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.

Vaccines decrease morbidity and mortality. Nevertheless, their benefits depend on public response. During COVID-19, vaccine hesitancy and refusal were rampant, threatening public health. A thorough understand-ing of opponents' arguments is required to address the diffusion of unreliable information on social media and prevent vaccine hesitancy from developing into vaccine refusal. Accordingly, the article examines vac-cine opponents' justifications on social media. Textual content analysis of reader comments on three health-related Israeli Facebook pages was conducted. Data collection encompassed the Israeli COVID-19 vaccination period from October 2020 to May 2022. The comments were analyzed according to the health beliefs model (HBM). We found that vaccine opponents were characterized by low perceptions of the severity of the disease combined with high perceptions of the damages of the vaccine; low perceived benefits of vac-cine compliance; vaccine hesitancy and fear along with public distrust as barriers to change; and call for ac-tion to resist the vaccine and spread related anti-establishment views on the web. As vaccination hesitancy was found to develop into public distrust in the state systems and escalate into conspiracy beliefs and an-ti-vaccination activism, its early detection may prevent future vaccine resistance.

Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

Background: Online survey-based observational cross-sectional study aimed at elucidating experience and attitudes of unstructured population regarding diagnostic imaging. Methods: Invitations to participate were distributed using mixed-mode design to deidentified residents aged 18 years and older. Main outcome measures included morbidity structure and incidence of diagnostic imaging administrations. Results: Respondents (n = 1069) aged 44.3 ± 14.4 years; 32.8% suffered from cardiovascular diseases (CVD); 9.5% had chronic respiratory pathology; 28.9% considered themselves healthy. Respondents with COVID-19 history (49.7%) reported higher rates of computed tomography (CT) (p < .0001), magnetic resonance imaging (MRI) (p < .001), and ultrasound (p < .05). COVID-19 history in CVD respondents shifted imaging administrations towards CT and MRI (p < .05). Every tenth respondent received MRI, CT, and ultrasound on paid basis; 29.0% could not pay for diagnostic procedures; 13.1% reported unavailable MRI. Professional status significantly affected the pattern of diagnostic modalities (p < .05). MRI and CT availability differed between respondents in urban and rural areas (p < .0001). History of technogenic events predisposed responders to overestimate diagnostic value of fluorography (p < .05). Conclusions: Preparedness to future pandemics requires development of community-based outreach programs focusing on people's awareness regarding medical imaging safety and diagnostic value.

More than half a century has passed since the discovery of the genetic code, but its origin is still one of the greatest mysteries in life science, although a plenty of theories have been proposed so far, as none can explain satisfactorily why the genetic code evolved in such a way, especially in the context of the biochemical system, a relation of part to whole. Here, a new hypothesis is proposed, according to which ATP is at the origin of the genetic code by its coevolution with the pristine biochemical system of the protocell. This hypothesis shows how primitive life with its genetic code emerged through a series of processes from energy flow to information communication mediated by ATP. First, ATP is the only energetic product of photosynthesis, and is at the energetic heart of the extant biochemical systems. Second, ATP serves as not only an energy carrier but also an informatization molecule, as ATP could energetically elongate chains of both polynucleotides and polypeptides, thus providing a bridge between these molecules and eventually mediating biochemical innovation in the protocell from energy transformation to informatization, a process for creating and managing information. Informatization was inevitably coupled with structuralization (processes for organizing or incorporating cellular structures), cyclizing polynucleotides and polypeptides into a feedback loop of reciprocal causation. The triplet codon might be only for stereochemical handling of amino acids through, e.g., Watson–Crick pairing interactions. It is only the evolutionary completion of the genetic code from RNA to DNA that, contrary to the central dogma, marked the dawn of cellular life, when Darwinian evolution began to operate. The ATP hypothesis sheds light on the origin of life, together with the formation of both photosynthetic and biochemical systems, which remains largely unknown thus far.

People from Black and Asian backgrounds are more likely to die from Covid-19 but less likely to be vaccinated, threatening to exacerbate health inequalities already experienced by ethnic minority groups. Literature suggests that mistrust rooted in structural inequality may be a key barrier to Covid-19 vaccine uptake. We need to better understand how structural inequalities influence vaccine confidence. Understanding and addressing these processes is likely to lead to longer-term impacts than information alone. We draw on health and sociological theories of structure and agency to inform our understanding of structural factors. We conducted qualitative interviews and focus groups with 22 people from London and surrounding areas in December 2021 to March 2022. Fifteen participants were members of the public from ethnic minority backgrounds and 7 were professionals working with the public to address concerns and encourage vaccine uptake. Our findings suggest that people from ethnic minority backgrounds make decisions regarding Covid-19 vaccination based on a combination of how they experience external social structures (including political authority, social positioning and racial inequality) and internal processes (what they believe and understand about Covid-19 vaccines). We may be able to support knowledge accumulation through the provision of reliable and accessible information, particularly through primary and community care. But we recommend a number of changes to research, policy and practice which address structural inequalities. These include working with communities to improve ethnicity data collection, increasing funding allocation to health conditions where ethnic minority communities experience poorer outcomes, greater transparency and public engagement in the vaccine development process, and culturally adapted research recruitment processes.

The aim of study was to investigate epidemiology aspects of magnetic resonance imaging (MRI) during COVID-19 pandemic. The study comprised depersonalized residents of Tomsk and Tomsk Region (n = 1714). Invitations to take online survey were sent to 50,000 residents by target SMS with response rate of 1.2% (n = 727, Cohort 1). Cohort 2 comprised retrospective patients (n = 987) who underwent contrast-enhanced cardiac MRI (CMR) in 2019-2022. Referrals, clinical characteristics, diagnosis, gender, age, past COVID-19, MRI study protocols, and MRI data were analyzed. 29% of respondents in cohort 1 received MRI examination within past two years; 26% of respondents considered MRI the most informative imaging modality for detecting COVID-19 pneumonia; 12% of respondents reported MRI unavailable. Proportion of CMR among MRI studies increased during COVID-19 pandemic, and maximum incidence of cardiac diseases detected by MRI was in 2021. Incidence of myocardial fibrosis increased from ~67% in 2019 to ~84% in 2022. The rate of outpatient MRI studies significantly increased in 2020, but returned to pre-pandemic level in 2021. COVID-19 pandemic increased the need for MRI and CMR. Patients with history of COVID-19 had persistent and newly occurring symptoms of myocardial damage suggesting chronic cardiac involvement requiring continuous follow-up.

This paper responds to the research question, “can urban farming help Nepali cities become more sustainable”? Especially after the Covid-19 pandemic, urban residents have begun to realize that food transported from long distances could not always be reliable. Urban farming can help produce fresh food locally and avoid long-distance transportation, and refrigeration. This practice also helps reduce greenhouse gases through plant carbon use efficiency (CUE). Urban farming not only helps city-dwellers towards achieving self-reliance in food production but also in vegetation carbon dynamics (VCD) while supporting the circular economy. Urban farming consists of edible landscapes, which can also be an aesthetic public space. As urban lands command higher prices than agricultural land, urban farming usually happens on residential yards, roofs, balconies, community gardens, and dedicated areas in public parks. Rainwater harvesting, and redirecting can help irrigate urban farms which can be part of rain gardens. The national census of 2021 (CBS 2022, p5) identifies that 66 percent of Nepal’s population live in urban areas. However, the World Bank (2018), shows that only 21 of Nepal’s population was projected to live in urban areas in 2021. It is not debatable that the urbanization process in Nepal is on the rise. Thus, urban agriculture can play an important role to supplement the residents’ food needs. Many cities in Nepal have already successfully adapted to urban farming where residents grow food on their building site, balconies, and rooftop often growing plants on pots, vases, and other types of containers. The UN-Habitat, with the support of European Union and local agencies, has published a rooftop farming training manual (2014) showing the feasibility of urban farming in Nepal.The paper discusses how Public Private Partnership (PPP) can promote urban agriculture and make the process more effective and attractive to urban farming households. It also analyzes how a PPP approach also facilitates the use of better technology, advisory support, and use of research extension activities. This paper draws on literature review, secondary data (e.g., from National Census Nepal 2021) and authors’ professional experiences related to best practices in the areas to analyze the benefits and challenges related to urban farming in Arizona, USA. The paper will provide recommendations for Nepali cities to maximize the benefit provided by urban farming. It is expected to be useful to Nepali policy makers, and government agencies, and nonprofit organizations which promote sustainability, and organic farming.

The urgency for a shift towards cleaner and more efficient energy alternatives for power generation is underscored by the escalating demand for energy and the detrimental environmental impacts of conventional fossil fuels. In the case of automotive power, electric vehicles are being adopted in many applications, however, challenges remain such as extended charging periods and limited ranges between charges. Therefore, this research study conducts a techno-economic analysis of renewable energy technologies (including solar modules, wind turbines and piezoelectric materials) to augment the efficiency and sustainability of electric buses. The study examines the scope for these technologies to be adopted on double-decker electric buses in London in the United Kingdom. The solar modules are placed on the rooftop and sides of the bus generating 15.9 kWh/day and the wind turbine in the front bumper of the bus generates 8.3 kWh/day. However, the piezoelectric material generated only 22.6 Wh/day, rendering it an impractical inclusion in further analysis. Therefore, both the solar modules and wind turbines combined generate 24.2 kWh/day, which can increase the driving range by 16.3 km per day and this results in savings of 19.36 minutes for charging at the stations. Investing in such projects would have a positive return as the internal rate of return (IRR) and net present value (NPV) are 2.8% and £11,175 respectively. The annual revenue would be £6,712, and the greenhouse gas (GHG) reduction would be two metric tons annually. Electricity exported to the grid, the electricity export rate, and the initial investment are identified as key factors influencing power outage in a sensitivity analysis. In conclusion, this numerical modelling study paves the way for experimental validation towards implementation of renewable energy technologies on electric bus fleets.

Low-cost personal exposure monitors (PEMs) to measure personal exposure to air pollution are potentially promising tools for health research. However, their adoption requires robust validation. This study evaluated the performance of twenty-one Plume Lab Flow2 (PLF) by comparing its air pollutant measurements, particulate matter with a diameter of 2.5 μm or less (PM2.5), 10 μm or less (PM10), and nitrogen dioxide (NO2), against several high-quality air pollution monitors under field conditions (at indoor, outdoor, and roadside locations). Correlation and regression analysis were used to evaluate measurements obtained by different PLFs against reference instrumentation. For all measured pollutants, the overall correlation coefficient between the PLFs and the reference instruments was often weak (r<0.4). Moderate correlation was observed for one PLF unit at indoor location and two units at roadside location, when measuring PM2.5, but not for PM10 and NO2 concentration. During periods of particularly higher pollution, 11 PLF tools showed stronger regression results (R2 values > 0.5) with one-hour and 9 PLF units with one-minute time interval. Results show that the PLF cannot be used robustly to determine high and low exposure to poor air. Therefore, the use of PLFs in research studies should be approached with caution if data quality is important to the research outputs.

Role identity theory describes the purpose and meaning in life that comes, in part, from occupying social roles. While robustly linked to health and well-being, this may become, however, when an individual is unable to fulfil the perceived requirements of an especially salient role in the way that they believe they should. Amid high rates of mental illness among public safety personnel, we interviewed a purposely selected sample of 21 paramedics from a single service in Ontario, Canada to explore incongruence between an espoused and able-to-enact paramedic role identity. Situated in an interpretivist epistemology, and using successive rounds of thematic analysis, we developed a framework for role identity dissonance wherein chronic, identity-relevant disruptive events cause emotional and psychological distress. While some participants were able to recalibrate their sense of self and understanding of the role, for others, this dissonance was irreconcilable, contributing to disability and lost time from work. In addition to contributing a novel perspective on paramedic mental health and well-being, our work also offers a modest contribution to the theory in using the paramedic context as an example to consider identity disruption through chronic workplace stress.

Reciprocal Personal/Public Protection (RPPP) featured with source control is introduced, Mask Discriminating Mouth and Nose (MDMN) is employed to serve the purpose, which includes polymer based mouth cover with optional nose cover. The new knowledge that mouth is a primary, active and dominant source of the virus has been well established, which is the base of MDMN. Source classification and related source control tools are discussed, mouth cover is recommended as the tool prioritized to use. Liquid droplets is identified as a hard issue related to mask, liquid droplets, mask fitting, comfort and facial recognition constitute real challenges of mask in addition to efficiency, All of these have been addressed with MDMN. Comparisons between MDMN and masks/face covering are taken on four aspects: efficiency and efficacy, tolerance and comfort, cost and waste, and civil rights and public interest. Mouth cover is recommended to replace the face covering and act as both a personal tool and a public utensil, mouth cover with nose cover can provide better protection than N95 etc. RPPP with MDMN, could be an alternative for lockdown, a parallel strategy to vaccine, and a collectively living way during the pandemic era. MDMN, featured with high efficiency protection, high degree comfort, easy wearing, tight-fitting, easy facial recognition & communication, reusability, cost-effective, environment friendly and scale manufacturing more readily and widely etc., is a simple and sustainable solution, which is essential for ordinary people to keep wearing it properly for protection.

To predict how the COVID-19 pandemic progresses, we developed a systematic method for predicting disease outcomes. In the method, we evaluate how personal disease outcomes are mainly affected by viral concentration and exposure time and four defense mechanisms: human innate immunity/host response, acquired immune response, inflammation resolution and micro circulation, and the available space in the thorax cage. By considering how pandemic measures affect viral exposure and those mechanisms, we found many pandemic measures are misused or abused to deliver long-term adverse impacts. We noted that lifestyles have been changed as a result of movement restriction measures. By using the method, we found that altered lifestyles are predicted to raise infection rate, disability and death risks in the future. We show that a person can use personal, environmental, emotional factors to reduce infection rate and death risk. To prove the validity of this finding, we extensively examined medical research models, holistic and reductionist models, epidemiological models, disease risk factors, etc, and found that population methods are unfit for studying holistic health, statistical population does not exist in most clinical trials, mathematical models were misused for studying disease properties for a population, mathematical equations for modeling personal diseases are beyond human ability to solve, statistical models are misused, population-derived treatments are inherently dangerous to patients, vaccines have limited benefits due to unique lung structure and rapid RNA mutation, and immune system damage is caused by fast viral replication rate. We found that altering biological properties to improve the defense mechanisms could prevent a super majority of deaths and prevent the virus from reaching a point to damage the immune system. For vulnerable persons, such measure is a viable strategy for surviving from the pandemic. As a whole, holistic personalized medicine is more powerful than population-based reductionist treatment by one to several orders of magnitudes. We urge people do their parts to force the medical establishment to abandon population treatment models that are responsible for failure of medicine and dissemination of misleading and factually wrong information on the effectiveness of medical treatments.

Our primary objectives were a) to determine the need for, and the availability of point-of-care testing (POCT) for infectious diseases and b) to recommend point-of-care testing strategies and spatial care paths (SCPs) that enhance public health preparedness in regional districts of Thua Thien Hue Province (TTHP), Central Vietnam, where we conducted field surveys. Medical professionals in 7 community health centers (CHCs), 7 district hospitals (DHs) and 1 provincial hospital (PH) participated. Survey questions (English and Vietnamese) determined the status of diagnostic testing capabilities for infectious diseases and other acute medical challenges in TTHP. Infectious disease testing was limited: 6 of 7 CHCs (86%) lacked infectious disease tests. One CHC (14%, 1/7) had two forms of diagnostic tests available for the detection of Malaria. All CHCs lacked adequate microbiology laboratories. District hospitals had few diagnostic tests for infectious diseases (Tuberculosis, Syphilis), blood culture (29%, 2/7), and pathogen culture (57%, 4/7) available. The PH had broader diagnostic testing capabilities but lacked preparedness for highly infectious disease threats (e.g., Ebola, MERS-CoV, SARS, Zika, and Monkeypox). All sites reported having COVID-19 rapid antigen tests; COVID-19 RT-PCR tests were limited to higher tier hospitals. We conclude that infectious disease diagnostic testing should be improved and POC tests must be supplied near patients’ homes and in primary care settings for the early detection of infected individuals and mitigation of the spread of new COVID-19 variants and other highly infectious diseases.

Improving the effectiveness of health interventions is a major challenge in public health research and program development. A large body of literature has found low or no impact of health education and promotional interventions. We aim to develop a conceptual framework in support of intervention designs for preventive health behavior improvement programs and outcomes. The proposed approach is based on a narrative review of empirical literature assessing the limitations of less effective or ineffective field experiments regarding preventive health education and promotion interventions. We found three major limitations regarding the mental model’s balance of treatment and comparison groups, treatment groups’ willingness to adopt suggested behaviors, and the type, length, frequency, intensity, and sequence of treatments. To minimize the influence of these concerns, we propose a mental model-based repeated multifaceted (MRM) intervention design framework to provide an intervention design for improving health education and promotional programs.

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

The COVID19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID19 number) with suspected COVID19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. 8,957 patients were included. 2,157 (48.0%) of the 4,493 patients assessed on the official emergency number had dyspnoea. 4,045 (90.6%) of 4,464 patients assessed on the COVID19 number had flu-like symptoms. 1,798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n=81) of cases, and caught 7 (7.7%) patients in life-threatening emergency. Medical triage decisions for suspected COVID19 patients are strongly influenced by the use of live video.

There is growing recognition in research and policy of a mental health crisis among Canada’s paramedics but despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with Post-Traumatic Stress Disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (a 97% completion rate) and found that 11% screened positive for PTSD, 15% for depression, and 15% for anxiety, with 1 in 4 active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service’s peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates – a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada.

Perhaps the greatest challenge in the graft copolymerization of acrylic acid onto starch initiated by Fenton’s is the selectivity of the grafting reaction. Low selectivity means that too much of unwanted homopolymer polyacrylic acid is produced. In this paper, it has been analyzed why with this reaction system, involving a water soluble monomer and indirect initiation, the graft selectivity is such a challenge. Several other grafting reactions, especially with monomers of low water solubility or when direct initiation is applied, show a better grafting performance. A scheme is presented based on reaction engineering principles, that supports an explanation of the observed differences. A more selective activation of starch is a factor, but perhaps even more important is a low monomer to starch ratio at the starting sites of graft reactions. Based on these insights, several methods to improve the graft selectivity are evaluated, with the help of literature data but mostly by experimental explorations in our laboratory. Most promising appears to be a dedicated dosage method, to add monomer in portions over time, tested in a batch reactor with gelatinized cassava starch. This way, both grafting percentage and graft selectivity could be improved. Such could not be realized with the more conventional dosage, which is to add all monomer before the start of the reaction. This can be considered a principal breaktrough. Still, more research and development would be needed to refine the method and to implement the idea also in a continuous reactor at larger scale.

In this article, we estimate the value of Government Expenditure on Education-GEE in the context of Environmental, Social and Governance-ESG dataset of the World Bank. We use data from 193 countries in the period 2011-2020. We use Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS, and Weighted Least Squares-WLS. Our results show that the value of GEE is positively associated among others to “Case of Death, by communicable disease and maternal, prenatal and nutrition conditions”, and “Unemployment”, and negatively associated among others to “Hospital Beds” and “Government Effectiveness”. Furthermore, we apply the k-Means algorithm optimized with the Elbow Method and we find the presence of four clusters. Finally, we confront eight machine learning algorithms for the prediction of the future value of GEE. We found that the Polynomial Regression is the best predictive algorithm. The Polynomial Regression predicts an increase in GEE of 7.09% on average for the analysed countries.

In this article, we estimate the role of Political Stability and Absence of Violence and Terrorism-PS in the context of Environmental, Social and Governance-ESG data at world level. We analyse data from 193 countries in the period 2011-2020. We apply Panel Data with Fixed Effects, Panel Data with Random Effects and Pooled Ordinary Least Square-OLS. We found that PS is positively associated, among others, to Population Density and Government Effectiveness, and negatively associated, among others, to Research and Development Expenditure and Maximum 5-day Rainfall. Furthermore, we apply the k-Means algorithm optimized with the application of the Elbow Method and we find the presence of four clusters. Finally, we propose a confrontation among eight different machine-learning algorithms for the prediction of PS and we find that the Polynomial Regression shows the higher performance. The Polynomial Regression predicts an increase in the level of PS of 0.25% on average for the analysed countries.

In this article, I estimate the value of “Individual Using Internet”-IUI in the context of Environmental, Social and Governance-ESG database of the World Bank. I use data from 193 countries for the period 2011-2020. I found that among others the value of IUI is positively associated to “Methane Emissions” and “People Using Safely Managed Sanitation Services” and negatively associated among others to “Fossil Fuel Energy Consumption” and “Renewable Energy Consumption”. I apply the k-Means algorithm for the clusterization optimized with the Elbow Method and we find the presence of three clusters. Finally, I confront eight machine-learning algorithms to predict the future value of IUI. I found that the best predictive algorithm is Linear Regression and that the value of IUI is expected to decrease on average of 0.30% for the analysed countries.

We analyze the question of GDP Growth-GDPG rate in the context of Environmental, Social and Governance-ESG framework. We use World Bank data for 193 countries in the period 2011-2020 using different econometric techniques i.e., Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS. We found that GDPG rate is positively associated, among others, to “Government Effectiveness” and “Prevalence of Undernourishment” and negatively associated among others to “Unemployment” and “Research and Development Expenditure”. Furthermore, we have applied the k-Means algorithm optimized with the Elbow method and we found the presence of four clusters in the sense of GDPG rate. Finally, we confront eight machine learning algorithms to predict the value of GDPG rate and we found that the Polynomial Regression is the best predictor. The Polynomial Regression predicts an increase of GDPG rate equal to 2.88% on average for the analysed countries.

We estimate the determinants of Emissions-COE in the context of Environmental, Social and Governance-ESG model at world level. We use data of the World Bank for 193 countries in the period 2011-2020. We found that the level of COE is positively associated, among others to “Methane Emissions”, “Research and Development Expenditures”, and negatively associated among others to “Renewable Energy Consumption” and “Mean Drought Index”. Furthermore, we have applied a cluster analysis with the k-Means algorithm optimized with the Elbow Method and we find the presence of four cluster. Finally, we apply eight machine-learning algorithms for the prediction of the future value of COE and we find that the Artificial Neural Network-ANN algorithm is the best predictor. The ANN predicts a reduction in the level of COE equal to 5.69% on average for the analysed countries.

We estimate the value of Research and Development Expenditures as a percentage of GDP-RDE in the context of Environmental, Social and Governance-ESG model. We use the ESG World Bank database. We analyze data from193 countries in the period 2011-2020. We apply a set of econometric techniques i.e. Pooled Ordinary Least Squares-OLS, Panel Data with Random Effects, Panel Data with Fixed Effects, Weighted Least Squares-WLS. We found that the level of RDE is positively associated, among others, to “Nitrous Oxide Emissions” and “Scientific and Technical Journal Articles”, and negatively associated, among others to “Heat Index 35”, “Maximum 5-day Rainfall”. Furthermore, we perform a cluster analysis with the application of the k-Means algorithm optimized with the Elbow Method. The results show the presence of four clusters. Finally, we confront eight different machine-learning algorithms to predict the future value of RDE. We find that Linear Regression is the best predictive algorithms. RDE is expected to growth on average of 0.07% for the analysed countries.

In this article, we analyse the determinants of Regulatory Quality-RQ for 193 countries in the period 2011-2020. We use a database from ESG-Environment Social Governance of the World Bank. We apply OLS, Panel Data with Fixed Effects and Panel Data with Random Effects. We found that the variables that have the most positive impact on RQ, among others, are “GHG Net Emission”, “Mean Drought Index”, and “Heat Index”. We also found that the variables that have the most negative impact on RQ are among others “Renewable Energy Consumption”, “Voice and Accountability” and “Rule of Law”. Furthermore, we have applied the k-Means algorithm optimized with the Elbow Method and we find the presence of five clusters. In adjunct, we confront eight machine learning algorithms to predict the value of RQ and we found that the best predictor is Polynomial Regression. The predictive level of RQ for the analysed countries is expected to diminish of -1,29%. In the end, we present a network analysis with the Euclidean distance and we found the presence of a structure of seven networks using augmented data.

In this article we estimate the level of Government Effectiveness-GE in 193 countries in the period 2011-2020 using data of the ESG World Bank Database. Different econometric techniques are used i.e. Panel Data with Random Effects, Panel Data with Fixed Effects, and Pooled OLS. Results show that GE is positively related among others to “Control of Corruption”, “Political Stability and Absence of Violence/Terrorism”, and negatively associated with “Percentage Annual GDP Growth”. We perform a cluster analysis with the k-Means algorithm optimized with the Elbow Method and we find the presence of four clusters. Finally, we confront eight machine learning algorithms for the prediction of GE. Results show that the Polynomial Regression is the best predictive algorithm. The value of GE is expected to growth on average by 15.97%.

Air pollution, climate change and global warming show direct linkage. Introduction - Background: Research in the field has proposed and demonstrated their link to increased allergenicity in plants, leading to increased allergic diseases. Allergen patterns are changing in response to climate change. Across Europe, up to 12% of the population suffers from allergic diseases (bronchial asthma and allergic rhinitis) caused by the pollen grains. The medical costs of these types of allergies are enormous and are increasing with the spread of common ragweed - Ambrosia artemisiifolia* in Europe. In practice, more and more patients are turning to allergists. Methods: Based on these data, the research aims to identify safety measures and specific legislation to control and eradicate common ragweed in the countries most affected by the spread of this plant in Europe, increase in population exposure in countries affected by the presence of common ragweed and the socio-economic impact of allergic rhinitis and bronchial asthma at European level.[1][2] Our database search did not reveal any other research that has addressed this topic to date. Results: This research identifies specific legislation to the countries most affected by the spread of this plant pollen grains at European level, changes in allergen patterns and monitoring/safety eradication measures decided by local authorities, and data on the spread of common ragweed over the last two decades, costs per treatment, increased allergic rhinitis and bronchial asthma morbidity in the most affected areas. Conclusions: At European level, there are no universally valid models for eradicating this weed. Various methods can be used to limit the spread of common ragweed and its pollen production (e.g. mowing once or twice a year of overgrown land, ploughing, chemical control, public information, etc.). Local and regional cooperation should be considered essential to promote phytosanitary &amp; safety measures and exchange of information on methods to identify and manage the spread of common ragweed. Unified legislation at European level would help all affected countries; reduce morbidity from respiratory allergic diseases and the costs of treating these diseases.

In this article we estimate the level of Control of Corruption for 193 countries in the period 2011-2020 using data from the ESG World Bank Database. Various econometric techniques are applied i.e.: Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled OLS, WLS. Results show that “Control of Corruption” is positively associated, among others, to “Government Effectiveness” and “Political Stability and Absence of Violence/Terrorism”, while it is negatively associated among others to “Agriculture, Forestry, and Fishing Value Added as Percentage of GDP” and “GHG Net Emissions/Removals by LUCF”. A cluster analysis implemented with the k-Means algorithm optimized with the Elbow Method shows four clusters. A confrontation among eight Machine Learning algorithms is proposed for the prediction of Control of Corruption. Polynomial Regression is the best predictor for the training data. The level of Control of Corruption is expected to growth by 10.36% on average.

This article explores the intersection of innovative leadership and climate change, aiming to provide outstanding contributions to the existing body of knowledge in this field. The article identifies the critical role of innovative leadership in driving sustainable solutions and strategies for addressing climate change. It examines the defining characteristics and behaviors of innovative leaders and explores how their transformative leadership approaches can create a positive impact on climate change mitigation and adaptation efforts. The article also highlights the importance of fostering innovation within organizations and societies to tackle the complex challenges posed by climate change. Through a comprehensive review of relevant literature and case studies, this article presents novel insights, theoretical frameworks, and practical implications for policymakers, organizations, and individuals involved in climate change leadership.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

The war to technology and economic power have been the driver for industrialization in most developed countries. The first industrial revolution (industry 1.0) earned millions for textile mill owners while the second industrial revolution (industry 2.0) opened the way for tycoons and captains of industry like John D. Rockefeller, J.P. Morgan and Henry Ford. The third industrial revolution (industry 3.0) engendered technology giants like Apple and Microsoft, and made magnates of men like Steve Jobs and Bill Gates. Now, the race for the fourth industrial revolution (industry 4.0) is on and there is no option, every country whether developed or developing must participate. Many countries have positively responded to industry 4.0 by developing strategic initiatives to strengthen industry 4.0 implementation. Unlocking the country’s potential to industry 4.0 has been of interest to researchers in the recent past. However, the extent to which industry 4.0 initiatives being launched globally has never been revealed. Therefore, the present study aimed at exploring industry 4.0 initiatives through comprehensive electronic survey of literature to estimate the extend of its launching in different regions. Inferences were drawn from industry 4.0 initiatives in developed nations to be used as the recommendations for East Africa Community. Results of the survey revealed that 117 industry 4.0 initiatives have been launched in 56 countries worldwide consisting of five regions. The country’s percent of industry 4.0 initiatives as per region were: Latin America and the Caribbean (15%), North America (40%), Europe (53%), Asia and Oceania (25%), Middle East and Africa (11%). While the worldwide percent was estimated as 25%. This revealed that the big gap is existing between countries towards the race for industry 4.0.