Search Results (27)

Mental disorders (MDs) constitute significant risk factors for self-harm and suicide. The incidence of MDs has been increasing annually, primarily due to inadequate diagnosis and intervention. Early identification and timely intervention can effectively slow the progression of MDs and enhance the quality of life. However, the high cost and complexity of in-hospital screening exacerbate the psychological burden on patients. Moreover, existing studies primarily focus on the identification of individual subcategories and lack attention to model explainability. These approaches fail to adequately address the complexity of clinical demands. Early screening of MDs using EEG signals and deep learning techniques has demonstrated simplicity and effectiveness. To this end, we constructed a Dual-Branch Network (DBN) leveraging resting-state Quantitative Electroencephalogram (QEEG) features. The DBN is designed to enable the detection of multiple categories of MDs. Firstly, a dual-branch feature extraction strategy was designed to capture multi-dimensional latent features. Further, we propose a Multi-Head Attention Mechanism (MHAM) that integrates dynamic routing. This architecture assigns greater weights to key elements and enhances information transmission efficiency. Finally, the diagnosis is derived from a fully connected layer. In addition, we incorporate SHAP analysis to facilitate feature attribution. This technique elucidates the contribution of significant features to MD detection and improves the transparency of model predictions. Experimental results demonstrate the effectiveness of DBN in detecting various MD categories. The performance of DBN surpasses that of traditional machine learning models. Ablation studies further validate the architectural soundness of DBN. The DBN effectively reduces screening complexity and demonstrates significant potential for clinical applications. Full article

Background: Prostate cancer (PCa) is one of the most common malignancies among men in Saudi Arabia and contributes significantly to cancer-related morbidity and mortality. The objective of this survey was to evaluate community awareness and screening practices related to PCa among men in the Asir region of Saudi Arabia. Method: A cross-sectional study was conducted from 5 October to 25 December 2024 among men aged 40 and above in the Asir region, excluding those with a prior PCa diagnosis. Using convenience sampling, 399 participants were recruited via social media and community outreach. Data were collected through a self-administered online questionnaire covering demographics, medical history, PCa knowledge, information sources, prevention, screening awareness, and barriers. Informed consent was obtained from all participants. Results: The study comprised 399 male participants, with 37.09% aged 40–50, 36.34% aged 51–60, and 26.56% over 60. Most participants (363; 90.97%) were married, 245 (61.4%) had a university education, 282 (70.67%) lived in urban areas, and 180 (45.11%) were employed. Over half of the participants, 222 (55.63%), had a personal history of prostate problems. Additionally, 272 (68.17%) had health insurance, and 153 (38.34%) reported a monthly income between 10,000 and 14,999 SAR. The study found that 329 (82.5%) participants had good knowledge of PCa but only 197 (49.4%) had good awareness of screening methods. Key predictors of good awareness of PCa screening included a personal history of prostate problems (odds ratio—OR = 4.791, p = 0.000, confidence interval—CI 2.727–8.418) and health insurance (OR = 0.359, p = 0.000, CI 0.203–0.636). Common barriers to screening were affordability, n = 116 (29.07%), and perceived good health, n = 201 (50.37%). Additionally, 154 participants (38.59%) found screening uncomfortable, while 156 (39.59%) believed the Digital Rectal Exam (DRE) was harmful or embarrassing. Significant differences in perceived barriers were found based on age (F = 11.449, p < 0.001), education (F = 2.608, p = 0.051), occupation (F = 3.668, p = 0.026), family history (F = 17.407, p < 0.001), and income (F = 5.148, p = 0.006). Conclusions: The study highlights a significant gap between general knowledge and specific awareness of prostate cancer (PCa) screening among men in the Asir region. Although 82.5% demonstrated good overall knowledge, only 49.4% were aware of screening methods, and just 44.36% had undergone PSA testing. Common barriers included perceived good health, fear of diagnosis, embarrassment, and financial concerns. However, due to the use of convenience sampling, online distribution, and geographic restriction to the Asir region, the findings may not be generalizable to the broader male population in Saudi Arabia, particularly older men and those in rural areas. Addressing these gaps requires targeted education, empowerment of healthcare providers, and coordinated public health strategies to enhance early detection and reduce the PCa burden. Full article

Background: Youth tobacco use remains a significant public health concern, particularly in urban communities disproportionately burdened by health disparities. In Baltimore City, where tobacco-related harms are elevated, understanding the relationship between tobacco use—including e-cigarettes—and mental health among high school students is essential for guiding equitable prevention and cessation strategies. The CEASE (Communities Engaged and Advocating for a Smoke-free Environment) program, in collaboration with the American Lung Association’s Not On Tobacco (N-O-T) initiative, developed an online school-based survey to inform community-responsive interventions. Aims: This study aimed to examine the associations between cigarette use, including conventional cigarette use, and self-rated mental health among high school students in Baltimore City. Methods: High school students in Baltimore City completed an anonymous online survey that assessed demographic characteristics, tobacco knowledge and use, mental health, and related behaviors. Self-rated mental health was dichotomized as poor versus fair/good. Tobacco use categories included current use of e-cigarettes and conventional cigarettes. Logistic regression models were used to examine associations between tobacco use and self-rated mental health, adjusting for age, gender, race, and parental education. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Results: No statistically significant associations were found between self-rated mental health and e-cigarette use and conventional tobacco use after adjusting for covariates. Conclusions: The absence of a significant association may reflect unique aspects of the social context in Baltimore City, where youth may not use tobacco products as a coping mechanism for mental health challenges. Alternatively, it may be due to limitations in measurement, particularly the use of a single-item mental health assessment. These findings should be considered preliminary. Future research using more comprehensive mental health measures and larger samples is warranted to further explore these complex relationships. Full article

Background: Suicide and self-harm pose significant global public health challenges with substantial economic implications. Recent Australian evidence shows considerable variations in the prevalence of suicidal behaviours and mortality among culturally and ethnically diverse population groups. This study aims to estimate the associated economic cost of suicide among culturally and linguistically diverse (CALD) migrants in Australia. Methods: We evaluated the economic impact of suicide by considering the years of life lost, years of productive life lost, and overall economic costs, including direct, indirect, and intangible costs. We used data on suicide deaths in 2020 from the National Coronial Information System. Results: The estimated economic cost associated with 346 suicide deaths among CALD migrants is $2.9 billion (Australian dollars), with an average cost per fatality equivalent to $8.47 million. This estimate varies in the sensitivity analysis from $1.9 billion to $3.9 billion, depending on the average age of fatality, with corresponding average costs of $5.59 million to $11.35 million, respectively. These estimates do not capture costs associated with suicidal behaviours, which may substantially increase the economic burden. Conclusions: The significant economic impacts of CALD migrants’ suicide in Australia highlight the urgent need for a comprehensive national suicide prevention programme tailored for CALD migrant populations. Full article

Background: Suicide and self-injury are serious public health concerns, especially in young populations, owing to multiple social, cultural, and gender determinants. Qualitative evidence exploring narratives regarding the factors behind suicide among young women is rare in Pakistan. Objective: The present study aims to explore the complex dimensions of suicide or self-injury among young women of Southern Punjab. Methods: Semi-structured interviews were conducted in a marginalized district in South Punjab, with participants consenting to in-person meetings at their homes or phone interviews. We collected detailed accounts of fifteen deceased girls or self-harm survivors, with insights provided by close relatives of the victims. Results: Our findings identified several conducive factors to suicidality, including receiving insults in front of others, low self-esteem, household pressures, work burdens, unfulfilled romantic desires, feelings of worthlessness, cheating in love, marriage without choice, and engagement in risky behaviors. These causes could be categorized into personal (such as an inferiority complex), social (a lack of family support and frequent conflicts), and cultural factors (forced marriages). Conclusions: Our study advocates for empowering women through education and restricting access to suicide means, such as pesticides or Paraphenylenediamine (PPD). Moreover, the government should take strict measures to discourage the forced marriage of young females in rural contexts. This study highlights the importance of integrating suicide prevention initiatives with research efforts within Pakistan’s healthcare system. Full article

Background/Objectives: Trauma is a psychological injury resulting from a distressing or overwhelming event. The SARS-CoV-2 pandemic has been disruptive and traumatic for many people with multiple sclerosis (pwMS). The relationship between patient characteristics and trauma in pwMS during the pandemic has not yet been thoroughly explored. The aim of this bicentric prospective cohort study was to analyze the prevalence and development of probable post-traumatic stress disorder (PTSD) among pwMS during the SARS-CoV-2 pandemic and to identify patient parameters associated with this condition. Methods: We have assessed pwMS for probable PTSD before and after the approval of the first SARS-CoV-2 vaccines in Germany using an adapted version of the Trauma Screening Questionnaire (TSQ). We compared pwMS with probable PTSD (TSQ sum score ≥ 6) with those without probable PTSD (TSQ sum score < 6) regarding sociodemographic and MS-specific clinical characteristics, polypharmacy status, comorbidities, anxiety/depression levels, personality traits, mental/physical/social burden, and general vaccination willingness. Results: Out of the 149 pwMS included, 8.1% were identified as having probable PTSD. These patients had significantly higher rates of pre-pandemic abnormal anxiety (66.7% vs. 18.5%, p < 0.001) and depression scores (45.5% vs. 12.6%, p = 0.013). The patients with probable PTSD exhibited a distinct personality profile, with significantly higher neuroticism and harm avoidance scores and lower conscientiousness, cooperativeness, and self-directedness scores. They were also significantly more likely to report severe or very severe mental/physical/social burdens during the pandemic compared to those without probable PTSD (p ≤ 0.045). Conclusions: Medical and social services should be provided to support patients who experienced serious stress or trauma. The development of concepts for education and vaccination procedures should be accompanied by comprehensive and clear communication that recognizes individual risk factors and addresses possible concerns with evidence-based and convincing arguments. Full article

Oleander poisoning, resulting from the ingestion of Nerium oleander or Thevetia peruviana, is a serious toxicological issue in various parts of the world, particularly in regions where these plants grow abundantly and are easily accessible. Oleander contains potent cardiac glycosides, such as oleandrin and thevetin, which exert powerful effects on the cardiovascular system, leading to symptoms ranging from nausea and abdominal pain to severe arrhythmias and sudden cardiac death. This review summarizes the existing literature on the epidemiology, clinical features, pathophysiology, and challenges in treatment management associated with oleander poisoning. While supportive care, gastric decontamination, and the administration of digoxin-specific Fab antibody fragments (Digifab) are essential therapeutic measures, limited access to Digifab, delays in intervention, and insufficient supportive care practices remain significant complicating factors. Particular attention is given to findings from autopsy reports, which provide critical insights into the pathophysiological effects of oleander toxins and help bridge gaps in understanding fatal cases. This review acknowledges key limitations, particularly the scarcity of English-language publications, which restricts input from regions such as southern Asia and the Mediterranean—areas where oleander-related poisoning, especially in cases of intentional self-harm, is more prevalent. Additionally, this review highlights the socio-cultural dimensions of oleander ingestion, often linked to intentional self-poisoning, and emphasizes the need for enhanced preventive measures and public education. Future research efforts should prioritize addressing these gaps through autopsy-based studies and the development of more accessible and effective antidotes, which are essential to mitigate the global health burden of oleander-related mortality. Full article

As the epidemic affected everyone across the world, the solution to the epidemic was developed globally. Many applications adopt Internet of Things (IoT) technology to detect epidemics, and effective monitoring systems are developed to monitor air pollution, personal transmission, early detection of serious cases, and remote assessment. However, care facilities in an aging society require effective disinfection and sterilization to prevent viral transmission. We integrated the interactive and real-time features of the Internet of Things (IoT) to design and build an intelligent self-propelled sterilization robot for sterilization. Intelligent sterilization and disinfection planning and task allocation mechanisms were designed for sterilization in clinics. For healthcare facilities, the developed robot can reduce the burden on healthcare professionals, help to manage the disinfection and sterilization process, and ensure patient safety. At the same time, robots promote the development of epidemic prevention industries and prepares for future attacks from harmful air pollutants or new infections. Full article

The issues of energy scarcity and environmental harm have become major priorities for both business and human progress. Hence, it is important and useful to focus on renewable energy research and efficient utilization of distributed energy sources (DERs). A microgrid (MG) is a self-managed system that encompasses these energy resources as well as interconnected consumers. It has the flexibility to function in both isolated and grid-connected configurations. This study aims to design an effective method of power management for a MG in the two operating modes. The proposed optimization model seeks to strike a balance between energy usage, protecting the life of batteries, and maximizing economic benefits for users in the MG, with consideration of the real-time electricity price and constraints of the power grid. Furthermore, in order to accurately account for the dynamic nature of not only the stationary battery banks used as the energy storage systems (ESS) but also the built-in batteries of electric vehicles (EVs), the model is presented as a multi-objective, multiparametric and constrained problem. The solution is proposed to be found using the Lagrange multiplier theory, which helps to achieve good performance with less computational burden. Lastly, simulation results from both the isolated and grid-connected modes also demonstrate the effectiveness of the designed method. Full article

Objective: To describe the secular trends of cause-specific mortality among adolescents aged 10 to 24 years from 2004 to 2019 and explore the association between mortality and economic status, education level as well as health investment. Methods: Mortality data of adolescents aged 10 to 24 years were obtained from the national disease surveillance points system. The age-standardized mortality rate (ASMR) was calculated by using the population data from the sixth national population census in 2010. GDP per capita, urbanization rate, illiteracy rate of the population over 15 years old, government education expenditure per capita, number of health service providers per 1000 people, and number of health beds per 1000 people were collected from China’s Economic and Social Big Data Research Platform. Age-period-cohort analysis was used to analyse the net age, period, and cohort effects of mortality among adolescents, while panel data regression was used to explore the association between mortality and economic status, education level as well as health investment. Results: Overall, the ASMR was 28.84 per 100,000 and the top five causes of mortality were road injuries, drowning, intentional self-harm and sequelae, leukaemia, and falls among adolescents aged 10 to 24 years in China in 2019. All-cause mortality declined with an annual percentage change of 4.02% (95% Confidence interval: 3.74% to 4.30%) from 2004 to 2019 yet with persistent differences across different demographic (gender and age) and geographical (urban-rural, and regional) subgroups. Notably, the ASMR for HIV/AIDS in males, lower respiratory infections in urban adolescents, and iron deficiency anaemia as well as cervical cancer in adolescents aged 20 to 24 years showed an increase over time. The multivariate panel data regression showed that the ASMR decreased by 5.18 (3.27, 7.08) per 100,000 for every increase in the number of health beds per 1000 population, but with insignificant association with GDP per capita and illiteracy rate in the total sample. Health beds investment was positively associated with ASMR at almost all subgroups except for adolescents aged 10 to 14 years; GDP per capita increase was helpful to males and rural adolescents while an increasing literacy rate was beneficial for females and adolescents aged 15 to 19 years. Conclusion: Given the persistent differences between subgroups, further investments including improving health services, especially increasing health bed investment, GDP per capita, and reducing the illiteracy rate and concern for adolescents in males, rural areas, the western regions, and aged 15 to 24 years are needed. Additionally, the increased burden of some diseases, such as HIV/AIDS, must be of further concern. Full article

This study evaluates the interaction of toxic elements cadmium (Cd) and lead (Pb) due to exposure from cigarette smoking, essential elements, and steroidogenesis in the maternal–placental–fetal unit. In a cohort of 155 healthy, postpartum women with vaginal term deliveries in clinical hospitals in Zagreb, Croatia, samples of maternal blood/serum and urine, placental tissue, and umbilical cord blood/serum were collected at childbirth. The biomarkers determined were concentrations of Cd, Pb, iron (Fe), zinc (Zn), copper (Cu), and selenium (Se), and steroid hormones progesterone and estradiol in maternal and umbilical cord blood and the placenta. Three study groups were designated based on self-reported data on cigarette smoking habits and confirmed by urine cotinine levels: never smokers (n = 71), former smokers (n = 48), and active smokers (n = 36). Metal(loid)s, steroid hormones, urine cotinine, and creatinine levels were analyzed by ICP–MS, ELISA, GC–MS, and spectrophotometry. Cigarette smoking during pregnancy was associated with increased Cd levels in maternal, placental, and fetal compartments, Pb in the placenta, and with decreased Fe in the placenta. In active smokers, decreased progesterone and estradiol concentrations in cord blood serum were found, while sex steroid hormones did not change in either maternal serum or placenta. This study provides further evidence regarding toxic and essential metal(loid) interactions during prenatal life, and new data on sex steroid disruption in cord serum related to cigarette smoking. The results indicate that umbilical cord sex steroid levels may be a putative early marker of developmental origins of the future burden of disease related to harmful prenatal exposure to cigarette smoke. Full article

Background: The foremost cause of children’s (1–19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child’s survival. Therefore, both parents and teachers of the children in kindergarten and elementary school must be knowledgeable in first aid practice and basic life support (BLS) training. Objectives: In the current study, our ambition is to evaluate the orientation level, knowledge, and attitudes around first aid and BLS training of kindergarten and elementary school teachers and parents in the city of Taif, Makkah region. Methods: A cross-sectional study in Taif, Saudi Arabia, targeted kindergarten and elementary school teachers and parents of students enrolled at these levels. There were 648 participants included in this study. The researchers assessed teachers’ and parents’ knowledge and attitudes around first aid and BLS using a validated, self-administered online questionnaire. Results: The study included 648 participants, including 248 (38.3%) teachers and 400 (61.7%) parents. The socio-demographic analysis showed that 412 (63.6%) are females and 233 (36.5%) are between the ages of 36 and 45 years. Approximately 142 (21.9%) participants reported previous training in the cardiopulmonary resuscitation (CPR) program, though more than half of them (53.5%) had outdated certificates (more than 2 years). The mean total knowledge for our study was 4.6 ± 1.4, with 22.4% of the participants being educated about first aid support and expressing a fair level of CPR foundations. Only a small percentage (2.3%) of the participants exposed a good and adequate theoretical level of knowledge around CPR skills and performance, while most of the contributors unveiled a poor level of knowledge (over 75%). There were no statistically significant differences between parents and teachers (p > 0.05). Finally, numerous participants (85%) appreciated training in the CPR program, and the most common motive was a “wish to avoid unnecessary death”. Conclusions: We concluded that a sizable portion of the contributors expressed a lack of proficiency in the fundamental CPR training knowledge and skills, pointing to an alarming public concern. Promisingly, a sizable percentage of participants expressed motivated attitudes toward CPR training. Therefore, additional study and data are required to effectively combat injury, with an emphasis on investigating causes and risk factors, burden and socioeconomic health determinants, community awareness level and desire to contribute, and accessibility for disseminating specific intervention strategies. Full article

Chronic wounds (CWs) are a growing issue for the health care system. Their treatment requires a synergic approach to reduce both inflammation and the bacterial burden. In this work, a promising system for treating CWs was developed, comprising cobalt-lignin nanoparticles (NPs) embedded in a supramolecular (SM) hydrogel. First, NPs were obtained through cobalt reduction with phenolated lignin, and their antibacterial properties were tested against both Gram-negative and Gram-positive strains. The anti-inflammatory capacity of the NPs was proven through their ability to inhibit myeloperoxidase (MPO) and matrix metalloproteases (MMPs), which are enzymes involved in the inflammatory process and wound chronicity. Then, the NPs were loaded in an SM hydrogel based on a blend of α-cyclodextrin and custom-made poly(ether urethane)s. The nano-enabled hydrogel showed injectability, self-healing properties, and linear release of the loaded cargo. Moreover, the SM hydrogel’s characteristics were optimized to absorb proteins when in contact with liquid, suggesting its capacity to uptake harmful enzymes from the wound exudate. These results render the developed multifunctional SM material an interesting candidate for the management of CWs. Full article

In the past decade, the Philippines has gained notoriety as the country with the fastest-growing human immunodeficiency virus (HIV) epidemic in the Western Pacific region. While the overall trends of HIV incidence and acquired immunodeficiency syndrome (AIDS)-related deaths are declining globally, an increase in new cases was reported to the HIV/AIDS and ART Registry of the Philippines. From 2012 to 2023, there was a 411% increase in daily incidence. Late presentation in care remains a concern, with 29% of new confirmed HIV cases in January 2023 having clinical manifestations of advanced HIV disease at the time of diagnosis. Men having sex with men (MSM) are disproportionately affected. Various steps have been taken to address the HIV epidemic in the country. The Philippine HIV and AIDS Policy Act of 2018 (Republic Act 11166) expanded access to HIV testing and treatment. HIV testing now allows for the screening of minors 15–17 years old without parental consent. Community-based organizations have been instrumental in expanding HIV screening to include self-testing and community-based screening. The Philippines moved from centralized HIV diagnosis confirmation by Western blot to a decentralized rapid HIV diagnostic algorithm (rHIVda). Dolutegravir-based antiretroviral therapy is now the first line. Pre-exposure prophylaxis in the form of emtricitabine–tenofovir disoproxil fumarate has been rolled out. The number of treatment hubs and primary HIV care facilities continues to increase. Despite these efforts, barriers to ending the HIV epidemic remain, including continued stigma, limited harm reduction services for people who inject drugs, sociocultural factors, and political deterrents. HIV RNA quantification and drug resistance testing are not routinely performed due to associated costs. The high burden of tuberculosis and hepatitis B virus co-infection complicate HIV management. CRF_01AE is now the predominant subtype, which has been associated with poorer clinical outcomes and faster CD4 T-cell decline. The HIV epidemic in the Philippines requires a multisectoral approach and calls for sustained political commitment, community involvement, and continued collaboration among various stakeholders. In this article, we outline the current progress and challenges in curbing the HIV epidemic in the Philippines. Full article

Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic burden in Australia. The most well-established benefit of exposure to ultraviolet (UV) radiation is vitamin D production. Australia has the highest incidence of skin cancer in the world but, despite the high ambient UV radiation, approximately one quarter of the population is estimated to be vitamin D deficient. Balancing the risks and benefits is challenging and requires effective communication. We sought to provide a snapshot of public knowledge and attitudes regarding sun exposure and vitamin D and to examine the associations between these factors and sun protective behaviors. In 2020 we administered an online survey; 4824 participants with self-reported fair or medium skin color were included in this analysis. Only 25% and 34% of participants were able to identify the amount of time outdoors needed to maintain adequate vitamin D status in summer and winter, respectively and 25% were concerned that sunscreen use inhibits vitamin D synthesis. This lack of knowledge was associated with suboptimal sun protection practices. Public education is warranted to prevent over-exposure, while supporting natural vitamin D production. Full article