Based upon 30-years of research by the author a new approach to hospital bed planning and international benchmarking is proposed. The number of hospital beds per 1000 population is commonly used to compare international bed numbers. This method is flawed because it does not consider population age structure or the effect of nearness-to-death on hospital utilization. Deaths are also serving as a proxy for wider bed demand arising from undetected outbreaks of 3000 species of human pathogens. To remedy this problem a new approach to bed modelling has been developed which plots beds per 1000 deaths against deaths per 1000 population. Lines of equivalence can be drawn on the plot to delineate countries with higher or lower bed supply. This method is extended to attempt to define the optimum region for bed supply in an effective health care system. England is used as an example of a health system descending into operational chaos due to too few beds and manpower. The former Soviet bloc countries represent a health system overly dependent on hospital beds. Several countries also show evidence for over-utilization of hospital beds. The new method is used to define a potential range for bed supply and manpower where the current most effective health systems currently reside. The method is applied to total curative beds, medical beds, psychiatric beds, critical care, geriatric care, etc., and can also be used to compare different types of healthcare staff, i.e., nurses, physicians, surgeons. Issues surrounding the optimum hospital size and the optimum average occupancy will also be discussed. The role of poor policy in the English NHS is used to show how the NHS has been led into a bed crisis. The method is also extended beyond international benchmarking to illustrate how it can be applied at a local or regional level in the process of long-term bed planning. Issues regarding the volatility in hospital admissions are also addressed to explain the need for surge capacity and why an adequate average bed occupancy margin is required for an optimally functioning hospital.

The construction of different roads, such as freeways, highways, major roads or minor roads must be accompanied by constant monitoring and evaluation of service delivery. Pavements are generally assessed by engineers in terms of the smoothness, surface condition, structural condition and surface safety. Pavement assessment is often conducted using the qualitative indices such as international roughness index (IRI), pavement condition index (PCI), structural condition index (SCI) and skid resistance value (SRV), which are used for smoothness assessment, surface condition assessment, structural condition assessment, and surface safety assessment, respectively. In this paper, Tehran-Qom Freeway in Iran has been selected as the case study and its smoothness and pavement surface conditions are assessed. At 2-km intervals, a 100-meter sample unit is selected in the slow-speed lane (totally, 118 sample units). In these sample units, the PCI is calculated after a visual inspection of the pavement and the recording of distresses. Then, in each sample unit, the average IRI is computed. The purpose of this study is to provide a method for estimating PCI based on IRI. The proposed theory was developed by Random Forest (RF), and Random Forest optimized by Genetic Algorithm (RF-GA) methods and these methods were validated using correlation coefficient (CC), scattered index (SI), and Willmott’s index of agreement (WI) criteria. The proposed method reduces costs, saves time and eliminates the safety risks.

The infections caused by various bacterial pathogens both in clinical and community settings represent a significant threat to public healthcare worldwide. The growing resistance to antimicrobial drugs acquired by bacterial species causing healthcare-associated infections has already become a life-threatening danger noticed by the World Health Organization. Several groups or lineages of bacterial isolates usually called ‘the clones of high risk’ often drive the spread of resistance within particular species. Thus, it is vitally important to reveal and track the spread of such clones and the mechanisms by which they acquire antibiotic resistance and enhance their survival skills. Currently, the analysis of whole genome sequences for bacterial isolates of interest is increasingly used for these purposes, including epidemiological surveillance and developing of spread prevention measures. However, the availability and uniformity of the data derived from the genomic sequences often represents a bottleneck for such investigations. In this dataset, we present the results of a comprehensive genomic epidemiology analysis of 17,546 genomes of a dangerous bacterial pathogen Acinetobacter baumannii. Important typing information including multilocus sequence typing (MLST)-based sequence types (STs), intrinsic blaOXA-51-like gene variants, capsular (KL) and oligosaccharide (OCL) types, CRISPR-Cas systems, and cgMLST profiles are presented, as well as the assignment of particular isolates to nine known international clones of high risk. The presence of antimicrobial resistance genes within the genomes is also reported. These data will be useful for researchers in the field of A. baumannii genomic epidemiology, resistance analysis and prevention measure development.

How much is religion quantitatively involved in global climate politics? After assessing the role of the Conference of Parties to the United Nations Framework Convention on Climate Change from a normative perspective, this descriptive, transdisciplinary and unconventional study offers the first comprehensive quantitative examination of religious nongovernmental organizations that formally participate in its annual meetings, the largest attempts to solve the climate crisis through global governance. This study finds that although their numbers are growing, only about 3 percent of registered nongovernmental organizations accredited to participate in the conference are overtly religious in nature — and that more than 80 percent of those faith-based groups are Christian. Additionally, this study finds that religious nongovernmental organizations that participate in the conference are mostly from the Global North. The results call for greater participation of religious institutions in the international climate negotiations in order for society to address the planetary emergency of climate change.

Background: Acceleration of mass vaccination strategies is the only pathway to overcome the COVID-19 pandemic. Healthcare professionals and students have a key role in shaping public opinion about vaccines. This study aimed to evaluate the attitudes of dental students globally towards COVID-19 vaccines and explore the potential drivers for students' acceptance levels; Methods: A global cross-sectional study was carried out in February 2021 using an online ques-tionnaire. The study was liaised by the scientific committee of the International Association of Dental Students (IADS), and data was collected through the national and local coordinators of IADS member organizations. The dependent variable was the willingness to take the COVID-19 vaccine, and the independent variables included demographic characteristics, COVID-19-related experi-ence, and the drivers of COVID-19 vaccine-related attitude suggested by the WHO-SAGE; Results: A total of 6639 students from 22 countries representing all world regions responded to the ques-tionnaire properly. Their mean age was 22.06 ± 2.79 (17-40) years, and the majority were females (70.5%), in clinical years (66.8%), and from upper-middle-income economies (45.7%). In general, 22.5% of dental students worldwide were hesitant, and 13.9% rejected COVID-19 vaccines. The students in low- and lower-middle-income (LLMI) economies had significantly higher levels of vaccine hesitancy compared to their peers in upper-middle- and high-income (UMHI) economies (30.4% vs 19.8%; p < 0.001); Conclusions: The global acceptance level of dental students for COVID-19 vaccines was suboptimal, and their worrisome level of vaccine hesitancy was influenced by the socioeconomic context where the dental students live and study. The media and social media, public figures, insufficient knowledge about vaccines, and mistrust of governments and the pharmaceutical industry were barriers to vaccination. The findings of this study call for further implementation of epidemiology (infectious diseases) education within undergraduate dental curricula.

This paper presents an overview of EREMI, a two-year project funded under ERASMUS+ KA203, and its results. The project team's main objective was to develop and validate an advanced interdisciplinary higher education curriculum, which includes lifelong learning components. The curriculum focuses on enhancing resource efficiency in manufacturing industries and optimizing poorly or non-digitized industrial physical infrastructure systems. The paper also discusses the results of the project, highlighting the successful achievement of its goals. EREMI effectively supports the transition to Industry 5.0 by preparing a common European pool of future experts. Through comprehensive research and collaboration, the project team has designed curriculum that equips students with the necessary skills and knowledge to thrive in the evolving manufacturing landscape. Furthermore, the paper explores the significance of EREMI's contributions to the field, emphasizing the importance of resource efficiency and system optimization in industrial settings. By addressing the challenges posed by under-digitized infrastructure, the project aims to drive sustainable and innovative practices in manufacturing. All five project partner organisations have been actively engaged in offering relevant educational content and framework for decentralised sustainable economic development in regional and national contexts through capacity building at local level. A crucial element of the added value is the new channel for feedback from students. The survey results, which are outlined in the paper, offer valuable insights gathered from students, contributing to the continuous improvement of the project.

Abstract Introduction:The Robert Koch Institute (RKI) managed the exchange of cross-border contact tracing data between public health authorities (PHA) in Germany and abroad during the COVID-19 pandemic. Aim: We aimed to describe the extent of RKI cross-border contact tracing and the challenges experienced. Methods:We analysed cross-border COVID-19 contact tracing events from 03 February to 05 April 2020 using information exchanged through the European “Early Warning Response System” (EWRS) as well as communication with International Health Regulation (IHR) national focal points. We described events by PHA involved, number of contact persons and exposure context. Results:The RKI processed 467 events, initiating contact to PHA 1,099 times (median 1, IQR [1;2]) and sharing data on 5,099 contact persons. Of 327 (70%) events with known exposure context, most common reported were exposures on aircraft 64 (14%), on cruise ships 24 (5%) and exposures related to non-transport contexts 210 (45%). Cruise ship and aircraft exposures yielded higher median numbers of authorities contacted (10[2;16], 4[2;11]) and contact persons (60 [9;269], 2[1;3]) than non-transport related exposures (1[1;6] and 1[1;2]), respectively. The median time spend on contact tracing activities was the highest for cruise ships: 5 days [IQR 3;9]. Conclusion:In the current COVID-19 pandemic cross-border contact tracing is considered a critical component of the outbreak response. While the majority of international contact tracing activities did not relate to exposure events in transport, they contributed substantially to the workload. The numerous communications highlight the need for fast and efficient global outbreak communication channels between PHA.

For better export marketing strategies (EMS), companies mobilize their internal resources, which are managerial commitment, firm experience, and product uniqueness. However, Small businesses with constrained resources cannot be well explained with this view. So, more research on how small business come up with EMS have been called for. To explain how resource-restricted firms which rely heavely on entrepreneur, this study adopted the concept of dynamic managerial capabilities (DMCs) and resource versatility to better explain small business exports. We analyzed small businesses in Mongolia with qualitative research methods, including interviews with entrepreneurs and support organizations, site visits, and group discussions. We suggest international dynamic marketing capabilities (IDMCs), which are entrepreneurial orientation, networking capability, and versatile dynamic capability for small business. Theoretical and managerial implications are discussed.

Maritime surveillance technology faces challenges of astronomical size in this vast ocean world—challenges vital to global security and environmental protection alike. Such as these may be reversible or not. Remotely sensed monitoring also uses photos taken from satellites, synthetic aperture radar (SAR) equipment, and unmanned aerial vehicles (UAVs) to fully monitor maritime activities but also ferret out suspicious behaviour like piracy, bootleg shipments, and illegal fishing. This mixed-method approach--quantitatively and qualitatively——measures the efficiency of difficulties associated with, and legal implications behind aerospace-monitored maritime surveillance. The results show that remote sensing provides a great deal of sea-level situational awareness; however, there are also many complex technical, operational, and legal issues, including information overcrowding, complications in integration, privacy issues, as well as the need for worldwide legal harmonisation. It ends with recommendations on ways to ultimately increase capacity, how to write standard procedures for secondary development and proposals for revising laws to absorb these new technologies. Its goal, therefore, is to benefit the global anti-maritime crime effort. Ultimately, though, it dreams that we might construct an entirely marine environment where all marine activities are conducted both safely and freely, without fear.

The maritime industry contributes to over 80% of global trade and ranks as the sixth-largest emitter of greenhouse gases. The International Maritime Organization has taken strides to reduce these emissions, while the European Union spearheads efforts to establish sustainable maritime transport. However, meeting decarbonisation targets poses significant challenges, with the potential implications of adopting an EU Emission Trading System (ETS) on shipping allowances, particularly at specific borders. If not managed effectively, this could result in diversifying regular container shipping routes away from EU ports, potentially leading to increased shipping emissions and disrupting the logistics trade and security chain. These challenges are exacerbated by the International Maritime Organization's lack of a carbon fee on bunkering, which creates an imbalance. The ETS Directive has fostered unfair competition between EU and non-EU ports due to discrepancies in applying emission unit allowances. It is imperative to implement preventive measures to contain and prevent the shift of operations from EU ports to nearby ports, ensure equitable treatment of EU transhipment ports and their competitors, and thwart carbon leakage. Additionally, the recent Houthis attacks on the Red Sea have significantly impacted shipping costs on the Cape of Good Hope route to Europe, necessitating increased allowances to and from Europe.

The maritime industry contributes to over 80% of global trade and ranks as the sixth-largest emitter of greenhouse gases. The International Maritime Organization has taken strides to reduce these emissions, while the European Union spearheads efforts to establish sustainable maritime transport. However, meeting decarbonisation targets poses significant challenges, with the potential implications of adopting an EU Emission Trading System (ETS) on shipping allowances, particularly at specific borders. If not managed effectively, this could result in diversifying regular container shipping routes away from EU ports, potentially leading to increased shipping emissions and disrupting the logistics trade and security chain. These challenges are exacerbated by the International Maritime Organization's lack of a carbon fee on bunkering, which creates an imbalance. The ETS Directive has fostered unfair competition between EU and non-EU ports due to discrepancies in applying emission unit allowances. It is imperative to implement preventive measures to contain and prevent the shift of operations from EU ports to nearby ports, ensure equitable treatment of EU transhipment ports and their competitors, and thwart carbon leakage. Additionally, the recent Houthis attacks on the Red Sea have significantly impacted shipping costs on the Cape of Good Hope route to Europe, necessitating increased allowances to and from Europe.

Early reports demonstrated the presence of cells with stem-like properties in bone marrow, with these cells having both hematopoietic and mesenchymal lineages. Over the years, various investigations have purified and characterized mesenchymal stromal/stem cells (MSCs) from different human tissues as cells with multi-lineage differentiation potential under the appropriate conditions. Due to their appealing characteristics and potential, MSCs are leveraged in many applications including medicine, oncology, bioprinting and as recent as treatment of COVID-19. To date, reports indicate mesenchymal stromal/stem cells have varied differentiation capabilities into different cell types and demonstrate immunomodulating and anti-inflammatory properties. Reports indicate that different MSCs microenvironments or niche and the resulting heterogeneity may influence their behavior and differentiation capacity. The potential clinical applications of mesenchymal stromal/stem cells have led to an avalanche of research reports on their properties and hundreds of clinical trials being undertaken. The future looks bright and promising for mesenchymal stem cell research with many clinical trials under way to prove their utility in many applications and in the clinic. This report provides an update on the potential broader use of mesenchymal stromal/stem cells, review early observations of the presence of these cells in the bone marrow and their magnificent differentiation capabilities and immunomodulation.

The increase in arrivals of new forest pests highlights the need for effective phytosanitary legislation and measures. This paper introduces legislation targeted at prevention and management of potential introductions of forest pests and pathogens. A summary is given on plant health regulations on a global and regional level with detailed information on the situation in the European Union (EU). The current and new European legislation is discussed and a particular focus is given on eradication and contingency plans for Fusarium circinatum.

Background: Physical and mental health of corporate employees is equally important, especially in international salespeople in the in vitro diagnostic (IVD) medical device industry. The rapid growth of the IVD market is driven by the increasing prevalence of chronic and infectious diseases. This study aims to identify the association of socio-demographic, occupational, organizational, and psychosocial factors with mental health outcomes for depression, anxiety, and somatic symptoms in Chinese IVD international salespeople. Methods: The study was a cross-sectional survey of ISs in IVD companies officially registered in China. An online survey was designed to collect data through email contact with IVD companies and social media between August 2022 and March 2023. Measured factors included effort-reward imbalance (ERI), health-promoting leadership (HPL), health climate (HC), inner strength (IS), and perceived social support (PSS). Mental health outcomes assessed using the Core Symptom Index (CSI) were depression, anxiety, and somatic symptoms. Results: A total of 244 salespeople responded to the survey. CSI scores indicated that 18.4% (n = 45) and 10.2% (n = 25) of the respondents had symptoms of major depression and anxiety, respectively. ERI was positively correlated, while the IS and PSS were negatively correlated with major depression, anxiety, and somatic symptoms (p < .01). Health climate was negatively correlated with major depression (p < .05). Education background was associated with somatic symptoms (p < .05). ERI, IS, and gender were significant predictors of major depression, anxiety, and somatic symptoms (p < .05). Conclusion: The prevalence of depression and anxiety in China’s IVD international salespeople was considered low compared with prevalence in Chinese populations during COVID-19, but higher than those before the pandemic. Effort–reward imbalance, inner strength, and gender were significant factors in major depression, anxiety, and somatic symptoms among IVD international salespeople.