, precise subtype identification remains a challenge for all models. These findings highlight the potential of AI-driven solutions to enhance surgical-instrument management and underscore the need for further refinements to improve accuracy and support patient safety. Full article

Ventilatory drive is modulated by a variety of neurochemical inputs that converge on spatially oriented clusters of cells within the brainstem. This regulation is required to maintain energy homeostasis and is essential to sustain life across all mammalian organisms. Therefore, the anatomical orientation of these cellular clusters during development must have a defined mechanistic basis with redundant genomic variants. Failure to completely develop these features causes several conditions including apnea of prematurity (AOP) and sudden infant death syndrome (SIDS). AOP is associated with many adverse outcomes including increased risk of interventricular hemorrhage. However, there are no pharmacological interventions that reduce SIDS and AOP prevalence by promoting brainstem development. AMP-activated protein kinase (AMPK) is a kinase that regulates ventilatory control to maintain homeostasis. This study identifies a signaling axis in which the pharmacological activation of AMPK in vivo via metformin in brainstem ventilatory control centers results in the phosphorylation of LIM homeobox transcription factor 1-beta (Lmx1b), a key player in dorsal–ventral patterning during fetal development. The phosphorylation of Lmx1b transactivates a neurogenic interactome important for the development and regulation of ventilatory control centers. These findings highlight the potential for metformin in the treatment and prevention of AOP. Full article

Background: Sleep care is crucial for the health and development of infants, with proper sleep patterns reducing the risk of sudden infant death syndrome (SIDS) and other sleep-related incidents. Educational interventions targeting caregivers are essential in promoting safe sleep practices. Methods: This systematic review adhered to PRISMA guidelines, searching databases such as PubMed, MEDLINE, Scopus, and the Cochrane Library. Inclusion criteria focused on studies involving home-based interventions for infants aged 0–12 months, including parental education and behavioral interventions. Exclusion criteria included studies in clinical settings and non-peer-reviewed articles. Data extraction and synthesis were performed by two independent reviewers, using a narrative approach to categorize interventions and outcomes. Results: Twenty-three studies met the inclusion criteria. Key findings indicate that home-based educational interventions, including hospital-based programs, home visits, and mobile health technologies, significantly improve parental knowledge and adherence to safe sleep practices. These interventions also enhance parental satisfaction and contribute positively to infant health outcomes. Conclusions: Educational interventions have demonstrated effectiveness in promoting safe sleep practices among caregivers, particularly in home settings. These interventions, including hospital-based programs, home visits, and digital tools, improve parental knowledge, adherence to guidelines, and overall satisfaction. The impact is evident in the reduction of unsafe sleep behaviors and enhanced infant health outcomes. However, variability in the intervention methods and delivery, cultural contexts, and geographic focus suggest a need for more tailored, long-term, and comprehensive studies. Future research should standardize outcome measures and assess the sustained impact of these educational strategies on infant sleep patterns and caregiver practices over time. This will provide deeper insights into the trends and long-term effectiveness of educational patterns and methods in diverse home environments. Full article

Background: Cardiovascular diseases are some of the most prevalent chronic diseases that generate not only high social but also economic costs. It is becoming increasingly crucial to take into account inborn errors of immunity (IEIs, formerly known as primary immunodeficiencies (PIDs)) and secondary immunodeficiencies (SIDs) in the diagnostic and therapeutic management of cardiac patients. The number of diseases classified as IEIs is on the rise, with a current total of 485. It is essential to pay attention not only to already confirmed conditions but also to symptoms suggestive of immunodeficiencies. Objectives: The aim of this article is to present IEIs with cardiovascular symptoms that may cause or exacerbate cardiovascular disease, as well as diagnostic and therapeutic procedures. Results: It is becoming increasingly evident that immunodeficiencies can be responsible for certain cardiovascular conditions, their hastened progression, and difficulties in their control. Conclusions: Early detection of deficiencies improves not only the quality and longevity of patients, but also allows for better control of cardiovascular diseases and even prevention of their occurrence. Full article

Sudden Infant Death Syndrome (SIDS) is a leading cause of infant mortality across the United States and the world. There are multiple environmental and behavioral determinants of sudden infant death which are modifiable risk factors and potential targets for intervention. In this increasingly digital era, health education and communication on SIDS have taken many forms, which extend to social media. Current published studies on coverage of infant safe sleep practices are scant and were published well before the newly revised guidelines of the American Academy of Pediatrics that review ways to prevent infant sleep-related deaths based on evidence-based SIDS-reduction measures. In this Perspective: Review of a Pediatric Field, the current state of published knowledge and coverage on a range of infant safe sleep considerations across social media are reviewed. We delineate gaps in the knowledge and practice as well as the central differences between the 2016 and 2022 AAP Safe Sleep guidelines. We also present recommendations for further research and practice which support coverage of future content on the revised guidelines across social media as the basis to present the most up-to-date and evidence-based information for reducing sudden infant death from sleep-related causes. Tapping into the potential of social media as a learning modality in health promotion also contributes towards the larger goal of the World Health Organization, United Nations International Children’s Emergency Fund (UNICEF), and Healthy People 2030 to reduce infant mortality on both global and national levels. Full article

Cloud cryptography is the art of converting plain text into an unreadable format, which protects data and prevents the data from being misused by the attacker. Different researchers designed various Caesar cipher algorithms for data security. With the help of these algorithms, the data can be converted into a nonreadable format, but the data cannot be completely secured. In this paper, data security is provided in different phases. Firstly, data are secured through a bit-reversing mechanism in which those replace the actual values with no relation to the original data. Then the four-bit values are added at the beginning and end of bits using a salting mechanism to interlink the salting and existing bit-values and hide the original data. A Caesar cipher value is obtained by applying the Caesar cipher algorithm to the resulting bits. The Caesar cipher algorithm is used to implement number-of-shifting on the obtained values. An efficient cipher matrix algorithm is then developed in which different rules are designed to encrypt the data. Afterward, a secure cipher value is obtained by implementing Cipher XORation rules on the result obtained and the user-defined key. In the end, the proposed algorithm is compared with various papers. It identifies how much better the proposed algorithm performs than all the previous algorithms and how much the attack rate can be reduced if this algorithm is used for data security. Full article

Sudden Infant Death Syndrome (SIDS) is the third leading cause of death among infants younger than one year of age. Effective SIDS prediction models have yet to be developed. Hence, we developed a risk score for SIDS, testing contemporary factors including infant exposure to passive smoke, circumcision, and sleep position along with known risk factors based on 291 SIDS and 242 healthy control infants. The data were retrieved from death certificates, parent interviews, and medical records collected between 1989–1992, prior to the Back to Sleep Campaign. Multivariable logistic regression models were performed to develop a risk score model. Our finalized risk score model included: (i) breastfeeding duration (OR = 13.85, p < 0.001); (ii) family history of SIDS (OR = 4.31, p < 0.001); (iii) low birth weight (OR = 2.74, p = 0.003); (iv) exposure to passive smoking (OR = 2.64, p < 0.001); (v) maternal anemia during pregnancy (OR = 2.07, p = 0.03); and (vi) maternal age <25 years (OR = 1.77, p = 0.01). The area under the curve for the overall model was 0.79, and the sensitivity and specificity were 79% and 63%, respectively. Once this risk score is further validated it could ultimately help physicians identify the high risk infants and counsel parents about modifiable risk factors that are most predictive of SIDS. Full article

Sudden infant death syndrome (SIDS) represents the leading cause of death in under one year of age in developing countries. Even in our century, its etiology is not clear, and there is no biomarker that is discriminative enough to predict the risk of suffering from it. Therefore, in this work, taking a public dataset on the lipidomic profile of babies who died from this syndrome compared to a control group, a univariate analysis was performed using the Mann–Whitney U test, with the aim of identifying the characteristics that enable discriminating between both groups. Those characteristics with a p-value less than or equal to 0.05 were taken; once these characteristics were obtained, classification models were implemented (random forests (RF), logistic regression (LR), support vector machine (SVM) and naive Bayes (NB)). We used seventy percent of the data for model training, subjecting it to a cross-validation (k = 5) and later submitting to validation in a blind test with 30% of the remaining data, which allows simulating the scenario in real life—that is, with an unknown population for the model. The model with the best performance was RF, since in the blind test, it obtained an AUC of 0.9, specificity of 1, and sensitivity of 0.8. The proposed model provides the basis for the construction of a SIDS risk prediction computer tool, which will contribute to prevention, and proposes lines of research to deal with this pathology. Full article

Hospital workers in Aruba have been facing an increased demand for healthcare in the unique setting of a Small Island Developing State (SIDS). This study assessed the impact of the first wave of the SARS-CoV-2 pandemic on the mental health of staff at the major hospital in Aruba, examining the differences between employee groups, with the goal of providing recommendations for targeted support and coping strategies in future crises in a small island setting. Patients and methods: In a mixed-method cohort design, Dr. Horacio E. Oduber Hospital staff were asked to complete a 25-item questionnaire about their concerns and worries, organization of work, and general wellbeing; 24% of the hospital staff filled in the questionnaire (mean age 41 ± 11 years, 79% female). Alongside the needs assessment questionnaire, six focus groups were established to explore staff feelings on specific measures taken by hospital management during the COVID-19 crisis. Results: Questionnaire analysis (n = 231) revealed employees’ concerns about infecting their relatives and their financial stability. In particular, nurses were significantly more concerned than other staff groups. In the wellbeing section of the questionnaire, items regarding future security scored poorest, alongside increased levels of tiredness and nervousness. Focus groups discussions revealed frustrations of the hospital staff with the foreign staff brought in to help during the crisis and a need for better leadership and communication practices from hospital management. Conclusions: Comprehensive and holistic approaches should be implemented by the hospital management to prevent occupational burnout and demoralized work ethics and further emotional exhaustion. Full article