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This cross-sectional study utilized the National School Health Survey 2015 database to assess the association between school cafeterias; the meals offered by the Brazilian School Food Program (PNAE); and the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks among Brazilian adolescents. A sample of 102,072 adolescents, aged 11–19 years, who were enrolled in the 9th grade completed the survey. The evaluated outcome was the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks. A Poisson regression model-based multivariate analysis was performed. The effect measure was the prevalence ratio (PR) with its respective 95% confidence intervals (CIs). The results indicated that Brazilian adolescents who attended schools without meals offered through the PNAE had a higher probability of regularly (≥5 times/week) consuming ultra-processed salty foods [PR = 1.06, CI = 1.01–1.11] and soft drinks [PR = 1.08, CI = 1.03–1.14] compared to those who attended schools that offered PNAE meals. Moreover, the presence of a school cafeteria was associated with a higher probability to consume industrialized/ultra-processed salty foods [PR = 1.05, CI = 1.02–1.08], sweets [PR = 1.09, CI = 1.07–1.11], and soft drinks [PR = 1.10, CI = 1.07–1.13]. School meals appear to be associated with the consumption of ultra-processed foods by Brazilian adolescents, indicating areas for health promotion programs.

Hypertension is a public health issue in Iran. The study aimed to estimate the prevalence, awareness, treatment, and control of hypertension, and to explore their determinants among 10,040 Kurdish adults from Ravansar Non-Communicable Disease (RaNCD) cohort study in Iran. Univariate, and multivariate analyses were used for statistical analysis. Prevalence of hypertension was 15.7%. Among hypertensive patients, awareness, treatment, and control of hypertension were 80.7%, 73.2%, and 53.3%, respectively. In multivariate analysis, significant associations were found between awareness and female sex, older age, being married rather than being single, literacy, living in rural areas, having family history, and comorbidities, with a higher probability for those who had both diabetes and dyslipidemia. Being married, living in rural areas, being ex-smokers, having less physical activity and individuals who had diabetes and dyslipidemia had higher odds of receiving treatment. Being female had a statistically significant association with the control of hypertension. The Kurdish population had higher awareness, with a greater proportion of treated, and controlled patients compared to populations included in previous studies for the last 20 years in Iran. With the continuing health promotion programs in Iran, it is expected to observe a lower prevalence of hypertension, higher awareness and greater number of treated individuals with controlled hypertension.

Modal shifts hold considerable potential to mitigate carbon emissions. Electric bikes (e-bikes) represent a promising energy- and carbon-efficient alternative to cars. However, as mobility behaviour is highly habitual, convincing people to switch from cars to e-bikes is challenging. One strategy to accomplish this is the disruption of existing habits-a key idea behind an annual e-bike promotion programme in Switzerland, in which car owners can try out an e-bike for free over a two-week period in exchange for their car keys. By means of a longitudinal survey, we measured the long-term effects of this trial on mobility-related habitual associations. After one year, participants' habitual association with car use had weakened significantly. This finding was valid both for participants who bought an e-bike after the trial and those who did not. Our findings contrast the results of other studies who find that the effect of interventions to induce modal shifts wears off over time. We conclude that an e-bike trial has the potential to break mobility habits and motivate car owners to use more sustainable means of transport.

Metabolic syndrome (MetS) is a growing public health concern worldwide. It has been demonstrated that individuals with MetS are at an increased risk of cardiovascular events and diabetes. We aimed to investigate the prevalence of MetS and its components among Turkic and Kurds ethnic groups in a bi-ethnic (Turk and Kurd) population. This cross-sectional study is part of the national health transformation plan created in response to the emerging epidemic of non-communicable diseases (Iran’s Package of Essential Non-communicable Disease study), launched in 2014 in Naqadeh, Iran. In total, 3506 participants aged 30–70 years were randomly included in the study from urban and rural regions. Cardio-metabolic risk factors related to MetS diagnosis and other related sociodemographic factors were assessed for men and women in both the Turk and the Kurd population. Multivariate logistic regressions were applied to identify MetS -associated factors among both the Turk and the Kurd population. The mean (SD) age of the participants was 49.6 (12.3) years. Of the participants, 56.2% (n = 1969) were women, and 43.8% (n = 1537) were men. Three-fifths of the participants were Turk (60.3%, n = 1751). The overall prevalence of MetS was 37.05%, with a higher prevalence in women (49.8% versus 24.3% in men). The prevalence of MetS and its components among Turk people (41.6%) were significantly higher than that among Kurd people (33.9%) (p < 0.0001). In addition, the prevalence of MetS was higher among women, urban, and older people for both ethnicities. Strong associations were found between MetS prevalence and being older, being female, being overweight, being obese, having a higher waist-to-hip ratio, and having a history of diabetes and cardiovascular disease (CVD) in the family for both Turks and Kurds. The raised waist circumference (WC) is the most prevalent MetS component for Turk men and women. Meanwhile, the most prevalent MetS component for Kurd participants is low high-density lipoprotein for women and a raised WC for men. Significant differences were found between Kurdish men and women for all components, except for a raised WC and a raised fasting blood glucose (p < 0.05). Because the Iranian population features multiple ethnicities, the recognition of the prevalence of MetS components is a major step in establishing intervention strategies for modifying cardio-metabolic risk factors based on the population ethnicities and their socio-demographic, cultural, and lifestyle factors. We recommend future studies for planning an efficient and sustainable health education and promotion program to halt MetS prevalence.

With the recent increase in the interest of individuals in health, lifecare, and disease, hospital medical services have been shifting from a treatment focus to prevention and health management. The medical industry is creating additional services for health- and life-promotion programs. This change represents a medical-service paradigm shift due to the prolonged life expectancy, aging, lifestyle changes, and income increases, and consequently, the concept of the smart health service has emerged as a major issue. Due to smart health, the existing health-promotion medical services that typically have been operated by large hospitals have been developing into remote medical-treatment services where personal health records are used in small hospitals; moreover, a further expansion has been occurring in the direction of u-Healthcare in which health conditions are continuously monitored in the everyday lives of the users. However, as the amount of data is increasing and the medical-data complexity is intensifying, the limitations of the previous approaches are increasingly problematic; furthermore, since even the same disease can show different symptoms depending on the personal health conditions, lifestyle, and genome information, universal healthcare is not effective for some patients, and it can even generate severe side effects. Thus, research on the AI-based healthcare that is in the form of mining-based smart health, which is a convergence technology of the 4IR, is actively being carried out. Particularly, the introduction of various smart medical equipment for which healthcare big data and a running machine have been combined and the expansion of the distribution of smartphone wearable devices have led to innovations such as personalized diagnostic and treatment services and chronic-disease management and prevention services. In addition, various already launched applications allow users to check their own health conditions and receive the corresponding feedback in real time. Based on these innovations, the preparation of a way to determine a user’s current health conditions, and to respond properly through contextual feedback in the case of unsound health conditions, is underway. However, since the previously made healthcare-related applications need to be linked to a wearable device, and they provide medical feedback to users based solely on specific biometric data, inaccurate information can be provided. In addition, the user interfaces of some healthcare applications are very complicated, causing user inconvenience regarding the attainment of desired information. Therefore, we propose a chatbot-based healthcare service with a knowledge base for cloud computing. The proposed method is a mobile health service in the form of a chatbot for the provision of fast treatment in response to accidents that may occur in everyday life, and also in response to changes of the conditions of patients with chronic diseases. A chatbot is an intelligent conversation platform that interacts with users via a chatting interface, and since its use can be facilitated by linkages with the major social network service messengers, general users can easily access and receive various health services. The proposed framework enables a smooth human–robot interaction that supports the efficient implementation of the chatbot healthcare service. The design of the framework comprises the following four levels: data level, information level, knowledge level, and service level.

This paper examines the morphological changes of Historic Citadel in Hit, Iraq, in relation to the changes in syntactic properties of street networks and land use distribution during the last century. Founded before 1600 BC, Historic Hit Citadel (HHC) has been considered as one of the most important fortified cores in Iraq. It consists of a rich variety of urban structures representing different historic periods of the city history. However, HHC was continuously deteriorated by a lack of urban development programs and maintenance processes since 1900s. The study thus covers the three remarkable changes of HHC in order to find proper sustainable actions for developing this historic site and to promote programs of economic diversity as a sustainable agenda. Methods use space syntax techniques and measures to describe the accessibility and connectivity of street networks based on syntactic properties of the built environment. Generated maps of syntactic structures helped to identify the integration and segregation urban areas on the city map. A discussion of the implications of integration areas, needed to be improved, and segregation areas, required to be developed, was conducted. Results have shown where the integrated and segregated cores were located and so helped to provide general improvements by adopting new activities, developing the existing spatial quality of the built environm.

Objectives The aim of this study was to investigate effects of a multicomponent program promoting physical activity on sedentary behavior, physical activity, and body measures, when relocating from cell offices to either a flex or cell office. Methods The Active Office Design (AOD) study is a longitudinal non-randomized controlled study performed in a municipality in northern Sweden. A subsample of 86 participants were randomly recruited from the AOD study to objectively measure sedentary behavior and physical activity, using ActivPAL and ActiGraph, before and after relocation to the two different office types. The multicomponent program promoting physical activity was performed in both offices. Data were analyzed using linear mixed models. Results Eighteen months after relocation, the total number of steps per work day increased by 21% in the flex office and 3% in the cell office group, compared to baseline. Moderate and vigorous physical activity (MVPA) during work hours increased by 42% in the flex office group and 19% in the cell office group. No changes were seen regarding sitting time at work. Small additive effects for walking and MVPA were seen for both groups during non-work time. Weight increased in the flex office group. Conclusions This long-term study shows that a multicomponent workplace intervention can lead to increased walking time, steps, and MVPA in a flex compared to a cell office. Small additive increases of physical activity were seen during non-work time in both groups. More long-term controlled studies are needed to confirm these results.

In this century, the value of information has become more significant; reflecting this change, focus has shifted to preparing pupils for the functional use of reading. Therefore, the latest international assessments of reading literacy are set up to address this kind of knowledge. Significant numbers of individuals are performing below the minimum level in these assessments in Hungary, signalling lower capacity for participation in the community. When attempting to eliminate functional illiteracy, it is crucial to analyse the present support system, and the efficiency of recognising reading problems in the early stages, in order to improve the provision of education systematically. When examining the probable causes of the struggle to comprehend texts, one of the prerequisites of understanding written language is appropriate decoding. This research focuses on investigating the access to intervention programmes of 5th-grade children with poor reading skills. The speed and accuracy of the aloud reading of 957 pupils attending mainstream classrooms were measured and compared to the data regarding the participation in rehabilitation programmes. The most relevant finding of the research was that only less than half of the children with poor reading skills receive help to improve their performance; 55% of slow readers and 60% of non-accurate readers were left without support, even though their performance is significantly worse than that of their peers. This finding indicates the need to revise the screening system and necessitates more extensive and less diagnosis-based access to intervention programmes. (DIPF/Orig.)

In recent years, automobile exhaust gas regulations have become stricter due to environmental problems such as global warming. A project by the Cabinet Office called the Strategic Innovation Promotion Program (SIP) began in 2014. SIP has 11 themes in total. One of them, innovative combustion technology, aimed to improve the thermal efficiency of automobiles from the existing 40% to 50%. To improve the thermal efficiency of the automobile, it was essential to improve the efficiency of the turbocharger. In this study, we developed a turbocharger for gasoline and diesel engines. First, to confirm the efficiency of the conventional turbocharger, experiments and CFD analysis of a commercial turbocharger were performed. ANSYS-CFX was used as a numerical code. To confirm the accuracy of the CFD, the CFD results were compared with the experimental results, and it had good agreement with the experimental results. From the analysis results, the loss region of the conventional turbocharger was clarified. The designed turbocharger compressor was tested as a prototype compressor. The results of the compressor had good agreement with CFD results, so it was confirmed that the accuracy of CFD and design method was valid. Finally, A one-dimensional simulation using GT-Power which is a system analysis software for automobiles was performed to evaluate the developed turbocharger on the engine. In the fifth year of the project, the target efficiency of 50% was achieved.

Overweight/obesity modified the effects of ambient particulate matter (PM) exposure on blood pressure (BP). This study aims to assess whether interaction of underweight and short-term PM exposure on BP exists in Chinese children. A cross-sectional analysis including 144,513 children aged 6 to 17 years in 2016 Health Promotion Program for Children and Adolescents of Suzhou, China, was performed. Daily concentrations of inhalable PM (PM 10 ) and fine PM (PM 2.5 ) were extracted from air monitoring stations close to students’ schools. We applied generalized linear mixed-effects models to estimate the interactions. Estimated changes (95% confidence intervals (CIs)) of systolic BP (SBP), diastolic BP (DBP), and odds ratios (ORs) (95% CIs) for prevalence of HBP were calculated. Significant interactions between PM and underweight on BP and prevalence of high BP (HBP) were observed. For example, at lag 6, the ORs (95% CIs) for HBP by each 10 μg/m 3 changes of PM 2.5 were 1.066 (1.039, 1.093) and 1.036 (1.028, 1.043) among underweight and normal weight subjects, respectively; these values for PM 10 were 1.048 (1.031, 1.065) and 1.025 (1.021, 1.030). At lag 5, the increases of SBP for PM 2.5 were 0.32 (95% CI 0.22, 0.43) mmHg and 0.23 (95% CI 0.29, 0.26) mmHg, while changes of DBP were 0.27 (95% CI 0.18, 0.35) mmHg and 0.19 (95% CI 0.16, 0.21) mmHg among underweight and normal weight subjects, respectively. Stratified analyses demonstrated that these interactions were only obtained in males. Effects of short-term PM exposure on BP and prevalence of HBP are enhanced in underweight children and adolescents.