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.

Cheap licit and artisanal illicit spirit drinks have been associated with numerous outbreaks of alcohol poisoning especially with methanol. This study aimed to evaluate the quality of cheap spirit drinks in Kibera slums in Nairobi County, Kenya. The samples consisted of cheap licit spirits (n=11) and the artisanal spirit drink, ‘chang’aa’, (n=28). The parameters of alcoholic strength and volatile composition were used as indicators of quality and were determined using GC-FID and GC-MS respectively. The pH of chang’aa was 3.3-4.2 and 4.4-8.8 for licit spirit drinks while ranges for alcoholic strength were 42.8-85.8 % vol. and 28.3-56.7% vol. for chang’aa and licit spirit drinks respectively. The majority of volatiles were found in artisanal spirits and they included higher alcohols, ethyl esters and carbonyl compounds. The alcoholic strength of all the artisanal spirits (100%) and 91% of the licit spirits was above the 40% vol. of standard spirits such as vodka. The high ethanol content of the alcohol products was the only element of public health significance in this study.

More than 400 million tons of livestock waste are generated annually by approximately 25,000 concentrated animal feeding operations (CAFOs) located in the United States (US). These operations give rise to externalities, including adverse local and global health impacts from CAFO waste emissions, which can potentially outweigh their economic viability. However, a shortage of evidence synthesis research on US-based CAFO emissions may hinder effective policy development. This scoping review (ScR) study, conducted following guidance from the Joanna Briggs Institute, searched databases including Scopus, Web of Science, PubMed and Embase in May 2020, yielding ten publications meeting inclusion criteria. Results suggest possible CAFO worker exposures to multidrug-resistant Staphylococcus aureus (MDRSA), campylobacteriosis and cryptosporidiosis. Communities near CAFOs experienced higher rates of adverse health impacts compared to those in non-CAFO areas, with patterns suggesting proximity may correlate with increased odds of detrimental health effects. Implicit global health threats include Methicillin-resistant Staphylococcus aureus  (MRSA), MDRSA, campylobacteriosis, tuberculosis, and cryptosporidiosis. These studies provide foundational insights into CAFO proximity, density patterns, and adverse public health effects, indicating a need for evidence-informed environmental health policies to minimize local and global risks.

Social media has become more popular in the last few years. It has been used in public health development and healthcare settings to promote healthier lifestyles. Given its important role in today's culture, it is necessary to understand its current trends and future directions in public health. This review aims to describe and summarize how public health professionals have been using social media to improve population outcomes. Additionally, it discusses potential future directions on how social media can be used to improve population health. The findings showed how social media has been used as a tool for research, designing and implementing health campaigns, messaging, and health promotion. In addition, social media integration with Artificial Intelligence (AI) and Generative Pre-Trained transformers (GPT) can have a big impact and offer an innovative approach to tackle the problems and difficulties in health informatics. These innovations might improve patient participation, individualized assistance, and care experiences. The research showed how likely social media will keep growing and evolving and, if used effectively, have the potential to help close public health gaps across different cultures and improve population health.

This study examined the effect of the media usage environment, particularly TV and mobile 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 mobile device usage environments had similar effects on advertisement acceptance. While TV did not influence the pursuit of personal life, mobile device use environments affected the pursuit of personal life. Mobile 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.

As an important carrier of urban residents' public life, urban public open space plays an indispensable role in improving the quality of life of urban residents. Accessibility is an important indicator to characterize the publicity and service level of a public open space. This study optimized the GIS-based, Gaussian two-part mobile search method to quantitatively calculate and evaluate the accessibility of public open space within a 5-minute walking distance for residents in Nanshan District, Shenzhen. On this basis, social survey methods, including the questionnaire survey method via a field survey and the interview method, were used to conduct field research on residents' accessibility satisfaction. Comparing the results of the survey on residents' accessibility satisfaction to the GIS quantitative evaluation results of accessibility, the results of the field research show that current residents of Nanshan are more satisfied with the accessibility of public open space. In view of the similarities and differences between the two sets of results, the influencing factors of public open space accessibility were analyzed, corresponding countermeasures were proposed for the construction of public open spaces in the future.

Trans fatty acids (TFA) are a concern for public health due to their negative impact on cardiovascular health. This study aimed to assess the levels of TFA and other fatty acids in popular edible oils and fried foods commonly consumed in Tanzania. A total of 57 samples from 38 brands of edible oils and 20 samples of fried street foods and fast foods were collected in Dar es Salaam, Tanzania. Capillary gas chromatography was used to determine TFA levels, while nutritional labeling and other fatty acid classes were also evaluated. Among the analyzed edible oils, 21% exceeded the recommended TFA levels, primarily found in popular brands of margarine, industrially refined sunflower oils, animal butter, and peanut butter. Only two food items surpassed the 2% TFA limit, but a majority of the foods had high levels of saturated fatty acids and a fatty acid profile similar to palm oil. Additionally, only 22% of the edible oils provided TFA content information. These findings indicate the persistence of TFA levels beyond recommended limits and inadequate TFA nutritional labeling in Tanzanian food products. Urgent interventions are necessary to reduce TFA levels and improve nutritional labeling practices to safeguard public health.

Background: Multidrug-resistant bacteria present resistance mechanisms against β-lactam antibiotics, such as Extended-Spectrum Beta-lactamases (ESBL) and Metallo-β-lactamases enzymes (MBLs) operon encoded in Gram-negative species. Likewise, Gram-positive bacteria have evolved other mechanisms through mec genes, which encode modified penicillin-binding proteins (PBP2). This study aimed to determine the presence and spread of β-lactam antibiotic resistance genes and the microbiome circulating in Quito’s Public Transport (QTP). Methods: A total of 29 station turnstiles were swabbed to extract the surface environmental DNA. PCRs were performed to detect the presence of 13 antibiotic resistance genes and to identify 16S rDNA barcoding, followed by clone analysis, Sanger sequencing and BLAST search. Results: ESBL genes blaTEM-1 and blaCTX-M-1 and MBL genes blaOXA-181 and mecA were detected along QPT stations. Two subvariants were found for blaTEM-1, blaCTX-M-1, and blaOXA-181. Almost half of the circulating bacteria found at QPT stations were common human microbiota species including those classified by the WHO as pathogens of critical and high-priority surveillance. Conclusions: β-lactam antibiotic resistance genes are widely spread throughout QPT. This is the first report of blaOXA-181 in environmental samples in Ecuador. Moreover, we detected a new putative variant of this gene. Some commensal coagulase-negative bacteria may have a role as mecA resistance reservoirs

The aim of this paper is to analyze the five grand parks in Dubai, United Arab Emirates (UAE) and provide a geoprocessing approach to different aspects such as sport, health, leisure, recreation, and public wellbeing. The study uses a hybrid of qualitative and quantitative approach as methodology. Sustainability offerings, accessibility for people of determination and special needs, typology and the geolocations of the grand parks plays crucial role in residents’ wellbeing. The paper concludes with recommendations for Dubai government to design new and innovative approaches to manage wellbeing of urban public places into the leisure environment for residents.

Serious outbreaks of foodborne disease have been caused by Listeria monocytogenes found in retail delicatessens and the severity of disease is significant, with high hospitalization and mortality rates. Little is understood about the formidable public health threat of L. monocytogenesin all four niches, humans, animals, food and environment in Egypt. This study analyzed the presence of L. monocytogenes collected from the four environmental niches and bioinformatic analysis was implemented to analyze and compare the data. PCR was used to detect virulence genes encoded by pathogenicity island (LIPI-1). prfA amino acid substation that causes constitutive expression of virulence was common in 77.7% of isolates. BLAST analysis did not match other isolates in the NCBI database suggesting this may be a characteristic of the region associated with these isolates. A second group included the NH1 isolate originating in China, and BLAST analysis showed this prfA allele was shared with isolates from other global locations such as Europe and North America. Identification of possible links and transmission pathways between the four niches, helps to decrease the risk of disease in humans, to take more specific control measures in the context of disease prevention, to limit economic losses associated with food recalls and highlightens the need to treatment options.

The integration of navigation technologies into spine surgery has improved precision and safety, yet traditional free-hand techniques are still widely used in anterior cervical discectomy and fusion (ACDF). This study uses the National Inpatient Sample (NIS) database to compare free-hand ver-sus navigation-guided ACDF, analyzing complications, costs, mortality, and hospital stay. Data from 2016 to 2019 identified 85,085 ACDF patients, including 560 navigation-guided surgeries. Propensity score matching balanced the cohorts for demographics and comorbidities. Navigation-guided surgeries showed higher total costs (p

Abstract: In recent years, low frequency (LF) electroencephalogram (EEG) signals have been decoded to obtain kinematic trajectories with the aim of achieving closed loop natural control. However, decoded trajectories suffer variability and low correlation against the measured movement. This paper suggests that if EEG features of motor intents are directly associated with fixed points along a given range of motion, then the natural kinematic parameters can be quantified. A novel classification method is proposed to evaluate this hypothesis along with equations for obtaining the movement parameters (velocity, acceleration). Furthermore, this implies that the force of an end-effector and work done in moving the end-effector may be computed, leading to natural control of EEG-based robotic arms and neuroprostheses. Finally, expectations are that combining the proposed method with existing classification methods will increase the accuracy and scalability of brain-computer interface (BCI) applications.

Abstract: We have filled a 24 mm diameter glass sphere with a transparent polymer-gel that is radio-fluorogenic, i.e. it becomes (permanently) fluorescent when irradiated, with an intensity proportional to the local dose deposited. The gel consists of >99.9% tertiary-butyl acrylate (TBA) pre-polymerized to ~15% conversion, and ~100 ppm maleimido-pyrene (MPy). Its dimensions and physical properties are close to those of the vitreous body of the human eye. We have irradiated the gel with a 3 mm diameter, 200 kVp X-ray beam with a dose rate of ~1 Gy/min. A 3D (video) view of the beam within the gel has been constructed from tomographic images obtained by scanning the sample through a thin sheet of UV light. To minimize optical artifacts, the cell was immersed in a square tank containing a refractive-index-matching medium. The 20%-80% penumbra of the beam was determined to be ~0.4 mm. The research was a preparatory investigation of the possibility of using the method to monitor the millimetre diameter proton pencil beams used in ocular radiotherapy.

Despite the successful introduction of oral cholera vaccines, Zambia continues to experience multiple, sporadic, and protracted cholera outbreaks in various parts of the country. While vaccines have been useful in staying the cholera outbreaks, the ideal window for re-vaccinating individual’s resident in cholera hotspot areas remains unclear. Using a prospective cohort study design, 225 individuals were enrolled, re-vaccinated with two doses of Shanchol™ regardless of previous vaccination and followed-up for 90 days. Bloods collected at baseline before re-vaccination, at day 14 prior to second dosing and subsequently on days 28, 60, and 90. Vibriocidal assay was performed on samples collected at all five time points. Our results showed that anti-LPS and vibriocidal antibody titers increased at day 14 after re-vaccination and decreased gradually at 28, 60 and 90 across all the groups. Seroconversion rates were generally comparable in all treatment arms. We therefore conclude that vibriocidal antibody titers generated in response to re-vaccination still wane quickly irrespective of previous vaccination status. However, despite the observed decline, the levels of vibriocidal antibodies remained elevated over baseline values across all groups, an important aspect for Zambia where there is no empirical evidence as to the ideal time for re-vaccination.

Ulleung County, one of the most medically vulnerable areas in South Korea, requires public attention because of the high incidence of liver cancer. This study was conducted as a part of the Ulleung Liver Cancer Prevention and Management Project. The purpose of this study was to estimate the community prevalence of hepatitis B and C viruses and to identify the associated risk factors. The Project’s interagency workgroup established a procedure for conducting blood sampling and health behavior surveys at the Ulleung Public Community Health Center. A total of 1,792 residents aged 40 years and older voluntarily participated in the study between 2019 and 2022. The hepatitis B surface antigen (HBs Ag) and hepatitis C virus antibody (anti-HCV) positive rates in Ulleung were 7.19% and 1.37%, respectively. Low education level and lifetime smoking were associated with HBsAg positivity, whereas cupping therapy at non-medical institutions was associated with anti-HCV positivity. The odds of HBs Ag positivity were lower among those with tattoos than among those without. There was a difference in the risk factors associated with hepatitis B and C viral infection. While a high HBs Ag positivity rate alone may not fully explain the high incidence of liver cancer in Ulleung, it may be a contributing factor.

The emergence of antimicrobial resistance (AMR) Candida auris presents a formidable global health challenge, causing severe healthcare-associated infections with high mortality rates. Its ability to colonize surfaces and resist standard disinfectants undermines traditional hygiene practices, prompting an urgent need for novel strategies. Ultraviolet C (UVC) light offers a promising approach due to its rapid and broad-spectrum germicidal efficacy. This review comprehensively examines the current knowledge of UVC LED technology in combating C. auris, highlighting its effectiveness, limitations, and potential applications in healthcare hygiene. UVC light has potent activity against C. auris, including multidrug-resistant (MDR) strains. UVC can reduce C. auris on contaminated surfaces, aiding in transmission prevention. This review explores implementation strategies, including mobile UVC systems for targeted disinfection of high-risk areas and equipment, integration into air handling units (AHUs) to continuously disinfect recirculating air, and incorporation into water treatment systems. Current limitations in our understanding of UVC safety and effectiveness necessitate further research to optimize application protocols and ensure treatment safety while maintaining efficacy against C. auris. Integrating UVC disinfection technology into infection control programs holds promise for strengthening hygiene practices that will curb the global spread of C. auris and improve patient outcomes.

Background: Malnutrition in critically ill paitents is closely linked with clinical outcomes. During acute inflammatory states, nutrition cannot reverse the loss of body cell mass completely. Studies on nutritional screening and strategy considering metabolic changes not yet been conducted. We aimed to identify nutrition strategies using the modified Nutrition Risk in the Critically ill (mNUTIRC) score. Methods: Nutrition support data, laboratory nutrition indicators, and prognosis indices were prospectively collected on the 2nd and 7th day after admission. It is to identify the effect of changes on the metabolic status and critical target of nutrition intervention. To discriminate the high-risk group of malnutrition, receiver operating characteristic curves were plotted. Risk factors associated with 28 day-mortality were evaluated using multivariable Cox proportional hazards regression. Results: A total of 490 and 266 patients were analyzed on the 2nd and 7th day, respectively. Only the mNUTRIC score showed significant differences in nutritional risk stratification. The use of vasopressors, hypo-protein supply (< 1.0 g/kg/day), high mNUTRIC score and hypoalbuminemia (<2.5 mg/dl) in the recovery phase was strongly associated with 28-day mortality. Conclusions: The implementation of the mNUTRIC score and protein supply in the post-acute phase is critical to improve 28-day mortality in critically ill patients.

The purpose of this study was to identify the factors that affect the mortality among adult HIV/TB co-infected patients and to see the nutritional difference among mortality in residence level. Retrospective cohort studies of 417 patients which fulfill our criteria were included. Multilevel logistic regression models were used. MLwiN and SPSS software are used to estimate the parameter. The variance of the random factor in the empty model was significant which indicates that there were residential differences in TB-HIV co-infected mortality and it shows multilevel analysis was an appropriate approach for further analysis. The prevalence of HIV/TB co-infected patients' death was 12.9% in study time. Functional status, age of patients, WHO clinical stages, nutritional status, CD4 counts, regimen, and BMI were found to be significant determinants of HIV/TB co-infected mortality. In our study, patients with the bedridden category of functional status, the fourth stages of WHO clinical stages (stage IV), patients with higher age, patients whose treatments were second-line regimen and low CD4 cell counts were more at risk of death. The study also revealed that; poor nutritional status increased the risk of mortality among HIV/TB co-infected patients and it varies among the residence of the patients (rural area were more at risk).

Healthy life style is associated with decreased risk of chronic kidney disease (CKD) and mortality in the general population. However, there is no definitive evidence on the benefits of physical activity and other health-related behaviors in the early-stage CKD. This study aimed to explore the association between health-related behaviors and end-stage renal disease (ESRD) and mortality in the early stages of CKD. The National Health Insurance Service (NHIS) database from January 1st, 2009 to December 31st, 2016 was used to screen 83,470 subjects with early stage CKD. Cox proportional hazard regression analysis was used to evaluate the association between health-related behaviors and ESRD and death. Kaplan-Meier curves for mortality and ESRD were plotted according to the physical activity, smoking status and alcohol consumption pattern. Risk of death decreased significantly in subjects who engaged in sufficient physical activity (adjusted Hazard Ratio (HR) 0.73; 95% CI: 0.64-0.83; p < 0.001). Risk of ESRD and death increased significantly in the current smoker with adjusted HR of 1.44 (95% CI: 1.06-1.95; p < 0.02) and 1.61 (95% CI: 1.44-1.80; p < 0.001) respectively. Therefore, systematic interventions to encourage physical activity and smoking cessation need to be actively considered in the early stages of CKD.

The main objective of this paper was description of seasonal and interannual trends in secondary production and mortality rates of the three most important Copepoda taxa in the Gulf of Gdańsk (southern Baltic Sea). Samples were collected monthly from 6 stations located in the western part of the Gulf of Gdańsk during three research periods: 1998-2000, 2006-2007 and 2010-2012. Production was computed basing on copepod biomass and mortality rates estimated according to vertical life table approach. Redundancy analysis was used to investigate relationship between secondary production and environmental conditions. Considering the entire research period there was significant interannual and seasonal variability of secondary production, mortality rate as well as abundance and biomass anomalies. Conducted analysis revealed correlation between increasing temperature and production of Acartia spp. and T.longicornis developmental stages, while older copepodites of P.acuspes showed almost negative correlation with temperature. The mortality rate estimations obtained for Acartia spp. Were highest in summer, while for T.longicornis peak was usually noted in spring-summer period. Lowest mortality rate estimations were noted in autumn and winter for almost all stages of investigated taxa.

Introduction: Senescence-resembling alterations on lymphocytes of dialysis patients have been widely described. However, pathophysiology behind these phenomena has not been clarified. In this study, we examine the impact of dialysis prescription and residual renal function on T and B lymphocytes, in dialysis patients. Methods: T and B cell subsets were determined with flow cytometry in 36 hemodialysis and 26 hemodiafiltration patients, according to the expression of CD45RA, CCR7, CD31, CD28, CD57 and PD1 for T cells, and IgD and CD27 for B cells. Immune phenotype was associated with dialysis modality, hemofiltration volume, and mortality. Results: Compared to hemodialysis, hemodiafiltration patients had significantly decreased percentage of CD4+CD28-CD57- T cells [3.8(2.4-5.3) vs 2.1(1.3-3.3)%, respectively, P=0.002] and exhausted CD4+ T cells [14.1(8.9-19.4) vs 8.5(6.8-11.7)% , respectively, P=0.005]. Additionally, hemofiltration volume was negatively correlated to CD8+ EMRA T cells (r=-0.46, P=0.03). Finally, exhausted CD4+ T cells percentage could predict all-cause mortality in dialysis patients, independently of age. Conclusion: Hemodiafiltration, especially with high hemofiltration volume, may have beneficial effects on senescence-related immune phenotype. Immune phenotype may also be a predicting factor for mortality in dialysis patients.

Background: The oldest old people (≥ 85 years) represent the fastest growing age group in Western populations. Knowledge on early outcomes of acute ischemic stroke (AIS) in very old female patients remains limited. Methods: We assessed gender differences and female-specific clinical data and in-hospital mortality in very old patients with AIS. Acute cerebral infarction was diagnosed in 506 very old female patients from a total of 4,600 acute cerebrovascular infarctions available in an ongoing 24-year hospital stroke data bank. A comparative analysis of vital status at discharge (alive versus dead) was performed in terms of cardiovascular risk factors, clinical data, and early outcomes. Results: The overall in-hospital mortality rate was 20.4%. In multivariate analysis, sudden onset, altered level of consciousness, and neurological, respiratory, cardiological or hemorrhagic complications, and lacunar infarcts appeared to be independent predictors of in-hospital mortality. Conclusions: Female patients ≥85 years with AIS are an unfavorable subgroup of stroke patients with a high risk of early mortality, which may be due to comorbidity, stroke subtype distribution, and higher frequency of medical complications. However, the presence of lacunar infarcts showed a significant protective effect.

The effects of statin use for primary prevention in reducing mortality among older adults in Asian populations are unknown. This study aimed to determine whether use of statins for primary prevention was associated with a decreased risk of all-cause mortality in a Japanese older adult population. A regional, population-based, longitudinal cohort study was conducted using the Shizuoka Kokuho Database (SKDB). Data were compared between the statin-treated group and a non-statin-treated (control) group using the inverse probability of treatment weighting (IPTW) method. In the SKDB cohort aged ≥65 years, new statin use was associated with a decreased risk of all-cause mortality (hazard ratio, 0.40; 95% confidence interval [CI], 0.33–0.48) after IPTW adjustment. The risk difference for mortality at 5 years in the statin-treated group (7.9%) compared with that in the control group (92.1%) was 0.05 (95% CI, 0.04–0.06), and the number needed to treat was 21.20 (95% CI, 18.10–24.70). In conclusion, statin use for primary prevention in older adults may reduce the risk of all-cause mortality in the population without atherosclerotic disease. Furthermore, statin use for primary prevention is feasible in patients aged 75 to &lt;85 years and in patients with comorbidities such as diabetes, or dementia.

Aims and Objectives: Our primary aim was to study association between nonsurgical techniques related complications and mortality and our secondary aim was to determine factors responsible for non surgical technique related complications. Material and Methods: All gastrointestinal and hepatobiliary procedures performed in last 3 years have been evaluated retrospectively. Nonsurgical procedure related postoperative complications were defined as perioperative complications nonrelated to surgical procedures or techniques and related to patients’ physiological health or comorbidities. To avoid selection bias in attempt to evaluate effect of non-surgical procedural related complication on mortality, we did 1:1 propensity score matching analysis with nonsurgical technique related complications as dependent factor. Propensity scores were calculated using logistic regression. Pre operative confounding factors like age, sex, American society of Anesthesia score (ASA), emergency surgery, type of surgeries like HPB surgeries, Upper gastrointestinal surgeries, small bowel surgeries, colorectal surgeries, hernia surgeries, open or laparoscopic surgeries were entered in model as covariates. We used nearest neighbor matching protocol with a calipher of 0.2. Cases were not reusable after matching. Statistical analysis was done using SPSS version 23. Results: Total 348 patients underwent various abdominal surgeries (gastrointestinal and hepatobiliary) in our department from April 2017 to March 2020. Total 24 patients developed nonsurgical technique related complications. Before Propensity score matching nonsurgical technique related complications were significantly higher in Upper Gastrointestinal surgeries (gastric and esophageal), emergency surgeries, Open surgeries, in patients who developed intraoperative hypotension, patients operated for malignancies, patients with higher ASA grades, patients in whom more blood products were used and patient who had more operative time. ASA scores independently predicted nonsurgical technique related complications. [P=0.001. Odds Ratio 3.955 (95% C.I.) 1.774-8.813)]. After Matching 24 patients patients were included in nonsurgical complication related complication group and they were compared with 23 matched controls. After matching also nonsurgical procedural related complications were significantly associated with mortality. (p< 0.0001). No intraoperative factors like intraoperative hypotension, blood product requirement, operative time predicted non-surgical technique related complication. Surgery related complications were not associated with mortality after matching. Conclusion: Nonsurgical technique related complications are associated with significant increase risk of mortality.

Background: It is unclear why certain countries have been more severely affected by COVID-19 than other countries. Methods: In this ecological study we compared COVID-19 mortality and incidence/100,000 as well as 4 putative explanatory factors by WHO world region. Linear regression was then used to assess the country-level predictors of COVID-19 mortality/100,000 and incidence/100,000 in 204 countries with available data. Results: COVID-19 incidence and mortality/capita were greater in Europe than other regions. This was despite a higher testing rate in Europe than other regions. Europe had an older population than all other regions and a higher prevalence of obesity than Africa, South East Asia and the Eastern Mediterranean. Country level multiple linear regression revealed positive associations between mortality/capita and testing rate, percent of the population 65 years or older, and Europe compared to Western Pacific and South East Asia (all P<0.005). Results for the analyses with cases/100,000 as outcome variable were similar. Conclusion: Our results suggest that older populations as well as other undefined regional and national factors, possibly related to efficacy of control efforts, are responsible for differences in national severity COVID-19 epidemics.

Objective. It is unknown whether the public accurately estimate socioeconomic health inequality and whether they wish to see it reduced or eliminated. Methods. Representative samples of the UK and US indicated the perceived and ideal lifespan of people working in “higher managerial/professional” and “routine” occupations. We present perceived and desired lifespan ratios for each sample and for key socio-demographic variables. Results. The UK public estimated the lifespan of professionals to be 5.9% longer than routine workers (true value of 5.8%), and 67.8% (UK) and 53.7% (US) participants correctly identified that professionals live longer than routine workers. In both populations, the median respondent expressed equal ideal lifespans for routine workers and professional workers. Conclusion. The UK public appear well-appraised on the average lifespan for professionals and routine workers. Across nationalities and most socio-demographic groups, the median respondent was aware of social class inequalities in lifespan and preferred that they be eliminated.

Florida geologic units and soils contain a wide range in concentrations of naturally-occurring arsenic. The average range of bulk rock concentrations is 1 to 13.1 mg/kg with concentrations in accessary minerals being over 1,000 mg/kg. Soils contain natural arsenic concentrations of between 0.18 and 2.06 mg/kg with organic-rich soils having the highest concentrations. Anthropogenic sources of arsenic have added about 610,000 metric tons of arsenic into the Florida environment since 1970, thereby increasing background concentrations in soils. The anthropogenic sources of arsenic in soils include: pesticides (used in Florida beginning in the 1890’s), fertilizers, chromated copper arsenate (CCA)-treated wood, soil amendments, cattle-dipping vats, chicken litter, sludges from water treatment plants, and others. The default Soil Cleanup Target Level (SCTL) in Florida for arsenic in residential soils is 2.1 mg/kg which is below some naturally-occurring background concentrations in soils and anthropogenic concentrations in agricultural soils. A review of risk considerations shows that adverse health impacts associated with exposure to arsenic is dependent on many factors and that the Florida cleanup levels are very conservative. Exposure to arsenic in soils at concentrations that exceed the Florida residential cleanup level in residential environments does not necessarily pose a meaningful public health risk.

Objective: Mechanical bowel preparation is essential for the visualisation of the colon during colonoscopy, and previous studies have identified changes in gut microbiota composition after bowel preparation and colonoscopy. Considering the gut microbiota is increasingly implicated in mood, we aimed to explore the potential impact of this intervention on mood and the microbiota-gut-brain axis. Methods: We conducted a pre-post intervention study, with timepoints of one week before and one month after bowel preparation and colonoscopy, in community-dwelling adults referred for colonoscopy. Our primary outcome was change in average Hospital Anxiety and Depression Scale depression sub-scores using generalised estimating equations. We also examined changes in average anxiety, stress, and quality of life scores, and faecal microbiota composition and potential function using 16S rRNA sequencing. We further explored associations between changes in depressive symptoms and the gut microbiota and conducted post-hoc analyses to explore potential effect modifiers. Key Results: 59 participants were included in the analyses. Depressive symptoms decreased one-month post-procedure compared to baseline (adjusted β=−0.64; 95%CI: −1.18, −0.11). Irritable bowel syndrome (IBS) appeared to moderate this relationship (1.78; 0.292, 3.26); depressive symptoms increased in those with, and decreased in those without, IBS. Changes in gut microbiome composition included reduced alpha diversity, modest effects on beta-diversity, and increases in genera associated with potential health benefits, one-month post-procedure compared to baseline. Increases in the CLR-transformed abundance of Ruminococcaceae UCG-009 were associated with improvements in depressive symptoms. Conclusions: There is preliminary evidence of a potential mental health effect of bowel preparation and colonoscopy, which may be associated with changes to the gut microbiota. There may also be a differential mental health impact of this procedure for those with and without IBS. Considering the limitations of our study, further research is required to confirm these findings and their clinical relevance.

Enteric infections are a major public health concern. Detecting risk areas requires a strong surveillance system for pathogenic viruses in possible sources such as wastewater. To build an environmental surveillance system, we aimed to identify group A rotavirus (RVA) and human adenovirus (HAdV) in wastewater. We also focused on three different methods of viral concentration to determine suitability for a regular surveillance system. We screened 20 wastewater samples for HAdV and RVA using quantitative polymerase chain reaction (qPCR) and conventional polymerase chain reaction (cPCR). Sixteen posi-tives (18/20) and ten (14/20) positives for HAdV and RVA, respectively, were obtained on qPCR, representing a prevalence of 90% and 70%. Twelve (12) positives were successfully amplified. Bag-mediated filtration system (BMFS) and skimmed milk (SM) flocculation were the most consistent viral concentration methods for HAdV and RVA, respectively. Human adenovirus was identified with nucleotide identity range of 98.48% to 99.53%. Statistical analysis of positives showed that viral burden differed by site (P

The potential advantages of plant-based interventions in decreasing the incidence and lessening the morbidity and mortality of COVID-19 are yet to be widely acknowledged. Nevertheless, recent publications propose that these interventions could be effective. Our cardiology center conducted an interventional study in which we incorporated plant-based foods and provided supplementation to 3470 elderly COVID-19 patients with multiple comorbidities. We pay close attention to the precise selection of food items, the application of appropriate processing methods, and the provision of nourishing meals to our patients. Our outcome was highly successful as we achieved a zero mortality rate, and none of our patients experienced worsening conditions or required hospitalization. In this review article we present the mechanisms how plant-based and supplement interventions can mitigate COVID-19 disease severity and mortality. And experts have validated our hypotheses very recently. The measures and methods used to address the ongoing SARS-CoV-2 pandemic through plant-based interventions and supplements are effective and may help prevent or manage future pandemics.

Survey data from 42 Australian eastern seaboard veterinary practices involving 506 cases are reported with regard to clinical signs, disease severity, mortality, use of pharmaceuticals, and recovery times. New measures of disease severity (visual analogue scales (VAS) and facial expressions) were tested alongside “gold standard” measures (neuromuscular junction (NMJ) scores). Univariable and multivariable logistic regression analyses were conducted to evaluate associations between variables. The VAS scores were progressive, prognostic (especially the respiratory scores) and correlated with the NMJ scores. The presence of inspiratory dyspnoea and crackles on the day of hospitalization, progressing to expiratory dyspnoea and an expiratory wheeze 24 hours later were highly predictive of mortality. Altered facial features on hospital admission were also highly predictive of mortality. The previously used respiratory score (using various clinical signs) was not predictive of mortality. Older animals had a higher mortality rate and no gender or breed susceptibility was found. The only pharmaceuticals that were positively associated with mortality were tick anti-serum and, in severe cases, antibiotics. The use of many pharmaceutical products (acepromazine, atropine, steroids, antihistamines, antiemetics, diuretics and S8 anti-anxiety and sedation drugs) had no effect on mortality. More drug classes were used with increasing clinical severity and specific factors (e.g. vomiting/retching, hydration) affected the period of hospitalisation. Geographic variation in respiratory signs and toxicity scores was evident, whereas mortality and disease severity were not different across regions.

Background and Objectives: Since the beginning of COVID-19 pandemic, the infection primarily affected patients with following chronic conditions: cardiovascular disease, hypertension, chronic obstructive pulmonary disease, diabetes mellitus, obesity and cancer. The aim of this study was to explore clinical and epidemiological characteristics associated with COVID-19 outcomes in patients at the primary health care centre from March 2020 to September 2022. Materials and Methods: The study included 40,692 citizens of Banja Luka County, Bosnia and Herzegovina, who were confirmed and registered as RT-PCR positive on COVID-19. Differences regarding the distributions of patients between groups were analysed using Pearson chi square test and Mantel-Haenszel chi square test for trends, while differences in mean values were compared using independent samples t test. Relationship between mortality and independent variables were examined using logistic regression. Results: Out of 40,692 COVID-19 positive patients, 7.76% were hospitalized. The average age of hospitalized patients was significantly higher than the age of non-hospitalized patients (64.2±16.1 vs. 45.4±18.7; p&lt;0.001). The average age of patients with lethal outcome was nearly twice higher compared to patients with non-lethal outcome (74.6±11.5 vs. 45.7±18.6; p&lt;0.001). Male patients had higher hospitalization and mortality rate, compared to females (9.8% vs. 5.9%, p&lt;0.001; 4.8% vs. 3%, p&lt;0.001, respectively). The highest hospitalization rate was in patients with chronic renal failure, diabetes and cardiovascular diseases, while the death rate was the highest among patients with CRF and hearth comorbidities. Fever, cough, fatigue, nausea and vomiting, chest pain, shortness of breath and appetite loss favoured hospitalization. Patients with fatigue and appetite loss had higher percentage of lethal outcome. Vaccinated patients had significantly lower rate of lethal outcome. Conclusions: Clinical symptoms, signs and outcomes, are posing as predictive parameters for further management of COVID-19. Vaccination has an important role in clinical outcomes of COVID-19.

Background: This study aims to develop a research framework for the Social Life Cycle Assessment (S-LCA) of public services by conducting a systematic review of existing literature from 2013 to 2022. The research question focuses on how the results of the literature review can inform the advancement of S-LCA for public services. Methods: To answer this question, a qualitative and quantitative analysis of data from the Web of Science and Scopus databases was carried out. The quantitative analysis determined the total number of S-LCA and SO-LCA papers published by main journals, and main authors. The qualitative analysis highlighted the different themes and research objectives addressed in the work relating to the S-LCA of products/services and organizations. Results: The results show that 222 papers dealing with S-LCA were published in 94 journals and revealed a scarcity of work on public services, with most papers focusing on products/services and organizations. While there is a lack of direct scientific data, the study identified 17 actors, 74 impact sub-categories, and 178 indicators that could be considered for the S-LCA of public services. Conclusions: Due to the diverse nature of public services, it is crucial to develop specific stakeholder categories, sub-categories, and performance indicators for each public service. This will support the scientific community and S-LCA practitioners in applying assessing the social impacts of public services.

The brick manufacturing sector in Bangladesh is experiencing rapid growth, leading to notable environmental and health concerns. The primary objective of this research is to examine the Savar Upazila, a region of significant economic significance owing to its favorable brick manufacturing conditions and proximity to Dhaka city. Brick kilns, among other sources, constitute significant contributors to air pollution. The study utilized primary and secondary data to examine brick kiln emissions' effects on the surrounding area's environment and public health. The collection of primary data was conducted in multiple zones within Savar Upazila, which is home to a significant number of brick kilns. The utilization of secondary data provided valuable insights regarding the toxic pollutants discharged by these kilns and the corresponding health risks they pose. The participants provided accounts of various health ailments, such as dermatological conditions, optical difficulty, and respiratory complications, further aggravated by brick kilns' incidents. The prevalence of crop losses, soil degradation, and reduced agricultural yields was confirmed by 74% of the respondents. The trees and crops in the surrounding area experienced adverse effects due to the deposition of dust particles. During periods of inactivity, the concentrations of sulfur oxide (SOx) were between 6 and 9 times lower compared to periods of operation. Similarly, nitrogen oxide (NOx) levels were observed to be 4 to 6 times lower during non-operational phases. The degradation of water quality in adjacent bodies has been attributed to the deposition of dust and ash originating from brickfields, resulting in substantial repercussions on aquaculture. A significant proportion of participants indicated experiencing diverse health issues, notwithstanding the employment prospects generated by brick kilns, thereby underscoring the adverse consequences on both the environment and the local economy.

The rural road landscape is crucial in forming rural areas' landscape character (LC). As a platform for portraying the rural landscape, the rural roads demonstrate the area's unique natural and cultural characteristics to the visitors. However, with the continuous development of rural areas, the rural LC has been severely impacted, thus impacting visitors' visual experience. In order to preserve and protect the rural landscape, this study aims to assess the visual quality of rural road landscapes based on public preference and heatmap analysis. The results indicated that most of the participants had a higher level of preference for rural landscapes with open horizontal views represented by agricultural areas such as paddy fields. It was also found that different paddy field characters based on their planting stages can also positively affect the visual quality of rural road landscapes. The study also revealed that rural LCs with roadside settlements, commercial structures, mixed agricultural crops, and vegetation received low preference ratings. These characters negatively impact the visual quality of the rural road landscape. These findings provide significant insight for planners and decision-makers regarding protecting and preserving the essential rural road landscapes for the rural tourism experience.

The paper presents the final results from the research project “Urban Abacus of Building Energy performances (Abaco Urbano Energeticodegli Edifci – AUREE)” aimed at supporting the renovation and energy efficiency enhancement of urban building heritage financed by the “Ricerca Sistema Elettrico (MISE) program”. The crux of AUREE project is a Web – GIS GeoBlog portal with customized semantic dashboards aimed at sharing information on urban built environment and promoting the participation of local stakeholders to its improvement. As the latest development of this research, a workflow integrating the AUREE portal with BIM authoring and an open source IoT platform has been implemented and applied to an experimental case study concerning a public building in Carbonia (Italy). The headquarters of the sustainable energy research center Sotacarbo was selected as case study. The presented results proved that it was possible to create an open system, which could be easily consulted by "non-expert" users as well, to make available real-time monitoring data obtained from IoT sensors measuring the energy consumption, the indoor environmental conditions and the usage profiles of public buildings. The proposed open system could also be suitable to be later used as an effective tool to support the rising “energy communities”.

In 1998, the Lisbon Universal Exhibition – Expo'98 – led to an urban regeneration process on Lisbon’s waterfront. Following other cities, this event was a pretext to replace a depressed area and to re-connect it with the river, through the creation of a set of new spaces for common use along the water. For them, it was promoted a public art program, which can be considered quite innovative in the Portuguese context, and that resulted in a monumentalisation of Lisbon’s eastern riverfront, later extended to other areas. Behind this framework, this article aims to debate the relations between public art and the dynamics of urban regeneration at the end of the 20th century. For that, it will analyse: 1) the Expo'98’s public art program, comparing its initial assumptions with the final results; 2) the impact of this program, through the identification of public art’s placements before (1974-1998) and after (1999-2009) the event. As a result, it is possible to find that the placement of public art reveals the spaces that were "conquered" to the port system, and a dialectic between functional/economic and leisure/symbolic values. It is concluded that public art had a significant role in the urban processes of the late 20th century, which is quite evident in a discourse that considers it as a qualifying factor of urban space and a mean of economic and social development.

We develop a mathematical model to provide epidemic predictions for the 2019-nCov epidemic in Wuhan, China. We use reported case data up to January 31, 2020 from the Chinese Center for Disease Control and Prevention and the Wuhan Municipal Health Commission to parameterize the model. From the parameterized model we identify the number of unreported cases. We then use the model to project the epidemic forward with varying level of public health interventions. The model predictions emphasize the importance of major public health interventions in controlling 2019-nCov epidemics.

Introduction: Adolescence is a critical period for the development of affectivity and sexual-ity. Adolescents begin to explore their sexual identity, form intimate relationships, and learn to manage their emotions in new and complex contexts. This study aims to analyze the prevalence of habits and behaviors related to the affective-sexual health of adolescents in the 4th year of ESO, identifying risk factors, comparing behaviors and risks, monitoring these behaviors, analyzing pornography consumption, and evaluating the use of the in-ternet as a source of sexual information. Method: Descriptive cross-sectional study using questionnaires. Participants are 4th-year ESO students from a school in the Baix Llobregat province (Catalonia) aged between 14 and 18 years. Descriptive and bivariate statistical analyses were conducted using the Chi-square test and p-value calculations with R Project software. Frequency and percentage analyses were also used to describe the health behav-iors of the participants. Results: The study reveals that girls have better knowledge of the contraceptive pill and male condom than boys. Sexual initiation and condom use man-agement vary between genders, with girls being more capable of persuading their partners to use them. Pornography consumption also shows significant differences in age of initia-tion and frequency between boys and girls. Conclusions: The study on adolescent affectiv-ity and sexuality reveals knowledge about contraceptives, early sexual initiation, and high pornography consumption, highlighting the need for early and diverse affective-sexual education, youth empowerment, and media misinformation management to promote safer and healthier behaviors in municipal public health. Keywords: Adolescents, Sexuality, Sexual Health, Pornography Consumption, Contracep-tive Knowledge, Gender Differences

This study investigated the influence of Teacher Availability -TAV (Number of Available Teachers, Teacher Punctuality -TP, Teacher Promptness to Class -TPC) on Student Academic Achievement (SAA) in Public Senior Secondary Schools (PSSS) in Southwestern Nigeria. The descriptive survey research design of correlational type was adopted while the multi-stage sampling procedure was used in the study. A simple random sampling technique was used to select three (Oyo, Ogun, and Ekiti) states out of the six in Southwestern Nigeria, as well as one Senatorial District (SD) from each state. The proportionate-to-size sampling technique was used to select 40% of the Local Government Areas (LGAs) in each SD and 50% (101) of the schools in the sampled LGAs. A class of 3,030 PSSS II was used; 202 Mathematics and English Language teachers and 202 Heads of Department (101 each from Science and Arts) were purposively sampled, while 101 school administrators were enumerated. The instruments were TP ( =0.75); TPC ( =0.82); English Language Achievement Test-ELAT (KR-20=7.47) and Mathematics Achievement Test-MAT (KR-20=7.46). Data were analysed using descriptive statistics. Respondents’ ages were 46.5±5.20 years (teachers) and 17.60±1.60 years (students). There were 59.0% male teachers and 57.0% female students. The SAA (ELAT=45.7% and MAT=38.4%) was low. Also, TAV ( =3.36) was high against the threshold of 2.5, and TAV (ß=0.59, t=7.29) significantly contributed to SAA. Teacher availability influenced the student academic achievement in public senior secondary schools in Southwestern Nigeria. Hence, all the education stakeholders should pay attention to this for improved student academic achievement.

The focus of this article is the evaluation of the quality and the degree of community engagement in an expert-based, public-health communicative intervention for Alcohol Use Disorder (AUD). In 2023 the Canadian Alcohol Use Disorder Society collaborated with a grass-roots community health group, a regional health authority, and an academic participatory researcher to organize a working group to mount a social-marketing campaign to increase community support for AUD medical treatment in family-practice settings in a rural community in British Columbia. The partnership working group conducted a series of activities in the school system, the town council, and the community. This article covers the formative evaluation and the summative evaluation of the working group's effectiveness. The formative evaluation ("lessons learned" and "recommendations") consists of consensus evaluations of the quality of each activity using a variety of data sources. The formative evaluation followed improvement science methods and used consensus meetings to provide and reflect on formal and informal feedback. Formative results reflect the consensus of the participants in the working group and they record the reactions in the community. The summative evaluation measures evidence of community engagement found in transcribed text from meeting minutes. The summative evaluation used theory-based frameworks and text data visualization to assess the engagement dynamics of the working group. The summative evaluation helps to put the formative evaluation into perspective as communicative action. The summative evaluation validates the formative evaluation by revealing the communicative dynamics of engagement which resulted in the community’s increased capacity to understand and support Alcohol Use Disorder Treatment options. The working group and the entire intervention was seen by the participants and the public as a success and capable of replication. In a small community, it instilled new understandings and attitudes, bringing an emerging awareness of medication as an optional health mitigation strategy for Alcohol Use Disorder. Our study furthers this overall assessment by using theoretical constructs and analysis of communicative records to trace engagement characteristics of interest to researchers, societies, and community groups contemplating similar interventions in the future. The study also validates the effectiveness of communicative analysis as a measure of social-marketing for expert-based public health interventions.

The work of this paper presents multiple novel findings from a comprehensive analysis of about 150,000 tweets about exoskeletons posted between May 2017 and May 2023. First, findings from content analysis and temporal analysis of these tweets reveal the specific months per year when a significantly higher volume of Tweets was posted and the time windows when the highest number of tweets, the lowest number of tweets, tweets with the highest number of hashtags, and tweets with the highest number of user mentions were posted. Second, the paper shows that there are statistically significant correlations between the number of tweets posted per hour and different characteristics of these tweets. Third, the paper presents a multiple linear regression model to predict the number of tweets posted per hour in terms of these characteristics of tweets. The R2 score of this model was observed to be 0.9540. Fourth, the paper reports that the 10 most popular hashtags were #exoskeleton, #robotics, #iot, #technology, #tech #innovation, #ai, #sci, #construction and #news. Fifth, sentiment analysis of these tweets was performed using VADER and the DistilRoBERTa-base library. The results show that the percentage of positive, neutral, and negative tweets were 46.8%, 33.1%, and 20.1%, respectively. The results also show that in the tweets that did not express a neutral sentiment, the sentiment of surprise was the most common sentiment. It was followed by the sentiments of joy, disgust, sadness, fear, and anger. Furthermore, analysis of hashtag-specific sentiments revealed several novel insights, for instance, for almost all the months in 2022, the usage of #ai in tweets about exoskeletons was mainly associated with a positive sentiment. Sixth, text processing-based approaches were used to detect possibly sarcastic tweets and tweets that contained news. Finally, a comparison of positive tweets, negative tweets, neutral tweets, possibly sarcastic tweets, and tweets that contained news, in terms of different characteristic properties of these tweets are presented. The findings reveal multiple novel insights, for instance, the average number of hashtags used in tweets that contained news has considerably increased since January 2022.

Antisepsis of the hands of medical personnel is one of the most important steps in the process of patient care, since direct contact can cause the cross-transfer of potentially pathogenic microorganisms at surgical sites.This study aimed to analyze the prevalence of microorganisms on the hands of 131 surgeons in a university hospital before the surgical procedure. Swabs were collected from each clinician's hands before and after handwashing. The samples were placed in a transport medium and immediately delivered to a private Clinical Analysis Laboratory from São Luis-Maranhão. The microorganisms were identified by ionization source mass spectrometry and matrix-assisted laser desorption (MALDI-TOF), and antibiotic susceptibility tests (AST) were performed using the Vitek2 automated system. The results showed a high frequency (100%) of microorganisms before handwashing, but after surgical antisepsis, the rate dropped significantly (p&lt;0.05) to 27.5%. Gram-positive cocci and rods were the most common microbes, followed by gram-negative bacilli species. The effectiveness of hand antisepsis was 72.5%. The ideal would be 100% efficacy, that is, 0% microorganisms in all surgeons. It is logical that the presence of any organism, no matter how infrequent it may be, will always represent a great risk of postoperative infection for any patient.

Social media informs the public about the most important events and conveys important information. Before, during and after disasters, social media are used to disseminate information about disasters and to collect data relevant to the implementation of preparedness, response and recovery activities and measures. Social networks are effective in disseminating information and warnings, as well as in educating the public. The subject of the research is examining the influence of demographic factors on the effectiveness of social media in informing the public about the risks of disasters. Using an online survey questionnaire, and according to the snowball principle, a survey of 247 respondents was conducted in 2022. The research results show no statistically significant relationship between the level of education of the respondents and the assessment of the effectiveness of social media reporting on disasters. The use of social media can improve communication between stakeholders in disaster management and facilitate coordination of efforts, fostering communication and allocation of resources. To effectively use social media in disaster management, decision-makers in the disaster management system must be aware of new technologies, their disadvantages and advantages, as well as ways in which data from social networks can be collected and analyzed.

Government-led legislation is a key strategy to reduce plastic pollution; however, societal perception can heavily influence government intervention for environmental issues. To understand the public acceptability of government action to reduce plastic pollution, we examine the perception of existing and upcoming legislative action on single-use plastics by means of a structured survey with additional semi-structured interviews. Our focus is on the four Atlantic provinces of Canada, which was the first region in Canada to implement provincial-wide legislation for plastic reduction at the consumer level in 2019. Results show strong public support (77 %, n = 838) for bans on single-use plastic bags at the consumer level, and for further plastic pollution reduction legislation. However, the level of support differed between regions and by demographics. Semi-structured interviews show that decision-makers should increase efforts in raising consumer awareness and standardizing regulations across jurisdictions for smoother transitions prior to legislative action.

This study aimed to examine trust in information provided by public authorities and financial measures put in place to address the impact of COVID-19. Using a cross-national approach among four Western countries; the United States of America, Norway, Australia, and the United Kingdom provides an analysis of responses related to trust and how they were associated with age group, gender, education level, employment status, size of place of residence, infection sta-tus, and social media use. When controlling for all included variables in logistic regression analyses, the likelihood of having trust in the public authorities’ information was higher for women, those with higher levels of education, and those living in urban areas. Being infected with the coronavirus, and spending more time daily on social media was associated with lower likelihood reporting trust in information. Although policies implemented to respond to eco-nomic concerns varied cross-nationally, higher age, identifying as female, being employed, liv-ing in a city, and lower levels of social media usage were associated with higher likelihood of trusting in the financial measures put in place to counteract the economic effects of COVID-19.

Let us all take a moment to talk, once again, about this new coronavirus pandemic that the world has been facing since November 2019 and about its global response. After a short period marked by the pandemic underestimation risk by most governments, the Western world went nuts and overreacted, most probably so as not to be accused of inaction. In many cases, the overall benefits of the chosen policies were not sufficiently questioned, which resulted in many side effects on global health .The medical motto “primum non nocere”, a moral principle everyone should at least consider following, was evidently not taken into account. It has been overlooked, and the virus has become an obsession, to the extent that nearly everything else, even the most valuable things in life, is still now under appreciated if not simply ignored. This review highlighted facts against this simplistic, one-dimensional view.

The main purpose of this research is to analyze the perception of climate change impacts on human health in Bangladesh through data from nationality representative surveys conducted in some district of Bangladesh. In Bangladesh there have a few research has been conducted on public perceptions about the impact of climate change on human health. A structured questionnaire method was conducted, and data collected from 615 respondents. The findings of this study reveal that out of 615 respondents, 76.0% of the respondents replied positively while remaining 24.0%, almost one-fourth of total respondents, indicated that they have not heard the term climate change before. Knowledgeable in climate change, 92.5% of respondents agreed that climate change has an impact on human health while only 7.5% respondents disagreed with this statement. 90.5% of respondents argued that they are agreed with the opinion that climate change is a serious threat to human health.

The COVID-19 pandemic has great adverse impacts on personal life, the U.S. economy, and the world economy. Freezing all human activities is not a sustainable measure. Thus we want to develop a public intervention framework that allows people to resume personal and economic activities. In this article, we examined transmission routes, disease severity, personal vulnerability, available treatments, and person-person interactions to establish a general public intervention framework. We divide people into risk groups, non-risk group and group that may serve as viral transmitters, explore interactions between individual persons within each group and between different groups, and propose interaction behavior modifications to mitigate viral exposures. For the non-risk groups, we identified preventive measures that can help them avoid the most serious exposures and infections that pose higher death risks. The invention measures for the vulnerable groups include prior-exposure measures, heightened protective measures, interaction behavior changes, post-exposure remedial measures, and multiple factors treatments to reduce death and disability risks. The multiple interventions and two-ways defensive behavior modifications are expected to result in reduced rate of detectable infections and lowered disease severity for the vulnerable groups. In this framework, most human activities and economic activities can continue as normal. With time passing, the population acquires population immunity against the COVID-19 virus. Implementation of this intervention framework requires considerable resources and governmental effects while the multiple factors treatment protocol requires the support of health care professionals.

Public participation is significant for the success of any urban planning project. However, most members of the general public are not planning professionals and may not understand the technical details of a 2D paper-based plan, which might hamper their participation. One way to expand the participation of citizens is to present plans in well-designed, user-friendly and interactive platforms that allow participation regardless of the technical skills of the participants. This paper investigates the impacts of the combined use of 3D visualization and E-participation on public participation in Kisumu, Kenya. A 3D City model, created with CityEngine2016, was exported into a web-based geo-portal and used as a Planning Support System in two stakeholder workshops in order to evaluate its usability. For e-participation, 300 questionnaires given out to planning practitioners. Five indicators were developed for evaluating the usability of the 3D model while the usability of e-participation was evaluated using communication, collaboration and learning as indicators. Results showed that effectiveness and efficiency varies within different professional groups while the questionnaires showed strong preference for e-participation methods, especially SMSs/USSDs and emails. The study concludes that the use of 3D visualization and E-participation has the potential for improving the quality and quantity of public participation and recommends further research on the subject.

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: a) immediate care, b) intermediate care, psychosocial care and d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed and the reinforcement of these advanced practices through the systematization of nurses’ skills, in order to promote victims’ rehabilitation, minimize their suffering and improving their quality of life during and after an earthquake.

Pet nutrition awareness has risen enormously, with an increasing interest in homemade diets aimed at controlling food composition. Literature in this field is scarce, especially regarding the homemade diet’s long-term effects on pathological conditions. This prospective study encompassed 167 healthy and sick dogs subjected to a customized dietary plan based on homemade food. After an initial visit, dog owners provided questionnaires with follow-up data on their perceptions of physical signs changes or symptom modifications. 104 (62%) subjects maintained the homemade diet, while 63 reverted to their previous diet. The median follow-up was 14 months. Out of 31 healthy dogs that continued the nutritional plan, 70% exhibited improvements in their coat condition and 47% a decrease in evacuation frequency. Regarding weight loss goals, 67% of dogs achieved their target. The 67 pathological dogs that completed the follow-up were primarily affected by gastrointestinal and dermatological disorders. Dogs with chronic enteropathy improved their symptoms in 95% of the cases, subjects with dermatological pathologies in 83%, and patients presenting both disorders in 100%. These clinical results are promising. Personalized and well-balanced homemade diets noticeably enhanced the overall pet’s health, with almost a complete remission of symptoms in pathological dogs.

Large epidemiological studies show U-shaped relationships between high-density lipoprotein cholesterol (HDL-C) levels and all-cause mortality in individuals without atherosclerotic cardiovascular diseases (ASCVD). Association in those with ASCVD by sex is unclear. We examined the association between HDL-C levels and 10-year all-cause mortality in subjects (≥40 years of age) with ASCVD using the 2010 National Health Insurance Service and the National Death Registry of Korea. We categorized HDL-C levels into three groups (low: <40 mg/dL for males, <50 mg/dL for females; high: 40-90 mg/dL for males, 50-90 mg/dL for females; extremely high: >90 mg/dL) and 10 mg/dL intervals. We conducted a sex-stratified and adjusted Cox proportional hazards analysis. Out of 1,711,548 individuals (54% female, mean age 61.4 years), 10-year mortality was observed in 218,252 (12.8%). Males had a higher mortality rate than females (16.2% vs 9.8%; P<0.001). When adjusting for age, body mass index, LDL-cholesterol, triglycerides, hypertension, diabetes, smoking, and alcohol consumption, the low and extremely high HDL-C groups had significantly higher hazard ratios for 10-year mortality compared to the high HDL-C group in males [1.183 (1.166-1.199), 1.359 (1.288-1.434)] and in females [1.153 (1.138-1.169), 1.095 (1.029-1.167)]. The frequency distribution bars for the 10-year mortality rate showed sex-specific nadirs of 50-59 mg/dL in males and 70-79 mg/dL in females. In this ASCVD cohort, the extremely high HDL-C (>90 mg/dL) group had 35.9% and 9.5% higher 10-year mortality risk than the high HDL-C group for males and females, respectively. There was a slightly U-shaped relationship between baseline HDL-C levels and 10-year mortality rate, with earlier inflection in males than in females.

The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83-90) were analysed. According to the baseline component (3D), 83.1% (95%CI: 78.2-87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95%CI: 54.1-65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95%CI: 93.0-98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95%CI: 0.73-0.86) for predicting 30-day mortality. 3D/3D+ enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.

Keywords: Red meat; Processed meat; poultry; dairy; mortality

With the rising trends in elderly populations around the world, there is a growing interest in understanding how climate sensitivity is related to their thermal perception. Therefore, we analyzed the associations between mortality in the elderly due to cardiovascular (CVD) and respiratory diseases (RD) and meteorological variables, for three cities in the State of São Paulo, Brazil: Campos do Jordão, Ribeirão Preto and Santos, from 1996 to 2017. We applied the Autoregressive Model Integrated with Moving Average (ARIMA) and the Principal Component Analysis (PCA) in order to evaluate statistical associations. Results showed CVD as a major cause of mortality, particularly in the cold period, when a high mortality rate is also observed due to RD. The mortality rate was higher in Campos do Jordão and lower in Santos (and intermediate values in Ribeirão Preto). Campos do Jordão results indicate an increased probability of mortality from CVD and RD due to lower temperatures. In Ribeirão Preto, the lower relative humidity may be related to the increase in CVD and RD deaths. This study emphasizes that, even among subtropical climates, there are significant differences. Therefore, this can assist decision makers in the implementation of mitigating and adaptive measures.

The objective of this study was to describe the overall pattern of morbidity and mortality of children seen at the Thai Binh Pediatric Hospital in Vietnam, with a focus on infectious diseases. A retrospective review of hospitalisation records was conducted from 1 January 2015 to 31 December 2019. Data were obtained from a total of 113,999 records. The median age of patients was 18 months, with 83.98% of patients aged <5 years. Infectious diseases accounted for 61.0% of all cases. The most prevalent diseases were lower respiratory tract infections (32.8%), followed by gastrointestinal infections (13.3%) and confirmed influenza (5.4%). Most infections were not microbiologically documented. A total of 81.4% patients received at least one antibiotic. Most patients (97.0%) were hospitalised for less than 15 days. Regarding outcomes, 87.8% patients were discharged home with a favourable outcome. 12.0% were transferred to the Vietnam National Children’s Hospital because their condition had worsened and 0.1% died. In total, infectious diseases accounted for 40.4% of deaths, followed by neonatal disorders (34.6%). Our data serves a basis for the identification of needs for diagnostic tools and for future evaluation of the effect of the targeted implementation of such facilities. Point-of-care tests, including real-time PCR assays to identify common pathogens should be implemented for more accurate diagnosis and more appropriate antibiotic use.

In vineyards, Botryosphaeria dieback (BD) occurs in young and old plants. In the field, the prevalence and severity of the disease increase proportionally with the age of the vineyards. Among the pathogens that cause (BD), Diplodia seriata is the most prevalent species in Chile and other countries with a Mediterranean climate. To date, no information is available on the sus-ceptibility of adult wood to infection by this pathogen since most of the pathogenicity tests have been carried out on 1- or 2-year-old shoots or detached canes. Therefore, a pathogenicity test was carried out on plants under field conditions, with inoculations in plants, on one-year-old shoots, and 2- and 10-year-old wood in grapevine cv. Cabernet Sauvignon. A pathogenicity test was carried out with two isolates of D. seriata selected in an assay in detached canes that were 2-year-old. The results on plants showed that D. seriata was significantly more aggressive on 10-year-old than on one- or two-year-old tissue. These results were compared with the lesions ob-tained from two-year-old canes. The results of this work are consistent with the damage ob-served in the field, highlight the importance of identifying each pathogenic species that causes (BD) and contribute to the knowledge of the epidemiology of this disease in Mediterranean cli-mates.

Over the past few decades, aircraft Ground Handling Operations (GHO) have been investigated by numerous researchers. Some aspects of GHO have been more focused on than others due to their importance in the GH processes. For instance, GHO performance has been tackled from different perspectives while workers and vehicles allocation suffer from the lack of research in the area. This paper is a literary review of the research that has been conducted in different areas of GHO. It sheds light on GHO performance, resource allocation and scheduling, operations scheduling, vehicle routing, and workers and vehicles allocation.

The platelet count, a component of the full blood count, has been identified as a useful diagnostic marker for cancer in primary care. The reference range for the platelet count is 150 to 400 or 450 × 109/l; this range does not account for natural variation in platelet count by age and sex. This study used three primary care cohorts from England Canada, and Australia. Patients aged 40 years and over with a full blood count were included and stratified by age (in 10-year bands), sex, (male/female), and platelet count group. Cancer incidence within one year of test date was estimated from linked registry data. In all three countries there was a clear upwards trend in cancer incidence with increasing platelet count, for both sexes and at all age groups. Lung and colorectal were the most common sites. These results have important implications for the international application of this work; analysis of local health datasets will be crucial to determine appropriate thresholds. Appropriate upper thresholds will depend on local populations, healthcare needs, and priorities. Further research is needed to assess the likely impact of new recommendations on the healthcare system, on cancer outcomes, and patient benefit.

When considering implementation of shallow geothermal energy as a renewable source for heating and cooling of the building, special care should be taken in hydraulic design of borehole heat exchanger system. Laminar flow can occur in pipes due to usage of glycol mixture at low temperature or inadequate flow rate. This can lead to lower heat extraction and rejection rates of the exchanger because of higher thermal resistances. Furthermore, by increasing flow rate to achieve turbulent flow and satisfactory heat transfer rate can lead to increase the pressure drop of the system and oversizing of circulation pump which leads to impairment of seasonal coefficient of performance at the heat pump. Most frequently used borehole heat exchanger system in Europe is double-loop pipe system with smooth inner wall. Lately, development is focused on implementation of different configuration as well as with ribbed inner wall which ensures turbulent flow in the system, even at lower flow rates. At a location in Zagreb, classical and extended thermal response test was conducted on three different heat exchanger configurations in the same geological environment. With classic TRT test, thermogeological properties of the ground and thermal resistance of the borehole were determined for each smooth or turbulator pipe configuration. Extended Steady-State Thermal Response Step Test (TRST) was implemented, which incorporate series of power steps to determine borehole extraction rate at the define steady-state heat transfer conditions of 0/-3°C. Results show that heat exchangers with ribbed inner pipe wall have advantages over classic double-loop smooth pipe design, in terms of greater steady state heat extraction rate and more favorable hydraulic conditions.

Indices such as Body Mass Index (BMI), Waist Circumference (WC) and Waist to Height Ratio (WHtR) have emerged as tools to assess cardiovascular risks associated with abdominal obesity. The Timed Up and Go Test (TTUG) assesses mobility and the risk of falls, especially in the elderly and individuals with physical limitations. Objective: To correlate anthropometric indicators of cardiovascular risk (BMI, WC, WHtR) and performance in the TTUG in elderly people who practice physical activity. Methods: Cross-sectional study, CAAE: 27116319.1.0000.8044, elderly people, both sexes, average age 68 years. Anthropometric data was collected: BMI, WC, WHtR and TUG test results. Results: Average values: weight (67.8 ± 12.7 kg), height (157.2 ± 8.4 cm), TTUG (10.3 ± 2.5 26 seconds), WC (93.3 ± 10.9 cm), waist-to-height ratio (0.59) and BMI (27.4 ± 4.4): Correlations between 27 TTUG and age (r = -0.086, p = 0.683), TTUG and BMI (r = 0.29, p = 0.892) WC and WHtR (r = 0.927, p 28 < 0.001). Conclusion: This study revealed correlations between anthropometric indicators of cardio vascular risk (BMI, waist circumference, waist-to-height ratio) and performance in the TUG test in the elderly.

Hubei, Hunan and Henan Provinces are located in Central China, a region with extensive transport networks and trade. Bursaphelenchus xylophilus, the causative agent of pine wilt disease, is spreads mainly through human activities. In order to further understand the genetic structure of PWN in Central China, we studied the genetic information of PWN populations in this region and compared the genetic relationship with strains from Guangdong and Jiangsu provinces. We found that the HB (Hubei) 15, HEN (Henan) 20, HN (Hunan) 07, HN08 and HN10 had significantly more SNPs and homozygotes than other strains from Central China, and their most frequent mutant genotypes also differed from other strains. The clustering results indicated that HB15, HEN 20, HN07, HN08 and HN10 were genetically distinct from other strains and closely related to Guangdong strains. We also observed significant genetic variation among strains in Henan province, suggesting that some of them might have different transmission sources than those from Hubei and Hunan provinces. The results provide a basis for tracing the origin and spread of PWD in China.

This article explores the emerging concept of atrial myopathy (AM) and its potential role as a risk factor for stroke and dementia, both independently and in association with atrial fibrillation (AF). AM refers to structural and functional abnormalities of the atria, potentially causing blood clots formation and their subsequent embolization even in patients without AF. Echocardiography, particularly Left Atrial (LA) strain analysis, is a promising non-invasive tool for AM evaluation and might offer additional risk stratification beyond the established CHADS2-VASc score, potentially impacting anticoagulation decisions. By understanding AM and utilizing advanced imaging techniques like LA strain, clinicians can achieve a more comprehensive understanding of thromboembolic risk in specific patient groups. Integrating LA strain analysis into routine clinical practice holds promise for improved patient management and targeted therapies, allowing for better risk stratification in AF patients. However, standardized definitions and diagnostic criteria for AM are essential for consistent evaluation and research. Further studies are needed to explore the efficacy and safety of anticoagulation in AM patients without AF.

COVID-19 vaccine hesitancy and its enablers would shape community uptake of non-covid vaccines such as oral cholera vaccine (OCV) in the post-COVID-19 era. This study assessed the impact of COVID-19 vaccine hesitancy and its drivers on OCV hesitancy in a cholera endemic region of the Democratic Republic of Congo. We conducted a community-based survey in Bukavu. The survey included characteristics, intention to take OCV and COVID-19, reasons for COVID-19 hesitancy, and thinking and feeling about COVID-19 vaccines. Poisson regression analyses were performed. Of the 1708 respondents, 84.66% and 77.57% were hesitant to OCV alone and to both OCV and COVID-19, respectively. Hesitancy to COVID-19 vaccines rose OCV hesitancy by 12% (crude Prevalence Ratio, [cPR]=1.12, 95%CI[1.03-1.21]). Independent predictors of OCV hesitancy were living in semi-urban area (adjusted Prevalence Ratio [aPR]=1.10, 95%CI[1.03-1.12]), religious refusal of vaccines (aPR=1.06, 95%CI[1.02-1.12]), concerns about vaccine safety (aPR=1.05, 95%CI[1.01-1.11]) and adverse effects (aPR=1.06, 95%CI[1.01-1.12]), as well as poor knowledge (aPR=1.07, 95%CI[1.01-1.14]). Conversely, the belief about COVID-19 vaccine effectiveness reduced OCV hesitancy (aPR=0.76, 95%CI[0.62-0.93]). COVID-19 vaccine hesitancy and its drivers exhibiting a significant domino effect on OCV uptake. Addressing vaccine hesitancy through community-based health literacy interventions would likely improve the introduction of novel non-COVID-19 vaccines in post-COVID-19 era.

Background: The goal of this study was to evaluate the effect of Extracorporeal Membrane Oxygenator (ECMO) on mortality in patients with cardiogenic shock excluding Impella and IABP use. Method: The large Nationwide Inpatient Sample (NIS) database was utilized to study any association between the use of ECMO in adults over age of 18 on mortality and complications with a diagnosis of cardiogenic shocks. Results: ICD-10 codes for ECMO, and cardiogenic shock for available years 2016-2020 were utilized. A total of 796,585 (age 66.5±14.4) patients had a diagnosis of cardiogenic shock excluding Impella. 13,160 (age 53.7±15.4) were treated with ECMO without IABP. Total inpatient mortality without any device was 32.7%. It was 47.9% with ECMO. Using multivariate analysis adjusting for 47 variables such as age, gender, race, lactic acidosis, three-vessel intervention, left main myocardial infarction, cardiomyopathy, systolic heart failure, acute ST-elevation myocardial infarction, peripheral vascular disease, chronic renal disease, etc., ECMO utilization remained highly associated with mortality (OR: 1.78, CI: 1.6-1.9, p<0.001). Evaluating teaching hospitals only revealed similar findings. Major complications were also high in ECMO cohort. Conclusion: In patients with cardiogenic shock, the use of ECMO was associated with the high in hospital mortality regardless of comorbid condition, high-risk futures, or type of hospital.

Background: Maternal mortality remains dire in Nigeria, claiming 40,000 lives yearly due to pregnancy complications. Factors like limited healthcare access, poverty, and early marriage worsen the crisis. Despite efforts to improve skilled birth attendance, Nigeria struggles to meet MDG targets, underscoring the urgent need for more effective interventions. Objectives: The objective of the study is to assess and understand the knowledge of community members regarding the risk factors influencing maternal mortality in the Ede South Local Government Area of Osun State, Nigeria. Methodology: A descriptive cross-sectional study was conducted. The study methodology involves employing the Leslie Kish formula to select 185 participants from the Ede South Local Government Area in Osun State, Nigeria. The selection process involved the use of a systematic sampling technique to ensure a representative sample based on population demographics and characteristics, ensuring a balanced and accurate selection process. Quantitative data was collected through a self-administered questionnaire and analysed using SPSS version 21. Results: The study encompassed 185 participants. 64.9% females with a mean age of 27.3 + 8.3 years. Among them, 60.5% were single, 46.6% being students, 55.7% held a BSc degree, 64.9% were Yoruba and 61.1% identified as Christian. 91.4% were aware about maternal mortality, 74.6% recognized maternal deaths in reproductive-aged women. Participants identified that maternal deaths mostly occur during labour (91.4%). Direct causes, such as bleeding (88.1%), unsafe abortion (88.6%), infection (49.2%), and hypertension (64.9%), were recognized. Results indicated substantial awareness concerning specific risk factors: lack of education (98.9%), poverty (91.6%), poor health care services in facilities (94.0%), alcohol consumption (87.6%) and poor transportation (78.4%). Conclusion: Findings revealed good awareness of maternal deaths and critical factors such as ANC impact and direct causes of maternal mortality like bleeding and unsafe abortion. However, gaps persisted in SDG awareness, suggesting the need for targeted interventions to enhance overall understanding and address identified knowledge gaps.

The incidence of multidrug-resistant (MDR) bloodstream infections (BSI) is associated with high morbidity and mortality. Little evidence exists regarding the epidemiology of BSIs and the use of appropriate empirical antimicrobial therapy in endemic regions. Novel diagnostic tests (RDTs) may facilitate and improve patient management. Data from patients with MDR GNB bacteremia at a university tertiary hospital were assessed over a 12-month period. 157 episodes of MDR GNB BSI were included in the study. Overall mortality rate was 50,3 percent. Rapid molecular diagnostic tests were used in 94% of BSI episodes. In univariate analysis, age (OR 1.05 (95% CI 1.03, 1.08) p<0.001), Charlson Comorbidity Index (OR 1.51 (95% CI 1.25, 1.83) p<0.001), Procalcitonin≥1(OR 3.67 (CI 95% 1.73, 7.79) p<0.001) and monotherapy with tigecycline (OR 3.64 (95% CI 1.13, 11.73) p=0.030) were the only factors associated with increased overall mortality. Surprisingly, time to appropriate antimicrobial treatment had no impact on mortality. MDR pathogen isolation, other than Klebsiella pneumoniae and Acinetobacter baumanii was associated with decreased mortality (OR 0.35 (95% CI 0.16, 0.79) p=0.011). In multivariate analysis though the only significant factor for mortality was Procalcitonin≥1(OR 2.84 (95% CI 1.13, 7.11) p=0.025). In conclusion, in an endemic area, mortality rates in MDR BSI remain high. High procalcitonin was the only variable that predicted death. The use of rapid diagnostics did not improve mortality rate.

Multiple myeloma (MM) is a hematological malignancy characterized by the clonal proliferation of plasma cells in the bone marrow (BM) microenvironment. Despite the progress made in treatment, some MM patients still die within the first year of diagnosis. Numerous studies investigating microRNA (miRNA) expression patterns suggest they may be good prognostic markers. The primary aim of this study was to analyze the expression of selected miRNAs in the serum of MM patients subsequently treated with bortezomib-based regimens and determine their potential to predict early mortality. The study was conducted in 69 prospectively-recruited patients with newly-diagnosed MM admitted to the Department of Hematology of the Copernicus Memorial Hospital, Lodz (Poland) between 2017 and 2021. Among them, 17 patients experienced death within 12 months of diagnosis. The expression of 31 selected miRNAs was determined using miRCURY LNA miRNA Custom PCR Panel. The obtained clinical data included patient characteristics on diagnosis, treatment regimen, response to treatment, and follow-up. Differential expression analysis found two miRNAs to be significantly downregulated in the early mortality group: hsa-miR-328-3p (fold change- FC: 0.72, p=0.0342) and hsa-miR-409-3p (FC: 0.49, p=0.0357). Univariate and multivariate logistic regression analyses were performed to assess the early mortality rate. The final model consisted of hsa-miR-409-3p, hsa-miR-328-3p, age and R-ISS 3. It yielded an area under the curve (AUC) of 0.863 (95%CI: 0.761-0.965) with 88.2% sensitivity and 77.5% specificity. Further external validation of our model is necessary to confirm its clinical value.

Background: The Sequential Organ Failure Assessment (SOFA) is a scoring system used for the evaluation of disease severity and prognosis of critically ill patients. The impedance ratio (Imp-R) is a novel mortality predictor. Aims: This study aimed to evaluate the combination of SOFA + Imp-R in the prediction of mortality in critically ill patients admitted to the emergency department (ED). Methods: A retrospective cohort study was performed in adult patients with acute illness admitted to the ED of a tertiary-care referral center. Baseline SOFA score and bioelectrical impedance analysis to obtain the Imp-R were performed within the first 24 hours after admission to the ED. A Cox regression analysis was performed to evaluate mortality risk of initial SOFA score plus Imp-R. Harrell's C-statistic and decision curve analyses (DCA) were performed. Results: Out of 325 patients, 240 were included for analysis. Overall mortality was 31.3%. Only 21.3% of non-surviving patients died after hospital discharge, and 78.4% died during hospital stay. Of the latter, 40.6% died in the ED. SOFA and Imp-R values were higher in non-survivors and were significantly associated with mortality in all models. The combination of SOFA + Imp-R significantly predicted 30-day mortality, in-hospital mortality, and ED mortality with area under the curve (AUC) of 0.80 (95% CI: 74-0.86), 0.79 (95% CI: 0.74-0.86) and 0.75 (95% CI: 0.66-0.84) respectively. The DCA showed that combining SOFA + Imp-R improved the prediction of mortality through the lower risk thresholds. Conclusion: The addition of Imp-R to baseline SOFA score at admission to the ED improves mortality prediction in severely acutely ill patients admitted to the ED.

Cervical cancer is a public health issue with high disease burden and mortality in Brazil. The objectives of the present study were analyzing age, period, and cohort effects on cervical cancer mortality in women 20 years old or older from 1980 to 2019 in the North, South, and Southeast Regions of Brazil; and evaluating whether the implementation of a national screening program and the expansion of access to public health services caused impacts over the examined period and reduced the risk of death over the past years and among younger cohorts. The effects were estimated by applying Poisson regression models with estimable functions. The highest mortality rate by 100,000 women was found in Amazonas (24.13), and the lowest in São Paulo (10.56). A positive gradient was obtained for death rates as women’s age increased. The states in the most developed regions (South and Southeast) showed a reduction in the risk of death in the period that followed the implementation of the screening program and in cohort from the 1960s onwards. The North Region showed a decreased risk of death only in Amapá (2000–2004) and Tocantins (1995–2004; 2010–2019). The findings indicated that health inequities remain in Brazil and suggested that the health system has limitations regarding decreasing mortality associated with this type of cancer in regions with lower socioeconomic development.

Nowadays, according to spectacular improvement in health care and biomedical level, a tremendous amount of data is recorded by hospitals. In addition, the most effective approach to reduce disease mortality is to diagnose it as soon as possible. As a result, data mining by applying machine learning in the field of diseases provides good opportunities to examine the hidden patterns of this collection. An exact forecast of the mortality after heart surgery will cause Successful medical treatment and fewer costs. This research wants to recommend a new stacking predictive model after utilizing the random forest feature importance method to foresee the mortality after heart surgery on a highly unbalanced dataset by using the most practical features. To solve the unbalanced data problem, a combination of the SVM-SMOTE over-sampling algorithm and the Edited-Nearest-Neighbor under-sampling algorithm is used. This research compares the introduced model with some other machine learning classifiers to ensure efficiency through shuffle hold-out and 10-fold cross-validation strategies. In order to validate the performance of the implemented machine learning methods in this research, both shuffle hold-out, and 10-fold cross-validation results indicated that our model had the highest efficiency compared to the other models. Furthermore, the Friedman statistical test is applied to survey the differences between models. The result demonstrates that the introduced stacking model reached the most accurate predicting performance after Logistic Regression.

Treatment with calcitriol, the hormonal form of vitamin D, has shown beneficial effects in ex-perimental models of acute lung injury. In this study we aimed to analyze the associations be-tween calcitriol supplementation and the risk of SARS-CoV2 infection or COVID-19 mortality. Individuals ≥18 years old living in Catalonia and supplemented with calcitriol from April 2019 to February 2020 were compared with propensity score matched controls. Outcome variables were SARS-CoV2 infection, severe COVID-19 and COVID-19 mortality. Associations between calcitriol supplementation and outcome variables were analyzed using multivariable Cox proportional regression. A total of 8076 patients were identified as being on calcitriol treatment. Advanced chronic kidney disease and hypoparathyroidism were the most frequent reasons for calcitriol supplementation in our population. Calcitriol use was associated with reduced risk of SARS-CoV2 infection (HR 0.78 [CI 95% 0.64-0.94], p=0.010), reduced risk of severe COVID-19 and reduced COVID-19 mortality (HR 0.57 (CI 95% 0.41-0.80), p=0.001) in patients with advanced chronic kidney disease. In addition, an inverse association between mean daily calcitriol dose and COVID-19 severity or mortality was observed in treated patients, independently of renal function. Our findings point out that patients with advanced chronic kidney disease could benefit from calcitriol supplementation during the COVID-19 pandemic.

Background. This study aims to estimate the rate of death by cancer, according to Radio Base Stations (RBS) radiofrequency exposure, especially for the types of breast, cervix, lung and esophagus cancer. Methods. We collected information about the number of deaths by cancer, gender, age group, Gross Domestic Product per capita, death year and the amount of exposure over the lifetime. We investigated all cancer types and some specific types (breast, cervix, lung and esophagus cancers). Results. In capitals where RBS radiofrequency exposure was higher than 2,000/antennas-year, the average mortality rate was 112/100,000 for all cancers. The adjusted analysis showed that the higher the exposure to RBS radiofrequency, the higher cancer mortality. The highest adjusted risk was observed for cervix cancer (Rate Ratio = 2.18). The spatial analysis showed that the highest RBS radiofrequency exposure was observed in a city in southern Brazil, which also showed the highest mortality rate for all types of cancer and specifically for lung and breast cancer. Conclusion. The balance of our results indicates that the exposure to radiofrequency electromagnetic fields from RBS increases the rate of death by all types of cancer.

Background: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. If reference sickle cell centers have been implemented in capital-cities of African countries and have proven to be beneficial for SCD patients, it has never been set up ina rural area for families with very low sources of income. Method: A cohort of 143 children with SCD aged 10 years old (IQR [inter quartile range]: 6–15 years) (sex ratio male: female = 1.3) were clinically followed for 12 months without any specific intervention, outside management of acute events ,and then 12 months with a monthly medical visit , a biological follow-up and regular prophylaxis. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1–5). The implementation of standardized and regular follow-up in a new sickle cell referral center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease of the lymphocytes count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. Conclusions: Creation of a sickle cell referral center and a regular follow-up of children with SCD are possible and applicable in the context of a remote city of an African country. Those simple and accessible measures can reduce the morbimortality of the sickle cell children.

Background: Infectious disease is a major challenge in aquaculture and poses a constraint for development of farming of new species. In 2017, Siberian sturgeon (Acipenser baerii) juveniles were imported from Italy to a Swedish farm. Due to stressful conditions, 30% died during transport and in the first days after arrival. Ten days after arrival, mortalities started to occur again. Within two months, only 5% of the juveniles were still alive. Methods: Diseased fish were transported live to the National Veterinary Institute (SVA) for necropsy and further analysis. Pathological and histopathological investigation was conducted. Virology was performed on gills and internal organs by cell culture isolation and specific PCR protocols. Results: The juveniles displayed neurological signs such as lethargy, inability to maintain upright position and erratic swimming. Body condition was low. Gills were pale. One fish had petechial hemorrhage on the abdomen and the snout. The ventricles were air-filled with, but swim bladders were deflated. One specimen had intestinal hemorrhage. Viral cell cultures were negative, but PCR of gills and internal organs detected the presence of Acipenser Iridovirus European (AcIV-E). Conclusions: AcIV-E was associated with disease and high mortality in the sturgeon juveniles. Stress probably aggravated the course of the infection.

Objective: The primary objective of this study was to develop a logistic regression model to predict post-operative in-hospital mortality rates for patients undergoing emergency cardiac surgeries, with the aim of improving predictive accuracy over traditional risk assessment tools and enhancing patient outcomes and clinical decision-making. Methods: Data were collected from 4,855 patients who underwent emergency cardiac surgeries at a tertiary hospital between 2008 and 2017. The analysis incorporated demographic, anthropomet- ric, and clinical factors, including the ASA classification, emergency status, and various preoperative laboratory values. A logistic regression model was developed, and the Elixhauser Comorbidity Index was calculated using standard ICD-10 codes for its comprehensive assessment of comorbidities. Model performance was evaluated using metrics such as AUROC, AUPRC, accuracy, precision, recall, and F1 score. Results: The logistic regression model demonstrated strong predictive performance, with an AUROC of 0.939 and an AUPRC of 0.350. Key pre-operative factors identified included emergency operation status, ASA classification, and preoperative prothrombin time. The model significantly outperformed the traditional ASA classification system, which showed an AUROC of 0.524 and an AUPRC of 0.010. These findings suggest a substantial improvement in predicting post-operative mortality. Conclusion: The logistic regression model significantly improves the prediction of post-operative mortality in emergency cardiac surgeries compared to the ASA classification system. These findings highlight the potential of incorporating comprehensive pre-operative factors into predictive models to enhance clinical decision-making and patient outcomes. Implementing such models in routine clinical practice could lead to more accurate risk assessments, better resource allocation, and improved patient care.

Abstract: This study aimed to evaluate the long-term impact of paediatric dentistry programmes on children and adolescents to reduce oral health inequalities. It measures and assesses the improvement effects of paediatric dentistry programmes on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and paediatric dentistry programmes between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. Frequency analysis was conducted for demographic characteristics, and binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. Data were analysed using PASW Statistics with the statistical significance level set at α=0.05. Regarding oral health indicators based on the frequency of participation in paediatric dentistry programmes for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health indicators in paediatric dentistry programmes between primary and adolescent age groups, individuals under continuous management showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, binary logistic regression analysis revealed significant influences (p

With the growing awareness of entrepreneurs and consumers of the tourism market in the field of sustainable development, it seems necessary to base hotel classification systems on an integrated approach to management quality, including fulfilment of ecological and environmental criteria. The article aims to indicate how environmental standards are implemented in the European system of hotel classification- HotelstarsUnion and the one in force in Poland. With regards to these systems, the differences in the classification criteria taken into account within the systems of hotel categorization by certifying organizations in the European Union in relation to the administrative hotel categorization system in Poland were pointed out. Particular emphasis was placed on the criteria related to environmental management in the hotel industry. Criteria related to environmental management were identified through analysis of the content of criteria of eight environmental management systems that are applicable to the contemporary hotel market. The results of the research proved that even though the HotelstarsUnion system takes into account the principles of sustainable development to a much greater extent than the Polish one, its primary weakness is that most of its criteria related to environmental ones are optional. In addition, the optional ones have higher weights than the obligatory ones. In turn, the Polish classification system makes very little reference to environmental standards. Moreover, it is not detailed and the assessment criteria are not up to date. Therefore, it is recommended that a greater number of environmental criteria is included when updating the HotelstarsUnion system, which should be obligatory for hotels to meet. In addition, the sustainability criteria included in the HotelstarsUnion system should be adapted to the policy system aimed at the hotel industry in Poland and other EU countries.

The allocation of funding for higher education typically focuses on competition in neoliberal mechanisms. Surprisingly, much less attention has been paid to considering the effect of fund locations for sustainable development through public goods purposes in neoliberal contexts. This study aims to examine specific funding schemes and determine the influential factors impacting funding for teaching, research, and public goods transformation. Taking Taiwan's Higher Education Sprout Project (HESP) as an example, we explored the effect of policy initiatives on public goods transformation towards sustainable development. The data were collected from the Ministry of Education and Scopus databases. First, a regression analysis was conducted to determine which factors influence the effect of funding allocations in academic institutes. Second, we used logistic regression to detect the effects of the system and the sector. Third, we used partial least square structural equation modeling (PLS-SEM) to explore the causal effects among the selected impact variables on expected outcomes. Finally, we used the bootstrap method to demonstrate the model’s robustness. Our study found that only diversity was shown in private technology groups receiving less HESP funding. At the same time, it did not widen the differences in the sector and system in the transformation process. Our findings suggest that funding allocations will not affect teaching and research based on sectors and systems. In contrast, this study demonstrates that transforming public goods through special funding can play a critical role in leading sustainable development in higher education.

This study explores the interplay between web-based professional development, teachers' self-efficacy, resilience, and work values in the context of the Davao Region. The investigation reveals significant findings in three key areas: web-based professional development, teachers' resilience, and teachers' work values. The survey indicates that web-based professional development significantly impacts teachers' self-efficacy, with interaction self-efficacy registering the highest mean score. Moreover, teachers' resilience is manifested across emotional, motivational, and social dimensions, with emotional resilience scoring the highest mean. Teachers' work values, encompassing physical facilities, social environment, job security, new challenges, professional growth, personal growth, and interpersonal relationships, all demonstrate high descriptive equivalents. The study establishes a significant positive correlation between web-based professional development and teachers' self-efficacy, as well as a significant relationship between teachers' resilience and their work values. Furthermore, both web-based professional development and teachers' resilience exert a significant influence on teachers' work values.The conclusions drawn from the study highlight the prominence of web-based professional development, teachers' resilience, and work values in the educational landscape of the Davao Region. The findings underscore the interconnectedness of these factors and their crucial role in shaping the teaching profession. In light of these results, recommendations are made to inform policy decisions and enhance professional development programs for teachers in the region. The study encourages a holistic understanding of the relationships between web-based professional development, self-efficacy, resilience, and work values, aiming to contribute to the continuous improvement of education quality in the Davao Region. Additionally, future research is suggested to delve deeper into specific aspects of teachers' general self-efficacy, social resilience, and interpersonal relationships for a more comprehensive understanding.

Objectives: Low and Middle Income Countries (LMICs) are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases (NCDs) such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity (MMD). However, preventing MMD has received little attention in LMICs, especially in Sub-Saharan African Countries. Design: Narrative review which scoped the most recent evidence in LMICs about MMD determinants and appropriated them for potential MMD prevention strategies. Methods: MMD in LMICs is affected by several determinants including increased age, female gender, environment, lower socio-economic status, obesity, and lifestyle behavious, especially poor nutrition and physical inactivity. Results: MMD public health interventions in LMICs, especially Sub-Saharan are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent MMD clusters, especially hypertension, diabetes and cardiovascular disease, can provide an early prevention of MMD, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing MMD in LMICs.

The issue of being pro-gender is still a controversial topic to be debated in Indonesian society. However, in the 21st Century, many women have been able to break through barriers and participate in the public sphere. It is a form of self-existence as proposed by Simone de Beauvoir on existentialist feminism. Based on these problems, this study aims to find out and answer questions about how Indonesian women exist in the public sphere in the 21st Century and find out how Indonesian women exist in the public sphere through Simone de Beauvoir's existentialist feminism paradigm. The research method used is descriptive-qualitative through a literature review of 23 journal articles, websites, and data reports with a range of 2019-2021. This study found that based on Simone de Beauvoir's feminist paradigm, Indonesian women in the 21st Century are no longer a figure other than complete. Furthermore, the data collected by the researcher shows that several gender indicators have shown that Indonesian women have been able to occupy public spaces in various aspects. Based on these results, it is hoped that it can provide information about Simone de Beauvoir's existentialist feminism thought and its relevance to the existence of Indonesian women in the public sphere in the 21st Century. However, this research has limitations, those are only about women in Indonesia, and the paradigm of feminism is limited to Simone de Beauvoir's existentialist feminism.

Though there have been works highlighting the advantages and disadvantages of online learning, no study focused on university-level economics students. None of the studies explored students' opinions about improving the quality and effectiveness of online classes. Many used questionable samples, closed-ended questions, and all those researches were carried out at the beginning of online classes. In this paper, we overcome these limitations of earlier studies. Using a convenience sampling technique and open-ended questions, we collect data from 154 university-level economics students after being exposed to the online class for a year. Some advantages of online classes are: students can do classes from home without being exposed to health risks, easily accessible, flexible class schedule, students remained connected with the study, it saves costs, reduce the likelihood of semester loss, easy to understand, less stressful, and learning new technologies. Major problems from students' perspectives include network problems, difficulties in understanding the topic, unsuitable for mathematical courses, concentration problem, class not interactive, financial constraint, adverse health impacts, device issues, power outages, unfamiliarity with digital technology, internet problem, and unfixed class-schedule. Disadvantages outnumbered advantages. Students made several suggestions to improve the quality and effectiveness of online classes. Some of the vital suggestions are: using state-of-the-art digital tools, recording and uploading lectures, resolving internet issues, holding classes regularly, higher efforts to make the topics easier, resolving network issues, lowering class duration, institutional support, implementing a fixed class schedule, and introducing online evaluation system.

Purpose: Our study focused on Pied Grow and Cattle Egret, two commensal and ubiquitous birds feeding in dumps and frequenting our homes. Our aim was to identify the bacteria that birds bring to our homes and could be a potential risk to Congolese health. Method: We have done bacteriological analyses of bird feces for to explore its gut micriobiota composition. The feces were collected in the uricotelic cloaca by using a swab in 52 Cattle Egrets (Bubulcus ibis) and 23 Pied Crows (Corvus albus) from Kinshasa city. Results: Bacteriological analyses revealed the presence of Proteus vulgaris (3.8%) and Klebsiella pneumoniae (5.8%) on Cattle Egret, Salmonella sp. (8.7%), Klebsiella pneumoniae (8.7%), Pseudomonas aeruginosa (21.7%), Proteus vulgaris (30.4%) on Pied Crow, Citrobacter spp and Escherichia coli (100%) on both Cattle Egret and Pied Crow respectively. Conclusion: The presence of these pathogenic germs, suggesting these commensal and ubiquitous birds may be potential vectors of various Diseases which pose serious health problems in the region.

Natural products (NPs) have been the centre of attention of the scientific community in the last decencies and the interest around them continues to grow incessantly. As a consequence, in the last 20 years, there was a rapid multiplication of various databases and collections as generalistic or thematic resources for NP information. In this review, we establish a complete overview of these resources, and the numbers are overwhelming: over 120 different NP databases and collections were published and re-used since 2000. 98 of them are still somehow accessible and only 50 are open access. The latter include not only databases but also big collections of NPs published as supplementary material in scientific publications and collections that were backed up in the ZINC database for commercially-available compounds. Some databases, even published relatively recently are already not accessible anymore, which leads to a dramatic loss of data on NPs. The data sources are presented in this manuscript, together with the comparison of the content of open ones. With this review, we also compiled the open-access natural compounds in one single dataset a COlleCtion of Open NatUral producTs (COCONUT), which is available on Zenodo and contains structures and sparse annotations for over 400000 non-redundant NPs, which makes it the biggest open collection of NPs available to this date.

Background: Zika virus (ZIKV) infection has significantly affected Latin America in 2015–2017. Most studies have been reported from Brazil and Colombia, and only a few from Central America. For these reasons we analyzed the incidence, incidence rates and evolution of cases in Honduras from 2016–2017. Methods: Using epidemiological weeks (EW) surveillance data on the ZIKV epidemics in Honduras, we estimated incidence rates (cases/100,000 population), and developed maps at national, departmental and municipal levels. Results: From 1 January 2016 to 31 December 2017, a total of 32,607 cases of ZIKV were reported (98.5% in 2016 for an incidence rate of 36.85 cases/100,000 pop; 1% confirmed by RT-PCR). The highest peak was reached on the EW 6°, 2016 (2,559 cases; 29.34 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortés (13,128 cases, 791.08 cases/100,000 pop in 2016). Discussion: The pattern and evolution of ZIKV infection in Honduras has been similar to that which occurred for chikungunya in 2015. As previously reported, infection with chikungunya involved predominantly the central and capital area of the country, reaching incidences there >750 cases/100,000 pop. Studies using geographical information systems linked with clinical disease characteristics are necessary to attain accurate epidemiological data for public health systems. Such information is also useful for assessment of risk for travelers who visit specific areas in a destination country.

We do this research to investigate the relationship between renewable energy, public health expenditure, logistics performance indices, and economic and environmental sustainability in the ASEAN member states, through the analysis of a panel data from 2007 to 2017. The study used secondary data, which is downloaded from the World Bank Website and employs SEM (Structural Equation Modelling) model for testing hypothesis. The results show that the usage of renewable energy in logistical operations would enhance the environmental and economic performance in terms of mitigating carbon emissions and greenhouse gas emissions. While, public health expenditure and environmental performance is negatively correlated, which confirms that greater environmental sustainability with lower carbon emissions and greenhouse gases will improve human health and economic growth. Moreover, greater public health expenditure and poor environmental performance has negative effect on economic growth, inefficiency and low productivity of labor slowdown to the economic activities. For another side, the usage of renewable energy and the adoption of green practices in international logistics will develop the environmental sustainability, establish better image of a country and attract foreign direct investment inflows, and also minimize carbon emissions and public health expenditure, spurring sustainable economic growth with better export opportunities in pro-environmental countries.

(1) Background: Pedestrian injuries (PIs) represent a significant proportion of road traffic injuries. We aimed at investigating the incidence and mortality of PIs in different age groups and Socio-demographic Index (SDI) categories between 1990 and 2017. (2) Method: Estimates of age-standardized incidence and mortality along with trends of PIs by SDI levels were obtained from the Global Burden of Disease from 1990 to 2017. We also calculated forecasts until 2040. (3) Results: Globally, PIs incidence increased by 3.31% (–9.94 to 16.56) in 2017 compared to 1990. Men have a higher incidence of PIs than women. Forecasted incidence was 132.02 (127.37 to 136.66) per 100,000 population in 2020, 101.52 (65.99 to 137.05) in 2030 and reduced further to 71.02 (10.62 to 152.65) by 2040. Globally across all SDI categories, there was a decreasing trend in mortality due to PIs with the global estimated percentage reduction of 37.12% (–45.19 to –29.04). (4) Conclusions: The results show that PIs are still a burden for all SDI categories despite some variation. Although incidence and mortality are expected to decrease globally, some SDI categories may require particular attention in addition to specific vulnerable age groups. Further studies addressing incidence and mortality patterns in vulnerable SDI categories are needed.

Buckwheat is important not only as a crop that improves soil quality and reduces erosion, but its excellent nutritional profile for usage in functional foods. This study aimed to investigate how long-term storage (3, 6, and 9 months) affects Novosadska variety buckwheat's chemical, nutritional, and antioxidative properties, phenolic acids and bioflavonoids profiles. Standard traditional methods were used for quality determinations, and instrumental (spectrophotometry, reverse-phase high performance liquid chromatography) for antioxidant activity and bioactive compounds determination. One-way ANOVA, and Tukey’s HSD post-hoc were performed for statistical data processing. Throughout the storage period, proximate composition and starch content significantly decreased (p&lt;0.05), while total carbohydrates, β-glucan, and energy value significantly increased (p&lt;0.05). Significant decrease in pH and alcoholic acidity of 0.55 pH units, and 0.33% DM, were observed. Total phenol content and antioxidant activity decrease to 5.57 mg GAE/g DM TPC, 22.20 μmol Fe2+/g DM FRAP and 8.12 μmol TE/g DM DPPH, during the storage (p&lt;0.05). Of fifteen phytochemical compounds, gallic, p-coumaric, trans-cinnamic acids, and epicatechin were in high abundance, with a notable decrease in epicatechin (38%). To the authors' knowledge, dihydrocaffeic and phloretic acids, daidzein, naringin, and naringenin were quantified in buckwheat flour for the first time. Easy adaptability to the environment, ability to attract various insects, speedy short-season growing plant for food, many nutritional and health benefits, gives buckwheat potential to be sustainable and biodiversity-friendly crops.

Background/Objectives: This study looks at how a kinematic chain exercise regimen that targets the lower, core, and upper body affects university shot put participants' shoulder muscle strength and throwing efficiency. This study fills an apparent research void on shot put training approaches by presenting a comprehensive kinematic chain workout program. It was anticipated that this method would improve performance the most, considering the complex biomechanical require-ments of the sport. Methodology: Athletes, seventy in age (19.87 ± 1.31 years), were assigned into two groups at random: experimental (n = 35) and control (n = 35). While the control group carried on with their usual training, the experimental group participated in an 8-week kinematic chain training program, pre- and post-training evaluations were carried out to evaluate shot put throwing ability, shoulder muscle strength, and participant satisfaction with the exercise regimen. Results: demonstrated that, when compared to the control group, the athletes in the kinematic chain program had a significantly improved throwing distance (p = 0.01) and shoulder muscle strength (p = 0.01). Furthermore, there was a significant difference (p = 0.005) in the athletes' satisfaction levels with the workout program among those in the experimental group. This implies that a kinematic chain-focused strategy improves performance and emphasizes the significance this type of training is for shot put athlete performance. Conclusion: As an improvement forward in sports science, the study's finding promotes the inclusion of kinematic chain workouts in shot put training programs and calls for more research on kinematic chain-based approaches in a variety of sports.

Background: The rise of new SARS-CoV-2 mutations brought challenges and progress in the global fight against COVID-19. Mutations in spike and accessory genes affect transmission, vaccine efficacy, treatments, testing, and public health strategies. Monitoring emerging variants is crucial to halt virus spread. Methods: 44 nasopharyngeal/oropharyngeal swabs from Kenyan patients were sequenced with the Illumina platform. Galaxy's bioinformatic tools were used for genomic analysis. SARS-CoV-2 genome classification was done using PANGOLIN and mutation annotation with the COVID-19 Annotator tool. Results: The study showed 5 clades to be circulating in the region. 38(86%) were BA.1.1; 2(5%) were BA.1.1.1; 1(2%) was BA.1; 1(2%) was BA.1.14 and 2(5%) were AY.46. These clades had a cumulative of 173 mutations among them with 50 novel mutations. Forty-eight of these novel mutations occurred in a low frequency of 2.3% of the sequences tested while the other two, S:R214R, and NSP2:A555A, were for 43.2% and 18.2% of the cases respectively. Conclusions: The high-frequency novel mutations were synonymous mutations, a phenomenon that was previously viewed as phenotypically silent but recent studies indicate they can affect viral fitness with potential functional associations. These findings add to the understanding of the SARS-CoV-2 virus future evolutionary and immunological dynamics in the region

Tumor entities of the Central Nervous System (CNS) are defined by the WHO classification and range from benign neoplasms to highly malignant tumors, making histopathological classification challenging. This diverse spectrum complicates clinical decision-making and the interpretation and validation of clinical trial results. The methodology based on DNA methylation profiling of CNS tumors offers greater diagnostic precision compared to traditional morphological methods. In this study, we analyzed 16 DNA samples from medulloblastomas and ependymomas, obtained from paraffin-embedded blocks from the Pathology Division archives of HCFMUSP, and with prior histological analysis. The samples were processed using the Infinium MethylationEPIC BeadChip (Illumina®) and methylation data analysis tools in R Studio. The data were submitted to the MolecularNeuropathology.org platform for methylation based classification and CNV chart generation. The classifier was consistent with the previous diagnosis in all cases, refining the diagnosis in 54% of cases to subclass, 38% to subtype, and 8% to family. The platform also provided CNV estimates for 87% of cases, revealing crucial information on genetic alterations such as gains, losses, amplifications, and gene fusions. Despite the challenges of implementation within the Brazilian Public Health System (SUS), the results demonstrate the method's robustness and reproducibility, promising invaluable support for precise diagnoses and the development of more effective therapeutic strategies.

Natural language processing model (NLP) are used in chatbots to understand user input, interpret its meaning, and generate conversational responses to provide immediate and consistent assistance. This reduces problem-solving time and staff workload and increases user satisfaction. There are both rule-based chatbots, which use decision trees and are programmed to answer specific questions, and self-learning chatbots, which can handle more complex conversations through continuous learning about data and user interactions. However, only a few chatbots have been developed specifically for the Italian language. This work proposes an NLP model to develop a powerful and efficient Italian QA (Question Answering) chatbot that is easy to use for Italian Public Administration (PA). The proposed model is based on BERT (Bidirectional Encoder Representations from Transformer) architecture, where an Encoder/Decoder module and a Highway Network module have been added to perform more efficient filtering of input text. The Italian version of the Stanford Question Answering Dataset (SQuAD-IT) is used to test the proposed model. The proposed model is one of the first models developed for Italian language-specific chatbots.

The production of public goods is a necessary condition for the survival of the species but it comes at the expense of individual growth. In a prototype bacterial colony, we model the role of quorum sensing as a resource redistribution mechanism. Two types of bacterial colonies are analyzed, one made up of a single strain and one made up of two different strains. Based on a recent series of experimental data present in the literature, we analyze two types of strains with different extinction times: strains that consume available resources very quickly, therefore becoming extinct quickly, and strains that consume resources slowly and die due to aging. We show that the proposed quorum sensing model describes the main experimental result, namely that coexistence favors the survival of both strains. Furthermore, the production of public goods is maximized when both types of individuals have the maximum proliferation output. Finally, we highlight the role played by so-called dormant cells in the duration of survival time. These cells are of particular interest, because their ability to counteract different types of stress (e.g. the use of antibiotics) still constitutes a challenge.

The main objective of this research was to analyze the relationship between socioeconomic and demographic indicators and the level of transparency of municipalities in the state of Maranhão. The transparency index was constructed based on the LRF and LAI and consisted of 32 items. Subsequently , for To identify which factors explain the level of transparency, a multiple linear regression was carried out, comparing the explanatory variables for the level of transparency adopted in this study. The sample consisted of municipalities in the State of Maranhão, totaling 211 municipalities, as 7 did not have a website. The results of the multiple linear regression model indicate that the IDHM, the log of total GDP, the GDP per capita and the variable log of POP explain the NT of the municipalities surveyed to the point of explain the level of transparency of the municipalities of Maranhão, only the IFDM did not show a relationship with the NT among the variables analyzed.

Despite air pollution being a leading cause of health issues in developing nations, public awareness and understanding of local air quality remains notably low. The present study assesses the perception, attitude, and environmental knowledge of local air pollution among adult urban residents (n=870) in a city with leading air pollution rates among cities of emerging economies: Astana, Kazakhstan. Structural equation modeling (SEM) was employed to investigate the causal relationship between perceived air quality, environmental literacy, and willingness to pay (WTP) for environmental protection. Findings indicate over 40% of residents neither consider the city being highly polluted nor recognize the association between air quality and adverse health outcomes, correlated with a generally low level of environmental literacy. The age, education, and health status of the participants significantly affected (p&lt;.001) their level of environmental knowledge and awareness. The SEM analysis indicates that knowledge is the major determinant in improving public awareness and perception of local air pollution (path value=0.626). Moreover, a close association between WTP and environmental attitude was also evident (path value=0.533). The findings of the present study may provide valuable insights for healthcare professionals, environmental researchers, and governmental institutions for implementing more effective public interventions to protect local air quality.