The analysis of the 2002 Prestige tanker accident showed how public misinformation can worsen marine pollution incidents, rendering their management suboptimal as these evolve, raising thus the issue of appropriately informing and educating coastal and island populations at risk. Two decades later, developments in electronic platforms, Geographic Information Systems (GIS), in Automatic Identification System (AIS) for ship signal transmission, and in social media, provide a set of means for public monitoring of such incidents, creating the possibility to antagonize effec-tively erroneous, or malevolent information which can hinder efficient actions for containing ma-rine pollution risks even without active training of populations concerned. The authors, in the framework of development of the Marine Coastal Observatory and Risk Management project “AEGIS+”, have developed E-S.A.V.E., an online platform which: a) meets the needs of different users as revealed by a survey run across groups of them, b) uses a suitable Geographic Infor-mation Systems (GIS) environment, c) cooperates with public authorities, for the reliable update of automated systems, and d) employs an artificial intelligence (AI) supported tool for social me-dia monitoring; the platform also provides educational and information national and interna-tional resources on marine environmental protection and sustainable maritime logistics.

The patient's satisfaction level concerning hospitalization has certain particularities, related to the geographical area, medical/non-medical assistance, the age, incomes, morbidity and mortality of the population. The objective of this study is to emphasize the degree of patients' satisfaction, depending on the specialty of the hospitalization department: surgical, medical, oncological, psychiatry, and to evidence the factors influencing the reliability and accuracy of patients' answers, such as: the patient's health condition upon admission, the duration of the admission, the level of physical pain and the emotional state. Patients and methods: The research was conducted between April and December 2021 on patients hospitalized in two public hospitals from the north-west of Romania, both of them being independent Legal Entities: the Municipal Clinical Hospital of Oradea (MCHO) and the County Clinical Emergency Hospital of Oradea (CCEHO). Results: The lowest score of PSS recorded in these two analyzed public hospitals from the north-western of Romania was appointed for the Pharmaceutical availability of patients medical treatment (2.24), attitude of the staff (2.56) and the quality of nursing care offered (2.58). Conclusions: The hospital management’s focus has been set to improve the communication skills among medical staff, to evidence their compassion, politeness, and to ensure the availability of essential drugs.

The paper presents a theoretical and empirical assessment of this social phenomenon. The achieved scientific solution-result (Main Finding) is presented a theoretical model of the develop-ment of public citizenship in a sustainable environment has been created for the case of Lithuania. First of all, the paper discusses the conceptual issues of the expression of modernisation of civil society, highlighting and justifying the interaction of social changes and sustainable environment in economic, social, political, environmental and cultural aspects, presenting the case of Lithuania (The Case of Lithuania). On the other hand, following the United Nations Sustainable Development Strategy document, the field of progress and resilience of Lithuanian society in modern society is discussed, identifying and analysing various criteria that have been empirically tested. The authors noted that the democratic cube model was used to create a theoretical model of the development of public citizenship in a harmonious environment, and the HDI (human development index model) was also integrated. The model created by the authors systematically explains the analysis of the relationship between the expression of modernisation changes identified in the research and the formation of civil society; secondly, it substantiates the process of interaction between modernisation changes and public citizenship, discussing four fields of expression. Practical applicability of the model: it will help researchers to conceptually analyse and empirically study public citizenship; will help public policymakers and implementers to manage effectively, ensuring quality changes in society and managing new challenges, and it will also contribute to the conceptual formation of the country's long-term development strategy.

The social vulnerability approach (SV) has set up that social inequalities and disadvantages have gone beyond monetary poverty in the last years, since the process is built at different scales. In its objectives, the SV multidimensional measurement is contemplated as a priority tool to monitor the compliance of the first goal – eliminate poverty in all its forms. Therefore, the objective of this research is to calculate the SV of the fishing communities of the Gulf of Ulloa (GU), Mexico by macro-markers to subsequently contrast them with field micro-data, and finally perform a behavior scenario, considering the current public policies restrictive to fishing in such areas. The results showed significant differences depending on the type of information used, obtaining a contingency coefficient of 83.42%, which indicates that the calculus depends strongly on the data used and suggesting that macro-data may be masking the true SV values in the area, in such a way they could be severely underestimated. Even though the context at micro-scale is not the only one, SV should be calculated to analyze the fishing communities since coastal fishery represents almost the total livelihood of the inhabitants. Nevertheless, these communities confront numerous local and global threats, and these pressures on SV put their livelihoods, well-being, food security and traditional lifestyle at risk. Therefore, the role of researching human dimensions and governance is not only basic but also urgent to turn to sustainable socioeconomic management.

Objective: Food security during public health emergencies relies on situational awareness of needs and resources. Artificial intelligence (AI) has revolutionized situational awareness during crises, allowing the allocation of resources to needs through machine learning algorithms. Limited research exists monitoring Twitter for changes in the food security-related public discourse during the COVID-19 pandemic. We aim to address that gap with AI by classifying food security topics on Twitter and showing topic frequency per day. Methods: Tweets were scraped from Twitter from January 2020 through December 2021 using food security keywords. Latent Dirichlet Allocation (LDA) topic modeling was performed, followed by time-series analyses on topic frequency per day.Results: 237,107 tweets were scraped and classified into topics, including food needs and resources, emergency preparedness and response, and mental/physical health. After the WHO’s pandemic declaration, there were relative increases in topic density per day regarding food pantries, food banks, economic and food security crises, essential services, and emergency preparedness advice. Threats to food security in Tigray emerged in 2021.Conclusions: AI is a powerful yet underused tool to monitor food insecurity on social media. Machine learning tools to improve emergency response should be prioritized, along with measurement of impact. Further food insecurity word patterns testing, as generated by this research, with supervised machine learning models can accelerate the uptake of these tools by policymakers and aid organizations.

In open, sustainable policymaking, we are expecting to develop the valuable results that will bring us closer to a fairer and more balanced society. One way to involve the public in these processes is to engage them in online e-participation projects. Despite the hopes, empirical analyses show that many e-participation initiatives have failed to deliver expected benefits. Revealing what actually works in examined projects and what requires improvement would allow for better policy planning in the future. In this article, I made an attempt to identify and assess the cognitive processes enabling emergence of collective intelligence (CI) in a singular e-participation project. For this reason, I worked out and tested an evaluation technique, combining the MILCS framework for group cognition and the results of empirical research on CI. A case study method based on semi-structured interviews was selected to evaluate a sample participatory budgeting initiative, Civic Budget of the City of Kraków. Results reveal that most cognitive processes are working satisfactorily, but the real problem is using collective memory, which works only to a very limited extent. A guideline for future policymakers should be to develop a shared memory system, to which all community members should have access.

Starting from the importance of risk perception for taking certain preventive measures to protect people and their property from disasters, the subject of the research is to examine the factors influencing public perception of mythically-based human behavior in disaster conditions. Using the random sampling method, 250 adult respondents were surveyed in the city of Belgrade, using a specially created and adapted survey questionnaire. The results of the research show that there is no statistically significant influence of gender, age, educational and economic factors on the public perception of human behavior in disaster conditions. The results of the research can be used to improve strategies and campaigns based on risk assessment, aimed at improving the safety of people in disasters.

Citizen Science has come up to perform analytics over the SARS-CoV-2 genome. Public GALAXY servers provide an automated platform for genomics analysis. Study includes design of GALAXY workflows for RNASEQ assembly and annotation as well as genomic variant discovery and perform analysis across four samples of SARS-CoV-2 infected humans obtained from the local population of Wuhan, China. It provides information about transcriptomics and genomic variants across the SARS-CoV-2 genome. Study can be extended to perform evolutionary and comparative study across each species of coronaviruses. Augmented and integrated study with cheminformatics and immunoinformatics will be a way forward for drug discovery and vaccine development.

After the appearance of first cases of ‘pneumonia of unknown origin’ in the Wuhan city, China, during late 2019, the disease progressed fast. Its cause was identified as a novel coronavirus, named provisionally 2019-nCoV. Subsequently, an official name was given as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) by the International Committee on Taxonomy of Viruses (ICTV) study group. The World Health Organization (WHO) named the Coronavirus disease-2019 as COVID-19. The epidemics of COVID-2019 have been recorded over 113 countries/territories/areas apart from China and filched more than 4292 humans, affecting severely around 1,18,326 cases in a short span. The status of COVID-2019 emergency revised by the WHO within 42 days from Public Health International Emergency (January 30, 2020) to a pandemic (March 11, 2020). Nonetheless, the case fatality rate (CFR) of the current epidemic is on the rise (between 2-4%), relatively is lower than the previous SARS-CoV (2002/2003) and MERS-CoV (2012) outbreaks. Even though investigations are on its way, the researchers across the globe have assumptions of animal-origin of current SARS-CoV-2. A recent case report provides evidence of mild COVID-2019 infection in a pet dog that acquired COVID-2019 infection from his owner in Hong Kong. The news on travellers associated spread across the globe have also put many countries on alert with the cancellation of tourist visa to all affected countries and postponement of events where international visits were required. A few diagnostic approaches, including quantitative and differential real-time polymerase chain reaction assays, have been recommended for the screening of the individuals at risk. In the absence of any selective vaccine against SARS-CoV-2, re-purposed drugs are advocated in many studies. This article discourse the current worldwide situation of COVID-2019 with information on virus, epidemiology, host, the role of animals, effective diagnosis, therapeutics, preventive and control approaches making people aware on the disease outcomes.

Background: Chronic lower limb ulcers (CLLU) have an important burden to the individual and the healthcare system. However, there is a lack of information about the cost of CLLU in Argentina.Objective: To determinate the number and cost of consultation and hospitalization associated to CLLU in a public hospital in Argentina. Methods: Retrospective observational study. Cost estimation were calculated based on days of stay, treatments and laboratory tests in a inpatient population and the number of consultations, treatments and laboratory tests, in a outpatient population. Results: In 2013 and 2014, the overall number of consultation with ICD-10 codes was 7,224 and the number of inpatient was 359. The mean age for male and female outpatient consultations was 59.53(±13.06) years and 59.04(±10.93), respectively. For CLLU male and female inpatient, the mean age was 63.9(±10.4) years and 54.5(±8.6) years, respectively. The length of stay was 22.88 days. There was a mean of 0.41 surgeries per patient where 25% were amputations. The mean annual cost in a single public hospital was US$4,053.65 per inpatient and US$3,589.24 per outpatient. Conclusion: Cost information allows new public health policies to reduce socioeconomic burden due to CLLU.

Since autism was first recognised, prevalence has increased rapidly. The growing economic as well as social cost to society can only be mitigated by effective interventions and supports. It is therefore not surprising that most governments have developed public policy documents to address the management of autism. Over the past 40-50 years, meaningful evidence has accrued showing that interventions based on the scientific discipline of Applied Behaviour Analysis (ABA) can help people with autism reach their potential. In view of this, nearly all of North America has laws to mandate that ABA-based interventions are available through the health care systems. In contrast, across Europe there are no such laws. In fact, the National Institute for Health and Care Excellence (NICE), the body guiding health and social policy in the UK, concluded that it could not find any evidence to support ABA, and therefore could not recommend it. This paper addresses the reasons for these diametrically opposed perspectives. In particular, it examines what happens when health and social care policy is misinformed about effective autism intervention.

Aim: Child-to-parent offenders (CPOs) are commonly specialist offenders and with high rates of recidivism. Thus, a field study was designed to estimate the prevalence in the reference measures of recidivism i.e., dangerousness, risk factors and psychopathy, and compare CPOs with non-child-to-parent juvenile offenders. Method: 136 juvenile offenders (76.5% boys), 76 CPOs and 60 non-CPOs juvenile offenders, aged from 14 to 18 years old, were measured in dangerousness, risk of factors and psychopathic traits. Results: The results showed in CPOs a more than common prevalence (> .50), 75.0%, 95% CI [.653, .847], of dangerousness (caseness); a significant prevalence (> .05) of diagnostic of psychopathy, 25.0%, 95% CI [.150, .350]; and a common prevalence (= .50), 55.3%, 95% CI [.441, .665] of classification as high and very high risk by risk factors. Comparatively, no significant differences were observed between CPOs and non-CPOS juvenile offenders in mental health problems (dangerousness), meanwhile that CPOs exhibited significant more interpersonal and affective psychopathic traits and significant more risk in family circumstances, and personality and behaviour risk factors. Conclusions: The implications for prevention and intervention programs with CPOs are discussed

Adequate public spaces and urban green areas are key criteria for urban development and infrastructure implementation of healthy cities. Latterly, there has been an increasing number of research methods using artificial intelligence (AI) to monitor, quantify, and control the state of these spaces with an aim towards pioneering research in Urban Studies. However, in informal areas, open-data access tends to lack adequate and updated information, making it difficult to use AI methods. Hence, we propose a methodology for restricted open data collection and preparation for future use in machine learning or spatial data science models for similar areas. To that extent, we examine two peripheral and low-income neighborhoods in Quito, Ecuador, La Bota and Toctiuco, to analyze their public spaces, urban green areas, points of interest, and road networks, and how they address healthy cities criteria. We develop an original methodological approach that combines an index of proximity, accessibility, quantity, and quality of these spaces with geospatial and network analysis techniques. Results indicate that the connectivity and structure of these spaces are centralized and nodal, representing exclusion and segregation. This work provides insights on potential healthy spaces, and information to urban planners and policymakers in decision-making for healthy urban infrastructure.

Managing epidemics need to unite each individual of the nations. Lockdown is an essential strategy to fatal and threatening epidemic. All of the citizens should realize that each of people has a responsibility to support the public health crisis. How to organize individual to fight against the epidemic plaque depends each of them. This essay discussed the COVID-19 pandemic relevant self-governance of community from a historical perspective in China. Self-governance of neighborhood committee and community residential office in urban and rural helped to control the COVID-19 pandemic in the communities in China. Co-operation and collective responsibility of citizens and community support is a critical condition to prevent epidemic. The community self-governance can track back Qin Dynasty in China history. It established baojia system to maintain social control for thousand years. Now, the community-based system, baojia system is becoming more autonomous for local citizenship and socialized governance in China. We reviewed a historical pneumonia plaque in North China in 1911. Chinese doctor, Wu Lien-teh (伍連德) confronted the epidemic crisis with many measures such as lockdown, quarantine, the wearing of mask, setup mobile hospitals, travel restriction, the cremation of victims, and border control. Dr. Wu made effort to establish the modern public health service in China. We think that the combination of culture background of China community with modern public healthcare system determinedly played important role to control the COVID-19 pandemic.

Introduction: Patients’ satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients’ feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients’ satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients’ perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares—path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients’ experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients’ satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients’ satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.

Introduction: Parameters used for neonatal mortality calculation vary among publications. Mortality in < 33 weeks gestational age at birth display global variations across different healthcare units. Objective: This study aims to explore trends in neonatal mortality among infants born preterm in the different units in Latin America and the Caribbean utilizing the EpicLatino Network Database in comparison to Canadian Neonatal Network (CNN) 2022. Materials and Methods: This study focused on an eight-year period, with a particular attention to mortality rates during the pre-pandemic (2015-2019) and pandemic/post pandemic (2020-2022) periods. Survival rates from CNN 2022 were included in the comparison analysis. Logistic regression analysis was confined to the 2020-2022 period. Adjustments were made for factors including gestational age, small for gestational age (SGA), Snape II score, inborn/outborn status, and center. As major malformations could account for mortality differences among units. The incidence of major congenital malformations, as defined by CNN, was compared among deceased patients. Results: A total of 15,454 records from 2015-2019 and 10,711 records from 2020-2022 were scrutinized. Overall, there were no significant differences in mortality rates between the two time periods (p=0.22). Moreover, the originating unit during the 2020-2022 period significantly influenced all statistical computations. Conclusions: Survival rates among infants < 26 weeks of gestation in Latin America and the Caribbean are on an upward trajectory, with the healthcare unit playing a pivotal role in this outcome within the EpicLatino database. Major malformations do not seem to be a significant contributing factor. These findings underscore the imperative of implementing quality improvement initiatives to elevate neonatal care standards in Latin America and the Caribbean.

Harnessing the Remarkable Bio-Remediation Potential of Vernonia spp. for the Sustainable Restoration of Hydrocarbon-Polluted Clay Soil in Ogoni Land, Nigeria This study explores the potential of utilizing Vernonia spp. for eco-friendly bio-remediation of hydrocarbon-polluted clay soil in Ogoni Land, Nigeria. The aim is to find a sustainable and effective solution that promotes the restoration of the polluted soil while minimizing the use of external additives. The process of bio-remediation can occur naturally, through natural attenuation or intrinsic bio-remediation. However, it has been observed that in certain cases, the addition of fertilizers, oxygen, or organic matter is required to enhance the effectiveness of bio-remediation. In this research, we focus on the bio-remediation potential of Vernonia spp., a native plant species known for its strong phytoremediation abilities. By harnessing the remarkable bio-remediation properties of Vernonia spp., we seek to restore the hydrocarbon-polluted clay soil in Ogoni Land in an environmentally friendly and sustainable manner. Our methodology involves conducting greenhouse experiments to assess the bio-remediation efficiency of Vernonia spp. in different soil conditions. We will analyze the soil's physical and chemical properties, as well as the degradation of hydrocarbons over time. The experimental results will provide valuable insights into the effectiveness of Vernonia spp. in removing hydrocarbon pollutants from clay soil. Through this study, we aim to develop a cost-effective and sustainable approach to restore hydrocarbon-polluted clay soil in Ogoni Land. By leveraging the natural bio-remediation potential of Vernonia spp., we can potentially reduce the reliance on external additives, thus minimizing the environmental impact associated with traditional remediation methods. The research article explores methods to promote the growth of pollution-eating microbes in order to enhance bio-remediation. Bio-remediation refers to the use of naturally occurring organisms to break down harmful substances into less toxic or non-toxic forms. In situ bio-remediation involves treating the contaminated material directly at the site, while ex-situ bio-remediation involves removing the contaminated material for treatment elsewhere. This study specifically investigates ex-situ bio-remediation techniques for hydrocarbon-contaminated clay soil. The researchers found that the application of room dry and wet blended bitter leaf showed promising results in the bio-remediation of hydrocarbons in the clay soil. Using Vernonia galamensis, a concentration as high as 0.55 ug/ml was achieved, while Vernonia amygdalina yielded a concentration as high as 0.67 ug/ml when applied at 35g and 40g respectively, based on the wet blended approach. These findings highlight the effectiveness of wet blended Vernonia species in the bio-remediation process.During the remediation process of the clay soil, the pH levels showed a trend of increasing from acidic to normal to alkaline. This can be attributed to the remediation of excessive metals present in the soil. After 40 days, the pH of the clay soil reached 6.97 when treated with 40 grams of Vernonia galamensis, and 7.00 when treated with 40 grams of Vernonia amygdalina. Interestingly, while the remediation efficiency of HC (hydrocarbon) decreased with increasing mass of Vernonia galamensis, the remediation efficiency of HC increased when using Vernonia amygdalina. These observations highlight the varying effects of different Vernonia species on hydrocarbon remediation.The highest remediation values were observed when using Vernonia galamensis at 35g and Vernonia amygdalina at 40g. These particular amounts of these Vernonia species demonstrated effective remediation of the targeted pollutants. However, in comparison to other metals, the remediation effects were relatively lower for zinc (Zn), with only approximately 0.25 ug/ml being remediated. This suggests that the remediation potential of the Vernonia species may vary depending on the specific contaminant.The higher remediation effects observed for Zn metal in the soil can be attributed to the wet blended preparation method of the Vernonia species. In contrast, the room dried Vernonia species exhibited the lowest performance in remediating the soil, with approximately 0.17 ug/ml and 0.10 ug/ml remediation for galamensis and amygdalina, respectively. Both Vernonia leaf extracts achieved a remediation of 0.5 ug/ml for chromium. The sun dried and room dried methods also showed considerable remediation potential, with values above 0.4 ug/ml. The level of significance for the model was attained at 0.05, and the r2 value was appreciable. These findings indicate the effectiveness of different preparation methods and Vernonia species in soil remediation

This paper proposes a concise literature review aimed at identifying the current body of knowledge on the adoption of Social Networks in Crisis Management. The major input is a structured research question based on the initial reading around the topic. Before the recent pan-demic, most literature has focused on local crises, with a relatively low number of exceptions. Additionally, self-organizing system are spontaneous established between people who are af-fected by a crisis. Among the identified challenges, there is the need to integrate official commu-nication by emergency agencies with citizen-generated contents in a contest of credibility and trustworthiness. In certain cases, it has been reported a lack of specific competence, knowledge, and expertise, as well as a lack of sufficient policies and guidelines in the use of Social Networks. Those challenges need to be framed by considering the classic difficulties to provide timely and accurate information, to deal with fake news, unverified or misleading information, and infor-mation overload. Bridging major gaps though advanced analytics and AI-based technology is expected to provide a key contribution to establish and safely enable in practice an effective and efficient communication, to contrast dissonant mental models, which are often fostered by Social Networks, and to enable a shared situational awareness.

Background: Although lower extremity revascularization is commonly performed in hemodialysis patients, poor prognosis remains a major problem. Protein-energy wasting is reportedly associated with chronic inflammation and advanced atherosclerosis in hemodialysis patients. We investigated the association between the geriatric nutritional risk index (GNRI) as a surrogate marker of protein-energy wasting, C-reactive protein (CRP), and their joint roles in the prediction of amputation and/or mortality. Methods: We enrolled 800 patients successfully underwent lower extremity revascularization. Patients were divided into low, middle and high tertile (T1, T2 and T3) according to GNRI and CRP levels, respectively. Results: Amputation-free survival rates for 8 years were 47.0%, 56.9%, and 69.5% in T1, T2, and T3 of the GNRI, and 65.8%, 58.7%, and 33.2% for T1, T2, and T3 of CRP, respectively (p<0.0001 for both). Declined GNRI [adjusted hazard ratio (aHR) 1.78, 95% confidence interval (CI) 1.24-2.59, p=0.0016 for T1 vs. T3] and elevated CRP (aHR 1.86, 95%CI 1.30-2.70, p=0.0007 for T3 vs. T1) were independent predictors of amputation and/or mortality. In the combined setting of both variables, the risk was 3.77-fold higher (95% CI 1.97-7.69, p<0.0001) in the T1 of GNRI with T3 of CRP than in the T3 of GNRI with T1 of CRP. Conclusions: Patients with pre-procedural decreased GNRI and elevated CRP levels frequently experienced amputation and/or mortality, and a combination of both variables could more accurately stratify the risk.

Rationale: The possible effect of Particulate Matter (PM10 and PM2.5 of diameter 10 and 2.5 µm respectively) levels on Covid-19 mortality is now well established. However, time-evolution of Covid-19 mortality according to PM2.5 levels has been scarcely investigated. Aim: To understand this relationship at the European level for the period 2020 (beginning) - 2022 (end). Methods: 16 representative locations in Europe (81 million people) with heterogeneous levels of PM2.5 (µg.m-3), from low to high. PM2.5 levels were assessed by various methods, and Covid-19 mortality was reported by Johns Hopkins University. Results: The trend of Covid-19 mortality vs. PM2.5 levels varied among locations. Overall, the estimated mean value was of a 40±20% mortality increase per 1 µg.m-3 PM2.5 increase. The stronger the positive gradient of the PM peak, the stronger the positive gradient of the Covid-19 mortality. Exposure to several PM peaks during about a 2-month period was the main contributor to Covid-19 mortality increases. Conclusion: Our data confirm a temporal relation between PM2.5 exposure and Covid-19 mortality, considering a 2-month integration-time for pollution events. Number-concentrations of PM should be used in the future rather than the PM2.5 mass-concentrations (µg.m-3) with the consideration of PM composition to better explain this finding.

Background: Heat waves are correlated with increased mortality in the aged population. Social isolation is known as a vulnerability factor. This study aims at evaluating the correlation between an intervention to reduce social isolation and the increase in mortality in the population over 80 during heat waves. Methods: The study adopts a retrospective ecologic design. We compared the excess mortality rate (EMR) in the over 80 population during heat waves in urban areas of Rome (Italy), where a program to reduce social isolation was implemented compared to others where it was not implemented. We measured mortality of the summer periods from 2015 to 2019 compared with 2014 (a year without heat waves). Winter mortality, cadastral income and proportion of over 90 were included in the multivariate Poisson regression. Results: The EMR in the intervention and controls was 2.70% and 3.81%, respectively. Rate ratio 0.70 (c.i. 0.54 - 0.92, p-value 0.01). The Incidence Rate Ratio (IRR) of the interventions with respect to the controls is 0.76 (c.i. 0.59 - 0.98). After adjusting for other variables, the IRR was 0.44 (c.i. 0.32 - 0.60). Conclusions: Reducing social isolation could limit the impact of heat waves on the mortality of the elderly population.

Family planning (FP) services are crucial interventions for improving maternal and child health outcomes and promoting gender equity. However, ensuring equitable access to these services remains a significant challenge, particularly in countries like Pakistan, where sociocultural norms, economic disparities, and geographic barriers hinder FP uptake. This study utilized spatial analysis techniques, including hotspot analysis, to investigate geographic disparities in FP uptake in Pakistan using data from Pakistan Demographic and Health Surveys (PDHS) conducted between 2006 and 2017. ArcMap 10.1 was used for spatial analysis and Stata 12.0 for statistical analysis. Results revealed significant spatial variations in FP uptake, with urban areas generally exhibiting higher uptake rates than rural regions. Hotspot analysis identified dynamic changes in contraceptive prevalence rates (CPR), with significant clustering in some regions and dispersion in others. It also identified areas with high unmet need and their low intention to use FP services and preference for family size (&gt;3 children), highlighting the need for targeted behavioral change interventions. This innovative spatial approach provides nuanced insights for policymakers and program planners to develop targeted interventions based on localized data to improve FP service delivery, mitigate disparities, and ultimately advance efforts to improve maternal and child health outcomes. The application of geospatial analysis is an effective tool for enhancing program planning, evaluation, and resource allocation in diverse geographical contexts.

The dawn of Artificial Intelligence (AI) in healthcare stands as a milestone in medical innovation. A plethora of different medical fields are heavily involved and pediatric emergency medicine is no exception. These new tools do not merely provide more advanced and efficient systems for patients’ diagnosis, management and treatment. They rather concern a strict shift from traditional methods based upon broad categories towards a more personalized healthcare. AI offers many promises in pediatric emergency medicine with a wide range of applications involving clinical decision making, patients’ flows management and prioritization. Main barriers to a widespread diffusion involve technological challenges but also ethical issues and the paucity of extensive datasets in pediatric contexts. We conducted a narrative review structured in two parts. The first part explores the theoretical principles of AI, providing all the necessary background to feel confident with these new state-of-the-art tools. The second part presents an informative analysis of AI models in pediatric emergencies, pointing out the actual applications and challenges until future feasible research perspectives.

Chikungunya virus (CHIKV), a single-stranded RNA virus transmitted by Aedes mosquitoes, poses a significant global health threat, with severe complications observed in vulnerable populations. The only licensed vaccine, IXCHIQ, approved by the USFDA, is insufficient to address the growing disease burden, particularly in endemic regions lacking herd immunity. Monoclonal antibodies (mAbs), explicitly targeting structural proteins E1/E2, demonstrate promise in passive transfer studies, with mouse and human-derived mAbs showing protective efficacy. The article explores various vaccine candidates, including live attenuated, killed, nucleic-acid-based (DNA/RNA), virus-like particle, chimeric, subunit, and adenovirus vectored vaccines. RNA vaccines emerge as promising candidates due to their rapid response capabilities and enhanced safety profile. The review underscores the importance of E1 and E2 proteins as immunogens, emphasising their antigenic potential. Several vaccine candidates, such as CHIKV/IRES, measles vector (MV-CHIK), synthetic DNA-encoded antibodies, and mRNA-lipid nanoparticle vaccines, demonstrate encouraging preclinical and clinical study results. In addition to identifying potential molecular targets for antiviral therapy, the study looks into the roles played by Toll-like receptors, RIG-I, and NOD-like receptors in the immune response to CHIKV. It also offers insights into novel tactics and promising vaccine candidates.

This article aimed to evaluate, using statistical tools, the generation and composition of urban solid waste (MSW) in the city of Belém, Pará, from nine urban collection sectors in the municipality, and the average nominal income of the population. Approximately 900kg of urban solid waste were col-lected from the municipality in the period from 2021 to 2022. Statistical tests were carried out on hypotheses with 5% significance in comparative evaluations, and their respective average nominal incomes. The results indicated that the organic fraction corresponds to 55.57% of the waste generated in the municipality, 14.26% is inert waste (potentially contaminating) and 0.67% is miscellaneous waste. It was observed that the waste generated by families with high purchasing power tends to contain higher percentages of recyclables, while in families with lower purchasing power the highest percentages tend to be organic. Knowledge of the generation of MSW is fundamental for the choice and dimensioning of operations and processes involved in the management chain at the municipal level. The decentralization of services offered based on solid waste management would enable greater success in serving the population.

There is a considerable increase in the use of substances and medical procedures aimed at changing the esthetics of the face, particularly the appearance of the lips. Permanent fillers such as polydimethylsiloxane, also called liquid silicone, are widely used, but their application for facial esthetics is currently obsolete. However, the long-term complications remain a reality, as they can occur decades after the application. Thus, the goal of this case report was to present a complication after 16 years of treatment using liquid silicone. This case report involved a 52-year-old male with a complication of bilateral permanent filler in the upper lip performed 16 years ago, its surgical removal, and histological analysis. Histologically, it was possible to identify a chronic inflammatory, lymphoplasmacytic, and granulomatous reaction, with foreign body giant cells’ reaction, in relation to non-polarizable exogenous material due to the reaction to silicone. The most common complications are granulomas' appearance and material displacement. The case report shows these granulomas are characterized as chronic low-caliber inflammation around the silicone. They have an unknown etiology but are probably multifactorial, from continuous trauma, friction or irritation, iatrogenic factors, infection, immunological mechanisms, and genetic and molecular variations, and can be highly related to the impurity of the injected material.

In 2019, the Global Burden of Disease (GBD) estimated that prostate cancer (PC) was the 16th cause of death globally in males. In Mexico, PC epidemiology has been reported for a selected number of metrics and years, although without including the most up-to-date estimates. Herein, we describe and compare the burden and trends of PC in Mexico and its 32 states from 2000 to 2019. For this, we extracted online available data from the GBD 2019 to estimate the crude and age-standardized rate (ASR per 100,000 people) of incidence, mortality, and disability-adjusted life years (DALYs). In Mexico, PC caused 27.1 thousand (95% uncertainty intervals, 20.6-36.0 thousand) incident cases, 9.2 thousand (7.7-12.7 thousand) deaths, and 161.5 thousand (122.7-219.5 thousand) DALYs in males of all ages in 2019. Among states, Sinaloa had the greatest ASR of incidence and Guerrero the highest values of deaths and DALYs. The burden of PC showed an increasing trend, although the magnitude of change differed between metrics and locations. We found both an increasing national trend and subnational variation in the burden of PC. Our results confirm the need for updated and timely estimates to design effective diagnostic and treatment campaigns in locations where the burden of PC is the highest.

Health services play an important role in people's lives and are the basic right of every individual. Equal and quality access to health services is crucial for people's welfare. This study aims to analyze the effectiveness of public service innovation in achieving 100% UHC in Semarang City, with a focus on PANGERAN DIPONEGORO’s inspirational contribution, in order to provide insight regarding the implementation of the health insurance program and its impact on UHC. The method used in this research is qualitative using the Double Diamond approach with primary data collection through documentation and innovation supporting literature studies and secondary data collection through literature studies and Focus Group Discussions. The results of the study show that the "PANGERAN DIPONEGORO" innovation succeeded in having a significant positive impact in achieving Universal Health Coverage (UHC) in Semarang City. There has been an increase in community participation, accessibility and quality of health services, as well as a competitive advantage that is rarely possessed by other agencies. There have been many studies using public service objects. However, little has been discussed about the contribution and innovation of public services, especially those that focus on the health sector.

Objective. To examine the relationship between experience and knowledge acquired in research methodology (RM) courses and attitudes toward research in a sample of undergraduate psychology students from a public university in Mexico City. Methods. A cross-sectional study was carried out with 261 students. A 10-unit analog scale to assess perceived experience in RM courses and two measures of attitudes toward research were used. Between the two attitude scales, four attitude dimensions were identified: positive appraisal, negative appraisal, meaningless and boring. Four multivariate models were estimated, one for each attitude dimension. Results. A positive correlation was found between learning experiences in RM courses and positive appraisal of research (p < 0.01). Negative associations were also found between RM course experience and two of the three negative research attitudes (p < 0.01). Conclusion. Results highlight the significance of teaching in the knowledge and attitude development of students' research competencies. An approach to teaching RM at the undergraduate level that places more emphasis on encouraging evidence-based practice than on developing and carrying out research projects seems to be a promising subject for study, with implications for changing teaching methods and contents.

Negative mental health in students currently is classified as a global crisis with the highest and lowest student achievers recognized at greatest risk. Public schooling, in reproducing accepted psychosocial beliefs through standardized learning, developed separately from necessitating student mental health, in contrast to self-directed learning. Differing from standardized learning, the objective of self-directed learning in public schools is the creation of relevant support structures for student mental health, promoting positive psychosocial outcomes. The designed separation of public schooling from both mental health and self-directed learning was first acknowledged—and lamented—by John Dewey, over 100 years ago, in anticipating today’s mental health crisis. Yet, in responding effectively to the limitations of COVID-19, self-directed learning became an acknowledged learning method in public schools, potentially able to be accommodated by them regularly in support of mental health through the use of online technology. This study investigates the COVID-19 results of self-directed online learning in public schools through a Google Scholar search of peer reviewed research regarding self-directed learning, online learning, and mental health during COVID-19, recommending support for self-initiated self-directed online learning so that self-directed learning can continue, post COVID-19, improving student mental health in public schools, leading to positive psychosocial outcomes.

In Italy, the number of buildings that have fallen into disuse is huge; also the normative and regulative framework promoting public portfolio’s re-use and revitalisation is still unclear and blurred. Nevertheless, in the last ten years, these buildings have become fertile ground for innovation and creative experiences by civic actors. The rise of this new category of civic actors plays an important role, both from the institutional side and the kind of initiatives and practices they process. They act in different manners but according to an in-depth analysis they share similar patterns of behaviour. What has emerged is that, although the different contexts, where they operate, the institutional performances might be successful if only certain kinds of conditions are taken into consideration. Based on some basic features, civic actors and their dynamics with public administrations are analysed to understand conditions that allow revitalisation processes to be successful in unused public buildings.

Purpose: This research aims to model a police agency ordering problem based on criteria that measure the performance of operational and logistical variables, using a multicriteria method. Design/methodology/approach: The multicriteria method PROMETHEE II was used, which with the aid of the Visual PROMETHEE software, emulated the systematized data in the impact matrix and produced the final ordering of the most efficient police agencies in equalizing the operational, logistical, financial, and human resources applied in the combating crime and reducing criminal indices. Findings: The results confirmed that the resources made available to police agencies located in different municipalities in the metropolitan region of the state of Rio de Janeiro are better applied by managers compared to police units in the capital of Rio de Janeiro. Research limitations/implications: As implications of the research, it can be inferred that the use of multicriteria methods in modelling problems in ​​public security can contribute to the rationalization of the use of available resources to fight crime in large cities. Research has shown that it is possible to use the multicriteria methodology in ordering police agencies that best equalize the available resources. Practical implications: The practical impact of this research lies in optimizing the resources available to law enforcement agencies in the fight against crime in general. Social implications: The results can influence the decision making of the local government in the allocation of resources, as well as offering sectors of the economy information relevant to local development. Originality/value: The results of the MCDA analysis can be used to help police agencies in Rio de Janeiro, Brazil to be more efficient. In addition, the application of MCDA can be a new approach to measuring the efficiency of police services.

Background: Epidemiological surveillance of nursing diagnosis is an approach anchored on a post-modern epidemiology focused on persons health-disease responses. Regarding to public health priorities, the population where our study occurred had as priority problem the arterial hypertension. Related to this chronical disease, nursing diagnoses about health-disease responses in primary healthcare has as major focus Therapeutic Regime Management. Our aim was to study the nursing diagnosis in this issue, from an epidemiological approach. Methods: A descriptive study from an epidemiological approach was developed, analyzing nursing diagnoses in hypertensive patients. Results: We found 17,7% of undiagnosed patients and better diagnoses in patients with complications than in those without complications. Conclusions: nursing records need to be improved in order to promote more robust studies in the post-modern epidemiology defended for the future.

Social media has become a powerful tool for spreading information and awareness campaigns on environmental issues, especially as they pertain to the conservation of wild animals. It is a double-edged sword, however, since it also facilitates the legal and illegal trade of wild animal species as well as the propagation of ‘wild animal selfies.’ This review presents some key literature to date which concerns the impact of social media on public perceptions of animals (such as through ‘viral’ videos), changing trends in animal encounters at wildlife tourism destinations, and the wildlife trade as it is facilitated by social media. Finally, avenues for future research are suggested with urgency, since the impact of social media on the welfare and conservation of wild animal species is most likely underestimated yet bears serious consequences.

This research aimed, within the scope of the anthropotechnological approach, analyze the technology transfer, performed via the offset policy in the field of public health, called the Radiotherapy Expansion Plan, from the Health Ministry. The objective of this policy is to create and improve accredited organizations, concerning the oncological treatment, specifically in the insertion of radiotherapeutic equipment. This process is divided into two stages: the insertion of the radiotherapy equipment, and the compensations provided for in the commercial agreement. To meet this purpose, the research started from understanding the theoretical and methodological approaches of the fields of study of anthropotechnology, technology transfer and offset policy. In this sense, there was used the methodological strategy of the case study, supported by applied research, with a qualitative and exploratory approach. External and internal environments of a specific situation were analyzed, located in the State of Paraná, which received the radiotherapy equipment. It was verified that the initiatives of insertion of radiotherapeutic equipment in the context of the Expansion Plan have undergone numerous confrontations, inserted in the contextual and organizational particularities that affect its development and effectiveness. There are challenges that require responses from a set of organizations involved, in order to implement the trade agreement established by the offset policy, highlighting the first stage as a process of technology transfer. Thus, the situation located in the State of Paraná consistently consolidated the insertion of the radiotherapy equipment. It allowed its disclosure as a reference situation, and based on the dimensions and indicators analysis provided by anthropotechnology, made possible the comprehensionof the technology transfer involved in the process.

The spread of charging infrastructure (CIS) for battery electric vehicles is crucial for coping with the increasing number of electric vehicles. Therefore, the selection of ideal (fast-) charging locations determines acceptance, utilization and, thus, the economic viability of a single site or the whole charging network. The methodology of the Integrated Model Approach STELLA[1] for site identification of CIS uses proven methods of traffic modeling such as the classic four-step traffic modeling in a new context to enable statements regarding the positioning of CIS. Based on different spatial analyzes and characterizations of urban quarters, traffic generated by individuals is calculated using the FGSV approach of 2010. Because only (electric) motorized individual traffic is of importance for CIS, the share of trips is calculated by differentiating the modal split between various transport groups. One approach is to concretize the modal split share of public transport based on analyzes of different criteria and data sets, e.g. the accessibility of stops. The model approach STELLA, which also combines various extensive data (e.g. transport networks and traffic volumes, settlement structures, vehicle characteristics, power supply data and user requirements), is currently developed for a planning area covering the entire territory of the Federal Republic of Germany. [1] STELLA is the acronym for the German term "STandortfindungsmodell für ELektrische LAdeinfrastruktur”.

Preterm infants have increased body adiposity at term equivalent age and risk for adverse metabolic outcomes. The aim of the study was to define how nutrient intake may impact body composition (BC) of very low birth weight infants fed with early progressive enteral feeding and standard fortification. Eighty-six infants with

Whole genome duplication (WGD) or polyploidization can occur at the cellular, tissue, and organismal levels. At the cellular level, tetraploidization has been proposed as a driver of aneuploidy and genome instability, and correlates strongly with cancer progression, metastasis, and development of drugs resistance[1–6]. WGD is also a key developmental strategy for regulating cell size, metabolism, and cellular function[1,7–10]. In specific tissues, WGD is involved in normal development (e.g. organogenesis), tissue homeostasis, wound healing, and regeneration[10–17]. At the organismal level, WGD propels evolutionary processes such as adaptation[18], speciation[19], and crop domestication[20]. An essential strategy to further our understanding of the mechanisms promoting WGD and its effects is to compare isogenic strains that differ only in their ploidy. Caenorhabditis elegans (C. elegans) is emerging as an animal model for these comparisons, in part because relatively stable and fertile tetraploid strains can be produced rapidly from nearly any diploid strain[7]. Here we review the use of Caenorhabditis polyploids as tools to understand important developmental processes (e.g. sex determination, dosage compensation, and allometric relationships)[21–27] and cellular processes (e.g. cell cycle regulation, chromosome dynamics during meiosis)[28–32]. We also discuss how the unique characteristics of the C. elegans WGD model will enable significant advances in our understanding of mechanisms of polyploidization and its role in development and disease.

Measurement of breast cancer burden and identification of its influencing factors help in the development of public health policy and strategy against the disease. This study aimed to examine the variability of the excess mortality of female breast cancer patients in the North East Region of Peninsular Malaysia. This retrospective cohort study was conducted using breast cancer data from the Kelantan Cancer Registry between 2007 and 2011, and Kelantan general population mortality data. The breast cancer cases were followed up for five years until 2016. Out of 598 cases, 549 cases met the study criteria and were included in the analysis. Modelling of excess mortality was conducted using Poisson regression. Excess mortality of breast cancer varied according to age group (50 years old and below vs above 50 years old, Adj. EHR: 1.47; 95% CI: 1.31, 4.09; P=0.004), ethnicity (Malay vs non-Malay, Adj. EHR: 2.31; 95% CI: 1.11, 1.96; P=0.008), and stage (stage III and IV vs. stage I and II, Adj. EHR: 5.75; 95% CI: 4.24, 7.81; P<0.001). In conclusion, public health policy and strategy aim to improve cancer survival should focus more on patients presented at age below 50 years old, Malay ethnicity, and at a later stage.

The purposes of this study were to identify clinician’s characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the information sources influencing medical decision-making about treatment of schizophrenia. We surveyed 202 psychiatrists during 6 regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic and information sources about their clinical decisions were collected. Most of psychiatrists used second-generation antipsychotic (SGA), and preferentially an oral formulation, in the treatment of schizophrenia. SGA LAI was prescribed to 30.4% of schizophrenic patients. The duration and the type of practice did not influence the class or formulation of antipsychotics used. The clinicians following the higher percentage of schizophrenic patients were associated with the higher use of LAI antipsychotics and the lower use of oral SGA. Personal experience, government regulatory approval and guidelines for the treatment of schizophrenia were the 3 main contributing factors guiding the clinical decision-making of clinicians about treatment of schizophrenia. The more clinicians follow schizophrenic patients, the more they use LAI antipsychotic. The development of specialised programmes with top specialists should lead to better use of LAI in the treatment of schizophrenia.

The forage fish, a crucial source of nutrition in developing countries, are unfortunately primarily used for fishmeal and aquafeed production for aquaculture that mainly serves consumers in developed countries. Industrial fish use leaves a meager portion of the catch for direct human consumption in the fish-producing countries, leading to inflated fish prices locally. Overfishing forage fish necessary to support the fish reduction industry disrupts the ecosystem, diminishes the catch of larger fish, such as mackerel, and marginalizes local artisanal fishermen. This article appraises roughly the financial and nutritional impacts of elevated fish prices on low-income consumers in forage fish-producing countries, drawing attention to the ethical implications of this situation. A hypothetical 10% boost in the annual supply of fresh forage fish to the current global supply of 5 million MT markets could save consumers hundreds of millions of US dollars globally, tens of mil-lions of US dollars nationally, and several dollars for a family while improving the nutrition of families that depend on forage fish. The numbers suggest that even a modest boost to the supply of forage fish in fresh fish markets could significantly benefit the fish-producing nations' consumers and the fish-producing nations. In some countries, such as South Africa, the orders of magnitude of these sums approach that of the entire local fish reduction industries' value. The increased fish prices could be considered involuntary subsidies by low-income consumers to the aquafeed and aquaculture industries. In summary, the reduction industry's and aquaculture's current use of captured forage fish warrants further scrutiny, as it inadvertently burdens disadvantaged societies financially and nutritionally. The article proposes alternative protein sources and cultivating non-carnivorous fish among several optional measures to ensure equitable distribution of forage fish resources.

Background & Aims: Reports of a rise in childhood cancer incidence in Australia and globally prompted the investigation of cancer incidence and survival in South Australia (SA) and the Northern Territory (NT) over a 28-year period, with emphasis on Indigenous peoples. Methods: This cross-sectional analysis of two prospective longitudinal databases, the SA and NT Cancer Registries (1990-2017), included all reported cases of childhood cancers. Poisson regression provided estimates of incidence rate ratios and survival was modelled using Cox proportional hazard models for children aged 0.05). With reference to the 1990-1999 era, overall survival improved in subsequent eras in SA (2000-2009: HR 0.53 [0.38-0.73]; 2010-2017: 0.44 [0.28-0.68]); however, remained unchanged in the NT (2000-2009: 0.78 [0.40-1.51]; 2010-2017: 0.50 [0.24-1.05]). In the NT, overall survival of Indigenous patients was significantly lower compared with the non-Indigenous cohort (3.42 [1.92-6.10]). While the survival of Indigenous children with cancer significantly improved in the last two eras (p0.05). Conclusions: The incidence of childhood cancers has remained unchanged over 28-years in SA and the NT. Encouragingly, improved survival rates over time were observed in SA and amongst Indigenous children of the NT. Nevertheless, survival rates in Indigenous children remain lower than non-Indigenous children.

The healthcare sector in Kuwait has been nurtured for many decades by the government where the Ministry of Health (MoH) controls up to 80 percent of the country’s health services. General and specialized public hospitals represent a significant proportion of health expenditures in Kuwait; amidst dwindling health resources, a declining global oil market in an oil-dependent welfare state, and a heavy reliance on a non-national clinical workforce. Although healthcare services in public sector hospitals are at highly subsidized rates, causing private sector involvement in healthcare to be considerably low, the growing demands for private delivery of care burgeoned participation of private hospitals in Kuwait, and improving hospital efficiency and productivity is more critical and timelier than ever. This paper aims to analyze public health system efficiency and hospital performance in the State of Kuwait, where we begin by evaluating the input-oriented technical efficiency (TE) of MoH hospitals in 2015-2019 and identifying potential areas for efficiency improvement by exploring influencing institutional and environmental factors. Over the five years between 2015 and 2019, TE in MoH hospitals has decreased by an average of 2.98% solely based on technical regress, where the six MoH general hospitals reported a pooled mean efficiency of 86.58%, and the nine sampled MoH specialized hospitals had a five-year pooled average of 65.47% efficiency. MoH policymakers should focus on improving allocative efficiency in the public health system, and healthcare policy reforms should focus on strengthening management structures in Kuwait’s public hospitals to improve production efficiency and financial sustainability.

Fungal plant diseases are a major threat to food security worldwide. Current efforts to identify and list loci involved in different biological processes are more complicated than originally thought, even when complete genome assemblies are available. Despite numerous experimental and computational efforts to characterize gene functions in plants, about ~ 40% of protein-coding genes in the model plant A. thaliana are still not categorized in the Gene Ontology Biological Process (BP) annotation. In non-model organisms, such as sunflower (Helianthus annuus), the number of BP term annotation is far fewer, ~22%. In the current study we performed gene co-expression network analysis using eight terabytes of public transcriptome datasets and performed expression-based functional prediction to categorize and identify loci involved in the response to fungal pathogens. We were able to construct a reference gene network of healthy green tissue (GreenGCN) and a gene network of healthy and stressed root tissues (RootGCN). Both networks achieved robust high quality scores on the metrics of guilt-by-association and selective constraints versus gene connectivity. We were able to identify eight modules enriched in defense functions, of which, two out of the three modules in the RootGCN were also conserved in the GreenGCN, suggesting similar defense-related expression patterns. We identified 16 WRKY genes involved in defense related functions and 65 previously uncharacterized loci now linked to defense response. In addition, we identified and classified 122 loci previously identified within QTL or near candidate loci reported in GWAS studies of disease resistance in sunflower linked to defense response. In all, we have implemented a valuable strategy to better describe genes within specific biological processes.

As public health laboratories expand their genomic sequencing and bioinformatics capacity for the surveillance of different pathogens, labs must carry out robust validation, training, and optimization of wet- and dry-lab procedures. Achieving these goals for algorithms, pipelines and instruments often requires that lower-quality datasets be made available for analysis and comparison alongside those of higher-quality. This range of data quality in reference sets can complicate the sharing of sub-optimal datasets that are vital for the community and for the reproducibility of assays. Sharing of useful, but sub-optimal datasets requires careful annotation and documentation of known issues to enable appropriate interpretation, avoid being mistaken for better quality information, and for these data (and their derivatives) to be easily identifiable in repositories. Unfortunately, there are currently no standardized attributes or mechanisms for tagging poor-quality datasets, or datasets generated for a specific purpose, to maximize their utility, searchability, accessibility and reuse. The Public Health Alliance for Genomic Epidemiology (PHA4GE) is an international community of scientists from public health, industry and academia focused on improving the reproducibility, interoperability, portability and openness of public health bioinformatic software, skills, tools and data. To address the challenges of sharing lower quality datasets, PHA4GE has developed a set of standardized contextual data tags, namely fields and terms, that can be included in public repository submissions as a means of flagging pathogen sequence data with known quality issues, increasing their discoverability. The contextual data tags were developed through consultations with the community including input from the International Nucleotide Sequence Data Collaboration (INSDC), and have been standardized using ontologies, community-based resources for defining the tag properties and the relationships between them. The standardized tags are agnostic to the organism and the sequencing technique used and thus can be applied to data generated from any pathogen using an array of sequencing techniques. The list of standardized tags is maintained by PHA4GE and can be found at https://github.com/pha4ge/contextual_data_QC_tags. Definitions, ontology IDs, examples of use, as well as a JSON representation, are provided. The PHA4GE QC tags were tested, and are now implemented, by the FDA’s GenomeTrakr laboratory network as part of its routine submission process for SARS-CoV-2 wastewater surveillance. We hope that these simple, standardized tags will help improve communication regarding quality control in public repositories, in addition to making datasets of variable quality more easily identifiable. Suggestions for additional tags can be submitted to PHA4GE via the New Term Request Form in the GitHub repository. By providing a mechanism for feedback and suggestions, we also expect that the tags will evolve with the needs of the community.

Background: Health policy is a set of comprehensive principles and legislations that guide how healthcare should be effectively delivered in the community. Medical schools should prepare students to undertake managerial responsibilities by incorporating health policy in the curriculum to deal with the intricacies of healthcare systems and their clinical roles in their future professional careers. Objective: To examine medical students' perception at a Public University in Malaysia regarding teaching health policy and their participation in health policy roles. Material and Methods: A cross-sectional study using universal sampling was carried out among the medical students using a paper-based questionnaire to collect the data. Results: Most respondents opined their willingness to learn health policy (80.9%) and that teaching health policy (83.6%) should be compulsory for medical students. The respondents thought health policy should be introduced earlier in Year 1 or 2. The student scores on their knowledge regarding health policy and year of study were significantly associated with their involvement in the health policy roles in both the simple and multiple logistic regression. Both statistical tests reported higher participation in health policy roles with the higher year of study, though only Year 4 and 5 were significant in the simple logistic regression and only Year 5 in the multiple logistic regression compared to Year 1. On the other hand, age and type of admission show significant results only in the simple logistic regression, while the race was only significant at the multivariate level. Conclusion: This study demonstrated that most respondents showed their willingness to learn health policy, participate in the health policy programs, and recommend that health policy be considered an essential topic in the medical curriculum, which should be taught right from the first year of medical school. We recommend encouraging students’ participation in health policy activities.

Over the past decade, China has witnessed fast-paced technological advancements in the media industry, as well as major shifts in the health agenda portrayed in the media. Therefore, a key starting point when discussing health communication lies in whether media attention and public attention towards health issues are structurally aligned, and to what extent the news media guide public attention. Based on data mined from 73,060 sets of the Baidu Search Index and Media Index on 20 terms covering different types of cancer from 2011 to 2020, the Granger test demonstrates that, in the last decade, public attention and media attention towards cancer in China has gone through two distinct phases. During the first phase, 2011-2015, Chinese news media still held the key in transferring the salience of issues on most cancer types to the public. In the second phase, from 2016-2020, public attention towards cancer has gradually diverged from media coverage, mirroring the imbalance and mismatch between the demand of active public and the supply of cancer information from news media. This study provides an overview of the dynamic transition on cancer issues in China over a ten-year span, along with descriptive results on public and media attention towards specific cancer types.

Background: After serious epidemics of chikungunya (CHIKV) and Zika (ZIKV) in the Americas, dengue (DENV) have reemerged in most countries. We analyzed the incidence, incidence rates, and evolution of DENV cases in Honduras from 2015-2018 and the ongoing 2019 epidemic. Methods: Using epidemiological weeks (EW) surveillance data on the DENV 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 21 July 2019, a total of 109,557 cases of DENV were reported, 28,603 in 2019, for an incidence rate of 312.32 cases/100,000 pop this year; 0.13% laboratory-confirmed. The highest peak was reached on the EW 28°, 2019 (5,299 cases; 57.89 cases/100,000 pop). The department with the highest number of cases and incidence rate was Cortes (8,404 cases, 479.68 cases/100,000 pop in 2019). Discussion: The pattern and evolution of DENV epidemic in 2019 in Honduras has been similar to that which occurred for in 2015. As previously reported, this epidemic involved the north and central areas of the country predominantly, reaching municipality incidences there >1,000 cases/100,000 pop (1%). 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.

This paper relies on accounting-based measures of country risk to investigate U.S. global banks' exposure to foreign country risk over the 2017 fiscal year as measured by the sum of cross-border risk, foreign office risk, and derivative risk claims. We achieve this using panel linear modeling methods with country level heterogeneity and time fixed effects, along with a constructed panel data of 284 observations on 71 countries distributed across 6 world regional blocks, and observed over 4 consecutive quarters starting from 4th quarter 2016 and ending with 3rd quarter 2017. The results show that on average, over the four quarters, a 1% increase in foreign banking sector's claims significantly increases U.S. global banks cross border risk exposure by 0.34%, while reducing derivative risk exposure by 0.22%, but have no significant impact on foreign office risk exposure. Similar results are observed with public sector claims which significantly increase banks' exposure to cross border risk by 0.21%, while reducing derivative risk exposure by 0.19%. Conversely however, non-bank financial sector claims are found to have no significant affect on cross-border risk exposure, but significantly reduce foreign office risk exposure by 0.09%, while increasing derivative risk exposure by 0.06%. These results indicate the presence of sectoral heterogeneities in U.S. banks' exposure to foreign counterparties' risk, and also that overall, over the course of 2017 the level of U.S. global banks' cross-border risk exposure increased, while their level of derivative risk exposure decreased, and the level of foreign office risk exposure remained relatively unchanged.

Background. It is unclear whether the use of clinical prediction rules is sufficient to rule out infective endocarditis (IE) in patients with Staphylococcus aureus bacteremia (SAB) without an echocardiogram evaluation, either transthoracic (TTE) and/or transesophageal (TEE). Our primary purpose was to test the usefulness of PREDICT, POSITIVE and VIRSTA scores to rule out IE without echocardiography. Our secondary purpose was to evaluate whether not performing an echocardiogram evaluation is associated with higher mortality. Methods. We conducted a unicentric retrospective cohort including all patients with a first SAB episode from January 2015 to December 2020. IE was defined according to modified Duke criteria. We predefined threshold cut-off points to consider that IE was ruled out by means of the mentioned scores. To assess 30-day mortality, we used a multivariable regression model considering performing an echocardiogram as covariate. Results. Out of 404 patients, IE was diagnosed in 50 (12.4%). Prevalence of IE within patients with negative PREDICT, POSITIVE and VIRSTA scores was: 3.6% (95% CI 0.1-6.9%), 4.9% (95% CI 2.2-7.7%), and 2.2% (95% CI 0.2-4.3%), respectively. Patients with negative VIRSTA and negative TTE had an IE prevalence of 0.9% (95% CI 0-2.8%). Performing an echocardiogram was independently associated with lower 30-day mortality (OR 0.24 95%CI 0.10-0.54, p=0.001). Conclusion. PREDICT and POSITIVE scores were not sufficient to rule out IE without TEE. In patients with negative VIRSTA score, it was doubtful if IE could be discarded with a negative TTE. Not performing an echocardiogram was associated with worse outcomes, which might be related to presence of occult IE. Further studies are needed to assess the usefulness of clinical prediction rules in avoiding echocardiographic evaluation in SAB patients.

Forty percent of patients with acute coronary occlusion myocardial infarction (OMI) do not present with STEMI criteria, which delays their treatment and increases morbidity and mor-tality. The need to identify these patients promptly is crucial, and this sets the stage for the pro-posed reclassification. Many of these patients can be identified by other ECG and clinical fea-tures. Background/Objectives: We sought to evaluate STEMI/NSTEMI cases that result in OMI and the consequences of delayed revascularization immediately among NSTEMI patients who have ACO (NSTEMI-OMI). Methods: The study is a retrospective analysis conducted on 334 pa-tients who underwent coronary angiography for acute coronary syndrome at UHC ‘‘Mother Te-resa,’’ Tirana, Albania, during January-May 2023. OMI was defined as an acute culprit lesion with TIMI 0-2 flow, or TIMI 3 flow with highly elevated troponin (cTnI>10.0 ng/mL, hs-cTnI>5000 ng/L). Ejection fraction (EF), total ischemia time, hospital day stay and complications were com-pared between groups. Results: There were 334 patients included of whom NSTEMI-OMI were 98 patients (29.3%) of patients with ACS. 96 patients (40%) of OMI patients did not fulfill the STEMI criteria. Only 11 patients (11%) of STEMI(-)OMI had PCI performed within the first 12 hours vs 76 patients (77%) of STEMI(+)OMI, p<0.001. There was no difference in the percent of patients requiring PCI between the STEMI(+)OMI 98 patients (93%) and STEMI(-)OMI 87 patients (89%) (p<0.001). The overall in-hospital mortality was 19 patients (5.7 %), with subgroup mortality of 14 patients (4.2%) STEMI(+)OMI, two patients (0.6%) STEMI(+) NOMI, three patients (0.9%) STEMI(-)OMI, 0% STEMI(-)NOMI, (p=0.013). Patients with mechanical complications were: 67 patients (46.8%) STEMI(+)OMI and 45 patients (46.4%) STEMI(-)OMI. 26 patients (18.5%) STEMI(+)OMI and 13 patients (13.1%) STEMI(-)OMI developed electrical complications. Conclusions STEMI(-)OMI patients had significant delays in catheterization, yet had angiographic findings, rate of PCI, and complications similar to STEMI(+)OMI. These data add further support to refocusing the paradigm of acute MI to improve recognition and rapid reperfusion of all OMIs, rather than only those with STEMI criteria.

The recently approved maternal vaccination against respiratory syncytial virus (RSV) can reduce its burden among infants. Vaccine hesitancy/resistance can undermine the beneficial impact of RSV vaccination. The aim of this study was to assess the willingness of pregnant women in Jordan to receive RSV vaccination and its associated determinants. Face-to-face interviews were conducted in obstetrics/gynecology clinics in Jordan during January-February 2024, with convenience sampling. Attitude to RSV vaccination was assessed using the previously validated ABCDEF scale. A total of 404 pregnant women participated in the study with a mean age of 30 years. A majority of the participants showed willingness to receive RSV vaccination (n=313, 77.5%), with hesitancy among 25 participants (6.2%), and resistance among 66 participants (16.3%). Variables that were significantly associated with a higher RSV vaccine acceptance in multivariate analysis were: age <30 years (aOR: 2.45, p=0.010), undergraduates (aOR: 3.27, p=0.026), being a healthcare worker (aOR: 4.50, p=0.036), and the history of previous COVID-19/influenza vaccine uptake (aOR: 2.47, p=0.045). Two out of the six ABCDEF constructs were significantly associated with RSV vaccine acceptance, namely the “Advice” construct (aOR: 10.38, p<0.001) and the “Fear” construct (aOR: 21.49, p<0.001). This study highlighted the multifaceted nature of attitude towards maternal RSV vaccination among pregnant women. The study showed the role of demographic variables, prior vaccination experience, trust in credible health institutions and vaccine safety, and fear of RSV disease consequences in infants in shaping maternal attitude to RSV vaccination. Addressing these factors can help to effectively promote RSV vaccine uptake, subsequently helping to protect infants from the significant RSV disease burden.

Livestock management is challenging for resource-poor (R-P) farmers due to unavailability of quality feed, limited professional advice and rumor-spreading about animal health condition in a herd. This research seeks to improve animal health in southern Africa by promoting sericea lespedeza (Lespedeza cuneata), a nutraceutical fodder legume. An automated geospatial model for precision agriculture (PA) can identify suitable locations for its cultivation. Additionally, a novel approach of radio frequency identifier (RFID) supported telemetry technology can track animal movement, and the analyses of data using artificial intelligence can determine sickness of small ruminants. This RFID-based system is being connected to a smartphone app (under construction) to alert farmers of potential livestock health issues in real-time so they can take immediate corrective measures. An accompanying Decision Support System (DSS) site is being developed for R-P farmers to obtain all possible support on livestock production, including the designed PA and RFID-based DSS.

Background: Nurses are essential members of the healthcare workforce and were among the first line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of contracting the disease, resulting in a significant number of reported deaths among them. Several preventive measures were adopted to contain the spread of this potentially lethal virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) of Barbados from December 2020 to July 2021, was conducted. Participants completed a questionnaire capturing socio-demographic information and knowledge and practices related to hand hygiene, using face masks, and social distancing . Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%). Results: Of 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). Findings revealed that 45.8% had poor knowledge of hand hygiene, and the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% CI 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask-wearing, 53.6% of nurses had average and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% CI 1.5, 7.4) of having good knowledge compared to nursing assistants. 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by WHO. Conclusion: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

Pb found in rain water is not only caused by tin roof on houses but also caused by the pollution of industrial activities, vehicles and land clearing activity by fire. Pb pollutant dissolves and enters into rain water storages and it’s consumed as drinking. Pb can cause bad impact to human, for example disruption of enzyme, anemia and low intelligence. The purposes of this research are (1) to evaluate Pb, pH and turbidity level in rain water, (2) to analyze the effectiveness of mollusk sand filtration and the absorption of activity carbon to decrease Pb, turbidity and pH, and (3) to analyze the correlation of Pb, length of stay and smoking habit on public health. This research is an experimental by using pre and post test designs with control and observational by using cross sectional design. The research was conducted in urban and rural areas of Pontianak and Kubu Raya regency. The sampling was done in determining the number of samples of Pb, pH and turbidity in rain water. The analyzing the data by using computer program. The results show that: (1) the average of Pb, pH and turbidity level before treatment is considered high at 131.7 µg/L on Pb, turbidity at 20 NTU and low pH at 5.2. After the treatment was the Pb has decreased to 0.71 µg/L and turbidity has to 5.66 NTU, pH to 6.9 and (2) Rain water treatment is very effective to decrease Pb for 99.4% and turbidity for 72%, and (3) there is a correlation among Pb found in rain water, length of stay and smoking activity to public health. Recommends that: the residents of Pontianak and Kubu Raya to process rain water before consuming. The rain water treatment can be done by applying mollusk sand filtration and absorption of active carbon.

During the pandemic, educational digitization experienced a significant increase. In Mexico, social service is a crucial component of technical and professional training, a phase during which individuals apply the knowledge gained throughout their university education. The aim of this study is to standardize a digital model for the management of social service in the health care sector within health care units. This study employed an analytical, observational, retrospective, and longitudinal approach, involving two groups of trainees: Group A (n=133), utilizing a Non-Digital Model, and Group B (n=50), employing a Digital Model. In Stage I. the model design underwent validation through the Delphi method with a panel of three experts. The model was implemented on a Classroom® digital platform with the integration of the elements 1) a monthly rotation rubric 2) care services rubric 3) clinical cases or nursing process rubric, and 4) innovation project rubric. The validation of the model achieved 100% agreement (K=1). The variables measured for each group included the school of origin, career, unit of assignment, timely enrolment, and timely delivery of rubrics on the platform. The difference between the two groups was measured using Chi-Square. To measure the impact, the difference in the timeliness of the products was considered. From the University of Quintana Roo, the difference was 20.3 vs 34%. According to the Unit of Attachment the most frequent was HGR No. 17 with Group A at 22.5 vs 52%. According to the product the least delivered was Product 4, with 69% vs 81%. Timely enrollment was observed in Group A at 89% vs Group B at 80% p=0.001. Overall timely delivery in Group A was 81% vs Group B at 91% p=0.001 in the first 6 months post-implementation. Demonstrating that the implementation of the digital platform was effective, representing a significant advance in the adaptation of medical education to the circumstances imposed by the pandemic, highlighting the feasibility and effectiveness of digital teaching methods in the training of health professionals.

Millions of people use public transportation daily worldwide and frequently touch surfaces, thereby producing a reservoir of microorganisms on surfaces increasing the risk of transmission. Constant occupation makes sufficient cleaning difficult to achieve. Thus, an autonomous, perma-nent antimicrobial coating (AMC) could keep down the microbial burden on such surfaces. A photodynamic AMC was applied to frequently touched surfaces in buses. The microbial burden (colony forming units, cfu) was determined weekly and compared to equivalent surfaces in buses without AMC (references). The microbial burden ranged from 0 – 209 cfu/cm² on references and from 0 – 54 cfu/cm² on AMC. The means were 13.4 ± 29.6 cfu/cm² on references and 4.5 ± 8.4 cfu/cm² on AMC (p<0.001). The difference of microbial burden on AMC and references was al-most constant throughout the study. Considering a hygiene benchmark of 5 cfu/cm², the data yield an absolute risk reduction of 22.6 % and a relative risk reduction of 50.7 %. In conclusion, photo-dynamic AMC kept down the microbial burden, reducing the risk of transmission of microor-ganisms. AMC permanently and autonomously contributes to hygienic conditions on surfaces in public transportation. Photodynamic AMC therefore are suitable for reducing the microbial load and closing hygiene gaps in public transportation.

Antibiotic residues in aquatic environment have the possibility to induce resistance in environmental bacteria, which ultimately might get transferred to pathogens making treatment of diseases difficultand poses a serious threat to public health. If antibiotic residues in the environment can be eliminated or reduced, it has the possibility to contribute antibiotic resistance. Towards this objective, water containing ciprofloxacin was treated with sunlight assisted photocatalysis using Fe doped ZnOnanoparticles for assessing the degradation potential of this system.Parameters like pH, temperature, catalytic dosage were assessed for the optimum performance of the system. To evaluate degradation of ciprofloxacin,both spectrophotometricas well as microbiological (loss of antibiotic activity)methods were employed. 100 mg/L Fe doped ZnO nanoparticle catalyst and sunlight intensity of 120,000–135,000 lux system gave optimum performance at pH 9 at 30 °C and 40 °C. At these conditions spectrophotometric analysis showed complete degradation of ciprofloxacin (10mg/L) by 210 min. Microbiological studies showed loss of antibacterial activity of the photocatalytically treated ciprofloxacin containingwater against Staphylococcus aureus (10⁸ CFU) in 60 min and for Escherichia coli (10⁸ CFU) in 75 min. Thedeveloped system, thus possess a potential for treatment of antibiotic contaminated waters for eliminating/reducing antibiotic residues from environment.

Scientific studies had shown that mixed forests of silver fir (Abies alba Mill.) and European beech (Fagus sylvatica L.) provide higher ecosystem services than monospecific forests. Mixed forests are known for their high resilience to climate change impacts and superior biodiversity compared to monospecific forests. In many countries, promotion of mixed forests in forest management is becoming a government policy since they can contribute to fulfill the Sustainable Development Goals set by the United Nation, respectively Goal 13 and 15. However, not much is known about public perceptions on mixed forests compared to monoculture forests. Our study on ecosystem services provided by mixed and monospecific forests in southwest Germany fill this gap. Based on a survey with 520 valid responses we analyzed people’s perception on 18 different supporting, cultural, regulating and provisioning ecosystem services measured by Likert scale. Stepwise regression analyses show relations between social profiles (gender, age, education, profession) and preferences on respondents’ perceptions. Our findings show that people perceive that mixed forests provide better cultural, regulating and supporting ecosystem services than monospecific forests of fir and beech whereas provisioning services were perceived as being equally or better provided by monospecific forests. Significant effects towards a positive perception on ecosystem services provided by mixed forests were mainly influenced by the perceived abundance of old trees, feeling of pleasantness in mixed forests, age, profession, and education. Our findings indicate that there is a high public support for the promotion of silver fir and beech mixed forests in Southwest Germany.

Trends in excess winter mortality (EWM) were investigated from the winter of 1900/01 to 2019/20. During the 1918-1919 Spanish flu epidemic a maximum EWM of 100% was observed in both Denmark and the USA. During the Spanish flu epidemic in the USA 70% of excess winter deaths were coded to influenza. EWM steadily declined from the Spanish flu peak to a minimum around the 1970’s to 1980’s. There is evidence that this decline was accompanied by a shift in deaths away from the winter, and that the EWM calculation shifted from a maximum around April to June in the early 1900’s to around March since 1967. EWM has a good correlation with the number of estimated influenza deaths, but in this context influenza pandemics after the Spanish flu only had an EWM equivalent to that for seasonal influenza. Using data from 1980 onward the effect of influenza vaccination on EWM was examined using a large international data set. No effect of increasing influenza vaccination could be discerned; however, there are multiple competing forces influencing EWM which will obscure any underlying trend, e.g., increasing age at death, multimorbidity, dementia, polypharmacy, diabetes, and obesity – all of which either interfere with vaccine effectiveness or are risk factors for influenza death. After adjusting the trend in EWM in the USA influenza vaccination can be seen to be masking higher winter deaths among a high morbidity US population. Winter deaths are clearly the outcome of a complex system of competing long-term trends.

This study aimed to determine whether the EQ-5D-5L tool captures the most common persistent symptoms, such as fatigue, memory/concentration problems and dyspnea in patients with post COVID-19 conditions, and if adding these symptoms improves the explained variance of the health-related quality of life (HRQoL). In this exploratory cross-sectional study, two cohorts of Swedish patients (n=177) with a history of COVID-19 infection answeared a questionnaire covering sociodemographic characteristics, clinical factors and HRQoL assessed using EQ-5D-5L with the Visual Analogue Scale (EQ-VAS). Spearman rank correlation and multiple regression analyses were employed to investigate the extent to which the most common persistent symptoms such as fatigue, memory/concentration problems and dyspnea were explained by the EQ-5D-5L. The explanatory power of EQ-5D-5L for EQ-VAS was also analysed, both with and without inclusion of symptom(s). We found that the EQ-5D-5L dimensions partly captured fatigue and memory/concentration problems but performed poorly in capturing dyspnea. Specifically, the EQ-5D-5L explained 55% of the variance in memory/concentration problems, 47% in fatigue and only 14% in dyspnea. Adding fatigue to the EQ-5D-5L increased the explained variance of the EQ-VAS by 5.7%, while the addition of memory/concentration problems and dyspnea had a comparatively smaller impact on the explained variance. Our study highlights the EQ-5D-5L’s strength in capturing fatigue and memory/concentration problems in post COVID-19 patients. However, it also underscores the challenges in assessing dyspnea in this group. Fatigue emerged as a notably influential symptom, significantly enhancing the EQ-5D-5L's predictive ability to for the EQ-VAS score in these patients.

Background: Vaccine hesitancy was one of India's problems after the COVID-19 vaccine roll-out. Earlier studies carried out to understand people's perception of the vaccine were mainly based on online or offline community-based surveys. These studies do not help to understand the actions taken by people towards vaccination. Hence, this study has been designed to understand the exact behavior of people toward the vaccine. Methods: Age-wise, the population was sub-grouped into three groups, above 18 years, 12-14 years, and 15-18 years. The data analysis has been done using cumulative coverage of vaccines in the said age groups. Results: The study shows a substantial population has missed second and booster doses of vaccine at the state, regional, and national levels in all three age groups. Even for the states that have shown the smallest number of people who missed their dose, their number is in the thousands. Conclusion: Further research is needed to know, in total population, how many people have not even taken a single dose of vaccine. Policy-level efforts are needed to cover the entire population of the country for at least a single dose and vulnerable populations, for additional booster doses after primary doses.

Staphylococcus aureus are commensal bacteria present on skin and mucosae in both humans and animals, but they can also be found in food, water and in various environments. They are also considered a major pathogen having a great morbidity leading to a wide range of infections. They are included in the list of most virulent and antimicrobic resistant bacterial pathogens (ESKAPE, Escherichia coli, Staphylococcus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterococcus faecalis and faecium)) by the Center for Disease Control and Prevention (CDC), and S. aureus is part of the worldwide threat represented by the presence of antimicrobial resistance (AMR). The outcomes of an epidemiological investigation on 26,430 S. aureus isolates from a global public database (NPDIB; NCBI Pathogen Detection Isolate Browser) support the evidence of significant differences in the distribution of isolates and ARGs (Antimicrobial Resistance Genes) clusters among geographical areas of origin and among sources of the isolates. Moreover, the ARGs cluster patterns suggest an association between the isolates from human and animal populations. This outcome and the large diffusion of the pathogens among human and animal populations support the importance of gaining information on the epidemiology of these infections with a One Health approach.

This study identified, analysed, and prioritised significant factors for standardising the Korean smart city project evaluation system. We analysed the efficiency and productivity of companies currently providing smart city services to consider both policy and practical aspects. The prioritisation of smart city planning reflects the latest trends in South Korea, where urban planning is moving towards smart city planning. Furthermore, the capacity building of public-private/private-private partnerships indicate the importance of business scalability. This indicates that smart city services are only stabilised when the private sector is involved and leads the project, rather than focusing on public development. The feasibility of building intelligent facilities indicates that smart city projects should be implemented after securing cost-benefit feasibility. The results were used as the basis for building an evaluation system, showing that in smart city convergence alliances, small- and medium-sized enterprises achieved the highest efficiency by reducing inputs to 81% and 86%, under the assumptions of constant and variable returns to scales, respectively. As the operational aspect is more problematic than the technical aspect, policy alternatives are necessary for smooth business progress, including increased flexibility of laws and institutions and the activation of policies that temporarily relieve regulations to demonstrate smart city projects.

Introduction: Tuberculosis (TB) is one of the most prevalent respiratory diseases in the world. In 2020 there were at least 9.9 million new infections, with 1.5 million deaths. Approximately 10% of people infected with Mycobacterium tuberculosis (LTBI) develop the disease during the first 2 to 5 years after infection. Currently in South America, the diagnosis of LTBI continues to be per-formed through the Mantoux tuberculin skin test (TST). Objective: The objective of our study was to compare the sensitivity of a new immunofluorescence IGRA test against a widely available IGRA kit on the market. Material and method: Close contact to infectious patients with TB, or HIV patients or immunocompromised for another cause were recruited. Two interferon gamma release assay (IGRA) diagnostic kits were used and compared with TST. Results: 76 patients were recruited. 93.42% were Chilean nationality, 98.68% of the patients did not have immunosuppres-sion. The sensitivity of the new technique was 88.89% and specificity 92.50% in the study popula-tion compared to the IGRA previously used. In the subgroup older than 36 years, the sensitivity was 95.65% and the specificity 89.47%. Conclusion: IGRA techniques are a new resource in clini-cal laboratories to be able to make an accurate diagnosis in LTBI in the region of the Americas. In our population, the greatest benefit of this new IGRA would be observed in people over 36 years of age, where the sensitivity of the technique was like that of the currently available test.

Background: Immunization prevents over 4-6 million deaths each year worldwide. Ensuring mother satisfaction is an important means of preventing the death of children caused by communicable diseases. However, in Ethiopia, there is paucity of evidence on maternal satisfaction with immunization services. Thus, this study is aimed at assessing the level of maternal satisfaction with childhood immunization services and associated factors among children’s caregivers. Methods: A facility-based cross-sectional study was conducted among 556 systematically selected children’s caregivers in public health facilities at Gondar Town from May through June, 2022. Data were collected using a pretested structured questionnaire. P≤ 0.25 during the bivariate binary logistic regression analysis was included in the multivariate analysis. From the multivariable analysis, variables with p ≤ 0.05 were declared statistically significant. Results: The prevalence of maternal satisfaction towards childhood immunization services was 69.3%(95%CI: 65.5, 73.1%). Of mothers, 45.3% had adequate knowledge, while 43.9% had favorable attitude. Mothers 19-24 years old [AOR = 5.29; 95%CI:2.58,10.86], mothers who waited less than one hour [AOR = 3.03; 95%CI: 1.92,4.77], mothers less than thirty minutes waiting in health facility[AOR=1.98;95%CI:1.24,3.15], mother feel happy during service[ AOR=4.00; 95%CI: 2.53,6.34], mothers adequate knowledge [AOR=2.91; 95%CI: 1.79, 4.73] and had favorable attitude [AOR=3.64; 95%CI: 2.25, 5.91] were significantly associated with maternal satisfaction during childhood immunization services.Conclusions: The overall level of mothers’ satisfaction with childhood immunization services was considerably lower as compared with other studies. Thus, the town health office and concerned stakeholders need more efforts to improve mothers’ satisfaction with childhood immunization services.

The coronavirus disease (COVID-19) pandemic is rapidly spreading across the world. In Democratic Republic of Congo (DRC), 11 out of 26 provinces have been affected on 19 June 2020. The purpose of this study was to assess the public views, attitudes and beliefs related to the COVID-19 pandemic among the population of an unaffected city.Methods: This is a descriptive observational study conducted in an unaffected city using a questionnaire. Findings: A total of 769 people participated. The average age was 36 ±14 years. The sex ratio (male: female) was 1.6. The majority of respondents (97%) is aware of the existence of the COVID-19 pandemic, it is well informed about the signs of the disease, its severity and barrier measures, however few of them have adopted the change in habit and behavior in respect of the barrier measures. Lack of water for handwashing is the most common difficulty in complying with barrier measures (71%). The COVID-19 is considered as an artificial virus designed to reduce the world population by 26%, God’s punishment (22%). Only 36% of the participants are in favor of vaccination against COVID-19. Vaccine is, a western conspiracy to spread COVID-19 in Africa (38%), testing it on Africans (35%), sterilize Africans’ people (12%).Conclusions: Cities not yet affected by COVID-19 in DRC are aware of the existence of the disease, but insufficiently prepared to deal with it. It is important to increase awareness on barrier measures, combating false information, and improving regular water supply for regular handwashing.

Recently, the awareness of energy conservation, carbon emission reduction, and environmental protection in Taiwan has begun to gradually improve, and bicycles have become an important vehicle for residents. In 2009, Kaohsiung began promoting public bicycle sharing. The number of users in that year amounted to 140,000. By 2015, the accumulated number of users reached nine million. This study adopted the Theory of Planned Behavior (TPB) to explore the factors influencing the behavioral intentions of public bicycle users, including the three dimensions of attitude, subjective norm, and perceived behavioral control, and probed into the relationship between the factors influencing the behavioral intentions of public bicycle users in Kaohsiung City and the dimensions. This study used a questionnaire to collect data and SPSS & AMOS for statistical analysis. The empirical results demonstrated that the most prominent factors influencing the behavioral intentions of public bicycle users in Kaohsiung City included perceived behavioral control, attitude, and subjective norm, in order. Among the influencing factors in the three dimensions, personal interests, main groups, and self-competence had a positive and significant correlation. Administrators should provide more incentives related to the three influencing factors to encourage the public in Kaohsiung City to use public bicycles more frequently as their short-distance travel mode, so as to achieve the purposes of saving energy, reducing carbon emissions, and protecting the urban environment.

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.

Abstract: We review the development and application of an organic polymer-gel capable of producing fixed, three-dimensional fluorescent images of complex radiation fields. The gel consists for more than 99% of γ-ray-polymerized (~15% conversion) tertiary-butyl acrylate (TBA) containing ~100 ppm of a fluorogenic compound, e.g. maleimido-pyrene (MPy). The radio-fluorogenic effect depends on copolymerization of the MPy into growing chains of TBA on radiation-induced polymerization. This converts the maleimido residue, which quenches the pyrene fluorescence, into a succinimido moeity (SPy), which doesn't. The intensity of the fluorescence is proportional to the yield of free-radicals formed and hence to the local dose deposited. Because the SPy moieties are built into the cross-linked polymer matrix the image is fixed. The method of preparing the gel and imaging the radiation-induced fluorescence are presented and discussed. The effect is illustrated with fluorescent images of the energy deposited in the gel by beams of X-rays, electrons and protons as well as a radioactive isotope.

Precise classification of sarcomas is crucial to drive optimal clinical management. In this prospective, multicenter, observational study within the Hellenic Group of Sarcoma and Rare Cancers (HGSRC) we assessed the effect of expert pathology review, coupled with the application of molecular diagnostics, on diagnosis and management of sarcoma patients. Newly diagnosed sarcoma patients were addressed by their physicians to one of the two sarcoma pathologists of HGSRC for histopathological diagnostic assessment. RNA next-generation sequencing was per-formed to all samples, using a platform targeting 86 sarcoma gene fusions. Additional molecular methods were performed on the opinion of the expert pathologist. Therefore, the expert pathologist provided a final diagnosis based on the histopathological findings and, when necessary on molecular tests. In total, 128 specimens from 122 patients were assessed. Among the 119 cases in which there was a preliminary diagnosis by a non-sarcoma pathologist, there were 37 modifications in diagnosis (31.1%) by the sarcoma pathologist, resulting in 17 (14.2%) modifications in management. Among the 110 cases in which molecular tests were performed, there were 29 modifications in diagnosis (26.4%) through the genomic results, resulting in 12 (10.9%) modifications in management. Our study confirms that expert pathology review is of utmost importance for the optimal sarcoma diagnosis and management and should be assisted by molecular methods in selected cases.

COVID-19 is fast spreading around the globe in a highly contagious manner. The results from our study showed that after intervention with successive Lockdowns, there was marked decrease in the rate of COVID-19 cases, though there was sporadic volatility in number of COVID-19 cases due to some extrinsic factors. Concomitant with reduction in rate of COVID-19 there was gradual increase in doubling time of COVID-19, steady increase in number of discharged/recovered patients from COVID-19 reaching to ≥ 58% taking the entire Indian population into consideration. Another important aspect was consistent low mortality rate was accompanied by gradual increase in recovery rate of COVID-19 in the population. The possible implication of these results in the development of protective immunity in the population has been discussed.

A Tamoxifen (TAM) response varies significantly among individuals due to genetic variations in cytochrome P450 2D6 (CYP2D6), as well as other TAM pharmacokinetic and/or pharmacodynamic proteins. In this study, 40 ER+ breast cancer patients who received at least 6 months of TAM treatment were prospectively recruited. The study aimed to evaluate, using HPLC-MS/MS, plasma concentrations of TAM and its metabolites, and to study the association with genetic polymorphisms (CYP2D6*4, CYP3A4*1B, CYP3A5*3, UGT2B7*2, UGT2B15*2, SULT1A1*2, and ESR1V364E) and adverse reactions. Bivariable linear regression analyses showed that CYP3A4*1/*1B is significantly associated with an increase of 4-hydroxyTAM plasmatic concentration, a decrease of endoxifen/4-hydroxyTAM ratio and the elimination of 17β estradiol. It was found that the CYP3A4*1/1B genotype alone could explain part of the variability in [4OHTAM], [endoxifen]/[4OHTAM], and 17β-estradiol plasma levels. Similarly, SULT1A1*1/*2 genotype affects the [endoxifen]/[4OHTAM] plasma ratio. Multivariable predictive models, incorporating both polymorphisms and non-genetic variables, are proposed to explain [NdesMeTAM]/[TAM], [4OHTAM]/[TAM], [endoxifen]/[NdesMeTAM], [endoxifen]/[4OHTAM], and 17β-estradiol plasma levels, as well as for predicting hot flashes and cramps. This preliminary study suggests that the genetic variants studied may influence the bioactivation and elimination of TAM, the clinically observed adverse reactions, and potentially the treatment efficacy.

Literature indicates scarcity of cross-national research on the association between physical fighting and bullying victimisation among adolescents, and the moderating role of perceived social support and education spending on this association. Using multilevel binary logistic regression, this study examined the association of physical fighting with traditional bullying and cyberbullying victimisation, with public education spending and perceived social support from families and teachers as moderators. Country-level data were combined with 2017/18 Health Behaviour in School-aged Children (HBSC) survey data from 162,792 adolescents (11-, 13- and 15-year-olds) in 27 European countries. Results showed that physical fighting was positively and significantly associated with cyberbullying and traditional bullying victimisation. These results signify that physical fighting is a robust predictor of bullying victimisation. The findings demonstrate that perceived social support and education spending buffered the association of physical fighting with traditional bullying and cyberbullying victimisation. The findings imply that social support not only prevents adolescents from engaging in physical fights, but also reduces the risk of bullying victimisation. Accordingly, to deter adolescents from engaging in physical violence and reduce the risk of bullying victimisation, there is need to fully comprehend the influence of physical fighting on bullying victimisation, and the moderating role of social support.

In Pakistan, 2018 National Nutrition Survey reported 40% of under five children were stunted. This study assesses the effectiveness of nutritional supplementation in reducing stunting among under-five children in two rural districts in Sindh, Pakistan. This was a mixed-method quasi-experimental study with intervention and control population. 3397 and 3277 under-five children participated in the baseline and end-line surveys. Both study areas were matched for demographic and economic circumstances. The participants received nutrient supplements underpinned by nutrition behaviour change communication for appropriate complementary feeding practices and hand hygiene targeted at primary caregivers during the first 1000 days of an infant's life. The impact was assessed using the difference in difference analysis with kernel propensity score matching to adjust the differences among control and intervention populations.

The spectrum, intensity and overlap of symptoms between FGIDs and other gastrointestinal disorders characterize patients with FIGDs, who are incredibly different in their backgrounds. An additional challenge with regard to the diagnosis and treatment's applicability is the ongoing expansion of the risk factors believed to be connected to these disorders. Many cytokines and inflammatory cells have been found causing the continuous existence of low-inflammation, which is thought to be a basic pathophysiological process. The idea of the gut-brain axis has been created to offer a basic framework for the complex interactions that occur between the nervous system and intestinal functions, including the involvement of the gut bacteria. In this review paper, we intend to promote a hypothesis that FGIDs, should be seen through the perspective of the network of the neuroendocrine, immunological, metabolic and microbiome pathways. Hypothesis arises from an increased understanding of chronic inflammation as a systemic disorder, being omnipresent in chronic health conditions. Better understanding of inflammation role in the pathogenesis of FGIDs can be achieved by clustering markers of inflammation with data indicating symptoms, comorbidities, and psycho-social factors. Finding subclasses among related entities of FGIDs, may reduce patient heterogeneity and help clarify pathophysiology for better treatment.

Purpose: The study investigates soil pores' impact on carbon dynamics and sequestration processes, examining their physical and chemical characteristics and their mechanisms for carbon sequestration.Research Method: Existing literature and research on soil pores, carbon dynamics, and carbon sequestration are analyzed. The interrelationships between soil pore structure, water movement, microbial activity, root penetration, carbon input, soil aggregation, and gas exchange are examined. Traditional techniques and advanced imaging methods are used to quantify and characterize soil pores.Findings: Soil pores play a critical role in facilitating carbon sequestration through various mechanisms. They affect water movement, microbial activity, root penetration, carbon input, soil aggregation, and gas exchange. Understanding these relationships is crucial for sustainable soil management.Research Limitations: This study relies on existing literature and research, which may have limitations and uncertainties. Further research is needed to address these gaps and enhance understanding.Originality Value: This research enhances the existing knowledge by comprehensively examining the significance of soil pores in carbon dynamics and sequestration. It incorporates both traditional and advanced methods, providing insights for soil management and contributing to climate change mitigation efforts.

Purpose: The objective of this paper is to explore the association between insufficient lycopene intake and risk of periodontitis among older adults. Methods: Data analysis was conducted using data from the National Health and Nutritional Examination Survey 2009-2014. Overall, 1227 adults aged 65- to 79-years-old were investigated. Results: Overall, 48.7% of older adults in this study were classified with different levels of periodontitis and 49.1% of individuals with a form of periodontitis had insufficient dietary lycopene intake. Sufficient lycopene intake was found to be associated with a lower likelihood of severe periodontitis (OR: .33; 95% CI: 0.17-.65; p=0.002). Non-Hispanic Black (NHB) older adults were more likely to develop severe forms of periodontal disease in comparison to Non-Hispanic White (NHW) older adults (OR: 2.82, 95% CI: 1.46-5.45, p=0.003). Gender was also found to play a role in periodontitis status, with women being less likely to have severe periodontitis status, compared to men (OR: 0.27; 95% CI: 0.14-0.55; p=0.0007,). However, only NHW females were less likely to have severe periodontitis compared to NHW males (OR: 0.26; 95% CI: 0.12-0.56; p= 0.001). Conclusion: Dietary intake of lycopene associated with periodontitis disease for individuals over the age of 65; those who consume a sufficient amount of lycopene are less likely to develop severe periodontitis. In general, more men suffered from periodontitis in comparison to women. Such association also has been found between NHB with severe periodontitis. In addition, reduced risk of moderate periodontitis is associated with sufficient lycopene intake is explored in NHW, future targeted interventions using lycopene in dietary intake as a preventative measure to delay or prevent the onset of periodontal disease needs to be race and gender specific.

Melasma is a challenging skin condition which involves both structural and functional skin alterations. Despite the availability of various treatment options, the management remains complex. This is the first study to investigate topical application of Rosa Damascena stem cell exosomes when used concomitantly with microneedling in women and men with facial melasma. We recruited 20 subjects with Fitzpatrick skin types I-III, exhibiting melasma of varying severity. The modified Melasma Area and Severity Index (mMASI) and Global Aesthetic Improvement Scale (GAIS) were utilized to evaluate treatment response. The treatment protocol involved microneedling followed by exosome application over four or five sessions, at 4-week intervals. Ninety percent of subjects demonstrated a significant improvement in mMASI scores, while only 10% showed no change. GAIS assessment further supports overall improvement, with just 10% categorized as "not changed". Tolerability was favorable, with mild, transient side effects. Our findings suggest promising outcomes with this combined therapy, underscoring its potential as a safe and effective approach for treating melasma, particularly in severe and moderate cases. However, further research with larger sample sizes and control arms is warranted to validate these findings and explore long-term efficacy.

Public health is an important aspect of community activities, making research on health necessary because it is a crucial field in maintaining and improving the quality of life in society as a whole. Research in public health allows for a deeper understanding of the health problems faced by a population, including disease prevalence, risk factors and other determinants of health. This work aims to explore the potential of hospital patient data analysis as a valuable tool for understanding community implications and deriving insights for effective community health interventions. The study recognises the significance of harnessing the vast amount of data generated within hospital settings to inform population-level health strategies. The methodology employed in this study involves the collection and analysis of deidentified patient data from a representative sample of a hospital in Indonesia. Various data analysis techniques, such as statistical modelling, data mining and machine learning algorithms, are utilised to identify patterns, trends and associations within the data. A program written in Python is used to analyse patient data in a hospital for five years from 2018 to 2022. These findings are then interpreted within the context of public health implications, considering factors such as disease prevalence, socioeconomic determinants and healthcare utilisation patterns. The results of the data analysis provide valuable insights into the public health implications of hospital patient data. The research also covers prediction for the patient data to the hospital based on disease, age and geographical residence. The research prediction shows that in 2023, the number of patients was not considerably affected, but in in March to April 2024, the number significantly increased to 10,000 patients. These recommendations encompass targeted prevention strategies, improved healthcare delivery models and community engagement initiatives. The research emphasises the importance of collaboration between healthcare providers, policymakers and community stakeholders in implementing and evaluating these interventions.

The current regeneration mode of public space in the old city of Guangzhou is ineffective, thus necessitating supplementation with a more systematic methodology. The “plug-in design” targets sustainable regeneration while preserving the overall urban texture and context, i.e., has little impact on the spatial qualities of the old city. The ultimate goal is to activate the public space of the old city of Guangzhou point-to-area through the insertion of various plug-ins. In this study, the methodology is applied to Xudi Gaodi Street, the core area of the old city of Guangzhou, to explore its effects on sustainability. The internal public space is isolated and supplied with rigid and flexible plug-ins from multiple dimensions, which not only improves the spatial environment but also injects new urban formats. This work provides a specific solution for regeneration in Guangzhou’s old city while enhancing empirical knowledge of the plug-in design to support urban regeneration theory and further practical development.

Type 1 diabetes imposes a complex and challenging routine on patients and caregivers. Therefore, considering individual experiences and personal facilitators to promote assertive interventions is crucial. However, no studies have addressed these perspectives in the Brazilian adult population. We aimed to identify psycho-behavioral characteristics perceived as facilitators for coping with the condition. We used a biographical method to conduct semi-structured, face-to-face, in-depth interviews for each participant. Transcripts were analyzed using inductive thematic analysis. Participants (n = 22) were aged 18–57 years (mean: 30.2, standard deviation (SD): 8.7), and the duration since diagnosis was approximately 20.6 years (SD: 4.6). Twelve (54.4%) were women, 13 (59.1%) used insulin pumps, 14 (63.6%) had at least a college degree, and 13 (59.1%) had HbA1C (glycated hemoglobin) levels above 58 mmol/mol (7.5%). Five major themes emerged: 1) peer learning, 2) ownership, 3) welcoming experiences, 4) equity, and 5) reframe the path (P.O.W.E.R.). All themes appeared in the lived experiences shared by participants with HbA1C levels below 58 mmol/mol (7.5%). Improved glycemic control can be achieved, and the challenges encountered in diabetes care within similar socioeconomic contexts can be addressed, by an interdisciplinary care team that takes P.O.W.E.R into consideration when providing person-centered care strategies.

Earliest critical context of the pandemic, preceding the first real epidemiological wave of contagion in Bulgaria, was examined in a socio-affective perspective. A retrospective and agnostic analytical approach was adopted. Our goal was to identify traits and trends that explain public health support (PHS) of Bulgarians during the first two months of the declared state of emergency. We investigated a set of variables with a unified method within an international scientific network, named International Collaboration on Social &amp; Moral Psychology of COVID-19 (ICSMP) in April and May 2020. Conspiracy Theories beliefs were a significant predictor of lower PHS. Psychological Well-being was significantly associated with Physical Contact and Anti-Corona Policy Support. Physical Contact was significantly predicted by less Conspiracy Theories beliefs, higher Collective Narcissism, Open-mindedness, higher Trait Self-Control, Moral Identity, Risk Perception, and Psychological Well-Being. Physical Hygiene compliance was predicted by less Conspiracy Theories beliefs, Collective Narcissism, Morality-as-Cooperation, Moral Identity, and Psychological Well-Being. Results revealed two polar trends of support and non-support of public health policies. The contribution of this study is in providing evidence for affective polarization and phenomenology of (non)precarity during the outbreak of the pandemic.

The Covid-19 pandemic has influenced the style of work of many people. However, it remains a question to what extent it has influenced the work of outdoor workers like forestry workers. Therefore, the objective of this study was to assess the level of professional burnout among forest-ry workers, as a lack of burnout symptoms is a dimension of well-being at work. The Oldenburg Burnout Inventory was administered to 42 respondents. Both subscales of the inventory were reliable: Cronbach’s alpha was 0.806 for disengagement and 0.865 for exhaustion. The mean number of overtime hours was 10.13 hours per month. The mean disengagement score of 2.24 was lower than the reference value of 2.25, but the mean exhaustion score of 2.33 was high-er than the reference value of 2.1. Age correlated significantly with stage of work, as did exhaustion with stage of work, and over-time hours with disengagement. The average forestry officer had no symptoms of disengagement and slight symptoms of exhaustion. These results suggest that being in the forest can help prevent burnout. Overtime work and a heavy workload appear to threaten forestry workers’ well-being, as they can cause exhaustion and lower commitment.

This paper surveys estimates of the transmission features of the novel coronavirus, and then proposes a model to address sample-selection bias in estimated determinants of infection. Containment assumptions of the infection forecasting models depend on assumed effects of policies and self-regulating behavior. In the commons dilemma of the pandemic, the perceived ‘low risks’ of unregulated marginal choices do not reflect the full social cost, implying non-pharmaceutical interventions (NPI) to reduce mortality can enhance social welfare. As more economic activity renews with liftings of restrictive NPI (RNPI), a critical question concerns the ability of milder NPI (MNPI) and voluntary precautions to mitigate the risk of greater infections and deaths while also limiting the pandemic’s economic damage and its social costs. Ineffective NPI could lead to continued COVID-19 waves and new types of crises, worsened expectations and delayed economic recoveries. From the central range of surveyed estimates of transmission and alternative herd-immunity-threshold estimates, a ‘worst-case’ virus guidepost suggests eventual deaths of around 25 to 41 million worldwide and 1.1 to 1.7 million in the U.S. needed to reach herd immunity with no vaccine or treatment. The most optimistic study surveyed (theoretical model from a non-reviewed preprint study) combined with the low end of the range of the estimated mortality rate suggests 6 to 9 million deaths worldwide and 250 to 370 thousand in the U.S. to reach herd immunity. Successes in the mix of NPI, treatments, and vaccine can limit the eventual global death toll of the virus. Improved estimation models for forecasting and decision making may assist in better targeting the local timings and mix of NPI. Diagnostic tests for the virus have been largely limited to symptomatic cases, causing possible sample selection bias. A recursive bivariate probit model of infection and testing is proposed along with several possible applications from cross-section or panel-data estimation. Multiple potential explanatory variables, data sources, and estimation needs are specified and discussed.

The purpose of this paper is to critique the definition of falsification as research misconduct according to the Public Health Service (PHS) in order to better understand what it entails. In support of this purpose, the approach decided upon for analysis was philosophical including framing the issue borrowing from both mereological and epistemological perspectives. Through the consideration given to parthood relations of mereology, we gained insight from a cognitive imperfection standpoint about similarities that exist between the epistemic constraints on knowledge and the nature of violations concerning research misconduct. Findings from the examination of a case study include the significance of accuracy in representation in falsification as misconduct and the core dimensions comprising an instance of falsification, which are Deliberateness, Alteration, and Inclusion. Given that either behavior or actions must occur that violate these three aspects in order to qualify as an instance of misconduct under falsification, the author proposes that, at a minimum, any revisions made to the definition of falsification stipulate what he refers to as the Violation Imperative.

Background: Although antiretroviral therapy (ART) effectively halt disease progression in HIV infections, complete eradiation of the virus remains elusive. Additionally, challenges such as long-term ART toxicity, drug resistance, and the demanding regimen of daily and lifelong ad-herence required by ART highlight the imperative need for alternative therapeutic and preventa-tive approaches. In recent years, broadly neutralizing antibodies (bNAbs) have emerged as promising candidates, offering potential for therapeutic, preventative and possibly curative in-terventions against HIV infection. Objective: This review aims to provide a comprehensive overview of the current state of knowledge regarding the passive immunization of bNAbs in HIV-1 infected individuals. Main findings: Recent findings from clinical trials have highlighted the potential of bNAbs in treatment, prevention, and in the quest of an HIV-1 cure. While monotherapy with a single bNAb is insufficient in maintaining viral suppression and preventing viral escape, ultimately leading to viral rebound, combination therapy with potent, non-overlapping epitope-targeting bNAbs have demonstrated prolonged viral suppression and delayed time to rebound by effec-tively restricting the emergence of escape mutations, albeit largely in individuals with bNAb-sensitive strains. Additionally, passive immunization of bNAb have provided ‘proof-of-concept’ for antibody-mediated prevention against HIV-1 acquisition, although com-plete prevention was not obtained. Therefore, further research on the use of bNAbs in HIV-1 treatment and prevention remains imperative.

This paper is a further development of our “Proposal of a new double-nozzle technique for in-gas-jet laser resonance ionization spectroscopy” published in journal Atoms earlier in this year. Here, we propose to equip the proposed double-nozzle technique with the RF-only funnel and RF-buncher placed in the gas-jet chamber at 70 mm distance downstream the double-nozzle exit. It allows for highly effective extraction into vacuum heavy ion beams, produced in two-steps laser resonance ionization in the argon supersonic jet. We explored the operation of this new full version of the double-nozzle technique through detailed gas dynamic and then Monte Carlo trajectory simulations, which results are presented and discussed. In particularly, we have shown by calculations that more than 80% of all nobelium-254 neutral atoms, extracted by argon flow from the gas stopping cell through the double-nozzle into the supersonic jet can be extracted into vacuum in a form of pulsed ion beam having low transverse and longitudinal emittance.s dynamic and Monte Carlo simulations

Worldwide, among older adults, infection is the leading mortality cause; chronic nutritional deficits confer significant mortality risk and increase healthcare costs. The association of the Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition with infection-related mortality, especially with renal dysfunction in older patients, remains unevaluated. In older patients hospitalized with infection, stratified by renal function, we investigated the association of malnutrition severity with mortality. This single-center, retrospective cohort study of 1220 participants (age ≥65 years) admitted to Aichi Medical University from 2019 to 2020 used a multivariate Cox proportional hazards model to determine the association of GLIM-defined nutritional status (no, moderate, or severe malnutrition) with all-cause mortality. Compared to no malnutrition, moderate and severe malnutrition conferred significantly higher mortality (adjusted hazard ratio [confidence interval ]: 1.00 [reference], 1.76 [1.28-2.42], and 2.44 [1.78-3.33], respectively), with the highest all-cause mortality in malnutrition with a low estimated glomerular filtration rate (eGFR &lt;30 mL/min/1.73m2; 7.35 [4.57-11.8]) compared to no malnutrition and normal eGFR (≥60 mL/min/1.73m2). GLIM-defined malnutrition confers higher all-cause mortality risk in older adults with infection, especially those with renal dysfunction. This information enables the identification of high-risk older patients with infection and targeted clinical management of those with malnutrition, renal dysfunction, and infection.

Low serum alanine aminotransferase activity and high aspartate aminotransferase (AST)/ALT ratio may be associated with high mortality in older people. We aimed to confirm this in an 8-year retrospective cohort study. Clinical data for 5,958 people aged 67–104 years were analyzed for their relationships with all-cause mortality using artificial intelligence (AI; Prediction One [Sony Network Communications Inc.]) and conventional statistical analysis (SAS Enterprise Guide [SAS Institute Inc.]). In total, 1,413 (23.7%) participants died during the study. Auto-AI analysis with five rounds of cross-validation showed that AST/ALT ratio was the third largest contributor to mortality, following age and sex. Serum albumin concentration and body mass index were the fourth and fifth largest contributors, and the individual serum ALT and AST activities were the seventh and tenth largest contributors. Conventional survival analysis showed that ALT, AST, and AST/ALT ratio as continuous variables were all associated with mortality (adjusted hazard ratios (95% confidence intervals): 0.98 (0.97–0.99), 1.02 (1.02–1.03), 1.46 (1.32–1.62), respectively; all p <0.0001). In conclusion, both AI and conventional analysis suggest that of the conventional biochemical markers, high AST/ALT ratio is most closely associated with all-cause mortality in older people.

Therapeutically effective treatments of cancer are limited. To calibrate the efficiency of the novel technique we recently discovered to modulate cancer cell viability using tuned electromagnetic fields; H1299 human lung cancer cells were irradiated in a sweeping regime of W-band (75-105 GHz) millimeter waves (MMW) at 0.2 mW/cm² (2 W/m²). Effects on cell morphology, cell death and senescence were examined and compared to that of non-tumorigenic MCF-10A human epithelial cells. MMW irradiation led to alterations of cell and nucleus morphology of H1299 cells, significantly increasing mortality and senescence over 14 days of observation. Extended irradiation of 10 minutes duration resulted in complete death of exposed H1299 cell population within two days, while healthy MCF-10A cells remained unaffected even after 16 minutes of irradiation under the same conditions. Irradiation effects were observed to be specific to MMW treated H1299 cells and absent in the control group of non-irradiated cells. MMW irradiation affected nuclear morphology of H1299 cells only and not of the immortalized MCF-10A cells. Irradiation with low intensity MMW shows an antitumor effect on H1299 lung cancer cells. This method provides a novel treatment modality enabling targeted specificity for various types of cancers.

This qualitative research study is a part of a larger research project exploring the experiences of young caregivers aged 5-26 years and their families navigating the COVID-19 pandemic between 2020 to 2023. Data was collected from 14 young caregivers who participated in baseline interviews. The central research question guiding this study: What was, is, and will be the impact of changing public health restrictions on young caregivers and their families during the pandemic and pandemic recovery? Seven themes emerged through analysis: 1) Navigating Care During the Height of Public Health Restrictions, 2) Neighbourhood and Built Environment During the Pandemic, 3) Perceptions Towards COVID and Public Health Restrictions/Efforts, 4) The Impact of Public Health Restrictions on Relationships, 5) Mental Health Challenges of Being a Young Caregiver During a Pandemic, 6) Navigating Formal Services and Supports and 7) Recommendations from Young Caregivers. The findings from this empirical research suggest that young caregivers found it easier to navigate their caregiving responsibilities when public health restrictions and work-from-home mandates were initially implemented, however, this later changed due to challenges in finding respite from caregiving, maintaining social connections with friends, creating personal space at home, and finding adequate replacements of programs once offered in-person.

Background: Health-related knowledge is among the essential factors to enable women to be aware of their rights to seek health services. However, little is known about knowledge of safe abortion care services among women of reproductive age in Ethiopia. The main purpose of the study was to assess knowledge of safe abortion care services and associated factors among women of reproductive age in Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from April-June 2019 among 432 respondents. Bivariate statistics including correlation coefficients, student t-test, one-way analysis of variance, and linear regressions, and multiple linear regression analyses were used. A significant statistical test was determined at a 95% confidence interval and p-value <0.05. Results: About 65.5% had heard about safe abortion care services; media being the main source of information for 79.5%. The finding from an independent-sample t-test shows that the place where the respondents grew up (p< 0.006), history of past miscarriage, and previous information of abortion care service were significantly associated with the knowledge about safe abortion care services (p< 0.001). Conclusions: Women without prior health experiences and those with rural origin could be targeted for reproductive health information interventions including safe abortion care provision.

Our goal was to determine the cellular immune response (CIR) among a random sample of the Borriana COVID-19 cohort (Spain) to identify its associated factors and their relationship with infection, reinfection and sequelae. We conducted a nested case-control study using a randomly selected sample of 225 individuals age 18 and older, including 36 individual naïve to SARS-CoV-2 infection, and 189 infected patients. We employed flow cytometry-based immunoassays for intracellular cytokine staining, utilizing Wuhan and BA.2 antigens and chemoluminescence microparticle immunoassay for detection SARS-CoV-2 antibodies. Logistic regression models were used. A total of 215 (95.6%) participants exhibited T-cell response (TCR) to at least one antigen. Positive responses of CD4+ and CD8+ T cells were 89.8% and 85.3% respectively. No difference in CIR was found for naïve and infected patients. Patients who experienced sequelae exhibited higher CIR than those without. A positive correlation was observed between TCR and Anti-Spike IgG levels. Factors positive associated with TCR included A-blood group, number of SARS-CoV-2 vaccine doses received, and Anti-N IgM; factors inversely related were the time elapsed since the last vaccine dose or infection, and B-blood group. These findings contribute valuable insights into the nuance immune landscape shaped by SARS-CoV-2 infection and vaccination.

CD4 count recovery is the main goal for an HIV patient who initiated ART. Some patients respond positively to ART and attain CD4 count recovery, some patients might fail to recover their CD4 count due to non-adherence, treatment resistance, and virological failure, leading to HIV-related complications and death. The purpose of this study is to find the determinants of death in patients who failed to recover their CD4 count after initiating antiretroviral therapy. The data used in this study was obtained from KwaZulu-Natal, South Africa, where 2528 HIV-infected patients with a baseline CD4 count of 200 cells/ were initiated on ART. We used a Fine-Gray sub-distribution hazard and cumulative incidence function to estimate potential confounding factors of death, where CD4 count recovery was a competing event for failure due to death. Patients who were not suffering from tuberculosis were 1.33 times at risk of dying before attaining CD4 count recovery [aSHR 1.33; 95% CI (0.96-1.85] compared to those who had no tuberculosis. Rural patients had a higher risk of not recovering and leading to death [aSHR 1.97; 95%CI (1.57-2.47)] than those from urban areas. The patient’s tuberculosis status, viral load, regimen, baseline CD4 count, and location were significant contributors to death before CD4 count recovery. Intervention programs targeting HIV testing in rural areas for early ART initiation and promoting treatment adherence are recommended.

Evidence was brought forward in England and the USA that Black, Asian, Latino and Minority Ethnic people exhibit higher mortality risk from COVID-19 than White people. While socioeconomic factors were suggested to contribute to this trend, they arguably do not explain the range of the differences observed, allowing for possible genetic implications. Almost concurrently, the analysis of a cohort in Chinese COVID-19 patients proposed an association between the severity of the disease and the presence of the minor allele of rs12252 of the Interferon-induced transmembrane protein 3 (IFITM3) gene. This SNP, together with rs34481144, are the two most studied polymorphisms of IFITM3 and have been associated in the past with increased severity in Influenza, Dengue, Ebola, and HIV viruses. IFITM3 is an immune effector protein that is pivotal for the restriction of viral replication, but also for the regulation of cytokine production. Following up to these two developments in the ongoing SARS-CoV-2 pandemic, the present study investigates a possible association between the differences in mortality of ethnic groups in England and the combined haplotypes of rs12252 and rs34481144. The respective allele frequencies were collected for 26 populations from 1000 Genomes Project and subgroups were pooled wherever possible to create correspondences with ethnic groups in England. A significant correlation (r=0.9687, p= 0.0003) was observed between the reported Standardized Mortality Ratios and the frequency of the combined haplotype of both reference alleles, suggesting that the combination of reference alleles of the specific SNPs may be implicated in more severe outcomes of COVID-19. This study calls for further focus on the role of IFITM3 variants in the mechanism of cellular invasion of SARS-CoV-2, their impact in COVID-19 severity and their possible implications in vaccination efficacy.

Objective: Racial/ethnic disparities in infant mortality (IM) continue to persist in the United States, with Black/African Americans (AA) being disproportionally affected with threefold increase in mortality compared to Whites. Epidemiologic data have identified maternal characteristics as risk IM such as eclampsia, maternal education, smoking, maternal weight, maternal SES, and family structure. Understanding the cause of causes including the method of labor and delivery and the racial heterogeneity may facilitate intervention mapping in narrowing the Black White IM risk differences. We aimed to assess the temporal/racial trends and the methods of delivery, mainly vaginal versus cesarean section (C-section) as exposure function of IM. Methods: The United States linked Birth/Infant Death records (2007-2016) were used with a cross-sectional ecologic design. The analysis involved chi squared statistic, incidence rate estimation, and period percent change. Results: Of the 40,445,070 births between 2007 and 2016, cumulative mortality incidence was 249,135 (1.16 per 1000). The IM rate was highest among Black/AA (11.41 per 1000), intermediate among Whites (5.19 per 1000), and lowest among Asian /Pacific Islanders (4.24 per 1000). The cumulative incidence rate difference, comparing vaginal to cesarean procedure was 1.73 per 1000 infants, implying excess IM with C-section. Compared to C-section, there was a 31% decreased risk of IM among mothers with vaginal delivery, rate ratio (RR) = 0.69, 95% CI 0.64-0.74. Racial disparities was observed in the method of delivery associated with IM. Black/AA mothers with vaginal delivery had a 6% decreased risk of IM compared to C-section, RR = 0.94, 95%CI 0.92-0.95, while Whites with vaginal delivery had a 38% decrease risk of IM relative to C-section, RR= 0.68, 95%CI 0.67-0.69, p<0.001. Conclusion: Infant mortality varied by race, with Black/AA disproportionally affected which is explained in part by labor and delivery procedures, suggesting reliable and equitable intrapartum assessment of Black/AA mothers during labor.

Culex quinquefasciatus is an important target for vector control because of its ability to transmit pathogens that cause disease. Most populations are resistant to pyrethroids and often to organophosphates, the two most common classes of active ingredients used by public health agencies. A knockdown resistance (kdr) mutation, resulting in a change from a leucine to phenylalanine in the voltage gated sodium channel, is one mechanism contributing to the pyrethroid resistant phenotype. Enzymatic resistance has also been shown to play a very important role. Recent studies have shown strong resistance in populations even when kdr is relatively low which indicates factors other than kdr may be larger contributors to resistance. In this study, we examined on a statewide scale (over 70 populations), the strength of the correlation between resistance in the CDC bottle bioassay and the kdr genotypes and allele frequencies. Spearman correlation analysis showed only moderate (-0.51) and weak (-0.29) correlation between the kdr genotype and permethrin and deltamethrin respectively. The frequency of the kdr allele was an even weaker correlate. These results indicate, in contrast to Aedes aegypti, assessing kdr in populations of Culex quinquefasciatus is not a good surrogate for phenotypic resistance testing.

Abstract Sodium glucose cotransporter type 2 inhibitors are a new class of drugs acting on cardiovascular system, renal and metabolism in a multiple way. Indeed, even their principal action is on the transporter of sodium and glucose in the convoluted distal tubule, they have multiple actions as antifibrotic and endothelial protective action. Their principal mechanism consist in the loss of sodium and glucose. Therefore, they have effect on blood pressure and glucose metabolism. In a first period their use has been in the diabetic general population, later on some studies documented their activity in non-diabetic general population, in heart failure in chronic kidney disease. Only in recent years several small studies documented their efficacy in diabetic and non-diabetic kidney transplant patients, larger studies are few and very recent and open new ways for these drugs

Introduction: Glomerulopathy is a term used to describe a broad spectrum of renal diseases, character-ized by dysfunction of glomerular filtration barrier, especially of podocytes. Several podocyte-associated proteins have been found and proved their usefulness as urine markers of podocyte dysfunction. Two of them are nephrin (NEP) and prodocalyxin (PDC). Purpose: This study aims to evaluate the association of podocyte damage, as it is demonstrated via the concentrations of urinary proteins, with clinical and histological data from patients with several types of glomerulonephritis. Methods: We measured urine levels of two podocyte-specific markers, NEP and PDC (corrected for urine creatinine levels), in patients with a wide range of glomerulopathies. Serum and urine parameters as well as histological parameters from renal biopsy were recorded. Results: In total, data from 37 patients with glomerulonephritis and 5 healthy controls were analyzed. PDC and NEP concentrations correlated between them and with serum creatinine levels (p=0.001 and p=0.013 respectively), and with histological lesions associated with chronicity index of renal cortex, such as severe interstitial fibrosis, severe tubular atrophy and hyalinosis (for PDC/NEP, all p3gr/24h with diffuse fusion of podocyte foot processes (p=0.016) was identified. Conclusions: Podocalyxin and nephrin concentrations in urine represent markers of podocyte dysfunction and in our study they were associated both with serum creatinine and histological chronicity indices.