Search Results (109)

Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks. Full article

Puerto Rico has faced significant damage from natural disasters and the COVID-19 pandemic, disrupting clinical services and scientific research logistics. In response, the RCMI-CCRHD Program at the UPR-MSC organized a retreat with the objective of understanding the challenges faced by its research network during the pandemic and strategies to overcome them. The retreat featured presentations on COVID-19 supplemental projects and included a discussion group. Twenty attendees identified the challenges they encountered and the strategies developed through an open-ended question and a satisfaction survey, implementing a mixed-method approach. We performed a content analysis on the open-ended survey questions and used descriptive statistics for the satisfaction survey. Key challenges included remote work implementation, recruitment difficulties, and mental health concerns. Attendees shared actions taken to address these issues, such as modifying protocols for remote planning and using digital platforms for improving communication. They also recognized opportunities that arose from remote work, which allowed them to focus on publishing and adapting mental health support tools. The retreat received positive feedback, with 93.8% of attendees giving a five-star rating. By reflecting on these experiences, investigators can refine strategies and implement effective solutions. Recommendations include flexible IRB protocols, improved digital tools, community involvement, and robust emergency preparedness plans. Full article

Background: The health benefits associated with the consumption of nuts and seeds are well established, yet this food group is known to be the furthest from the recommended intake; therefore, actions aiming to increase nut intake are needed. The main front-of-pack communication device in Australia, the Health Star Rating (HSR), inadvertently penalises nuts with negative points associated with energy and saturated fat content. Methods: This study aims to suggest options to policy makers by (i) examining how the HSR rates a sample of 82 nuts, seeds and products containing them and (ii) testing three sets of moderate adjustments of the HSR algorithm on the sampled products: discounting the energy from nuts and seeds (S1), discounting the saturated fat from nuts and seeds (S2) and applying an adapted algorithm based on that for ‘oils and spreads’ for foods with ≥50% nuts and seeds (S3). Results: All three scenarios improved the Spearman correlation between the HSR score and the nut and seed content (−0.80, −0.75 and −0.71 for S1, S2 and S3, respectively) compared to the original HSR (−0.66). Products with more than 50% of their weight being nuts and seeds benefited much more from these adjustments than those below 50%. For all scenarios, but most clearly for S3, the products that had a lower HSR score than the original HSR (the healthier products) benefited more from the changes brought about by the adjusted algorithms than those of lower nutritional quality. The HSR of foods that contained no nuts or seeds remained unchanged. Conclusions: With minor changes to the HSR algorithm, nut and seed products could be brought into alignment with the current evidence, encouraging their regular inclusion in dietary patterns, which could help guide consumers at the supermarket shelf. Full article

Background/Objectives: Nursing staff turnover can adversely affect nursing home (NH) performance. To address staffing shortages, NHs are increasingly turning to agency nursing staff as a solution. This study examined the relationship between the use of agency nursing staff and turnover rates among NH permanent nursing staff. Methods: This retrospective, observational study used secondary data from several sources, including the Payroll-Based Journal, the Care Compare: Five Star Quality Rating System, and Area Health Resource Files (n: =35,200, years: 2021–2023). The dependent variable was turnover rates among registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs). The independent variable was the classification of NHs based on their level of agency nursing staff utilization. Facilities were classified as “high utilizers” (the top 25% in agency nursing staff use) and “low utilizers” (the remaining 75%). This classification was informed by prior research indicating that the impact of agency nursing staff on NH performance is most pronounced at higher levels of utilization. A two-way fixed-effects regression model (facility and year) was used, with appropriate control variables. Results: NHs identified as high utilizers had significantly higher turnover rates among permanent RNs (7%) and CNAs (1.9%) compared to facilities that had low utilization of agency nurses (p < 0.001). No significant association was found between agency LPN utilization and LPN turnover. Conclusions: Greater reliance on agency nursing staff was associated with increased turnover, with the strongest effect observed for RNs. NH administrators should consider strategies to balance agency staff utilization with efforts to retain permanent staff, emphasizing long-term workforce stability. Full article

Background/Objectives: The incidence of pedestrian traffic injuries is an escalating concern for public health worldwide. Particularly in fast-developing nations, such as Saudi Arabia, these injuries form a significant portion of trauma-related healthcare challenges. This study aims to explore age-specific differences in trends, seasonal variations, and the overall impact of pedestrian traffic injuries in Riyadh, Saudi Arabia, with a focus on injury characteristics and clinical outcomes. Methods: The study conducted a retrospective analysis using data from the Saudi Trauma Registry (STAR) covering the period between August 2017 and December 2022. It employed descriptive statistics, chi-square tests, and multivariable linear regression analyses to explore demographic trends, characteristics of injuries, and hospital-based outcomes. Results: This study analyzed data from 1062 pedestrian injury cases, revealing key demographic and clinical patterns. Most incidents occurred on weekdays (71.9%) and during nighttime hours (63.3%), with seasonal peaks observed from April to June (30.4%). The lower extremities (27.5%) and head (21.3%) were the most frequently injured body regions. ICU admissions were more common among individuals aged 30–40, females, and those with head or chest trauma, while higher in-hospital mortality was associated with patients over 60 years old, transport by private or police vehicles, and extended ICU and hospital stays. Approximately 25.6% of cases required ICU care, with an overall in-hospital mortality rate of 4.9%. Conclusions: This study provides an in-depth analysis of pedestrian traffic injuries treated at a trauma center in Riyadh, highlighting significant demographic, temporal, and clinical patterns. Understanding these trends is essential for optimizing resource allocation and improving emergency care outcomes. Furthermore, the identified age-specific risk factors and seasonal variations underscore the critical need for targeted interventions and policy enhancements to improve road safety and reduce the burden of pedestrian injuries. Full article

Open source software (OSS) projects rely on voluntary contributions, but their long-term survivability depends on sustained community engagement and effective problem-solving. Survivability, critical for maintaining project quality and trustworthiness, is closely linked to issue activity, as unresolved issues reflect a decline in maintenance capacity and problem-solving ability. Thus, analyzing issue retention rates provides valuable insights into a project’s health. This study evaluates OSS survivability by identifying the features that influence issue activity and analyzing their relationships with survivability. Kaplan–Meier survival analysis is employed to quantify issue activity and visualize trends in unresolved issue rates, providing a measure of project maintenance dynamics. A random forest model is used to examine the relationships between project features—such as popularity metrics, community engagement, code complexity, and project age—and issue retention rates. The results show that stars significantly reduce issue retention rates, with rates dropping from 0.62 to 0.52 as stars increase to 4000, while larger codebases, higher cyclomatic complexity, and older project age are associated with unresolved issue rates, rising by up to 15%. Forks also have a nonlinear impact, initially stabilizing retention rates but increasing unresolved issues as contributions became unmanageable. By identifying these critical factors and quantifying their impacts, this research offers actionable insights for OSS project managers to enhance project survivability and address key maintenance challenges, ensuring sustainable long-term success. Full article

The COVID-19 pandemic drove the use of cleaning products, causing organic solvent contamination in hospitality environments. This pilot study investigated the presence and concentrations of volatile organic compounds (VOCs) in selected hotels in four different US cities with varying star ratings at the end of the pandemic period. Targeting 139 VOCs, 57 were detected across eight groups: alcohols, halocarbons, aromatics, alkanes, terpenes, carbonyls, ethers, and esters, in the indoor air. Alcohols were the most prevalent, especially in lower-rated hotels, suggesting higher use of cleaning supplies. Elevated levels of aromatics were detected in hotels rated under three stars, with a notable disparity compared to higher-rated hotels. Additionally, alkanes and terpenes such as n-tetradecane and d-limonene were consistently detected. Health risk assessment showed concentrations of all VOCs remained below their health criteria for customers. The cumulative cancer risk was 2.25 × 10⁻⁶ for hotel workers from chronic occupational exposure to eight carcinogenic VOCs, representing 1/3 of the lifetime risk from these chemicals in the ambient air. Cancer risks from individual VOCs ranged from 0.001 × 10⁻⁶ to 1.07 × 10⁻⁶, with chloroform accounting for nearly half of the cumulative risk. The findings underscore the need for careful selection and use of furnishings and cleaning supplies and for effective indoor air pollution control and management in hotel indoor environments. Full article

Numerous nutrient profiling models (NPMs) exist worldwide, but Japan lacks an official NPM. Using the Australian and New Zealand Health Star Rating (HSR) as a reference, “Processed Foods in Japan version 1.0” (NPM-PFJ (1.0)) was developed to fit Japanese food culture and policies. In total, 668 processed foods from the Standard Tables of Food Composition in Japan were analyzed, excluding seasonings/spices, fats/oils, alcoholic beverages, and infant food. The NPM-PFJ (1.0) scoring algorithm was adapted from HSR, with revised reference values for energy, saturated fat, total sugars, sodium, protein, and dietary fiber in alignment with Japanese standards. Reference values for fruits, vegetables, nuts, and legumes (fvnl) remained unchanged. Median scores were 4.5 for HSR and 5.0 for NPM-PFJ (1.0), showing high correlation (r = 0.939, p < 0.01). Thereafter, food categories familiar and meaningful in Japan were defined based on a hierarchical cluster analysis of scoring patterns, creating six categories with distinct characteristics. Finally, the rating algorithm for NPM-PFJ (1.0) was created using each group’s score distribution (10th percentile). The NPM-PFJ (1.0) was developed through a fully transparent and evidence-based process and is expected to facilitate the reformulation of food products by food industries and help consumers easily access healthier processed foods. This model marks a significant step forward in developing an NPM tailored to Japanese food culture and health policies, with the potential to enhance public health. Full article

In response to growing public health concerns, governments worldwide have implemented various nutrition labelling schemes to promote healthier eating habits. This study aimed to assess the consistency and effectiveness of these labels in an out-of-home context, specifically focusing on restaurant, hospitality, and institutional food service settings. In total, 178 different dishes from Spain were analysed using labels from the Mazocco method, the UK’s traffic light system, the Health Star Rating (Australia), Nutri-Score (France), multiple traffic lights (Ecuador), and warning labels (Chile and Uruguay). The results demonstrated a generally low level of agreement among these labels (K < 0.40), indicating notable variability and a lack of consensus, which could hinder consumers’ ability to make informed food choices in out-of-home settings. Nutri-Score classified the highest number of dishes as unhealthy (38%). This study underscores the need for an easy-to-understand labelling system tailored to each country’s culinary and socio-cultural contexts to improve consumer decision-making in various dining environments. Future research should focus on developing and testing qualitative methods to more accurately gauge the nutritional quality of cooked dishes in diverse out-of-home settings, thereby enhancing public health outcomes. By addressing the specific needs of the home, restaurants, hospitality, and institutional food services, tailored labelling schemes could significantly improve consumers’ ability to make healthier food choices. Full article

Numerous studies have investigated healthy diets and nutrients. Governments and scientists have communicated their findings to the public in an easy-to-understand manner, which has played a critical role in achieving citizens’ well-being. Some countries have published dietary reference intakes (DRIs), whereas some academic organizations have provided scientific evidence on dietary methods, such as traditional diets. Recently, more user-friendly methods have been introduced; the Health Star Rating system and Optimized Nutri-Dense Meals are examples from Australia and Japan, respectively. Both organizations adopt a novel approach that incorporates nudges. This review summarizes the science communication regarding food policies, guidelines, and novel methods in Japan and other countries. In the food policies section, we discuss the advantages and disadvantages of the DRIs and food-based guidelines published by the government. Dietary methods widely known, such as The Mediterranean diet, Nordic diet, Japanese traditional diet, and the EAT-Lancet guidelines, were also reviewed. Finally, we discussed future methods of science communications, such as nudge. Full article

Androgen production primarily occurs in Leydig cells located in the interstitial compartment of the testis. In aging males, testosterone is crucial for maintaining muscle mass and strength, bone density, sexual function, metabolic health, energy levels, cognitive function, as well as overall well-being. As men age, testosterone production by Leydig cells of the testes begins to decline at a rate of approximately 1% per year starting from their 30s. This review highlights recent findings concerning the use of natural polyphenolics compounds, such as flavonoids, resveratrol, and phenolic acids, to enhance testosterone production, thereby preventing age-related degenerative conditions associated with testosterone insufficiency. Interestingly, most of the natural polyphenolic antioxidants having beneficial effects on testosterone production tend to enhance the expression of the steroidogenic acute regulatory protein (Star) gene in Leydig cells. The STAR protein facilitates the entry of the steroid precursor cholesterol inside mitochondria, a rate-limiting step for androgen biosynthesis. Natural polyphenolic compounds can also improve the activities of steroidogenic enzymes, hypothalamus-pituitary gland axis signaling, and testosterone bioavailability. Thus, many polyphenolic compounds such as luteolin, quercetin, resveratrol, ferulic acid phenethyl ester or gigantol may be promising in delaying the initiation of late-onset hypogonadism accompanying aging in males. Full article

Wireless Body Area Networks (WBANs), low power, and short-range wireless communication in a near-body area provide advantages, particularly in the medical and healthcare sector: (i) they enable continuous monitoring of patients and (ii) the recording and correlation of physical and biological information. Along with the utilization and integration of these (sensitive) private and personal data, there are substantial requirements concerning security and privacy, as well as protection during processing and transmission. Contrary to the star topology frequently used in various standards, the overall concept of a novel low-data rate token-based WBAN framework is proposed. This work further comprises the evaluation of strategies for handling medical data with WBANs and emphasizes the importance and necessity of encryption and security strategies in the context of sensitive information. Furthermore, this work considers the recent advancements in Artificial Intelligence (AI), which are opening up opportunities for enhancing cyber resilience, but on the other hand, also new attack vectors. Moreover, the implications of targeted regulatory measures, such as the European AI Act, are considered. In contrast to, for instance, the proposed star network topologies of the IEEE 802.15.6 WBAN standard or the Technical Committee (TC) SmartBAN of the European Telecommunication Standards Institute (ETSI), the concept of a ring topology is proposed which concatenates information in the form of a ‘data train’ and thus results in faster and more efficient communication. Beyond that, the conductivity of human skin is included in the approach presented to incorporate a supplementary channel. This direct contact requirement not only fortifies the security of the system but also facilitates a reliable means of secure communication, pivotal in maintaining the integrity of sensitive health data. The work identifies different threat models associated with the WBAN system and evaluates potential data vulnerabilities and risks to maximize security. It highlights the crucial balance between security and efficiency in WBANs, using the token-based approach as a case study. Further, it sets a foundation for future healthcare technology advancements, aiming to ensure the secure and efficient integration of patient data. Full article

This study introduces the Meiji Nutritional Profiling System (Meiji NPS), which was specifically designed to respond to age-related shifts in nutrient requirements among Japanese adults (<65 years old) and older adults (≥65 years old). Japan has one of the most aged societies in the world. The health issues of interest are malnutrition and lifestyle-related diseases among adults and frailty among older adults. Two versions of the NPS were developed based on nutrients to encourage (protein, dietary fibers, calcium, iron, and vitamin D), food groups to encourage (fruits, vegetables, nuts, legumes, and dairy), and nutrients to limit (energy, saturated fatty acids, sugars, and salt equivalents). The Meiji NPS for older adults did not include iron or saturated fatty acids. The algorithms were based on the Nutrient-Rich Foods Index (NRF). The convergent validity between the Meiji NPS and the existing NPSs for the same foods was confirmed using Spearman’s correlation coefficients (NRF: r = 0.67 for adults and r = 0.60 for older adults; Health Star Rating: r = 0.64 for adults and r = 0.61 for older adults). The Meiji NPS may be useful for nutritional evaluation and reformulation of food products, tailored to adults and older adults to ameliorate health issues in Japan. Full article

Background: The purpose of nutrient profiling models (NPM) is to evaluate and categorize food products, in order to make it easier for consumers to choose healthier options, to encourage the development of nutritious foods, and to restrict the excessive advertising of products with poor nutritional value. In Thailand, a front-of-package nutrition labeling scheme (FOPNL), known as the “Healthier Choice” symbol (HCL), has been adopted. For composite meal products, the HCL uses a nutrient profiling model (HCL–NPM) to determine which product qualifies as ‘healthier’ and is allowed to display the HCL symbol. This research aims to assess the convergent validity of this scoring algorithm. Methods: A secondary data analysis, using the Mintel Global New Products Database, was conducted. The nutrient composition of newly launched composite meals marketed in Thailand from 2016 to 2021 was included. An analysis of convergent validity was conducted using the following tests: (1) the Pearson correlation test with the Nutri-Score Nutrient Profiling Model (NS–NPM), Health Star Rating Nutrient Profiling Model (HSR–NPM), and Nutrient-Rich Food Index 6.3 (NRF6.3); (2) the Cohen’s kappa coefficient agreement analysis, to identify ‘healthier’ products with the Nutri-Score FOPNL (NS–FOPNL), Health Star Rating FOPNL (HSR–FOPNL), Chilean Warning Label (CWL–FOPNL), and Choices International (CI–FOPNL). Results: A total of 589 composite meal products were included. The median score of HCL–NPM was 18.0 points (with an interquartile range of 14.0–22.0), and the mean +/− standard deviation score was 18.3+/−5.4 points. The Pearson’s correlation coefficient revealed that the HCL–NPM had a moderate negative correlation with the NS–NPM (r = −0.458; 95%CI: −0.520 to −0.391) and with HSR–NPM (r = −0.524; 95%CI: −0.520 to −0.391), while a weak positive correlation was found with NRF6.3 (r = 0.369; 95%CI: 0.297 to 0.436). In the agreement analysis, HCL–FOPNL had a fair pair-wise agreement with CI–FOPNL (κ = 0.335; 95%CI: 0.218 to 0.453), whereas a slight agreement was reported when compared to CWL–FOPNL (κ = 0.187; 95%CI: 0.145 to 0.228), NS–FOPNL (κ = 0.172; 95%CI: 0.132 to 0.211), and HSR–FOPNL (κ = 0.157; 95%CI: 120 to 0.193). Conclusion: The HCL algorithm system could be used to evaluate culture-specific packaged composite meal products in Thailand. It exhibits sufficient correlation and agreement with other international FOPNLs. These results may be helpful in informing improvements to the “Healthier Choice” scheme in Thailand. Full article

The CONVINCE trial demonstrates that high-dose hemodiafiltration offers a survival advantage for patients in the high-flux hemodiafiltration group compared to hemodialysis. We compared the outcomes of hemodialysis and hemodiafiltration using real-world data. We conducted an analysis on a cohort of patients who underwent hemodiafiltration therapy (HDF) at a single center, NefroStar Clinics. The results obtained were then compared with data from patients receiving hemodialysis (HD) therapy within the Brazilian Public Health System (SUS). The primary outcome was mortality from any cause. Results: A total of 85 patients undergoing hemodiafiltration were compared with 149,372 patients receiving hemodialysis through the Brazilian Public Health System (SUS). Using a 2:1 propensity score, we compared the 170 best-match HD patients with 85 HDF patients. In the Cox analysis, HDF therapy showed a reduced risk of mortality with an HR of 0.29 [0.11–0.77]. The propensity score analysis showed a HR of 0.32 [95% CI: 0.11–0.91]. This analysis was adjusted for age, type of access, KT/v, hemoglobin, and phosphorus. The Kaplan–Meier analysis showed respective survival rates for HDF and HD at the end of one year, 92.1% and 79.9%, p < 0.001. These results suggest high-flux hemodiafiltration has survival advantages over hemodialysis in a real-world scenario. Full article