Green Infrastructures (GI) are considered key to reconcile ecological and social benefits by providing multiple functions. The concept is increasingly promoted and guidelines for its implementation have been developed in many countries and regions of the Western Hemisphere. However, for other parts of the world, especially for countries with less developed infrastructures, promotion, guidance for decision-making and manuals for GI are often lacking. But the state of infrastructure development and often unplanned character of settlements in the Global South differ and result in specific constraints as well as demands to GI that need to be addressed explicitly. This study presents a methodological approach to explicitly address the specific conditions and physical limitations to GI development in urban areas of the Global South. A four step methodology was developed to assess the implementation potential for retrofitted and multifunctional urban green infrastructure in public areas. An initial site analysis (1) and the definition of design criteria as well as general strategies (2) to achieve the different dimensions of multi-functionality are the basis to derive spatial typologies (3) for GI elements and finally the spatial suitability assessment for potential placements (4). An application of the methodology to a study area in the metropolitan region of San José, Costa Rica, shows exemplarily that the potential to improve the hydrological conditions (up to 34% of surface runoff reduction), ecological conditions (increase of green space by 2,2 %, creation of 1500 m length of roadside greenery and two new habitat types), and social conditions (2.200 m of road type upgrading) of multi-functionality of the site through Green Infrastructures. These assessment results of different multi-functionality dimension can serve as a guidance for GI promotion and implementation in urban areas of the Global South.

Objectives: Social distancing measures are currently implemented to control COVID-19 pandemic in many countries, including Saudi Arabia. The aim of this study was therefore to evaluate the awareness and adherence of the Saudi population to these measures. Methods: A web-based questionnaire was designed with 16 questions (8 questions related to demographics, 3 in relation to awareness about social distancing and 5 related to overall practice of social distancing). Results: 5105 participants completed the survey [58.4% female, 66.3% young individuals (aged 18-37 years), 55.8% bachelor degree holders, and 51.0% from the western region]. The Saudi Ministry of Health (MOH) was the main source of information about COVID-19 for most participants (78.2%). High awareness (81.3%) regarding social distancing was observed, associated mainly with female participants, those from the middle region and those with high education and income. Overall implementation of social distancing was satisfactory (score 3.13/5), with 37.8% never leaving home during the home-stay period. Better adherence to social distancing was observed for female participants, higher degree holders and those aged over 38 years. Conclusions: Organised plans by the Saudi MOH have been effective in raising awareness and improving practice of social distancing among public. However, the observed lower practice of social distancing by individuals with lower education and income indicates the need for targeted interventions to achieve better outcome.

Access to medicines is one of the essential problems in Public Health of low- and middle-income countries (LMICs). The World Health Organization (WHO) defines access to medicines as the possibility of "having continuously accessible and affordable medicines in public or private health facilities that are within a kilometer of the place of residence." Access to medicines, as defined by the WHO, is not fully guaranteed in many LMICs and even in many regions of high-resource countries. The WHO identifies several factors as determinants of limitations in the access to medicines: rational selection, affordable prices, sustainable financing, and reliable health services. The action on these factors makes it possible to improve universal access to medicines with consequent improvement in Public Health. Adequate access to antibiotics and vaccination will avoid a large part of the deaths caused by infectious diseases in the LMICs. However, the emergence of resistance and the difficulties in vaccination campaigns due to socio-political or cultural problems make it challenging to fight many easily treatable infectious diseases. The use and abuse of antibiotics are inevitably associated with the appearance of resistances that make them ineffective. Thus, whereas limited access to antibiotics raises mortality rates from infectious diseases, generalized open access to them ends up eliminating their clinical value. Moreover, the contraction of research in this field for many years has reduced the success in discovering new drugs. Additionally, local market regulations, inadequate selection, inaccessible prices, especially for those of second and third-generation, inefficient health systems, and difficulties of administration and control of prescription compliance, especially in the case of combined therapies, are additional obstacles to universal access to antibiotics. In order to simultaneously improve access to antibiotics and keep resistances under control, it is necessary to develop training and education activities at different social levels (from patients to various Health Care Providers) to complement the national or supranational strategic plans.

Global pandemic COVID-19 is in stage 4 of widespread local transmission in Bangladesh- the country which did not have a noteworthy health policy and legislative structures to combat COVID-19 like a pandemic. Early strategic planning and groundwork for evolving and established challenges are crucial to assemble resources and react in an appropriate timely manner. This article, therefore, focuses on the public perception of comparative lockdown scenario analysis and how they may affect the sustainable development and the strategic management regime of COVID-19 pandemic in Bangladesh socioeconomically. Response from 159 respondents was collected via a purposive sampling survey method through a questionnaire, and 54 statements were collected for scenario analysis. Datasets were analyzed through a set of statistical techniques including Principal Component Analysis (PCA), hierarchical Cluster Analysis (CA), Pearson’s correlation matrix (PCM), Linear regression analysis (LRA), and psychometric characteristics were included in the Classical Test Theory (CTT) analysis. There were good associations among the lockdown scenarios and response strategies to be formulated. A strong significant positive relationship was observed between people who will start moving towards regular life and the formal and informal economic activities will be started in lockdown scenario 1(r=0.671, p<0.01). The scenario one describes how the death and infection rate will increase if Govt withdraw the partial lockdown before 40 to 50 days. Scenario 2 outlines people’s movement will enable low-level community transmission of COVID-19 with the infection and death rate will increase slowly (r=0.540, p<0.01). Moreover, there will be less supply of necessities of daily use with a price hike (r= 0.680, p<0.01). Scenario 3, full lock down will reduce the community transmission and death from COVID-19 (r=0.545, p<0.01). Moreover, along with the other problems gender discrimination and gender-based violence will increase rapidly (r=0.661, p<0.01). Form regression analysis, due to full lockdown, the formal and informal business, economy and education sector will be hampered severely (R=0.695), there was a strong association between the loss of livelihood and unemployment rate will increase due to business shutdown (p<0.01) and poor communities both in urban and rural areas will be affected severely (p<0.01).All these will further aggravate the humanitarian needs of the most vulnerable groups in the country in the coming months to be followed which needs to be dealt with proper response plans. It will undoubtedly affect the targets of global sustainable development goals (SDGs) of 2030 and all other development targets.

Climate change is increasing the occurrence of disastrous events in the world, but several disparities in population vulnerability are being registered. One of the causes of these variances is different public risk perception also due to the degree of education and knowledge of the population. In this study, some of the results obtained in a risk perception survey are presented. The survey was carried out in an area of Calabria (Southern Italy) hit by geo-hydrological events that have occurred in recent years with damage to roads, tourism facilities and private houses. A statistical interpretation of the results highlights the importance of education and knowledge to risk perception on the part of the population investigated.

This paper presents a research carried out in the city of Chillan, a medium size city located on the southern limit of the Chilean Mediterranean domain, at 36º 36`s south latitude. Chillán provides a good representative example of warm summers in central and southern Chilean cities. Five public spaces were selected, representing different typologies and relating to different urban background conditions. Users in these public spaces were observed, counted and photographed five times a day (12, 14, 16, 18 and 20 hours, local time) during a heat wave event in the summer of 2016, while meteorological parameters were established at different points within the public space. The variables evaluated were impervious surfaces, Skyview factor, H/W, azimuth, shadow and radiation. Local public environmental management should pay attention to the complex relations between urban climate, public spaces and thermal comfort since they affect the quality of life of the most vulnerable sectors of the population. This is particularly important given the increasing episodes of high temperatures and intense heat waves occurred in the city of Chillán in recent summers, which are related to urban heat islands and climate change.

We developed a novel machine learning (ML) algorithm with the goal of producing transparent models (i.e. understandable-by-humans) while also flexibly accounting for nonlinearity and interactions. Our method is based on ranked sparsity, and allows for flexibility and user-control in varying the shade of the opacity of black-box machine learning methods. The main tenet of ranked sparsity is that an algorithm should be more skeptical of higher-order polynomials and interactions \textit{a~priori} compared to main effects, and hence the inclusion of these more complex terms should require a higher level of evidence. In this work, we put our new ranked sparsity algorithm (as implemented in the open-source R package, `sparseR`) to the test in a predictive model "bakeoff" (i.e. a benchmarking study of ML algorithms applied "out-of-the-box," that is, with no special tuning). Algorithms were trained on a diverse set of simulated and real-world data sets from the Penn Machine Learning Benchmarks database, addressing both regression and binary classification problems. We evaluate the extent to which our human-centered algorithm can attain predictive accuracy that rivals popular black-box approaches such as neural networks, random forests, and support vector machines, while also producing more interpretable models. Using out-of-bag error as a meta-outcome, we describe the properties of data sets in which human-centered approaches can perform as well as or better than black-box approaches. We find that interpretable approaches predicted optimally or within 5% of the optimal method in most real-world data sets. We provide a more in-depth comparison of the performances of random forests to interpretable methods for several case studies, including exemplars in which algorithms performed similarly, and several cases when interpretable methods underperformed. This work provides a strong rationale for including human-centered transparent algorithms such as ours in predictive modeling applications.

Vitamin D plays an important role in maintaining healthy mineralized skeleton. It is also consid-ered an immunomodulatory agent that regulate the innate and adaptive immune systems. Multi-ple observational studies have demonstrated the association between low level of serum 25-hydroxyvitamin D [25(OH)D] and presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies and oste-oarthritis (OA). Nevertheless, the specific benefits of vitamin D supplement for treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceivable benefits of vitamin D for improvement of disease ac-tivity of RA, SLE and OA have been demonstrated in meta-analyses. It is also possible that some individuals might benefit from vitamin D differently from others since inter-individual difference in responsiveness to vitamin D supplementation has been observed in genomic studies. Although the optimal level of serum 25(OH)D is still debatable, it is advisable it is advisable that patients with rheumatic diseases should maintain serum 25(OH)D level at least 30 ng/mL (75 nmol/L) to prevent osteomalacia, secondary osteoporosis and fracture, and possibly 40 – 60 ng/mL (100 – 150 nmol/L) to achieve maximal benefit from vitamin D for immune health and overall health.

Effects and interactions of incubation time and chick preplacement holding time on mortality at placement, utilization of yolk sac, crop filling rate, early feeding–drinking behavior and broiler live performance were investigated. Ross 308 broiler hatching eggs from a 39-week-old flock were set in two identical setters in a commercial hatchery,with setting time 12 hours earlier in one machine. At the end of incubation, chicks were removed from the hatchers at the same time. Thus, incubation times were either 504 h (normal incubation time (NIT) treatment) or 516 h (longer incubation time (LIT) treatment). After pull time, chicks from each incubation time group were subjected to either 6, 24, 48, 60 or 72 h preplacement holding times. At placement, chicks were given access to feed and water. In total, 19,200 chicks were randomly assigned to a total of 10 subtreatment groups (2 incubation times × 5 preplacement holding times). Therefore, a total of 1,920 chicks were used in each subtreatment group for the grow-out period in a commercial broiler house. An interaction was found between incubation time and preplacement holding time for residual yolk sac (RYS) weight (g, %) (p &lt; 0.001). RYS weight was greater at pull time and at 6 and 24 h of preplacement holding time in the NIT treatment compared to the LIT treatment, while differences were no longer evident at 48–72 h. The lowest percentage of chicks with full crops and eating activity was observed in the shortest preplacement holding time (6 h) group at 3 h after placement. As expected, the initial BW at placement clearly decreased with increasing duration after the pull time (p &lt; 0.05) with the highest and lowest weights were found in the 6 and 72 h holding time treatments respectively. This BW difference was still evident at 35 d after placement and chicks held for the longest period after the pull time (72 h) showed the lowest BW (p &lt; 0.001). However, there was no significant difference between the 6 and 60 h preplacement holding times. Mortality during the first 7 d after placement increased only when the preplacement holding time was extended to 72 h (p = 0.031). Similar to the 7 d results, chicks held for 72 h exhibited higher 0-35 day mortality compared to those held for 6 or 24 h (p = 0.028). Neither BW nor mortality was affected by incubation time treatment at 35 d after placement (p &gt; 0.05). It can be concluded that there were no significant differences in average BW and mortality, up to and including a 60-h holding time under thermal comfort conditions, but a 72-h preplacement holding time resulted in final BW and mortality being negatively affected. In addition, LIT tended to have a beneficial effect on BW and mortality compared to NIT when the preplacement holding time was shorter (6–24 h) but had a negative effect for extended holding times (48–72 h).

Introduction: Cervical cancer is the fourth most common cancer in women globally and the most common cancer in Tanzania, resulting in about 9772 new cases and 6695 deaths each year. Research has shown an association between low levels of risk perception and knowledge of the prevention, risks, signs, etiology, and treatment of cervical cancer and low screening uptake, as contributing to high rates of cervical cancer-related mortality. However, there is scant literature on the perspectives of a wider group of stakeholders (e.g., policymakers, healthcare providers (HCPs), and women at risk), especially those living in rural and semi-rural settings. Methods: We adapted Risso-Gill and colleagues’ framework for a Health Systems Appraisal (HSA), to identify HCPs' perspective of the extent to which health system requirements for effective cervical cancer screening, prevention, and control are in place in Tanzania. We adapted interview topic guides for cervical cancer screening using the HSA framework approach. Study participants (69 in total) were interviewed between 2014-2018 –participants included key stakeholders, HCPs, and women at risk for cervical cancer. The data was analyzed using reflexive thematic analysis methodology. Results: Seven themes emerged from our analysis of semi-structured interviews and focus groups: 1) knowledge of cervical cancer risk and the role of screening and preventive care/services (e.g., prevention, risks, signs, etiology, and treatment), 2) training and knowledge of HCPs, 3) knowledge of cervical cancer screening among women at risk, 4) beliefs about cervical cancer screening, 5) role of traditional medicine, 6) risk factors, and 7) symptoms and signs. Conclusion: It is evident that there is a low level of knowledge of cervical cancer risk and the role of screening and preventive services among stakeholders, HCPs, and women living in rural and semi-rural locations in Tanzania. There is a critical need to implement more initiatives and programs to increase the uptake of screening and related services and allow women to make more informed decisions on their health.

The primary objective of this study is to determine the existence of a significant correlation between inflammation levels, as measured by inflammatory markers IL-6, IL-1β, and TNF-α, and the severity of depressive symptoms assessed using HAM-D assessment scale. This could provide additional evidence supporting the hypothesis that inflammation plays a notable role in the pathogenesis of depression. The data analysis supports the hypothesis that the biological mechanisms of inflammation contributes to the clinical manifestations of depression. Elevated levels of inflammatory markers, especially interleukins (IL6, IL1β), tumor necrosis factor-alpha (TNFα), and C-reactive protein (CRP) have been identified in patients with major depressive disorder compared to the findings in healthy controls. Materials and Methods: Inflammatory markers (IL-6, IL-1β, and TNF-α) were measured in a sample of 31 patients hospitalized at the Socola Institute of Psychiatry in Iasi, Romania, and compared to a control group with no psychiatric or inflammatory conditions. One of the main objectives is to determine if there is a significant correlation between inflammation levels, measured by inflammatory markers (IL-6, IL-1β, and TNF-α), and the severity of depressive symptoms assessed using HAM-D scores. Conclusions: The study results suggest a significant correlation between inflammation levels measured by inflammatory markers IL-1β and IL-6 and the severity of depressive symptoms evaluated by HAM-D scores in the study group. These findings support the hypothesis that inflammation may play an important role in the development or exacerbation of depressive symptoms. The relationship between inflammation and depression is also influenced by risk and protective factors that require further research.

In May of 2022, millions of U.S. parents faced uncertainty in safely feeding their infants due to the infant formula shortage. Methods: An anonymous, electronic, cross-sectional, retrospective survey was used. Results: U.S. parents (n =187) whose infants were 10.2 weeks old during the short-age completed the survey. Eighty-one percent of parents switched formulas during the shortage, 87% switched because they could not find the formula they typically used, 34% switched 3-5 times, 29% of parents visited ≥ 4 stores/24 hours and 26% of parents traveled >20 miles/24 hours to purchase formula. Use of infant formula increased (p< 0.01); in infants requiring specialty for-mula, use of intact cow’s milk formula increased (p < 0.05) and use of premature infant formulas decreased (p < 0.05). Infants relying on specialty formulas experienced at least one undesirable outcome compared with non-specialty users. Parents used social media, relatives/friends, and healthcare providers for support during the shortage, but their helpfulness scores were suboptimal. Parents reported needs for greater infant formula availability, free prenatal lactation education and postpartum lactation support. Conclusions: Government, regulatory and healthcare policy oversight are needed to protect the infant feeding system, including more commercially available products, access to banked donor milk and lactation support.

In the early 2000s, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) emerged as a performant and relevant tool for identifying micro-organisms. Since then, it has become practically essential for identifying bacteria in microbiological diagnostic laboratories. In the last decade, it was successfully applied for arthropod identification allowing to distinguish vectors from non-vectors of infectious diseases. However, identification failures are not rare, hampering it widely use. Failure is generally attributed either to the absence of respective counter species MS spectra in the database, or to the insufficient quality of query MS spectra (i.e. lower intensity and diversity of MS peaks detected). To avoid matching errors due to non-compliant spectra, the development of a strategy for detecting and excluding outlier MS profiles became compulsory. To this end, we created MSProfileR, an R package leading to a bioinformatics tool through a simple installation, integrating the control quality system of MS spectra and an analysis pipeline including peak detection and MS spectra comparisons. MSProfileR can also add metadata concerning the sample that the spectra are derived from. MSProfileR has been developed in the R environment and offers a user-friendly web interface using the R Shiny framework. It is available on Microsoft Windows as a web browser application by simply navigation using the link of the package on the Github. MSProfileR is therefore accessible to non-computer specialists and is freely available to the scientific community. We evaluated MSProfileR using two datasets including exclusively MS spectra from arthropods. In addition to coherent sample classification, outlier MS spectra were detected in each dataset confirming the value of MSProfileR.

Introduction: The World Health Organization (WHO) recommends visual inspection with acetic acid (VIA) for cervical cancer screening (CCS) in lower-resource settings; however, quality varies widely, and it is difficult to maintain a well-trained cadre of providers. The Smartphone-Enhanced Visual Inspection with Acetic acid (SEVIA) program was designed to offer secure sharing of cervical images and real-time supportive supervision to health care workers providing screening in semirural Tanzania, in order to improve quality and accuracy of visual assessment of the cervix for treatment. The purpose of this evaluation was to document early learnings from patients, providers, and higher-level program stakeholders, on barriers and enablers to program implementation. Methods: From September 9th to December 8th, 2016, observational activities and open-ended interviews were conducted with image reviewers (n= 5), providers (n=17), community mobilizers (n=14), patients (n=21), supervisors (n=4) and implementation partners (n=5) involved with SEVIA. Sixty-six interviews were conducted at 14 facilities, in all 5 of the program regions. Results SEVIA was found to be a highly regarded tool for the enhancement of CCS services in Northern Tanzania. Acceptability, adoption, appropriateness, feasibility, and coverage of the intervention were highly recognized. It appeared to be an effective means of improving good clinical practice among providers and fit seamlessly into existing roles and processes. Barriers to implementation included network connectivity issues, and community misconceptions and adoption of CCS more generally. Conclusion: SEVIA is a practical and feasible mobile health intervention and tool that easily integrated into the National CCS program to enhance quality of care. With the introduction of HPV DNA testing as a primary screening strategy for cervical cancer prevention in settings such as Tanzania, the role of a mobile health platform for program surveillance, tracking follow-up care, and quality assurance of visual assessment of the cervix for treatment (in women who test positive for high-risk HPV) further supports the importance of programs, such as SEVIA, in low resource contexts. Further expansion of the program, especially to rural areas where screening providers can benefit from virtual support for screening services through the use of the mobile App, could strengthen the delivery of services within the national cervical cancer prevention program.

At the beginning of December 2019, a new type of coronavirus emerged, SARS-CoV-2. This virus causes COVID-19, a highly contagious disease that can initially present asymptomatically and can also lead to death. Our ecological study goal was to evaluate the incidence, mortality, and lethality rates for COVID-19 between the states of Espírito Santo and Minas Gerais, with time series analysis using secondary and public databases on COVID-19 from January 2020 to July 2022. Prais-Winsten linear regression was used for trend analyses. In 2020, the rate in Espírito Santo was 2.19 times greater than Minas Gerais. This trend continued in 2021, with Espírito Santo's rate being 1.29 times greater. In 2022, Espírito Santo's rate remained 2.65 times higher than Minas Gerais. Furthermore, Espírito Santo had the highest mortality, with the exception of 2021. In turn, Minas Gerais had the highest fatality rate throughout the analyzed pandemic period. The state of Espírito Santo had a higher incidence of COVID-19, as well as higher mortality, when compared to the state of Minas Gerais. In turn, Minas Gerais had a higher fatality rate. Furthermore, both states showed similar trends for mortality, lethality, and incidence in the years 2020 and 2021.

Introduction: On March 11, 2020, the World Health Organization (WHO) declared Coronavirus disease 2019 (COVID-19) as a pandemic. The spread of the Delta variant of coronavirus started in June 2021 and accounted for the fifth peak of COVID-19 in Iran in July 2021. According to reports from other countries, vaccination protects against severe diseases caused by COVID-19, including the Delta variant. Studies have also shown that vaccination provides strong protection against SARS-CoV-2 infection, COVID-19-related hospitalization, and mortality. This retrospective cohort study was designed based on the medical care monitoring center (MCMC) database of Sayyad Shirazi Hospital.Methods: The following patient data were extracted for this study: demographic characteristics, signs and symptoms, ICU admission, need for aggressive oxygen therapy, including intubation, mortality, and vaccination status. Results: Being vaccinated was associated with a 4.14-fold increase in survival (adjusted OR=4.14; 95% CI: 2.22 to 7.69; P<0.01), and individuals in a younger age group demonstrated a 5.58-fold higher likelihood of surviving (adjusted OR=5.58; 95% CI: 4.25 to 8.14; P<0.01). The risk of severe COVID-19 was significantly lower in vaccinated individuals, showing a 3.12-fold decrease in risk (adjusted OR=3.12; 95% CI: 2.06 to 4.72; P<0.01), and in younger age groups, the risk exhibited a 3.28-fold decrease (adjusted OR=3.28; 95% CI: 2.66 to 4.04; P<0.01).Conclusion: The present results suggest that receiving at least one dose of COVID-19 vaccine had a significant relationship with decreased COVID-19 severity and mortality in vaccinated patients compared to unvaccinated patients.

Introduction: The goals of this retrospective cohort study of 129,443 persons admitted to Calgary acute care hospitals 2013-2021 were to ascertain correlations of “potentially inappropriate medi-cations” (PIMs), “potential prescribing omissions” (PPOs) and other risk factors with readmissions and mortality. Methods: Processing and analysis codes were built in Oracle Database 19c (PL/SQL), R and Excel. Results: The percentage dying during their hospital stay rose from 3.03% during the first to 7.2% during the 6th admission. The percentage dying within 6 months of discharge rose from 9.4% after the first to 24.9 after the sixth admission. Odds ratios (adjusted for age, gender and comorbidities) for readmission were the post-admission number of medications (1.16; 1.12-1.12), STOPP PIMs (1.16; 1.15-1.16); AGS Beers PIMs (1.11; 1.11-1.11) and START omissions not corrected with a prescription (1.39 (1.35-1.42). Odds ratios for mortality were post-admission number of medications (1.04; 1.04-1.05), STOPP PIMs (0.99; 0.96-1.00); AGS Beers PIMs (1.08; 1.07-1.08) and START omissions not corrected with a prescription (1.56 (1.50-1.63). START omissions corrected with a prescription correlated with a dramatic reduction in mortality (0.51; 0.49-0.53). Odds ratios for readmissions for the second through 39th admission were consistently higher if START PPOs were not corrected for the second admission (1.41; 1.36-1.46), third (1.41;1.35-1.48); fourth 1.35;1.28-1.44); fifth 1.38; 1.28-1.49); sixth (1.47;1.34-1.62) and 7th through 39th admission (1.23; 1.14-1.34). For all admissions when a pre-scription was given to correct START PPOs ORs for mortality within six months of discharge were dramatically improved (0.51; 0.49-0.53). This was also true for the second (0.52; 0.50-0.55; fourth (0.56; 0.52-0.61; fifth (0.63; 0.57-0.68); sixth (0.68; 0.61-0.76); and 7th through 39th admissions (0.71; 0.65-0.78). Conclusions: PPOs should be corrected by prescriptions and teams of family physicians, pharmacists and nurses should focus on patients’ understanding of their illnesses, medications and ability for self-care.

The use of Artificial Neural Networks (ANN) is a great contribution to medical studies since the application of forecasting concepts allows the analysis of future diseases propagations. In this context, this paper presents a study of the new coronavirus SARS-COV-2 with a focus on verifying the virus propagation associated with mitigation procedures and massive vaccination campaigns. There were proposed two methodologies to predict 28 days ahead the number of new cases, deaths, and ICU patients of five European countries: Portugal, France, Italy, United Kingdom, and Germany, and a case study of the results of massive immunization in Israel. The data input of cases, deaths, and daily ICU patients was normalized to reduce discrepant numbers due to the countries size, and the cumulative vaccination values by the percentage of population immunized, at least with one dose of vaccine. As a comparative criterion, the calculation of the mean absolute error (MAE) of all predictions presents the best methodology and targets other possibilities of use for the proposed method. The best architecture achieved a general MAE for the 1 to 28 days ahead forecast lower than 30 cases, 0,6 deaths and 2,5 ICU patients by million people.

Introduction: The viral respiratory disorder known as severe acute respiratory syndrome (SARS) is caused by the SARS-associated coronavirus. End of May 2021, there have been over 170 million reported cases and more than 3.53 million deaths worldwide. In the field of cardiovascular performance, the shock index (SI) is a simple and widely used formula that measures the physiological response prior to systemic hypotension. It is obtained by dividing the heart rate by the systolic blood pressure. Another parameter, the modified shock index (MSI), is defined as the ratio of heart rate to mean arterial pressure (MAP). Methods: In this retrospective study, we examined the data of COVID-19 patients who were admitted to the ICU between June 1st, 2020, and January 31st, 2021. The patient details were collected from the Medical Records Department (MRD) in a tertiary care center. A case-recorded proforma was used to record the patient information, which was then analyzed using SPSS software. Results: The mean age of the patients was 67 years, consisting of 64 males (68.9%) and 29 females (31.1%). The standard deviation was calculated as 13.557. Among the patients, the minimum age recorded was 28, while the maximum age was 97. Patients with known CAD (Coronary Artery Disease) had a higher mortality rate among comorbidities. The p-value for Shock Index and Mortality Status was 0.205 (with an alpha value greater than 0.05), indicating no significant association. However, the modified shock index (MSI) showed a significant association with mortality status. The Pearson chi-square value for MSI and Mortality Status was 4.19, with a p-value of 0.041 (with an alpha value less than 0.05). These results suggest that there is a higher risk of mortality for patients with a Modified Shock Index of less than 0.7 or greater than 1.3. The MSI Odds ratio was found to be 4.500, indicating that such patients have a 4.5 times higher risk of mortality compared to others. Conclusion: In conclusion, our study found that there is no significant association between the Shock Index (SI) and mortality, as the p-value was greater than 0.05. However, the Modified Shock Index (MSI) showed a significant association with mortality status, with a p-value less than 0.05. This suggests that patients with a Modified Shock Index less than 0.7 or greater than 1.3 are at a higher risk of mortality. It is important to consider these findings when assessing the prognosis and potential interventions for COVID-19 patients.

(1) Background: Until December 2021, French Guiana (FG), located in South America, faced four consecutive COVID-19 epidemic waves. This study sought to analyze the mortality trend of severe COVID-19 patients admitted to the referral ICU of FG. (2) Methods: We conducted a prospective, observational, and non-interventional study in ICU at Cayenne Hospital. We included 383 patients older than 18 admitted with SARS-CoV-2-related pneumonia hospitalized from May 2020 to December 2021. The study covers three periods. Period 1 (Waves 1 and 2, original variant), period 2 (Wave 3, gamma variant), and period 3 (Wave 4, delta variant). (3) Results: The median age was 63 years (52-70). Frailty was diagnosed in 36 patients over 70 (32.4%). Only 4.8% of patients were vaccinated. The median ICU LOS was 10 days (6-19). Hospital mortality was 37.3%. It was 30.9% in period 1, 36.6% in period 2 (p=0.329 vs. period 1), and 47.1% in period 3 (0.015 vs. period 1). In multivariate analysis, independent factors associated with hospital mortality were age more than 40 years (]40-60 years] OR=5.2, 95%CI: 1.4-19.5; (]60-70 years] OR=8.5 95%CI: 2.2-32; (]70+ years] OR=17.9, 95%CI: 4.5-70.9), frailty (OR=5.6, 95%CI: 2.2-17.2), immunosuppression (OR=2.6, 95%CI: 1.05-6.7), and MV use (OR=11, 95%CI: 6.1-19.9). This model had an overall sensitivity of 72%, a specificity of 80.4%, a positive predictive value of 68.7%, and a negative predictive value of 82.8%. (4) Conclusions: The mortality of severe COVID-19 patients in French Amazonia was higher during the delta variant wave. This over-death is explained by the virulence of the responsible SARS-CoV-2 variant and the under-vaccination coverage of the studied population.

Laboratory analyses reveal significant differences between vaccinated and unvaccinated patients in parameters like C-reactive protein, ferritin, and white blood cell counts. Univariate and multivariate Cox proportional hazards regression analyses identify several factors influencing mortality, including comorbidities, pneumonia development, and various inflammatory markers.

The performance of 5 forecasting models was investigated for predicting nursery mortality using the master table built for 3,242 groups of pigs (~ 13 million animals) and 42 variables, which concerned the pre-weaning phase of production and conditions at placement in growing sites. After training and testing each model’s performance through cross-validation, the model with the best overall prediction results was the Support Vector Machine model in terms of Root Mean Squared Error (RMSE=0.406), Mean Absolute Error (MAE=0.284), and Coefficient of Determination (R2=0.731). Subsequently, the forecasting performance of the SVM model was tested on a new dataset containing 72 new groups, simulating ongoing and near real-time forecasting analysis. Despite a decrease in R2 values on the new dataset (R2=0.554), the model demonstrated high accuracy (77.78%) for predicting groups with high (5&gt;%) or low (5&lt;%) nursery mortality. This study demonstrated the capability of forecasting models to predict the nursery mortality of commercial groups of pigs using pre-weaning information and stocking conditions variables collected post-placement in nursery sites.

Osteoporotic spinal fractures represent an increasingly widespread health problem in our aging society. We aimed to investigate the treatment options for low-energy spinal fractures in the el-derly and their impact on mortality, focusing on surgical stabilization using minimally invasive and open techniques. We evaluated 1356 patients over 50 years of age with compression frac-tures sustained due to low energy trauma treated at a single trauma center. We compared the mortality of patients following stable and operated/non-operated unstable compression frac-tures and the eligibility to surgery using the open and minimally invasive approach. The pa-tients received surgical or conservative care according to severity and eligibility to surgery. The mortality hazard ratio of patients who underwent screw fixation was 1.02 (P > .91), of patients who refused surgery was 1.68 (P < .001) and that of patients with anesthesiological contraindica-tion was 1.57 (P = .08), compared to conservatively treated patients with stable fractures. The dif-ference in mortality between open and minimally invasive surgeries was not significant, but the number of patients eligible for surgery with the minimally invasive procedure was significantly higher (OR: 0.25; P < .001). Spinal stability after fractures may be an important predictor of sur-vival in patients with low-impact fractures.

(1) Background: Extremely low alanine aminotransferase (ALT) levels are be-ing recognized as a risk factor of increasing mortality in the elderly in relation to frailty. In the elderly, both frailty and ischemic stroke are not only common, but also associated with mortality. This study aimed to investigate whether extremely low ALT levels increase the all-cause mortality rate in the elderly after ischemic stroke. (2) Methods: A retrospective review was performed on 901 patients with ischemic stroke admitted to a university-affiliated hospital between February 2014 and April 2019. The multivariate Cox proportional hazard analysis was performed to determine whether extremely low ALT lev-els are an independent risk factor of mortality in elderly patients after ischem-ic stroke. (3) Results: This study enrolled 323 older adults (age ≥65 years) who were first diagnosed with ischemic stroke. The mean age of the participants was 76.5 ± 6.6 years, mean survival time was 37.1 ± 20.4 months, and the num-ber of deaths was 96 (29.7%). The multivariate Cox proportional hazard analy-sis revealed that the risk factors for all-cause mortality in the elderly after is-chemic stroke were age, initial National Institutes of Health Stroke Scale score, serum creatinine, and extremely low ALT level (<10 U/L) at the time of diag-nosis (adjusted hazard ratio: 3.243, 95% confidence interval: 1.945–5.408; P < 0.001) (4) Conclusions: Extremely low ALT level at the time of diagnosis (<10 U/L) is an independent risk factor that increases the mortality rate in the el-derly after ischemic stroke.

Background: Hypoalbuminemia is known to be associated with adverse outcome in critical illness. In this study, we attempted to identify if hypoalbuminemia on emergency department (ED) arrival a reliable predictor for in-hospital mortality in necrotizing fasciitis (NF). patients. Method: A retrospective cohort study of hospitalized patients with NF was conducted in a tertiary teaching hospital in Taiwan between March 2010 and March 2018. Blood samples were collected in the ED upon arrival, and serum albumin levels were determined. we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality. All collected data were statistically analyzed. Result: Of the 707 NF patients, 40 (5.66%) died in the hospital. The mean serum albumin level was 3.1 ± 0.9 g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (2.8± 0.7 g/dL vs. 3.5 ± 0.8 g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (odds ratio[OR] 0.92, 95% confidential interval (CI) 0.88–0.96, P <0.001). The area under-the-receiver-operating-characteristic curve (AUC) for in-hospital survival was 0.77 (95% CI 0.72–0.82) and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 66%, 74%, 33%, 88%, 2.25 and 0.48, respectively. High sensitivity (96%) was shown at albumin level of 4.0 g/dL and high specificity (91%) was shown at level of 2.5 g/dL. Conclusion: Initial serum albumin levels were independently associated with in-hospital mortality among adult patients with necrotizing fasciitis and demonstrated fair discriminative performance in the prediction of in-hospital mortality. NF patients with hypoalbuminemia on ED arrival should be closely monitored for signs of deterioration and consider early and aggressive intervention to prevent mortality.

Previous studies investigated the effects of seed rates and seed recycling practices on the yield and yield related variables. However, higher yield does not always guarantee cost-efficiency. This study aimed at investigating the yield effects of plot-level seed rate along with the cost-benefit analysis of seed recycling practices. This study has introduced the dose-response model to the existing analytical methods used in analyzing the effect of different agrochemicals on crop yield. A multi-stage stratified sampling technique was used to select a total of 450 sample respondents. Data was gathered using a mix of data collection tools. Descriptive statistics along with the dose-response model have been applied for data analysis. Farmers of the study were found to be dissimilar in terms of their seed rate application. The dose-response analysis indicated that the highest average wheat yield has been associated with a seed rate of 50 kg ha-1 above what is recommended. The yield effect of seed recycling has also been assessed and a one-time seed recycling has caused a yield decline of 665 kg ha-1 as compared to the non-recycled seeds. The cost reduced by using recycled seed is by far lower than the economic gains associated with using unrecycled and fresh seeds. The cost-benefit analysis made clear that farmers can reduce their seed costs through seed recycling but their yields and net income can be best improved by using unrecycled CBWS. Thus, farmers must be encouraged to make use of unrecycled seed by establishing agricultural credit schemes geared towards seed procurement and seed price subsidy as key strategies to reduce economically wasteful seed recycling practices.

(1) Background: Hepatitis B virus (HBV) viral load (VL) is useful in determining treatment eligibility, however, due to high costs associated with the test, hepatitis B e antigen (HBeAg) is recommended as a proxy for HBV VL in resource-limited settings. (2) Methods: We used 299 archived plasma samples with hepatitis B surface antigen (HBsAg), HBeAg, and HBV VL (cut-off of 20,000 IU/mL and 200,000 IU/mL) results from people living with human immunodeficiency virus (PLWH). HBeAg and HBV VL results were analyzed to evaluate the use of HBeAg to determine CHB treatment eligibility and qualification of HBV prevention of mother-to-child transmission (PMTCT) prophylaxis for the first time in Botswana. (3) Results: Approximately 70.8% and 87.5% of participants with HBeAg-positive serology had HBV viral loads ≥20,000 IU/mL and 200,000 IU/mL respectively. Using logistic regression, the odds of having a qualifying HBV VL for CHB treatment and PMTCT prophylaxis were respectively 55.5 and 110.4 times higher in participants with positive HBeAg serology indicating a statistically significant association between HBeAg status and HBV VL. (4) Conclusions: HBeAg detection may not always correlate with high HBV VL, warranting further research focusing on this association, and other biomarkers that correlate better with HBV VL.

This study examines the capacity of a Site-Specific Fodder Management Decision Support System (SSFM-DSS) model to assist in successful cultivation of sericea lespedeza [SL; Lespedeza cuneata (Dum.-Cours.) G. Don.], with a specific focus on small-scale agricultural systems in the southeastern United States (U.S.). The study emphasizes incorporating advanced geospatial technologies, such as Geographic Information Systems (GIS), remote sensing, and Global Navigation Satellite Systems (GNSS), to improve fodder production. The research showcases the versatility of SL under varying environmental conditions, underscoring its significance in promoting sustainable livestock production. The methodology integrates empirical field data, geospatial analysis, and predictive modeling to formulate an SSFM strategy customized to address the distinct difficulties climate change presents, such as sudden and severe drought conditions. The study introduces an automated geospatial model for assessing the appropriateness of SL production throughout Alabama, Georgia, and South Carolina. The model uses many environmental criteria, including soil properties, climate fluctuations, and terrain. Furthermore, the research was instrumental in development of a WebGIS Dashboard, which offers farmers a decision assistance system to enhance the sustainable production of SL. The results highlight the significant impact that a SSFM-DSS can have on promoting sustainable agricultural practices, providing a solution to address the issues of food security and environmental concerns in agriculture.

Background: The current review was conducted to determine the effectiveness of atenolol on all-cause mortality rate among Asian patients with chronic progressive diseases, mainly diabetes mellitus, primary hypertension, and coronary artery disease. Methods: We searched the COCHRANE, MEDLINE, TRIP, and EMBASE databases for published articles up to 31 March 2023. Studies that compared all-cause mortality rates among Asian patients who were on atenolol or other medications were included. Results: The review included 79603 Asian patients from three cohort studies. Out of the studied patients, 36046 were atenolol users and 43557 were non-atenolol users. The review revealed that atenolol users recorded lower all-cause mortality rates compared to non-users with a significant difference (OR= 0.57, CI= 0.44-0.75, P<0.001). The pooled estimate of the all-cause mortality rate was also lower among atenolol users (7.02%) compared to metoprolol tartrate users (13.15%) with a significant difference (OR= 0.50, CI= 0.47-0.53, p < 0.0001). Although the included studies were categorized as having a low risk of bias for most of the studied domains, significant heterogeneity was recorded across these studies (I2 =88%, P=0.001). Conclusion: This review found that atenolol when compared to a control or metoprolol tartrate, has a significant effect in reducing the all-cause mortality rate among Asian patients with chronic progressive disease.

Background: Colorectal cancer (CRC) is one of the most prevalent diseases and the second leading cause of death worldwide. However, the relationship between CRC and cerebrovascular-specific mortality (CVSM) remains elusive and less is known about the influencing factors associated with CVSM in CRC. Here, we aimed to analyze the incidence as well as the risk factors of CVSM in CRC. Methods: Patients with a primary CRC diagnosed between 1973 and 2015 were identified from Surveillance Epidemiology and End Results database with follow-up data available until 31 December 2016. Conditional standardized mortality ratios were calculated to compare the incidence of CVSM between CRC patients and the general US population. Univariate and multivariate survival analyses with a competing risk model were used to interrogate the risk factors for CVSM. Results: A total of 563298 CRC individuals were included. The CVSM in CRC patients was significantly higher than the general population in all age subgroups. Among competing causes of death in patients, the cumulative mortality caused by cerebrovascular-specific diseases steadily increased during study period. While age and surgery positively influenced CVSM on both univariate and multivariate analyses, male patients and those who had radiotherapy, chemotherapy, more recent year (2001-2015) of diagnosis as well as multiple primary or distant tumors experienced a lower risk of CVSM. Interpretation: Our data suggest a potential role for CRC in the incidence of CVSM and also identify several significant predictors of CVSM, which may be helpful for risk stratification and therapeutic optimization of cerebrovascular-specific diseases in CRC patients.

Abstract: The objective of this meta-analysis was to evaluate the factors associated with mortality of elderly Italians diagnosed with the new coronavirus who resided in institutions or who were hospitalized as a result of the disease. Methods: A systematic review following the recommenda-tions of The Joanna Briggs Institute (JBI), where the PEO strategy was utilized - Population, Exposure and Outcome. P, being the elderly over 65 years old. E, the SARS-CoV_2 pandemic. O, mortality. The NCBI / PubMed, LILACS, EMBASE and CINAHL databases were used until July 31, 2020.; Results: Five Italian studies were included in the meta-analysis, with the number of elderly people varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were: dementia, diabetes, chronic kidney disease and hypertension. Conclusions: The factors as-sociated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in in-stitutions or who were hospitalized because of the disease were evaluated. It was found that de-mentia, diabetes, chronic kidney disease and hypertension are the main the main diagnosed dis-eases for mortality in elderly people with Covid-19.

Abstract Background. There is an inherent limit in the accuracy of our measurements, set by nature itself and predicted by Heisenberg's uncertainty principle, which defines the properties of nature in the microcosmos. There is a fundamental limit to the accuracy with which complementary phys-ical quantities of a particle can be predicted from their initial conditions. As classical physics is essentially considered at borderline of quantum mechanics, so the power of uncertainty princi-ple is limited in describing everyday life perceived or managed phenomena. Method. In this study, we apply Heisenberg's uncertainty principle to children under diagnostic uncertainty re-garding appendicitis. We analyze this phenomenon in clinical practice. Results. Medical practice is full of uncertainty. False negative decisions correlate with delays in treatment and adverse outcomes in children with atypical appendicitis. On the other hand, false-positive surgery deci-sions result in negative appendectomies. With improvement of technology, the incidence of complicated appendicitis or negative appendectomies due to diagnostic uncertainty has de-creased but cannot be ignored or eliminated. Conclusion. According to the principle, there is a fundamental limit to the accuracy with which the complementary variables of negative appen-dectomy and complicated appendicitis can be observed or measured simultaneously. What does all this mean for the physician?

Brown-marbled grouper is one of the most important mariculture species in China, which is used as an important crossbreeding parent in grouper industry. Enhancing growth rates is a key target in fish breeding, and gaining insight into the underlying mechanisms responsible for growth differences among individuals can aid in the improvement of grouper growth rates. However, the mechanism behind this difference in growth in this fish is unclear. The difference of transcriptome profiles of muscle tissue between fast- and slow-growing brown-marbled grouper was analyzed by RNA-Seq. 77 significantly up-regulated genes and 92 significantly down-regulated genes were identified in the growth extreme groups. The up-regulated of ghr and tnni2 and the down-regulated of stc2 led to the growth advantages of brown-marbled grouper. The differently expressed genes (DEGs) were used for GO and KEGG enrichment analysis. The results of GO enrichments indicated that the significantly upregulated genes in the fast-growing group were involved in protein folding, actin cytoskeleton, myosin complex, etc. The results of KEGG enrichments indicated that the significantly upregulated genes in the fast-growing group were involved in glycolysis/ gluconeogenesis, adipocytokine signaling pathway, MAPK signaling pathway, carbon metabolism, PI3K-Akt signaling pathway, etc. To analysis the difference gene sets between fast- and slow-growing group, the RNA-seq data were used by gene set enrichment analysis (GSEA). The results showed that the PI3K/AKT/mTOR pathway was up-regulated in the fast-growing group. The up-regulated of this pathway could lead to higher nutrient absorption efficiency and lead to muscle growth in the fast-growing group. These results contribute to understanding of the molecular mechanisms of fast growth and regulative pathways regulating growth in brown-marbled grouper.

Blockchain is considered a technological trend with a unique and unprecedented foundation of ways of working, and has the potential to fundamentally change society in conducting activities related to the public or private sector. Although the academic literature on blockchain is generally focused on cryptocurrencies, in recent years, literature with different perspectives has begun to emerge regarding the use of blockchain in the context of the public sector. The unique characteristics of how blockchain technology works make it an innovation that is expected to change many activities, structures, and processes related to the implementation of public sector activities, especially in public services such as administrative processes, welfare provision, and regulatory practices. This article discusses through a systematic literature review about the potential use of blockchain in public services. This literature review identifies the types of public services most likely affected by the introduction of blockchain. In addition, this article highlights the benefits, potentials, and challenges and risks of blockchain for governments and citizens/society in general. Governments, in general, can optimize efficiency and tracking through the use of blockchain, but regulatory uncertainty and scalability capabilities being major challenges, which are still poorly researched in the literature, can benefit from reduced bureaucracy and improved coordination through blockchain adoption, despite the lack of blockchain knowledge and skills being significant barriers to its implementation. For citizens or the public, security and transparency are key benefits, while the main risk lies in data security concerns. The article closes by noting a number of limitations in the existing literature and providing suggestions and recommendations for future research.

Generative artificial intelligence (AI), in particular large language models such as ChatGPT have reached public consciousness with a wide-ranging discussion of their capabilities and suitability for various professions. Following the printing press and internet, generative AI language models are the third transformative technological invention with truly cross-sectoral impact on knowledge transmission. While the printing press allowed for the transmission of knowledge that is independent of the physical presence of the knowledge holder with publishers acting as gatekeepers, the internet added levels of democratization allowing anyone to publish, along with global immediacy. The development of social media resulted in an increased fragmentation and tribalization of on-line communities on their ways of knowing, resulting in alternative truths propagated in echo chambers. It is against this background that generative AI language models have entered public consciousness. Using strategic foresight methodology, this paper will examine the polemic proposition that the age of generative AI will emerge as an age of public ignorance.

The collective considerations presented here lead to a crucial question: What truly constitutes the primary public health challenge posed by SARSCoV-2 infection and its variants?The findings of Bowen et al.(1) and Noé et al.(4) have offered us new insights into the actual repercussions of SARSCoV-2 virus infections on public health. They unmistakably point to the late sequelae and complications arising as secondary effects of the viral infection, causing severe and long-term damage to global public health. Rather than the acute infection which has a very low mortality rate in the general population, as initially and commonly believed.

In the last decade and a half, the world has experienced the outbreak of a range of viruses such as COVID-19, H1N1, flu, Ebola, Zika Virus, Middle East Respiratory Syndrome (MERS), Measles, and West Nile Virus, just to name a few. During these virus outbreaks, the usage and effectiveness of social media platforms increased significantly as such platforms served as virtual communities, enabling their users to share and exchange information, news, perspectives, opinions, ideas, and comments related to the outbreaks. Analysis of this Big Data of conversations related to virus outbreaks using concepts of Natural Language Processing such as Topic Modeling has attracted the attention of researchers from different disciplines such as Healthcare, Epidemiology, Data Science, Medicine, and Computer Science. The recent outbreak of the MPox virus has resulted in a tremendous increase in the usage of Twitter. Prior works in this field have primarily focused on the sentiment analysis and content analysis of these Tweets, and the few works that have focused on topic modeling have multiple limitations. This paper aims to address this research gap and makes two scientific contributions to this field. First, it presents the results of performing Topic Modeling on 601,432 Tweets about the 2022 Mpox outbreak, which were posted on Twitter between May 7, 2022, and March 3, 2023. The results indicate that the conversations on Twitter related to Mpox during this time range may be broadly categorized into four distinct themes - Views and Perspectives about MPox, Updates on Cases and Investigations about Mpox, MPox and the LGBTQIA+ Community, and MPox and COVID-19. Second, the paper presents the findings from the analysis of these Tweets. The results show that the theme that was most popular on Twitter (in terms of the number of Tweets posted) during this time range was - Views and Perspectives about MPox. It is followed by the theme of MPox and the LGBTQIA+ Community, which is followed by the themes of MPox and COVID-19 and Updates on Cases and Investigations about Mpox, respectively. Finally, a comparison with prior works in this field is also presented to highlight the novelty and significance of this research work.

This systematic review seeks to position online radicalisation within whole system frameworks incorporating individual, family, community and wider structural influences, whilst reporting evidence of public mental health approaches for individuals engaging in radical online content. Methods: Authors searched Medline (via Ovid), PsycInfo (via Ebscohost) and Web of Science (Core Collection), with the use of Boolean operators across ‘extremism’, ‘online content’, and ‘intervention’. Results: Following assessment of full text, all retrieved papers had to be excluded. Results from six excluded articles which did not fit inclusion criteria but identified theoretical relationships between all three elements of online extremism, psychological outcomes, and intervention strategy, were discussed. Authors found no articles outlining public mental health approaches to specifically online radicalisation. Conclusions: There is an immediate need for further research in this field given the increase in different factions of radicalised beliefs resulting from online, particularly social media, usage.

Artificial intelligence (AI) has the potential to revolutionize research by automating data analysis, generating new insights, and supporting the discovery of new knowledge. The top 10 contribution areas of AI towards public health were gathered in this feasibility study. We utilized the “text-davinci-003” model of GPT-3, using OpenAI playground default parameters. The model was trained with the largest training dataset any AI had, limited to a cut-off date in 2021. This study aimed to test the ability of GPT-3 to advance public health and to explore the feasibility of using AI as scientific co-author. The AI was asked for input including scientific quotations and the human authors reviewed responses for plausibility. We found that GPT-3 was able to assemble, summarize, and generate plausible text blocks relevant for public health concerns, elucidating valuable areas of application for itself. However, most quotations were invented by GPT-3 and thus, invalid. Ac-cording to today’s rules, we conclude that AI can contribute to public health research as a team member. Nevertheless, good scientific practice needs to be also followed for AI contributions, and a broad scientific discourse on AI contributions is needed. Policies for good scientific practice should be updated timely following this discourse.

Within the field of movement sensing and sound interaction research, multi-user systems have gradually gained interest as a means to facilitate an expressive non-verbal dialogue. When tied with studies grounded in psychology and choreographic theory, we consider the qualities of interaction that foster an elevated sense of social connectedness, non-contingent to occupying one’s personal space. In reflection of the newly adopted social distancing concept, we orchestrate a technological intervention, starting with interpersonal distance and sound at the core of interaction. Materialised as a set of sensory face-masks, a novel wearable system was developed and tested in the context of a live public performance from which we obtain the user’s individual perspectives and correlate this with patterns identified in the recorded data. We identify and discuss traits of the user’s behaviour that were accredited to the system’s influence and construct 4 fundamental design considerations for physically distanced sound interaction. The study concludes with essential technical reflections, accompanied by an adaptation for a pervasive sensory intervention that’s finally deployed in an open public space.

As of 2020, public data for game ratings provided by Game Ratings And Administration Committee(GRAC) are more limited than public data for movie and video ratings provided by Korea Media Ratings Board and do not provide data which allow us to see information on ratings clearly and in detail. To get information on game ratings, we need to find information by searching for specific target on homepage which is inconvenient for us. In order to improve such inconvenience and extend scope of provision in public data, the author of this paper intends to study public data API which has been extended based on information on video ratings. To draw items to be extended, this study analyzes data for ratings on homepage of GRAC and designs collection system to build database. This study intends to implement system that provides data collected based on extended public data items in a form which users want. This study is expected to provide information on ratings to GRAC which will strengthen fairness and satisfy game users and people’s rights to know and contribute to promotion and development of game industry.

There exists a compelling need to better understand the temporal dynamics of public sentiment towards COVID-19 vaccines in the US on a national and state-wise level for facilitating appropriate public policy applications. Our analysis of social media data from early February of 2021 and late March of 2021 shows that in spite of overall strength of positive sentiment, and increasing numbers of Americans being fully vaccinated, negative sentiment about COVID-19 vaccines still persists among sections of people who are hesitant towards the vaccine. In this study, we performed sentiment analytics on vaccine tweets, studied changes in public sentiment over time, conducted vaccination sentiment validation using actual vaccination data from the US CDC and Household Pulse Survey (HPS), explored influence of maturity of Twitter user-accounts and generated geographic mapping of sentiments by location of Twitter users. Furthermore, we leverage the emotion polarity based Public Sentiment Scenarios (PSS) framework which was developed for COVID-19 sentiment analytics, to systematically analyze directions for public policy processes to potentially improve the administration of vaccines. Application of the PSS framework provides important time sensitive insights for state and federal government agencies and associated organizations to better implement public policy processes for healthcare management, communication, transparency, motivation and societal operational policies such as social distancing. These insights are expected to contribute to processes that can expedite the vaccination program and move closer to the cherished herd immunity goal.

Urban accessibility represents one of the great challenges of the contemporary city, which is required to adopt sustainable development models in line with the UN Agenda 2030 objectives, recently confirmed by the health emergency. Urban accessibility and walkability are topics closely related to those aiming at a livable, healthy and inclusive city, based on a system of high-quality public spaces and on a network of services and infrastructures. However, these principles collide with the fragmentation of many urban contexts, built following vehicular accessibility needs. Within this framework, the city of Cagliari represents an interesting case study as it is affected by the disposal of public properties which appear as “enclaves” in the historic urban fabric. This research aims to evaluate if and in which terms the abandoned assets can facilitate the development of the 15-minutes city, as a city reducing the need to move over a certain time and space and therefore granting a more equal access to urban services to a wide range of citizens. This is done by proposing indexes defined as porosity, crossing and attractiveness, which constitute a combined index to improve the pedestrian accessibility in the “central places” of the contemporary city, where the walkability can also become a possible “free choice” for a new healthy lifestyle. These indexes were calculated for the most significant large disused public buildings in the historic center to guide future scenarios towards a 15 minutes city.

We have an unprecedented ability to analyze and map the Earth’s surface, as deep learning technologies are applied to an abundance of Earth observation systems collecting images of the planet daily. In order to realize the potential of these data to improve conservation outcomes, simple, free, and effective methods are needed to enable a wide variety of stakeholders to derive actionable insights from these tools. In this paper we demonstrate simple methods and workflows using free, open computing resources to train well-studied convolutional neural networks and use these to delineate objects of interest in publicly available Earth observation images. With limited training datasets (<1000 observations), we used Google Earth Engine and Tensorflow to process Sentinel-2 and National Agricultural Imaging Program data, and use these to train U-Net and DeepLab models that delineate ground mounted solar arrays and parking lots in satellite imagery. The trained models achieved 81.5% intersection over union between predictions and ground-truth observations in validation images. These images were generated at different times and from different places from those upon which they were trained, indicating the ability of models to generalize outside of data on which they were trained. The two case studies we present illustrate how these methods can be used to inform and improve the development of renewable energy in a manner that is consistent with wildlife conservation.

Corporate sustainability reporting, also known as Triple-bottom-line reporting, involves reporting nonfinancial and financial information to a broader set of stakeholders than just shareholders and seek to fortify an organization’s ability to manage key risks. The current case is that, the quality, rigor, and utility of sustainability reporting remains contentious with concerns about the suitability of the criteria or standards used to prepare the reports. Despite the rapid increase in the number of companies around the world adopting Global Reporting Initiative standards, little is known about the extent of practice of corporate sustainability reporting in public universities in Kenya. The study selected five universities that had their 2017-18 audited financial reports available online for the readers, which served as the main source of secondary data. The guidelines on corporate sustainability reporting was derived from literature review, which provided key indicators upon which the data from each university was evaluated. It was observed that almost all the institutions recognize the critical role of both internal and external independent audit of financial statements. In conclusion, financial reporting sustainability is guided by strict compliance to the factors of sustainability.

Evolution of cooperation has traditionally been studied by assuming that individuals adopt either of two pure strategies, to cooperate or defect. Recent work have considered continuous cooperative investments, turning full cooperation and full defection into two opposing ends of a spectrum and sometimes allowing for the emergence of the traditionally-studied pure strategies through evolutionary diversification. These studies have typically assumed a well-mixed population in which individuals are encountered with equal probability, Here, we allow for the possibility of assortative interactions by assuming that, with specified probabilities, an individual interacts with one or more other individuals of the same strategy. A closely related assumption has previously been made in evolutionary game theory and has been interpreted in terms of relatedness. We systematically study the effect of relatedness and find, among other conclusions, that the scope for evolutionary branching is reduced by either higher average degree of, or higher uncertainty in, relatedness with interaction partners. We also determine how different types of non-linear dependencies of benefits and costs constrain the types of evolutionary outcomes that can occur. While our results overall corroborate the conclusions of earlier studies, that higher relatedness promotes the evolution of cooperation, our investigation gives a comprehensive picture of how relatedness affects the evolution of cooperation with continuous investments.

A new optical steganography scheme is proposed that transmits a stealth optical code-division multiple-access (OCDMA) signal through a public binary phase-shift keying (BPSK) channel. Polarization beam splitters and arrayed waveguide gratings are used to implement a spectral-polarization coding (SPC) system with an incoherent optical source. We employ a Walsh–Hadamard code as the signature code of the user who wants to transmit stealth information using the system. A free space optical link applied to this system maintains the polarization states of light during propagation. The secret data is extracted using correlation detection and balanced subtraction in the OCDMA decoder of the intended receiver, and the other signal from the public channel is reduced by the OCDMA decoder. At the demodulator of the public channel, BPSK demodulation eliminates the stealth signal so that the public channel is not affected by the stealth signal. The two signals cannot interfere with each other. The results of this study show that our proposed optical steganography system is highly secure. The stealth signal can be favorably hidden in the public channel when the average source power of the stealth signal, public noise, and public signal are −5, −3, and 0 dBm, respectively.

South Korea proposed reducing greenhouse gas emissions by 37% compared to the expected emissions by 2030 as the POST-2020 greenhouse gas reduction target. Electric vehicle distribution in the public sector is essential to achieve the carbon dioxide reduction target for transportation. In particular, when buses with internal combustion engines, which travel long distances and contribute substantially to greenhouse gas emissions, are replaced with electric buses, it is expected that greenhouse gas emissions will be significantly reduced. There are three types of electric buses with different power supply systems: a plug-in type in which power is supplied when a plug is inserted, a battery-swapping type in which a battery mounted on top of the vehicle is swapped at a swapping station, and a wireless type in which the battery is wirelessly charged through self-induction at a charging facility installed on the road. Vehicles of each charging type have different advantages and disadvantages. The performance, charging type, battery capacity, and operating environment of electric buses are mutually related parameters that must be considered when introducing such vehicles. Therefore, the optimal charging type must be selected according to the operating environment to enable the widespread use of electric buses. As such, this report proposes the optimal charging type according to the operating environment of public-sector electric vehicles.

Taking an existing public building as an example, on the basis of the measured data, the mathematical model of each equipment module of the chilled station and the TRNSYS custom module are established. The mathematical model of “chilled station cooling capacity—equipment power” is proposed and established. The full-frequency control strategy based on device contribution rate is proposed and established to set up the Matlab control module of the chilled station. The TRNSYS simulation platform is used to simulate a public building chilled station in cooling season. The result shows that the season energy efficiency rate of the public building air-conditioning system is 2.15 times the original after applying the new control strategy.

Abstract: Sustainable use of Native American heritage places is viewed in this analysis as serving to preserve their traditional purposes and sustain the cultural landscapes that give them heritage meaning. The research is about the potential impacts of heritage tourism to selected Native American places at Arches National Park, Canyonlands National Park, and Hovenweep National Monument. The impacts of tourists to a heritage place must be understood as having both potential effects on the place itself and on an integrated cultural landscape. Impacts to one place potentially change other places- functions in a Native American landscape and the integrity of the landscape itself. The analysis is based on 696 interviews with representatives from nine tribes and pueblos, who in addition to defining the cultural meaning of places, officially made 349 heritage management recommendations. The U.S. National Park Service interprets Natives American resources and then brings millions of tourists to these through museums, brochures, outdoor displays, and ranger-guided tours. Native American ethnographic study participants argued that tourist education and regulation can increase the sustainability of Native American places in a park and can help protect related places beyond the park.

This study examined the effect of the media usage environment, particularly TV and SNS devices, on advertisement acceptance, lifestyle, and psychological satisfaction. Hypothesis pathways and comparative structural mediating effects were analyzed. Media and Consumer Research public data were used for empirical analysis. A total of 6,640 people who participated in sports activities were included in the study. The results demonstrated that TV and SNS device usage environments had similar effects on advertisement acceptance. While TV did not influence the pursuit of personal life, SNS device use environments affected the pursuit of personal life. SNS device use environments had a greater effect on individual psychological satisfaction than TV. Adoption had a mediating effect on the influence of media usage environments on the pursuit of personal life. The pursuit of a personal life had a significant mediating effect on the influence of media use environments on psychological stability. This study revealed no differences in the effects of new and traditional media on advertisement acceptance, while new media had a greater influence on lifestyle and psychological satisfaction.

The risk of 'zoonotic spillovers,' or the transmission of viruses from animals to humans, has been raised by climate change and the devastation of nature, as infectious disease experts have long warned. Even as the world works to stop the spread of the currently unfolding pandemic of coronavirus disease 2019 (COVID-19) and the breakout of monkeypox virus (MPXV), a new animal virus, the Langya henipavirus (LayV), has been discovered in humans in Eastern China. The scientists say there is little danger of the virus spreading among humans, but it shares genetic material with Hendra virus and Nipah virus, two other henipaviruses that infect humans and cause life-threatening respiratory diseases. Humans infected with LayV can expect to experience high body temperature, cough, weariness, poor appetite, muscle discomfort, myalgia, nausea and vomiting. It is likely that the virus will spread from animals to humans. Currently, the health authorities of Taiwan and other health organizations are tracking the progress of the ailment to ensure it does not reach humans. Researchers have examined 25 species of small wild animals for presence of the virus, and so far, shrews are the only ones that have tested positive for the virus's RNA. Based on these results, shrews are a possible candidate for the virus's natural reservoir. Too far, no therapies or vaccines have been developed and licensed for henipaviruses like the LayV. When other therapies fail to alleviate viral infections, ribavirin may be the next best thing. The need for novel vaccinations against the LayV infection and the timely delivery of these vaccines to areas at high epidemiological risk is real. To lessen the likelihood of a health calamity being caused by this newly developing virus, it is crucial to conduct active surveillance in a transparent and globally collaborative manner. The questions that have not been answered yet require additional study.

Objective: To verify knowledge about HPV, promote educational action and encourage vaccination among students from 6th to 9th grade in the public school system of Campo Grande - MS. Methods: Conducting a structured interview. Results: It was pointed out that 70.1% had heard about HPV, however, 38.1% stated that it is a virus that causes cancer and 11.3% related it to the virus that causes warts. The free availability of the vaccine was known to 57.7% of participants and 62.3% were vaccinated with at least one dose. 79 students were vaccinated during the actions. Conclusion: There is a lack of knowledge, as the majority did not know how to relate HPV to the development of cervical cancer. The interaction between primary health care and schools resulted in the dissemination of knowledge about HPV, an increase in vaccine doses administered, favoring an increase in vaccination coverage among students.

The limited understanding of how digital platforms, especially the Metaverse, influence public perception and attitude towards sustainable fashion in large scaled markets such as China highlights a critical gap. This study aims to examine the perspectives and perception of the Chinese public regarding sustainable fashion in the Metaverse. Through content analysis, this study evaluated 3,889 Weibo posts from Shanghai Fashion Week 2024 to identify key sentiments and discussions on sustainable and digital fashion. Results indicate that 76.08% of the conversations centered on sustainable fashion, reflecting strong public commitment to environmental issues. The findings highlight characteristics of public perception towards the utilization of immersive technologies and underscore the Metaverse's potential as a platform for fostering environmental consciousness in the fashion industry. This research provides crucial insights for fashion brands looking to integrate sustainability into their digital strategies, addressing a significant gap in current literature and offering practical guidance for leveraging digital platforms to promote sustainable consumption.

The growing congestion in delivery rooms and maternity wards in Israeli hospitals is the underlying issue of the current study. The study sought to examine various alternatives for an effective public policy aimed at reducing congestion. The choice of Israel as a case study derives from its conspicuous imbalance between supply and demand in the maternity, resulting from the high demand for prenatal and birthing services on one hand and the low supply, both in absolute terms and relative to OECD countries, of medical resources such as physicians, nurses, and hospital beds. The research findings present fertility and birth data for Israel in the last decade, which are leading to increased congestion and crowding in delivery rooms and maternity wards at local hospitals. At the same time, two possible alternatives are proposed for designing and implementing public policy capable of contributing to the regulation of this congestion. One alternative is the option of home birth and the second is promoting the establishment of private birthing centers outside the hospitals. The research conclusions indicate that policy makers in Israel must anticipate the increasing congestion in hospital delivery rooms and maternity wards and expedite efforts at designing alternative solutions before the emergence of a crisis situation that will make it essential to identify immediate solutions. The study recommends exploring and advancing the adoption of the two alternatives simultaneously as part of public policy, in the assumption that the increasing demand for pregnancy and childbirth services in Israeli society will persist and therefore it is necessary to act to increase the supply of childbirth facilities.

Renewable Energy Communities (RECs), strongly sustained by the European Community as a viable way to fasten low carbon transition, slowly develop in Italy for regulatory . This study delves into the framework of RECs and explores the perspective of the specifically small and medium industries in the Lombardy region of Italy through a survey. Our findings reveal that while SMEs exhibit interest in RECs, there is a notable gap in knowledge and engagement. We argue that the active involvement of Public Administration Bodies (PABs) is crucial in disseminating information about RECs and highlighting their benefits. The survey results, elaborated through a non-parametric test (Mann-Whitney U test) indicate that PABs play a pivotal role in influencing SMEs' perceptions and willingness to participate in RECs. The data suggest that more direct and effective communication strategies by PABs could significantly enhance SMEs' understanding and involvement in RECs. This research underscores the need for targeted and strategic efforts by PABs to foster a more informed and proactive approach among SMEs towards renewable energy initiatives. Such endeavors could be instrumental in accelerating the adoption of RECs, contributing to a more sustainable and resilient energy future.

Taxes on the consumption of certain products have played a key role in public revenue analysis in European countries. This work aims to assess the differences in tax planning on new non-combustion products across some European territories. Through theoretical analysis, the paper has three distinct aspects. Firstly, we show the taxpayer profile in different countries. Secondly, the study analyzes the risks for the health system and the individual. Thirdly, the design of the land tax is based on previous experience and planning in Europe. This paper concludes with a case study for different countries: 1) Spain “vapers” and “smokers”, where the analysis is based on micro-data from the European Health Interview Survey 2020. 2) Sweden with the analysis of snus, shows it as a practice to reach economic savings while decreasing economic costs thanks to the nudging of consumers towards better products. The results show taxation and, specially, land taxation, should consider differences in planning in the case of new products, such as the non-combustion products, given the user per capita income and the potential lower health risks involved.

Background: Studies addressing diet quality and mental health have shown a strong association. There is limited evidence of specific vitamins essential for treating depression. This study aims to understand the impact of diet quality through supplementation of vitamins D, B6, and magnesium on depressive symptoms. Methods: Multiple datasets from the National Health and Nutrition Examination Survey 2017-March 2020 investigated the associations between vitamin D, B6, and magnesium on depression symptoms. A cross-sectional sample of adults over 20 was extracted (n=9,232). Chi-square tests and logistic regression analyses were used to investigate the associations. Results: Individuals with low doses of vitamin D were more likely to report symptoms of depression relative to those with low doses of vitamin B6 (χ²=3.9063, p=0.0481 vs. χ²=5.2071, p=0.0225). These results remained significant among those with high magnesium proportionate to high vitamin B6 (χ²=6.1272, p=0.0133 vs. χ²=5.2071, p=0.0225). Logistic regression results provided associations for all models except unadjusted vitamin D and adjusted vitamin D. Conclusions: Preventive measures could be addressed by identifying the risks of vitamin deficiencies. Further epidemiological research is needed for the individual effects of vitamin supplementation and depression symptoms.

Understanding how the public perceives various risks and hazards associated with our well-being and health is crucial for government and policymakers. The present research aimed to assess the public's perception of various risks and hazards associated with their well-being and health. The study combined two well-known approaches to risk assessment, namely, the analytical hierarchical process (AHP) and the psychometric paradigm. Seven risk attributes were chosen from the risk perception literature to evaluate 27 risks and hazard activities using a survey questionnaire developed based on the psychometric paradigm literature. The collected data was then analyzed using AHP to determine the priority weight for each risk attribute. The results showed that the most important risk attribute was voluntariness of risk, followed by chronic-catastrophic and newness of risk. Furthermore, the study found that natural hazards were ranked the highest, followed by refugee influx and fire hazards. In contrast, the mobile phone was perceived as the lowest type of risk. The findings can be used by policymakers to develop effective and sustainable risk communication strategies. Policymakers can use the research findings to create effective and sustainable risk communication strategies that help the government to inform and educate the public about potential risks, improve coordination among agencies and stakeholders, and enhance public trust in government decision-making.

How to optimally allocate COVID-19 vaccines and scarce public goods is a crucial and sensitive question to scholars, policy-makers, and practitioners. The ethical dimensions and principles of vaccine allocation between groups are widely agreed upon, whereas the ethical dimensions and principles of vaccine distribution between countries at the peak of the COVID-19 pandemic are highly controversial. This article aims to investigate how vaccines were globally allocated across countries and propose an optimal allocation mechanism for vaccines and scarce public goods. The results show that, to a certain extent, the global allocation of COVID-19 vaccines was fair and effective. Countries with more cases and deaths obtained more vaccines and vaccinations. Wealthier countries might receive more vaccinations but also suffer more severe consequences of COVID-19. Though COVAX could miss its initial vaccine delivery targets, the facility should be considered successful in its core goals and plays a critical role in controlling the pandemic. The study proposes a fair and effective mechanism of vaccine allocation that combines the roles of markets and interventions of international organizations and national governments with three degrees: emergency, priority, and market.

This document serves as supplemental information to Shapero et al. (2023), which is itself a comment on Nowell et al. (2022). Environmental Health Perspective’s publishing standards for article comments have strict word counts and do not allow the addition of new primary data analyses; therefore, this document provides an additional level of detail and supporting analyses that serve as an important backup to and expansion of Shapero et al. (2023) and that also respond to some comments within the author’s reply to our comments (Holmes and Nowell, 2023). Nowell et al. (2022) evaluated potential PM_2.5 community impacts from sugarcane harvesting. However, their analysis is flawed by erroneous assumptions and misapplied technical approaches, as discussed in Shapero et al. (2023) and as detailed in this supplemental information document. Additionally, the authors ended their analysis with 2018 data, but later data shows no marginal increase in PM_2.5 during sugarcane harvest following 2019 even using the authors’ approach (Holmes and Nowell, 2023). Therefore, the authors’ evaluations have no relevance to current conditions. Nonetheless, even their evaluation and conclusions regarding PM_2.5 concentrations purportedly attributable to sugarcane harvesting prior to 2019 are unsupported and technically unsound as detailed below.

This study analyzes the academic performance of students from an official school in Bogotá (Colombia) who had asymmetric access to Information and Communication Technologies during the first year of the Covid-19 pandemic. The Classical Linear Regression Model is employed using data from a survey of a representative group of students in the year 2020. Results show technological gaps between students that are associated with asymmetric academic performance against students with limited or null access to the Internet and electronic devices. Results also show that, among students with permanent access to the Internet, women have better scores compared to men’s scores, which implies that women can achieve better academic results than men in virtual education. It is also noted that the sole access to an electronic device does not guarantee good academic achievements if there is no full access to the Internet, and if ICT-use skills have not been developed.

Open campus policies that grant access to the off-campus food environment influence U.S. high school students’ exposure to unhealthy foods, yet predictors of these policies are unknown. Policy holding and built (walkability), food (access to grocery stores), social (school-to-neighborhood demographic similarity), and organizational (policy holding of neighboring schools) environment data were collected for 200 Oregon public high schools. These existing data derived from the Oregon School Board Association, WalkScore.com, 2010 Decennial Census, 2010-2014 American Community Survey, Supplemental Nutrition Assistance Program, TDLinex, Nielson directories, U.S. Department of Education, National Center for Education Statistics, and Common Core of Data. Most (67%) of Oregon public high schools had open campus policies. Logistic regression analyses modeled open campus policy holding as a function of built, food, social, and organizational environment influences. With health and policy implications, results indicate that schools’ walkability, food access, and extent of neighboring open campus policy-schools are significantly associated with open campus policy holding in Oregon.

Fighting corruption and enhancing tax compliance through digital public services represent key factors for increasing sustainable development in Romania. We argue that fighting corruption may increase the level of sustainable development, through digital pubic services. Using digital public services leads to the increase of the level of tax compliance, because entrepreneurs will feel more confident and responsible and they will decide to better comply. Tax regulations can affect the level of tax compliance through the additional costs they generate. The discussion is based on the consideration of the costs generated by compliant behavior and we explain how such costs influence the entrepreneurs’ decision in the fiscal environment. If the costs are higher, entrepreneurs will take evasive initiatives and will refuse to comply. Among the numerous tools developed to fight corruption, the use of communication technologies has recently been researched and there is still need for further research in the Romanian economic environment. The use of digital public services reduces costs for entrepreneurs and increases their confidence in state institutions due to higher levels of transparency. We argue for increasing sustainable development in Romania through digital public services, thus fighting corruption and enhancing tax compliance.

Small business sector around the world is regarded as a catalyst of employment for the largest number of people. To reduce massive unemployment and inequality in the country, the Government of South Africa introduced various initiatives to stimulate and support small businesses, the Expanded Public Works Programme (EPWP) is one of such initiatives. The enterprise development approach, is one of the delivery mechanisms of the EPWP, which seeks to transfer income to poor households in the short to medium-term. This study critically assess the impact and effectiveness of training and support interventions provided to small businesses through the EPWP. The study employs a quantitative research method and due to the size, availability and ease of access to the participants, the entire population of twenty (20) small businesses supported by the EPWP in Pretoria Region was sampled. A questionnaire-based survey was conducted. The study demonstrates that the training intervention provided through the EPWP is making positive impact and achieving its intended goals of enhancing business management skills to participants. It also reveals an interesting outcome that the majority of the participants are women. The study also identified some weaknesses in the programme which leads to the recommendation that long-term support mechanisms are essential to ensure sustainability of emerging enterprises.

Background: Internal migrants had obstacles in accessing local public health services in China. This study aimed to estimate the utilization of local public health services and its determinants among internal migrants. Methods: Data were from the 2014 and 2015 nationally representative cross-sectional survey of internal migrants in China. Multivariate logistic regressions were used to estimate the relationship between socioeconomic, migration, demographic characteristics and public health services utilization. Results: Internal migrants in more developed eastern regions used less public health services. Those with higher socioeconomic status were more likely to use public health services. The broader and shorter they migrated, the less they used public health services. Compared to migration within the city, migration across provinces is negatively associated with health records (OR=0.88, 95% CI: 0.86-0.90), health education (OR=0.97, 95% CI: 0.94-1.00), and health education on NCDs (OR=0.92, 95% CI: 0.89-0.95) or through Internet channel (OR=0.96, 95% CI: 0.94-0.99). Conclusion: Public health services coverage for internal migrants has seen great improvement due to government subsides. Internal migrants with lower socioeconomic status and across provinces need to be targeted. More attention should be given to the local government in the developed eastern regions in order to narrow the regional gaps.

Rationale: Genetically modified (GM) foods have the potential to reduce food insecurity and address economic and environmental issues. Despite these benefits, GM foods continue to face significant criticism and there is limited information on public awareness and understanding of their nutritional and environmental health benefits in Nigeria. This study aims to fill this gap by investigating public knowledge and perceptions of GM foods in Victoria Island, Lagos. Methods: A convenience sampling method was used to recruit 369 respondents from Victoria Island, Lagos. Data were gathered using a structured questionnaire. The target population comprised employed adults either residing or working on Victoria Island. Statistical analyses were conducted to examine the relationship between sociodemographic factors and awareness of GM foods. Results: The study found that a majority of respondents (62.9%, n=232) were knowledgeable about GM foods and their associated issues. However, many believed that their community was not well-informed on the topic. Awareness of GM foods was significantly associated with sociodemographic factors such as marital status and education (P<0.01). Most respondents were well-informed about the environmental and health benefits of GM foods, with 61.8% believing that GM food production could sustainably reduce reliance on chemical pesticides, fertilizers, and other energy inputs, thus mitigating their ecological impacts. Additionally, most respondents did not feel that purchasing or consuming GM foods conflicted with their beliefs or would affect their food choices. Conclusion: The study concludes that while individual awareness of GM foods is relatively high, there is a perception that community awareness is low. Sociodemographic factors play a significant role in shaping public awareness and perceptions of GM foods. Recommendations: This includes government should actively educate the public on the ecological and health benefits of GM foods and address any safety concerns; Implement strict border controls and food labeling for GM products to protect consumer rights and preferences for organic foods, provide sufficient technical and financial assistance to farmers who participate in organic seed programs to enhance national food security. Significant Statement: This study highlights the importance of public education on GM foods and underscores the need for government intervention to ensure informed consumer choices and support for sustainable agricultural practices.

Abstract: Letter migrations between words in reading aloud (e.g., reading "cane love" as "lane love" or "lane cove") are known to result from a deficit in the visual-orthographic analysis and characterize attentional dyslexia. In spontaneous speech, individuals with impairment in the phonological output buffer may show migrations of phonemes between words. The purpose of this study was to examine whether migrations between words in reading aloud can also result from a deficit in the phonological output buffer, to explore the characteristics of migrations resulting from orthographic input and from phonological output deficits, and to examine methods to distinguish these two sources. Using tasks of reading aloud of 92-182 word pairs, we identified 18 adults and adolescents with developmental dyslexia who made between-word letter migrations in reading aloud, significantly more than age-matched controls (372 adults and 26 7th-graders). To distinguish between orthographic-input and phonological-output sources for these migrations, we administered a test assessing orthographic-input without spoken-output (written-semantic-decision on 140 migratable word pairs) and a test of repetition of 36 auditorily-presented migratable word pairs, assessing spoken output without orthographic-input (and word span tests). These tests indicated that the migrations of ten of the participants with dyslexia resulted from an orthographic-input deficit, and for the other eight participants, migrations resulted from a phonological-output deficit. We identified several differences between the two types of between-word errors: first, whereas the individuals with attentional dyslexia made omissions of a letter that appeared in the same position in the two words, the phonological output buffer group did not make such omissions. In addition, the groups differed in the origin of migration: orthographic input migrations involve letters that are orthographically adjacent, whereas phonological output migrations involve phonemes that have just been spoken or that are prepared together in the phonological buffer for production. This was manifested in that migrations from the line below and from two lines above occurred only in the orthographic input deficit group, and migrations occurred from a word vertically close to the target in the orthographic input group but from a word that has just been spoken (placed diagonally to the target) in the phonological output group. This study thus indicates that between-word migrations in reading-aloud can result not only from attentional dyslexia, but also from a phonological output buffer deficit, and offers ways to distinguish between the two.

Ocean big data is the scientific practice of using big data technology in the marine field. Data from satellites, manned spacecraft, space stations, airship, unmanned aerial vehicles, shore-based radar and observation stations, exploration platforms, buoys, underwater gliders, submersibles, and submarine observation networks are seamlessly combined into the ocean’s big data. Increasing numbers of scholars have tried to fully analyze the ocean’s big data. To explore the key research technology knowledge graphs related to ocean big data, articles between 1990 and 2020 were collected from the “Web of Science”. By comparing bibliometric software and using the visualization software Cite-Space, the pivotal literature related to ocean big data, as well as countries, institutions, categories, and keywords, were visualized and recognized. Journal co-citation analysis networks can help determine the national distribution of core journals. Co-citation analysis networks for documents show authors who are influential at key technical levels. Key co-occurrence analysis network keywords can determine research hot spots and research frontiers. The three supporting elements of marine big data research are shown in the co-citation network. These elements are author, institution, and country. By examining the co-occurrence of keywords, the key technology research directions for future marine big data were determined.

Background: Tumor microenvironment (TME) plays a crucial role in virtually every aspect of tumorigenesis of glioblastoma multiforme (GBM). The dysfunctional TME promotes drug resistance, disease recurrence and distant metastasis. Recent evidence indicates that exosomes released by stromal cells within TME may promote oncogenic phenotypes via transferring signaling molecules such as cytokines, proteins and microRNAs. Results: In this study, clinical GBM samples were collected and analyzed. We found that GBM-associated macrophages (GAMs) secreted exosomes which were enriched with oncomiR-21. Co-culture of GAMs (and GAM derived exosomes) and GBM cell lines resulted in the increased GBM cells’ resistance against temozolomide (TMZ) by upregulating pro-survival gene, PDCD4 and stemness markers Sox2, STAT3, Nestin and miR-21-5p and increased M2 cytokines, IL-6 and TGF-β1 secreted by GBM cells, promoting the M2 polarization of GAMs. Subsequently, pacritinib treatment suppressed GBM tumorigenesis and stemness; more importantly, pacritinib-treated GBM cells showed markedly reduced ability to secret M2 cytokines and reduced miR-21 enriched exosomes secreted by GAMs. Pacritinib-mediated effects were accompanied by a reduction of oncomiR miR-21-5p, by which tumor suppressor PDCD4 was targeted. We subsequently established a patient-derived xenograft models where mice bore patient GBM and GAMs. The treatment of pacritinib, and the combination of pacritinib/TMZ appeared to significantly reduce tumorigenesis of GBM/GAM PDX mice, overcome TMZ-resistance, and M2 polarization of GAMs. Conclusion: In summation, we showed that potential of pacritinib alone or in combination with TMZ for suppressing GBM tumorigenesis via modulating STAT3/miR-21/PDCD4 signaling. Further investigations are warranted for adopting pacritinib for the treatment of TMZ-resistant GBM in the clinical settings.

Rabies persists as a longstanding issue in Zambia, despite being preventable. The current control measures, including dog vaccination, population control, and movement restriction, guided by ‘The Control of Dogs Act Chapter 247 of the Laws of Zambia’, have not yielded the desired impact in many areas of the country including Manyinga and Mwansabombwe districts. These two districts continue to report low dog vaccination rates, unrestricted dog movements, and escalating cases of animal and human rabies, along with dog bites. Aligned with global aspirations to achieve zero human rabies cases by 2030, this study scrutinizes the determinants and obstacles hampering the execution of rabies control initiatives in Manyinga and Mwansabombwe. Spanning approximately 11 months, this cross-sectional study gathered pre- and post-vaccination data from 301 households in Manyinga and 100 households in Mwansabombwe. Questionnaires probed knowledge, attitudes, and practices related to rabies prevention and control. A transect survey, key informant interviews, and assessment of rabies vaccination and dog bite records complemented the data collection. Findings revealed that 88% of respondents from both districts possessed knowledge about rabies, confirming affected species and transmission. Moreover, 76.8% in Manyinga and 88.6% in Mwansabombwe were acquainted with rabies prevention and control methods. Concerning dog owners, 89% were aware of rabies, 66% understood its prevention and control, and the majority identified bites as the primary mode of transmission. Vaccination coverage stood at 64% in Manyinga and 21% in Mwansabombwe. Notably, education and occupation exhibited a positive significant association with rabies knowledge. In terms of dog bite cases, Manyinga recorded 538 dog bite cases from 2017 to June 2022 while Mwansabombwe recorded 81 dog bite and 23 jackal bite cases from 2021 to June 2022. The study underscores critical knowledge gaps in rural areas and emphasizes the imperative for enhanced public education and awareness programs, improved rabies surveillance, free mass vaccination campaigns, and community engagement to augment vaccination coverage and knowledge about rabies.

Zinc (Zn) is the second most abundant metal in the human body, and is essential for the function of 10% of all proteins. As metals cannot be synthesized or degraded, they must be assimilated from diet by specialized transport proteins, which unfortunately also provide an entry route for the toxic metal pollutant cadmium (Cd). The intestinal absorption of Zn depends on the composition of food that is consumed, firstly the amount of Zn itself, and then the quantity of other food constituents such as phytate, protein and calcium (Ca). In cells, Zn is involved in regulation of intermediary metabolism, gene expression, cell growth, differentiation, apoptosis, and antioxidant defense mechanisms. Cellular influx, efflux, subcellular compartmentalization, and trafficking of Zn are coordinated by transporter proteins, the Solute-Linked Carrier 30A and 39A (SLC30A and SLC39A), known as the ZnT and the Zrt-/Irt-like protein (ZIP). Because of its chemical similarity with Zn and Ca, Cd disrupts the physiological functions of both. The concurrent induction of a Zn efflux transporter ZnT1 (SLC30A1) and metallothionein by Cd disrupts the homeostasis and reduces the bioavailability of Zn. The present review highlights the increased mortality and the severity of various diseases, including those induced by COVID-19 infections, among Cd-exposed persons and the roles of Zn and other transport proteins in the manifestation of Cd cytotoxicity. Special emphasis is given to the potential protective effects of Zn against bone, lung and heart diseases associated with Cd exposure. The difficult challenge of determining a permissible intake level of Cd is discussed in relation to the recommended dietary Zn intake levels.

Background: Identifying sex-related differences/variables associated with 30-day/1-year mortality in patients with chronic limb-threatening ischemia (CLTI). Methods: Multicenter/retrospective/observational study. Database sent to all-the-Italian vascular surgeries to collect all-the¬-patients operated for CLTI in 2019. Acute lower-limb ischemia and neuropathic-diabetic foot not included. Follow-up: 1-year. Data on demographics/comorbidities, treatments/outcome, and 30-day/1-year mortality investigated. Results: Information on 2399 cases (69.8% men) from 36/143 (25.2%) centers. Median (IQR) age: 73 (66-80) and 79 (71-85) yrs for men/women, respectively (p<.0001). Women more over-75 (63.2%vs40.1%, p=.0001). More men smokers (73.7%vs42.2%, p<.0001), on hemodialysis (10.1%vs6.7%, p=.006), affected by diabetes (61.9%vs52.8%, p<.0001), dyslipidemia (69.3%vs61.3%, p<.0001), hypertension (91.8%vs88.5%, p=.011), coronaropathy (43.9%vs29.4%, p<.0001), bronchopneumopathy (37.1%vs25.6%, p<.0001), underwent more open/hybrid surgeries (37.9%vs28.8%, p<.0001), and minor amputations (22%vs13.7%, p<.0001). More women underwent endovascular revascularizations (61.6%vs55.2%, p=.004), major amputations (9.6%vs6.9%, p=.024), and obtained limb-salvage if with limited gangrene (50.8%vs44.9%, p=.017). Age >75 (HR3.63, p=.003) associated with 30-day mortality. Age >75 (HR2.14, p<.0001), nephropathy (HR1.54, p<.0001), coronaropathy (HR1.26, p=.036), infection/necrosis of the foot (dry, HR1.42, p=.040; wet, HR2.04, p<.0001) associated with 1-year mortality. No sex-linked difference in mortality statistics. Conclusion: Women exhibit fewer comorbidities, but are struck by CLTI when over-75, a factor associated with short/mid-term mortality, explaining why mortality doesn’t statistically differ between the sexes.

The objective of this study was to investigate the relationship between high-performance work systems and a company’s social performance, taking into account the organizational climate as a situational variable. Specifically, this study aimed to analyze the impact of perceptions of a high-performance work system on the perception of a company’s social responsibility (CSR) among employees of Jordanian companies with an organizational size of 300 or more. This study used 175 valid questionnaires, and SPSS and AMOS 24 were used to test the hypotheses. The results showed that there was a positive relationship between the perception of a high-performance work system and the perception of a company’s CSR. Furthermore, this study found that a positive diversity climate could enhance the positive relationship between the two. These findings suggest that high-performance work systems can contribute to the development of sustainable human resource management systems and that a positive diversity climate is essential in shaping these systems. Based on these results, it is recommended that companies implement HPWSs and encourage workforce diversity to maximize the value of CSR activities and ensure their sustainability.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Introduction: Anterior cervical discectomy and fusion (ACDF) for cervical disc herniation (CDH) is commonly performed. Specific postoperative complications include dysphagia, dysphonia, cervicalgia, adjacent segment disorder, cage subsidence, and infections. However, interscapular pain is commonly reported by these patients after surgery, although its mechanisms have been not clarified yet. Methods: This retrospective series of 31 patients undergoing ACDF for CDH at a single Academic Hospital. Baseline and postoperative clinical, radiological, and surgical data were analyzed. The linear regression analysis was conducted to identify any factor independently influencing the occurrence rate of postoperative interscapular pain. Results: The mean age was 57.6±10.8 years, and the M:F ratio was 2.1. The preoperative mean VAS-arm was 7.15±0.81 among the 20 patients reporting brachialgia, and the mean VAS-neck was 4.36±1.43 among those 9 patients reporting cervicalgia. At 1 month interscapular pain was still reported by 8 out of the 17 patients who experienced it postoperatively, and it was recovered in all patients after 2 months. The regression analysis showed how the interscapular pain was not directly associated to age(p=0,74), gender(p=0,46), smoking status(p=0,44), diabetes(0,42), preoperative brachialgia(p=0,21) or cervicalgia(p=0,48), symptoms duration(p=0,13), baseline VAS-arm(p=0,11), VAS-neck(p=0,93), or mJOA(p=0,63) scores, or disc height modification(p=0,90). However, the postoperative increase of the mean zygapophyseal joint rims distance was identified as an independent factor in determining interscapular pain (p=0,02). Conclusions: Our study revealed that the onset of interscapular pain following ACDF may be determined by over-distraction of the zygapophyseal joints rim. Then, proper sizing of prosthetic implants could reduce this painful complication.

Endodontic treatments are performed to avoid extractions and maintain the natural dentition. Root canal treatments are undertaken to eliminate or prevent an infection within the root canal system. Chemical and mechanical root canal debridement are the main methods used in endo-dontics to remove necrotic tissue, microorganisms, and microbial byproducts from the canal. However, to date there is no objective method to clinically determine the proper root canal disin-fection level and thus proceed with the obturation. Clinicians just rely on their experience and habits or can trust in empirical methods such as the insertion of paper cones inside the channel and then check their appearance after the removal. Even in the in vitro and ex vivo scientific stud-ies there is no objective method to analyze and compare the efficacy of different endodontic chemo-mechanical techniques and materials. The most frequently used method is to visually an-alyze some areas with a scanning electron microscope (SEM), even if the resulting images are hardly quantifiable and could greatly vary according to the analyzed area. A new device to clin-ically test the cleanliness of a root canal and display the result in an objective score was recently developed. The device analyzes the luminescence generated by an enzyme cycling method that process the adenosine triphosphate (ATP), adenosine diphosphate (ADP) and adenosine mono-phosphate (AMP) present in organic residues. The aim of the present in vitro study was to test the efficacy and reliability of this novel device in a controlled in vitro environment, before using it in clinical practice.

Background Acute kidney injury (AKI) is a common comorbidity in the intensive care unit (ICU), with higher mortality rate among those who receive continuous renal replacement therapy (CRRT). This study aimed to investigate the association of white blood cell (WBC) levels with all-cause mortality in AKI patients undergoing CRRT. Method We conducted a post hoc analysis of ICU patient data from multiple centers in Korea. First, the levels of WBCs were classified into four groups based on quartiles. Second, the relationship between different WBC levels and mortality was investigated with the Kaplan-Meier (K-M) survival curves, Cox proportional hazards model, and generalized additivity model (GAM). Finally, we used multiple imputation to avoid bias caused by non-randomized missing data. The endpoints were short-term (28 days) and long-term (90 days) mortality. Result In our analysis, a total of 1,100 ICU patients were included. Among them, 670 (60.90%) and 781 (71.00%) died within 28 and 90 days, respectively. K-M survival curves showed that patients with the lowest WBC levels had the highest risk of mortality for both outcomes. Adjusted multivariate Cox regression analysis confirmed that compared with the reference level (quartile 2), low WBC levels increased the risk of both 28-day mortality (quartile 1, HR = 1.43, 95% CI: 1.13–1.83, P = 0.004) and 90-day mortality (quartile 1: HR = 1.32; 95% CI: 1.05-1.66, P = 0.016). GAM analysis showed a non-linear, U-shaped relationship between pre-CRRT WBC levels and all-cause mortality (non-linear P < 0.05). Conclusion The baseline WBC level is an independent predictor of prognosis for ICU patients receiving CRRT. Patients in the lowest WBC quartile had the highest risk of all-cause mortality. These results provide further evidence that early observation and intervention may have a prognostic value for these high-risk patients.

Acute kidney injury (AKI) is a complication that can occur after cardiac surgery and requires ongoing research in light of the exponential expansion of technological advancements and knowledge in medicine. In this study, we aim to evaluate the outcomes of treated electives of emergency aortic disease with high serum creatinine levels (SCr). Methods: The cohort includes 183 patients, all of whom have an aortic disease and whose SCr levels were checked upon admission on the first day in the intensive care unit (ICU) and upon discharge from the hospital. We examined the correlation of SCr levels with in-hospital mortality and immediate mortality at least six months after discharge as well as with cross-clamp time and bypass time.Results: A high SCr level upon admission is a significant predictive factor of n-hospital mortality (p = 0.001) but not immediate mortality (p = 0.409). A statistically significant correlation was also observed between elevated SCr level on the first day of ICU and aortic disease (p = 0.041) but not immediate mortality (p = 0.119). We observed a significant correlation between aortic disease and in-hospital mortality (p < 0.001), but no correlation was found between high SCr level on the first day of ICU and immediate mortality (p = 0.119). The cross-clamp time is statistically significant correlated with elevated SCr level (p = 0.013) and in-hospital mortality (p = 0.001) but not immediate mortality (p = 0.847). Furthermore, the bypass time is negatively correlated with a high SCr level on the first day of ICU (p = 0.090), in-hospital mortality (p = 0.410), and immediate mortality (p = 0.625). We also found that aortic disease is not correlated with elevated creatinine levels at ICU discharge (p = 0.152) or long-term mortality (p = 0.106). Conclusions: Although this study only included a small portion of the elaborate aspects of surgical and medical management developed around cardiac patients who received invasive treatment, the conclusions reached are nevertheless clearly relevant, as evidenced by the significantly correlations uncovered. In order to manage AKI after AAS and improve the outcome, the SCr level could be used as a marker for renoprotective strategy. Moving forward, these results serve as a first step in motivating us to expand the range of our research, collect newly relevant data, and use it to benefit patients.

Economic burden due to premature mortality has a negative impact not only in health system even though in the society. The aim of this study was to estimate the potential years of work tenure lost (PYWL) due to Chagas disease in Colombia from 2010-2017. National data on mortality by sex and ages between 15 and 62 dues to Chagas from 2010 to 2017. The PYWL methodology was applied to assess the impact of Chagas disease in workers who suffer from them. In total, 1,261 deaths were analyzed in the study, of which 60% corresponded to males. The loss of labor productivity caused by Chagas disease was estimated at $29 million. Overall, 48,621 PYWL were lost, and there was an average of 21 years for all subjects with Chagas. Throughout the analyzed period, PYWL increased substantially, and it is necessary to continue with early detection programs to avoid premature death in working age population.

Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era. Antimicrobial stewardship (AMS) programs are recognized as a key intervention to improve antimicrobial use and combat AMR. However, implementation of AMS programs remains limited in Africa, particularly in Rwanda. This qualitative study, conducted at King Faisal Hospital (KFH) in Rwanda, aimed at assessing current prescription practices to identify areas for improvement and promote adherence to AMS principles. The interviews were recorded, transcribed, and thematically analyzed, revealing four emerging themes. First, emerged on AMS activities that were working well which includes availability of microbiology laboratory results, and prescription guidelines as factors influencing antibiotic prescription adjustments. Second, Implementations challenges to AMS which identified the prescription of broad-spectrum antibiotics, limited local data on AMR patterns, stock-outs of essential antibiotics, Thirdly, the importance of adhering to AMR management guidelines at KFH was underscored. Lastly, participant recommendations centered on regular training for healthcare workers, widespread dissemination of AMR findings across departments, and the enforcement of antibiotic restriction policies. These actions can improve prescription behaviors, upholding the highest standards of patient care, and strengthening the nascent AMS program.

Despite widespread vaccination, early treatments, and improved understanding of the disease, the effects of SARS-CoV-2 infection remain significant worldwide. Many patients still suffer from severe COVID-19, necessitating admission to intensive care units. Remdesivir is a primary treatment option among viral RNA polymerase inhibitors for hospitalized SARS-CoV-2 patients. However, there is a lack of studies examining factors influencing its effectiveness in this context. We conducted a retrospective study throughout 2022, analyzing clinical, laboratory, and sociodemographic data from 252 hospitalized COVID-19 patients treated with remdesivir. Six machine learning algorithms were compared and validated to predict factors associated with the loss of clinical benefit from remdesivir in terms of mortality and hospital stay. Data were extracted from electronic health records. The eXtreme Gradient Boost (XGB) method achieved the highest balanced accuracy for both mortality (95.45%) and hospital stay (94.24%). Factors associated with worse outcomes of remdesivir use in terms of mortality included limitation of life support treatment, need for ventilatory support (especially invasive mechanical ventilation) on day 14 after the first dose of remdesivir, lymphopenia, low levels of albumin and hemoglobin, presence of flu and/or coinfection, and cough. Factors associated with worse outcomes of remdesivir use in terms of hospital stay included the number of doses of the COVID-19 vaccine, patchy lung density, bilateral pulmonary radiological status, number of comorbidities, oxygen therapy, troponin and lactate dehydrogenase levels, and asthenia. These findings highlight the effectiveness of XGB as a strong candidate for accurately categorizing COVID-19 patients undergoing remdesivir treatment.

Background: In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. Objective: To give an overview of the study designs, statistical methods and comparison of research in identifying the predictors of melioidosis mortality in Malaysia between January 2010 to December 2021. This review articles were divided into two sections; Section 1: Review of literature and Section 2: Findings on predictors of melioidosis mortality in Malaysia. Data sources: Pubmed/Medline. Study Eligibility Criteria: Original English-language articles were abstracted. The articles that identified the predictors of melioidosis from mortality in Malaysia only included. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports and any other ineligible articles were excluded. Results: A total of 7 studies were identified related to predictors of melioidosis mortality in Malaysia. From the selected articles, all of the data were retrospectively collected. Six out of 7 articles (85.7%) used the logistic regression in identifying the predictors of melioidosis mortality. Only 1 (14.3%) used advanced survival analysis methods of Cox regression analysis. Conclusion: Logistic regression methods remain the most common methods of analysis in publications on predictors of melioidosis mortality in Malaysia while retrospective research designs are favoured. There is a limitation of research in predictors of melioidosis mortality and the use of advanced statistical techniques reported using the melioidosis data in Malaysia. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

Introduction: The presence of multiple comorbidities increases the risk of all-cause mortality, but the effects of the comorbidity sequence before the baseline date on mortality remained unexplored. This study investigated the relationship between coronary heart disease (CHD), atrial fibrillation (AF) and heart failure (HF) sequence on all-cause mortality risk in type 2 diabetes mellitus. Methods: This study included patients with type 2 diabetes mellitus prescribed antidiabetic/cardiovascular medications in public hospitals of Hong Kong between January 1st, 2009 and December 31st, 2009 with follow-up until death or December 31st, 2019. Cox regression was used to identify comorbidity sequences predicting all-cause mortality in patients with different medication subgroups. Results: A total of 249291 patients (age: 66.0±12.4 years, 47.4% male) were included. At baseline, 7564, 10900 and 25589 patients had AF, HF and CHD, respectively. Over follow-up (3524±1218 days), 85870 patients died (mortality rate: 35.7 per 1000 person-years). Sulphonylurea users with CHD developed later, but insulin users with CHD developing earlier, in the disease course had lower mortality risks. Amongst insulin users with two of the three comorbidities, CHD with preceding AF (hazard ratio [HR]: 3.06, 95% CI: [2.60-3.61], p<0.001) or HF (HR: 3.84 [3.47- 4.24], p<0.001) had a higher mortality. In users of lipid-lowering agents with all three comorbidities, those with preceding AF had higher risk of mortality (AF-CHD-HF: HR: 3.22, [2.24-4.61], p<0.001; AF-HF-CHD: HR: 3.71, [2.66-5.16], p<0.001). Conclusion: The sequence of comorbidity development affects the risk of all-cause mortality to varying degrees in diabetic patients on different antidiabetic/cardiovascular medications.

The workforce crisis of primary care is reflected in the increasing number of general medical practices (GMP) with vacant general practitioner (GP) position, and the GPs’ ageing. Our study aimed to describe the association between this crisis and premature mortality. Age-sex-standardized mortality for 18-64 years old adults were calculated for all Hungarian GMPs annually in the period from 2006 to 2014. The relationship of premature mortality with GPs’ age and vacant GP position were evaluated by standardized linear regression controlled for list size, urbanization, geographical location, clients’ education, and type of the GMP. The clients’ education was the strongest protective factor (beta=-0175; p<0.001), followed by urban residence (beta=-0.149; p<0.001), and the bigger list size (beta1601-2000=-0.054; p<0.001; beta2001-X=-0.096; p<0.001). The geographical localization influenced significantly also the risk. Although, GMP with a GP aged older than 65 years (beta=0; p=0.995) did not affected the risk, GP vacancy was associated with higher risk (beta=0.010; p=0.033), but the corresponding number of attributable cases was 23.54 for 9 years. The vacant GP position is associated with significant but hardly detectable increased risk of premature mortality without considerable public health importance. Nevertheless, employment of GPs aged more than 65 does not impose premature mortality risk elevation.

Aneurysmal wall enhancement (AWE) of non-ruptured sacular intracranial aneurysms (IA) after endovascular treatment (ET) is a frequently observed imaging finding. So far, its value remains unclear. We aimed to investigate the effect of AWE on aneurysm reperfusion rates in a longitudinal cohort. This is a retrospective MRI study over the timespan of up to 5 years, assessing the correlation of increased AWE of non-ruptured IAs and events of aneurysm reperfusion and retreatment, PHASES Score and grade of AWE. T1 SPACE fat saturation (FS) and T1 SE FS blood suppression sequences after contrast administration were used for visual interpretation of increased AWE. The IAs’ sizes were assessed via the biggest diameter. The grade of enhancement was defined in a grading system from grade 1 to grade 3. 127 consecutive non ruptured IA-patients (58.9 ± 9.0 years, 94 female, 33 male) who underwent elective aneurysm occlusion were included. AWE was observed in 40.2% of patients (51/127) after ET, 6 patients already showed AWE before treatment. In large IAs (which were defined as a single maximum diameter of over 7.5mm,) AWE was significantly associated with aneurysm reperfusion in contrast to large aneurysm without AWE (p = 000.1). All grades of AWE were significantly associated with reperfusion. Our data suggests that in patients with initially large IAs, AWE is correlated with aneurysm reperfusion.

Several studies have already demonstrated the relationship between the loss of natural habitats and the incidence of diseases caused by vectors, such as dengue, which is an acute fever disease, considered a serious public health problem. The aim of the present study was to analyze the relationship between land use changes between 2009 and 2019 and the occurrence of dengue fever in 2015 and 2019 by municipality, using the state of Minas Gerais as a case study. For this, secondary data obtained from openly available sources were used. Natural vegetation cover data were obtained from the MAPBiomas platform and dengue occurrence data from the Ministry of Health, in addition to socioeconomic indicators from the Brazilian Institute for Geography and Statistics. Between 2015 and 2019, 1,255,731 cases of dengue were recorded throughout the state of Minas Gerais, ranging from 0 to 227 per thousand inhabitants between municipalities. The occurrence of dengue was distributed throughout all regions of Minas Gerais, affected by climatic and socioeconomic aspects. In general, municipalities with net loss of natural vegetation, predominantly located in the Cerrado biome, had the highest number of dengue cases in the studied period. Despite the significant positive relationship between these two variables, three of the eight socioeconomic parameters analyzed also affected the occurrence of dengue: population density, human development index (both positively) and Gini inequality index (negatively). These results indicate that, contrary to expectations, municipalities with better social conditions had more dengue cases. Our study indicates that natural vegetation is, directly or indirectly, involved in the ecosystem service of dengue control, despite the occurrence of this disease being affected by multiple factors that interact in a complex way. Thus, policies towards reducing deforestation must be complemented by a continuous investment in public health policies and reduction of social inequalities to efficiently control dengue fever.

Bacteriological and physico-chemical analyses of fish pond water are very important in aquaculture as they give insights into likely threats to aquaculture and associated personnel. Bacteriological and physico-chemical profiles of selected fish ponds in the Ilorin West area of Kwara State, Nigeria, were investigated to evaluate the water quality of rearing enclosures. Physico-chemical analyses revealed quality parameters were within the recommended range for aquaculture. Following bacteriological analyses of static water pond culture, the TVC and TCC showed temporal variations, with concentration increasing with sampling time. However, the FCC showed fluctuation. Totally, 8 bacteria groups were isolated from both rearing enclosures. Of these, Gram-negative bacteria showed dominance. In which 5 Gram-negative (Escherichia coli, Proteus spp, Serratia spp, Enterobacter spp, and Pseudomonas spp) and 3 Gram-positive (Staphylococcus spp, Streptococcus spp, and Bacillus spp) were encountered. Estimates of bacteria occurrence in both rearing facilities respectively gave: Staphylococcus spp (20%), Streptococcus spp (12%), Proteus spp (8%) Enterobacter spp (20%), Serratia spp (16%), Bacillus spp (9%), Escherichia coli (8%), Pseudomonas spp (7%) from earthen pond water sampled. While Staphylococcus spp (18%), Streptococcus spp (16%), Proteus spp (8%), Enterobacter spp (22)%, Serratia spp (8%), Bacillus spp (15%), Escherichia coli (8%), Pseudomonas spp (6%) from concrete water sampled. Conclusively, although there is the presence of bacteria groups of public health concern, the static water exchange provides benefits of natural processing of wastes and restoration of the pond ecosystem. Notably, the presence of Escherichia coli indicates the presence of pathogenic organisms of enteric origin. The presence of these organisms has been associated with a lack of tentative pond management and effective biosecurity procedures.

The American Academy of Arts and Sciences suggested the definition of science literacy emphasize how crucial understanding the scientific process and the ability to evaluate conflicting scientific evidence is. The purpose of this article is to present an evidence-supported curriculum covering the fundamentals of logic, reasoning, and argumentation skills to address the emphasized basic knowledge, skills, and abilities required to be scientifically literate, which will prepare the public to understand and engage with science meaningfully. An analytic-synthetic approach toward understanding the notion of public is taken using a theoretical biomimetics framework that identifies naturally occurring objects or phenomena that descriptively captures the essence of a construct to facilitate creative problem-solving. In the present case, the problem being solved is how to reconcile what is meant by public, how it ought to be interpreted, the different levels of confidence in science that exist, and various understandings of science all with one another. The results demonstrate there is an inherent denotative-connotative inconsistency in the traditional notion of public that can be explicated through the concept of a fractal allowing for comprehension of the relationship between public confidence in, and understanding of, science.

Newborn screening (NBS) is hailed as a public health success, but little is known about long-term outcomes following a positive newborn screen. There has been difficulty gathering long-term follow-up (LTFU) data consistently, reliably, and with minimal effort. Six programs developed and tested a core set of minimal LTFU data elements. After an iterative data collection process and the development of a data collection tool, the group agreed on minimal LTFU data elements. The denominator captured all infants with an NBS diagnosis, accounting for children who moved or died prior to the follow-up year. They also agreed on three LTFU outcomes: if the child was still alive, had contact with a specialist, and received appropriate care specific to their diagnosis within the year. The six programs representing NBS public health programs, clinical providers, and research programs provided data across multiple NBS disorders. In 2022, 83.8% (563/672) of the children identified by the LTFU programs were alive and living in the jurisdiction; of those, 92.0% (518/563) saw a specialist, and 87.7% (494/563) received appropriate care. The core LTFU data elements can be applied as a foundation to address the impact of early diagnosis by NBS within and across jurisdictions.

Abstract: (1) Background: We determined the prevalence of hepatitis B virus (HBV) amongst people without human immunodeficiency virus (HIV) in rural and peri-urban areas in Botswana. (2) Methods: We screened hepatitis B surface antigen (HBsAg) from archived plasma samples of people without HIV (n=2135) randomly selected from the Botswana Combination Prevention Program (BCPP) (2013–2018). We sequenced 415 bp of the surface region using BigDye sequencing chemistry. (3) Results: The median age of participants was 31 (IQR: 24–46) and 64% (1360/2135) were female. HBsAg prevalence was 4.0% (86/2135) [95% CI: 3.3 – 4.9]) and ranged between 0%–9.2%. Older participants (>35 years) had increased odds of HBsAg positivity (OR: 1.94; 95% CI: [1.32–2.86]; p = 0.001. Thirteen samples were sequenced and 7 (53.8%) were genotype A, 3 (23.1%) were genotype D and genotype E each. Clinically significant mutations were identified in the surface region, but no classic drug resistance mutations were identified. (4) Conclusions: We report an HBV prevalence of 4.0% (95% CI 3.3 – 4.9) among people without HIV in rural and pe-ri-urban communities in Botswana with varying rates in different communities. A comprehen-sive national HBV program is required in Botswana to guide HBV prevention, testing and management.

Greenflation or inflation for green energy transition in Europe, it becomes a structural problem of new scarcity and poverty, because the Green Deal and its fiscal and monetary policies. In this paper, it is paid attention to the Green financial bubble and the European greenflation paradox: in order to achieve greater future social wellbeing, due to a looming climate risk, present wellbeing and wealth is reduced, causing a real and ongoing risk of social impoverishment. According to the European Union data, it is going to show the relations between green transition (emissions, tax, debt, credit boom, etc.), GDP and inflation. As many emissions are reduced, there is a decrease of GDP (once deflated) and GDP per capita, evidencing social deflation, which in turn means more widespread poverty and a reduction of middle-class. Also, there is a risk of a green-bubble, like in the Great Recession of 2008 (but this time supported by the European Union) and possible stagflation. To analyze this problem, it is used here some econometric tools, but under the theoretical support of heterodox approaches, especially the Austrian Economics and the New-Institutional Schools.

A comprehensive Energy Audit of a Maintenance facility was performed to assess its energy performance and identify scope for improvement. The facility’s Energy Use Intensity (EUI) for 2022 was 404 kWh/m2 — more than double the Benchmark EUI for Maintenance facilities (151 kWh/m2) recommended by EnergyStar. Furthermore, the Load Factor for 2022 was 0.22, which is lower than the recommended minimum of 0.75 for an efficient building. The audit encompassed an in-depth evaluation of the building's structural and operational characteristics, comprising HVAC systems, lighting, building envelope, and energy-intensive machinery. An energy model of the building was developed to emulate the baseline building energy performance for 2022. Following the energy model's development and validation, an analysis was conducted to identify energy-intensive areas and opportunities for optimization. Energy Efficiency Measures were then formulated, focusing on improving energy efficiency while focusing on energy consumption reduction and GHG emission reduction. Results demonstrated the potential of Energy Audits and Modeling to enable significant reductions in energy consumption and promote sustainable building practices. Among the Energy Efficiency Measures considered, re-sizing and decarbonizing HVAC equipment contributed the most to energy savings, with a 100% decrease in natural gas and 37% decrease in electricity use annually.

The increasing demand for sustainable products and services has become a constant requirement by the different stakeholders in an organization. Higher Education Institutions (HEI) have a crucial role in training conscious and competent professionals to lead these changes. Chemical analyses laboratories bring together the proper mix, where the adoption of mature and efficient management systems proves to be crucial not only to better train the institutions´ human resources but also to cooperate in recruiting research projects and other services to benefit society. Maturity models assist in the needed stages for sustainable growth to take place. This paper proposes a Maturity Model based on standardized norms to guide adjustments related to quality, risks, safety, and environment of chemical analyses laboratories in public higher education institutions. This research was done in four stages: theoretical research about Maturity Models, sustainability, and integrated management systems; survey with laboratories; case study at a chemical analyses laboratory of an HEI; and structuring and validating a maturity model. As a result of this, the model includes eight dimensions (Strategy, Leadership, Management, Operations, Continuous Improvement, Sustainability, Culture, and Integration), 31 subdimensions, and 204 management practices to assess and guide chemical analyses laboratories to sustainable maturity levels.

The modern civil engineering and construction sector requires collaborative work environments, learning and trust among all parties involved, qualities that are absent in the Peruvian reality. This research, which is based on an extensive literature review, investigates this challenge. The study reflects upon (i) the current situation of public works procurement in Peru and (ii) the New Engineering Contract (NEC). Comparisons are presented between the characteristics, documentation and roles of these two systems, with the purpose of understanding and representing the advantages, disadvantages and possibilities of integrating tools of NEC4 Engineering and Construction Contract to the Peruvian State Contracting Law (Ley de Contrataciones del Estado: LCE). The research is validated through the case study of a high impact road infrastructure project in the city of Arequipa, Peru; which revealed five main negative impacts on good contractual management and, also, facilitated an initial assessment of challenges and improvement opportunities in public infrastructure procurement. Thus, contribution is made to closing the knowledge gap regarding the implementation of NEC4 ECC in public sector works.

Information cascades (tree-like structures formed by posts, comments, likes, replies, etc.) constitute the spine of the public online information environment, reflecting its various trends, evolving with it and, importantly, affecting its development. While users participate in online discussions, they display their views and thus contribute to the growth of cascades. At the same time, users’ opinions are influenced by cascades’ elements. The current paper aims to advance our knowledge regarding this social phenomenon by developing an agent-based model in which agents participate in a discussion around a post on the Internet. Agents display their opinions by writing comments on the post and liking them (i.e., leaving positive assessments). The result of these processes is dual: on the one hand, agents develop an information cascade; on the other hand, they update their views. Our purpose is to understand how agents’ activity, openness to influence, and cognitive constraints (that condition the amount of information individuals are able to proceed with) affect opinion dynamics. We also control for social contagions (when people’ perception of a message may depend not only on the message’s opinion, but also on how other individuals perceive this object, with more positive evaluations increasing the probability of adoption) and ranking algorithms that steer the order in which agents learn new messages. Among other things, we demonstrated that replies to disagreeable opinions are extremely effective for promoting your own position. In contrast, likes have a tiny effect on this issue.

The severe disease outbreak COVID-19 pandemic impacted public health and safety and the educational systems worldwide. For fear of the further spread of diseases, most educational institutions, including Bangladesh, have postponed their face-to-face teaching. Therefore, this study explores public university student's perceptions towards online classes during the COVID-19 pandemic in Bangladesh. Data were collected among students of Islamic University, Kushtia, Bangladesh, through an online survey. The study followed both a qualitative and quantitative approach, where the survey technique was used as an instrument of data collection. Results showed that most students were facing difficulty participating in virtual classes and could not communicate with their friends correctly during online classes. They faced challenges in online schooling, and the majority of the students preferred conventional types of learning to virtual classes and did not understand the content of virtual classes easily. The study also explored that most students did not feel comfortable in online classes. Still, considering the present pandemic situation, they decided to participate in online classes to continue schooling. Besides, the study discovered that female students showed better real perceptions than male students regarding online classes, and urban students have more optimistic appreciation than rural students. Moreover, laptop or personal computer users showed more positive perceptions towards online education than mobile users. Furthermore, Broadband/ Wi-Fi users have more positive perceptions than mobile network users. These findings would be an essential guideline for governments, policymakers, technology developers, and university authorities for making better policy choices in the future.

Along with the increasing number of Covid-19 cases, the development of false news or misinformation about Covid-19 -19 is getting bigger. This article aims to analyze public opinion about the various hoaxes that were widely spread in Indonesia during the pandemic. The method used is a mixture, namely literature review, in the form of searching for related journals regarding the distribution of hoaxes during the pandemic and conducting online surveys via a google form. The research conducted indicates that during the pandemic there were rapid spreads of fake news, it is proven with more than 45% of the participants who were often heard hoax news about Covid-19 on online media. From this evidence, it also can be discovered that hoax news can affect a person's belief in the Covid-19 virus.

1) Public health remains a tiny portion of the undergraduate pharmacy curriculum and the material is integrated into other modules. The objective of this study is to describe the UK undergraduate pharmacy curriculum, including its public health content; 2) Methods: A qualitative method (content analysis of websites) was used to describe the UK undergraduate pharmacy curriculum and teaching and learning policy. This involved selecting relevant concepts and then quantifying their presence and the relationships between them. The NVivo software was used to carry out ‘group queries’ and visualisation of results; 3) Results: Public health remains an optional module in the curricula of many UK schools of pharmacy. Several public health-related topics are often integrated into other modules, but UK undergraduate pharmacy curricula are still dominated by traditional pharmacy modules; and 4) Conclusions: Most of the curricula analysed were dominated by traditional pharmacy modules designed to enhance students' knowledge and skills. The skill set of UK pharmacy students with respect to macro-level public health activities needs to be improved in order to enhance pharmacists’ contribution to public health.

Publicly-funded scientists have a responsibility to engage with the public on scientific information, but are lacking a standardized framework and assessment strategy to do it well. The PEPS (Public Engagement Practices for Scientists) Method is an outcomes-centered framework employing standardized pedagogical methods with quantifiable outcomes. This approach reveals that scientists often have unrealistic expectations for achieving affective learning outcomes (i.e. changing views from anti- to pro-vaccine) by solely cognitive learning strategies (i.e. supplying data). The PEPS Method can serve as a roadmap for standardized science communication assessments, complementing existing science communication training programs for the next generation of scientists.