International House

BackgroundStress resilience is a dynamic process shaped by the interaction between demands and adaptive resources. Existing measures assess stress and resilience as separate constructs, limiting their use in digital health and workplace interventions. An integrated measure capturing both domains is needed.ObjectiveWe developed and validated the WONE Index, a multidimensional stress resilience tool designed to measure both current stress load and adaptive resources among full-time working adults.MethodsWe developed the 32-item WONE Index through literature review, expert consultation, and iterative refinement to assess stress load and resilience resources across behavioral, cognitive, and social domains. Phase 1 (N=1005; United States– or United Kingdom–based full-time employees) evaluated the initial item pool using exploratory and confirmatory factor analyses to establish the preliminary factor structure and assess reliability and validity. Phase 2 (N=306; United States–based adults) expanded underperforming domains, refined items, and tested incremental validity, test-retest reliability, and measurement invariance. Data were collected online through CloudResearch (Connect) and Prolific (Prolific Academic Ltd) using secure survey platforms.ResultsPhase 1 supported a 2-domain structure: a Stress Load factor (Work Stress, Personal Stress, and Burnout) and a Resilience Resources factor (Emotion Regulation and Coping, Social Connectedness, and Sleep). Model fit indices were excellent (comparative fit index, CFI=0.95; Tucker-Lewis index, TLI=0.94; and root mean square error of approximation, RMSEA=0.05). Phase 2 replicated and extended this structure, expanding Resilience Resources into 7 domains (adding Purpose and Prosociality, Physical Activity, Dietary Intake, and Perseverative Thinking). Confirmatory factor analyses supported a 2-domain structure, comprising a higher-order Stress Load factor with 3 subdomains (Work Stress, Personal Stress, and Burnout) and a higher-order Resilience Resources factor with 7 subdomains (Emotion Regulation and Coping, Social Connectedness, Purpose and Prosociality, Sleep, Physical Activity, Dietary Intake, and Perseverative Thinking). The Stress Load model demonstrated excellent fit (χ²33=64.18; P=.01; CFI=0.99; TLI=0.98; RMSEA=0.06; and standardized root mean square residual=0.05), and the Resilience Resources model also fit well (χ²443=745.20, P<.001; CFI=0.94; TLI=0.94; RMSEA=0.05; and standardized root mean square residual=0.06). All subscales showed strong internal consistency (composite reliability: mean 0.84, SD 0.10; range 0.74‐0.93) and excellent test-retest reliability over 3 weeks (intraclass correlation coefficients 0.77‐0.90, 95% CI 0.87-0.93). The index showed strong convergent validity (r=0.73 with Connor-Davidson Resilience Scale and r=–0.66 with Perceived Stress Scale-4) and explained additional variance beyond established measures in predicting depression, anxiety, and well-being (ΔR²=0.07‐0.11; P<.001).ConclusionsThe WONE Index provides a psychometrically robust tool for assessing stress resilience capacity in working adults. Its integrated structure captures dynamic relationships between stress exposure and resilience resources, thereby supporting personalized intervention delivery in digital health platforms and organizational well-being programs.

The present study assessed heavy metal contamination, phytochemical content, antioxidant potential, and health risk in twelve wild food plants (WFPs) from Deosai National Park (DNP), Pakistan. Eight heavy metals were quantified in edible parts of WFPs with the following decreasing order: Zn > Cu > Hg > As > Pb > Cr > Ni > Cd based on mean values. The highest concentration of As and Hg was in the leaves of Taraxacum officinale (3.562 ± 1.08 and 8.20 ± 2.06mg/kg) and Ni and Cd in the fruit of Ribes alpestre (0.288 ± 0.11 and 0.013 ± 0.004mg/kg) in respective orders. The highest concentrations of Cr (1.13 ± 0.06mg/kg), Cu (37.3 ± 5.67mg/kg), and Pb (1.18 ± 0.001mg/kg) were quantified in the leaves of Chenopodium foliosum, Convolvulus arvensis, and Thymus linearis, respectively. Zn was maximum in the fruits of Rosa webbiana fruit (95.93 ± 9.15mg/kg). Phytochemical analysis revealed T. officinale leaves had maximum total phenolic content (877.8 ± 50.2 mgGAE/100g DW), while total flavonoids were highest in Pleurospermum candollei (672.8 ± 40.6 mgQE/100g DW). Antioxidant assays emphasized R. alpestre fruits with the highest total antioxidant capacity (2679.8 ± 15.4 mgAAE/100g) and P. candollei with maximum ferric reducing power (1932.6 ± 256.2 mgAAE/100g). However, hydroxyl and DPPH radical scavenging was maximum in the fruits of Ephedra gerardiana (89.6 ± 2.0%) and R. webbiana (68.5 ± 0.53%). These variations may be attributed to diverse altitude, anthropogenic activities, and soil composition across different sampling sites of DNP. Health risk indices (HRI, THQ, HI, and TCR) were generally below threshold levels, indicating low non-carcinogenic and carcinogenic risks. However, HI in T. officinale exceeded 1 due to elevated levels of As and Hg, suggesting long-term risks with excessive consumption, particularly for children. Overall, WFPs of DNP are a safe dietary option, with promising nutraceutical potential, but continuous ecological monitoring and sustainable utilization of these food plants can enhance health benefits, food security, and bioresource conservation in alpine ecosystems.

Mesenchymal Stem cells (MSCs) have a wide range of therapeutic applications due to their self-renewal and multi-lineage differentiation ability; large-scale production of MSCs is possible only with a highly efficient medium, which facilitates increased proliferation of MSCs within a short period. Recently, Human Platelet Lysate (hPL) has emerged as a promising substitute for fetal bovine serum (FBS) for cell expansion. The goal of this study is to optimize a stable gel formulation for the 3D expansion of MSCs using hPL as a matrix material for the improved proliferation of Human Umbilical Cord Tissue derived MSCs (hUCT-MSCs)in comparison to FBS and hPL-supplemented media in 2D culture. To assess the potential benefits of the hPL gel system, in promoting cell proliferation capacity, hUCT-MSCs were cultured on hPL gel coated-dish supplemented with hPL CM, and inFBS CM. Among the varying concentrations, 20% hPL gel was optimized to have more functional stability and shorter gelation time. SEM analysis and gel degradation study at different concentrations revealed the structural integrity and morphology of the gel. Microscopic images and histological staining by H&E were conducted to understand the multi-layered proliferation of hUCT-MSCs in hPL Gel. Flow cytometry analysis reported the expression of positive markers for human umbilical cord MSCs, namely CD 90+ and CD 105+, in hPL Gel and hPL Complete Medium (CM) similar to that in FBS. The CCK8 Assay carried out for each culture system, generated OD values respective to cell viability and proliferation. OD values of 1.65nm, 1.27nm, and 0.92nm on average were observed for hPL Gel, hPL CM, and FBS control, respectively. Cells in hPL gel showed a 50% higher proliferation rate of viable cells compared to other culture media. AO/EtBr staining with FBS CM, hPL CM, and hPL gel revealed an increase in viable cells and a decrease in early apoptotic and necrotic cells in hPL Gel. In conclusion, the results of this study highlight the potential of hPL-based gels as superior matrices for multi-layered and enhanced proliferation of hUCT-MSCs.

Crustacean bottom trawling in southern Portugal is an economic and culturally important fishing activity but may result in considerable bycatch of deep-sea elasmobranchs (DSE). Due to DSE life-history strategies, at-vessel mortality (AVM) rates in crustacean bottom trawl fisheries are expectedly high but require further investigations. This study assessed the at-vessel condition of 18 species of DSE, and AVM rates and stress of four deep-sea shark species (Etmopterus pusillus, E. spinax, Galeus melastomus, and Scymnodon ringens), to understand the impact of bottom trawling on these animals. Opportunistic sampling on a crustacean trawler in the southern Portuguese coast, revealed that 95% of specimens were either dead (n = 1,258) or in poor condition (n = 224) upon collection, underscoring their minimal chance of post-release survival. General linear model analyses showed that AVM was species-specific and highest in smaller sharks, as well as in those from hauls that exhibited larger temperature differences between bottom and surface waters, and those caught in hauls with heavier codend weight using a 55 mm codend mesh (targeting shrimp and prawns) instead of those caught in hauls using a 70 mm codend mesh (targeting Norway lobster). Stress, evaluated through metabolites and electrolytes levels in sharks' plasma, indicated significant differences in potassium, urea, and magnesium levels between live and deceased specimens of E. pusillus and G. melastomus, suggesting these as reliable mortality markers. Elevated lactate levels in G. melastomus further pointed to high post-release mortality risk. These findings highlight an urgent need to find solutions to mitigate the impacts of bottom trawling on those DSE, which are thoroughly discussed. A coordinated, multi-stakeholder approach involving researchers, the fishing industry, and regulatory bodies is crucial for developing and implementing effective, and more sustainable fisheries management and protection of DSE populations.

The global pandemic has brought very difficult times to the economy, with funding issues, supply chain disruptions, and changes in the way people buy.This article will examine this issue and, concerning real-life examples, explore the importance of having a good plan to anticipate and respond to economic crises.It points out some warning signs, such as poor cash flow, customer churn, and changes in people's consumer confidence.The goal is to provide companies and policymakers with plans to cope with periods of economic contraction.By combining real events, number crunching, and comparing different situations, the study examines the effects of different prevention and response measures and tries to come up with ideas that can be used to make the economy stronger and more stable.We hope that the lessons learned will prepare us and enable us to respond better to prevent adverse effects when the economy is in turmoil again.

BackgroundAnxiety and depression represent prevalent yet frequently undetected mental health concerns within the older population. The challenge of identifying these conditions presents an opportunity for artificial intelligence (AI)–driven, remotely available, tools capable of screening and monitoring mental health. A critical criterion for such tools is their cultural adaptability to ensure effectiveness across diverse populations.ObjectiveThis study aims to illustrate the preliminary transferability of two established AI models designed to detect high depression and anxiety symptom scores. The models were initially trained on data from a nonverbal working memory game (1- and 2-back tasks) in a dataset by thymia, a company that develops AI solutions for mental health and well-being assessments, encompassing over 6000 participants from the United Kingdom, United States, Mexico, Spain, and Indonesia. We seek to validate the models’ performance by applying it to a new dataset comprising older Brazilian adults, thereby exploring its transferability and generalizability across different demographics and cultures.MethodsA total of 69 Brazilian participants aged 51-92 years old were recruited with the help of Laços Saúde, a company specializing in nurse-led, holistic home care. Participants received a link to the thymia dashboard every Monday and Thursday for 6 months. The dashboard had a set of activities assigned to them that would take 10-15 minutes to complete, which included a 5-minute game with two levels of the n-back tasks. Two Random Forest models trained on thymia data to classify depression and anxiety based on thresholds defined by scores of the Patient Health Questionnaire (8 items) (PHQ-8) ≥10 and those of the Generalized Anxiety Disorder Assessment (7 items) (GAD-7) ≥10, respectively, were subsequently tested on the Laços Saúde patient cohort.ResultsThe depression classification model exhibited robust performance, achieving an area under the receiver operating characteristic curve (AUC) of 0.78, a specificity of 0.69, and a sensitivity of 0.72. The anxiety classification model showed an initial AUC of 0.63, with a specificity of 0.58 and a sensitivity of 0.64. This performance surpassed a benchmark model using only age and gender, which had AUCs of 0.47 for PHQ-8 and 0.53 for GAD-7. After recomputing the AUC scores on a cross-sectional subset of the data (the first n-back game session), we found AUCs of 0.79 for PHQ-8 and 0.76 for GAD-7.ConclusionsThis study successfully demonstrates the preliminary transferability of two AI models trained on a nonverbal working memory task, one for depression and the other for anxiety classification, to a novel sample of older Brazilian adults. Future research could seek to replicate these findings in larger samples and other cultural contexts.

Abstract Background Obesity is a rapidly growing global health concern. Limited long-term success of diet, behavioural modification and medical therapy have led to the increased performance of bariatric surgery. Laparoscopic sleeve gastrectomy, which permanently reduces the size of the stomach, has been shown to cause considerable weight loss, as well as improving or even eliminating obesity related medical comorbidities such as diabetes, obstructive sleep apnoea and hypertension. Unfortunately, this surgery can also result in significant postoperative pain which, when combined with the dangers of perioperative opioid administration for bariatric patients, can lead to a significantly reduced quality of recovery. Opioid-sparing analgesia has been widely recommended for perioperative bariatric patients but research into the optimum regional analgesia approach for this surgery is lacking, with no trials to date comparing different regional analgesic techniques. This study protocol describes a randomised clinical trial aimed at answering this question, comparing the quality of recovery after laparoscopic sleeve gastrectomy for patients who receive erector spinae plane block, versus those who receive serratus anterior plane block plus subcostal TAP block. Methods We propose a prospective, randomised, blinded (investigator) clinical trial in a tertiary hospital in Ireland. 70 patients presenting for laparoscopic sleeve gastrectomy will be randomised to two study groups – group A will receive bilateral erector spinae blockade, group B will receive left sided serratus anterior plane block plus subcostal TAP blocks. Both groups will receive the same dose of the same local anaesthetic and the different regional technique performed will be the only difference in their care. The primary outcome will be QoR-15 scores at 24 hours postoperatively, a validated international tool for assessing a patient’s overall postoperative recovery. Discussion Regional analgesia should be a mainstay of perioperative opioid-sparing analgesia where possible. This is especially important in the bariatric cohort who are particularly susceptible to the complications of perioperative opioid administration. To the best of our knowledge, this trial will be the first to compare efficacy of two different regional analgesia techniques for bariatric patients undergoing laparoscopic sleeve gastrectomy surgery. Trial Registration This trial was pre-registered on clinicaltrials.gov, reference number NCT05839704, on March 5th 2023. All items from the World Health Organisation Trial Registration Data Set have been included.