Search Results (744)

This study examined data from participants who completed the SLeep Education for Everyone Program (SLEEP) to explore how various demographic variables affected sleep outcomes and to determine which participant characteristics predicted success. A total of 104 individuals participated. The Sleep Hygiene Index (SHI) measured undesirable sleep behaviors; the Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality and self-reported sleep duration. Participant demographic information was collected at baseline. A mixed ANOVA evaluated group differences, and a multiple linear regression model identified predictors of sleep improvements. Change in SHI scores from pre- to post-intervention demonstrated a significant time × group interaction between Black and white participants (p = 0.024); further analysis indicated Black participants improved more. Better baseline scores predicted more favorable post-intervention outcomes for SHI, PSQI, and sleep duration. Fewer chronic conditions predicted better post-intervention SHI and PSQI scores. Older age also predicted better SHI scores. More favorable initial scores, fewer chronic conditions, and older age were the strongest predictors of positive outcomes following SLEEP. Improved sleep hygiene, sleep quality, and sleep duration were observed over time within subjects across all groups. In summary, SLEEP appears to be effective. Further work exploring challenges experienced by younger participants or those with multiple co-morbidities is warranted. Full article

Sleep is crucial to overall health and plays a significant role in skin function. While the circadian rhythm has been extensively researched for its impact on the body’s optimal functioning, the skin also possesses an independent circadian system that serves many important functions. Sleep disruptions or deprivation can significantly affect skin conditions, by compromising the skin barrier and impairing processes such as collagen production, cellular repair, and wound healing. Given the commonality of sleep disturbances, it is crucial to understand the connection between sleep, circadian regulation, and skin health. This is particularly important in understudied populations, such as those with occupational sleep disruption and individuals with hormone-related conditions like PCOS and menopause. Bidirectional relationships have been established between sleep and several inflammatory skin conditions, including atopic dermatitis, psoriasis, rosacea, and hidradenitis suppurativa. While acne is influenced by sleep, the reverse relationship, how acne affects sleep quality, has not been well established. Chronic sleep disruption can increase cortisol levels and oxidative stress, both of which contribute to skin aging and the progression of autoimmune skin conditions, including systemic lupus erythematosus. As sleep is a modifiable risk factor, it is crucial to consider therapeutic options and interventions to prevent or alleviate skin conditions. This review discusses various therapeutic approaches, including melatonin, L-Theanine, Magnesium-L-threonate, Inositol, Cinnamomi cortex, nervous system regulation, and proper sleep hygiene. These therapeutic options have been studied for their impact on sleep, and importantly, several have been evaluated for their utility as adjuncts for treating skin conditions. Overall, the relationship between sleep and skin health is clear, and incorporating sleep-focused therapeutic interventions offers potential to improve both sleep quality and skin health in individuals with a variety of skin conditions. Full article

Many hospitals still lack digital traceability in hygiene and cleaning management, leading to operational inefficiencies and inconsistent quality control. This study aims to establish cleaning and hygiene processes in healthcare services that are planned in accordance with standards, as well as to enhance the traceability and sustainability of these processes through digitalization. This study proposes a Hyperledger Fabric-based blockchain architecture to establish a reliable and transparent quality assurance system in process management. The proposed Quality Assurance Model utilizes digital technologies and IoT-based RFID devices to ensure the transparent and reliable monitoring of cleaning processes. Operational data related to cleaning processes are automatically recorded and secured using a decentralized blockchain infrastructure. The permissioned nature of Hyperledger Fabric provides a more secure solution compared to traditional data management systems in the healthcare sector while preserving data privacy. Additionally, the execute–order–validate mechanism supports effective data sharing among stakeholders, and consensus algorithms along with chaincode rules enhance the reliability of processes. A working prototype was implemented and validated using Hyperledger Caliper under resource-constrained cloud environments, confirming the system’s feasibility through over 100 TPS throughput and zero transaction failures. Through the proposed system, cleaning/hygiene processes in patient rooms are conducted securely, contributing to the improvement of quality standards in healthcare services. Full article

Most research studies have investigated the impact of pet ownership on the mental and physical well-being of elderly populations, supporting the beneficial effect that pets have on their owners. However, few researchers focused on the well-being of both owner and pet. The present study aimed to explore the well-being of pets owned by elderly individuals using an owner assessment tool and the relationship between elderly characteristics and the pet’s health-related quality of life based on the owner’s assessment of their pet’s well-being. Sixty elderly pet owners who made regular visits to veterinary clinics were selected to complete an electronic questionnaire about their pet’s health-related quality of life. The results identified a high agreement percentage on positive indicators related to the pet’s well-being such as “My pet wants to play and My pet responds to my presence” in the happiness domain, “My pet has more good days than bad days” in mental status, “My pet moves normally” in physical status and “My pet keeps him/herself clean” in hygiene which also resulted in a positive relationship with elderly age. Marital status influenced their responses to “My pet responds to my presence and My pet is as active as he/she has been”. The results also support the use of the applied questionnaire to help identify variables that contribute to a pet’s health-related quality of life. The correlation matrix revealed statistically significant positive associations (p < 0.001) among positively phrased items across all domains, as well as among negatively phrased items. These consistent alignments between direct and between reversed items suggest directional coherence and help mitigate potential response bias. Furthermore, the replication of these patterns across multiple domains reinforces the interpretation that the instrument captures a unified construct of pet well-being, In conclusion, based on subjective evaluation of pet-owner relationships, the ownership of pets by elderly individuals could be mutually beneficial to both elderly owners and their pets. Full article

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article

Following hygiene standards in milk production is essential for making high-quality sour cream, especially when using traditional methods that rely on raw milk. The aim of this study was to determine the physicochemical, microbiological, and sensory quality of artisanal sour cream samples collected from major marketplaces in the wider Zagreb area. On average, the samples contained 27.99% milk fat, 3.30% protein, 34.29% dry matter, 6.51% fat-free dry matter and 3.00% lactose, with considerable variability observed across all components. Microbiological analysis revealed the presence of Staphylococcus aureus in 35.30% of the samples, Enterobacteriaceae in 76.47%, Escherichia coli in 94.11%, Bacillus spp. in 23.53%, and yeasts in 100% of the samples. Listeria monocytogenes and Salmonella spp. were not detected. The sensory analysis of the textural properties showed significant variability in firmness, adhesiveness, viscosity, creaminess, and fizziness. Samples with higher milk fat and dry matter content were rated better for creaminess, viscosity and mouth firmness. Flavour assessments, particularly for cream and diacetyl notes, also varied widely among samples. These findings highlight the complexity of sour cream’s sensory attributes and the significant influence of ingredient composition and processing techniques on appearance, aroma, texture, taste, and flavour. Principal component analysis (PCA) with Varimax rotation simplified the data structure and identified key dimensions of quality variation. Principal component analysis (PCA) revealed that the first principal component (PC1) effectively discriminated the cream samples based on sensory attractiveness and indicators of spoilage and highlighted the association between off-flavour and microbial contamination with inferior characteristics. The second principal component (PC2) captured the differences in physicochemical characteristics and showed a gradient from richer, creamier samples with higher fat content to those with lower acidity and higher freshness. Full article

Viral conjunctivitis is a highly contagious ocular condition that significantly impacts patient quality of life and healthcare resources. Despite its self-limiting nature, the condition remains a significant public health concern due to its high transmissibility, prolonged symptoms, and potential complications such as subepithelial infiltrates (SEIs). This review aimed to synthesize and evaluate current management strategies for adenoviral conjunctivitis and provide an evidence-based treatment framework. A systematic literature search of PubMed and the Cochrane Library was conducted, identifying 25 eligible studies published between 2009 and 2024 that focused on clinical interventions including supportive care, antiseptics, corticosteroids, antivirals, and immune modulators. The findings indicate that while supportive therapy and hygiene measures remain central to care, antiseptic agents, specifically povidone–iodine, and topical steroids offer additional benefit in reducing symptom duration and complications. Combination therapies integrating antiseptics, corticosteroids, and immunomodulators show promise for more severe cases, especially those complicated by SEIs. This review proposes an evidence-based comprehensive, multimodal approach management algorithm while highlighting the need for future research in antiviral development and diagnostic innovation to avoid mistreatment and unnecessary antibiotic use. Full article

This study investigated the effect of different farming systems and lactation stages on the physicochemical characteristics, somatic cell count (SCC), and total bacterial count (TBC) of milk from Skopelos goats. This study was conducted over two consecutive lactation periods on two commercial farms in Greece, an extensive system on Skopelos Island and an intensive system in the Attica region, involving 237 goats of shared genetic background, thereby minimizing genetic variability and strengthening the validity of the comparisons between the production systems. Higher milk yields were observed in the extensive system (0.98 vs. 0.85 kg/day), while milk from this system also had a higher protein (3.57% vs. 3.47%; p < 0.001) and casein content (2.72% vs. 2.57%; p < 0.001), which are traits favorable for cheese production. Fat content peaked during mid-lactation (4.83%; p < 0.05) and remained unaffected by the farming system. Lactose declined from early (4.74%) to late lactation (4.42%; p < 0.001). Both SCC and TBC were significantly elevated in the extensive system (p < 0.001), possibly due to hand milking, environmental exposure, and less-controlled hygiene conditions. These findings highlight a trade-off between the nutritional advantages of extensive systems and challenges related to milk hygiene. A balanced approach, optimizing both quality and sustainability, is recommended. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Purpose—This research paper examines the critical factors in customer satisfaction while purchasing fruits and vegetables at farmers’ markets. Design/methodology/approach—This study was conducted using a prepared questionnaire to collect data on a random sample of 235 customers of farmers’ markets in the state of Maharashtra, India. The research was carried out in the year 2023. Seven hypotheses were tested concerning the relationships between the variables of interest. The variables of convenience, variety, quality, price, health and hygiene, and service conditions were used as independent constructs and were proxied by reflective indicators. Customer satisfaction and customer loyalty were treated as an exogenous variable and an endogenous variable, respectively. Structural equation modeling was used to investigate the model relationships and confirm the theoretical model. Findings—The findings validate all the reflective indicators used in the study. The latent variables of convenience, variety, quality, price, health and hygiene, and service conditions positively and significantly affect customer satisfaction, and customer satisfaction positively and significantly affects customer loyalty toward farmers’ markets. The structural equation explains approximately 55% of the variation in customer satisfaction related to convenience, variety, price, quality, health and hygiene, and service conditions. Significance—The study results provide insights into the factors that influence consumer behavior and attitudes toward farmers’ markets. By identifying these predictors, this study can help farmers’ markets and other stakeholders develop effective marketing strategies to attract and retain customers, ultimately promoting sustainable food production and consumption. Additionally, the results can inform policymakers on how to support and promote farmers’ markets as healthy and sustainable food sources. Practical implication—By implementing the practical suggestions derived from the implications of this research, farmers’ markets can optimize customer satisfaction, boost customer loyalty, and reinforce their position as valuable contributors to local communities’ well-being and sustainability. Originality/value—The acceptance of farmers’ markets in India as an alternative shopping destination for fruits and vegetables is gradually increasing. This exploratory study conducted on farmers’ markets examined several factors, including price, in assessing customer satisfaction and farmers’ markets’ effectiveness at positioning themselves as shopping destinations for consumers in India. Full article

Edible insects are gaining traction worldwide; however, the existing data regarding their microbiological quality remain inadequate. This study investigated the bacterial communities and microbiological quality of five types of frozen edible insects commercially available in Thailand. Amplicon sequencing revealed Firmicutes (Bacillota) and Proteobacteria (Pseudomonadota) as the main phyla across all samples; Bacteroidota was predominant in house crickets, Actinobacteriota in silkworms, and Desulfobacterota was exclusively found in house and mole crickets. Culture-based assays showed total viable counts, lactic acid bacteria, yeasts–molds, and spore-formers ranging from 3.41–6.58, 2.52–7.41, 1.83–5.62, to 2.00–4.70 log CFU·g⁻¹, respectively. In some samples, Enterobacteriaceae and Escherichia coli, key hygiene indicators, reached 5.05 and 2.70 log CFU·g⁻¹, respectively. Among foodborne pathogens, presumptive Bacillus cereus was found to vary from <1.70 to 3.93 log CFU·g⁻¹, while Clostridium perfringens and Staphylococcus aureus were under the quantitation limit, and Salmonella was absent. Overall, the results indicate significant variation in microbial diversity and quality among different insect types. The high levels of microbial hygiene indicators and foodborne pathogens in some samples raised food safety concerns and point to the need to develop or implement production guidelines and microbiological criteria for frozen edible insects to ensure food safety. Full article

Background: Clostridioides difficile (CD) is the main cause of nosocomial diarrhea, resulting in increased morbidity and mortality, and is thought to be greatly affected by strict hygiene. In this study, we assessed changes in CD infection prevalence and outcomes pre- and during the COVID-19 pandemic (CP). Methods: This was an observational cohort performed at a tertiary medical center (MC) and a geriatric hospital (GH). Patients from both hospitals diagnosed with CD were included, and the period of one year prior to the pandemic to one year after was compared. Data was extracted from electronic medical records (EMR). Results: A total of 145 CD-associated diarrhea (CDAD) cases were diagnosed in the MC and 54 in the GH. There was no change in CDAD prevalence or mortality between the study periods in either hospital. Disease duration, measured as days with diarrhea (DWD), was shorter during the CP in the GH (10.6 days vs. 8.1 days, p < 0.01). CDAD was more prevalent in the GH during both periods; however, the disease was milder, with only three mortality cases and a significantly shorter disease duration (3.19 DWD vs. 10.67 in the MC before CP; 3.11 vs. 8.1 during CP, p < 0.01). In a survival analysis for MC patients, no significant differences were found between periods before and after adjustment for age, gender and period. Conclusions: The CP affected the duration but not the prevalence of CDAD. The milder course of CDAD in the GH may have been due to the quality of treatment provided in an academic GH and the subsequent faster diagnosis and treatment. Full article

Steak tartare is a ready-to-eat (RTE) meat product, prepared with finely chopped or ground raw beef, with a rich culinary history and increasing consumption trend in the last years. Yet, its microbiological safety and technological challenges remain largely under-investigated. This review analyses the regulations, the safety, and technological advances in steak tartare manufacturing, focusing on microbiological risks due to potential contamination by pathogens like Salmonella spp., Listeria monocytogenes, and Escherichia coli O157:H7. From this perspective, the outbreaks associated with the consumption of raw meat products have confirmed the importance of good hygiene practice and process control, currently based on the presence of nitrite in the formulation and accurate cold chain management. Recently, the EU regulations have set stricter limits for the use of nitrites and nitrates in meat products, and this evolution has increased the interest in natural alternatives. The scientific literature indicates that plant-based antimicrobials, high-pressure processing (HPP), and novel starter cultures can be promising tools to improve raw meat safety and shelf life. This review analyses the possible options for nitrite replacement, which might involve combined interventions with natural antimicrobials, starter cultures, and packaging solutions. Future studies need to address the microbial behaviour and dynamics in nitrite-free formulations, including safety validation by challenge testing with foodborne pathogens. In this respect, steak tartare could be a model for innovation in the meat industry. However, considering the challenges that must be faced, collaboration across disciplines will be essential to meet regulatory constraints and consumer expectations while ensuring product quality and safety. Full article

The expected cutaneous adverse effects (CAE) of oncology therapies can be disabling and even force the patient to discontinue treatment. The incorporation of cosmetics into skin care regimens (SCRs) as true therapeutic adjuvants can prevent, control, and avoid sequelae. However, cosmetics may also lead to adverse reactions in patients. The aim of our study was to assess the impact of the tolerability of cosmetics used in routine skin care on quality of life in this vulnerable population group through a survey. In addition, information was collected to improve the knowledge of the beneficial effects of cosmetics and the composition recommended. Hospital nurses guided the patients to fill in the surveys, which were done once. The main uses are related to daily hygiene care, photoprotection, and dermo-cosmetic treatment to prevent or at least reduce the skin’s adverse effects. More than 30% (36.36%) of patients perceived undesirable effects or discomfort with the use of cosmetics (27.27% in the facial area, 27.27% in the body and hands, and 22.73% in the scalp and hair). Intolerance was described for some soaps and creams used in the facial area. This study provides additional evidence on perceived tolerance supporting updates of clinical practice guidelines, highlights consolidated knowledge and evidence on the use of cosmetics, as well as new recommendations on the use and composition of cosmetics intended for oncological patients. There is a need for more knowledge about cosmetic ingredients and formulations, including ingredients of concern, such as endocrine disruptors. Full article

Medicinal products available on the market should be characterised by therapeutic efficacy, high quality, and safety for patients. They must either be sterile or comply with the appropriate pharmacopoeial microbiological purity requirements. Pharmacopoeial monographs related to microbiological tests of drug quality were also referenced. Despite stringent regulations governing pharmaceutical production, irregularities in the microbiological quality of drugs still occur. These are monitored by relevant agencies, which may order the recall of defective product batches from the market. However, in recent years, numerous cases of microbiological contamination in drugs and drug-related infections have been reported. Both isolated incidents and larger outbreaks or epidemics linked to contaminated medicines have been documented. Various microorganisms, including Gram-negative and Gram-positive bacteria, anaerobes, and yeast-like and mould fungi, have been identified in medicinal products or in patients affected by contaminated drugs. Ensuring the appropriate purity or sterility of pharmaceutical raw materials; maintaining cleanliness in the manufacturing environment, facilities, and equipment; and adhering to hygiene protocols and Good Manufacturing Practice regulations are essential for the production of safe and high-quality medicinal products. The aim of this study is to collect and compile information on the microbiological quality of drugs available on the market, with particular attention to identified irregularities, objectionable microorganisms isolated from medicinal products, and drug-related infections. Full article