Integrating factors associated with complex wound healing into a mobile application: Findings from a cohort study.

Complex, chronic or hard-to-heal wounds are a prevalent health problem worldwide, with significant physical, psychological and social consequences. This study aims to identify factors associated with the healing process of these wounds and develop a mobile application for wound care that incorporates these factors. A prospective multicentre cohort study was conducted in nine health units in Portugal, involving data collection through a mobile application by nurses from April to October 2022. The study followed 46 patients with 57 wounds for up to 5 weeks, conducting six evaluations. Healing time was the main outcome measure, analysed using the Mann-Whitney test and three Cox regression models to calculate risk ratios. The study sample comprised various wound types, with pressure ulcers being the most common (61.4%), followed by venous leg ulcers (17.5%) and diabetic foot ulcers (8.8%). Factors that were found to impair the wound healing process included chronic kidney disease (U = 13.50; p = 0.046), obesity (U = 18.0; p = 0.021), non-adherence to treatment (U = 1.0; p = 0.029) and interference of the wound with daily routines (U = 11.0; p = 0.028). Risk factors for delayed healing over time were identified as bone involvement (RR 3.91; p < 0.001), presence of odour (RR 3.36; p = 0.007), presence of neuropathy (RR 2.49; p = 0.002), use of anti-inflammatory drugs (RR 2.45; p = 0.011), stalled wound (RR 2.26; p = 0.022), greater width (RR 2.03; p = 0.002), greater depth (RR 1.72; p = 0.036) and a high score on the healing scale (RR 1.21; p = 0.001). Integrating the identified risk factors for delayed healing into the assessment of patients and incorporating them into a mobile application can enhance decision-making in wound care.

Microbial, Physicochemical Profile and Sensory Perception of Dry-Aged Beef Quality: A Preliminary Portuguese Contribution to the Validation of the Dry Aging Process.

Beef dry-aging consists of a selection of unpackaged prime cuts placed in a controlled environment cold room for several weeks. The goals are to concentrate flavors like nutty and beefy and to improve tenderness. The aim of this study was to verify the microbiological and physicochemical behavior and sensory perception of meat during a sample process example of meat dry-aging. Twelve beef loins were selected for 90 days of dry aging and placed in a cold room with average temperature, relative humidity and forced air 3.2 ± 0.7 °C, 60.7 ± 4.2% and 0.5-2 m/s, respectively. Samples of crust and lean meat were collected on days 1, 14, 21, 35, 60 and 90 of the dry aging process for microbiological, physicochemical (pH, aw, color L*a*b*) and sensory analysis. During drying, no pathogenic bacteria were detected, and the average counts were higher for the crust. The average values for water activity (aw) and pH were 0.98 ± 0.02 and 5.77 ± 0.015, respectively. A slight decrease in aw and an increase in pH were observed over the aging period (p < 0.05). The lower microbial counts on the lean meat and the overall assessment of freshness confirm the importance of good manufacturing and storage practices during dry aging.

Distance to Natural Environments, Physical Activity, Sleep, and Body Composition in Women: An Exploratory Analysis.

A growing body of evidence indicates that living close to nature is associated with better health and well-being. However, the literature still lacks studies analyzing the benefits of this proximity for sleep and obesity, particularly in women. The purpose of this study was to explore how distance to natural spaces is reflected in women's physical activity, sleep, and adiposity levels. The sample consisted of 111 adult women (37.78 ± 14.70). Accessibility to green and blue spaces was assessed using a geographic-information-system-based method. Physical activity and sleep parameters were measured using ActiGraph accelerometers (wGT3X-BT), and body composition was assessed using octopolar bioimpedance (InBody 720). Nonlinear canonical correlation analysis was used to analyze the data. Our findings reveal that women living in green spaces close to their homes had lower levels of obesity and intra-abdominal adiposity. We also demonstrated that a shorter distance to green spaces seemed to correlate with better sleep onset latency. However, no relationship was found between physical activity and sleep duration. In relation to blue spaces, the distance to these environments was not related to any health indicator analyzed in this study.

Pro-Environmental Behaviors: Relationship With Nature Visits, Connectedness to Nature and Physical Activity.

PURPOSE: Examine the association of visits to the natural environment, connectedness to nature, physical activity, and the adoption of pro-environmental behaviors (PEBs) in individuals aged 18 years or older. DESIGN: Cross-sectional study. SETTING: City of Vila Real, located in the north of Portugal. SUBJECTS: We recruited 194 individuals (61 men and 133 women) aged 18-75 years. MESURES: A self-administered questionnaire was used to measure nature visits, connectedness to nature, PEBs, and demographic characteristics. Neighborhood green space was appreciated through a Simplified Land Occupation Map and physical activity was measured using ActiGraph accelerometers (wGT3X-BT). ANALYSIS: Correlations and nonlinear canonical correlation analysis were used to analyze the data. The coefficients of canonical and multiple correlations were calculated. RESULTS: Nature visits were associated with involvement in environmental volunteering (V = .317, P ≤ .05) among men. In these, higher levels of moderate-vigorous PA were associated with green travel behavior (η2 = .325, P ≤ .05). Connectedness with nature was related (P ≤ .05) to private sphere behaviors, such as purchase of eco-products (η2 = .191) and local/seasonal products (η2 = .186) in females and encouraging care and protection of natural environment (η2 = .336, P ≤ .01) in males. CONCLUSIONS: Nature visits, connection to nature, and physical activity levels were related to the adoption of PEBs in the private and public sphere, and these relationships differed between men and women.

Connectedness to Nature Does Not Explain the Variation in Physical Activity and Body Composition in Adults and Older People.

Connectedness to nature (CN) is a significant predictor of pro-environmental behaviours, human health and well-being. However, research on how this connection to the natural world might promote a more active lifestyle and improve body mass composition according to gender is lacking. This study investigated the influence of CN on physical activity (PA) and body composition in adults and older people. We recruited a sample of 219 individuals (77 men and 142 women), and a self-administered questionnaire was used to measure CN and obtain demographic data. Body composition was assessed by bioimpedance, and PA was assessed by accelerometry. Correlations and stepwise multiple regressions were used in data analysis. CN's association with other variables was more pronounced in women than in men, and we only identified significant associations with steps/day and body composition. However, this variable would not be included in the regression models that we developed. Adiposity levels and muscle status were significant predictors of PA in women. In both genders, age, percentage of fat mass and fat-free mass were selected as regressors in the models developed for visceral fat area and muscle condition (R2 Adjusted ≥ 0.908).

A Multi-Block Multivariate Analysis to Explore the Influence of the Somatic Maturation in Youth Basketball.

The aim of this study was to examine the influence of somatic maturation in anthropometric, physical, and game-related variables in youth basketball age groups under-13 (U-13) and under-15 (U-15). One-hundred and eighty-five basketball players performed anthropometrical and physical tests during a non-official youth basketball tournament. Predicted maturity offset (MO) and game-related variables were also analyzed. Cluster analysis was used to analyze the between-maturation status differences in all parameters in each age group. Also, regularized generalized canonical correlation analysis (RGCCA) was used to assess relative contributions of maturational, physical, and game-related variables within each age group. Based on MO, two different clusters were identified within each age category. Greater differences in MO were identified among U-13 clusters than among U-15 clusters. No significant differences were observed between clusters in terms of physical and game-related variables. High correlations between maturational, physical, and game-related variables (i.e., points scored, field goals attempted, and rebounds) were found for boys. In girls, different trends in terms of correlations were observed. The strongest association between blocks was observed between physical tests and game-related variables in all age categories, except for U-15 girls. Knowing and identifying performance profiles according to biological age is of upmost importance since it allows the coach to create challenging situations adjusted to the individual's needs.

Effect of Soil Chemical Properties on the Occurrence and Distribution of Entomopathogenic Fungi in Portuguese Grapevine Fields.

Entomopathogenic fungi (EPF) contribute to different ecosystem services. However, factors affecting their natural occurrences in soil remain poorly understood. In a previous study, 81 soil samples were subjected to insect baiting using Galleria mellonella and Tenebrio molitor to isolate EPF from Portuguese vine farms. Here, soils yielding any of the four common EPF, i.e., Beauveria bassiana, Purpureocillium lilacinum, Metarhizium robertsii, and Clonostachys rosea f. rosea, were correlated with their chemical properties. Beauveria bassiana was negatively affected by higher available P (p = 0.02), exchangeable K-ions (p = 0.016) and positively affected by higher soil pH_H2O (p = 0.021). High exchangeable K-ions inhibited P. lilacinum (p = 0.011) and promoted C. rosea f. rosea (p = 0.03). Moreover, high available K also suppressed P. lilacinum (p = 0.027). Metarhizium robertsii was inhibited by higher organic matter content (p = 0.009), higher C:N (p = 0.017), total N (p = 0.007), and exchangeable Mg-ions (p = 0.026), and promoted by higher exchangeable Na-ions (p = 0.003). Nonetheless, mean comparisons and principal component analysis suggested that higher soil pH and exchangeable Ca-ions have contrasting effects on EPF occurrences, as they promote B. bassiana and inhibit M. robertsii. Herbicides did not seem to affect EPF presence. Overall, this study is among the first reports on the effects of soil chemistry on EPF other than Metarhizium, and will facilitate biological pest management approaches.

Impact of pre-slaughter factors on welfare of broilers.

Pre-slaughter factors adversely affecting bird welfare were studied at the slaughterhouse. The incidence of dead on arrival (DoA), bruises and dehydration was investigated in 64 different mixed-sex batches of broilers coming from 64 different farms rearing fast-growing genotypes (Ross or Cobb). The effects of catching team, method of catching, time of day for catching and transport, density per cage, transport duration, transport distance, lairage duration and water withdrawal were considered. The average DoA was 0.29%, ranging from 0.02% to 1.89% per batch. DoA rate has a higher probability of increase with the increase in transport distance (t=2.142; P=0.037; estimate=0.009) and with catching the birds after midnight (t=-2.931; P=0.005; estimate=0.022). Longer transport durations for birds caught after midnight as well as longer lairage durations for birds caught after midnight are associated with the increase of DoA rate. Bruises were observed in 3.37% of birds, ranging from 0.43% to 8.29% per batch. Bruises occurred mostly on wings (3.06%), followed by legs (0.19%) and breast (0.12%). A higher percentage of bruises occurred in batches with more birds per transport crate (t=2.185; P=0.029; estimate=0.001). Dehydrated carcasses were observed in 22 out of 64 batches, accounting for 2.68% of condemnations. Signs of dehydration on carcasses were more frequently observed in batches subjected to longer withdrawal durations. Short transport distances, catching the birds before midnight and doing the transport by night are crucial in decreasing the DoA rate. Catching and crating processes seem to be responsible for the increase of percentage of bruises. Pre-slaughter operations should be adequate planned namely, transport and lairage durations, catching period and crating procedure in view to reduce negative effects on animal welfare.

Soil Chemical Properties Barely Perturb the Abundance of Entomopathogenic Fusarium oxysporum: A Case Study Using a Generalized Linear Mixed Model for Microbial Pathogen Occurrence Count Data.

Fusarium oxysporum exhibits insect pathogenicity-however, generalized concerns of releasing phytopathogens within agroecosystems marred its entomopathogenicity-related investigations. In a previous study, soils were sampled from Douro vineyards and adjacent hedgerows. In this study, 80 of those soils were analyzed for their chemical properties and were subsequently co-related with the abundance of entomopathogenic F. oxysporum, after insect baiting of soils with Galleria mellonella and Tenebrio molitor larvae. The soil chemical properties studied were organic matter content; total organic carbon; total nitrogen; available potassium; available phosphorus; exchangeable cations, such as K⁺, Na⁺, Ca2+, and Mg2+; pH; total acidity; degree of base saturation; and effective cation exchange capacity. Entomopathogenic F. oxysporum was found in 48 soils, i.e., 60% ± 5.47%, of the total soil samples. Out of the 1280 insect larvae used, 93, i.e., 7.26% ± 0.72%, were found dead by entomopathogenic F. oxysporum. Stepwise deletion of non-significant variables using a generalized linear model was followed by a generalized linear mixed model (GLMM). A higher C:N (logarithmized) (p < 0.001) and lower exchangeable K⁺ (logarithmized) (p = 0.008) were found significant for higher fungal abundance. Overall, this study suggests that entomopathogenic F. oxysporum is robust with regard to agricultural changes, and GLMM is a useful statistical tool for count data in ecology.

Entomopathogenic fungi in Portuguese vineyards soils: suggesting a 'Galleria-Tenebrio-bait method' as bait-insects Galleria and Tenebrio significantly underestimate the respective recoveries of Metarhizium (robertsii) and Beauveria (bassiana).

Entomopathogenic fungi (EPF) are the natural enemies of insect-pests. However, EPF recoveries can be influenced by the soil habitat-type(s) incorporated and/or the bait-insect(s) used. Galleriamellonella (GM) as bait-insect, i.e. 'Galleria-bait', is arguably the most common methodology, which is sometimes used solely, to isolate EPF from soils. Insect baiting using Tenebriomolitor (TM) has also been employed occasionally. Here 183 soils were used to estimate the functional diversity of EPF in Portuguese Douro vineyards (cultivated habitat) and adjacent hedgerows (semi-natural habitat), using the TM bait method. Moreover, to study the effect of insect baiting on EPF recovery, 81 of these 183 soil samples were also tested for EPF occurrences using the GM bait method. Twelve species were found in 44.26% ± 3.67% of the total of 183 soils. Clonostachysroseaf.rosea was found in maximum soils (30.05% ± 3.38%), followed by Beauveriabassiana (12.57% ± 2.37%), Purpureocilliumlilacinum (9.29% ± 2.14%) and Metarhiziumrobertsii (6.01% ± 1.75%). Beauveriapseudobassiana (P < 0.001), C.roseaf.rosea (P = 0.006) and Cordycepscicadae (P=0.023) were isolated significantly more from hedgerows, highlighting their sensitivities towards agricultural disturbances. Beauveriabassiana (P = 0.038) and M.robertsii (P = 0.003) were isolated significantly more using GM and TM, respectively. Principal component analysis revealed that M.robertsii was associated both with TM baiting and cultivated habitats, however, B.bassiana was slightly linked with GM baiting only. Ecological profiles of B.bassiana and P.lilacinum were quite similar while M.robertsii and C.roseaf.rosea were relatively distant and distinct. To us, this is the first report on (a) C.cicadae isolation from Mediterranean soils, (b) Purpureocilliumlavendulum as an EPF worldwide; and (c) significant recoveries of M.robertsii using TM over GM. Overall, a 'Galleria-Tenebrio-bait method' is advocated to study the functional diversity of EPF in agroecosystems.

Battling a Tangled Web: The Lived Experience of Nurses Providing End-of-Life Care on an Acute Medical Unit.

Meeting the heath care needs of patients at the end of life is becoming more complex. In Canada, most patients with life-limiting illness will die in hospitals, many on medical units. Yet, few studies have qualitatively investigated end-of-life care (EOLC) in this context, or from the perspectives of nurses providing EOLC. The purpose of this study was to seek to understand the lived experience of nurses on a medical unit providing EOLC to patients. Interpretive phenomenology guided the method and analysis. Individual face-to-face interviews were conducted with 10 nurses from 2 hospital medical units. The underlying essence of these nurses' experiences was that of "battling a tangled web." Battling a tangled web represented their struggles in attempting to provide EOLC in an environment that was not always conducive to it. Seven themes were generated from the analysis: caring in complexity, caught in a tangled web, bearing witness to suffering, weaving a way to get there: struggling through the process, creating comfort for the patient, working through the dying process with the family, and finding a way through the web. The findings contribute to an understanding of the experiences of nurses in providing EOLC on a medical unit including perceived facilitators and barriers.

Use of MALDI-TOF mass spectrometry fingerprinting to characterize Enterococcus spp. and Escherichia coli isolates.

Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a faster and more accurate method to identify intact bacteria than conventional microbiology and/or molecular biology methods. The MALDI-TOF MS method is potentially applicable in diagnostic laboratories to characterize commensal bacterial species, some of which are major pathogens, from human or animal gastrointestinal tracts. The aim of this study was to analyze at the cluster and statistical level the capacity of MALDI-TOF MS to distinguish between previously characterized enterococci and Escherichia coli isolated from wild birds of the Azores archipelago. Soluble proteins were extracted from intact cell cultures of 60 isolates of Enterococcus spp. and 60 isolates of E. coli by an expedient method. MALDI-TOF MS was used to obtain 1200 mass spectra that were statistically analyzed and compared. A total of 215 distinct mass-to-charge (m/z) peaks were obtained, including a peak at m/z 4428±3, which is exclusively found in spectra from Enterococcus isolates, and peaks at m/z 5379±3 and m/z 6253±3, which are only detected in spectra from E. coli isolates. By processing mass spectra and analyzing them statistically with MassUp software, including principal component analysis (PCA) and clustering, it was possible to correctly distinguish between isolates of Enterococcus and Escherichia genera. The results of the proteomic analysis confirm that these tools could be used to characterize whole bacterial cells. In the future, with an optimized protocol for obtaining plasmid-associated proteins and the further development of bioinformatics methods, it is likely that mass peak characteristic of antimicrobial resistance will be detected, increasing the potential usefulness of MALDI-TOF in routine clinical assays. BIOLOGICAL SIGNIFICANCE: This study highlights the importance of MALDI-TOF MS in the rapid and reliable identification of bacteria by whole-cell analysis. The mass spectrometry approach performed in this study further contributes for the microbial biomarker discovery culminating in a preferable bacteria identification and antimicrobial resistance tool for the future of clinical microbiology. This article is part of a Special Issue entitled: HUPO 2014.

Comfort measures: a concept analysis.

Reference to the concept of comfort measures is growing in the nursing and medical literature; however, the concept of comfort measures is rarely defined. For the comfort work of nurses to be recognized, nurses must be able to identify and delineate the key attributes of comfort measures. A concept analysis using Rodgers' evolutionary method (2000) was undertaken with the goal of identifying the core attributes of comfort measures and thereby clarifying this concept. Health care literature was accessed from the CINAHL and PubMed databases. No restrictions were placed on publication dates. Four main themes of attributes for comfort measures were identified during the analysis. Comfort measures involve an active, strategic process including elements of "stepping in" and "stepping back," are both simple and complex, move from a physical to a holistic perspective and are a part of supportive care. The antecedents to comfort measures are comfort needs and the most common consequence of comfort measures is enhanced comfort. Although the concept of comfort measures is often associated with end-of-life care, this analysis suggests that comfort measures are appropriate for nursing care in all settings and should be increasingly considered in the clinical management of patients who are living with multiple, chronic comorbidities.