To describe the prevalence of adoption of Covid-19 preventive behaviors and to evaluate associated factors among users of health units in Salvador and Rio de Janeiro.

Cross-sectional study conducted between July 2022 and July 2023. Adoption of preventive behaviors was assessed based on eight behaviors, grouped into the following outcomes: social distancing; respiratory etiquette; mask use; hand hygiene; sociodemographic, housing, structural characteristics, and individual perceptions. All analyses were stratified by study site. Bivariate and multivariate analyses were performed using Poisson regression with robust variance.

A total of 5,476 participants from Salvador and 1,940 from Rio de Janeiro were evaluated. The most prevalent preventive behaviors were respiratory etiquette (82.7 and 84.3%) and hand hygiene (84.9 and 79.1%), respectively. In Salvador, age remained associated with all behaviors assessed. In Rio de Janeiro, adoption of preventive behaviors increased among those who received a Covid-19 vaccine booster. In both cities, individuals aged 40-59 years, ≥ 60 years, and those not employed showed higher adherence to social distancing. Respiratory etiquette was more prevalent among women, individuals with complete high school education, and those who received a Covid-19 booster. Mask use and hand hygiene were associated with female sex, older age, and vaccine booster in both locations. Mask use was also more frequent among those vaccinated against influenza, while hand hygiene was associated with higher education.

These findings reinforce the importance of public policies that promote maintenance of preventive behaviors and awareness of epidemic prevention, particularly among men, younger individuals, those with lower education, and those who do not receive recommended vaccines or booster doses.

To identify factors associated with the acceptability of Covid-19 self-testing among socioeconomically vulnerable populations.

Cross-sectional study using data from the "TQT Covid-19" project, which involved users from 19 primary health care (PHC) units located in socioeconomically vulnerable areas in Salvador (BA) and Rio de Janeiro (RJ), Brazil. Data were collected between July 2022 and July 2023. Descriptive analysis of Covid-19 self-test acceptability was performed, and logistic regression models were used to estimate factors associated with acceptability, with respective 95% confidence intervals (95%CI).

Among 7,939 study participants, 45.8% (95%CI 44.75-46.95) reported willingness to use a Covid-19 self-test. In the analysis of associated factors, regarding sociodemographic profile, non-Black individuals (ORa = 1.17; 95%CI 1.02-1.34), cisgender men (ORa = 1.23; 95%CI 1.12-1.37), and participants with higher educational levels (ORa = 1.60; 95%CI 1.43-1.79) were more likely to accept the self-test. Those with prior knowledge of the self-test (ORa = 2.33; 95%CI 2.11-2.58) and those previously diagnosed with Covid-19 (ORa = 1.17; 95%CI 1.05-1.28) also reported higher acceptance.

Provision of Covid-19 self-testing should be considered as a complement to testing within the public health system, especially due to its acceptance among vulnerable populations and the difficulties in accessing testing in many Brazilian regions. During periods of increased Covid-19 incidence, self-testing may serve as an important strategy for mass case detection, provided that access and knowledge are expanded so communities can play an active role in SARS-CoV-2 epidemiological surveillance.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, with frequent exacerbations of COPD (ECOPD) significantly impacting patient health and health care systems. Predicting ECOPD early would increase patients' quality of life and decrease the economic burden. The advancement of wearable technologies and Internet of Things (IoT) sensors has enabled continuous remote monitoring (RM), offering new opportunities for early ECOPD prediction. However, effectively leveraging wearable data requires robust artificial intelligence (AI) frameworks capable of processing heterogeneous physiological and environmental information.

This systematic review aims to provide a comprehensive overview of both hardware and software solutions for predicting ECOPD using RM. From the reviewed literature, we first focus on key physiological and environmental variables essential for COPD monitoring that can be extracted from wearables and IoT sensors. Second, we describe the wearable and IoT devices currently deployed in COPD management. Finally, we review machine learning, including deep learning models, used for ECOPD prediction, discussing limitations for real-world implementation. By bridging AI-driven data processing with real-world sensor applications, this review aims to outline the current landscape, existing challenges, and future directions for developing effective RM solutions for ECOPD predictions.

A comprehensive search was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to identify studies using AI or machine learning techniques for predicting ECOPD in in-home contexts.

This review identified 26 studies that met the inclusion criteria. Twenty studies aimed at predicting or detecting exacerbations at the onset. The variables tracked most frequently were heart rate (n=9), peripheral oxygen saturation (n=9), and symptoms (n=8). Daily or weekly sampling was most common (n=14). Most studies (n=13) applied machine learning models-primarily random forest (n=5), CatBoost (n=2), decision trees (n=2), and support vector machines (n=2). Deep learning was used in 3 papers, while the remaining applied rule-based logics and probabilistic models. Wearables and IoT were used in only 6 out of 20 studies. Six papers analyzed changes in vital parameters during prodromal phases, defined as the period shortly before the onset of an exacerbation. Three studies collected data continuously, 2 daily, and 1 compared once-daily versus overnight monitoring; 4 of these 6 used wearable devices.

Overall, current evidence highlights the potential of continuous monitoring of physiological and environmental variables for early ECOPD prediction, offering advantages over questionnaires or once-daily measurements. While wearables and IoT devices show promise, their use remains limited. Many studies rely on balanced datasets that do not mirror real-world exacerbation patterns and lack external validation across diverse populations. Future research should emphasize large-scale validation, integration of multimodal data, and translation of AI models into clinically feasible tools to enable timely intervention and improve COPD management.

The rise of social media has significantly impacted public health programs, with platforms such as YouTube, Facebook, X (formerly known as Twitter), Instagram, and, more recently, TikTok being used to promote health information, raise awareness about disease outbreaks, and support disease prevention programs. However, the diverse and often unverified nature of the content on social media can make it challenging to discern accurate information, contributing to user uncertainty, which may in turn contribute to low vaccination rates in some regions. This is especially true in Louisiana as its COVID-19 vaccination rates were among the lowest in the country in 2022. Therefore, understanding public sentiment on social media and developing targeted campaigns to counter unverified information is essential for advancing public health campaigns.

The goal was to gain insights into the underlying factors that contribute to Louisiana's low vaccination rates for routine immunizations by (1) performing social media listening to develop an infodemic management plan and (2) promoting accurate information via a social media campaign.

Social media listening was conducted using Meltwater, a media monitoring and social media listening platform, supplemented by Google Alerts and Google News to identify if vaccine-related stories or sentiments were attracting unusual attention. Additionally, a social media campaign aimed at educating Louisiana residents about disease manifestation, symptoms, vaccines available for disease prevention, and potential side effects was developed. Posts were published 2 to 3 times a week and boosted for 7 days.

From November 13, 2023, to June 11, 2024, social media listening identified at least 15 unique, noteworthy stories that signified sentiment spikes. These conversations were predominantly related to vaccine hesitancy, with users expressing opposition to vaccines or reluctance to engaging with vaccine-related information. Sentiment spikes included themes related to mistrust of vaccines and concerns about their safety and efficacy. The social media campaign received 69,600 impressions, reached 43,429 users, and received 652 reactions and likes, 62 shares, and 105 comments. Most of the audience was female, with higher engagement from older users on Facebook and younger users on Instagram. Finally, posts related to hepatitis B, rotavirus, and measles, mumps, and rubella vaccines received the most attention.

Social media has become a key tool for digital health, helping to implement disease prevention programs and promoting advances in medicine. However, unverified information remains a major reason for the aversion to vaccination despite the dissemination of information from reputable public health organizations, health professionals, hospitals, and medical centers. To address this, information that is accessible, understandable, and culturally competent must be circulated to mitigate disinformation and improve attitudes toward vaccination. More research is needed to evaluate the effectiveness of social media campaigns in reducing vaccine hesitancy and improving willingness to adopt public health recommendations to increase vaccination rates.

The COVID-19 pandemic disrupted healthcare utilization and access for many, with persons living with pre-existing pulmonary conditions like cystic fibrosis (pwCF) having been the most impacted. PwCF appeared to have improvements in lung function and reduction in pulmonary exacerbations during the pandemic. However, it is not clear if general healthcare utilization beyond CF centers were also reduced and whether there existed any sex-based differences in health outcomes during the pandemic. Our objective was to use population-level administrative data to gain a comprehensive understanding of healthcare utilization and outcomes for pwCF pre- compared to post-COVID.

A retrospective provincial-level analysis was conducted using linked administrative datasets from a single-payer health jurisdiction in Alberta, Canada. We measured hospitalization, emergency department and outpatient visits in pwCF 18 months before and after March 12, 2020. Subgroup analysis was undertaken to differences between sexes.

Acute care encounters (including general emergency department [ED] visits and hospitalizations) for pwCF declined during the pandemic. There was a trend towards an increase in outpatient primary care and specialist clinics (both virtual and in-person) in the post-COVID period. Mortality rate was largely unchanged during the pandemic. CF females and males experienced the same relative change in healthcare utilization during the pandemic with a greater reduction in ED visits by CF females.

PwCF accessed acute care resources less but females experienced a greater drop in ED visits despite similar hospitalization rates as males, raising the possibility that females with CF experienced a disproportionate barrier to accessing acute care.

Acute rhinosinusitis (ARS) affects approximately 15% of adults annually. It accounts for nearly 30 million outpatient visits and one in five antibiotic prescriptions, and contributes to over $11 billion in direct healthcare costs in the United States. Because routine clinical evaluation cannot reliably distinguish viral from bacterial ARS, antibiotics are frequently prescribed for infections that are likely viral. Non-antibiotic therapies such as intranasal corticosteroids (INCS) and saline nasal irrigation may provide symptom relief, but their comparative effectiveness in ARS has not been rigorously evaluated.

This protocol describes the design and methodology of a large, multi-center, pragmatic randomized controlled trial to evaluate antibiotic and non-antibiotic treatment strategies for ARS. The trial will compare supportive care, and clinical and laboratory indicators that may identify subgroups most likely to benefit from specific therapies.

This placebo-controlled trial is underway in primary care and urgent care settings in six regions across the U.S. Adults aged 18-75 years with ARS initially receive clinician-directed care. Participants who do not improve after 9 days of symptoms will be randomized into one of four groups: antibiotics alone; placebo-antibiotics plus INCS; antibiotics plus INCS; or placebo-antibiotics alone. All participants receive educational materials and kits for saline nasal irrigation. The trial will enroll 3,720 participants, with approximately 60% expected to enter the randomized phase. Primary outcomes include symptom severity prior to and 3 days post-randomization, as measured by the modified Sino-Nasal Outcome Test-16).

This trial will generate high-quality evidence to inform targeted treatment of ARS, identify subgroups most likely to benefit from antibiotics or non-antibiotic therapies, and support more judicious antibiotic stewardship in routine clinical practice.

Objective: To investigate the effects of the sphingosine-1-phosphate receptor-2 (S1PR2) inhibitor JTE-013 on pulmonary fibrosis in silicosis mice and its underlying molecular mechanisms. Methods: In October 2024, 40 SPF male C57BL/6J mice were randomly divided into control group, JTE-013 control group, silicosis model group, and JTE-013 treatment group. A silicosis model was established by non-exposure intratracheal instillation of SiO(2) suspension. One week after model was establishment, mice in the JTE-013 treatment group were intraperitoneally injected with JTE-013 (10 mg/kg, twice a week for a total of 6 times), while mice in other groups were intraperitoneally injected with the same volume of normal saline. After 28 d of modeling, the lung coefficients of mice in each group were detected. The lung tissues were stained with HE, Masson, and Sirius Red to assess pathological damage and collagen deposition. The content of hydroxyproline (HYP) was determined. The expressions of S1PR2, epithelial-mesenchymal transition (EMT) marker proteins [E-cadherin (E-cad), Vimentin, α-smooth muscle actin (α-SMA) ], and Ras homolog family member A/Rho-related coiled helix kinase 1 (RhoA/ROCK1) pathway proteins were detected by protein immunoblotting method. Human alveolar epithelial A549 cells were cultured in vitro. The cells were divided into normal control group (cultured in complete medium for 26 h), JTE-013 control group (cultured in medium prepared to 1 μmol/L JTE-013 solution for 26 h), SiO(2) treatment group (cultured for 2 h with normal medium, then treated with 50 μg/ml SiO(2) suspension for 24 h), and SiO(2)+JTE-013 treatment group (pre-treated with 1 μmol/L JTE-013 for 2 h, then added 50 μg/ml SiO(2) suspension for 24 h). After group intervention, the expression levels of S1PR2, EMT-related proteins, RhoA and ROCK1 in the cells were detected. For the normally distributed measurement data, one-way ANOVA analysis of variance was used for inter-group comparison, and LSD-t test was used for pairwise comparison. Results: Compared with the control group, the mice in the silicosis model group had a significant decrease in body weight, and their lung coefficient and HYP content were significantly increased (P<0.05), silicotic nodules formed in the lungs, accompanied by collagen deposition. And the expression levels of SIPR2 protein, EMT-related proteins Vimentin, α-SMA, and the RhoA and ROCK1 proteins in signaling pathway were significantly increased, while the expression level of the epithelial marker E-cad was significantly decreased (P<0.05). Compared with the silicosis model group, the mice in the JTE-013 treatment group had a significantly increase in body weight, the lung coefficient and HYP content were significantly decreased (P<0.05), the pulmonary fibrosis was significantly reduced. And the expression levels of SIPR2 protein, EMT-related proteins Vimentin, α-SMA, and the RhoA and ROCK1 proteins in the signaling pathway were significantly decreased, while the expression level of the epithelial marker E-cad was significantly increased (P<0.05). In the in vitro experiments, compared with the normal control group, the expression levels of EMT-related proteins Vimentin, α-SMA and the proteins RhoA and ROCK1 in the signaling pathway in the SiO(2) treatment group were significantly increased, while the expression level of the epithelial marker E-cad was significantly decreased (P<0.05). Compared with the SiO(2) group, the expression levels of EMT-related proteins Vimentin, α-SMA, and the proteins RhoA and ROCK1 in the signaling pathway in the SiO(2)+JTE-013 treatment group were significantly decreased, while the expression level of the epithelial marker E-cad was significantly increased (P<0.05) . Conclusion: JTE-013 can alleviate the pulmonary fibrosis in silicosis mice, which may be related to the inhibition of the EMT process through the RhoA/ROCK1 signaling pathway.

A persistently crooked nose refers to a condition in which the deviation of the nasal pyramid from the facial midline remains or reappears after the rhinoplasty surgery. Asymmetries in any compartment of the nose are among the main concerns of patients seeking revision rhinoplasty. Therefore, mastering surgical techniques to address these issues is essential to achieve success in revision cases. In this article, we discuss various surgical techniques, present case examples, and provide supplementary revision rhinoplasty videos performed by the senior author to enhance understanding.

Revision rhinoplasty remains one of the most demanding procedures in facial plastic surgery, challenging not only because of the altered anatomy, deficiencies of structural support, and complex 3-dimensional morphology of the nose, but also because of the varying degrees of scarring. Although the open approach dominates contemporary revision rhinoplasty practice, the endonasal technique remains a valuable option in appropriately selected patients. By preserving the skin-soft tissue envelope and the intrinsic ligamentous support of the nose, endonasal revision offers advantages including reduced edema, avoidance of external scars, and maintenance of a more natural nasal appearance and feel.

In a standard septoplasty, most of the quadrangular cartilage is resected while preserving an L-strut to maintain structure of the nose. Deviation may recur due to contractile forces causing flexure or torsion of the L-strut, which may be reduced by modifying the shape of the L-strut chondrotomy. Alternatively, deviations may have been insufficiently addressed by the initial septoplasty. Grafting techniques are often used to address deviations of the L-strut, and repositioning of the posterior septal angle may be required when displaced off the anterior nasal spine. With certain severe sepal deformities, extracorporeal septoplasty may be a more effective option.