Impact of Spiritual Support Interventions on the Quality of Life of Patients Who Receive Palliative Care: A Systematic Review.

BACKGROUND: Palliative care focuses on the prevention of worsening health, improving the quality of the patient's life, and the relief of suffering, and therefore has a considerable impact on both the patient suffering from a life-threatening or potentially life-threatening illness and on their family. Spirituality, as the dimension of human life involving the search for meaning, purpose, and transcendence, and connection with oneself, others, and the sacred, could be essential in supporting these patients. The aim of this study was to synthesise the scientific evidence describing the interventions and/or activities undertaken to meet the spiritual needs of the palliative patient. METHODS: A literature search was carried out across the following databases: PubMed, LILACS, Scopus, and Web of Science. The PRISMA statement was used to guide this review. RESULTS: Twenty-four articles were included. The thematic categories included spiritual needs at the end of life, the influence of music and dance as palliative care, care for family caregivers, and the comparison between counselling and dignity therapy. CONCLUSIONS: Interventions in the biopsychosocial-spiritual spheres impact on the patient's peace of mind and promote the acceptance of a "good death". Healthcare personnel play an essential role in the way their patients prepare for the moment of death, and the meaning and values they convey help them to accompany and welcome patients. Last but not least, universities can play a crucial role by training nurses to integrate spiritual interventions such as music and dance, or by considering the family as a unit of care. The systematic review protocol was registered in the Prospective International Register of Systematic Reviews (PROSPERO) under protocol number CRD42023490852.

Impact of nursing interventions on the prevention of ocular surface disorders in critical care patients: A systematic review.

BACKGROUND: Intensive care unit (ICU) patients are at an increased risk of ocular surface injuries because of various factors such as reduced tear production and impaired protective mechanisms. Despite the significance of ocular care in ICU settings, there is a lack of consensus on effective interventions, leading to inadequate prevention of ocular surface disease (OSD). AIM: This systematic review aimed to assess the effectiveness of nursing eye care in preventing OSD in ICU patients. Secondary objectives included identifying primary risk factors for ocular injuries and examining the most effective preventive methods. STUDY DESIGN: A systematic review following PRISMA guidelines was conducted, encompassing a literature search, article selection, quality assessment and data synthesis. Studies meeting inclusion criteria were observational studies and clinical trials, focusing on adults admitted to ICUs under sedation and receiving mechanical ventilation. RESULTS: Of 3545 initially identified articles, 12 studies met inclusion criteria. These studies involved a total of 1853 participants. Various interventions were assessed, including saline rinsing, lubricating drops, gel lubricants, occlusion with polyethylene dressing, passive blinking and eyelid closure with tape. Moist chamber occlusion every 6 h combined with gel lubrication emerged as the most effective method in preventing OSD. CONCLUSIONS: Gel lubrication along with moist chamber occlusion proved to be the most effective strategy in preventing ocular injuries in ICU patients. Conversely, the routine use of physiological saline was associated with increased severity of corneal lesions. Properly defined protocols and well-trained nursing teams are crucial for reducing ocular injuries in ICU settings. RELEVANCE TO CLINICAL PRACTICE: The findings underscore the importance of implementing evidence-based eye care protocols in ICUs, emphasizing the use of gel lubrication and ocular surface protection to mitigate the risk of OSD. This highlights the need for comprehensive training programmes for ICU nursing staff to ensure optimal ocular care delivery.

Enhancing Sleep Quality in Pediatric Intensive Care: A Chronobiological Perspective.

Biologic synchronized rhythmicity is a critical physiologic process. The lack of synchronized rhythms, mainly those showing a circadian basis, like sleep, heart rate, and arterial pressure, often leads to several organic challenges usually associated with adverse outcomes. Sleep itself, as an independent regulator of many crucial body functions, should preferentially occur with minimum interferences to optimize its plastic role toward structural and functional recovery and regeneration. Hence, patients will mostly benefit from both circadian and sleep-related optimized functions in order to improve prognosis and reduce patients' discharge times.

Pharmacological Blockade of the Adenosine A2B Receptor Is Protective of Proteinuria in Diabetic Rats, through Affecting Focal Adhesion Kinase Activation and the Adhesion Dynamics of Podocytes.

Induction of the adenosine receptor A2B (A2BAR) expression in diabetic glomeruli correlates with an increased abundance of its endogenous ligand adenosine and the progression of kidney dysfunction. Remarkably, A2BAR antagonism protects from proteinuria in experimental diabetic nephropathy. We found that A2BAR antagonism preserves the arrangement of podocytes on the glomerular filtration barrier, reduces diabetes-induced focal adhesion kinase (FAK) activation, and attenuates podocyte foot processes effacement. In spreading assays using human podocytes in vitro, adenosine enhanced the rate of cell body expansion on laminin-coated glass and promoted peripheral pY397-FAK subcellular distribution, while selective A2BAR antagonism impeded these effects and attenuated the migratory capability of podocytes. Increased phosphorylation of the Myosin2A light chain accompanied the effects of adenosine. Furthermore, when the A2BAR was stimulated, the cells expanded more broadly and more staining of pS19 myosin was detected which co-localized with actin cables, suggesting increased contractility potential in cells planted onto a matrix with a stiffness similar to of the glomerular basement membrane. We conclude that A2BAR is involved in adhesion dynamics and contractile actin bundle formation, leading to podocyte foot processes effacement. The antagonism of this receptor may be an alternative to the intervention of glomerular barrier deterioration and proteinuria in the diabetic kidney disease.

Targeting the Endothelin-1 pathway to reduce invasion and chemoresistance in gallbladder cancer cells.

BACKGROUND: Gallbladder cancer (GBC) is a prevalent and deadly biliary tract carcinoma, often diagnosed at advanced stages with limited treatment options. The 5-year survival rate varies widely from 4 to 60%, mainly due to differences in disease stage detection. With only a small fraction of patients having resectable tumors and a high incidence of metastasis, advanced GBC stages are characterized by significant chemoresistance. Identification of new therapeutic targets is crucial, and recent studies have shown that the Endothelin-1 (ET-1) signaling pathway, involving ETAR and/or ETBR receptors (ETRs), plays a crucial role in promoting tumor aggressiveness in various cancer models. Blocking one or both receptors has been reported to reduce invasiveness and chemoresistance in cancers like ovarian, prostate, and colon. Furthermore, transcriptomic studies have associated ET-1 levels with late stages of GBC; however, it remains unclear whether its signaling or its inhibition has implications for its aggressiveness. Although the role of ET-1 signaling in gallbladder physiology is minimally understood, its significance in other tumor models leads us to hypothesize its involvement in GBC malignancy. RESULTS: In this study, we investigated the expression of ET-1 pathway proteins in three GBC cell lines and a primary GBC culture. Our findings demonstrated that both ETAR and ETBR receptors are expressed in GBC cells and tumor samples. Moreover, we successfully down-regulated ET-1 signaling using a non-selective ETR antagonist, Macitentan, which resulted in reduced migratory and invasive capacities of GBC cells. Additionally, Macitentan treatment chemosensitized the cells to Gemcitabine, a commonly used therapy for GBC. CONCLUSION: For the first time, we reveal the role of the ET-1 pathway in GBC cells, providing insight into the potential therapeutic targeting of its receptors to mitigate invasion and chemoresistance in this cancer with limited treatment options. These findings pave the way for further exploration of Macitentan or other ETR antagonists as potential therapeutic strategies for GBC management. In summary, our study represents a groundbreaking contribution to the field by providing the first evidence of the ET 1 pathway's pivotal role in modulating the behavior and aggressiveness of GBC cells, shedding new light on potential therapeutic targets.

Patients Age 40 Years and Younger With Multiple Myeloma Have the Same Prognosis as Older Patients: An Analysis of Real-World Patients' Evidence From Latin America.

PURPOSE: Multiple myeloma (MM) is a highly heterogeneous, incurable disease most frequently diagnosed in the elderly. Therefore, data on clinical characteristics and outcomes in the very young population are scarce. PATIENTS AND METHODS: We analyzed clinical characteristics, response to treatment, and survival in 103 patients with newly diagnosed MM age 40 years or younger compared with 256 patients age 41-50 years and 957 patients age 51 years or older. RESULTS: There were no statistical differences in sex, isotype, International Scoring System, renal involvement, hypercalcemia, anemia, dialysis, bony lesions, extramedullary disease, and lactate dehydrogenase (LDH). The most used regimen in young patients was cyclophosphamide, bortezomib, dexamethasone, followed by cyclophosphamide, thalidomide, dexamethasone and bortezomib, thalidomide, dexamethasone. Of the patients age 40 years or younger, only 53% received autologous stem-cell transplant (ASCT) and 71.1% received maintenance. There were no differences in overall survival (OS) in the three patient cohorts. In the multivariate analysis, only high LDH, high cytogenetic risk, and ASCT were statistically associated with survival. CONCLUSION: In conclusion, younger patients with MM in Latin America have similar clinical characteristics, responses, and OS compared with the elderly.

Multivariate optimization of methylene blue dye degradation using electro-Fenton process with self-doped TiO2 nanotube anode.

This paper reports the optimization of the electro-Fenton (EF) process using different anode materials for the degradation of Methylene Blue (MB) dye as a model compound. The cathode used was an air-diffusion PTFE, while three different anode materials (Pt, DSA, and self-doped TiO2 nanotubes - SD-TNT) were tested individually. A full factorial design (FFD) with a central point combined with response surface methodology (RSM) was employed to optimize the experimental variables, including solution pH, applied current, and anode material. The optimized EF conditions involved a pH of 4.0, a current of 100 mA, and an SD-TNT anode for 120 min of electrolysis. Under these conditions, the MB solution achieved complete decolorization and 45% of total organic carbon (TOC) removal after 120 min of EF treatment. The findings indicate that the hydroxyl radical (•OH) plays a crucial role as the primary oxidizing agent in the EF process. The decay of MB followed pseudo-first-order kinetics, reflecting a consistent formation of •OH radicals that effectively attacked the MB dye and its subproducts during mineralization. Moreover, the EF process exhibited superior performance in terms of energy consumption (EC) and mineralization current efficiency (ECM) in the initial treatment stages, while the presence of recalcitrant by-products and loss of anode self-doping impacted performance in the later stages. The optimized EF conditions and the understanding gained from this study contribute to the advancement of sustainable wastewater treatment strategies for the removal of organic dyes.

Challenging beliefs for quality sleep: A systematic review of maladaptive sleep beliefs and treatment outcomes following cognitive behavioral therapy for insomnia.

Cognitive behavioral therapy for insomnia (CBT-I) is an empirically supported intervention for insomnia. Given the strong, consistent support of its efficacy, scholars have become increasingly interested in the behavioral and cognitive mechanisms targeted during CBT-I. The purpose of the systematic review was to synthesize findings from the literature regarding the associations among maladaptive sleep beliefs, a cognitive mechanism implicated in maintaining insomnia, and treatment outcomes following CBT-I. The systematic review was completed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Seventeen studies were included in the final sample of reviewed articles and a study quality assessment was performed for all studies included in the review. The results suggested that reductions in maladaptive sleep beliefs were associated with improved insomnia severity; however, reductions in maladaptive beliefs were not associated with changes in sleep efficiency or other sleep parameters. Moreover, in some cases, improved sleep parameters preceded reductions in maladaptive beliefs. Maladaptive sleep beliefs may be an important target for improving insomnia. Targeting maladaptive sleep beliefs may initiate a trickle-down process that limits the influence of other cognitive and behavioral processes maintaining insomnia. Additional investigation is needed to evaluate the directional relationship between improved insomnia symptoms and reduced maladaptive beliefs.

Foot Temperature by Infrared Thermography in Patients with Peripheral Artery Disease before and after Structured Home-Based Exercise: A Gender-Based Observational Study.

Decreased arterial perfusion is a typical condition of patients with peripheral artery disease (PAD), with the microvascular picture particularly present among women. This observational study aimed to detect foot perfusion changes by infrared thermography (IRT) after a home-based exercise program in both sexes. A total of 76 PAD patients with claudication (72 ± 4 years; 52 males) were enrolled in a structured in-home exercise program composed of two daily 8 min interval walking sessions (1:1 walk:rest ratio) with progressively increasing speed. Outcome measures collected at baseline (T0) and at each hospital visit after 5 weeks, 12 weeks and 20 weeks included foot temperature measured by IRT (anterior tibial, posterior tibial, dorsalis pedis and arcuate artery regions), ankle brachial index and the 6 min walking test. After 20 weeks, foot temperature in both limbs showed a significant increasing trend, with a mean variation of 1.3 °C for the more impaired limb and 0.9 °C for the contralateral limb (t = 8.88, p < 0.001 and t = 5.36; p < 0.001, respectively), with significant changes occurring after 5 weeks of training. The sex-oriented analysis did not highlight any significant difference, with an improvement of mean foot temperature of 1.5 ± 0.6 °C in females versus 1.2 ± 0.5 °C in males (p = 0.42). Ankle brachial index and performance also significantly improved over time (p < 0.001) without gender differences. In patients with PAD, a structured low-intensity exercise program significantly improved foot temperature and exercise capacity without any sex-related difference.

Knowledge, Attitudes, and Behavior in the administration of medication in the home care setting: Cross-cultural Spanish adaptation.

OBJECTIVE: The aim of the study is to validate and adapt the "Knowledge Attitute and Behaviour in the administration of medication in the home care setting questionnaire" in the home care setting in Cordoba, Spain, through a cross-validation process. DESIGN: Cross-sectional study SAMPLE: 106 community nurses provide home care in Cordoba, and are involved in the management of the medication process in the patient's home. MEASUREMENTS: Community nurses' knowledge, attitudes, and behaviors toward medication error prevention strategies in-home care. RESULTS: For the evaluation of psychometric properties, Cronbach's α was calculated, which returned a value of 0.639, showing good internal consistency. Most participants agreed that the home care setting increases the risk of medication errors. CONCLUSION: The study, underscores the importance of analyzing the phenomenon of medication errors in the home care setting. The characteristics and peculiarities of a home care setting are different from a hospital setting, which means that factors such as the environment, the figures involved in the care process (caregivers and/or family members), and the way in which they communicate with the rest of the multi-professional team can influence both the type of errors and the likelihood of their occurrence.

Formal and Informal Services Used by Women Who Suffer Intimate Partner Violence in Spain.

Intimate partner violence (IPV) is an important public health problem. Female victims of IPV do not always use the institutional resources available to them. We conducted a cross-sectional study using data from the Spanish 2014 Macro-Survey on Violence Against Women. The findings show that 15% of the survey participants suffered from IPV in the last year. The factors associated with a higher probability of suffering IPV are being of non-Spanish nationality, being a student, having a low-educational level, having no income, being the household head, and not having a current partner. Regarding the resources used by women subjected to IPV, almost half resorted to informal sources, such as female friends and/or their own mothers. The use of formal resources was low. Therefore, IPV continues to be a problem in Spain that seems to remain in the private domain. Consequently, it is necessary to increase the availability of and access to legal resources.

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults.

BACKGROUND: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. METHODS: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. RESULTS: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. CONCLUSIONS: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies. TRIAL REGISTRATION: The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).

Prevalence and Mode of Birth in Late Fetal Mortality in Spain, 2016-2019.

(1) Background: The rate of cesarean sections in late fetal mortality remains high. We aimed to determine the prevalence of late fetal mortality in Spain and risk factors for cesarean birth in women with stillbirth ≥ 28 weeks gestation between 2016-2019. (2) Methods: A retrospective observational study with national data between 2016-2019. A total of 3504 births with fetal dead were included. Sociodemographic, obstetrical and neonatal variables were analyzed using univariate and multivariate logistic regression (MLR), with cesarean birth with a stillborn ≥ 28 weeks gestation as the dependent variable. (3) Results: The late fetal mortality rate was 2.8 × 1000; 22.7% of births were by cesarean section. Factors associated with cesarean were having a multiple birth (aOR 6.78); stillbirth weight (aOR 2.41); birth taking place in towns with over 50,000 inhabitants (aOR 1.34); and mother's age ≥ 35 (aOR 1.23). (4) Conclusions: The late fetal mortality rate increased during the period. The performance of cesarean sections was associated with the mother's age, obstetric factors and place of birth. Our findings encourage reflection on how to best put into practice national clinical and socio-educational prevention strategies, as well as the approved protocols on how childbirth should be correctly conducted.

Safety, Tolerability and Pharmacokinetics of Half-Life Extended Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Monoclonal Antibodies AZD7442 (Tixagevimab-Cilgavimab) in Healthy Adults.

BACKGROUND: AZD7442 is a combination of extended half-life, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-specific neutralizing monoclonal antibodies (tixagevimab and cilgavimab). METHODS: This phase 1, first-in-human, randomized, double-blind, placebo-controlled, dose-escalation study evaluated AZD7442 administered intramuscularly (300 mg) or intravenously (300, 1000, or 3000 mg) in healthy adults (aged 18-55 years). The primary end point was safety and tolerability. Secondary end points included pharmacokinetics and antidrug antibodies. RESULTS: Between 18 August and 16 October 2020, a total of 60 participants were enrolled; 50 received AZD7442, and 10 received placebo. Adverse events (all of mild or moderate intensity) occurred in 26 participants (52.0%) in the AZD7442 groups and 8 (80.0%) in the placebo group. No infusion or injection site or hypersensitivity reactions occurred. Tixagevimab and cilgavimab had mean half-lives of approximately 90 days (range, 87.0-95.3 days for tixagevimab and 79.8--91.1 days for cilgavimab) and similar pharmacokinetic profiles over the 361-day study period. SARS-CoV-2-specific neutralizing antibody titers provided by AZD7442 were maintained above those in plasma from convalescent patients with coronavirus disease 2019 (COVID-19). CONCLUSIONS: AZD7442 was well tolerated in healthy adults, showing a favorable safety profile across all doses. Depending on the SARS-CoV-2 variant, pharmacokinetic analyses suggest the AZD7442 could offer protection for ≥6 months against symptomatic COVID-19 after a single 300-mg intramuscular administration. CLINICAL TRIALS REGISTRATION: NCT04507256.

Antibodies are proteins produced by the body in response to infections caused by microbes, including viruses. AZD7442 is a combination of 2 human antibodies, with an extended duration of effect, sourced from people who had recovered from coronavirus disease 2019 (COVID-19). These antibodies recognize a specific part (spike protein) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, and prevent the virus from infecting cells in the body. The current study evaluated the safety of AZD7442 in healthy volunteers. Sixty adults were given AZD7442 or placebo (salt solution) as injections into the muscle (300-mg dose) or infusions into a vein (300­3000-mg doses). The study did not find any safety issues with AZD7442, including at the highest dose. AZD7442 was measured in the blood 12 months after dosing, suggesting a long duration of protection. Following this study, AZD7442 was tested in larger clinical trials to investigate its potential in preventing and treating COVID-19. AZD7442 is currently authorized as treatment for outpatients with COVID-19 and as a preventive drug in people who may not respond well to COVID-19 vaccines and need additional protection (eg, those taking medications that dampen the immune system).

Environmental pollution in North-Eastern Italy and its influence on chronic obstructive pulmonary disease: time series modelling and analysis using visibility graphs.

The impact on human health from environmental pollution is receiving increasing attention. In the case of respiratory diseases such as chronic obstructive pulmonary disease (COPD), the relationship is now well documented. However, few studies have been carried out in areas with low population density and low industrial production, such as the province of Belluno (North-Eastern Italy). The aim of the study was to analyze the effect of exposure to certain pollutants on the temporal dynamics of hospital admissions for COPD in the province of Belluno. Daily air pollution concentration, humidity, precipitations, and temperature were collected from the air monitoring stations in Belluno. Generalized additive mixed models (GAMM) and visibility graphs were used to determine the effects of the short-term exposure to environmental agents on hospital admissions associated to COPD. In the case of the city of Belluno, the GAMM showed that hospital admissions were associated with NO2, PM10, date, and temperature, while for the city of Feltre, GAMM produced no associated variables. Several visibility graph indices (average edge overlap and interlayer mutual information) showed a significant overlap between environmental agents and hospital admission for both cities. Our study has shown that visibility graphs can be useful in establishing associations between environmental agents and COPD hospitalization in sparsely populated areas.

Daylight Saving Time transitions and Cardiovascular Disease in Andalusia: Time Series Modeling and Analysis Using Visibility Graphs.

The present study aimed to determine whether transitions both to and from daylight saving time (DST) led to an increase in the incidence of hospital admissions for major acute cardiovascular events (MACE). To support the analysis, natural visibility graphs (NVGs) were used with data from Andalusian public hospitals between 2009 and 2019. We calculated the incidence rates of hospital admissions for MACE, and specifically acute myocardial infarction and ischemic stroke during the 2 weeks leading up to, and 2 weeks after, the DST transition. NVG were applied to identify dynamic patterns. The study included 157 221 patients diagnosed with MACE, 71 992 with AMI (42 975 ST-elevation myocardial infarction (STEMI) and 26 752 non-ST-elevation myocardial infarction (NSTEMI)), and 51 420 with ischemic stroke. Observed/expected ratios shown an increased risk of AMI (1.06; 95% CI (1.00-1.11); P = .044), NSTEMI (1.12; 95% CI (1.02-1.22); P = .013), and acute coronary syndrome (1.05; 95% CI (1.00-1.10); P = .04) around the autumn DST. The NVG showed slight variations in the daily pattern of pre-DST and post-DST hospitalization admissions for all pathologies, but indicated that the increase in the incidence of hospital admissions after the DST is not sufficient to change the normal pattern significantly.

[Dermatologic side effects with use of lithium]. / Efectos adversos dermatológicos con uso de litio.

Lithium is a mood stabilizer recommended by most clinical guidelines as the gold standard to prevent relapses in the treatment of Bipolar Affective Disorder. It is highly effective, but unfortunately, it causes adverse effects at several levels, including the skin. AIM: To review the frequency, presentation, evolution, and management of adverse dermatologic effects caused by this drug. METHODS: We performed a narrative review using Scielo, Web of Science (WoS), and Google Scholar search engines, using keywords in Spanish and English. RESULTS: The skin presentations that appear most frequently are the progression of previously existing or newly diagnosed psoriasis, alopecia, acne, follicular inflammation, and maculopapular eruptions. CONCLUSIONS: Lithium produces and/or exacerbates a series of dermatological conditions of different severity, even at therapeutic levels, which are not usually severe but, even so, should not be underestimated since it can affect adherence to the drug.

Googling Insomnia, Light, Metabolism, and Circadian: A Population Interest Simple Report.

Exposure to light at night, insomnia, and disrupted circadian patterns could be considered risk factors for developing noncommunicable diseases. Understanding the awareness of the general population about the abovementioned factors could be essential to predict noncommunicable diseases. This report aimed to investigate the general community's interest in circadian, insomnia, metabolism, and light using Google Trends, and to evaluate results from different geographic areas. Relative search volumes (RSVs) for the factors mentioned, filtered by the "Health" category, were collected between 2007 and 2021. Moreover, RSVs were analysed in five different European languages. Worldwide mean RSVs for "Circadian", "Insomnia", "Light", and "Metabolism" during the study period were 2%, 13.4%, 62.2%, and 10%, respectively. In different developed countries, searching for light, insomnia, and metabolism were different, suggesting a variable level of awareness. Limited knowledge about the circadian pattern of human activities was detected. The highest correlation coefficient was calculated. Our results suggest the potential role of extensive data analysis in understanding the public interest and awareness about these risk factors. Moreover, it should be interpreted as the onset of stimulus for researchers to use comprehensible language for reaching comprehensive media coverage to prevent sleep and circadian system disturbances.

Effect of physical activity interventions on quality of life in older adults: A protocol for systematic review and meta-analysis.

INTRODUCTION: Quality of life (QoL) has been acknowledged as a fundamental concept in the field of health and is favorably improved by physical activity (PA). This systematic review aims to assess the benefits and harms of different types of PA to improve health-related QoL in both community-dwelling and diseased older adults to provide a recommendation for the minimum amount of PA needed to obtain measurable QoL benefits. METHODS AND ANALYSIS: We will search MEDLINE, Cochrane Central Register of Controlled Trials, CINHAL, Epistemonikos, Web of Science and gray literature. Randomized controlled trials enrolling healthy or diseased older adults aged > 65 years, providing any kind of physical activity intervention and having quality of life as an outcome will be included. There will be no language restriction. Two independent reviewers will screen the papers, and a third reviewer will resolve the conflicts. The quality of the included studies will be assessed through the Risk of Bias 2.0 tool. Finally, data will be extracted to create proper meta-analyses of comparisons between the different kinds of physical activity interventions or to control groups. ETHICS AND DISSEMINATION: This review does not require approval from the Ethics Committee. The results will be disseminated in peer-reviewed journals and at international conferences; moreover, the findings will be shared on social media using an accessible language.

The Value of Infrared Thermography to Assess Foot and Limb Perfusion in Relation to Medical, Surgical, Exercise or Pharmacological Interventions in Peripheral Artery Disease: A Systematic Review.

Infrared thermography (IRT) is a promising imaging method in patients with peripheral artery disease (PAD). This systematic review aims to provide an up-to-date overview of the employment of IRT as both a diagnostic method and an outcome measure in PAD patients in relation to any kind of intervention. On September 2022, MEDLINE, EMBASE, CENTRAL, Google Scholar, Web of Science, and gray literature were screened. Eligible articles employing IRT in PAD were screened for possible inclusion. The RoB 2.0 tool was used to assess the risk of bias. Twenty-one eligible articles were finally included, recruiting a total of 1078 patients. The IRT was used for PAD diagnosis/monitoring in 11 studies or to assess the effect of interventions (revascularization, pharmacological therapy, or exercise rehabilitation) in 10 studies. The analysis of the included papers raised high concerns about the overall quality of the studies. In conclusion, IRT as a noninvasive technique showed promising results in detecting foot perfusion in PAD patients. However, limits related to devices, points of reference, and measurement conditions need to be overcome by properly designed trials before recommending its implementation in current vascular practice.