The COVID-19 pandemic has caused ~ 2 million fatalities. Significant progress has been made in advancing our understanding of the disease process, one of the unanswered questions, however, is the anomaly in the case/mortality ratio with Mexico as a clear example. Herein, this anomaly is explored by spatial analysis and whether mortality varies locally according to local factors. To address this, hexagonal cartogram maps (hexbin) used to spatially map COVID-19 mortality and visualise association with patient-level data on demographics and pre-existing health conditions. This was further interrogated at local Mexico City level by choropleth mapping. Our data show that the use of hexagonal cartograms is a better approach for spatial mapping of COVID-19 data in Mexico as it addresses bias in area size and population. We report sex/age-related spatial relationship with mortality amongst the Mexican states and a trend between health conditions and mortality at the state level. Within Mexico City, there is a clear south, north divide with higher mortality in the northern municipalities. Deceased patients in these northern municipalities have the highest pre-existing health conditions. Taken together, this study provides an improved presentation of COVID-19 mapping in Mexico and demonstrates spatial divergence of the mortality in Mexico.

Background: Maternal mortality (MM) is a matter of serious concern in low income developing countries (LDCs). Perspective: A great reduction has been observed regarding the maternal deaths globally after huge efforts since 1990 todate. However, the situation continues to be either stagnant or worsening in developing countries, suggesting that the efforts to cope with this issue are either insufficient or not properly implemented. We need to first diagnose the problem areas that are a great hurdle in the road to success towards the reduction of MM. Postpartum haemorrhage and preeclampsia are one of the most common causes of MM. Malnutrition, neurological dysfunction and cancer are among the non-obstetric causes. Trained medical and paramedical staff can be of great help in this regard by increasing awareness among masses at grass root level. Target set by Millennium Development goal has minimized the MM by 44%. But it has not met the target set by Millenium Development Goals 5 and a lot of measures need to be taken in this regard. Conclusions: Majority of the MDs are preventable and can be avoided by adopting appropriate frameworks, linked data sets, surveillance, birth attendants training, preparation for births, etc. Delay in decision to get healthcare, access to healthcare center and receiving these facilities are the main factors in MM.

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

This pandemic of COVID-19 is tedious to control. The only lockdown is the way to stop the spread of this infection. Conventional health care is facing a real challenge to operate. Primarily the challenge is to provide health care support for COVID-19 patients with limited resources and continue the health care services like earlier.Perhaps, this challenge is the same but magnitude is different from different geographical locations around the globe. In this article, we presented a Bayesian algorithm with the Code to predict cancer death due to COVID-19. This code is possible to run at different time points and different geographical locations around the world. This code will help us to get the best strategy and shift the treatment option for cancer treatment. The model would provide physicians with an objective tool for counseling and decision making at different hotspots and small areas to implement.

Objectives: The aim of this study was to describe potential factors contributing to neonatal mortality in Takeo, Cambodia through assessment of verbal autopsies collected following newborn deaths in the community. The mortality review was nested within a trial of a behavioral intervention to improve newborn survival, and was conducted after the close of the trial, within the study setting. The World Health Organization standardized definition of neonatal mortality was employed, and two pediatricians independently reviewed data collected from each event to assign a cause of death. Results: Thirteen newborn deaths of infants born in health facilities participating in a community based, behavioral intervention were reported during February 2015–November 2016. Ten deaths (76.92%) were early neonatal deaths, two (15.38%) were late neonatal deaths, and one was a stillbirth. Five out of 13 deaths (38.46%) occurred within the first day of life. The largest single contributor to mortality was neonatal sepsis; six of 13 deaths (46.15%) were attributed to some form of sepsis. Twenty-three percent of deaths were attributed to asphyxia. The study highlights the continuing need to improve quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.: The study highlights the continuing need to improve both intrapartum and postnatal quality of care and infection prevention and control, and to fully address causes of sepsis, in order to effectively reduce mortality in the newborn period.

This cross-sectional study investigates the impact of Virtual Private Networks (VPNs) on Nigerians during the 2021 Twitter ban, prompted by the Nigerian government's suspension of Twitter operations following the deletion of a tweet by the President. The study aims to analyze the frequency and awareness of VPN and Twitter usage among Nigerians during the ban, addressing specific objectives. Employing a survey research method, data was collected from 400 respondents through online and offline questionnaires. Descriptive statistical tools were used for data analysis, revealing significant findings. Results indicate a substantial decrease in Twitter usage during the ban, with IPVanish emerging as the preferred VPN brand. The study also highlights an increase in VPN awareness post-ban, emphasizing the need for educational initiatives. The demographic analysis reveals a dominant age group of 21 to 25 among social media users. Overall, the research underscores the complex interplay between social media dynamics, VPN adoption, and demographic factors, emphasizing the importance of nuanced regulatory approaches and ongoing user education in Nigeria's online landscape.

Given the extreme importance of improving the accountability of Private Social Solidarity Institutions (IPSS), both for reasons of legal compliance (hard law) and for reasons of improving legitimacy and notoriety among their stakeholders (soft law), this paper aims to present a framework designed under a more comprehensive research project, for the assessment of IPSS accountability and, consequently, its improvement. This study also present results of the indicators conceived, identifying the main trends of the framework dimensions and sub-dimensions from a pilot test for the years 2018, 2019 and 2020 in Portugal. Given the results, we believe that the framework designed answers the research question: How to promote accountability (social, financial and economic) in the social economy sector, in particular: the case of the IPSS?, however, as this is an exploratory article, it incorporates the limitation that this is a pilot test with only 7 entities.

Background: The COVID-19 outbreak has accelerated the huge difference between medical care and disease prevention in Chinese medical institutions. This study aimed to investigated the relationship between the symbiotic units, environments, models, and effects of the integration of medical and disease prevention. Methods: This cross-sectional study involved 762 employees of public hospitals in 11 cities in Zhejiang Province by random stratified sampling. We analyzed the influence paths of elements in the mechanism of integration of medical and disease prevention and the mediating effect of symbiotic models among symbiotic units, symbiotic environments, and effects for on this integration. Results: The path coefficient of symbiotic unit on the symbiosis model was 0.46 (p<.001), the path coefficient of symbiotic environment on symbiosis model was 0.52 (p<.001). The path coefficient of the symbiotic unit and environment was 0.91 (p<.001). The symbiotic models exhibited a partial mediation effect between symbiotic units and the effect of this integration. Sobel test = 3.27, β = 0.152, and the mediating effect accounted for 34.6%. Conclusions: It is suggested that Health policy-makers and public hospital managers should provide sufficient symbiotic units, establish collaborative symbiotic models, and improve the effects of integration of medical and disease prevention in public hospitals.

Dye/salt separation has gained increasing attention in recent years, prompting the quest for cost-effective and environmentally-friendly raw materials for synthesis high performance nanofiltration (NF) membrane for effective dye/salt separation. Herein, a high-performance loose structured NF membrane was fabricated by via a simple vacuum filtration method using a green nanomaterial, 2,2,6,6-tetramethylpiperidine-1-oxide radical (TEMPO)-oxidized cellulose nanofiber (TOCNF), by sequentially filtrating larger-size and finer-size TOCNFs on a microporous substrate, followed by cross-linked with trimesoyl chloride. The resultant TCM membrane possesses a separating layer composed entirely of pure TOCNF, eliminating the need for other polymer or nanomaterials additives. TCM membranes exhibits high performance and effective dye/salt selectivity. Scanning Electron Microscope (SEM) analysis shows that the TCM membrane with Fine-TOCNF layer has a tight layered structure. Further characterizations via Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) confirm the presence of functional groups and chemical bonds of the crosslinked membrane. Notably, the optimized TCM-5 membrane exhibits a rejection rate of over 99% for various dyes (Congo red, orange yellow) and 14.2% for NaCl, showcasing a potential candidate for efficient dye wastewater treatment.

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBM^TMSPSS^® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have <50 beds, 42.8% between 50-150 beds, and 5%> 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers <50 beds (30.5%); 64 of the 50-150 beds (14.2%); and 1 of the> 150 beds (1.9%) (p = 0.000). 395 of the <50 beds did not register deaths due to COVID-19 (71.8%), 232 of the 50-150 beds (51.3%), and 9 of the> 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

The release profiles of methotrexate, an anticancer drug, from the monoolein liquid crystalline cubic phases were studied. The cubic phases were used either in the form of a lipidic film deposited onto a glassy carbon electrode surface or in the dispersed form of magnetocubosomes, which are considered a prospective hybrid drug delivery system. Commonly, cubosomes or liposomes are employed, but not in the case of toxic methotrexate, known to block receptors responsible for folate transport into the cells. The release profiles of the drug from the lipidic films were monitored electrochemically and described using the Higuchi model. They were also modified via changes in temperature; the release was faster, although deviating from the model when the temperature was increased. Magnetocubosomes - cubic phase nanoparticles containing hydrophobic magnetic nanoparticles placed in an alternating magnetic field of low frequency and amplitude, stimulated drug release from the suspension, which was monitored spectroscopically. These new biocompatible hybrid materials are very promising, allowing to control the release of the drug at the appropriate sites, but do require further investigations into their in vitro cytotoxicity and in vivo biodistribution.

Rising obesity and associated multi-systemic complications amplify the health burden. Euphorbia kansui (EK) extract is clinically recognized for managing obesity. In human study, 240 obese individuals were categorized into two cohorts: those receiving solely herbal medicine (HM group), and those administered EK concomitantly with herbal medicine (EK group). An in vivo examination using C57BL/6-Lepob/Lepob mice elucidated mechanisms involving macrophages and gut microbiota, with associated metabolic advantages. The clinical study revealed a significant 7.22% body weight reduction during 91.55 average treatment days, and examined 16.71% weight loss at 300 days after treatment. In the whole subjects, 60.4%, 21.3% and 6.3% achieved weight reductions exceeding 5%, 10% and 15%, respectively. Impressively, the EK group exhibited superior weight loss compared to the HM group (EK: -7.73% vs. HM: -6.27%, p=0.012). The anti-obesity effect was positively associated with EK therapy frequency and herbal medicine duration. In vivo, EK significantly improved insulin sensitivity and mitigated infiltration of adipose tissue macrophages (ATMs) by modulating the CD11c+ and CD206+ subtypes. EK also correlated with increased Bacteroidetes and Firmicutes populations and reduced Proteobacteria and Verrucomicrobia. Consequently, EK is an effective adjunctive anti-obesity therapy offering metabolic benefits by modulating ATMs and gut microbiota profiles.

Infections with multi-drug-resistant (MDR) pathogens in food-animals threaten public health and food security. However, the epidemiology and factors associated with MDR Escherichia coli on Ugandan farms are not well known. This study investigated the prevalence, resistance patterns and factors associated with MDR E. coli carriage on chicken farms. A total of 158 E. coli strains were isolated from 158 chicken farms. The disc diffusion method for susceptibility testing was performed. Clinical breakpoints were interpreted according to Clinical and Laboratory Standards Institute guidelines. MDR was defined as resistance to three or more classes of antimicrobials. MDR E. coli prevalence on chicken farms was 62.7% (95% CI: 55.0 – 70.3). High resistance was observed against ampicillin 79.8% (95% CI: 72.7–85.4), tetracycline 72.8% (95% CI: 65.2–79.2), cotrimoxazole 55.7% (95% CI: 47.8–63.3), and ciprofloxacin 38% (95% CI: 30.7–45.9). Farmers who were males (APR = 0.72, CI: 0.55, 0.93), and attained at least secondary education (APR=0.64, CI: 0.46, 0.88) and administration of recommended antibiotic doses (APR = 0.76, CI: 0.59–0.96) posed a lower risk of MDR E. coli carriage. Farms without footbaths posed a heighten risk (APR=1.48, CI: 1.16–1.88). MDR E. coli were highly prevalent on chicken farms. This study underscores the need for antimicrobial stewardship and improved infection prevention strategies on chicken farms.

Abstract: This article provides a brief review of the ontogeny of chondrocytes and the pathophysiology of osteoarthritis (OA), and details how physical exercise improves the health of osteoarthritic joints and enhances the potential of mesenchymal stem cells for successful transplantation therapy. In response to exercise chondrocytes increase their production of glycosaminoglycans, bone morphogenic proteins and antiinflammatory cytokines and decrease their production of proinflammatory cytokines and matrix degrading metalloproteinases. These changes are associated with improvements in cartilage organization and reductions in cartilage degeneration. Studies in humans indicate that exercise increases peripheral blood recruitment of bone marrow-derived mesenchymal stem cells (BM-MSC) and upregulates BM-MSC expression of osteogenic and chondrogenic genes, osteogenic micro-RNAs, and osteogenic growth factors. Rodent experiments are uniform in demonstrating that exercise enhances the osteogenic potential of BM-MSC while diminishing their adipogenic potential, and that exercise done after stem cell implantation may benefit stem cell transplant viability. Physical exercise also exerts a beneficial effect on the skeletal system by decreasing immune cell production of osteoclastogenic cytokines interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and interferon (INF)-γ while increasing their production anti-osteoclastogenic cytokines IL-10 and transforming growth factor (TGF)-β. In conclusion, physical exercise done both by stem cell donors and recipients may improve the outcome of mesenchymal stem cell transplantation.

Goat milk's medicinal properties and potential cosmetic and health benefits have prompted extensive scientific investigation into its therapeutic applications, particularly for human skin conditions like eczema and psoriasis. Genetic factors, including genes such as lactoferrin (LTF), lysozyme (LYZ), and β-casein (CSN2), play a crucial role in shaping milk composition and its effects on skin health. This review explores the utilization of genomic tools to elucidate the genomic profiles of dairy goat breeds and the medicinal properties of goat milk, particularly in addressing key skin diseases. Genetic determinants of milk composition, quality, nutritional quality, and functional properties such as the growth hormone receptor (GHR), butyrophilin (BTN1A1) and lactoglobulin (LGB) genes, facilitating targeted breeding strategies to enhance the production of bioactive compounds with dermatological relevance have been identified. Future genomic approaches should aim at exploring goat milk's immunomodulatory, antimicrobial, and antioxidant activities, offering potential applications in skin care formulations for managing inflammatory skin conditions. Furthermore, the integration of genomic data with functional studies can provide valuable insights into the therapeutic effects of goat’s milk and its derivatives in addressing skin diseases.

Background: Infective endocarditis (IE) remains a difficult disease to diagnose and treat, with a persistently high mortality rate. There is a lack of recent data on IE in Bulgaria over the last decades. Methods: The study is retrospective, single centered, includes 270 patients diagnosed with IE, for the period 2005 - 2021. We compared the two periods 2005-2015 (n=119) and 2016-2021 (n=151) to find the characteristics changes. Results: The median age was 65 (23) years and 65.5% (177) were male. In the second period, there is a significant increase in age from 62 (29) to 67 (22), (p=0.023); Charlson comorbidities index (CCI) from 3 (3) to 4 (4), (p=0.000); cases with chronic kidney diseases (CKD) from 12.6% (15) to 36.9% (55), (p=0.001); coronary arterial diseases (CAD) from16.85% (20) to 29.1% (44), (p=0.018); atrial fibrillation (AF) from 10.9% (13) to 23.8% (36), (p=0.006). Injection fraction decreased significantly in the second period from 63 (14) to 59 (15), (p=0.000). Almost half of the patients 45.6% (123) had no known predisposing cardiac condition and 46.3 (125) had an unknown port of entry. IE was community-acquired in 173 (64.1%), healthcare-associated in 26.7% (72), and injection drug use related IE in 9.3% (25).The study population included 67.8% (183) native valve IE, 31.5% (85) prosthetic IE, and 0.74% (2) intracardiac device­related IE. The hemoculture were positive in 59.6%, and the most frequent pathogenic agent was Staphylococcus - 33.3 % ( aureus – 16.5 % and coagulase negative - 16.8 %). Only 20% of patients underwent early surgery. The all­cause 30 days mortality rate was 24.8%. There is no significant difference between the two periods in terms of the characteristics listed above. Conclusion: The profile of IE in Bulgaria has changed with increasing age and comorbidity, changing predisposing cardiac conditions and entry door. The most common pathogen was the Staphylococcus group. The 30 day mortality rate remains high.

Human immunodeficiency virus (HIV) and malaria, caused by infection with Plasmodium spp., are endemic in similar geographical locations. As a result, there is high potential for HIV/Plasmodium co-infection, which increases the pathology of both diseases. However, the immunological mechanisms underlying the exacerbated disease pathology observed in co-infected individuals are poorly understood. Here, we used the rhesus macaque (RM) model to characterize the immunopathogenic impact of Plasmodium fragile co-infection during antiretroviral therapy (ART)-treated simian immunodeficiency virus (SIV)-infection. We observed that P. fragile co-infection resulted in parasitemia and anemia, as well as persistently detectable viral loads (VL) and decreased absolute CD4+ T-cell counts despite daily ART treatment. Notably, P. fragile co-infection was associated with increased levels of inflammatory cytokines linked with neutrophil function, including monocyte chemoattractant protein 1 (MCP-1). P. fragile co-infection was associated with increased levels of neutrophil elastase, a plasma marker of neutrophil extracellular trap (NET) formation, but significant decreases in markers of neutrophil degranulation, potentially indicating a shift in neutrophil functionality during co-infection. Finally, we characterized levels of plasma markers of gastrointestinal (GI) barrier permeability and microbial translocation and observed significant correlations between indicators of GI dysfunction, clinical markers of SIV and Plasmodium infection, and neutrophil frequency and function. Taken together, these data indicate that neutrophil-driven inflammation and GI dysfunction may underlie heightened SIV/P. fragile co-infection pathogenesis.

The COVID-19 pandemic has had a significant impact on every individual in the United States. The launch of the COVID-19 vaccines is estimated to have averted millions of deaths and reduced over 18 million COVID-19 related hospitalizations. In September 2023, the updated 2023-2024 COVID-19 vaccine that include a monovalent component that corresponding to the omicron variant XBB.1.5 reflecting the predominant circulating variant at the time of strain selection, was approved and was recommended for use in all people ≥ 6 months of age. Despite this recommendation, the US uptake of the updated COVID vaccines over the 2023-2024 season has been far from optimal, placing many people at unnecessary risk of severe COVID-19 outcomes. This paper provides an overview of the current state of COVID-19 in 2023-2024, and barriers to vaccine uptake. With the continued evolution of the virus, the potential for more virulent variants and the lower public acceptance of vaccination, the potential barriers that contributed to low vaccine uptake are explored, as well as to provide solutions for improving COVID-19 protection for future seasons.

The rapid retreat of coastal cliffs poses a profound risk to property, transport infrastructure and public safety both in Ireland and globally. This study combines historical data (maps and orthophotos, 1842 to 2000) with contemporary UAV surveys (2019 to 2023) to quantify cliff top and cliff face retreat along a 250 m wide coastal drumlin at Silverstrand in Galway Bay, Ireland. Retreat rates for the cliff top and cliff face were calculated using 2D mapping and 3D modelling, respectively. Critically, the choice of method appears to have a major impact on apparent rates of cliff top retreat, with output from the 2D mapping approach (0.14 +/- 0.02 m yr-1) being double that of the 3D modelling approach (0.08 +/- 0.02 m year-1). The aperiodic development of a talus cone, which offers temporary protection to the cliff from storm waves, also influences the estimation of cliff retreat. The repeat cycles of talus slope formation and removal in this high wave energy climate suggest that the drumlin transitions between a periodically transport-limited system and supply limited system over short- and long-time periods, respectively, on the continuum of cliff types. These results warrant further research to identify and quantify the rates, patterns, drivers (marine and subaerial processes), and timing of cliff retreat rates in response to climate change.

Carbon offsetting is currently a major tool in managing carbon emissions and the drive to Net-Zero. This study aims to identify the offsetting potential of existing conservation schemes, and whether carbon offsetting credits could potentially finance the continued management of the conservation activities. The results from Dorset, in the UK indicate that many existing conservation schemes in woodland, heathland and grasslands can not only enhance biodiversity but also capture significant amounts of carbon. We show that the cost per additional tonne of carbon sequestered as a result of conservation activities varies considerably between different conservation projects. On average, the cost of this offsetting is £80 per tonne CO2e sequestered and ranging between £120 and £0 depending on the project and whether existing biodiversity grants would be available. However, this figure was based on adapting and refining existing conservation projects, and did not involve expensive factors such as purchase of land, which make the prices potentially unrealistic. While the costs identified are higher than many offsetting schemes at present, it could present a useful option for those wishing to localise their offsetting, and could be combined with biodiversity credits or other credit schemes to make the higher costs more attractive.

Aim: To investigate how much aerobic and resisted physical exercise affects the behavior of AST and ALT proteins in the NAFLD spectrum. Background: Non-alcoholic fatty liver disease (NAFLD) is a pathology resulting from the excessive accumulation of triglycerides in the liver. The pathophysiology of the disease comes from several mechanisms, among them, metabolic, environmental, and genetic. The measurement of liver enzymes, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) are essential to perform a differential diagnosis of NAFLD with other pathologies that affect the liver. The non-pharmacological treatment of NAFLD is based on aerobic and resisted physical exercise, and one of its aims is to reduce the inflammatory markers AST and ALT. Materials and Methods: Systematic review carried out in PubMed, Scopus, Embase, and Cochrane databases. Clinical trials that evaluated the effect of physical exercise on NAFLD on AST and ALT enzymes were included. Results: A total of 24 clinical trials met the inclusion criteria, with a sample size of 1141 participants, aged 20-82 years. The study protocol varied between aerobic exercise and resistance exercise with a weekly frequency between 2-6 times a week, a duration of 20-90 minutes for aerobics, and an intensity between 50-80% of peak VO2 and/or maximum HR for the resisted. Of the 24 studies included, only five showed improvements in both enzymes in the intervention group. Conclusion: Physical exercise cannot make significant changes in the behavior of AST and ALT liver parameters.

The association between mental illness and violent crimes such as homicide is complex. In 1939, Lionel Penrose hypothesized that the availability of psychiatric hospital beds was inversely related to the prison population, presumably due to the hospitalization of potential offenders with a mental illness. Subsequent studies have found evidence for this association, but questions remain about the contributions of confounding factors. Moreover, there has been a move towards deinstitutionalization and community care of the mentally ill over the past six decades. In this study, the association between national homicide rates and three measures of the availability of psychiatric care – the numbers of psychiatrists, general hospital psychiatric beds, and psychiatric hospital beds per 100,000 population – was examined using a time-lagged correlation analysis. Associations between homicide rates and socioeconomic factors associated with crime were also examined. It was found that the availability of psychiatrists and of general hospital psychiatric beds were both negatively correlated with homicide rates, and that the association with general hospital psychiatric beds remained significant even after correction for confounding factors. These results suggest the need for a more nuanced interpretation of Penrose’s original formulation, involving the interplay of social, economic factors and psychological factors rather than linear causality.

This study was undertaken to forecast waste generation rates of accommodation sector of North Cyprus as a case. Three predictor models including multiple linear regression (MLR), artificial neural networks (ANNs) and central composite design (CCD) were applied to predict the waste generation rate during the lean and peak seasons. ANN showed highest prediction performance, specifically, lowest values of the standard error of prediction (SEP = 2.153), mean absolute error (MAE=1.378) and highest R2 value (0.998) confirmed the accuracy of the model. The analysed wastes were categorised into recyclable, general waste and food residues. The authors estimated the total waste generated during the lean season as 2010.5 kg/day, in which large-sized hotel accounted for largest fraction (66.7%), followed by the medium hotels (19.4%) and guesthouse accounted for smallest part (2.6%). During the peak season, about 49.6% increases in the waste generation rates were obtained. Interestingly, 45% of the wastes were generated by the British tourists while the least waste was generated by African tourists (7.5%). The ANN predicted that the small and large hotels would produce 5.45 and 22.24 tons of waste by the year 2020, respectively. The findings herein are promising and useful in establishing a sustainable waste management system.

Background: During the COVID-19 pandemic, hygiene behaviors such as keeping distance, avoid-ing masses, wearing face masks and adhering to hand hygiene recommendations became impera-tive. The current study aims to determine factors interrelating with hygiene behaviors. Methods: 4,049 individuals (1,305 male, 2,709 female, aged 18-80 years) were recruited from rehabilitation clinics or freely on the internet and surveyed via online questionnaire between May 2020 and August 2021. Socio-demographics, hygiene behaviors, emotions (fear), life-satisfaction, risk factors and disability as well as communication were assessed. Results: Prevalence for hygiene behaviors was: keeping the distance 84.9%, avoiding mass gatherings 84.6%, wearing face masks 96.5% and hand hygiene 80.7%. Hygiene behaviors were significantly related to fear with linear and quad-ratic associations. Conclusion: Individuals with disabilities, risk factors and psychological symp-toms are more compliant. Especially hand hygiene should be targeted to achieve higher compli-ance rates. A medium level of fear is more functional than too elevated fear. Behavioral interven-tions and targeted communication aiming at improving different behaviors in orchestration can help individuals to remain healthy and maintain a high life-satisfaction. Thereby, communication in the healthcare setting is imperative and all involved individuals should become more aware of this to ensure high hygiene standards and patient safety.

Nitrogen (N) is an essential nutrient and plays an important role in plant growth and physiology. In addition, N is also the limiting nutrient in most terrestrial ecosystems. The increasing use of N fertilizers increases agricultural production, but also has negative impacts on biodiversity, water quality and increases emissions of greenhouse gases such as nitrogen oxides (NOx) and nitrous oxide (N2O) into the atmosphere. N2O is a strong greenhouse gas and the product of microbial transformation processes of N introduced into soil and groundwater (nitrification and denitrification). The production of N2O in soils is highly dependent on oxygen and water content, soil temperature and texture and the available amount of reactive nitrogen (NO3- or NH4+). In agricultural soils, N2O emissions are also influenced by the type of fertilizer used, crops grown, soil pH and NO3- concentration. Refined forms of land management, such as the cultivation of legumes, can reduce the use of fertilizers and thus also the emission of N2O. Legumes can use symbiotic nodule bacteria (rhizobia) to bind atmospheric N2 and make it available to the plant. Non-symbiotic soil microorganisms such as cyanobacteria or other heterotrophic and autotrophic prokaryotes are also able to fix N2. Furthermore, the N2-fixing enzyme nitrogenase, which is specific for most organisms, is not specific for other N2 compounds, especially N2O. To study the N2 and N2O fixation potential of soils and legumes, experiments with isotope-enriched N-gases (100 mol% 15N2 and 15N2O) were performed. Three different soil types (forest, meadow and wetland) as well as legume plants inoculated with rhizobia bacteria (Rhizobium leucaneae) (Leucaena leucocephala) were incubated in microcosms with different mixing ratios of N2 and N2O over a period of one week. The measured 15N enrichment was then used to determine the biological uptake rates. Both in plants and in soils admixtures of up to 40% N2O had no influence on the N2 fixation rate. N2 uptake rates were 1.2 ± 0.4 ug N gdw-1 d- 1in forest and grassland soils and 3.9 ± 1.2 ug N gdw-1 d- 1 in wetland soils. In contrast, the N2 fixation rates of leguminous plants were significantly higher (130 ± 40 ug N gdw-1 d- 1), with the highest accumulation not in root nodules but in the roots. In both plants and soil, the N2O fixation of 0.2 ± 0.1 ug N gdw-1 d- 1 could only be measured from a concentration of 4 vol%. The results indicate that both soils and legumes have a high potential to bind atmospheric nitrogen in the form of both N2 but not N2O. The fate of nitrogen in soil needs to be further investigated. N2 fixation seems to play an important role in wetland soils. Legumes in particular have the potential for NH4+ input and N2O reduction, as most of the solid nitrogen has been transferred to the roots, which can contribute significantly to soil nutrient input.

This study aims to characterize the molecular profile of hepatitis B virus (HBV) among socially vulnerable immigrants residing in Brazil to investigate the introduction of uncommon HBV strains into the country. Serum samples from 102 immigrants with positive serology for HBV core antibody (anti-HBc) were tested for the presence of HBV DNA by PCR assays. Among these, 24 were also positive for the HBV surface antigen (HBsAg). The full or partial genome was sequenced to determine genotype by phylogenetic analysis. Participants were from Haiti (79.4%), Guinea Bissau (11.8%), Venezuela (7.8%), and Colombia (1%). Of the 21 HBV DNA-positive samples, subgenotypes A1 (52.4%), A5 (28.6%), E (9.5%), F2 (4.8%), and F3 (4.8%) were identified. Among the 78 HBsAg-negative participants, four were positive for HBV DNA, resulting in an occult HBV infection rate of 5.1%. Phylogenetic analysis suggested that most strains were likely introduced to Brazil by migration. Importantly, 80% of A5 sequences had the A1762T/G1764A double mutation, linked to an increased risk of hepatocellular carcinoma development. In conclusion, this study is the first report of HBV subgenotype A5 in Brazil, shedding new light on the diversity of HBV strains circulating in the country. Understanding the genetic diversity of HBV in immigrant communities can lead to better prevention and control strategies, benefiting both immigrants and the broader society.

Background. During the COVID-19 pandemic, there was an increased number of the hospitalized COVID-19 positive patients suffering from type 2 diabetes mellitus (T2DM). The objective of this research was to explore factors associated with the length of hospitalization of patients with T2DM and mild form of COVID-19. Material and Methods. This retrospective cohort study involved all patients who tested positive for COVID-19 and were treated in the dedicated COVID department of the University Clinical Center (UCC) in Nis between September 10, 2021, and December 31, 2021. Upon admission, patients underwent blood tests for biochemical analysis, including blood count, kidney and liver function parameters (C-reactive protein-CRP, creatinine kinase, D-dimer), as well as glycemia and HbA1c assessments. Additionally, all patients underwent lung radiography. Univariate and multivariate regression analyses were employed to assess the impact of specific factors on the length of hospitalization among patients with T2DM. Results. Out of the total 549 COVID-19 positive patients treated, 124 (21.0%) had T2DM, while 470 (79.0%) did not have diabetes. Among patients with T2DM, men were significantly younger than women (60.6±16.8 vs. 64.2±15.3, p

The human malaria parasite, Plasmodium falciparum, accounts for more than 500,000 deaths worldwide per year. From 2000 to 2019, the malaria global death toll fell from 864,000 to 576,000 deaths; however, progress on reducing this toll has since slowed, with the COVID-19 pandemic contributing to an increase in the mortality rate since 2020. The emergence of widespread resistance in P. falciparum to first-line treatment drugs has highlighted the need for new antimalarial drugs, and smarter approaches, including better combination therapies and mass drug administration. Nevertheless, recent successes of the first malaria vaccine (RTS,S/AS01) and the approval of a second (R21/MM), have renewed the promise of widely applicable vaccines in the future. Since 2015, the Eastern Mediterranean Region has experienced an overall increase in malaria cases and deaths. In the Arabian Peninsula, while most of the Gulf Cooperation Council (GCC) countries have been declared free of indigenous malaria (Bahrain, Kuwait, Qatar, and the United Arab Emirates), malaria is still endemic in two GCC countries (Saudi Arabia and Oman) and its neighbors (Yemen). Furthermore, a number of factors threaten malaria control in this region, at the level of the parasite (antimalarial drug resistance), the mosquito (the emergence of highly invasive species), the environment (climate change and increasing average temperatures), and society (imported malaria). In this review, we assess the current world-wide status of malaria in terms of public health, prevention and treatment, before providing an Arabian regional perspective, with a critical evaluation of the malaria situation in the GCC countries.

This paper investigates the relationship between public debt and economic growth in the context of a panel kink regression with latent group structures. The proposed model allows us to explore the heterogeneous threshold effects of public debt on economic growth based on unknown group patterns. We propose a least squares estimator and demonstrate the consistency of estimating group structures. The finite sample performance of the proposed estimator is evaluated by simulations. Our findings reveal that the nonlinear relationship between public debt and economic growth is characterized by a heterogeneous threshold level, which varies among different groups, and highlight that the mixed results found in previous studies may stem from the assumption of a homogeneous threshold effect.

Yersiniosis is a common zoonotic enteral disease among humans, which has been linked to pigs and contaminated food, especially pork. Studies on yersiniosis in pets are very scarce. In this study, we performed pheno- and genotypic characterization of 50 Yersinia strains isolated from pets in Finland between 2012 and 2023. Y. enterocolitica 4/O:3/ST135, the most common type in human yersiniosis, was also the most common Y. enterocolitica type (68%) found in clinical faecal samples in our study. Also, human pathogenic Y. enterocolitica 2/O:9/ST139 and Y. pseudotuberculosis O:1/ST9 and O:1/ST42 strains carrying all essential pathogenic genes were identified. Three Y. enterocolitica 4/O:3/ST9 strains were multi-drug resistant and two of them were highly related showing one allelic difference (AD) with core-genome multi-locus sequence typing. Non-pathogenic, genotypically highly diverse Y. enterocolitica 1A strains, showing more than 1000 ADs and missing the essential virulence genes, were also recognized in dogs and cats. Our study demonstrates that pets can excrete human pathogenic Y. enterocolitica and Y. pseudotuberculosis in their faeces and may serve as an infection source for human yersiniosis, especially in families with small children in close contact with their pets.

Recent dramatic reductions in the timeframe in which genomic sequencing can deliver results means its application in time-sensitive screening programs such as newborn screening (NBS) is becoming a reality. As genomic NBS (gNBS) programs are developed around the world, there is an increasing need to address the ethical and social issues that such initiatives raise. This study therefore aimed to explore the Australian public’s perspectives and values regarding key gNBS characteristics and preferences for service delivery. We recruited English-speaking members of the Australian public over 18 years of age via social media; 75 people aged 23-72 participated in one of 15 focus groups. Participants were generally supportive of introducing genomic sequencing into newborn screening, with several stating that adoption of such revolutionary and beneficial technology was a moral obligation. Participants consistently highlighted receiving an early diagnosis as the leading benefit, which was frequently linked to the potential for early treatment and intervention, or access to other forms of assistance, such as peer support. Informing parents about the test during pregnancy was considered important. This study provides insights into the Australian public’s views and preferences to inform the delivery of a gNBS program in the Australian context.

There is growing recognition of the adverse effects of body image dissatisfaction (BID) and eating disorder (ED) symptoms on adolescent health. The aim of this study was to estimate the prevalence of ED symptoms, BID, and their relationship in adolescents from public schools in Southern Brazil. A total of 782 schoolchildren (male: n=420, female: n=362); age: 15 ± 0,4 years) answered a self-administrated questionnaire to identify sociodemographic data. Children´s Figure Rating Scale was adopted to identify body image and Eating Attitudes Test (EAT-26) was applied to investigate ED symptoms. Inferential statistics and hierarchical model-controlled logistic regression were used for association between variables. Most of the schoolchildren reported being satisfied with their bodies. However, we observed a higher prevalence of dissatisfaction among girls for being overweight and thinness among boys. Female students and students from schools located in the central area of the city showed higher chances of developing ED symptoms, and the absence of symptoms of ED appeared to act as a protective factor against BID in schoolchildren. Results of this study show the need to reflect on these factors that influence the development of ED and non-acceptance of their own body in a population concerned with their physical appearance.

Affordable Housing, the basic human necessity has now become a critical problem in global cities with direct impacts on people's well-being. While a well-functioning housing market may augment the economic efficiency and productivity of a city, it may trigger housing affordability issues leading crucial economic and political crises side by side if not handled properly. In global cities e.g. Singapore and Hong Kong where affordable housing for all has become one of the greatest concerns of the Government, this issue can be tackled capably by the provision of public housing. In Singapore, nearly 90% of the total population lives in public housing including public rental and subsidized ownership, whereas the figure tally only about 45% in Hong Kong. Hence this study is an effort to scrutinizing the key drivers of success in affordable public housing through following a qualitative case study based research methodological approach to present successful experience and insight from different socio-economic and geo-political context. As a major intervention, this research has clinched that, housing affordability should be backed up by demand-side policies aiming to help occupants and proprietors to grow financial capacity e.g. subsidized rental and subsidized ownership can be an integral part of the public housing system to improve housing affordability.

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.

The 'big data revolution' has enabled novel types of analyses in the life sciences, facilitated by public sharing and reuse of datasets. Here, we review the prodigious potential of reusing publicly available datasets and the challenges, limitations and risks associated with it. Possible solutions to issues and research integrity considerations are also discussed. Due to the prominence, abundance and wide distribution of sequencing data, we focus on the reuse of publicly available sequence datasets. We define ‘successful reuse’ as the use of previously published data to enable novel scientific findings and use selected examples of such reuse from different disciplines to illustrate the enormous potential of the practice, while acknowledging their respective limitations and risks. A checklist to determine the reuse value and potential of a particular dataset is also provided. The open discussion of data reuse and the establishment of the practice as a norm has the potential to benefit all stakeholders in the life sciences.

Along with environmental pollutions, urban planning has been connected to public health. The research indicates that the quality of built environments plays an important role in reducing mental disorders and overall health. The structure and shape of the city are considered as one of the factors influencing happiness and health in urban communities and the type of the daily activities of citizens. The aim of this study was to promote physical activity in the main structure of the city via urban design in a way that the main form and morphology of the city can encourage citizens to move around and have physical activity within the city. Functional, physical, cultural-social, and perceptual-visual features are regarded as the most important and effective criteria in increasing physical activities in urban spaces based on literature review. The environmental quality of urban spaces and their role in the physical activities of citizens in urban spaces were assessed by using the questionnaire tool and analytical network process (ANP) of structural equation modeling. Further, the space syntax method was utilized to evaluate the role of the spatial integration of urban spaces on improving physical activities. Based on the results, the consideration of functional diversity, spatial flexibility and integration, security, and the aesthetic and visual quality of urban spaces plays an important role in improving the physical health of citizens in urban spaces. Further, more physical activities, including motivation for walking and consequently, the sense of public health and happiness, were observed in the streets having higher linkage and space syntax indexes with their surrounding texture.

With an increasing demand for quality of care and lower costs, hospitals are looking for industry-based methods to improve efficiency in their processes. This study aims to reduce waste in a public hospital in Mexico by improving the medical supply process for the operating room. To this end, a lean healthcare (LH) implementation following the DMAIC approach (Define-Measure-Analyze-Improve-Control) is carried out. We analyze the value stream of the supply process, including main surgical procedures and their related medical supplies, and identify different causes of inefficiency, which are evaluated and controlled through different tools, including a value stream map, Kanban, and the 5S program. As a result, five types of waste were reduced. Over-processing requests were reduced by 15.3%, defective identification numbers were reduced by 46.5%, redundant processing was improved by 94.8%, near 2.8% of the unnecessary inventory was reduced, and transportation waste was reduced by up to 16.7%. Finally, the lead-time for the main supplies was reduced by 33 days. This work demonstrates that LH and DMAIC are effective in reducing waste and are highly conducive to improving sustainability in healthcare processes. Moreover, it provides practical insights for practitioners regarding the implementation of LH in public hospitals in developing countries.

Disease related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analyzed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical patients. In 59126 medical patients included between 2006-2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. Nutrition care processes increases slightly with presence of risk factors but never done in more than 50% of patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM.

Managing household solid waste is an urban problem in recent years. To tackle this problem, recycling is one of the most effective methods applicable in waste management. Recycling in the city of Laramie in Wyoming has a history that dates to 1983 with the establishment of Ark Recycling center. Laramie officially started its curbside recycling services in September 2011 and In April 2012, the city declared its long-term goal to achieve 40% diversion rate by 2030. The study involved a mail-back survey to understand public participation landscape and factors affecting recycling behaviors and attitudes of residents in Laramie. Quantitative result of the survey responses, civic engagement score, recycling importance score recycling satisfaction and recycling behavior scores were created to understand these attributes. In addition, three key informant interviews were conducted to explore efforts of the city, the University of Wyoming and the Ark Regional Services. Findings of the study show that more than 80% of the survey respondents indicated environmental concern was the major motivation to join recycling with high level of recycling importance and satisfaction. The Study further uncovered hints that Laramie needs to introduce an aggressive educational policy, incentive policies and a Master Plan to meet its 40% waste diversion rate by 2030 by maintaining stronger public participation in its planning process and community outreach programs.

Source water quality is a key determinant of drinking water quality. The recast European Union 2020/2184 drinking water directive (DWD) introduced the obligation for comprehensive risk assessment in drinking water supplies, including the water source and incorporated new elements of natural origin in the list of parameters to be monitored. The current study is the first comprehensive assessment of 15 natural elements (B, Ba, Be, Ca, Co, K, Li, Mg, Mo, Na, Se, Sr, Ti, U and V) in 1155 (82%) Hungarian drinking water sources, including surface water, bank filtered and groundwater sources. Parameters posing a risk to health (Se, V and U) were typically below the lower limit of quantification (LOQ), but higher concentrations (max. 7.0, 17 and 41 µg/L, respectively) may occur in confined locations, the latter exceeding the DWD parametric value in one water supply. Li in a small geographical area, Mg and Ca in the majority of the water supplies reached the concentration range assumed to be protective to health. Water sources were grouped in 6 clusters based on their element distribution, some of them also showing clear geographical patterns. Water types were not differentiated, with the exception of karstic waters (dominated by Ca and Mg). None of the investigated parameters are expected to be a source of public health concern.

Background: Both of cognitive decline and unhealthy lifestyle have been associated with an increased risk of mortality in older people. We aimed to investigate whether lifestyle behaviors might modify the association between cognitive function and the risk of all-cause mortality in Chinese older populations. Methods: The study included 5,124 individuals free of dementia in the Chinese Longitudinal Healthy Longevity Survey from 2011 to 2018. Cognitive function was measured using the Mini-Mental State Examination in 2011. A lifestyle score was calculated on the basis of five lifestyle factors including smoking, alcohol consumption, physical activity, diet and body mass index. Cox proportional hazards models were performed to examine the association between baseline cognitive function and all-cause mortality, with an interaction term of cognitive function and lifestyle score being added to the models Results: During a median follow-up of 6.4 years, we documented 1,461 deaths. Both higher cognitive function (HR: 0.96; 95% CI: 0.96–0.97) and healthier lifestyle (HR: 0.92; 95% CI: 0.87–0.97) were significantly associated with a lower risk of mortality. We found that lifestyle significantly modified the association of cognitive function with mortality (P for interaction = 0.004). The inverse association between high cognitive function and mortality was more prominent among participants with healthier lifestyle. Of note, among the lifestyle scores component, diet showed a significant interaction with mortality (P for interaction = 0.003), with the protective HR of the all-cause mortality associated with higher MMSE scores was stronger among participants with healthy diets compared with unhealthy diets. Conclusion: Our study indicates that cognitive decline is associated with an increased risk of mortality, and such relations are modified by overall lifestyle, with healthy diet being the major contributor.

Background: Recent reports on the national temporal trends of sepsis-related mortality in the United States (US) suggested outcome improvement in several race and ethnicity groups. However, it is unknown whether national data reflect state-level trajectories. Methods: We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death dataset to identify all decedents with sepsis in the US during 2010-2019. Negative binomial regression models were fit to estimate national and state-level trends of age-adjusted sepsis-related mortality rates within race and ethnicity groups. Results: There were 1,852,610 sepsis-related deaths in the US during 2010-2019. Nationally, sepsis-related mortality rates decreased among Blacks and Asians, were unchanged among Hispanics and Native Americans, and rose among Whites. The percent of states with similar trends were 30.0% among Blacks, 32.1% among Asians, 74.3% among Hispanics, 75.0% among Native Americans, and 66.7%% among Whites, while trending in opposite direction from 3.6% among Asians to 15.0% among Blacks. Conclusions: National trends in sepsis-related mortality in the US did not represent state-level trajectories in race and ethnicity groups. Gains in sepsis outcomes among race and ethnicity groups at the national level were not shared equitably at the state level.

Population events such as natural disasters, pandemics, extreme weather, and wars might cause jumps that have an immediate impact on mortality rates. The recent COVID-19 pandemic has demonstrated that these events should not be treated as nonrepetitive exogenous interventions. Therefore, mortality models incorporating jump effects are particularly important to capture the adverse mortality shocks. The mortality models with jumps, proposed by Cox. et al. , Chen and Cox , and Özen and Şahin , which we consider in this study, differ in terms of the duration of the jumps - transitory or permanent, frequency of the jumps, and size of the jumps. To illustrate the effect of jumps, we also consider benchmark mortality models without jump effects, such as the Lee-Carter , Renshaw and Haberman and the Cairns-Blake-Dowd models. We discuss the performance of all the models by analysing their ability to capture the mortality deterioration caused by COVID-19. We use data from different countries to simulate the mortality rates for the pandemic years and examine their accuracy in forecasting the mortality jumps due to the pandemic. Moreover, we also analyse the impact of mortality jump models on catastrophe bond pricing.

Background and Objectives: Cardiovascular events are the leading cause of morbidity and mortal-ity in hemodialysis (HD) patients. Identifying risk factors can help in the effort to reduce cardi-ovascular risk and improve life expectancy. The purpose of this study was to evaluate the ability of CHA2DS2-VASc score [risk index of stroke in atrial fibrillation (AF)] in patients with end stage kidney disease, to predict stroke, major cardiovascular events and mortality. Materials and Meth-ods: CHA2DS2-VASc and HAS-BLED (bleeding risk from use of anticoagulation in AF) scores were calculated in 237 HD patients, [99 women, median age 76 (15) years], at time they com-menced on HD. The scores’ ability to predict long term cardiovascular morbidity and mortality was estimated, both in those with and without AF. Results: CHA2DS2-VASc score was signifi-cantly increased in AF (n=69) compared to non-AF (n=168) patients, 5 (2.5) versus 4 (2), p<0.0001, respectively. Increased CHA2DS2-VASc score was associated with heart failure (p=0.007, p=0.024), stroke (p<0.0001, p<0.0001) and risk of all-cause mortality (p<0.0001, p<0.0001), in both groups, respectively. C statistics indicated that CHA2DS2-VASc score performed modest discrimination in this HD population with and without AF for heart failure, stroke, and all-cause mortality, but for cardiovascular mortality in AF group only. Conclusions: Increased CHA2DS2-VASc score at time starting on HD, can predict stroke, heart failure and all-cause mortality in HD patients in-dependent of the presence of AF. Risk of cardiovascular mortality could be predicted only on patients with AF.

Background: COVID-19 is currently one of the most important medical challenges as it affects the entire population with children being infected as easily as adults. Objective: The study evaluated the mortality of under 17-year-olds and compare the frequency with that of adults in a cohort of 8986 COVID-19 positive patients hospitalized in a single care center. Design: retrospective clinical trial, all hospitalizations of COVID-19 positive patients as diagnosed by RT-qPCR were analyzed by revisiting their medical records. Setting: 8986 COVID-19 positive patients hospitalized in a Hospital de Base and the Infant and Maternal Hospital of São Jose do Rio Preto, SP, Brazil (HB/HCM) being these totals of 383 COVID-19 positive under 17-patients. Patients: patients COVID-19 positive under 17-year-olds were grouped by age and evaluated by analyzing their medical records. They were categorized as Group I, children, and adolescents under 19 years old and Group II, adults over 19 years. Results: Overall mortality in under 19-year-olds was 12 deaths, that is, 3.13% of the patients in this age group and 0.55% of the overall mortality from COVID-19. Mortality in the group of adults was 2197 equivalent to 24.45% of the hospitalized adults and 99.45% of overall deaths. Mortality was significantly higher for adults than for under 19-year olds (p-value < 0.0001). Regarding the different ages of children and adolescents, the number of deaths of under 1-year olds was 2/123 (1.62%), of 1-4 years it was 4/95 (2.11%), of 5-9 years it was 1/47 (2.13%), of 10-14 years it was 1/40 (2.5%) and of 15-19 years it was 4/78 (5.13%). There were no statistical differences between the different age groups ( p-value = 0.3). Conclusion: Mortality from COVID-19 in children and adolescents was lower than in adults and generally associated with other comorbidities with the main association being with heart disease.

Chronic Kidney Disease (CKD) is a major public health concern with an increasing proportion of sufferers progressing to renal replacement therapy (RRT). Early identification of those at risk of disease progression could be key in improving outcomes. We hypothesise that urinary liver-type fatty acid binding protein (uL-FABP) may be a suitable biomarker for CKD progression and can add value to currently established biomarkers such as urinary protein to creatinine ratio (uPCR) 583 participants with CKD 1-5 (not receiving renal replacement therapy) entered a 2-yr prospective longitudinal study. UPCR and uL-FABP were measured at baseline and CKD progression was defined as either i) a decline in eGFR of >5ml/min/1.73m2 or an increase in serum creatinine by 10% at 1-yr or ii) a decline in eGFR of >6 ml/min/1.73m2, or an increase in serum creatinine by 20% at 2-yrs or iii) the initiation of RRT. A combined outcome of initiating RRT or death was also included. Approximately 40% of participants showed CKD progression. UL-FABP predicted CKD progression at both years 1 and 2 (OR 1.01, p<0.01). Sensitivity and specificity were comparable to those of uPCR (AUC 0.623 v 0.706) and heat map analysis suggested that uL-FABP in the absence of significant proteinuria can predict an increase in serum creatinine of 10% at 1yr and 20% at 2yr. The risk of the combined outcome of initiating RRT or death was 23% higher in those with high uL-FABP (p<0.01) independent of uPCR. UL-FABP appears to be a highly sensitive and specific biomarker of CKD progression. The use of this biomarker could enhance the risk stratification of CKD and its progression and should be assessed further.

Early diagnosis and appropriate treatments are crucial to reducing mortality risk in septic patients. Low SOFA scores and current biomarkers may not discern adequately patients that could develop severe organ dysfunction or have an elevated mortality risk. The aim of this prospective observational study is to evaluate the predictive value of the biomarkers midregional proadrenomedullin (MR-proADM), procalcitonin (PCT), C-Reactive Protein (CRP), and lactate for 28-day mortality in patients with sepsis and a SOFA score ≤ 6. 284 patients were included, with a 28-day all-cause mortality of 8.45 % (N=24). Non-survivors were older (p=0.003), required mechanical ventilation (p=0.04) and were ventilated for longer (p=0.02), had a higher APACHE II (p=0.015) and SOFA (p=0.027) scores. Lactate showed the highest predictive ability for all-cause 28-day mortality with an area under the receiver-operating characteristic curve (AUROC) of 0.67 (0.55–0.79). The AUROC for all-cause 28-day mortality in patients with community-acquired infection was 0.69 (0.57–0.84) for SOFA, and 0.70 (0.58–0.82) for MR-proADM. A 2.1 nmol/L cut-off point for this biomarker in this subgroup of patients discerned with 100% sensibility survivors from non-survivors at 28 days. In patients with community acquired sepsis and initial SOFA score ≤ 6, MR-proADM could help identify patients at risk of 28-day mortality.

(1) Background: With the United Nations Sustainable Development Goals (SDG) (2015-2030) fo-cusing on reducing maternal mortality, monitoring and forecasting Maternal Mortality Rates (MMR) in regions like Africa become crucial for health strategy planning by policymakers, in-ternational organizations, and NGOs. (2) Methods: We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Join Point regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990-2015 data to forecast the MMR for the next 15 years. (3) Results: The study found a decline in MMR in Africa with an average annual percentage change (APC) of -2.6% (95% CI -2.7; -2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 65 deaths per 100,000 births in North Africa to 249 deaths per 100,000 births in Central Africa., averaging 197 per 100,000 births for the continent. (4) Conclusions: Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, only North and South Africa will likely reach the SDG target.

With the rapid development of network science, Turing pattern on complex networks has attracted extensive attention from researchers. In this paper, we focus on spatial patterns in multiplex ER (Erdös-Rényi) random networks, taking the predator-prey model with Allee effect and hyperbolic mortality as an example. In theory, the threshold condition for generating Turing pattern is given using the Turing instability theory of multiplex networks. Numerically, we design relevant experiments to explore the impact of network topology on Turing pattern. The factors considered include model parameters, diffusion rate, average degree of the network, and differences in the average degree of different layers. The results indicate that the importance of diffusion rate and network average degree for Turing pattern is affirmed on the single-layer network. For multiplex networks, the differentiation of average degrees in different layers controls the generation of Turing pattern, which is not affected by the diffusion rates of the two populations. More interestingly, we observe the switching of Turing pattern and spatiotemporal pattern. We believe that these findings contribute to a better understanding of self-organization on complex networks.

The association between angiotensin-converting enzyme insertion/deletion (ACE I/D) polymorphisms and plasma ACE levels may allow for the optimization of a preventive intervention to reduce cardiovascular morbidity and mortality in the chronic kidney disease (CKD) population. In this study, we aimed to analyze the association between ACE I/D polymorphism and cardiovascular mortality risk among non-hemodialyzed chronic kidney disease patients. This cross-sectional study examined 70 patients of Javanese ethnic origin with stable CKD who did not receive hemodialysis. ACE I/D polymorphisms, plasma ACE levels, atherosclerotic cardiovascular disease (ASCVD) risk, and cardiovascular mortality risk were investigated. As per our findings, the I allele was found to be more frequent (78.6) than the D allele (21.4), and the DD genotype was less frequent than the II genotype (4.3 vs. 61.4). The ACE I/D polymorphism had a significant direct positive effect on plasma ACE levels (path coefficient = 0.302, p = 0.021). Similarly, plasma ACE levels had a direct and significant positive effect on the risk of atherosclerotic cardiovascular disease (path coefficient = 0.410, p = 0.000). Moreover, atherosclerotic cardiovascular disease risk had a significant positive effect on cardiovascular mortality risk (path coefficient = 0.918, p = 0.000). The ACE I/D polymorphism had no direct effect on ASCVD and cardiovascular mortality risk. However, our findings show that the indirect effects of high plasma ACE levels may be a factor in the increased risk of ASCVD and cardiovascular mortality in Javanese CKD patients.

Health differences across socioeconomic strata have always pointed out that poorer and minorities have higher mortality and morbidity than richer and majorities. This difference is exacerbated for particular populations such as the victims of ongoing armed conflicts, who are also much harder to quantify due to the conflict itself. This study applies network analysis to a combination of three large administrative records for the health system and mortality records in the province of Risaralda (Colombia) between 2011 and 2016. It produces the most common causes of morbi-mortality for both victims of violence and the poorest inhabitants of Risaralda, defined as those who qualify as recipients of subsidies from the Colombian welfare program called SISBEN in the categories of highest need. Both populations show high morbidity frequencies for non-communicable diseases such as Type II diabetes, hypertension, and hyperglyceridaemia, mostly associated with exposure to unhealthy lifestyles. Additionally, the mortality outcomes reflect the different lifestyles and medical treatments of both subpopulations. While the poorest replicate the same causes identified for morbidity, the victims of armed conflict die of additional causes including Type II diabetes, which reflects the even worse conditions they face.

Background: This study stands as a pioneer in the histological evaluation of the biological behavior of a novel implant design featuring decompressive cervical blades. Hence, the aim of the present study was to evaluate the healing outcome in cortical regions at where decompressive protocols were adopted using implants equipped with blades. Materials and methods: Blades with varying diameters were integrated into the coronal portion of the implant to prepare the cortical region of rabbit tibiae. The blade diameters differed from the implant collar by the following amounts: control group (0 µm), +50 µm, and +200 µm. Results: No marginal bone loss was detected. Instead, all implants exhibited new bone formation in the coronal region. Complete closure was observed in the CG-0 group, as well as in the TG-50 and TG-200 groups, despite the presence of marginal gaps without primary bone contact at installation. In the apical region, most implants breached the cortical layer. Nevertheless, new bone formation in this region completely closed the osteotomy, effectively isolating the internal environment of the tibia from the external. Conclusions: The use of a blade attached to the implant body enabled precise preparation of the cortical layer, allowing for controlled decompression in the targeted area. This technique resulted in optimal osseointegration with no loss of marginal bone, and complete restoration of marginal gaps ranging from 0 µm to 200 µm.

Number of studies claim that tobacco control (TC) regulations are associated with reductions in smoking-related hospitalisation rates, however very few have estimated the impact of TC laws (TCL) at both countrywide and regional levels, and none of them - in relation to compliance with TC regulations. This study evaluates the effects of Russian TCL on hospital admission (HA) rates for pneumonia countrywide and in 10 Russian regions and the extent of these effects in connection with the compliance to TCL. Methods: HA rates for pneumonia during 2005–2019 were analysed to compare the periods before and after the adoption of TCL in 2013. An interrupted time series design and a Poisson regression model were used to estimate the immediate and long-term effects of TCL on pneumonia annual hospitalisation rates after the TCL adoption, compared with the pre-law period. The 10 Russian regions were compared using the TCL Implementation Scale (TCIS) developed on the basis of the results of Russian TC policy evaluation survey; Spearman’s rank correlation and linear regression models were employed. Results showed a 14.3% reduction in HA rates for pneumonia (RR 0.88; p=0.01) after the adoption of TCL in Russia with significant long-term effect after 2013 (RR 0.86; p=0.006). Regions with better enforcement of TCL exhibited greater reductions in pneumonia HA rates (rsp=−0.55; p=0.04); (=−4.21; p=0.02). Conclusions: TCL resulted in a sustained reduction in pneumonia hospitalisation rates, but these effects, varying by region, may depend on the scale of the TCL enforcement.

The Victorian Government Inquiry into wildfires that killed 173 people in 2009 has driven an Australian policy shift from self-evacuation or staying and defending a well-prepared property (‘go or stay’) to self-evacuation under catastrophic fire weather (‘leave early’). The Inquiry also led to the establishment of national ‘performance standards’ for Private Fire Shelters (PFS, that also known as bunkers). Nonetheless, incorporation of PFS into national bushfire policy remains embryonic with only Victoria having streamlined accreditation and planning approval processes. Arguments against PFS include potentially engendering complacency about preparing dwellings to survive fire and encourage risky behavior in response to a fire threat. Counteracting these arguments is research that shows that residents without PFS have low engagement with bushfire preparation and typically delay evacuation. In any case, because wildfire is unpredictable it is accepted that self-evacuation plans must have fallback positions that include sheltering ‘in place’ from the bushfire, making properly used and well maintained PFS an important element of bushfire safety. A less discussed barrier to PFS uptake outside Victoria appears to hinge on a lack of clarity about obligations for their design, certification, and consistency with planning approvals. The escalating Australian fire crisis demands much greater research and development in legal frameworks, policy and planning processes for PFS, as well as design and construction standards.

Accounting information is a crucial management tool for Nigerian national development services. In every state or country, accounting is crucial to maintaining social peace, political stability, and economic sustainability. The explanation for this clear truth about the development of Nigeria is not plausible given the massive multi-sectoral scope of Nigerian economic activities in both the public and private sectors. For government national progress, reliable accounting information is essential. This research aims to explore the role of accounting on public sector accountability in Nigeria.

Plant breeding is central to agriculture, and shifts in plant breeding practices (e.g., hybrid development) and selection goals (e.g., response to synthetic fertilizer) have catalyzed monumental and persistent changes in agricultural production systems of all scales with social, political, economic, and environmental repercussions. While plant breeders are largely trained in the sciences of biology, genetics, and statistics, we posit an ethical imperative to examine the degree of equity with which the benefits of new research and plant varieties are distributed. In the United States, the history of plant breeding parallels the colonial history of agriculture, which compels reflection by current plant breeders about their role in shaping our agricultural system. In this perspective essay, we examine longstanding ideas about equitable food systems through the lens of public plant breeding in the United States. We propose a framework for equitable public plant breeding with respect to both its process and outcomes, and we intend for the ideas presented herein to catalyze reflection, discussions, and actions as the plant breeding community seeks greater equity in the food and seed systems our work supports.

Airborne wind energy (AWE) systems use tethered flying devices to harvest higher-altitude winds to produce electricity. For a successful deployment of these systems, it is crucial to understand how the public perceives them. If public concerns about the technology are not taken seriously, implementation could be delayed or, in some cases, prevented, resulting in increased costs for project developers and a lower contribution of the sector to renewable energy targets. This literature review assessed the current state of knowledge on public responses to AWE. An exhaustive literature search led to the identification of 40 relevant publications that were reviewed. The literature assumed that the safety, visibility, acoustic emissions, ecological impacts, and the siting of AWE systems shape public responses to the technology. The reviewed literature views people’s responses to AWE very optimistically but lacks scientific evidence to back up its claims. It seems to overlook that the influence of AWE’s characteristics (e.g., visibility) on public responses will also depend on a range of situational and psychological factors (e.g., people’s general attitude towards AWE, the public’s trust in project developers). Therefore, empirical social scientific research is needed to increase the field’s understanding of public responses to AWE and thereby facilitate deployment.

The purpose of this study is to explore conceptual approaches in co-production studies and to examine current research trends of the study. The conceptual paper includes research articles related to co-production in public administration field. By thoroughly scrutinizing 32 research works of co-production, this study highlights major loopholes in the field of the study. The contributions of the study are: (1) identifying two common characteristics of co-production, (2) categorising three types of co-producing by end-users, and (3) finding that goals and success of co-production are more beneficial for service providers though its initial approach is citizen-centric approach. We suggest that future studies should be (1) to focus on reasons for co-production failures or success, (2) to discover further hindrances for co-production in service production, (3) to examine influencing factors on service providers as well as institutional impacts on co-production process, and (4) to include practical assessment in co-production study.

We report the experiences of the bike sharing system in Ningbo, China. To analyze the impact of the system, system log data are collected for the whole month of May 2014 (with more than 1.7 million usage records), supplemented by questionnaire data from 1,856 respondents. Our results show that public bike usage follows the same pattern as road traffic, with morning and evening peaks on week days. In terms of mode substitution, 16% of public bike trips would have been made by private cars. In average, each public bike is used 3.7 times per day, with each trip lasting around 23 minutes and covering around 3.5 kilometre. This translates into a reduction of car travel by more than 11 million kilometre per year, a significant contribution to the sustainability of urban transport in Ningbo.

Thanks to rapid advances in the Internet of Things (IoT) and Edge-Fog-Cloud Computing technologies, Smart Public Safety (SPS) system has become feasible by integrating heterogeneous computing devices and different types of networks to collaboratively provide seamless public safety services. While SPS facilitates convenient exchanges of surveillance data streams among device owners and third-party applications, the existing monolithic service oriented architecture (SOA) architecture is unable to provide scalable and extensible services in a large-scale heterogeneous network environment. Moreover, traditional security solutions rely on centralized trusted third-party authority, which not only can be a performance bottleneck or the single point of failure, but it also incurs privacy concerns on improperly use of private information. Inspired by blockchain and microservices technologies, this paper proposed a BLockchain-ENabled Decentralized Smart Public Safety (BlendSPS) system. Leveraging hybrid blockchain fabrics, a microservices based security mechanism is implemented to enable decentralized security architecture, and it supports immutability, auditability and traceability for secured data sharing and operations among participants of the SPS system. An extensive experimental study verified the feasibility of the proposed Blend-SPS that possesses security and privacy proprieties with limited overhead on IoT based edge networks.

The current Coronavirus Disease 19 (COVID-19) pandemic, caused by the SARS-CoV-2 virus, is unprecedented in recent history and threatens the lives and livelihoods of billions worldwide. The rapid spread and lack of modern parallels have left governments, health agencies, and the public racing to understand how to best mitigate and ultimately suppress the pandemic, but we are still working to understand the strengths and weaknesses of various interventions at our disposal. Few issues have been as contentious as the public use of face masks to control the pandemic’s spread. There is ongoing debate about their effectiveness, but an increasing body of evidence suggests that masks could be a useful in preventing the spread of coronavirus, leading several governments and health agencies to review and revise their policies. Here, we review the theory and evidence behind use of masks. The theory behind masks is that they prevent the spread of viral particles by infected persons, and inhalation of viral particles by uninfected persons. Even assuming masks are not 100% effective in preventing infection, they may reduce severity of infection by reducing viral dosing. Laboratory studies suggest masks may be effective in stopping both exhalation and inhalation of viral particles. However, real-world studies provided limited evidence for the use of masks in controlling influenza transmission and highlight potential problems associated with their misuse, such as poor compliance or improper use. Evidence for efficacy of face masks against the first SARS virus, SARS-CoV-1, implies that they may be effective against the current outbreak of SARS-Cov-2 virus. This is important as mathematical modeling suggests that even small reductions of in transmission rates can make a large difference over time, potentially slowing the pace of viral pandemics and limiting their spread. Perhaps the strongest argument for the use of masks is that countries with early adoption of masks have tended to see flatter pandemic curves, even without strict nationwide lockdowns. There is little evidence that respirators are more effective than surgical masks, but this may be due to misuse or poor compliance. Studies suggest some non-medical masks perform on par with medical masks. Improvised masks are less effective than medical masks, but may provide better protection than nothing at all. While many governments now encourage the use of improvised face coverings, more will need to be known about material, design, and who needs to wear masks, and when, to ensure effectiveness. Proper use of masks will also be important; if masks are used improperly or infrequently they may provide limited protection. It is important that public health policy makers consider the debate and the potential of masks as part of multi-faceted coronavirus control strategies.

Threats to natural ecosystems are closely linked to human development, and the lack, insufficiency or inefficiency of public policies are some of the most important drivers of negative effects on the environment. The contribution of the IUCN’s Red List of Ecosystems (RLE) to conservation topics has been discussed in previous studies; however, to date its implications for conservation in public policies have not been addressed. This perspective discusses how the RLE may support the improvement and development of these policies, specifically through the implications for public policy of each of the criteria that substantiate the threat status of ecosystems. We aim to provide a plausible baseline to the operationalization of RLE in public and conservation policy, facilitating the work of governments, practitioners and decision makers. Finally, we provide recommendations and examples as to how to proceed in creating and modifying different public policy instruments, such as land-use planning, spatial zoning, tax reduction, compensation schemes, climate change adaptation plans, management of introduced species, development offsets and restoration investment. This perspective contributes to implement RLE into public policy and to improve ecosystem conservation by expanding the current scope of RLE into practical and political dimensions through plausible actions, policies and strategies.

This research was focused on Public Service of departmental auction state officers of Makassar . It aimed to determine the state officers’ performance who passed departmental auction that had been assessed based on competence, and integrity in particular, the ability to provide and develop good service to the community at the 9 Local Government Work Unit (SKPD) Makassar, namely the Regional Revenue Board of Makassar City, the Land Board of Makassar City, the Office of Investment and Integrated One Stop Service of Makassar City and the Department of Population and Civil Registration of Makassar City, Ujung Pandang District Office, Makassar District , Rappocini District , Bontoala District , and Panakkukang District . The 9 SKPD were chosen purposively from 53 SKPD within the Makassar City Administration by considering the representation of SKPD of the Agency and the Department as well as the representation of the district Institution located in the northern, middle and southern part of Makassar City. Interviews and observation data were collected by 3 interviewers and narrated as facts and elaborated by the research team with qualitative and normative studies. The result of the research shown that the state officers’ performance in Makassar city administration area had been able to develop good service to the society at 9 Local Government Work Unit (SKPD) of Makassar City. However, it was necessary to improve the quality of human relations especially for the leading position of all SKPD so that the communication can be better served to the citizens. System reward dan punishment need to be upgraded and enforced as a trigger of employees’ motivation in work.

Even though Greece is considered a vulnerable region in terms of climate hazards, public perception and attitude do not always identify climate change as an important environmental area of concern, especially when compared to socio-economic issues. The key issue of this paper is to investigate and analyse public perception in Greece as regards to climate change risk. Through a questionnaire survey this paper analyses trends that exist, peoples’ opinion and awareness with regards to climate risk and how willing they are to change current lifestyle, to pay or to act to minimize or to prevent the risk. Conventional wisdom of this paper is to highlight factors that influence individual perception and point out drivers of behavior change that can support efficiently future adaptation plans.

Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in northern California. Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.

In this study, long-term mortality effects associated with exposure to PM10, PM2.5, BC (black carbon), and NOx were analyzed in a cohort in southern Sweden during the period from 1991‒2016. Participants (those residing in Malmö, Sweden, born between 1923‒1950) were randomly recruited from 1991‒1996. At enrollment, 30,438 participants underwent a health screening, which consisted of questionnaires about lifestyle and diet, a clinical examination, and blood sampling. Mortality data were retrieved from the Swedish national cause of death register. The modeled concentrations of PM10 (particles with an aerodynamic diameter smaller than or equal to 10 µm), PM2.5 (particles with an aerodynamic diameter smaller than or equal to 2.5 µm), BC (black carbon), and NOx (nitrogen oxides) at the cohort participants' home addresses were used to assess air pollution exposure. Cox proportional hazard models were used to estimate the associations between long-term exposure to PM10, PM2.5, BC, and NOx and the time until death among the participants during the period from 1991‒2016. The hazard ratios (HRs) associated with an interquartile range (IQR) increase in each air pollutant were calculated based on the exposure lag windows of the same year (lag0), 1‒5 years (lag1‒5), and 6‒10 years (lag6‒10). Three models were used with varying adjustments for possible confounders including both single-pollutant estimates and two-pollutant estimates. With adjustments for all covariates, the HRs for PM10, PM2.5, BC, and NOx in the single-pollutant models at lag1‒5 were 1.06 (95% CI: 1.02‒1.11), 1.01 (95% CI: 0.95‒1.08), 1.07 (95% CI: 1.04‒1.11), and 1.11 (95% CI: 1.07‒1.16) per IQR increase, respectively. The HRs were in most cases decreased by the inclusion of a larger number of covariates in the models. The most robust associations were shown for NOx, with statistically significant positive HRs in all models. An overall conclusion is that road traffic-related pollutants had a significant association with mortality in the cohort.

Background: The prognostic value of erythrocyte levels of the n-6 fatty acids (FAs) for total mortality and cardiovascular disease (CVD) outcomes remains an open question. Methods: We examined CV outcomes and death in 2500 individuals in the Framingham Heart Study Offspring cohort without prevalent CVD (mean age 66 years, 57% women) as a function of baseline levels of different length n-6 FAs (18 carbon, 20 carbon and 22 carbon) in the erythrocyte membranes. Clinical outcomes were monitored for up to 9.5 years (median follow up, 7.26 years). Cox proportional hazards models were adjusted for a variety of demographic characteristics, clinical status and RBC n-6 and long chain n-3 FA content. Results: There were 245 CV events, 119 CHD events, 105 ischemic strokes, 58 CVD deaths, and 350 deaths from all causes. Few associations between either mortality or CVD outcomes were observed for the n-6 FAs, with those that were observed becoming non-significant after adjusting for n-3 FA levels. Conclusions: Higher circulating levels of the marine n-3 FA levels are associated with reduced risk for incident CVD and ischemic stroke and for death from CHD and all-causes, however in the same sample, little evidence exists for association with n-6 FAs. Further work is needed to identify a full profile of FAs associated with cardiovascular risk and mortality.

Over the past decade, Knowledge bases (KB) have been increasingly utilized to complete and enrich the representation of queries and documents in order to improve the document retrieval task. Although many approaches have used KB for such purpose, understanding how effectively lev-erage entity-based representation still needs to be resolved. This paper proposes a Purely Enti-ty-based Semantic Search Approach for Information Retrieval (PESS4IR) as a novel solution. The approach includes (i) its own entity linking method, (ii) an inverted indexing method, and for document retrieval and ranking, (iii) an appropriate ranking method is designed to take advantage of all the strengths of the approach. We report the findings on the performance of our approach tested by queries annotated by two known entity linking tools, REL and DBpedia-Spotlight. The experiments are performed on the standard TREC 2004 Robust and MSMARCO collections. By using the REL method, for queries whose all terms are annotated and whose average annotation scores are greater than or equal to 0.75, our approach achieves the maximum nDCG@5 score (1.000). Thus, using our approach with any other document retrieval method would be an added value, unless that method achieves the maximum nDCG@5 score for those highly annotated queries.

Nature-based Solutions (NbS) have rapidly been gaining traction across the research, policy, and practice spheres, touted as transformative actions to jointly address biodiversity loss and climate change. However, there are multiple, alternative ways to imagine NbS in those three spheres. To inform the NbS discourses across these three spheres, we critically reflect on the prevailing framing of NbS and consider the potential of a different framing of NbS to support transformations towards regenerative relationships between humans and nature. Such reflection is urgently needed to ensure that research, policy, and practice delivers on the transformative ambitions of NbS. We propose a novel “core framing” of NbS, charting two pathways for how such a framing can support a human value-based transformation – first through influencing individual beliefs and values, and second through the communication and application of the NbS concept in research, policy, and practice. We argue that for NbS to support transformation, it must support a reframing of human-nature relationships, one where the interdependencies between people and nature are recognized as essential for social and environmental well-being. We elaborate on how such a framing is key to support inclusivity and collaboration between diverse research perspectives, policy objectives across scales, and implementation practices, to deliver successful NbS.

Abstract: The trend of fasting until noon (omission or delayed breakfast) is increasingly prevalent in modern society. This eating pattern triggers discordance between endogenous circadian clock rhythms and the feeding/fasting cycle and is associated with an increased incidence of obesity and T2D. Although the underlying mechanism of this association is not well understood, growing evidence suggests that fasting until noon, also known as an “extended postabsorptive state,” has the potential to cause a deleterious effect on clock gene expression and disrupted regulation of body weight, postprandial and overall glycemia, skeletal muscle protein synthesis, appetite and may also lead to lower energy expenditure. This manuscript overviews the clock gene-controlled glucose metabolism during the active and resting phases. The consequences of postponing until noon the transition from postabsorptive to fed state on glucose metabolism, weight control, and energy expenditure. Finally, we will discuss the metabolic advantage of shifting more energy, carbohydrates (CH), and proteins to the early hours of the day.

Aortic dissection (AD) is a critical heart condition with potentially severe outcomes. Our study aims to investigate the existence of a "weekend effect" in AD by examining the correlation between patient outcomes and the timing of their treatment during weekdays vs weekends. Specifically, we assessed prospectively the effects of the timing of treatment on patient outcomes for acute aortic dissection, both before surgical intervention and during hospitalization, as well as during the follow-up period. The mean age of the study population used here was 62.5 years with a high degree of variability. We recorded a rate of mortality before surgery of 8.65% for the weekend group and 15% for the weekday group, with no significant differences noted in the results of statistical tests. During hospitalization, mortality was found to be 50% (n=52) in the weekend group and 25% (n=5) in the weekday group, again with no significant differences observed in the results of the same statistical tests. Patient mortality after discharge was 9.61% (n=10) in the weekend group and 5% (n=1) in the weekday group. Our findings suggest that there is no significant difference in mortality rates between patients admitted to the hospital on weekends versus weekdays. Therefore, the period of the week when a patient presents to the hospital with aortic dissection appears to not affect their mortality outcomes.

The age-related mortality and morbidity risk of COVID-19 has been considered speculative without enough scientific evidence. This study aimed to collect more evidence on the association between patient age and risk of severe disease state and/or mortality from SARS-CoV-2 infection. Genomic dataset along with metadata (3608 samples) retrieved from GISAID from different geographical regions were grouped into 10 age groups (0-10, 11-20, 21-30, 31-40, 41-50, 51-60, 61-70, 71-80, 81-90, 91-100 years) as well as high-risk or low-risk according to patient clinical status. Genomic sequences were aligned and analyzed using MAFFT and FASTTREE to build a phylogenetic tree in order to identify age-risk associations based on phylogenetic clustering. Case fatality rates (CFR), as well as the Odds ratio (OR) for high-risk outcomes, were calculated for different age groups. Results revealed that individuals aged between 25-50 years have the best immune response to the infection. On the other hand, disease fatality was higher in patients aging above 50 years. We created an application to calculate the OR of being at high risk given a certain age threshold from GISAID datasets. OR values increased between ages 1-10 years (1.271) and 11-20 years (1.313) but reduced at age range 21-30 years (1.290) and increased again for 61-70 years (2.465). CFR calculated for each of the age groups had peak values at 90-100 years (26.8%) and the lowest at 0-10 years (0%). The CFR for ages above 50 years was about twice greater (11.6%-26.8%) than that for ages below (0-6.6%). The phylogenetic analysis revealed that the majority of samples obtained from India showed low-risk among different age groups and were defined as clade GH. Another cluster from Singapore visualization showed unfavorable patient outcome across several age groups and were classified under clade O. To conclude, this study analyses showed a variety of age-risk associations. As scientists from different countries upload more genomes to globally shared databases, more evidence will reinforce mortality risk associations in COVID-19 patients.

A cross-sectional study was conducted to gain insight into the epidemiology of canine ehrlichiosis and rickettsiosis in northern Portugal. Specific IgG antibodies to Ehrlichia canis were analysed using a commercial indirect ELISA test, and antibodies to Rickettsia conorii using a commercial IFAT. A total of 113 dogs from two different shelters were sampled, and seroprevalence values of 0.9% (95% confidence [CI]: 0.2–4.8%) for E. canis and 9.7 (95% CI: 5.5–16.6%) for R. conorii were found. Univariable models investigated risk factors for seropositivity. The odds ratios (OR) of R. conorii seropositivity were higher for female dogs (OR = 2.32; 95% CI: 1.58–3.39) and for dogs belonging to Shelter 2 (OR = 3.0; 95% CI: 2.28–3.95). Seropositive dogs for co-infection (E. canis + R. conorii) were more frequently observed in females (OR = 2.4; CI 95%: 1.66–3.47) and in Shelter 2 (OR = 2.72; 95% CI: 1.97–3.76). These findings show that shelter dogs in northern Portugal are exposed to E. canis and R. conorii, which can affect both canines and humans. It is imperative to adopt a One Health approach to educate the public about the hazards of canine zoonoses and develop legislation and procedures to control their spread and preserve public health.

This paper describes a research project carried out in an Italian public school to assess whether parents were willing to take part in food procurement decisions, as well as their ability to accurately predict what foods children would pick at school lunch and their propensity to support sustainable food choices made by the school. The methodology included a questionnaire to 500 parents and an in-depth study of 138 child/parent pairs. The study comprised: (i) presentation of an innovative recipe in the weekly menu of the school canteen; (ii) meal observations of children’s intake at school lunch during the week of the menu modification; (iii) collection of both parents’ and children’s reports on their choices of recipes from the modified weekly menu. The results are commented in light of two important changes that have recently affected Italian public school food procurement: the opening of school canteens to lunches brought from home and the measures adopted since 2020 to contain the Covid-19 pandemic. Both events go in the direction of delegating to parents the multifaceted role of the school in the food arena. The article concludes that the results of the study should discourage this approach.

In this paper, the validity of the Wagner’s law is investigated in tenth selected Sub- Saharan African countries, namely Botswana, Equatorial Guinea, Mauritania, Nigeria, South Africa, Sierra Leone, Tanzania, Ethiopia, Madagascar, and DR Congo. Five variants of the Wagner’s law were tested for the period 2005-2014, using panel econometric approaches encompassing cointegration and causality. The study found a long run relationship between the public expenditure and the various explanatory variables used as proxies of income. The long-run causality tests indicate that there is bidirectional causality between expenditure and income in all models with the exemption of the Gupta model. It is concluded that for Sub-Saharan Africa, both the Wagner’s law the Keynesian hypothesis tend to be valid under the period of investigation. The explanation is that there has been the tendency for public expenditure to grow relative to national income (Wagner’s law) and that public expenditure is a policy instrument (an exogenous factor) for improving national income (Keynesian hypothesis) during the 10-year period.

This study was aimed to examine the recent trends of antibiotic resistance (AR) prevalence in Staphylococcus aureus isolated from milk of animals with clinical mastitis in areas of the Abruzzo and Molise regions in central Italy. Fifty-four S. aureus isolates could be obtained from routine testing for clinical mastitis agents carried out in the author institution in years 2021 and 2022. These were analyzed for phenotypic resistance to eight antibiotics recommended for testing by European norms and belonging to the antibiotic classes used for mastitis treatment in milk producing animals. Moreover, the presence of 14 transferable genetic determinants encoding resistance to the same antibiotics was analyzed by qPCR tests developed in this study. Phenotypic resistance to non-β-lactams was infrequent, with only one 2022 isolate resistant to clindamycin. However, low level resistance to the β-lactam cefoxitin was observed in 59.2% isolates in both years making these isolates classifiable as methicillin resistant. The AR genotypes detected were blaZ gene (50% 2021 isolates and 44.4% 2022 isolates), ermC/T- aphA3-blaZ (one 2021 isolate), ant6-ermC/T-aphA3-blaZ (one 2021 isolate), ermB-blaZ (one 2022 isolate) and mecA-mph (one 2022 isolate). An interview to the veterinarians who conferred the samples, regarding antimicrobials prescribed for mastitis treatment and criteria of usage, indicated a possible causal relation with the AR test results. The low prevalence of AR genotypes, not increasing in time, most probably reflecting the reported management of antibiotic therapies in farms. However, the frequently observed cefoxitin resistance needs to be explained genotypically, further monitored and limited by modifying antibiotic usage practices. The identification of a mecA positive isolate in 2022 suggests to investigate further if this genotype is emerging locally.

The initial development of seahorse juveniles is characterized by low digestion capabilities. Stable isotope analysis is an effective tool in studies of trophic food webs and animal feeding patterns. The present study provides new insights for the understanding of growth and food assimilation in early developing seahorses following a laboratory diet switch. The study was performed in early life stages of the seahorse Hippocampus reidi by assessing the influence of diet shift on changes and turnovers in carbon (δ13C) and nitrogen (δ15N) stable isotope in juveniles. Newborn seahorses were fed for 60 days following two feeding schedules (A6 and A11) based initially on copepods Acartia tonsa and subsequently on Artemia nauplii (since days 6 and 11, respectively). After prey shift, we determined δ13C and δ15N turnover rates as functions of change in either body mass (fitting model G) and days of development (fitting model D), contributions of metabolism and growth to those turnover rates, and diet-tissue discrimination factors. Survival, final dry weight and final standard length for diet A11 were higher compared to diet A6. The shift from copepods to Artemia lead to fast initial enrichments in δ13C and δ15N. Afterwards, the enrichment was gradually reduced until reaching the isotopic equilibrium with diet. In most cases, both fitting models performed similarly. The isotopic analysis revealed that 100% of tissue turnover was attributed to growth in diet A11, whereas 19-25% was endorsed to metabolism in diet A6. Diet-tissue discrimination factors were estimated for the first time in seahorse juveniles, resulting in higher estimates for diet A11 (2.9 ± 0.7‰ for δ13C; 2.5 ± 0.2‰ for δ15N) than in diet A6 (1.8 ± 0.1‰ for δ13C; 1.9 ± 0.1‰ for δ15N). This study highlights the relevance of feeding on copepods and their effect on isotopic patterns and discrimination factors in seahorse juveniles after a dietary shift. Regarding the application of the results achieved to feeding schedules in the rearing of H. reidi, a long period of feeding on copepods during the first days of development is highly recommended.

Monte Carlo simulations were conducted to investigate the interaction between nucleation and the rates of chemical reduction in Au/Ag, Au/Pt and Au/Pd nanoparticles prepared in microemulsions using a one-pot method. The impact of nucleation on final nanostructure depends on the critical nucleus size value: at a high critical nucleus size, nucleation becomes the main factor in determining the final nanostructure, even with very large difference in reduction rates, as seen in the Au/Pd pair. However, when the critical nucleus size is small, the difference in reduction rates of the two metals becomes the key parameter determining the final nanostructure. Furthermore, the relevance of heteroatomic nucleation on the mechanism of nanoparticle formation depends on the difference between the reduction rates of the two metals. Smaller differences, such as in the Au/Ag or Au/Pt pairs, result in a greater impact of heteroatomic nucleation on the final nanostructure. In contrast, in the Au/Pd pair, heteroatomic nucleation becomes less important due to the low availability of Pd until late stages of synthesis. This study provides deeper insight into the complex mechanisms that govern reactions in microemulsions.

The increasing number of caesarean section (CS) is a major challenge in modern obstetrics. This rise is not supported by better neonatal and maternal outcomes. The prevention of unnecessary primary CS is a global priority. This study focuses on effectiveness and safety of yoga practice during pregnancy and it’s connection to perinatal outcome. We conducted a single-blinded, randomized controlled clinical trial, with healthy singleton primiparas, randomized at first trimester of pregnancy. A total of 214 participants were randomized, 106 in yoga and 108 in controls. The study group performed yoga exercise while the controls received standard antenatal care. The yoga exercises were performed once a week, lasted 90 minutes, under the supervision of a certified yoga teacher. All pregnant women from study group completed 12 yoga exercises. The results showed that the yoga group had a lower rate of urgent intrapartum CS (p-0.004) and more frequent spontaneous vaginal delivery (p-0.009), while the control group had a higher rate of induced labour (p-0.032). Conclusion: Yoga practice in pregnancy is a promising intervention that has a potential to decrease intrapartum urgent CS rates and assures natural and spontaneous vaginal birth; it’s highly recommendable to healthy pregnant women.

The aims of the review were to elucidate the spatial variation in sea ice algae primary production rates and biomasses (Chl a) in the Canadian Arctic – Greenland region, characterized by comparable physical settings. A database was compiled from 30 studies of sea ice algae primary production rates, biomasses (Chl a), snow and ice thicknesses, ice types, nutrient (Si(OH)4, PO4, (NO3+NO2), and (NH4) concentrations in ice and below ice from the region. Production rates were significantly high (463 mg C m-2 d-1) in Resolute Bay and in Northern Baffin Bay (317 mg C m-2 d-1) both in Canadian Arctic, as compared to a rate of 0.2 mg C m-2 d-1 in northeast Greenland. The biomasses reached 340 mg Chl a m-2 in Resolute Bay in comparison to a 0.02 mg Chl a m-2 in southwest Greenland. Primary production at other Canadian and Greenland sites were comparable but sea ice Chl a was higher (15.0 ± 13.4 mg Chl a m-2) at Canadian sites as compared to Greenland (0.8 ± 0.5 mg Chl a m-2). Resolute and Northern Baffin Bays production rates were significantly higher when compared to other Arctic Ocean sites outside the studied region. The review concludes that high production rates and biomasses in Resolute and Northern Baffin Bay’s were related to inflow and mixing of nutrient rich waters of Pacific origin. A conceptual model with drivers and inhibitors of sea ice algae primary production is projected, and the database compiles a dataset of published data for further studies.

Severe inherited alpha-1 antitrypsin deficiency (AATD) is an autosomal genetic condition linked to chronic obstructive pulmonary disease (COPD). The significance of heterozygous, milder deficiency variants (Pi*M, Pi*S, Pi*Z) is less clear. We studied AATD genotypes in 145 children (up to 72 months old) with assessed wheezing severity using the Pediatric Respiratory Assessment Measure (BCCH PRAM score). A control group of 74 children without airway obstruction was included. AAT concentration and Pi phenotype were determined from dry blood spot samples using nephelometry and real-time PCR; PiS and PiZ alleles were identified by isoelectrofocusing. Among the wheezers, the Pi*S allele incidence was 2.07% (3 cases) and Pi*Z allele was 6.9% (10 cases). The Pi*Z allele frequency was higher in wheezers compared to controls (44.8% vs. 20.27%) and the general Lithuanian population (44.8% vs. 13.6%) and was similar to adult COPD patients in Lithuania: Pi*S 10.3% vs. 15.8% and Pi*Z 44.8% vs. 46.1%. No association was found between AAT genotypes and wheezing severity. Finding that wheezer children exhibit a frequency of Z* and S* alleles like that found in adults with COPD suggests a potential genetic predisposition that links early wheezing in children to the development of COPD in adulthood. Larger cohort studies are needed to confirm this finding.

Snakebite envenomation remains a major cause of morbidity and mortality in rural populations. This study aimed to identify factors associated with complications from snakebite envenomation reported in health facilities in the Cascades region of Burkina Faso. This cross-sectional study used routine data of patients admitted for snakebite envenomation in five health facilities between January 1, 2016, and December 31, 2021. Data were collected on sociodemographic, clinical, and therapeutic characteristics of patients showing signs of envenomation. Bivariate and multivariate analyses were conducted to determine factors associated with complications. Among the 846 patients with envenomation, 355 (42%) experienced complications. Local complications at the bite site included wounds (21.5%) and skin necrosis (12.5%). Systemic complications included hemorrhage (30.5%), shock (16.3%), and coma (4.3%), with a mortality rate of 3.2%. Factors significantly associated with complications were rural residence (AOR: 4.80; 95% CI: 2.21-11.4), incision at the bite site (AOR: 4.31; 95% CI: 2.51-7.52), tourniquet application (AOR: 5.52; 95% CI: 1.42-30.8), bleeding (AOR: 14.2; 95% CI: 8.80-23.4), abnormal vital signs (AOR: 14.3; 95% CI: 9.22-22.7), and non-administration of antivenom serum (AOR: 2.92; 95% CI: 1.8-4.8). These findings highlight the importance of antivenom availability and public awareness to reduce complications from snakebite envenomation.

Total-body PET/CT scanners provide increased sensitivity, enabling the adjustment of imaging parameters by reducing injected activity or shortening acquisition time. This study aimed to evaluate the limitations of reduced [18F]FDG activity doses on image quality, lesion detectabil-ity, and quantification of lesion uptake in the Biograph Vision Quadra, as well as to assess the benefits of the recently introduced ultra-high sensitivity mode in a clinical setting. A number of 26 patients who underwent [18F]FDG-PET/CT (3.0 MBq/kg, 5 min. scan time) were included in this analysis. PET raw data was rebinned for shorter frame durations to simulate 5 min. scans with lower activities in high sensitivity (HS) and ultra-high sensitivity (UHS) modes. Image quality, noise, and lesion detectability (n=82) were assessed using a 5-point Likert scale. The co-efficient of variation (CoV), signal-to-noise ratio (SNR), tumor-to-background ratio (TBR), and standardized uptake values (SUV) including SUVmean, SUVmax, and SUVpeak were evaluated. Sub-jective image ratings were generally superior in UHS compared to HS mode. At 0.5 MBq/kg, le-sion detectability decreased to 95% (HS) and 98% (UHS). SNR was comparable at 1.0 MBq/kg in HS (5.7±0.6) and 0.5 MBq/kg in UHS (5.5±0.5). With lower doses, there were negligible reductions in SUVmean and SUVpeak, whereas SUVmax increased steadily. Reducing [18F]FDG activity to 1.0 MBq/kg (HS/UHS) in a total-body PET/CT provides diagnostic image quality without statistical-ly significant changes in uptake parameters. UHS mode improves image quality, noise, and le-sion detectability compared to HS mode.

Purpose: To explore how race and residential zip codes' socioeconomic index (SES) influenced COVID-19 testing rates in St. Louis during the early and peak phases of the pandemic. Method: An ecological study was conducted using COVID-19 testing data from March to November 2020 in St. Louis City. The study included 16,915 individual tests from 30 residential zip codes. Results: The overall testing rate in St. Louis was 303.97 per 10,000 population. Testing rates among Blacks, Whites, American Indian/Alaskan Natives, and Asians were 374.26, 247.77, 360.63, and 242.41 per 10,000, respectively. Higher testing rates were observed in low and middle SES zip codes compared to high SES zip codes. Adjusted for SES, testing rates were 1.68% higher among Blacks and 0.43% higher among American Indian/Alaskan Natives compared to Whites, and 0.033% lower among Asians. Geographical mapping showed higher testing rates in the inner core and lower rates in the periphery of St. Louis. Conclusion: Race and SES influence testing rates. Areas with low testing rates should be targeted for intervention in St. Louis.

This study encourages volunteer managers to innovate when enhancing volunteers' organizational commitment by adopting the new variable of psychological ownership, thus creating new management practices and systems. The findings indicate that psychological ownership significantly affects organizational commitment and can also enhance it through the partial mediating effect of volunteer motivation. Evidently, psychological ownership can become a major factor influencing volunteer retention. Consequently, two innovative management strategies are suggested to foster volunteer organizational commitment: Firstly, construct a diverse knowledge base for volunteer managers, facilitating a cognitive shift in leaders to enhance leadership, achieve better information sharing, and collaboration using diverse knowledge. Secondly, treat the organization's volunteers as a subsystem, develop psychological ownership as the foundation for system operations, integrate the volunteer system with the staff system through a decentralized decision-making structure, 'empower' the volunteer system, and stimulate members' sense of participation and responsibility, thereby fostering innovation and continuous improvement.

Background: The Victorian era in Great Britain was a historical period that brought about profound changes for humanity. The confluence of various factors fostered the development of numerous scientific disciplines. In the field of health sciences, Florence Nightingale played a central role. Following her training as a nurse and her role as superintendent during the Crimean War, she made decisive contributions to establishing a public health network. Methods: This is a retrospective historical heuristic and hermeneutic study analyzing documentation of Nightingale's contributions to public health from around 1890 to 1900. The historical method was used to collect, classify, and analyze primary and secondary sources relevant to the study's objectives. Results: Nightingale supported the development of the concept of “health at home” by training women to implement healthy measures that contributed to the well-being of families and communities. Through the training and development of a formal “Health Missioners program”, she provided the necessary guidance to improve the health of rural communities across the English countryside. Conclusion: The role of Health Missioners has persisted, as health visitors continue to visit homes in the United Kingdom. Therefore, the contribution of Florence Nightingale to public health is unquestionable. This study was not registered.

Advancements in computer vision are rapidly revolutionizing the way traffic agencies gather roadway geometry data, leading to significant savings in both time and money. Utilizing aerial and satellite imagery for data collection proves to be more cost-effective, more accurate, and safer compared to traditional field observations, considering factors such as equipment cost, crew safety, and data collection efficiency. Consequently, there is a pressing need to develop more efficient methodologies for promptly, safely, and economically acquiring roadway geometry data. While image processing has previously been regarded as a time-consuming and error-prone approach for capturing these data, recent developments in computing power and image recognition techniques have opened up new avenues for accurately detecting and mapping various roadway features from a wide range of imagery data sources. This research introduces a novel approach combining image processing with a YOLO-based methodology to detect turning lane pavement markings from high-resolution aerial images, specifically focusing on Florida's public roadways. Upon comparison with ground truth data from Leon County, Florida, the developed model achieved an average accuracy of 87% at a 25% confidence threshold for detected features. Implementation of the model in Leon County identified approximately 3,026 left turn, 1,210 right turn, and 200 center lane features automatically. This methodology holds paramount significance for transportation agencies in facilitating tasks such as identifying deteriorated markings, comparing turning lane positions with other roadway features like crosswalks, and analyzing intersection-related accidents. The extracted roadway geometry data can also be seamlessly integrated with crash and traffic data, providing crucial insights for policymakers and road users.

Abstract Big datasets are becoming increasingly common and can be challenging to understand and apply in public health. One method for lowering the dimensionality of these datasets and improving interpretability while minimizing information loss is data reduction using principal component analysis (PCA). It achieves this by successively maximizing variance through the creation of new, uncorrelated variables. PCA is an adaptive data analysis technique because it simplifies the process of finding new variables, or principal components, by solving an eigenvalue or eigenvector problem. These new variables are determined by the dataset being used, rather than by the analyst starting from scratch. It is also adaptable in another way because varieties of the method have been designed to adjust to various data structures and types. However, there are serious problems in the theoretical understanding and practical application of PCA in public health researchers, whereas its application is becoming popular in developing countries. Therefore, this article, which concentrated on using PCA to reduce data, began by outlining the fundamental concepts of PCA and going over what it can and cannot do, as well as when and how to use it. We also discussed the fundamental assumptions, benefits, and drawbacks of PCA. Furthermore, this article demonstrated and resolved PCA practical application problems in public health that most scholars are unaware of, such as variable preparation, variable inclusion and exclusion criteria for PCA, iteration steps, wealth index analysis, interpretation, and ranking.

Introduction: In recent decades, health literacy, in connection with a broad range of public 1 health terms, has become a burgeoning field. This study aims to explore trends and biases in this 2 area through a bibliometric analysis. Methods: A Random Forest Model was utilized to identify 3 keywords and other metadata that predict annual citations in the field. In order to supplement 4 this machine learning analysis, we have also implemented a bibliometric review of the corpus. 5 Results: Findings indicate a high positive coefficient for the keyword ’Covid-19’ and ’Male’, whereas a 6 negative coefficient was observed for ’Female’, suggesting potential biases. Evolving themes such as 7 Covid-19, Mental Health, and Social Media were discovered. A significant shift was noted in the main 8 publishing journals, while the major contributing authors remained the same. Discussion: The results 9 hint at the influence of the Covid-19 pandemic and potential gender biases on citation likelihood, as 10 well as changing publication strategies despite the fact that the main researchers remain as the ones 11 that have been studying health literacy since its creation.

This paper presents an alternative conceptualization and definition of technology in the context of university technology transfer. The ambiguity regarding the conceptualization of technology is apparent in the technology transfer literature. An expanded conceptualization of technology potentially opens new approaches to researching the topic of technology transfer. It may also cause policymakers to think more comprehensively about what it means to successfully transfer technologies derived from federally funded research to the private sector for use that benefits the public interest. This paper integrates constructs and ideas in the related literature to provide a new perspective of technology that can support future scholarly research and public policy formulation about technology transfer in general, and university technology transfer specifically. Although the paper focuses on university technology transfer to the private sector in the United States, the insights it presents are relevant to technology transfer more broadly and applicable in other geopolitical contexts.

Thanks to the pioneering studies of Østerud and co-workers it is now increasingly understood that natural polyphenols present in marine oils play an essential role in protecting omega-3 lipids from oxidation and autooxidation ensuring that no proinflammatory products are formed after intake as it often happens with assumption of refined omega-3 concentrates. Strong antioxidants exerting multiple biological functions, olive biophenols are ideally suited to functionalize marine oils creating a synergy which has the potential to foster public health across the world. This study identifies suitable avenues to advance the sustainable production of health-beneficial formulations based on newly obtained natural marine oils and olive phenolic extracts. Important educational outcomes for bioeconomy educators conclude the study.

Green public space immensely provides ecological soundness (ES), social resilience, social inclusiveness, mental health, self-esteem, and cultural prosperity from privileged class to lower ones. This research aims at estimating the effect of social services, safety, and infrastructural amenity in green space (parks) on mental health building self-esteem for elderly population. Data were collected from four parks out of 21 in Dhaka selected by systematic random sampling. Two-hundred and three elderly participants were picked up for survey using snowball sampling. The survey was conducted in a pre-structured questionnaire consisted of 40 close-ended questions. Data was analyzed applying ordinal logistic model, multivariate regression analysis, and Partial Least Square (PLS) -Path Modeling. The study explored several key findings-1) Infrastructural amenities impacted social services of parks; 2) Social services contributed positively to mental health boosting up self-esteem for elderly population. 3) Likewise, mental health for elderly population was affected by safety measure of green space. Dhaka requires constructing age-friendly parks to promote elderly mental health.

Water supply is a mandatory service for Tanzanians from respective legal public water utilities, and their sustainability reflects implementations of best management strategies at a local level. The objective of this study was to assess current approaches used in water quality and quantity management in Tanzania. This was achieved through secondary water data tends, on-site water quality assessments, visits of respective water supply and sanitation authorities, and assessment of their performances. It was observed that water supplied in rural-based authorities was quite different from that supplied in an urban setting as far as quality and quantity is concerned, urban-based supplies being of assistance to users over rural ones. A new strategy on water management is presented for sustainable water supply in Tanzania; it is based on controlling groundwater abstractions and preference of surface water in public water supplies. Rural water supply management must learn several practices realized at urban supplies for the betterment of respective majority water users.

Background and objectives: Due to resistance and lack of treatment options, hospital-acquired Acinetobacter baumannii (A. baumannii) infections are associated with high mortality. The aim of this study was to identify the characteristics and outcomes of patients with infections caused by multidrug resistant A. baumannii in a tertiary-care teaching hospital and to determine the risk factors for in-hospital mortality. Materials and methods: A retrospective cohort study including 196 patients with A. baumannii strains isolated from different clinical specimens in the Hospital of the Lithuanian University of Health Sciences in 2016, 2017 and 2020, 2021 was conducted. Data on patients’ characteristics, comorbid diseases, treatment, length of hospital and ICU stay, outcome were collected. To determine risk factors for in-hospital mortality, logistic regression analysis was performed. Results: There were 60 (30.6%) women 136 (69.4%) men with a mean age of 61.7 ± 16.6 years (range, 52–74). More than three-fourths (76.5%, n = 150) of the patients had at least one comorbid disease. The highest number of A. baumannii strains were isolated from patients hospitalized in ICUs (43.4%, n = 85). A. baumannii strains producing three types of β-lactamases were more frequently isolated from women than men (77.8 % vs. 22.2%, p = 0.006). Infections caused by A. baumannii strains producing two types of β-lactamases were significantly more often treated with combination therapy than infections caused by strains producing one type of β-lactamase (78.9% vs. 60.0%, p = 0.019). Patients with A. baumannii strains producing two different types of β-lactamases (AmpC plus KPC, AmpC plus ESBL, or ESBL plus KPC) stayed significantly shorter at the ICU compared to patients with A. baumannii strains not producing β-lactamases (median of 9, IQR 2–18, vs. median of 26, IQR 7–38, p = 0.022). Death occurred in 58.7% (n = 115) of patients. Logistic regression analysis showed that combination therapy, length of hospital stay of < 10 days after A. baumannii infection, age of > 58 years, and absence of co-infection were independent predictors of in-hospital mortality. Conclusions: Patients with infection caused by A. baumannii strains producing two different types of β-lactamases were more frequently treated with combination therapy. Mortality of patients with multidrug resistant A. baumannii infection was high, and it was associated with patient’s age, length of hospital stay after the diagnosis of A. baumannii infection, absence of co-infection, and combination treatment.

This study presents virtual reality (VR) videos as an effective technique for delivering extension educational materials on manure and mortality management. Virtual reality is a technology that can enable immersive distance learning. Using VR tours can enable the public to learn manure and mortality management technologies without in-person farm visits, thus saving traveling time and money and avoiding exposure to pathogens and noxious odors in farms. As the first part of this project, 360° VR tours were created on multiple aspects of manure management, including composting, anaerobic digestion, and preliminary wastewater treatment. These videos were presented to a diverse audience of agricultural producers, extension specialists, and researchers through in-person and online extension events and the Texas Manure YouTube channel. The effectiveness of videos was evaluated using surveys, which measured the audience's awareness of the topics before and after watching VR videos. Statistical analysis revealed that the increase in awareness after watching the videos was statistically significant, with a p-value of less than 0.0001. Statistical analysis also revealed that job classification and professional experience significantly impacted the change in awareness. Researchers, extension specialists/agents, and participants with less experience in manure and mortality management experienced a greater change in awareness than agricultural producers and participants with more experience. Interest and impression of the audience on the VR videos was also evaluated. According to survey data, the majority of the audience rated these videos as an effective technique for educating the public about manure and mortality management, found the VR videos interesting, were willing to learn more content through VR videos, and were likely to recommend them to their colleagues. A statistically significant correlation could be observed between the awareness change and the effectiveness rating given to the videos by the participant.

With covid infection having a periodic occurrence and each wave affecting millions of people, there is an urgent need for healthcare providers to develop readily available biological markers to predict the severity and mortality of COVID-19 infection at an early stage of the disease to predict the most optimal management. The Neutrophil – lymphocyte Ratio (NLR) and Platelet-lymphocyte ratio (PLR), are novel inflammatory markers suggested to predict the severity of illness in COVID -19 patients. We evaluated a retrospective cohort of 224 patients with covid 19 illnesses from August 2020 to October 2020. We categorized the patients into 'mild' and 'moderate to severe as per the severity of their illnesses. The optimal cut-off values of the continuous NLR, PLR, and Age were calculated by applying the receiver operating characteristic (ROC) curve analysis. Sensitivity, specificity, and likelihood ratios were calculated from ROC analysis. The results showed that Age, Hb, and NLR are significant predictors of the severity of illness. So we quantified the predictive contribution of those variables by its Z- score and showed that NLR is the strongest predictor followed by Age.ROC curve analysis revealed NLR to be an excellent predictor of disease severity (sensitivity 88.30% and specificity 82.60%) at a cut-off of > 4.24. A cut-off of 165.63 was obtained for PLR, which showed good predictive value for the severity of illness. A NLR > 6 was used as a predictor for mortality due to covid illness with good sensitivity and specificity. Conclusion: NLR and PLR can be used as prognostic markers to identify the severity of covid illness and the probability of mortality in the future in low-resource settings. Given its low cost, easily available, accessible, and reproducible data, it can be used as a useful marker to assist the physician in early referral and treatment of covid 19 infected patients.

(1) Background: To investigate the dynamic issues behind international variation in EWM. (2) A rolling EWM calculation is used to reveal seasonal changes in the EWM calculation and is especially relevant nearer to the equator. (3) Results: In addition to latitude country specific factors determine EWM. Females generally show higher EWM mainly due to respiratory conditions. The EWM for respiratory conditions in England and Wales ranges from 44% to 83% which is about double the all-cause mortality equivalent. Age has a profound effect on EWM with a peak in puberty and then increasing EWM at old age. The gap between male and female EWM seems to act as a diagnostic tool reflecting the infectious/metrological mix in each winter. Additional difference due to ethnicity are also observed. An EWM equivalent calculation for sickness absence demonstrates how additional health-related variables can be linked to EWM. (4) Conclusions: EWM does not reach a peak at the same time each year, especially so in the tropics. Countries midway between the equator and the poles show highest EWM. Differences between the genders are highly significant and seem to vary according to the mix of variables active each winter. Pandemic influenza does not elevate EWM, although seasonal influenza plays a part each winter.

It is widely discussed that growth of GDP has a vague impact on environmental pollution due to the emissions of carbon dioxide from consumed fossil fuels in production, transportation and power generation, and creation of required instruments to control environmental pollution as well. Due to the fact that environmental pollution can be a reason of mortality increase in a society, the main purpose of this study is to investigate the relationship between economic growth, fossil fuel consumption, mortality (from cardiovascular disease, cancer, diabetes and chronic respiratory disease) and environmental pollution using Generalized Method of Moments (GMM) estimation technique in the case of CIS member states over the period of 1993-2018. The major results revealed CO2 emissions in in the region of CIS have a positive effect on increase of mortality from cardiovascular disease, cancer, diabetes and chronic respiratory disease. In regards to fossil fuel consumption, the estimation proved that this variable affects mortality from cardiovascular disease, cancer, diabetes and chronic respiratory disease positively. In addition, we found effect of economic growth, population growth and inflation rate positively, while any improvement in human development index (HDI) has a negative effect on increase of mortality from cardiovascular disease, cancer, diabetes and chronic respiratory disease in the CIS region. It is recommended that the CIS member states carry out different policies to improve energy transition indicating movement from fossil fuel energy sources to renewable ones. Moreover, we recommend the CIS member states to enhance various policies for easy access to the electricity from green sources and increase of renewable supply through improved technologies, sustainable economic growth, and increase of using green source in daily social life.

Objective: to create a set of eligibility criteria for the use of MHT in non-gynecological cancer patients. Methods: We searched all articles published in peer-reviewed journals up to March 2021. The PICOS standards were used and the selection criteria as follows: menopausal women of any age with non-gynecological and non-breast cancer receiving HMT, any MHT preparation (oestrogens alone or combined with a progestogen, tibolone or tissue selective oestrogen complex) or any route of administration (oral, transdermal, vaginal or intra-nasal), recurrence and mortality, randomized controlled trials, and related extension studies or follow-up reports. Results: Women colorectal cancer survivors who use MHT have a lower risk of death from any cause than those survivors who do not use MHT. Women Skin Melanoma Survivors Using MHT Have Longer Survival than Non-MHT Survivors. There is no evidence that women lung cancer survivors who use MHT have a different survival rates than those survivors who do not use MHT. Conclusion: MHT is safe in women who have suffered from colorectal, lung or skin melanoma cancers The study was registered at www.prospero.org (CRD42020166658)

This work offers a new log generalized odd log-logistic exponential regression model for analyzing weekly dengue fever cases in 2022 with a location-systematic component. To achieve this, a data set of 49 observations of dengue fever cases in the Federal District of Brazil is employed. A review of the mathematical properties of the generalized odd log-logistic exponential distribution is provided, the maximum likelihood method is used to estimate the parameters, and, through Monte Carlo simulations, the accuracy of the estimators is investigated. The model's fit is assessed using global influence metrics and residual analysis. For the time scenario studied, the proposed regression identified factors that have an impact on dengue fever cases, which may contribute to improve disease control. Finally, several interpretations are addressed, and a discussion presents results that aid in better understanding the data set and future research on different data.