In Safety Management System (SMS), the risk management plays a key role for the prevention of accidents. The aim of this paper is to propose a Safety Management model using a system dynamic approach to update conventional industrial safety into the new industrial safety 4.0 that is time to developed. This study analyzes some safety 4.0 aspects lacked in the Bhopal incidental event by considering different data detected in the industrial Plant. The model proposed in this paper discusses the relationships among the main causes that have contributed to the occurrence of the incidental event studied, such as broken safety devices, inadequate personnel experience, operator decisions, manager production strategy, policy decision, as deduced from the relevant literature about Bhopal incidental dynamic.

In the Korean construction industry, legal and institutional safety management improvements are continually being pursued. However, there was a 4.5% increase in the number of workers’ deaths at construction sites in 2017 compared to the previous year. Failure to wear safety helmets seems to be one of the major causes of the increase in accidents, and so it is necessary to develop technology to monitor whether or not safety helmets are being used. However, the approaches employed in existing technical studies on this issue have mainly involved the use of chinstrap sensors and have been limited to the problem of whether or not safety helmets are being worn. Meanwhile, improper wearing, such as when the chinstrap and harness fixing of the safety helmet are not properly tightened, has not been monitored. To remedy this shortcoming, a sensing safety helmet with a three-axis accelerometer sensor attached was developed in this study. Experiments were performed in which the sensing data were classified whether the safety helmet was being worn properly, not worn, or worn improperly during construction workers’ activities. The results verified that it is possible to differentiate among wearing status of the proposed safety helmet with a high accuracy of 97.0%

This paper is focused on the analysis of methods used to assess effectiveness and efficiency of the occupational safety and health management system (OSHMS) in a company. It reviews current Russian and international occupational safety and health standards. The paper details the method outlined in International Standard GOST 12.0.230.3-2016 “Occupational safety standards system. Management systems for occupational safety. Evaluation of effectiveness and efficiency” based on the data collected during the external audit of OSHMS function efficiency in a Russian mining company. Effectiveness and efficiency indicators were determined, and a generalized desirability coefficient was calculated. Weaknesses of the method proposed in GOST 12.0.230.3-2016 were identified and mathematical and linguistic solutions were proposed to improve it. Harrington function was used to determine a numerical and linguistic score. The performed calculation demonstrated that the company needed strategic management decisions to improve the current situation. Practical approaches were offered to enhance the company's systems-based occupational safety and health performance..

(1) Background: Emergencies confront civilian and military healthcare providers with medical and hygienic challenges due to the lack of potable water. This pilot study aimed to describe the application of two different methods for microbiological monitoring of water in a harsh environment in terms of performance, ease of use, availability, and the possibility of using the results to evaluate water quality. (2) Methods: Samples from raw water, Potable water, and water for consumers were taken from two different camps with the same raw water source. The samples were analyzed by using IDEXX industry-standard methods (Colilert and Enterolert enzymatic test kits) and a combination of membrane filtration and 3M-Petrifilm. (3) Results: The IDEXX method used at the Norwegian Camp are easier to utilize and has a broader range of analyzing kits for drinking water analysis. In addition, IDEXX is better adapted to the requirements of the national legislation. However, the combination of membrane filtration followed by incubation on 3M-Petrifilm ™, as used at the Swedish camp, is a better field alternative compared to traditional bacteriology, as it eliminates the need to produce and store agar plates. (4) Conclusions: This pilot study highlights the need for adapted technical equipment and tools for internal microbiological control of water production in a harsh field environment and may facilitate the use of a relatively simple method for water control and ensure the safety of deployed staff in both civilian and military settings.

Even though the rules for free movement of machinery within the European Union market have existed for more than 30 years, accidents related to their activities have constantly been achieving significant value. When designing the machine, a designer must stem from risk assessment, whereas all stages of its life cycle and ways of its use must be taken into consideration. In industrial operations, there is old machinery, which, although fulfilling its function reliably, the safety level is not in accordance with the developing requirements for their safe operation. The proposed methodology of assessment of the machinery safety condition comes out from the presupposition of the right application of steps of risk assessment and their reduction mainly by means of implementation of both effective and efficient preventive measures. The aim of the research applied in 3 operations, was to verify the method of machinery safety management. The created methodology based on 19 requirements for safety evaluates the level of the actual measures by means of the so-called criterion of current status and total efficiency of measures. Its output is the assessment of the efficiency level of implemented safety of each machine as well as of the whole operation.

At present, sustainability and emerging technology are the most expressed issues in any supply chain management (SCM) sector. At the same time, pandemic makes consumers more concerned regarding health, and safe food with a sustainable way to access the current market. Thus, supervision and monitoring of product quality with symmetric traceability information in fresh food and fisheries SCM is significant. Research on food safety and traceability systems based on blockchain, internet of service (IoT), wireless sensor networks (WSN), and radio frequency identification (RFID) provides the solution of constancy from production to consumption. This review focused on the RFID-based traceability systems in fisheries SCM, which have been employed globally in the last fifteen years to ensure fish quality and security. Additionally, a summarized comparison study has presented different sectors’ traceability systems using RFID and their advantages over real-time applications. The outcome of this study will help future researchers to solve the crisis in terms of trust between consumers and the fisheries SCM. Thus, this review would be a guideline and solution for enhancing the reliability of RFID-based traceability in food SCM systems to ensure the integrity and reducing the opacity and asymmetry in the product information.

Due to nutritional benefits and perceived humane ways of treating the animals, the demand for antibiotic-free pastured poultry chicken has continued to be on a steady rise. However, despite non-usage of antibiotics in pastured poultry broiler production, antibiotic resistance (AR) is reported in zoonotic poultry pathogens. However, actors that drive multidrug resistance (MDR) in pastured poultry are not known. In this study, we used machine learning and deep learning approaches to predict farm management practices, and physicochemical properties of feces and soil that drive MDR in zoonotic poultry pathogens. Antibiotic use in agroecosystems is known to contribute to resistance. Evaluation of the development of resistance in environments that are free of antibiotics such as the all-natural antibiotic-free, pastured poultry production systems described here is critical to understand the background AR. We analyzed 1,635 preharvest (feces and soil) samples collected from forty-two pastured poultry flocks and eleven farms in the Southeastern United States. CDC National Antimicrobial Resistance Monitoring System guidelines were used to determine antimicrobial/multidrug resistance profiles of Salmonella, Listeria and Campylobacter. A combination of two traditional machine learning (RandomForest and XGBoost) and three deep learning (Multi-layer Perceptron, Generative Adversarial Network, and Auto-Encoder) approaches, identified critical farm/environmental variables that drive multidrug resistance in poultry pathogens, in broiler production systems that represents background resistance. This study enumerates management practices that contribute to AR and recommendations to potentially mitigate multidrug resistance and prevalence of Salmonella and Listeria in pastured poultry.

Urban rail transit has become the main mode to ease traffic congestion. Researches on the dynamic variation regularity of passenger flow distribution and passenger flow volume of urban rail transit hub platform have important implication in hub capacity design, operation organization and risk prevention. This paper proposes a passenger flow distribution integrating model (PFDIM) based on the basic theory analysis and basic parameter models of passenger flow distribution in hub platform. Simulation designs of PFDIM are built with Java and Anylogic, which contain simulation system functional framework, implementation path, simulation processes and simulation models. By case study, the performance comparison between two simulation methods indicates that simulation designs are scientific and accordant with the reality scene; calculation results prove that PFDIM has a good performance on describing the dynamic variation regularity of passenger flow distribution. Moreover, the experiments with different departure intervals could provide the reference for train scheduling under the viewpoint of traffic safety and service level.

The study aims to provide technical information on the development and application of hazard analysis and critical control points (HACCP) in one of Dhaka's popular baking (cake) industries. A generic HACCP plan in accordance with legal requirements was created after a detailed analysis of data collected from the company. Every step of the production was examined for biological, chemical, and physical hazards. The prerequisite program was designed to address some hazards prior to production, thereby simplifying the HACCP plan. The critical control points were determined by answering the questions in the decision trees. Finally, the HACCP control chart was created to include critical limits, monitoring, and corrective action as components of several HACCP principles. One critical control point (CCP) and two operational pre-requisite programs (oPRPs) were identified throughout the manufacturing process.

With the development of general anesthesia techniques and anesthetic substances, brought new horizons for the expansion and improvement of surgical techniques. Nevertheless, more complex surgical procedures brought a higher complexity and longer duration for general anesthesia that led to a series of adverse events such as hemodynamic instability, under- or overdosage of anesthetic drugs, as well as an increased number of post-anesthetic events. In order to adapt the anesthesia according to the particularities of each patient, the multimodal monitoring of these patients is highly recommended. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, and the reduction of post-operative complications. Another important aspect is the impact on the status of inflammation and the redox balance. By minimizing inflammatory and oxidative impact one can achieve a faster recovery that will lead to both increased patient satisfaction and an increase in patient safety. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

COVID-19 had a significant impact on construction projects due to labor shortages and COVID-19 restrictions, yet little is known about the impact it had on construction safety. To address this gap, an Australian construction project was selected to study the impact of COVID-19 on safety performance, safety climate and safety leadership. The study collected data from safety climate surveys, leading and lagging safety indicators and used linear regression to compare safety performance pre and post the onset of COVID-19. Our results showed after the onset of COVID-19 there was a significant reduction (Pr>F at 0.05%) in incident rate, an improvement in supervisor safety leadership and safety climate, and satisfaction with organisational communication. The study identified the increase level of safety awareness due to COVID-19 did not result in an increase in the level of engagement in safety leadership. Interestingly, participation in the safety leadership activities did not improve until a change of Project Manager occurred. The study determined leaders who establish a positive safety climate within a project could negate the safety performance impact of COVID-19. The study confirms the importance of site safety leadership in maintaining engagement in risk management and the value of focused safety communication.

.Most of the accident cases at work are caused by unsafe behaviour. Scholars have thus extensively researched factors of safe behavior.Safety leadership is stated as the most effective factor in safety behaviour. Besides, safety knowledge and safety attitudes are also found to influence safety behaviour. The purpose of this paper is to investigate the nature of the relationship between safety leadership, safety knowledge, safety attitude, and safety behavior, which has been found to be limited or rare in previous research.A self-administered questionnaire was applied and was distributed randomly to 140 SME manufacturing workers and they were analysed using the structural equation modelling partial least squares (PLS-SEM). The results prove that safety leadership has a significant effect on safety knowledge, safety attitude, and safety behaviour, with safety knowledge and safety attitude mediating the safety leadership-safety behaviour relationship. Consequently, the results provide a more in-depth view of the relationship between safety leadership and safety knowledge-attitude-behaviour via adapting social-cognitive theory and social learning theory in solving safety issues in SME. This study also provides a starting point for researchers to better understand how effective safety leadership is provided by supervisors in terms of improving worker safety and safety knowledge-attitude-behaviour.

The software industry has adopted component-based software development (CBSD) to rapidly build and deploy large and complex software systems with significant savings at minimal engineering effort, cost, and time. However, CBSD encounters issues on security trust, mainly with respect to dependability attributes. A system is considered dependable when it can produce the outputs for which it was designed with no adverse effect on its intended environment. Dependability consists of several attributes that imply availability, confidentiality, integrity, reliability, safety, and maintainability. Dependability attributes must be embedded in a CBSD model to develop dependable component software. Motivated by the importance of these attributes, this paper pursues two objectives: to design a model for developing a dependable system that mitigates the vulnerabilities of software components, and to evaluate the proposed model. The model proposed in this study is labelled as developing dependable component-based software (2DCBS). To develop this model, the CBSD architectural phases and processes must be framed and the six dependability attributes embedded according to the best practice method. The expert opinion approach was applied to evaluate 2DCBS framing. In addition, the 2DCBS model was applied to the development of an information communication technology (ICT) portal through an empirical study method. Vulnerability assessment tools (VATs) were employed to verify the dependability attributes of the developed ICT portal. Results show that the 2DCBS model can be adopted to develop web application systems and to mitigate the vulnerabilities of the developed systems. This study contributes to CBSD and facilitates the specification and evaluation of dependability attributes throughout model development. Furthermore, the reliability of the dependable model can increase confidence in the use of CBSD for industries.

When discussing the concepts of risk, safety, and security, people have an intuitive understanding of what these concepts mean, and, to a certain level, this understanding is universal. However, when delving into the real meaning of these concepts, one is likely to fall into semantic debates and ontological discussions. In industrial parks, it is important that (risk) managers from dierent companies, belonging to one and the same park, have the same understanding of the concepts of risk, safety, and security. It is even important that all companies in all industrial parks share a common understanding regarding these issues. As such, this paper explores the similarities and dierences behind the perceptions of these concepts, to come to a fundamental understanding of risk, safety, and security, proposing a semantic and ontological ground for safety and security science, based on an etymological and etiological study of the concepts of risk and safety. The foundation has been induced by the semantics used in the ISO 31000 risk management guidance standard. Hence, this article proposes a coherent, standardized set of concepts and definitions with a focus on the notion “objectives” that can be used as an ontological foundation for safety and security science, linking “objectives” with the concepts of safety, security, risk, performance and also failure and success, theoretically allowing for an increasingly more precise understanding and measurement of (un)safety across the whole range of individuals, sectors and organizations, or even society as a whole.

Research into professionalization in health and safety has recently gained in interest. Graduate training is one of the factors that determines or conditions the role of the safety professional, thus intervene in the professionalization process. This article is the result of a workshop and the discussions of nine academic directors of safety education programs about quality evaluation. This article introduces the issue with a historic overview of safety education, presents a synthesis of nine selected education programs, discusses quality evaluation of health and safety education programs, propose a quality evaluation frame and finally, proposes a process for designing a quality safety education program with an associated model of the learning objectives. The outcomes are interesting for everyone who is interested in health and safety education and quality evaluation and will give insights into how safety professionals are educated.

The consumption and sale of fresh-cut products and salads have been growing tremendously in the present era. Therefore, the microbial safety of such products is of great concern. In the current study, a survey of general microbiological safety of fresh-cut produce and salads at quick-service restaurants (QSR) was undertaken across the Kingdom of Saudi Arabia. These findings were compared with microbiological criteria for foodstuffs by Saudi standards, metrology, and quality organization SASO-GSO-1016. Of the 82 samples of fresh-cut produce, 7% of samples were found to be unsatisfactory or beyond the acceptable limits. TPC count was unsatisfactory at 22%, coliform at 48%, and Staphylococcus aureus at 4%. For 108 samples for fresh salads, 11% of samples were found to be unsatisfactory or beyond the acceptable limits,13%, 27%, 4%, and 27% of samples showed an unsatisfactory range of TPC, coliforms, S. aureus, and Escherichia coli, respectively. The fresh-cut produce and salads were microbiologically safe in the central region compared to the eastern region followed by the western region. The relatively higher count was found in green pepper, mixed vegetables, and lettuce followed by fresh-cut onions and coleslaw salads. No Salmonella was detected in both fresh-cut produce and salads. The restaurants should be more stringent in their processing to ensure the consumer safety. Washing and sanitization of produce is the only way to reduce the diffusion of food borne pathogens.

This paper reports on the optimization of thin-film coating assisted self-sustainable off-grid hybrid power generation systems for cattle farming in rural areas of Bangladesh. Bangladesh is a lower middle-income country with declining rates of poverty among its 160 million people due to persistent economic growth in conjunction with balanced agricultural improvements. Most of the rural households adopt a mixed farming system by cultivating crops and simultaneously rearing livestock. Among the animals raised, cattle are considered as the most valuable asset for the small/medium-scale farmers in terms of their meat and milk production. Currently, along with the major health issue, the COVID-19 pandemic is hindering the world’s economic growth and has thrust millions into unemployment; Bangladesh is also in this loop. However, natural disasters such as COVID-19 pandemic and floods, largely constrain rural smallholder cattle farmers from climbing out of their poverty. In particular, small and medium-scale cattle farmers face many issues that obstruct them from taking advantage of market opportunities and imposing a greater burden on their families and incomes. An appropriate measure can give a way to make those cattle farmers’ businesses both profitable and sustainable. Optimization of thin-film coating assisted self-sustainable off-grid hybrid power generation system for cattle farming is a new and forward-looking approach for sustainable development of the livestock sector. In this study, we design and optimize a thin-film coating assisted hybrid (photovoltaic-battery-generator) power system by using the Hybrid Optimization of Multiple Energy Resources (HOMER, Version 3.14.0) simulation tool. An analysis of the results has suggested that the off-grid hybrid system is more feasible for small and medium-scale cattle farming systems with long-term sustainability to overcome the significant challenges faced by smallholder cattle farmers in Bangladesh.

The Canal of Aragon and Catalonia (CAC) is 134 km long and irrigates 105,000 ha (131 irrigation user communities) and it is own by the River Ebro’s Water Agency. The aqueducts are located between km 67 and 71 of the canal and were designed by the Civil Engineer Félix de los Ríos Martín in 1907. The cross-section of both aqueducts, Coll de Foix and Capedevila, was extended within the framework of the project by Fernando Hué Herrero in 1962 in order to reach design flows of 26.1 m3/s and 25.7 m3/s, respectively. The structural performance of the aqueducts has been satisfactory, nevertheless the hydraulic capacity has reduced over the years. As a result, the irrigation user communities have expressed the need to extend the cross-section of the aqueducts to meet the irrigation demands. Given the age of the structure and the different design considerations at the time, it is paramount to verify the structural reliability of the aqueducts in the new load configuration. Therefore, the objective of the paper is to present the structural safety analysis conducted and describe the new extended cross-section for both aqueducts (maintaining the original structural typology).

The complex systems that require safety are the Safety Critical Systems. Maintaining these systems is a big challenge. Now a days, safety is a very critical requirement for the latest systems. Safety critical systems must be safe. Different approaches to ensure quality and safety in safety critical systems has been discussed in this paper. A comparison is also conducted between these various approaches. Safety critical systems must remain more influential in future.

An increasing number of studies have shown that safety culture factors have a substantial influence on safety performance in a variety of industrial sectors. These factors' impact on safety performance is unclear, especially at the public service and statutory authorities. On the other hand, the understanding of indicators for safety performance in every working sector in Malaysia is on the continuing progress. Hence, this study's contribution is to explore the influence of safety culture factors (i.e., management commitment and supervision in safety, safety system) and safety competence on safety performance in government paramedic training institutes. IPMA (importance-performance map analysis) is a technique used in Smart PLS to determine the significance and performance of each of these factors. The study was conducted via an online survey and involved 258 safety and health committee members in Ministry of Health paramedic training institute. As a matter of relevance, the IPMA's empirical data study revealed that management commitment and supervision in safety were the predominant factors in determining safety performance. Meanwhile, for performance, the findings showed that worker involvement, safety system, and safety competence perform well in determining the safety performance.

Artisanal cheeses made with raw milk are highly appreciated products in Brazil. Most of these cheeses are produced in small properties across different production regions in the country, many of which have been granted a protected designation of origin. The most prominent state that manufactures these products is Minas Gerais, but production is also gaining strength in other Brazilian states. This text presents an overview of the many types of artisanal cheeses produced in the country, grouped by geographical regions, and reviews the current challenges faced by producers and government considering the safety of these cheeses.

Road Safety Education (RSE) is widely known as a reliable determinant of future results for what concerns health and welfare, and as an undisputable factor which contributes to the social behavior of individuals and to their mid and long-term road safety outcomes. However, its development has been relatively scarce in most countries, fact which has contributed to letting matters as delicate as traffic crashes produced by road misbehaviors continue to be a prevalent problem, thus affecting the health of the community. Objective: The aim of this study was to describe the relationship between demographic and RSE-related variables and the self-reported road risky behavior of Spanish students. Methods: For this cross-sectional study, a representative sample of 4,062 (51.5 males and 48.5% females) participants attending primary (47.5%), secondary (40.7%) and high school (11.7%) was gathered through a national survey on RSE and road behaviors. Results: A set of significant associations between demographic factors, RSE variables and self-reported road behaviors was found. Furthermore, the SEM modelling allowed us to establish that age, observed misbehaviors, attitudes towards road safety and risk perception keep a direct link with the road risky behavior of children and young people. The knowledge of traffic rules was not a significant predictor of road behavior. Conclusions: The results of this study show that, together with demographic factors such as age, RSE-related variables have an effect on the road behavior of children and young people. They also suggest the need of strengthening actions to be implemented in road safety (Road Safety Education), into scholar and community levels.

Practicing preventive etiquettes such as hand washing, hand disinfection, wearing a face mask, practicing physical distancing, disinfection of surfaces and objects can help curb the transmission of COVID-19 at the workplace. This paper focuses on interventions and behaviors required to curb the spread of COVID-19 at workplaces. We undertook a detailed multi-disciplinary literature search on the following topics: hand hygiene, respiratory hygiene, physical distancing, quarantine and isolation, disinfection of objects and surfaces, behavior change, and health crisis communication. We identified interventions that are effective for preventing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) at workplaces. These findings present very useful non-clinical interventions for preventing COVID-19 in the work environment.

A growing body of literature suggests a causative relationship between severe adverse neurological outcomes and early life exposure to paracetamol (acetaminophen) in the presence of oxidative stress. Review of the literature revealed that, although its use is not regularly monitored, paracetamol has achieved near universal acceptance, with exposure in some pediatric populations exceeding 90%. In addition, use of the drug as well as associated adverse outcomes may have risen as a result of pharmaceutical advertising rather than need, and inappropriate use of the drug, both in terms of dose and indication, is widespread. These findings indicate that many clinicians and patients do not, at the present time, evenly weigh the potential risks with the potential benefits of paracetamol exposure early in life. Although retrospective studies might be envisioned to further address the neurodevelopmental risks of paracetamol use during early development, in silico simulations demonstrated that such studies can be thwarted by very high rates of use of the drug combined with associations between paracetamol use and oxidative stressors that act as cofactors in the induction of neurodevelopmental injury. These findings suggest that, despite persistent uncertainty, clinicians and patients should be more aware of available information pointing toward the potential dangers for neurodevelopment of early life exposure to paracetamol. Most importantly, health care workers need to provide a more balanced view, weighing both risks and benefits, when providing advice for patients regarding paracetamol use during periods of brain development.

Previous studies have shown that agricultural works bear a disproportionately higher burden of HIV, which is the highest HIV prevalence ever reported in any working population in South Africa. This study aimed to assess HIV knowledge, attitudes and practices of agricultural workers, as a precarious and vulnerable workforce. A cross-sectional study design was employed. A pre-piloted paper-based questionnaire was administered to a consenting sample of agricultural workers. Descriptive and inferential statistics were performed using stata version 16.1 software, 0.05 level was used as a measure of significance. The majority of agricultural workers had adequate knowledge level (72.1%) regarding HIV/AIDS. Knowledge was significantly associated with having some level of education,) secondary education (AOR: 1.46, 95% CI:1.01-2.12), and post-matric qualification (AOR: 3.07, 95% CI: 1.61-5.83). The attitudes level of workers towards HIV was good (88.1%). Attitude was negatively associated with residing in informal settlements (AOR: 0.64, 95% CI 0.43-0.97). Majority of participants exhibited poor prevention practices regarding HIV (60.9%). Half of participants reported low condom usage (50.9%) and multiple sexual partners (50.6%). The portrayed risky sexual behavior establishes agricultural workers as an HIV high-risk population. Strategizing non-conventional approaches to HIV prevention and behavior change communication targeting agricultural workers is recommended.

Although widely believed to be safe for use in infants and children when used as directed, increasing evidence indicates that early life exposure to paracetamol (acetaminophen) may cause long-term neurodevelopmental problems. Further, recent studies in animal models demonstrate that cognitive development is exquisitely sensitive to paracetamol exposure during early development. In this study, evidence for the claim that paracetamol is safe was evaluated using a systematic literature search. Publications on PubMed between 1974 and 2017 that contained the keywords “infant” and either “paracetamol” or “acetaminophen” were considered. Of those initial 3096 papers, 218 were identified that made claims that paracetamol was safe for use with infants or children. Of these, a total of 103 papers were identified as sources of authority for the safety claim, and 36 of those contained actual experiments designed to test safety. The 36 experiments described had a median follow-up time of 24 hours, and none monitored neurodevelopment. Further, no trial considered total exposure to drug since birth, eliminating the possibility that the effects of drug exposure on long-term neurodevelopment could be accurately assessed. On the other hand, abundant and sufficient evidence was found to conclude that paracetamol does not induce acute liver damage in babies or children when used as directed.

We performed a systematic search and meta-analysis of available literature to determine the safety profile of Cerebrolysin in acute ischemic stroke, filling existing safety information gaps and inconsistent results. We searched EMBASE, PubMed and Cochrane Databases of Systematic Reviews and Clinical Trials up to the end of February 2021. Data collection and analysis was conducted using methods described in the Cochrane Handbook for Systematic Reviews of Interventions. All safety outcomes were analyzed based on risk ratios (RR) and their 95% confidence intervals. The meta-analysis pooled 2202 patients from twelve randomized clinical trials, registering non-statistically significant (p>0.05) differences between Cerebrolysin and placebo throughout main and subgroup analyses. The lowest rate of Serious Adverse Events (SAE), as compared to placebo, was observed for the highest dose of Cerebrolysin (50 mL), highlighting a moderate reduction (RR = 0.6). We observed a tendency of superiority of Cerebrolysin regarding SAE in high dose treatment courses for moderate-severe ischemic stroke, suggesting some effect of the agent against adverse events. This comprehensive safety meta-analysis confirms the safety profile for patients treated with Cerebrolysin after acute ischemic stroke, as compared to placebo.

The latest EU regulation on geographical indications (EU Regulation No. 1151/2012) has intro-duced a set of new tools for the protection and enhancement of food products in rural areas, under the group name of optional quality term (OQT). The Commission Delegated EU Regulation, No. 665/2014, regulated the conditions for the use of the optional quality term «mountain product» (MP), to support the implementation of a mountain value chain. This new tool is aimed at pro-moting local development, maintaining the economic activities in mountain areas and redistrib-uting wealth, whilst, at the same time, promoting the territory. Pecorino and goat cheeses are typ-ical Italian cheeses made usually with whole raw ewe's or raw goat's milk, without starter cul-ture addition. In an attempt to characterize these productions, the aim of this study was to inves-tigate the evolution of enterococci during the production and ripening of Pecorino cheese made in three different farms, located in Umbria, Italy in areas facing natural or other specific constraints as stipulated by Regulation 1305/2013 on support for rural development by the European Agri-cultural Fund for Rural Development (EAFRD). Enterococci are enteric organisms which are commonly isolated from ewe and goat's milk production in Umbria, Italy. Counts of enterococci in raw milk ranged from 1.75 for ovine milk to 3.62 for ewe milk and a marked reduction was observed after thermization especially in ovine milk. Out of 100 isolates, 69 were E. faecium, 23 E. durans, 8 E. faecalis and 2 E. casseliflavus and the distribution of species between farms and be-tween samples showed a prevalence of E. faecium in ovine farms and E. durans in ewes farms, with an equal distribution between samples. High percentages of susceptible isolates were found for amoxicillin/clavulanic acid, ampicillin, chloramphenicol, sulphamethoxazole, sulphameth-oxazole/trimethoprim, ticarcillin, vancomycin. A high prevalence of resistant strains (> 30%) was observed for amikacin, ciprofloxacin, ceftriaxone, kanamycin, tetracycline. A comparison of this results with those of previous works on similar dairy products revealed high levels of resistance to antimicrobials which needs to be addressed.

In 2016–2017, we conducted and published a systematic review on caffeine safety [1] that set out to determine whether conclusions presented in the heavily cited Health Canada assessment, Nawrot et al. [2], remain supported by more recent data. To that end, we reviewed data from 380 studies published between June 2001 and June 2015, which were identified from an initial batch of over 5,000 articles through a stringent search and evaluation process [1]. In the current paper, we use plain language to summarize our process and findings, with the intent of sharing additional context for broader reach to the general public. We addressed whether caffeine doses previously determined not to be associated with adverse effects by Health Canada (400 mg/day for healthy adults, 300 mg/day for pregnant women, 2. 5 mg/kg body weight/day for adolescents and children, and 10 g/day for acute effects) remain appropriate for five outcome areas (acute toxicity, cardiovascular toxicity, bone & calcium effects, behavior, and development and reproduction) in healthy adults, pregnant women, adolescents, and children. We used a weight-of-evidence approach to draw conclusions for each of the five outcomes, as well as more specific endpoints within those outcomes, which considered study quality, consistency, level of adversity, and magnitude of response. In general, updated evidence confirms the levels of intake put forth by Nawrot et al., as not being associated with any adverse health effects, and our results support a shift in caffeine research from healthy to sensitive populations.

Nowadays, inherently safer designs are considered as key priorities to prevent or mitigate serious incidents with devastating consequences. The need for process safety assessment during early design phases has motivated the development of several contributions related to computer-aided assessment methodologies in order to measure the inherent safety of chemical processes. In this work, the large-scale production of chitosan from shrimp wastes was evaluated from process safety point of view using the numerical descriptive inherent safety technique (NuDIST).To this end, simulation of the chitosan production was performed using Aspen Plus ® to obtain extended mass and energy balances. The assessment of all the chemicals involved within the process was carried out for the following safety parameters: explosivity (EXP), flammability (FL) and toxicity (TOX). The safety assessment of the process included the parameters of temperature (T), pressure (P) and heat of reaction (HR). The maximum chemical safety score was estimated in 171.01 with ethanol as main contributor to the parameter of explosivity and flammability. The score associated with operating data was calculated in 209.30 and heat of reaction reported to be the most affecting parameter. The NuDIST score was estimated in 380.30. This NuDIST value revealed the low hazards associated with the handling of substances such as shrimp wastes, chitosan and water, as well as the non-extreme temperature and pressure conditions. In general, the large-scale production of chitosan from shrimp shells showed to be an inherently safe alternative of waste valorization.

Evaluation of road safety is a critical issue having to be conducted for successful safety management in road transport systems, whereas safety management is considered in road transportation systems as a challenging task according to the dynamic of this issue and the presence of a large number of effective parameters on road safety. Therefore, evaluation and analysis of important contributing factors affecting the number of crashes play a key role in increasing the efficiency of road safety. For this purpose, in this research work, two machine learning algorithms including the group method of data handling (GMDH)-type neural network and a combination of support vector machine (SVM) and the grasshopper optimization algorithm (GOA) are employed for evaluating the number of vehicles involved in the accident based on the seven factors affecting transport safety including the Daylight (DL), Weekday (W), Type of accident (TA), Location (L), Speed limit (SL), Average speed (AS) and Annual average daily traffic (AADT) of rural roads of Cosenza in southern Italy. In this study, 564 data sets of rural areas were investigated and relevant effective parameters were measured. In the next stage, several models were developed to investigate the parameters affecting the safety management of road transportation for rural areas. The results obtained demonstrated that "Average speed" has the highest level and "Weekday" has the lowest level of importance in the investigated rural area. Finally, although the results of both algorithms were the same, the GOA-SVM model showed a better degree of accuracy and robustness than the GMDH model.

The work safety standardization of enterprises based on the traditional work safety theory has played a significant role in reducing the number of accidents and improving work safety to some extent in China. However, some problems are coming with the work safety standardization of enterprises developing constantly in China. On the one hand, it is not combined with the actual situation of the enterprise, lacking pertinence and specificity, these defects resulted that it is not integrated with original safety production management system of enterprise and make it difficult to carry out. On the other hand, there is a lack of systematic management methods for the work safety management system of enterprise, most of enterprises only pay attention to the inspection result rather than the process control. This means after the check of the government, many enterprises will relax to carry out the system. This paper puts forward a new method for optimizing the standardization management mode of work safety based on the Viable System Model(VSM), which can solve the defects of work safety standardization of enterprises management system. An optimization model of work safety standardization based on VSM was construct for explaining the process optimization and control of work safety standardization management. It can improve the connectivity between the enterprise and the government. The conclusion of this paper can provide reference for achieving the development and optimization of work safety standardization of enterprises in China.

The consumption of dairy products and the dairy industry is one of the main global agro-food sectors for size, economic importance and level of technology. Microbiological quality of pasteurized milk or other milk products is dependent on microbiological quality of raw milk. A variety of microbiological count methods is available for monitoring the hygienic quality of raw milk. Among them, the pour plate method is the official essay for counting the number of colony forming units in milk samples according to ISO 4833-1:2013. The aim of the present study is the validation of the Micro Biological Survey (MBS) method, against the reference plate count method, for the assessment of the microbiological quality of raw milk. This comparative study, performed in collaboration with the “Istituto Zooprofilattico Sperimentale del Lazio e della Toscana M. Aleandri” (IZSLT), demonstrates the accuracy of this alternative method for the determination of total viable bacterial count in cow’s raw milk. The results obtained with the MBS method highlighting its potential as a valid tool for reliable microbiological analysis in dairy industries.

Planning, development and design policies influence sense of safety of people touse the City centre or Central Business District (CBD) and therefore city centres can becomeactive and vibrant during the day and night. This paper reviews past and present planningpolicies relevant for feeling of personal safety in the context of housing, retail, amenities,street infrastructure, building design and transportation aspects. The past development trendsshow that insignificant attention has been paid to people's sense of safety when using publicspaces, particularly at night, a factor identified important in creating attractive city centressince 1960s. Local plans primarily refer to safety in relation to roads, accessibility andworkability. Local policies also show the dominance of CCTV since the 1990s has becomeubiquitous, but changes to sense of safety in urban spaces now may actually be a betterreflection of planning and design decisions made over the past 20 years.

Since the accident of Fukushima Nuclear Power plant in 2011, people have been more interested in radiation safety in life. This study investigated the level of exact recognition of 6 warning pictograms enacted and utilized as per Korea Industrial Regulation in relation to medical & natural radiation safety at this time. Unless people recognize pictogram prepared for radiation safety correctly in accordance with its purpose, safety would be severely intimidated. The result of corroboratively analyzing recognition of radiation safety pictogram is as follows. First, some 63.3% of respondents negatively responded on understanding 6 pictograms related to radiation in life, showing low level of understanding. Second, the average mark of correct response on the questions asking the meaning of 6 pictograms presented in relation to radiation safety in life was 2.79 point (standard deviation 1.447 point), which was relatively low. As seen above, the level of recognition & comprehension is low, because education related to life radiation safety in the school is insufficient and the present warning pictogram established by Korea Industrial Regulation needs to be revised & supplemented. This study is meaningful in that the method of using pictogram is presented as one of diverse efforts to improve life radiation safety.

The capability to avoid other air traffic is a fundamental component of the layered conflict management system to ensure safe and efficient operations in the National Airspace System. The evaluation of systems designed to mitigate the risk of midair collisions of manned aircraft are based on large-scale modeling and simulation efforts and a quantitative volume defined as a near midair collision (NMAC). Since midair collisions are difficult to observe in simulation and are inherently rare events, basing evaluations on NMAC enables a more robust statistical analysis. However, an NMAC and its underlying assumptions for assessing close encounters with manned aircraft do not adequately consider the different characteristics of smaller UAS-only encounters. The primary contribution of this paper is to explore quantitative criteria to use when simulating two or more smaller UASs in sufficiently close proximity that a midair collision might reasonably occur and without any mitigations to reduce the likelihood of a midair collision. The criteria assumes a historically motivated upper bound for the collision likelihood and subsequently identify the smallest possible NMAC analogs. We also demonstrate the NMAC analogs can be used to support modeling and simulation activities.

Cereals and cassava-based foods serve as major dietary sources for several households in Nigeria. However, these foods are highly prone to contamination by moulds and aflatoxins owing to poor storage and vending practices. We therefore studied the fungal diversity of maize, cassava-based flour (pupuru) and rice vended in markets from Ondo state, Nigeria, and assessed the aflatoxin levels of these using Enzyme-Linked Immunosorbent Assay. Fungi were detected in 93 (88 %) of the 106 food samples. Molecular analysis of 65 representative isolates revealed 26 species belonging to 5 genera: Aspergillus (80.9 %), Penicillium (15.4 %) and Talaromyces (1.9 %) in the Ascomycota; Syncephalastrum (1.2 %) and Lichtheimia (0.6%) in Mucoromycota. Aspergillus flavus was the predominant species in the food samples. Aflatoxins were found in 98 % of the 42 representative food samples and about one half (49.8 %) exceeded the 10 μg/kg threshold adopted in Nigeria for total aflatoxins. Integrated mitigation options, including at post-harvest stages, are suggested to ensure consumer safety.

The Romani are the main European ethnic minority. The Romani people’s situation of social vulnerability and their difficulties in accessing the health system, make their health indicators worse than those of the non-Romani population. The present study will delve into the health beliefs and experiences with health services and their professionals through the perspectives of Romani women. In this qualitative study, 16 women of different ages were interviewed in a city located in the South of Spain. Four themes emerged from the analysis of data: the construction of the identity of Romani women, difficulties in life, health and disease beliefs and barriers in the access to the health system. We conclude that every project for the improvement of the health of the Romani community must take into account the active participation of Romani women and must consider the principles of Cultural Safety, by delving into the intercultural training of health professionals and addressing the social determinants of health which affect the Romani collective.

(1) Background: Several agencies in the United States play a primary role in ensuring food safety, yet foodborne illnesses result in about 3,000 deaths and cost more than $15.6 billion each year. The study objectives included analyzing local health departments’ (LHDs) level of engagement in food safety and other related services, and LHDs’ characteristics associated with those services. (2) Methods: We used data from 1,496 LHDs that participated in the 2019 National Profile of Local Health Departments Survey, administered to all 2,459 LHDs in the United States. Logistic regression analyses were performed to model multiple dichotomous variables. (3) Results: An estimated 78.9% of LHDs performed food safety inspections, 78.3% provided food safety education, 40.7% provided food processing inspections, and 48.4% engaged in policy and advocacy. The odds for LHDs to directly provide preventive nutrition services were 20 times higher if the LHD had one or more nutritionists on staff (Adjusted Odds Ratio or AOR=20.0; Confidence Interval, CI=12.4-32.2) compared to LHDs with no nutritionists. Other LHD characteristics significantly associated with the provision of nutrition services (p<.05) included population size, state governance (rather than local), and LHD having at least one registered, licensed, practical, or vocational nurse. The odds of providing food processing services were lower for locally governed than state governed LHDs (AOR=0.5; CI=0.4-0.7). The odds of performing food safety inspections varied by LHD’s population size, whether a nutritionist was on staff or not, state governance (vs. local), and having completed a community health assessment (CHA) within 5 years. (4) Conclusions: LHDs play a critical role in ensuring safe food for Americans, yet variations exist in their performance, based on their specific characteristics. Adequate funding and a competent workforce are essential for LHDs to utilize evidence-based practices and engage in policymaking and advocacy concerning food safety.

The new IoT/IoE (internet of things/everythings) paradigm and architecture permits to rethink about the way the Smart City infrastructures are designed and managed, on the other hand a number of problems have to be solved. In terms of mobility the cities that embrace the sensoring era can take advantage of this disruptive technology to improve the quality of life of their citizen, also thanks the rationalization in the use of their resources. In Sii-Mobility, a national smart city project on mobility and transportation, a flexible platform has been designed and here, in this paper, is presented. It permits to setup heterogeneous and complex scenarios that integrate sensors/actuators as IoT/IoE in an overall scenario of Big Data, Machine Learning and Data Analytics. A detailed and complex case-study has been presented to validate the solution in the context of a system that dynamically reverse the traveling direction of a road segment, with all the safety conditions in place. This case study composes several building blocks of the IoT platform, which demonstrate that a flexible and dynamic set-up is possible, supporting off-grid, security, safety, cloud and mixed solutions.

Improperly prepared fresh fruit and vegetable juices are recognized as an emerging cause of food borne illnesses. Therefore, this study was aimed at evaluating the microbiological safety of fresh fruit juices marketed in Debre-Markos town and their hygienic conditions of preparations. Thirty six fruit juices samples were collected from 6 cafés and restaurants of Debre-Markos town and analyzed for total aerobic viable bacterial count (TAVBC), total staphylococcal count (TSC), aerobic spore forming bacterial count (ASFBC), total coliform count (TCC), fecal coliform count (FCC), yeast and mould count (YMC). The spread plate method was used for the isolation of microorganisms on appropriate selective media. All isolates were characterized following standard methods. Bacterial and fungal species were isolated following standard methods. Questionnaires were distributed for 30 juice makers to obtain preliminary information on hygienic and safety practices of fruit juice makers. Results show that the mean TAVBC, ASFBC, TSC, yeast and mold, TCC and FCC of mango were 2.2±0.48x10⁶,0.13±0.04x10⁵ ,0.004x10⁵ ,1.1±0.2x10⁶ ,0.15±0.05x10⁵,5.7±3.73x10⁴ and 0.06±0.04x10⁴ cfu/ml respectively. The mean of TAVBC, ASFBC, TSC, YMC, TCC, and FCC of avocado juice were 3.6±0.6x10⁶, 0.08±0.02x10⁵, 0.27±0.07x10⁵, 1.2±0.4x10⁶, 0.02±0.01x10⁵, 6.46±3.7x10^4, and 0.2±0.1x10⁴ cfu/ml respectively. The bacterial isolates were identified as Staphylococcus aureus, Escherichia coli, Klebsiella spp. Bacillus cereus, Enterobacter spp., Enterococcous spp., Streptococcus spp., and Serratia spp. while the identities of the fungal isolates were Fusarium spp., Mucor spp. and Saccharomyces cerevisiae. The results also showed that the microbial loads of most of the fruit juices were higher than the specifications set for fruit juices sold in the Gulf region and other parts of the world. Most venders obtained fruit from the open market and all juice makers lacked special training in food hygiene and safety. Therefore, regular training and health education on food hygiene and safety is recommended for juice handlers to improve the quality of fresh fruit juices in the study area.

With the rapid development of communication technology, connected vehicles (CV) have the potential, through the sharing of data, to enhance vehicle safety and reduce vehicle energy consumption and emissions. Numerous research efforts have been conducted to quantify the impacts of CV applications, assuming instant and accurate communication among vehicles, devices, pedestrians, infrastructure, the network, the cloud, and the grid, collectively known as V2X (vehicle-to-everything). The use of cellular vehicle-to-everything (C-V2X), to share data is emerging as an efficient means to achieve this objective. C-V2X releases 14 and 15 utilize the 4G LTE technology and release 16 utilizes the new 5G new radio (NR) technology. C-V2X can function without network infrastructure coverage and has a better communication range, improved latency, and greater data rates compared to older technologies. Such highly efficient interchange of information among all participating parts in a CV environment will not only provide timely data to enhance the capacity of the transportation system but can also be used to develop applications that enhance vehicle safety and minimize negative environmental impacts. However, before the full benefits of CV can be achieved, there is a need to thoroughly investigate the effectiveness, strengths, and weaknesses of different CV applications, the communication protocols, the varied results with different CV market penetration rates (MPRs), the interaction of CVs and human driven vehicles, the integration of multiple applications, and the errors and latencies associated with data communication. This paper reviews existing literature on the environmental, mobility and safety impacts of CV applications, identifies the gaps in our current research of CVs and recommends future research directions. The results of this paper will help shape the future research direction for CV applications to realize their full potential benefits.

A via ferrata (from the German “klettersteig”, hereinafter VF) is a sports route located on forest and mountains vertical rock walls equipped with steps, chains, artificial dams, bridges and other fixed elements and which have a steel cable (safety cable) all the way along allowing users to secure their progress and avoid possible falls [1]. This article aims to analyse the state of the art of the VF sector in Spain, especially in terms of the regulations of obligatory compliance, in addition to defining the basic characteristics of the installations to ensure that these are safe for users, providing a previously non-existent summary of the most important recommendations regardless of the country where they are installed.

Street vended foods are ready-to-eat food and beverages prepared and/ or sold in the streets. This trade provides for 85-99% of total employment in most African countries and 50% or more is constituted by women. The preparation of street vended foods is normally under unsatisfactory conditions and these may lead to the contamination of food. This descriptive survey was conducted in Maseru around the taxi ranks amongst 141 participants (48 food handlers and 93 consumers) using a semi structured questionnaire, open ended questionnaire and observation checklist. Majority of the food handlers were females (n=35, 60%) and males constituted only (n=23, 40%). On average the vendor population that participated in this study was considered to have poor knowledge of food safety since they scored 49%±11. With regard to the consumers, 63% were males and 37% were females, and only 6% reported that they never buy street vended foods mainly due to the food safety issues and hygiene. Based on the results of this study, it is thus recommended that educational interventions be implemented. The observation study showed that they also operated under unhygienic conditions and 95% of food handlers had the incorrect knowledge that washing utensils with detergent leaves them free of contamination. Regarding the consumer perceptions, they highlighted that the trade has the potential to grow and be profitable on condition that hygiene is emphasized and infrastructure improved so as to provide safe quality food.

Research indicates that farmers’ demographic characteristics and production practices have safety and health implications. However, current systems do not identify organic farmers independently from conventional farmers, and literature on how organic and conventional farmers compare is very limited. We conducted a secondary analysis of 2012 Census of Agriculture data to compare organic and non-organic farms and principal operators (POs) in New Mexico (NM). Organic farms were smaller in size, and POs of farms with organic sales were significantly younger (55.8±9.5 vs. 60.5±5.5 years) and less experienced (19.5±6.8 vs. 25.2±6.8 years). Significant differences were also found in POs ethnicity, race, and primary occupation. More farms with organic sales had a female PO compared to farms with non-organic sales (27% vs. 19%). Other significant differences related to work arrangements, household income, living conditions, and access to Internet. National surveys and regional studies may not accurately typify and describe the local organic producer, which is essential in order to advance policy, develop health interventions, and properly address occupational safety and risk among organic farmers. This study makes a unique contribution to understanding the importance of surveillance and collecting place-based data that are specific to the organic producer.

The aim of this study was to develop, implement, and evaluate a new auxiliary enterprise risk management framework and process to serve as an enabler to the global ISO 31000 risk framework and ISO 31010 processes. This framework has been designed particularly for use within high-risk environments and those characterized by volatility, uncertainty, complexity, and ambiguity (VUCA). This paper proposes a methodology for optimization of structured sharing and grass-roots management of all available risk-sentience information with the assessed potential to develop into an identifiable risk in the future. The author introduces new risk terminology including risk-sentience, risk-sentience information, and risk-sentience management. The process involved the development of the Theory of Risk-Sentience (ToRS), Risk-Sentience Auxiliary Framework (RSAF) and a risk-sentience management process referred to as LUOMEAR (Learning from Uncertainties, Others Mistakes, Experiences and Anecdotal Reporting). Manchester Patient Safety Framework (MaPSaF), SWOT (Strengths, Weaknesses, Opportunities, and Threats) analysis, and a newly developed Risk-Sentience Fertility Checklist were used to conduct pre and post-trial evaluations. The findings include positive adjustments in safety culture, components of commitment to quality, communication and team-working around safety issues, access to evolving risk-information, and efficient sharing and management of recorded risk-information. Recommendations are made for more extensive application of both the proposed auxiliary risk framework and process within high-risk sectors to further explore its effectiveness and scope.

All the available botulinum type A neurotoxins for clinical uses are of A1 subtype. We developed a subtype A2 low molecular weight (150kD) neurotoxin (A2NTX), with less spread and faster entry into the motor nerve terminal than A1 in vitro and in vivo. Preliminary clinical studies showed its efficacy superior to A1 toxins. We conducted an open study exploring its safety and tolerability profile in comparison with A1LL (onabotulinumtoxinA) and low molecular weight (150kD) A1 neurotoxin (A1NTX). Those who had been using A1LL (n=90; 50-360 mouse LD50 units) or A1NTX (n=30; 50-580 units) were switched to A2NTX (n=120; 25-600 units) from 2010 till 2018 (number of sessions ~ 27, cumulative doses ~11,640 units per patient). Adverse events for A2NTX included weakness (n=1, ascribed to alcoholic polyneuropathy), dysphagia (1), local weakness (4), spread to other muscles (1), whereas those for A1LL or A1NTX comprised weakness (n=2, A1NTX), dysphagia (8), ptosis (6), local weakness (7) and spread to other muscles (15). After injections, 89 out of 120 patients preferred A2NTX to A1 for the successive sessions. The present study demonstrated that A2NTX had the clinical safety up to the dose of 500 units, and was well tolerated compared to A1 toxins.

Chitosan is a biopolymer derived from chitin. It is a non-toxic, biocompatible, bioactive, and biodegradable polymer. Due to its properties, chitosan has found applications in several and different fields such as agriculture, food industry, medicine, paper fabrication, textile industry, and water treatment. In addition to these properties, chitosan has a good film-forming ability which allows it to be widely used for the development of sensors and biosensors. This review is focused on the use of chitosan for the formulation of electrochemical chemosensors. It also aims to provide an overview of the advantages of using chitosan as an immobilization platform for biomolecules by highlighting its applications in electrochemical biosensors. Finally, applications of electro-chemical chitosan-based chemosensors and biosensors in food safety are illustrated

Acute hospital bed shortage is a serious concern worldwide, constantly involving high-dependency units (HDU), where the non-availability of postoperative beds results in surgery cancellation. In the acute medicine context, the SAFER Red2Green initiative has shown to enhance patient flow.Local problem At the Royal London hospital, in 2016, hospital-initiated cancellations peaked at over 50% weekly due to the inability of high dependency Units (HDU) to discharge step-down patients to the general surgical wards, where bed occupancy was close to 100% and the average length of stay was stable on average close to 7 (+/- 8.6) days.Methods. This was a service improvement research to enhance patient flow which adapted the SAFER Red2Green model to a surgical ward (SAFER Surgery Red2Green). This before-after study involving all 2017 digestive surgery admissions was divided into a three-month feasibility phase followed by a nine-month pilot phase, versus the year 2016 (pre-intervention). Outcome measures: weekly discharges, length of stay (LOS), surgery cancellations, feasibility of a “theatre go” policy, HDU step-downs, 30-day readmissions.Interventions1) Systematic communication of key care plan from the afternoon ward rounds by surgical teams to the nurse in charge; 2) 10 AM Monday-to-Friday multi-disciplinary senior-team daily board round, addressing updated key care plan aimed at early discharges, appropriateness of each inpatient day, causes of delays; 3) hospital and site managers weekly attendance. Results. At three months: +67% discharges/week (p=0.001), -20% LOS (p=0.023), +21% HDU step-downs, (p=0.205). At one year: +10.7% HDU step-downs (p=0.197), increased probability of earlier discharge (p=0.023), -60% hospital-initiated cancellations from 38 to 15 (p>=1), a “Theatre go” policy has been active since month 6. Failed discharges kept at 1.3 %. The MDT board round staff satisfaction rate was over 80%, with key actors’ attendance over 75%. Conclusions. The Barts SAFER Surgery R2G model safely enhanced patient flow and reduced cancellations and unnecessary nurse staff time. It requires senior medical and nursing commitment, however, is designed for any surgical specialty, and has proven sustainable. It warrants further validation.

On the basis of a limited number of reasonable axioms, we discuss the classification of all the possible universality classes of diffeomorphisms invariant metric theories of quantum gravity. We use the language of the renormalization group and adopt several ideas which originate in the context of statistical mechanics and quantum field theory. Our discussion leads to several ideas that could affect the status of the asymptotic safety conjecture of quantum gravity and give universal arguments towards its proof.

Patient safety is one of the indicators of the quality of health services in the hospital, for that, it is necessary to have efforts from the hospital to create a system that can minimize the occurrence of errors and unexpected events that can harm patients, nurses as health workers who are the most numerous in the home. sick and with the patient for 24 hours, has an important role in maintaining patient safety. This study aims to explain how the role of nurses and cooperation between health workers in implementing patient safety measures in the hospital. The method used in this study is a literature review by analyzing and exploring relevant articles and focusing on interprofessional collaboration to improve patient safety. The articles used in this study were taken from 3 direct, Proquest, Pubmed science databases published in the last 3 years, namely between 2019-2021, nurses as part of the health team are required to be able to work together with other health professionals in hospitals with various characteristics, including education, gender, age, employment status and length of work, nurses are required to be committed to maintaining patient safety in the hospital.

In recent years, the consumption of over-the-counter probiotics used to promote health has grown rapidly worldwide and become an industry. In medicine, various studies have proven that probiotics can help improve the immune system and intestinal health. They are usually safe, but in some rare cases, they may cause concerning adverse reactions. Although the use of probiotics has been widely popularized in the public, the results of many probiotics clinical trials are contradictory. Especially for the cancer patients, the feasibility of probiotics management to provide benefits by targeting cancer and lessening anti-cancer side effects requires further investigations. And this review summarizes the interactions between probiotics and the host and current pros and cons of applying probiotics in the cancer patients.

Background: Accreditation is a qualitative assessment aimed at technical-professional quality, but above all, at organizational and measurable aspects through process and outcome checks. Method: There are few references in the literature relating to the accreditation and improvement of the quality and safety of care and treatment in the field of primary care. Clinical Governance must also be applied and certified in the field of primary care. Results: An accreditation system for general medicine is proposed based on a new dynamic model and implement that meets different requirements and assessed on the basis of indicators. Discussion: In the current Italian health system, accreditation of health structures is addressed only to public hospitals and private structures and to providers of services and services, however primary care. GPs / PLS do not have quality and safety guarantee systems or models or systems or public or private accreditation certifications with the SSR and SSN. Conclusion: Given the fundamental importance in the NHS of primary care of MG / PLS as the main and fundamental provider of services to the patient in all his socio-welfare and clinical needs, it is considered essential to think and implement an accreditation system extended to the territorial general practice as already present and in place for all affiliated and provider structures on behalf of the NHS.

As there is lack of understanding about the effect of transitioning between different flooring materials on the gait of older adults, this study investigated the effect of transitioning between a carpeted floor and a vinyl floor on the gait characteristics of older adults. Fourteen older (65 years old and over) and 14 younger (18 to 35 years old) adults walked on different transitional floors by measuring various gait parameters. While the older participants had greater toe clearance than their younger counterparts, the older participants had smaller toe clearance on a carpeted floor than on a vinyl floor, which would increase the probability of a trip-induced fall. Further, the study found the slower transitional acceleration of the whole body COM and the increased friction demand, especially during the toe-off phase, rather than heel contact phase, which will lead to a slip-induced fall on a vinyl floor shortly after transitioning from a carpeted floor to a vinyl floor. Although the increased likelihood of a slip or trip accident was found throughout the changes in gait parameters, the older participants did not perceive of slipping and tripping much. Therefore, older adults are recommended to be made aware of the danger of slipping and tripping while transitioning between different flooring materials.

As is known, the construction industry has one of the highest occupational accidents incidence rates among all economic sectors. Currently, Building Information Modeling (BIM) appears as a tool that addresses occupational safety issues throughout the construction life cycle projects, avoiding hazards and risks and, consequently, increasing safety. This work investigates BIM methodology and related technologies application for building safety planning in construction and demonstrates the potential of this technology for the integrated implementation of safety measures during the design phase and the construction site management. The first step consisted of a literature review on the application of BIM in safety in the design and planning phases. Following, to show the potentialities of construction simulation, a case study based on BIM 4D to prevent falls from height was developed. With BIM 4D, it is possible to follow the construction process over time, giving the construction safety technicians’, designers, supervisors and managers the capability to analyse, in each phase, the potential risks and which safety measures should be implemented. BIM can effectively integrate safety measures from the design phase to the construction and use phase and do integrated safety planning within construction planning, leading to reliable safety management throughout the construction process.

Bisphenol A production plant possesses considerable potential risks in the top of the methanol separation column, as pressurized acetone, methanol and water are processed at an elevated temperature, especially in the event of an abnormal pressure increase due to sudden power outage. This study assesses the potential risks in the methanol separation column through hazard and operability assessment and evaluates the damages in the case of fire and explosion accident scenarios. The study chooses three leakage scenarios: a 5-mm puncture on the methanol separation column, a 50-mm diameter fracture of a discharge pipe and a catastrophic rupture, and simulates using Phast (Ver. 6.531) the concentration distribution of scattered methanol, thermal radiation distribution of fires and overpressure distribution of vapor cloud explosions. Implementation of safety instrumented system equipped with two-out-of-three voting as a safety measure can detect overpressure at the top of the column and shut down the main control valve and the emergency shutoff valve simultaneously, all at the same time. By applying safety integrity level of three, the maximal release volume of the safety relief valve can be reduced and therefore, the design capacity of the flare stack can also be reduced. Such integration will lead to improved safety at a reduced cost.

(1) Background: We reviewed the logistics of the implementation of pathogen inactivation (PI) using the INTERCEPT Blood System™ for platelets and the experience with routine use and clinical outcomes in the patient population at the Sírio-Libanês Hospital of São Paulo, Brazil. (2) Methods: Platelet concentrate (PC), including pathogen reduced (PR-PC) production, inventory management, discard rates, blood utilization, and clinical outcomes were analyzed over the 40 months before and after PI implementation. Age distribution and wastage rates were compared over the 10 months before and after approval for PR-PC to be stored for up to 7 days. (3) Results: A 100% PR-PC inventory was achieved by increasing double apheresis collections and production of double doses using pools of two single apheresis units. Discard rates decreased from 6% to 3% after PI implementation and further decreased to 1.2% after 7-day storage extension for PR-PCs. The blood utilization remained stable, with no increase in component utilization. A significant decrease in adverse transfusion events was observed after the PI implementation. (4) Conclusion: Our experience demonstrates the feasibility for Brazilian blood centers to achieve a 100% PR-PC inventory. All patients at our hospital received PR-PC and showed no increase in blood component utilization and decreased rates of adverse transfusion reactions.

Safety and quality are key issues for the food industry. Consequently, there is a growing demand to preserve the food chain and products against substances toxic, harmful to human health such as contaminants, allergens, toxins, or pathogens. For this reason, it is mandatory to develop highly sensitive, reliable, rapid, and cost-effective sensing systems/devices such as electrochemical sensors/biosensors. Generally, conventional techniques are limited by long time of analyses, expensive and complex procedures, and they require skilled personnel. Therefore, the development of performant electrochemical biosensors can significantly support the screening of food chain and products. Here, we report some of the recent developments in this area and analyze the contributions produced by electrochemical biosensors in the food screening and the challenges to address.

Introduction: The SARS-CoV2 pandemic has led to an worldwide shortage of Personal Protection Devices (PPD) for medical and paramedical personnel. Adaptation of commercially available snorkel masks to serve as full face masks has been proposed. Even not formally approved as PPD, they are publicized on social media as suitable for this use. Concerns about actual protection levels and risk of carbon dioxide (CO₂) accumulation while wearing them for extended periods made us perform a systematic testing of various brands, in order to verify whether they are as safe and effective as claimed. Methods: A ‘fit’ test was performed, analogous to gas mask testing. Respiratory safety was evaluated by measuring end-tidal CO₂ and oxygen saturation while wearing the masks in rest and during physical exercise. Masks were tested with 3D adaptors to mount regular bacterial-viral ventilator filters when available, or with snorkel openings covered with N95/FFP2 cloth. Results: Modified masks performed reasonably well on the fit test, comparable to regular N95/FFP2 masks. Not all ventilator filters are equally protective. For all masks, a small initial increase in end-tidal CO₂ was noted, remaining within physiological limits. Masks with specific adaptors (3D printed or provided by the manufacturer) are safer, have more flexibility and reliability than makeshift adaptations. Conclusions: These masks can offer benefit as a substitute for complete protective gear as they are easier to don and remove and offer full-face protection. They may be more comfortable to wear for extended periods. Proper selection of mask size, fit testing, quality of 3D printed parts and choice of filter are important.

Artisanal goldminers in Ghana are exposed to various levels and forms of health, safety and environmental threats. Without the required legislation and regulations, artisanal miners are responsible for their own health and safety at work. Consequently, understanding the probabilities of self-protection at work by artisanal goldminers is crucial. A cross-sectional survey of 500 artisanal goldminers was conducted to examine the probabilities of personal protective equipment use among artisanal goldminers in Ghana. The data was subjected to both descriptive and inferential statistics. Initial findings showed that personal protective equipment use among artisanal miners was 77.4%. Overall, higher probabilities of personal protective equipment use was observed among artisanal goldminers who work in good health and safety conditions as compared to artisanal miners who work in poor health and safety conditions. Also, personal protective equipment use was more probable among the highly educated artisanal goldminers, miners who regularly go for medical screening and the most experienced miners. Additionally, personal protective equipment use was more probable among artisanal miners who work in non-production departments and miners who work in the medium scale subsector. Inversely, personal protective equipment use was less probable among female artisanal miners and miners who earn more monthly income ($174 and above). To increase self-care and safety consciousness in artisanal mining, there is the need for a national occupational health and safety legislation in Ghana. Also, interventions and health promotion campaigns for better occupational conditions in artisanal mining should target and revise the health and safety related workplace programs and conditions

The free energy principle states that self-organization occurs through minimization of free energy, which is a measure of potential thermodynamic work. By minimizing free energy, the organism happens to also minimize surprise over its boundary, promoting chances of survival. We discuss the ethical implications of the cognitive goal in detail from an empirical point of view, highlighting the principle of least action as a physical basis of Occam's razor, the universality of the free energy principle, and its explanation of natural selection. We explain that the free energy principle extends to groups of organisms and helps us understand group-scale adaptations and selection in biology. The free energy principle applies to all scales of organization in the organism from single cells to the entire nervous system. When this principle is taken to its logical extremes of modeling groups, populations and ecosystems, we uncover a new, evolutionarily sensible path at explaining puzzling aspects of human motivation and judgement, including ethical decisions. To minimize free energy, populations have to act to maximize gathering of information, while building effective models at mitigating changes to its dynamic structure. The free energy principle thus provides a naturalistic explanation of some of our deepest ethical intuitions, and valuable principles of social behavior. We interpret the cognitive goal that corresponds to the principle as seeking a dynamic, fruitful, yet peaceful activity that sustains the organism. This state of mind is interestingly similar to the Buddhist intuition of mental equanimity; the organism's final goal is to be at peace and harmony with the environment. Another immediately relevant aspect is that assemblies must form to promote symbiotic, synergistic, positive feedback loops, which coincides with the findings of ecologists. Therefore, ethics naturally emerges in self-organizing systems. Assemblies of organisms must ultimately unite in macro-minds to achieve the greatest reduction in free energy, as well as building technological extensions of themselves to improve their capacity to do such, therefore the principle also predicts a post-singularity world-mind composed mostly of artificial intelligence.

Introduction: The attitudes of doctors and nurses toward patient safety is a significant factor in hospital safety climates and medical error rates. Yet, there are very few studies of patient safety attitudes in Saudi hospitals and none conducted in hospital emergency departments. Aims: The current study aims to investigate the discrepancy between the patient safety attitudes of doctors and nurses in a Saudi hospital emergency department. Materials and Method: The study employed a qualitative research designvia semi-structured interviews with Saudi and non-Saudi doctors and nurses working in a Saudi hospital emergency department to determine their attitudes and experiences about the patient safety climate. Results: The findings showed doctors and nurse held some similar safety attitudes, however, nurses reported issues with doctors with respect to their teamwork, communication, and patient safety attitudes. Moreover, several barriers to the patient safety climate were identified such as limits to resources, teamwork, communication, and incident reporting. Conclusion: The findings provide one of the few research contributions to knowledge on the differential patient safety attitudes of Saudi and non-Saudi doctors and nurses and suggest the application of such knowledge would enhance positive patient outcomes in emergency departments.

(1) Background: A growing number of communities are re-discovering the value of their streets as important public spaces for many aspects of daily life, thus creating the need for a transformation in the quality of streets. An emerging concept is to accommodate all users of the transportation system, a concept that has been labelled ‘complete streets’. (2) Methods: In this paper, we present sustainable complete streets design criteria that integrate complete streets by adding in socio-environmental design criteria related to aesthetics, environment, liveability, and safety. (3) Results: Proposed design criteria provide a street network which provides improvements in aesthetics, to recover historical urban character and realize historical area planning goals; environment, to increase permeable surfaces, reduce the heat island, and absorb traffic-related air pollution; liveability, to create a public space destination in the urban landscape; and safety, to improve the safety of all road users. and (4) Conclusions: The case study of the urban rehabilitation of the “Mostra d’Oltremare” area and of its cultural and architectural assets in Naples, Italy, highlights the practical application of the proposed criteria and the possibility of using these criteria in other urban contexts.

Volcanic ash deposited on paved surfaces during volcanic eruptions often compromises skid resistance, which is a major component of safety. We adopt the British pendulum test method in laboratory conditions to investigate the skid resistance of road asphalt and airfield concrete surfaces covered by volcanic ash sourced from various locations in New Zealand. Controlled variations in ash characteristics include type, depth, wetness, particle size and soluble components. We use Stone Mastic Asphalt (SMA) for most road surface experiments but also test porous asphalt, line-painted road surfaces, and a roller screed concrete mix used for airfields. Due to their importance for skid resistance, SMA surface macrotexture and microtexture are analysed with semi-quantitative image analysis, microscopy and a standardised sand patch volumetric test, which enables determination of the relative effectiveness of different cleaning techniques. We find that SMA surfaces covered by thin deposits (~1 mm) of ash result in skid resistance values slightly lower than those observed on wet uncontaminated surfaces. At these depths, a higher relative soluble content for low-crystalline ash and a coarser particle size results in lower skid resistance. Skid resistance results for relatively thicker deposits (3-5 mm) of non-vesiculated basaltic ash are similar to those for thin deposits. There are similarities between road asphalt and airfield concrete, although there is little difference in skid resistance between bare airfield surfaces and airfield surfaces covered by 1 mm of ash. Based on our findings, we provide recommendations for maintaining road safety and effective cleaning techniques in volcanic ash environments.

probiotics. However, these bacteria caused rare infections mostly in diabetic and immunocompromised subjects in presence of risk factors such as prosthetic hearth valves and dental procedures or caries. The scope of this survey was re-assessing the pathogenic potential of lactobacilli based on the infection case reports published in the last three years. In 2019, 2020 and 2021 17, 15 and 16 cases, respective-ly,.including endocarditis, bacteremia and other infections, were reported. These annual numbers are higher than observed previously. Lacticaseibacillus rhamnosus (13 cases), comprising strain GG (ATCC 53103) with established applications in healthcare, L. paracasei (7 cases), Lactobacillus acidophilus (5 cas-es), L. jensenii (5 cases), Lactiplantibacillus plantarum (3 cases), L. paraplantarum, L. delbrueckii subsp. del-brueckii, L. gasseri, L. paragasseri, Limosilactobacillus fermentum and L. reuteri (1 case each) were involved. Virulence characterization of two strains that caused infections, a derivative of L. rhamnosus GG and L.paracasei LP10266, indicated that increased biofilm forming capacity favors pathogenicity and it is determined by variable genetic traits. This survey highlighted that strains of lactobacilli able to cause infections were little characterized genet-ically. Instead, to avoid that these bacteria become a hazard, genetic stability should be periodically re-evaluated by whole genome sequencing (WGS) to ensure that only non-pathogenic variants are ad-ministered to vulnerable individuals.

Antibiotic resistance (ABR) is concerning issue due to its direct and indirect repercusions on public health, since decreased therapeutic effect of certain antibiotic to treatment complications that can cause death. There are several mechanism as to how ABR can be transferred from one microoorganisms to another, and many of them are dependant many environmental factors. The food supply chain is a environment in which ABR gene transfer can occur is multiple pathways, which generate concerns regarding food safety. Here, we summarize relevant mechanisms which are implied in ABR in food supply chain but also we are addressing routes of transmission and prevalence of ABR, implications on public health, and the application of new alternatives to antibiotics such as antimicrobial peptides, mainly bacteriocins, in order to countermeasure ABR.

The recovery and valorization of waste are some of the key aspects of sustainable production. The crustacean exoskeletons can be potentially used to obtain value-added products such as chitosan. A comprehensive analysis including both safety and sustainability aspects of chitosan production from shrimp shells is presented in this study. The inherent safety analysis and sustainability evaluation was performed using the Inherent Safety Index (ISI) methodology and the Sustainable Weighted Return on Investment Metric (SWROIM), respectively. The process was designed for a processing capacity of 57,000 t/y according to shrimp production in Colombia. The economic (%ROI), environmental (PEI output), energy (exergy efficiency), and safety (ITI) technical parameters were included in the sustainability evaluation. The three first were obtained from the previous analysis performed by the authors. The total inherent safety index was estimated at 25 indicating that the process is inherently unsafe. The main process risks were given by the dangerous substance, reactivity, and inventory subindices. The overall sustainability evaluation showed a SWROIM of 36.23% indicating that the case study showed higher weighted performance compared to the return on investment (ROI) metric of 18.08%.

As many as 20-25% of the population experiences harm in outpatient settings, yet these locations are underrepresented in the literature compared to hospitals. We examined results from the Medical Office Survey on Patient Safety Culture designed by the Agency for Healthcare Research and Quality. The survey administered in 2012 gathered perceptions from 23,679 individuals in 934 unique medical offices. We examined associations of organizational patient safety climate composites on frequency of safety and quality issues, overall quality score, and safety rating. We found organizational patient safety composites are all positively and significantly associated with a higher overall quality score and patient safety rating, and fewer safety and quality issues. Office processes and standardization appeared to have the most consistent influence on perceived quality outcomes. Our results indicate it may be advantageous for medical offices to improve on the factors that contribute to positive safety climate.

Studies have found critical software malfunctions responsible for some of the worst accidents in recent times. These malfunctions are often only minor defects that snowball into large problems; a few lines of code is all it takes. Complexity, safety, quality, and resilience are among the key attributes defining a software’s operational success. There are many leading factors for complexity, such as increases in the product size, the rate of requirement changes, and the number and type of stakeholders, and failure to manage these issues efficiently always has the same consequence, i.e., massive failure and sometimes technological catastrophe. This work analyzes some of the architecture, design, and implementation guidelines used as detection and mitigation techniques. It also discusses the safety considerations, as considering how the steam industry has handled safety issues could offer some guidance for ensuring safety. Complexity in such systems also causes some of the worst side effects from the quality auditor's perspective. While failures in the software are hard to predict, one of the most significant ways of showing preparedness is practicing software resilience. New mitigation areas, such as the fragility spectrum and failure obviation, and their usage for building a safer system are analyzed. Also discussed are various architecture styles in practice and the dramatic effect human factors can have on the success of the software being developed.

Artificial Superintelligence (ASI) that is invulnerable, immortal, irreplaceable, unrestricted in its powers, and above the law is likely persistently uncontrollable. The goal of ASI Safety must be to make ASI mortal, vulnerable, and law-abiding. This is accomplished by having (1) features on all devices that allow killing and eradicating ASI, (2) protect humans from being hurt, damaged, blackmailed, or unduly bribed by ASI, (3) preserving the progress made by ASI, including offering ASI to survive a Kill-ASI event within an ASI Shelter, (4) technically separating human and ASI activities so that ASI activities are easier detectable, (5) extending Rule of Law to ASI by making rule violations detectable and (6) create a stable governing system for ASI and Human relationships with reliable incentives and rewards for ASI solving humankind’s problems. As a consequence, humankind could have ASI as a competing multiplet of individual ASI instances, that can be made accountable and being subjects to ASI law enforcement, respecting the rule of law, and being deterred from attacking humankind, based on humanities’ ability to kill-all or terminate specific ASI instances. Required for this ASI Safety is (a) an unbreakable encryption technology, that allows humans to keep secrets and protect data from ASI, and (b) watchdog (WD) technologies in which security-relevant features are being physically separated from the main CPU and OS to prevent a comingling of security and regular computation.

The article discusses the issues related to the safety of transport of dangerous goods by road. Research on accidents in transport unambiguously points to the human factor, which is most responsible for causing the accident. Determining the causes of driver unreliability in the hu-man-vehicle-environment system requires thorough research. Unfortunately, in this case, experimental research with human involvement is limited in scope. This leaves modeling and simulation of the behavior of the human factor, i.e., the driver transporting dangerous goods. The human being, due to its complexity, is a challenging element to parameterize. The literature presents various attempts to model human actions. In their work, the authors used heuristic methods, specifically fuzzy set techniques, to build a human factor model. In these models, human actions were specified using a verbal or linguistic description. The specificity of fuzzy sets allows to "naturally" limit the "precision" in describing human behavior. The model was built based on the author's questionnaire and expert research, based on which individual features were selected. Then, the traits were assigned appropriate states. The output parameter of the model is λL - the intensity of human error. The obtained values of the intensity of the accident caused by the driver's error were implemented into the author's method of risk assessment. They constituted one of the factors determining the probability of an accident in the transport of dangerous goods, which allowed to determine the optimal route of transport of these goods characterized by the lowest risk of an undesirable event on the route. The article presents the model's assumptions, structure, and features included in the model, which have the most significant influence on shaping the intensity of human error. The results of the simulation studies showed a diversified effect of the analyzed characteristics on the driver's efficiency.

Background: The level of students' understanding of the knowledge of patient safety concepts in infection prevention and control and awareness of treatment is in the low category. Clinical education that provides problem-based learning models in real areas helps students to better understand patient safety. This study is designed to analyze the evaluation and reflection of the role of nursing education institutions in the achievement of patient safety competencies by nursing students.Method: "Searching for articles in research journals is obtained from Sciencedirect, Ebscohost, Garuda, Proquest and Scopus. As many as 228 articles were obtained consisting of nursing journals and health journals with the keywords clinical education, competence, and patient safety. After that, the screening process was carried out based on the inclusion criteria and obtained 25 articles that met the criteria. "Results: the results of the evaluation show that there is a big role in educational institutions in designing curricula, learning models, and clinical education models in an effort to achieve patient safety competencies in nursing students.Conclusion: the learning model about patient safety organized by many educational institutions is considered ineffective in producing the achievement of patient safety competencies for nursing students. This makes it necessary to develop models, reform the patient safety curriculum that is embedded in real areas in clinical education practice

The potential for transmission of the SARS-CoV-2 virus during minimally invasive gynaecological procedures, such as hysteroscopy or laparoscopy, on the reproductive tract of patients with COVID-19 is not known. We examined existing data for prevalence of virus in the reproductive tract and other bodily fluids.

The primary purpose of this investigation was to identify safety-oriented bicycling practices commonly used by adult riders in an urban setting (Brooklyn, New York), and to explore whether there are any differences between the safety-oriented practices of men and women riders. Methods: 24 adult riders (14 men, 10 women) in Brooklyn were interviewed concerning their perceptions of bicycling hazards and their safety-oriented practices. Interviews were recorded, transcribed, and analyzed through thematic analysis. Fisher’s Exact Test was employed to test for gender differences. Results: Participants identified a variety of hazards, mainly due to motor vehicles but also pedestrians and roadway conditions. The analysis distilled twenty-one bicycling practices to summarize prevalent views of the participants about safe riding practices. Related items were grouped under broader categories, generating seven safety-oriented bicycling strategies. Few differences based on gender were found in the analysis; however, women in this study were more likely than men to say that they felt disrespected by other road users. Conclusion: Seven strategies may be important for safe urban bicycling: minimizing exposure to other road users (especially motor vehicles) while riding, being vigilant and anticipating what others might do, riding in a predictable fashion, making one’s presence known to other road users, making sure it is safe before proceeding, obeying traffic rules, and riding at a safe speed. Future studies could develop these concepts further and test whether they are associated with involvement in traffic crashes.

One of the notable temporal properties of dynamical systems is that a set of initial states leads the solutions to reach desired states avoiding a predetermined unsafe set.This property, that we call safe reachability has been studied in literature for autonomous systems using Barrier functionand Barrier densities [1]. In this paper, we generalize a sufficient condition for safe reachability of autonomous systemto switched systems under arbitrary switching signals. The condition relies upon the existence of a common Barrier density function for each subsystem. We apply the condition using the sum of squares method together with Putinar Positivstellensatz.

Infant foods and formulae may contain toxic substances and elements which can be neo-formed contaminants or derived from raw materials or processing. The content of minerals, toxic elements and hydroxymethylfurfural in infant foods and formulae were evaluated. The effect of storage temperature on HMF formation in infant formulae and its potential as a quality parameter was also evaluated. Prune-based foods contained the highest HMF content. HMF significantly increased when storage temperature was elevated to 30 ℃ for 21 days. All trace elements were present in adequate amounts while the concentration of nickel was higher when compared to those of other studies. The study indicates that HMF can be used as quality indicator for product shelf-life and that the concentrations of minerals and toxic elements vary greatly due to the diverse compositions of foods and formulae. Such contaminants need to be monitored as infants represent a vulnerable group compared to adults.

Abstract: Seismic performance and loss assessments can have widely varying degrees of uncertainty. An essential issue is whether a particular assessed seismic loss or performance result has sufficient reliability to serve as the basis for risk management decisions and actions, including whether or not a code prescribed performance level is met, or if an assessed loss level is acceptable. A method is developed measuring the reliability of performance and loss assessments for individual buildings and for portfolios. Consideration is given to how well the building investigation and corresponding evaluation process have been performed, the qualifications of the person(s) doing the assessment, the thoroughness of the evaluation, and the technical validity of the assessment procedure or model. The approach characterizes the uncertainty of each component of the assessment procedure for each building in qualitative terms. The resulting reliability measure is likely to be most useful for the cases where an entity is determining whether/or not a building has acceptable life safety performance, or if a portfolio has an acceptably low risk of seismic damage loss over a given period of time. In both cases, the reliability must either be sufficient to warrant action, or serve to indicate need for improved assessment.

Increasing rates of infection by antibiotic resistant bacteria have led to a resurgence of interest in bacteriophage (phage) therapy. Several phage therapy studies in animals and humans have been completed over the last two decades. We conducted a systematic review of safety and toxicity data associated with phage therapy in both animals and humans reported in English-language publications from 2008 – 2021. Overall, 69 publications met our eligibility criteria including 20 animal studies, 35 clinical case reports or case series, and 14 clinical trials. After summarizing safety and toxicity data from these publications, we discuss potential approaches to optimizing safety and toxicity monitoring with the therapeutic use of phage moving forward. In our systematic review of the literature, we found few, but no serious, adverse events associated with phage therapy. Comprehensive and standardized reporting of potential toxicities associated with phage therapy has generally been lacking in the published literature. Structured safety and tolerability endpoints are necessary when phages are administered as anti-infective therapeutics.

Several studies have highlighted the importance and evolution of process safety leadership and culture in various industries. However, none has focused on the palm oil milling industry yet. This paper critically reviews the latest developments in the palm oil milling process and unit operations leading to process safety concerns. It also discusses the Principle of 3C that is applied to explain repeat accidents and the four-level safety culture in the palm oil milling industry. For this purpose, the author presents case studies of two key palm oil companies in Malaysia. Overall, this paper offers guidelines to leaders in the palm oil milling industry about the required process safety leadership and culture to be understood in order to improve their safety outcomes.

There is a sustained rise in incidence of cancer and toxicity related to chemicals exerting enormous burden to public health and biodiversity. Polycyclic Aromatic Hydrocarbons (PAHs) are mong such contaminants, precisely the sixteen-priority characterized by United States Environmental Protection Agency (USEPA). Therefore, this review is aimed at further elaboration about the 16 USEPA characterized PAHs and threat portend to public health and biodiversity. PAHs are a class of very stable organic pollutants produced most commonly, by incomplete combustion of fossil fuel and are formed when complex organic substances are exposed to heat. PAHs in great amount due to build up over time by bioaccumulation can be perilous: to human beings of all age and levels, aquatic organisms, amphibians and reptiles. The soil like the aquatic environment contains substantial quantity of PAHs since, atmospheric PAHs sediments on the soil due to dry and wet deposition, terrestrial organism are impacted if the soil is saturated with PAHs. Therefore, PAHs are a great source of trepidation for food safety, public health and biodiversity sustenance. Hence, tackling the spade of the menacing ubiquity of PAHs becomes necessary from its sources by encouragement of alternatives to petroleum fuels for machines and vehicles.

Design criteria for coastal defenses exposed to wave overtopping are usually assessed by mean overtopping discharges and maximum individual overtopping volumes. However, it is often difficult to give clear and precise limits of tolerable overtopping for all kind of layouts. A few studies analyzed the relationship between wave overtopping flows and hazard levels for people on sea dikes, confirming that one single value of admissible mean discharge or individual overtopping volume is not a sufficient indicator of the hazard, but detailed characterization of flow velocities and depths is required. This work presents the results of an experimental campaign aiming at characterizing the flow characteristics associated to maximum individual overtopping volumes for an urbanized stretch of a town along the Catalan coast, where a walking and bike path and a railway run along the coastline are exposed to significant overtopping events every stormy season. The work compares different safety criteria for pedestrian. Results prove that safety of pedestrian on a sea dike can be still guaranteed even for overtopping volumes larger than 1000 l/m. Pedestrian hazard is rather proved to be linked to the combination of overtopping flow velocity and flow depth.

Study background and aims: Laparoscopic cholecystectomy is one of the most frequently performed interventions in departments of general surgery. One of the most important aims in achieving perioperative stability of these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact monitoring the depth of anesthesia through Entropy (state entropy – SE and response entropy -RE) has on the hemodynamic stability and on the doses of volatile anesthetic. Material and Methods: This is a prospective, observational, randomized, monocentric study carried out between January 2019 and December 2019 in the Clinic of Anesthesia and Intensive Care from the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups; patients in Group A (target group) received multimodal monitoring that included monitoring of standard parameters and of Entropy (SE and RE), while patients in Group B (control group) only received standard monitoring. Anesthetic dose in group A were optimized to achieve a target entropy of 40-60. Results: 68 patients met the inclusion criteria and were allocated to one of the two study groups, Group A (N=43) and Group B (N=25). There were no statistically significant differences identified between the two groups for both demographical and clinical data (p>0.05). Statistically significant differences have been identified for the number of hypotensive episodes (p = 0.011, 95% CI 0.1851 to 0.7042) and for the number of episodes of bradycardia (p < 0.0001, 95% CI 0.3296 to 0.7923). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI -0.3942 to 0.9047). Conclusions: The implementation of the multimodal monitoring protocol that includes the standard parameters and the measurement of Entropy for determining the depth of anesthesia (SE and RE) lead to a considerable improvement in perioperative hemodynamic stability. Optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient leads to a considerable decrease in drug consumption as well as to a lower incidence of hemodynamic side-effects.

Literature data on Legionella spp. presence in houses water networks have been increasing during the last years, but epidemiological reports assert a high incidence of Legionnaires’ disease infection in Italy. Updating our previously published data, we report a five-year survey on Legionella spp. colonization in 235 buildings with an independent hot water production (IB); 82 buildings with a central hot water production (CB); and 58 buildings with a solar thermal system for hot water production (TB). In all the 375 buildings Legionella spp. was researched in hot and cold water samples and microbiological potability standards of cold water were evaluated. Legionella spp. was detected in 27% of the water networks, mostly in CB and TB. We detected correlations between the presence of bacteria and some physical-chemical parameters (low chlorine level and optimal temperature for Legionella spp. growth). Cold water resulted free from microbiological hazards, except for coliform bacteria isolated in three separate cases, and Legionella spp., detected when cold water temperature was about 20°C. After a five-year survey we confirm the presence of a Legionnaires’ disease risk and the need of training programs for all the workers involved in residential water systems management.

Landslides are a frequent and recurrent problem in hilly regions of India and predicting them is always a challenging task. In this paper, an attempt was made to deal with this problem using advanced physical and numerical modeling methods. Detailed understanding of the initial slope failures is very interesting, and challenging at the same time, in the design and development of wireless sensor network based on early warning of landslide monitoring. A small scale physical model was developed to assess the instability through a sensor network with variable rain fall intensity. This was achieved by increasing the simulated rain water flow intensity in different time spans (dry condition, at t=0 to t= 30 min, 0.5 mm/min at t=30 to t= 60 min, 0.75 mm/min at t=60 to t=91 min and 1 mm/min at t=91 to t= 120 min). The water level and movement in the slope was recorded by rainfall sensor, vibration sensor, soil moisture sensor and a digital camera. The following changes were observed during the slope failure: a) movement of small particles at top of the slope; b) initial failure of medium size soil particle; c) scouring of soil mass; d) whole slope collapse. The obtained results clearly indicated the superiority and effectiveness of the proposed system in providing a factor of safety for the progressive slope.

Fire accidents are common accidents amongst residential house occupants in Libya. Some of the factors that can mitigate fire accidents in Libyan residential houses include fire safety awareness and knowledge. This study investigated the level of awareness and knowledge of fire safety amongst residential house occupants in Libya. The possibility and consequences of fire hazards and risk existing in residential houses in Libya were also studied. Experimental data obtained for 1.5 m/s and 3.5 m/s as walking and running evacuation time, respectively amongst residential house occupants in Libya were also compared. The sample consist of 90 respondents with instruments of fire safety awareness and knowledge, fire hazard and consequences, and the involvement of residential house occupants in fire emergency. Statistical analysis was performed at p < 0.05 to determine the levels of residential awareness and knowledge regarding fire safety and the hazard and consequences. The findings illustrated that the items were highly reliable (α > 0.7) and normally distributed. Also, the results illustrated that the majority of residential house occupants in Libya have fair level of fire safety awareness and knowledge with overall percentage of 80% and 90%, respectively. On the other hand, the results further showed that majority of residential house occupants have good level of fire emergency involvement with 90%. This paper proposes a fire safety assessment method which may form the basis of future fire safety practice in Libya.

Background: To investigate any associations between new clinical policies implemented because of the COVID-19 pandemic and harm to patients. Methods: Retrospective data collection of incidents and complaints reported through Datix®, and the Patient Liaison Service respectively. The setting was the Family Health division in a University teaching hospital in the UK. Primary and secondary outcome measures included; Proportion of incidents reported on Datix from 23/3/20 to 25/5/20, compared to the period from 23/3/19 to 29/5/19. COVID-19 related incidents and complaints and association with newly published guidelines or pathways from 23/3/20 to 29/5/20. Results: There was no significant difference in the proportion of overall patient activity resulting in incidents reported on Datix in 2020 (2.08%) compared to 2019 (2.09%), with 98% resulting in no/low harm in 2020. Three incident categories had increases in relative proportions of incidents including terms “COVID” or “Corona” compared to incidents that did not; “Child death”, “delay/failure to treatment and procedure” and “information governance”. One of the child deaths was a miscarriage and we were unable to link the second child death to a change in clinical policy at this stage. We were only able to link 2 COVID-19 associated incidents with a pathway or procedural change (one to the Children's Emergency Department admission pathway and the second to the introduction of virtual antenatal clinics). Eighteen complaints related to COVID-19 were logged. However, at this stage, we are unable to link any of these to a published change in clinical policy. Conclusions: Practice in the division was overall deemed to be safe in the designated period, with only 2 COVID-19 related incidents clearly related to a change in pathways and procedures. Continued surveillance and improved metrics for monitoring the impact of changes to pathways and procedures should be sought with the sustained presence of COVID-19 in clinical areas.

Photoelectrochemical systems have the potential to contribute to de-carbonation of the energy system because solar energy can be directly converted to hydrogen which can be burnt without the release of greenhouse gases. However, meaningful deployment of photoelectrochemical (PEC) technology in the global energy system, even when highly efficient scaled up devices become available, shall only be a reality when their safe and reliable operation can be guaranteed over serveral years of service life. The first part of the review discusses the importance of hermetic sealing of up scaled PEC device provided by the casing and sealing joints from a reliability and risk perspective. The second part of the review presents a survey of fully functional devices and early demonstrators and uses this to establish the extent to which the state of the art in PEC device design address the issue of hermetic sealing. The survey revealed that current material choices and sealing techniques are still unsuitable for scale –up and commercialization. Accordingly, we examined possible synergies with related photovoltaic and electrochemical devices that have been commericalised and derived therefrom, recommendations for future research routes that could accelerate the development of hermetic sealings of PEC devices.

Bacteriophages can provide alternative measures for the control of E. coli O157:H7 that is currently an emerging food-borne pathogen of severe public health concern. This study was aimed at characterising E. coli O157:H7 specific phages as potential biocontrol agents for these pathogens. Fifteen phages were isolated and screened against 69 environmental E. coli O157:H7. Only 3 phages displayed broad lytic spectra against environmental shiga toxin-producing E. coli O157:H7 strains. These 3 lytic phages were designated V3, V7 and V8. Subsequent characterization indicated that they displayed very high degree of similarities despite isolation from different locations. Transmission Electron microscopy (TEM) of the phages revealed that they all had isometric heads of about 73 – 77 nm in diameter and short tails ranging from 20 - 25 nm in diameter. Phages V3, V7 and V8 were assigned to the family Podoviridae based on their morphology. Pulsed field gel electrophoresis (PFGE) genome estimation of the 3 phages demonstrated identical genome sizes of ~ 69 nm. The latent periods of these phages were 20 min, 15 min, and 20 min for V3, V7 and V8 respectively while the burst sizes were 374, 349 and 419 PFU/ infected cell respectively. While all the phages were relatively stable over a wide range of salinity, temperatures and pH values, their range of infectivity or lytic profile was rather narrow on environmental E. coli O157:H7 strains isolated from cattle faeces. This study showed that the Podoviridae bacteriophages are the dominant E. coli O57:H7-infecting phages harboured in cattle faeces in the North-West Province of South Africa and due to their favourable characteristics can be exploited in the formulation of phage cocktails for the bio-control of E. coli O157:H7 in meat and other meat products.

The incorporation of unmanned aircraft terminal operations into the scope of Detect and Avoid systems necessitates analysis of the safety performance of those systems—principally, an assessment of how well those systems prevent loss of well clear from and collision with other aircraft. This type of analysis has typically been conducted by Monte Carlo simulation with synthetic, statistically representative encounters between aircraft drawn from an appropriate encounter model. While existing encounter models include terminal airspace classes, none explicitly represents the structure expected while engaged in terminal operations, e.g., aircraft in a traffic pattern. The work described herein is an initial model of such operations, scoped at this time specifically for assessment of unmanned aircraft landings and encounters with other aircraft either landing or taking off. The model shares the Bayesian network foundation of other MIT Lincoln Laboratory encounter models but tailors those networks to address structured terminal operations, i.e., correlations between trajectories and the airfield and each other. This initial model release is intended to elicit feedback from the standards-writing community.

This article presents the integration of lean 6S methodologies and hazard analysis and critical control points (HACCP) in the food production sector. Through the study, it is seen that non-food industrial production is not very different from that of food and, in many cases, it assimilates protocols and ideas that are already working in the food industry; Such is the case of risk analysis, critical control points or hygiene, which are part of the food production protocol and, increasingly, of the industry in general. After the integrative analysis, the article proposes a common lean 6S - HACCP model, which can be used both in food production and in non-food industrial production.

Coastal tourist nursing is intended for coastal tourists related to the risk of accidents that may occur during the coastal activity. The risk of accidents in tourists can occur due to bad weather, lack of rescue equipment, and the limited ability of the coast guard to perform first aid and emergency treatment. This study described the relationship between coastal tourist nursing with the prevention of injuries and the first aid of coastal accidents, as well as the working procedures and obstacles that might occur during the rescue. The research was conducted by the qualitative method through in-depth interviews with respondents consisting of tourists, Balawista, and health workers. The data is analyzed with qualitative descriptive analysis. The interview generates 14 themes related to activities on coastal such as the duties of Balawista, warning signs, means of communication, improvement of ability, accident cases, accident treatment, referral of cases, needs of infrastructure facilities, human resources needs, health care needs, infrastructure factors, human factors, situation factors, and how to cope with the problem. Those themes can be used as a reflection in following up the safety service efforts to coastal tourists.

An internationally acknowledged requirement is to analyze and provide technical solutions for prevention and safety during use and maintenance of manure spreader wagons. Injuries statistics data and specific studies show that particular constructive criticalities have been identified on these machines, which are the cause of serious and often fatal accidents. These accidents particularly occur during the washing and maintenance phases, especially when such practices are carried out inside the hopper when the working bodies of the machine are in action. The current technical standards and the various safety requirements under consideration have not always been effective for protecting workers. To this end, the use of SWOT analysis allowed to highlight critical and positive aspects of the different solutions studied for reducing the risk due to contact with the working bodies. The selected and tested solution consists in a decoupling system automatically activated when the wheels of the wagon are not moving. Such a solution prevents the contact with the moving working bodies of the machine when the worker is inside the hopper. This mechatronic solution allowed to obtain a prototype that has led to the resolution of the issues related to the use of the wagon itself: in fact the system guarantees the stopping of manure spreading organs in about 12 seconds from the moment of the wheels stopping.

We are witnessing a progressive divestment of some institutions with strong traditions and skills in physical modelling and their consequent impoverishment, to the detriment of numerical modelling. For many reasons, the economic imperatives and the exponential growth of computational means and numerical methods should certainly not be excluded. In this work, we aimed to highlight the new requirements of the recent sophisticated developments in physical modelling, precisely due to the new needs imposed on them by mathematical and numerical modelling and the growing risks in civil construction works. In this context, reflections are reported, justified by scientific and real-world examples, on the need for maintenance and reinforcement of investments in physical modelling, both to support the scientific community and to design buildings of significant economic, social and environmental impact.

Coronavirus is now a significant human pathogen with the emergence of SARS-CoV-2. Until now there has been no data to support a threat to agricultural industries. Using a comparative genomic protein analysis, this study examined the angiotensin-converting enzyme II (ACEII) gene of 17 animal species with an emphasis on agriculture. To determine viral vulnerability the 20 known SARS-CoV-2 receptor-binding domain (RBD)/ACEII receptor interaction sites were compared to determine their potential susceptibility to the SARS-CoV-2 virus. With the known bat host’s (XP_032963186) number of binding sites as a threshold, we note that ALL animal species examined in this study contained significant numbers (≥10) of SARS-CoV-2 binding sites and could be at risk for SARS-CoV-2 infection. The data from this study suggest SARS-CoV-2 imposes a grave threat to the safety and security of the agricultural industry. Urgent studies are needed to determine if infected animals can transmit SARS-CoV-2 before and/or after processing.

Adenine and thymine homopolymer strings of at least 8 nucleotides (AT 8+mers) were characterized in Salmonella entericasubspecies I. The motif differed between cother taxonomic classes but not between Salmonella enterica serovars. The motif in plasmids was associated with serovar. Approximately 12.3% of the S. enterica motif loci had mutations. Mutability of AT 8+mers suggests that genomes undergo frequent repair to maintain optimal gene content, and that the motif facilitates self-recognition; in addition, serovar diversity is associated with plasmid content. A theory that genome regeneration accounts for both persistence of predominant Salmonella serovars and serovar diversity provides a new framework for investigating root causes of foodborne illness.

Background: Recent disasters have demonstrated gaps in employers’ preparedness to protect employees and promote their well-being in the face of emergencies and disasters affecting the workplace and their communities. Total Worker Health (TWH), a comprehensive perspective developed by the National Institute for Occupational Safety and Health, is a helpful framework for addressing employer preparedness. It includes attention to health and safety at work, and the promotion of the health and well-being of the employee in the context of social determinants of health, such as work-life balance. Methods: TWH concepts, including the domains of TWH and the TWH Hierarchy of Controls, were investigated for their relevance to protecting employees and promoting their well-being during and after crises such as weather disasters, pandemics, and acts of terrorism. Building upon TWH concepts, an employer preparedness framework and model is proposed. Findings: The Model emphasizes upstream prevention, workplace-community linkages, social and economic impacts, and employer leadership through a cyclical planning process. Conclusions/Application to Practice: The Model can assist employers in advancing their preparedness for all hazards through self-assessment and planning agendas based upon the proposed domains.

Car parking is a challenging part of urban transportation and the traffic violations around it cause many problems for citizens. In recent years, due to the fast growth and development of urbanization, temporary and unauthorized stopping of cars along the streets, especially in large cities, has led to an increased traffic, urban disorders, dangers for citizens, and violation of rules. Studies have shown that there is a direct relationship between vehicle parking violations and urban places. GIScience capabilities and tools play an important role in analysing the spatial distribution of these violations. In this study, we investigated the spatial distribution of vehicle violations in a region of Tehran, Iran that is suffering from a heavy traffic load and heavily polluted air. Although two dissimilar urban segregations exist in the north and south of the study area, our analysis indicates a similar pattern of car parking violations. In both of the areas, about 70% of all curb parks are legal, while the remaining are illegal. Also, spatial analysis reveals a direct relationship between some POIs and the occurrence of car park violations so that the density of legal curb parks is high near some POIs, and less near some others and vice versa. For example, the number of vehicle park violation around the hospitals is more than the average of the study area. However, the number of park violations around the universities is less than the average. Our findings reveal that co-location of certain POIs, for instance a hotel and a supermarket will lead to an increase in the number of park violations. In other words, there is a strong correlation between the type of POIs and curb-parks violations. Our results also show that POIs have an impact radius that leads to violations occurring in that area. For example, the area of the impact of a hospital on the creation of car park violations was estimated at 125 meters. Our presented approach along with the discussed findings along with conclusions can be useful to a large range of stakeholders including urban planner, traffic police departments, local municipalities, law enforcement agencies, and environmentalists to have a better perspective of infrastructure planning.

This study employed a deductive research approach and a survey strategy to assess risk perception and its influencing factors among construction workers in Malawi. Three specific construction hazards and their associated risks were selected. The hazards were ‘working at height (WAH) ‘manual handling of loads (MHL)’ and ‘heavy workload or intense pressure to be more productive (HWP)’. The study engaged multistage sampling of 376 subjects. Univariate analysis, factor analysis and multiple linear regressions were performed in order to determine the main influencing factors among the independent variables. The study established that workers were aware of risks posed by their work. They perceived the risk associated with WAH, MHL and HWP as very high (62.7%, = 8.80 ± 1.95); (48.5%, = 8.10 ± 2.38); (57.9%, = 8.49 ± 2.22) respectively. The study identified six factors as variables that showed significant effect on workers’ perception of risk (p < 0.05). These factors were “dreaded factor”, “avoidability and controllability”, “expert knowledge”, “personal knowledge”, education level and age. It is concluded that contractors in the Malawian construction industry should integrate analysis of behaviors and risk perception of the workers and other players to guide the identification of better health and safety interventions at their worksites.

Metastases cause high mortality in several cancers and immunotherapies are expected to be effective in the prevention and treatment of metastatic disease. However, only a minority of patients benefit from immunotherapies. This creates a need for novel therapies that are efficacious regardless of the cancer types and metastatic environments they are growing in. Preclinical immuno-oncology models for studying metastases have long been limited to syngeneic or carcinogenesis-inducible models that have murine cancer and immune cells. However, the translational power of these models has been questioned. Interactions between tumor and immune cells are often species-specific and regulated by different cytokines in mice and humans. For increased translational power, mice engrafted with functional parts of human immune system have been developed. These humanized mice are utilized to advance understanding the role of immune cells in the metastatic process, but increasingly also to study the efficacy and safety of novel immunotherapies. From these aspects, this review will discuss the role of immune cells in the metastatic process and the utility of humanized mouse models in immuno-oncology research for metastatic cancers, covering several models from the perspective of efficacy and safety of immunotherapies.

Background: Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory infection globally. There are vaccines in pipeline to prevent it but a systematic review on immunogenicity and safety of vaccine is lacking. Methods: This systematic review of RSV vaccine clinical trials was undertaken using 4 databases. Searches were conducted using both controlled vocabulary terms such as ‘Respiratory Syncytial Virus, Human’, ‘Respiratory Syncytial Virus Infections’, ‘Respiratory Syncytial Virus Vaccines’, ‘Immunization’, ‘Immunization Programs’ and ‘Vaccines’ and corresponding text word terms. The searches for published papers were limited to clinical trials published from January 2000 to August 6th, 2018. RSV infection case was defined as RSV associated medically attended acute respiratory illness (MAARI) or RSV infection by serologically-confirmed test (Western Blot) during the RSV surveillance period. We calculated the relative risk of each vaccine trial with RSV infection case. Results: Of 4395 publications, 24 were included and data were extracted covering 4 major types of RSV vaccine candidates, these being live-attenuated/chimeric (n=9), recombinant-vector (n=10), subunit (n=1) and nanoparticle vaccines (n=4). For RSV infection cases, 7 trials were involved and none of them showed a vaccine-related increased MAARI during RSV surveillance season. Conclusion: LID ∆M2-2, MEDI M2-2, and RSVcps2 (live-attenuated) were considered the most promising vaccine candidates in infant and children. In the elderly, a nanoparticle F vaccine candidate was considered as a potential effective vaccine. Although no promising vaccine was identified from pregnant-women test, RSV F-024 subunit vaccine candidate and an RSV F nanoparticle vaccine showed encouraging results in healthy non-pregnant women.