Google Trends data can be informative for infectious disease incidences, including Lyme disease. However, the use of Google Trends for predictive purposes is underutilized. In this study, we tested the ability of Google Trends search data to predict monthly state-level Lyme disease case counts in the United States. We requested Lyme disease data for the years 2010-2021. We downloaded Google Trends search data on terms for Lyme disease, symptoms of Lyme disease, and diseases with similar symptoms as Lyme disease. We built mixed negative binomial models based on a training dataset (2010-2016) and tested the models on a test dataset (2017-2021). A model was built for each search term and monthly lags of search terms were included as predictors. The highest performing models had high predictive ability, indicated by low Root Mean Squared Errors (RMSEs) and close association between observed and predicted case counts. The highest performing model was for the search term “Summer Flu”, which indicates low specificity of some of the terms. We outline challenges of using Google Trends data, including data availability and a mismatch between geographic units. We discuss opportunities for Google Trends data, including prediction of additional zoonotic diseases and incorporating environmental and companion animal data.

(1) Background: Environmental and public health research has given considerable attention to the impact of air quality on brain health, with systematic reviews widespread. No literature review has been done for cognitive frailty – a multidimensional syndrome combining physical frailty and cognitive impairment and their apparent co-dependence, linked to increased vulnerability and adverse health outcomes, including dementia. Instead, cognitive decline and frailty is implicitly explored through research on air quality and comorbid cognitive and physical decline in elderly populations. (2) Methods: A scoping review was conducted to explore the need for a systematic review. Combining Arksey and O’Malley [1] and PRISMA-ScR checklist [2], a scoping review of SCOPUS using ‘cogniti*’ + ‘resilience’ + ‘air quality’ or ‘cogniti*’ + ‘ageing’ + ‘air quality’ resulted in N=2503 articles, screened and reduced using inclusion and exclusion criteria, to N=16 articles. (3) Results: Air quality appears to be a critical risk factor for cognitive decline, even at air quality levels below WHO targets. Moderate long-term ambient air pollution appears linked to increased risk of cognitive frailty, suggesting earlier and more active interventions to protect older people. There are varied effects on cognition across the life course, with both emotional and functional impacts. Effects may be more detrimental to elderly people with existing conditions, including economic and health inequalities. Generalisation of results is limited due to the absence of a dose-response, variations in methods, controlling for comorbid effects, and variance across studies. (4) Conclusions: The findings support the need for more research and a more extensive summary of the literature.

Wildfires are a rising environmental threat which health impact remains poorly documented, in particular beyond the fire period. This ecological study investigates changes in health conditions before, during, and after two consecutive wildfires that occurred in France´s Gironde district in the summer 2022. Electronic records from the district´s emergency medical communication centre were used to identify calls with respiratory and cardiovascular diseases, and two specific subgroups of those, asthma (all ages and 0-5 years) and cardiac arrest, respectively. Compared to before the fires, respiratory disease cases were fewer during each fire (OR = 0.85, 95% CI: 0.79, 0.90 and OR = 0.62, 95% CI: 0.58, 0.67, respectively), cardiovascular disease cases, more common during the second fire, and asthma cases, higher following the fires (ORall ages= 1.85, 95% CI: 1.56, 2.21 and ORchildren= 3.52, 95% CI: 2.62, 4.80). Asthma cases also rose during the same calendar time in 2021, but to a lesser extent. In sum, except for asthma, emergency calls data in Gironde reveal few significant potentially smoke-related symptoms around fire periods, apart from post-fire asthma. Whether the effects are smoke- or season-related remains to be determined, preferably using additional data sources.

The public health risk associated with the autopsy unit is high and information on indoor microbial air contamination is limited. Airborne pathogenic fungi thrive in moist indoor environments similar to autopsy room conditions. They spread through spores, cause infections in immunocompromised patients, and exhibit resistance to antimicrobials, making them a public health threat. This study profiled fungi circulating in the indoor air of a referral autopsy unit in Accra, Ghana. The different sections of the unit were sampled using the standard open plate technique. Fungal isolates obtained were phenotypically and molecularly characterized. The resistance to fluconazole and itraconazole, as well as a germicide used in routine cleaning of the unit, was tested using broth microdilution assays. Fungi isolated include species of clinically relevant strains of Candida and Aspergillus; also, Penicillium spp. and Mucor spp. They exhibited high levels of resistance to fluconazole and itraconazole, as well as Denzal® germicide used in routine cleaning of the autopsy unit. This study is the first to profile the fungal diversity of an autopsy unit in Ghana, and the findings suggest that workers might be exposed to fungi with high pathogenic potential that could cause infections.

The purpose of this study was to compare players anthropometric (AP) and body composition (BC) characteristics between different maturity bands (pre-PHV, circa-PHV, post-PHV)) in youth elite football. This study considered 320 male football players (mean age 13.8 y.) from U14 (n=157) and U15 (n=163) age-groups. The Khamis-Roche method was used for calculating the percentage of predicted adult height (PAH) at the time of observation based on which the players were further divided into maturity bands (pre-PHV ≤ 87%, circa-PHV = 88-95%, post-PHV > 95%). Height and weight were measured, body mass index (BMI), fat free mass (FFM), total body water (TBW), body fat mass (BFM), percentage of body fat (%BF), skeletal muscle mass (SMM), FFM of both upper limbs and lower limbs and FFM of trunk were estimated according to In-body 270. All observed AP and BC characteristics differed between maturity bands (F= 139.344 – 7.925; p< 0.001; large effect sizes) except the BFM (F= 2.998; p=0.051; small effect size). Current somatic maturity stage of athletes should be considered while evaluating BC results, otherwise there is a risk of misinterpretation.

The study aimed to investigate the effect of climate change exposure on affect and pro-environmental behavioural intentions in a randomised controlled trial. An online survey was completed by 100 adult participants and included measures of affect and pro-environmental behavioural intentions pre- and post-exposure. Participants were randomly allocated to a group that saw a climate change video (n=55) or a group that saw a non-climate change video (n=45). The findings showed were that participants in the climate change group showed a significant increase in negative affect and pro-environmental behavioural intention scores post-video exposure compared to the non-climate change video group. This suggests that climate change video exposure negatively influences affect but also potentially increases the intention to act pro-environmentally. These findings have the potential to support policies and societal change, however further investigation into the type of contents, actual behaviour change, and impacts on diverse populations (e.g., minority groups) is needed that influences pro-environmental behaviours is required. Furthermore, to achieve a greater impact, future research should be conducted measuring actual pro-environmental behaviour change, including with those from diverse populations.

(1) Background: The rapid expansion of 4G and 5G networks has raised public concerns about potential health risks associated with electromagnetic radiation. This study addresses these fears by investigating electromagnetic measurements in crowded squares, where human exposure is heightened. Despite rigorous scientific methodologies showing generally low levels of radiation from these technologies, public apprehension persists; (2) Methods: We conducted 496 measurements in Larissa's major squares, using a portable field strength analyzer and GIS mapping. Squares were categorized by traffic and population density; (3) Results: Low-traffic squares exhibited exposure ratios consistently below ICNIRP limits, with median values of 0.0012 and 0.00173 in non-active and active mobile phone cases, respectively. In high-traffic squares, the median exposure ratio was 0.00335 in non-active mobile phone cases, remaining below recommended limits; (4) Conclusions: These findings indicate no significant risk of electromagnetic radiation in crowded squares in Larissa, emphasizing the importance of factual communication and dispelling public misconceptions.

In the context of sustainable development, integrating the work aspect into health promotion systems is essential, ensuring that employees maintain a healthy balance between their professional and personal lives, which respects and amplifies the potential of every individual. Lately, there has been a noticeable shift of medical professionals from the public to the private sector. This trend paints a bleak picture, highlighting the vulnerabilities of a system teetering on the brink of failure, with significant impacts on patient care. Among the myriad reasons behind this shift, burnout stands out prominently. Medical professionals face increasing pressures due to understaffing, limited organizational support, and insufficient resources, leading to feelings of cynicism, exhaustion, and detachment from their roles. Utilizing the Maslach et al. questionnaire, we assessed the risk of burnout among physicians in public hospitals to identify and underscore preventive measures and improvements, correlating our findings with key aspects of organizational empowerment. Our research indicates that enhancing interpersonal relationships and resources—both within teams and between the organization and its physicians—is crucial for the revival of the healthcare system. This approach aims at improving the delivery of healthcare services and offering appropriate recognition to healthcare professionals, aligning with the principles of sustainable employment.

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between February 1, 2021, through February 28, 2022, two paramedic-supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high interrater agreement across the dimensions (k=0.73-0.83), and after resolving discrepant cases, we found that 1 in 4 violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience in the course of their work and its potential for psychological harm.

This study explores how young people’s mental health was affected by the COVID-19 pandemic using artwork and semi-structured interviews. This is important to understand so that policy and practice professionals can support those affected, prepare, and respond to future crises, and support young people who are isolated and restricted in other contexts. Co-designed participatory art workshops and interviews were conducted with 16–18-year-olds (N = 21) from the London-based Longitudinal cohort Study of Cognition, Adolescents and Mobile Phones (SCAMP). Artworks and interview transcripts were qualitatively co-analysed with young people. From interviews, six themes were identified: adaptation, restriction, change, challenges, overcoming adversity, and lockdown life. From artwork, four themes were identified; trapped, negative mental wellbeing, positive emotions, and technology. Everyday factors such as home environment, relationships, hobbies, habits, and education or work were key determinants of how challenged and restricted participants felt, and their capacity to overcome this. This implies that young people’s mental health services should collaborate with other sectors to address wider life determinants in a holistic way, and that clearer guidance and support in these areas could mitigate the negative mental health impacts of major environmental changes on young people.

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

Enteric infections are a major public health concern. Detecting risk areas requires a strong surveillance system for pathogenic viruses in possible sources such as wastewater. To build an environmental surveillance system, we aimed to identify group A rotavirus (RVA) and human adenovirus (HAdV) in wastewater. We also focused on three different methods of viral concentration to determine suitability for a regular surveillance system. We screened 20 wastewater samples for HAdV and RVA using quantitative polymerase chain reaction (qPCR) and conventional polymerase chain reaction (cPCR). Sixteen posi-tives (18/20) and ten (14/20) positives for HAdV and RVA, respectively, were obtained on qPCR, representing a prevalence of 90% and 70%. Twelve (12) positives were successfully amplified. Bag-mediated filtration system (BMFS) and skimmed milk (SM) flocculation were the most consistent viral concentration methods for HAdV and RVA, respectively. Human adenovirus was identified with nucleotide identity range of 98.48% to 99.53%. Statistical analysis of positives showed that viral burden differed by site (P

2003 it is shown that after the Chernobyl accident, childhood leukemia by single age and year of birth in the 0-4y cohort increased significantly in Wales and Scotland combined in the period 1986-1990 compared with controls born 1970-1985 and 1991-1994. Relative risk RR = 1.41; 95% CI 1.20<RR<1.65; p = 0.00004. These exposure periods were chosen because whole body Caesium-137 monitoring had demonstrated that internal exposures persisted for more than 4 years. The dose-response exhibits saturation and reversal, interpreted as biological censoring effects in the developing individual.

(1) Background: Mpox was declared an international public health emergency by WHO. Initially, Smallpox vaccine in Italy was offered only to laboratory personnel at direct risk of infection. Currently, Healthcare workers (HCWs) are all considered by European Centre for Disease Prevention and Control (ECDC) to be at low or moderate risk. (2) Methods: To assess smallpox vaccination coverage among HCWs in an Italian hospital with different levels of risk of exposure to Mpox infection and to assess their attitudes toward vaccination, a self-report was administered to HCWs stratified at high and low/moderate risk. (3) Results: Of the 338 HCWs evaluated, 60.36% provided the requested data; among them the percentage of previously vaccinated staff was 38.7%, which corresponds to 23.4% of the total HCWs in the departments considered. Considering those born before 1979 as vaccinated, vaccination coverage increases from 23.4% to 41.4%. The department with the highest percentage of vaccinated is infectious diseases (60.5%); The percentage of HCWs who adhered to vaccination is 23%; only 8.8% of laboratory staff want to vaccinate, compared with 100% of midwives. The department with the highest percentage of vaccination adherence is proctology (85.7%). (4) Conclusions: Given the vaccination adherence rate and the vaccination coverage of the departments analyzed, it would be useful to extend vaccination against Smallpox to frontline HCWs involved in patient care in Italy too.

Historically, viral hepatitis is a considerable public health problem in Central Asian countries, which may have worsened after dissolution of the Soviet Union. However, up-to-date seroepidemiological studies are lacking. The aim of the present study was, therefore, to provide current estimates of seroprevalence of viral hepatitis in Kyrgyzstan, one of the economically least developed countries in the region. We conducted a population-based cross-sectional study in 2018 in the capital of Kyrgyzstan, Bishkek (n=1075). Participants, children and adults, were recruited from an outpatient clinic. Data were collected during face-to-face interviews. A blood sample (6 ml) was collected from each participant and tested with ELISA for the presence of serological markers for five viral hepatitides (A, B, C, D and E). Poststratification weighting was performed to obtain nationally representative findings. The overwhelming majority of the study participants were positive for anti-HAV (estimated seroprevalence, 75.3%; 95% confidence interval: 72.5–77.9%). The weighted seroprevalence estimates of HBsAg, anti-HCV and anti-HDV were 2.2% (1.5–3.3%), 3.8% (2.8–5.1%), and 0.40% (0.15–1.01%), respectively. Anti-HEV seropositivity was 3.3% (2.4–4.5%). Of the 33 HBsAg positive participants, five (15%) were anti-HDV positive. Our study confirms that Kyrgyzstan remains a high endemic country for hepatitis virus A and C infections. However, seroprevalences of HBV and HDV were lower than previously reported, and based on these data, the country could potentially be reclassified from high to (lower) intermediate endemicity. The observed anti-HEV seroprevalence resembles the low endemicity pattern characteristic of high-income countries.

(1) Background: Human-generated greenhouse gas (GHG) emissions are the largest contributor to climate change worldwide. Climate change negatively impacts human and planetary health threatening the existence of life on earth. The healthcare industry is responsible for approximately 8.5% of carbon emissions in the United States. Measuring baseline GHG emissions is the first step in emissions reduction. However, very few models of measurement exist for health care organizations. This project aimed to develop and implement a program to measure and track GHG emissions at a Midwestern Academic Medical Center (MAMC) and to educate staff to manage the process. (2) Methods: A Plan, Do, Study, Act (PDSA) cycle and Quality Improvement methodology was used to develop, implement, and assess a standardized GHG emission inventory process to measure Scope 1 and Scope 2 baseline emissions, and provide virtual training and education to the accountable staff. A pre- and post-survey design was used to measure the knowledge and readiness of the staff after the implementation of the GHG inventory training. (3) Results: The GHG inventory process was validated through an external verification process and the measurement of Scope 1 and Scope 2 baseline GHG emissions was completed and verified for accuracy through a data comparison review. The pre-post-training survey showed an increase in the knowledge and readiness of staff in maintaining a GHG inventory. (4) Conclusions: This work shows the feasibility of obtaining baseline GHG emissions data at large medical centers. It represents the initial phase of the overarching goal to develop site-wide and system-wide carbon reduction strategies and a climate action plan within this health system.

The aim of the research presented here is to assess the impact of depressive disorders on the potential of the labour markets in the countries of the European Union, with particular reference to the disparities between the 'old' and 'new' EU countries. The initial hypothesis of persistent inequalities in the system under study was verified by analysing the process of convergence in the burden of depressive disorders among people aged 20-54 that occurred in the EU-27 group of countries between 1990 and 2019. The study used data from the Global Burden of Disease Study 2019 (IHME, 2020), which examined the number of years lived with disability (YLD) due to depression in the working age population. The analysis showed that the high burden of the consequences of depressive disorders is particularly true for the highly developed economies of the EU-14. The results of the convergence assessment did not confirm the real effect of catching up over time with economies in a more favourable situation, and the inequalities observed at the beginning of the analysis period deepened..

There is a noticeable absence of health education among college students. This study aimed to evaluate the extent of general nutrition knowledge among Chinese university students and explore its association with eating attitudes. Data were collected from a group of 273 students in Spring of 2023, using a valid and reliable research instrument consisting of three sections: demographic variables, the General Nutrition Knowledge Questionnaire (GNKQ), and the Eating Attitudes Test (EAT-26). The results were analyzed using SPSS, with correlations and t-tests to examine the relationships between nutritional knowledge and dietary attitudes. Furthermore, the present study employed the Random Forest (RF) algorithm, a machine learning technique, utilizing the Mean Decrease Impurity (MDI) method to investigate the influence of various features on participants' eating attitudes. The findings revealed that Chinese university students had an average accuracy of over 60% in their nutritional knowledge, but their understanding of the relationship between diet and disease still needs improvement. Moreover, male students had significantly lower nutritional knowledge than female students, and there was a positive correlation between nutritional knowledge and parents’ income. The study also found a significant correlation between the level of nutritional knowledge and eating attitudes. RF results indicated that family income level exhibited the most substantial impact on the eating attitudes of the participants. The study highlights the need for nutrition education curriculum developers to focus more on improving students' nutritional knowledge, with particular attention given to male students, low-income individuals, and those with an abnormal BMI.

This work proposes a hollow-core photonic crystal fiber-based edible oil sensor in the terahertz (THz) range (e.g., 1.0THz ≤ f ≤ 3.0THz) and different sensing characteristics are numerically analyzed. The suggested sensor’s performance was assessed by means of COMSOL Multiphysics, a commercial program that uses the finite element approach. The computational results indicate that the relative sensitivity is 85.591%, 84.648%, 82.625%, 82.683%, and 79.161%, respectively, at f = 2.2 THz, for several types of sunflower oil, mustard oil, coconut oil, olive oil and palm oil; and the corresponding effective areas are 7.22×10-8 um2, 7.09×10-8 um2, 6.83×10-8 um2,7.09×10-8 um2, 6.5231 ×10-8 um2. In addition, the effective material loss for sunflower oil, muster oil, coconut oil, olive oil, and palm oil has been found to be 0.02561 cm-1, 0.027054 cm-1, 0.030322 cm-1, 0.028854 cm-1 ,0.035427cm-1 respectively. Moreover, the proposed sensor also has low confinement loss are 1.55×10-8 dB/m, 1.63×10-8 dB/m, 1.31×10-8 dB/m, 1.99×10-8 dB/m, 4.0345×10-8 dB/m.This proposed sensor can be fabricated using extrusion and 3D-printing technologies, and due to its augmented detecting capabilities, it can be a vital part of oil sensing devices implemented in real life such as industry fields.

(1) Background: Burnout syndrome results from chronic stress in the work-place. The COVID-19 pandemic has imposed a heavy workload on health professionals, doctors and nurses to respond to first-line health care during the first two years of an emergency caused by this virus. The aim of this study was to evaluate the prevalence of burnout in healthcare personnel, doctors and nurses during the COVID-19 pandemic. (2) Methods: This was a review of reviews on the prevalence of professional burnout syndrome in healthcare personnel, doctors and nurses before or during the COVID-19 pandemic, without language restrictions or missing data from the Cochrane Library electronic databases. In total, 48,657 articles were obtained from Pub-Med/MEDLINE and the Web of Science. (3) Results: After completing the examination, 20 articles were included in the review. Of these articles, 7% included nurses in their study population, 72% interviewed doctors from different specialties, and the remaining 21% reported personnel data. Healthcare as a whole: In total, 624 articles with 233,087 participants were included. Regarding the prevalence by subscale, a PD of 33% (95% CI; 33%- 34%), an AE of 37% (95% CI; 37%- 37%) and a PR of 29% (95% CI) were found. %; 29% and 29%). ; (4) Conclusions: The incidences of DP and AE are high, and that of RP is low. These findings demonstrate the high prevalence of burnout according to subscale. Burnout is a problem of great magnitude, and as such, interventions must be implemented immediately at the individual and group levels by institutions and health systems.

Cyanobacterial harmful algal blooms (CyanoHABs) are increasing in prevalence and severity globally and locally in the Great Lakes region. CyanoHABs have the potential to produce serious adverse human health effects due to the production of cyanotoxins from cyanobacteria. Common routes of exposure include recreational exposure (swimming, skiing, and boating), ingestion, and aerosolization of contaminated water sources. Cyanotoxins have been shown to adversely affect several major organ systems contributing to hepatotoxicity, gastrointestinal distress, and pulmonary inflammation. We present three pediatric case-reports that coincided with CyanoHABs exposure with a focus on presentation of illness, diagnostic work-up, and treatment of CyanoHAB-related illnesses. Potential cyanotoxin exposure occurred while swimming in the Maumee River and Maumee State Park in Northwest OH during the Summer months which coincide with peak CyanoHAB activity. Primary symptoms included generalized macular rash, fever, vomiting, diarrhea, and severe respiratory distress. Significant labs included leukocytosis and elevated C-reactive protein. All patients ultimately recovered with supportive care. Symptoms following potential cyanotoxin exposure coincide with multiple disease states representing an urgent need to develop specific diagnostic tests of exposure.

This study aimed to conduct a cross-cultural adaptation of the development of the cat-owner/dog-owner relationship scales. The method encompassed several stages: conceptual, item, semantic, operational, measurement, and functional equivalence. Processes included translations, synthesis of translations, back-translations, consensus on the English versions, external evaluation by the original authors, expert committee evaluation, and pre-tests. The study involved surveying 342 pet owners throughout Brazil using a 20-item questionnaire. Data analyses utilized confirmatory factor analysis, covariance-based modeling, and multigroup analysis. The techniques confirmed that the scale preserved its psychometric properties and showed no variance between dog and cat owners, indicating that the measured constructs are universal and unaffected by specific cultural nuances. Hence, the cross-cultural adaptation and validation of the scale facilitate applying and testing concepts and measures in diverse contexts, enriching our understanding of the dynamics between owners and their pets (dogs and cats) in different living situations. In addition, this research holds particular significance in Brazil, given the country’s vast cultural diversity.

Rare earth elements (REEs) are a type of new material resources, which have attracted significant attention in recent years. REEs have emerged as essential metals in modern-day technology due to their unique functions. Long-term large-scale mining and utilization of rare earths have caused serious environmental pollution and constitutes a global health issue, which raised concerns about human health safety. However, the toxicity profile of suspended particulate matter of REEs in the environment interacts with the human body in remain largely unknown. Studies have shown that REEs can enter the human body through a variety of pathways, leading to a variety of organ and system dysfunctions through changes in genetics, epigenetics, and signaling pathways. Through an extensive literature search and critical analysis, we provide a comprehensive overview of the available evidence, identify knowledge gaps, and make recommendations for future research directions.

Background:. Knowledge and positive perception of climate change are crucial for public participation in activities that contain climate change. Limited studies, particularly in South Africa have reported on the knowledge and perceptions of climate change by university students. Study Aim: This study aimed to assess the level of knowledge and perceptions of climate change by the science students at the University of South Africa (UNISA). Methods: This was a quantitative cross sectional survey, undertaken among science students using questionnaire emailed to 500 students in the School of Science through Unisa email system. Bivariate logistic regression was used to test the association between socio-demographics, level of knowledge and perceptions of climate change. Results: A total of 420 students participated in the study. They were predominantly male (70.3%), mostly younger than 35 years of age. Most of the respondents were in the 2nd (34.7%) and 3rd (33.8%) year of study. Majority of respondents (97.9%) knew and perceived (93.6%) that climate change was happening. Overall, 93.8% of respondents had an excellent knowledge and basic concepts of climate change. Conclusion: The majority of students were knowledgeable and had positive perceptions about the basic concepts of climate change. However, the year of study was not significantly associated with positive perceptions of climate change. There is need to include climate change modules in South African university curriculum.

Transitioning towards sustainable food systems and sustainable diets is critical in reducing environmental impact and achieving the Sustainable Development Goals established by the United Nations General Assembly. This transition requires collaborative efforts across multiple stakeholders, including the general public’s knowledge and attitudes. To assess the knowledge and attitudes towards food sustainability we carried out a cross-sectional study among Kuwait University students with a total of 278 participants aged ≥18 years (78% females and 22% males). A validated questionnaire was used for this study. Most respondents (&gt;70%) recognized the concept of “local food” and “environmental impact.” The concept “green water-blue water” was least recognized among respondents (75%). Participants perceived that a sustainable diet was rich in vegetables, included plenty of fresh products and was affordable. Participants (&gt;66%) perceived that a positive impact of meat and its derivatives towards sustainability, a misconception most common among males. Overall, participants with more knowledge about environmental concepts showed favorable attitudes towards a sustainable diet. Women showed more interest in changing their current dietary habits towards food sustainability. In conclusion, despite participants’ positive attitude towards food sustainability, lack of understanding persists, necessitating public health interventions aimed at educating consumers about sustainable diets and its impact on the environment.

A systematic review and meta-analysis were conducted to estimate the prevalence of chlamydiosis in small ruminants. The study included 133 publications that reported the presence of Chlamydia abortus in 109 and 74 studies in sheep and goats from 45 countries. The prevalence of chlamydiosis was estimated at global, regional, and national levels using meta-analyses of proportions. Meta-regression and cumulative meta-analyses were also performed. Globally, the prevalence of chlamydiosis in sheep and goats was estimated at 20.1% (95% CI: 17.8-22.4) and 14.4% (11.6-17.4), respectively. For sheep, chlamydiosis prevalence was heterogeneous at regional and national levels. South Asia had the highest prevalence (30.6%) and East Asia and Pacific the lowest (14.0%). Nationally, chlamydiosis was more prevalent in Romania, Hungary, and Germany (range 53.3-87.0%) compared to Costa Rica, Australia, and Zimbabwe (4.7-5.2%). Among goats, chlamydiosis prevalence was similar across regions (10.4-19.7%), but varied significantly among countries, 0.0% in Romania and Australia and 91.7% in Bosnia and Herzegovina. In both species, sample size, number of diagnostic techniques, and latitude were significant covariates. Prevalence varied widely in the first decades of publications before stabilizing. Our study found a high prevalence of chlamydiosis in small ruminants, with the pathogen being distributed globally but heterogeneously across countries.

The aim of the present study was to provide initial validity evidence of a Greek translation of the 24-item Brunel Mood Scale, referred to as the BRUMS-Greek, a measure of anger, confusion, depression, fatigue, tension, and vigour. Data were collected from 1,417 Greek adult exercise participants and 369 physically inactive adults, totaling 1,786 adults (male = 578, female = 1,208) aged 18–64 years (M = 34.73 ± 11.81 years). Given the large univariate and multivariate non-normality, confirmatory factor analyses treating responses as ordered categorical variables was conducted, which supported the hypothesised six correlated-factor measurement model. Internal consistency reliability of BRUMS-Greek subscales was supported via Cronbach alpha coefficients. Construct validity of scales was supported (a) via correlations in the hypothesised direction with trait positive and negative affect, (b) with more positive and less negative moods reported immediately after participation in a single exercise class compared to pre-exercise mood, and (c) with exercise participants reporting more positive and less negative mood states compared to physically inactive adults. Women reported higher tension and lower vigour scores than men. Tension scores were higher and confusion scores lower among younger participants (≤ 35 years) than older participants (≥ 36 years). Participants with obesity reported higher negative mood scores than those who were underweight or normal weight. In sum, the BRUMS-Greek demonstrated acceptable psychometric characteristics, and is proposed to be a suitable measure for use with exercise participants, physically inactive adults, and other Greek populations to explore research questions related to mood.

Cadmium (Cd) is an environmental toxicant of worldwide public health significance. Diet is the main non-workplace Cd exposure source other than smoking. The intestinal absorption of Cd involves the transporters for iron, zinc, copper, and calcium. These metal transporters essentially determine the body burden of Cd because only 0.001-0.005% of Cd accumulated in the body can be excreted in urine each day. The International Agency for Research on Cancer listed Cd as a human lung carcinogen. Current evidence, however, suggests that environmental Cd may increase the prevalence of many types of cancer, notably lung, liver, breast, pancreas, and kidney. A two-year bioassay that mimics a lifelong exposure demonstrates Cd caused neoplasms in multiple tissues of mice. Also, several non-tumorigenic human cell lines underwent malignant cell transformation, when they were exposed to a sublethal dose of Cd for a prolonged time. Cd does not directly damage DNA, but it can profoundly affect gene expression through its interactions with various proteins, and Cd can thus be viewed as a transcription modulator. The present review highlights epidemiological studies that connected an enhanced risk of various neoplastic diseases to chronic exposure to environmental Cd. Special emphasis is on the impact of body iron stores on the absorption rate of Cd, and its implications for breast cancer prevention in highly susceptible subpopulation groups of women. Resistance to cell death and other cancer phenotypes acquired during Cd-induced cancer-cell transformation, under in vitro conditions, are briefly discussed. The potential role for ZnT1 efflux transporter in cellular acquisition of tolerance to Cd cytotoxicity are highlighted.

The educational and play-related activities of children are proceeded mainly indoors in a kin-dergarten. The exposure of children to high concentrations of PM2.5 and CO2 indoors have leaded to various harmful effects and negatively impact educational outcomes in a kindergarten. Therefore, this study presents a numerical model of CO2 and PM2.5 concentration based on two classrooms in a kindergarten. Using this numerical model, we present different scenarios of oper-ating mechanical ventilation and air purifiers in kindergartens with the aim of optimizing for reducing the concentrations of CO2 and PM2.5. We found that the amount of ventilation required to maintain good air quality, per child, was approximately 20.4 m3/h. However, we also found that as the amount of ventilation increased, so did the concentration of indoor PM2.5; we found that this issue can be resolved through the use of a high-grade filter (i.e., a MERV 13 grade filter with a collection efficiency of 75%). This study provides a scientific basis for reducing PM2.5concentrations in kindergartens, while keeping CO2 levels low.

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

Cadmium (Cd) is a pervasive, toxic environmental pollutant that preferentially accumulates in tubular epithelium of the kidney. Current evidence suggests that the cumulative burden of Cd here leads to progress loss of the glomerular filtration rate (GFR). In this study, we have quantified changes in estimated GFR (eGFR) and albumin excretion (Ealb) in according to levels of blood Cd ([Cd]b) and excretion of Cd (ECd) after adjustment for confounders. ECd and Ealb were normalized to creatinine clearance (Ccr) as ECd/Ccr and Ealb/Ccr. Among 482 residents of Cd-polluted and non-polluted regions of Thailand, 8.1% had low eGFR and 16.9% had albuminuria, (Ealb/Ccr)×100 ≥ 20 mg/L filtrate. In the low Cd burden group, (ECd/Ccr) ×100 &lt; 1.44 µg/L filtrate, eGFR did not correlate with ECd/Ccr (β = 0.007), while an inverse association with ECd/Ccr was found in the medium (β =−0.230) and high-burden groups (β =−0.349). Prevalence odds ratios (POR) for low eGFR were increased in the medium (POR 8.26) and high Cd burden groups (POR 3.64). Also, eGFR explained a significant proportion of Ealb/Ccr variation among those with middle (η2 0.093) and high [Cd]b tertiles (η2 0.132), but did not with low tertile (η2 0.001). With adjustment of eGFR, age and BMI, POR values for albuminuria were increased in the middle (POR 2.36) and high [Cd]b tertiles (POR 2.74) and those with diabetes (POR 6.02) and hypertension (2.05). These data argue that ECd/Ccr of 1.44 µg/L filtrate (0.01−0.02 µg/g creatinine) could determine a Cd threshold level from which protective exposure guidelines should be formulated.

Antibiotic Resistance (ABR) is increasing the mortality and morbidity associated with infectious diseases, besides increasing the cost of healthcare, saturating health-system capacity, and adversely affecting food security. Framing an appropriate narrative and engaging local communities through ‘One Health’ approach is essential to complement the top down measures. However, the absence of objective criteria to measure the performance of ABR interventions at community settings make it difficult to mobilize interest and investment for such interventions. An exercise was therefore done to develop an indicator framework for this purpose. An exhaustive list of indicators was developed from experiences gathered through community engagement work in a local panchayat (small administrative area) in Kerala, India, and a consultative process with health, veterinary, environment, and development experts. A prioritization exercise was done, looking at appropriateness, feasibility and validity, by global experts on ABR. A 15-point indicator framework was designed based on the prioritization process. The final set of indicators covers human health, animal health, environment management and Water Sanitation and hygiene (WASH) domains. The indicator framework was piloted in the panchayat(located in Kerala), which attained a score of 34 (maximum 45). The score increased when interventions were implemented to mitigate the ABR drives, indicating the framework is sensitive to change. Simultaneously, the indicator framework was tested in four sites from three other Indian states with different socioeconomic and health profiles, yielding different scores. Those collecting the field data were able to use it with minimal training. To conclude, this indicator framework can help policymakers broadly understand the factors contributing to ABR and measure the performance of interventions they choose to implement in the community

Enterobacteriaceae can contaminate meat during various stages of processing, including slaughter, evisceration, and butchering, causing foodborne illnesses. The purpose of the study was to investigate the prevalence of Enterobacteriaceae associated with carcasses obtained from slaughterhouses and raw cut meat collected from butcher shops. A total of 120 samples of camels and cattle were identified using biochemistry and PCR testing. Total viable count (TVC) was range from 4.91 to 5.37 Log10 CFU/g in slaughterhouses and butcher shops. E. coli was predominating with 84 (70%) among all samples, where the camels had the highest with 100% and sheep the lowest with 30%. Salmonella spp. was confirmed in 40% of camel samples, 47.5% of cattle samples, and 32.5% in sheep samples. Twenty-five Enterobacteriaceae genera were confirmed using PCR. Where sheep’s samples had the highest occurrence of Enterobacteriaceae with 15 different genera followed by camels and cattle samples with 14 different genera. The prevalence of Enterobacteriaceae among camel, cattle, and sheep carcasses raises significant concerns regarding food safety. Adherence to good hygiene practices throughout animal slaughtering is crucial to minimize the risk of infection and transmission and ensure food safety.

Background Nigeria is among the top 5 countries that have the highest gap between people reported as diagnosed and estimated to have developed Tuberculosis (TB). To bridge this gap, there is a need for innovative approaches to identify geographical areas at high risk of TB transmission and targeted Active Case Finding (ACF) interventions. Leveraging community level data together with granular sociodemographic contextual information can unmask local hotspots which could be otherwise missed. This work evaluated if this approach helps to reach communities with higher numbers of undiagnosed TB. Methodology A retrospective analysis of the data generated from an ACF intervention program in 4 south-western states in Nigeria was conducted. Wards (the smallest administrative level in Nigeria) were subdivided into further smaller population clusters. ACF sites and their respective TB screening outputs were mapped to these population clusters. This data was then combined with open-source high resolution contextual data to train a Bayesian inference model. The model predicted TB positivity rates on the community level (population cluster level), and these were visualised on a customised geoportal for use by the local teams to identify communities at high risk of TB transmission and plan ACF interventions. The TB positivity yield (proportion) observed at model-predicted hotspots was compared with the yield obtained at other sites identified based on aggregated notification data. Results The yield in population clusters that were predicted to have high TB positivity rates by the model was at least 1.75 times higher (p-value <0.001) than the yield in other locations in all four states. Conclusion The community level Bayesian predictive model has the potential to guide ACF implementers to high TB positivity areas for finding undiagnosed TB in the communities, thus improving efficiency of interventions.

The Global Burden of Disease Study (GBD) 2019 reveals an increasing prevalence of Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. This study delves into the role of dietary risk factors across different demographic and socioeconomic groups. Utilizing data from the GBD 2019, it analyzes age-adjusted T2DM metrics—death counts, Disability-Adjusted Life Years (DALYs), and Age-Standardized Rates (ASR)—stratified by age, sex, and region. The study employed Estimated Annual Percentage Changes (EAPCs) to track trends over time. Results show that in 2019, 26.07% of T2DM mortality and 27.08% of T2DM DALYs were attributable to poor diets, particularly those low in fruits and high in red and processed meats. Geographic variations in T2DM trends were significant, with regions like Southern Sub-Saharan Africa and Central Asia experiencing the most substantial increases in Age-Standardized Mortality Rate (ASMR) and Age-Standardized DALY Rate (ASDR). A positive correlation was noted between Socio-Demographic Index (SDI) and T2DM burden due to dietary risk factors. The study concludes that targeted public health initiatives promoting dietary changes could substantially reduce the global T2DM burden.

The bacterial adhesion to food contact surfaces is a threat to human health, as these surfaces can serve as a reservoir of pathogenic bacteria. Escherichia coli is a biofilm-forming bacterium involved in surface contamination. Despite the application of disinfection protocols, contamination continues to occur. Hence, new effective and sustainable approaches are needed. Bacteriophages (or simply phages), viruses that only infect bacteria, have proven to be effective in reducing biofilms. Here, phage phT4A was applied to prevent and reduce E. coli biofilm on plastic and stainless steel. The assays were performed in Tryptic Soy Broth (TSB), at 25 °C. The biofilm formation capacity of phage-resistant and sensitive bacteria, after treatment, was also evaluated. Maximum reductions on E. coli biofilm of 5.5 log colony forming units (CFU)/cm2 (after 6 h) and 4.1 log CFU/cm2 (after 9 h), on plastic and stainless steel, respectively, were observed. In the prevention assays, phage prevented biofilm formation in 3.2 log CFU/cm2, after 12 h. Although the emergence of phage-resistant bacteria has been observed during phage treatment, a lower biofilm formation capacity was observed by phage-resistant bacteria comparatively to phage-sensitive bacteria. Overall, phages have shown to be a promising approach to decontaminate food handling surfaces.

Colistin [polymyxin E] is a veterinary exclusive antimicrobial and one of the oldest antibiotics that is currently recognised as one of the highest priority critically important antimicrobials for humans. It is extensively used for multiple medical and non-medical purposes particularly for growth promotion, prophylaxis/metaphylaxis and therapeutic in food animals. As a result, colistin resistance was widespread along the food-chain linking to multidrug resistant bacterial infections in humans reflected by greater use of colistin in healthcare settings resulted in different types of bans/restrictions in food-producing animals, around the world. This report debates the testimonies of 23 countries representing the bulk of global food producing animal production, providing robust evidence on the essential need for colistin in animal production.

Background: School meals represent a significant supply of nutrients for children in Brazil, especially those in conditions of social vulnerability. Objectives: This study aimed to assess the levels of arsenic (As), cadmium (Cd), and lead (Pb) in meals served in public elementary schools in four municipalities in the state of Bahia, Brazil, and assess the risk posed to children's health. Methods: Ninety-six samples were collected from 16 schools, freeze-dried, and subjected to microwave-assisted digestion. The As, Cd, and Pb levels were determined by graphite furnace atomic absorption spectrometry. The risk assessment was based on calculating each element's hazard quotient (HQ). Results: None of the samples reached or exceeded the tolerable levels for the elements analyzed. Pb was the metal that obtained the most significant result, reaching maximum levels of 39-157 µg.kg-¹. Conclusions: No element exceeded the PTWI proposed by JECFA; thus, the toxic metal content in school meals poses a negligible risk to children´s health.

Nonylphenol is a endocrine disruptors who belongs to alkyphenol groups. It´s high occurrence in the environment can caused an adverse effect on human health. The breast milk can serve as a marker to take measure of human exposure to these chemicals through different routes of exposure. In this study, the influence of different factors (including the length of accommodation, kind of wastes mothers drink, con summation of fish, pork and beef; using gloves, mail polish, using vitamins and medication) on the concentration on nonylphenol in breast milk were studied. The length of accommodation has a statistically significant effect on nonylphenol, concentration in breast milk (p value was 0.02). Other mentioned factors had not a significant influence on nonylphenol values.

The coastal zone of Bangladesh covers an area of 47,201 square km, 32% of the country, around 35 million people are living coastal zone, where about 15 million are women (Ahmad, 2019). Though the women of this area have a significant contribution in aquaculture, food production and economic growth of Bangladesh, still the health issues of women remain ignored, especially sexual and reproductive health issue. Women and girls experience heightened vulnerabilities to reproductive health problems in coastal areas. In aiming to investigate the prevalence of vaginal problems in coastal area the study has been designed. The study followed retrospective cohort study as a study design and use percentile and regression analysis to draw the result of the study. The study found that 94% of women are experiencing vaginal problems in coastal villages in Bangladesh. This number is about 05 times higher than the non-coastal villages and it also found water use for hygiene practice as a significant role for high rate of vaginal diseases in coastal areas of Bangladesh

Increasing quality of life (QoL) is both an end in itself and a means to optimize the impact of treatment in HIV-infected persons. Possibly due to cultural and social influences, the predictors of QoL vary across studies, which highlights the importance of studying specific populations. In the present study, we wanted to determine the sociodemographic (age, sex, schooling) and psychosocial correlates (meaning in life, social support, positive and negative affect) of QoL in HIV-infected patients living in Mozambique, a country with high prevalence of HIV, but also with well-structured strategies to fight the disease. To that end, we made correlational analyses followed by regression models, and we examined potential mediation processes among predictors. All correlates were relevant except sex. Meaning in life was the strongest predictor, while social support was the weakest. Schooling was both directly and indirectly related with QoL - in the latter case, it was mediated by meaning in life, social support and positive affect. Our findings suggest that investments in education may be highly rewarding to Mozambicans, and that satisfying needs of self-actualization and purpose may be more urgent than improving social connections.

Urban governance and sanitation in the peri-urban commune of Agoè-Nyvé 6 in Togo: Diagnosis of the sanitation system in Adétikopé.

Cadmium (Cd) is a pervasive toxic metal, present in most food types, cigarette smoke, and contaminated air. It has no nutritional or physiological value, but most cells in the body will assimilate Cd, as its charge and ionic radius are similar to the essential metals, iron, zinc, and calcium (Fe, Zn, Ca), which are required for cellular metabolism and functional integrity. The kidney is regarded as the principal site of Cd toxicity as it preferentially accumulates in the proximal tubular epithelium here. As these cells die due to toxic accumulation, Cd complexed with metallothionein are released into tubular lumen and excreted. Excretion of Cd, signifying current renal cell toxicity, is used as a measure of long-term Cd exposure. Approximately 10% of the global population are now living with diabetes and over 80% of these are overweight or obese. This association has fueled an intense search for any exogenous chemicals and life-style factors that could induce excessive weight gain. Whilst epidemiological studies have clearly linked diabetes to Cd exposure, this appears to be independent of obesity. Indeed, obesity may enhance diabetogenic effects of Cd. This review highlights Cd exposure sources and levels associated with diabetes type 2 along with the pathophysiologic mechanisms by which Cd disrupt glucose metabolism. Special emphasis is on roles of the liver and kidney in glucose homeostasis, heme-glucose cross-talk, and the involvement of heme oxygenase-1 and -2 (HO-1 and HO-2). From heme degradation, both HO-1 and HO-2 release Fe, carbon monoxide and a precursor substrate for producing a cytoprotective biochemical, bilirubin, whilst HO-2 appears to have also anti-diabetic and anti-obese actions.

This study investigated gender differences in exposure to hazardous factors, health problems, and work environment satisfaction and identified the effects of such differences on farmworkers in Korea. Through the 6th Korean Working Conditions Survey (KWCS) conducted by the Occupational Safety and Health Research Institute (OSHRI), the raw data on 2,347 farm-workers were analyzed to present descriptive statistics for demographic characteristics, exposure to hazardous factors, health problems, and work environment satisfaction. We compared be-tween genders using chi-squared tests and investigated the effects of gender-specific working conditions on work-related health problems and work environment satisfaction using multi-variate logistic analysis. The results were presented as an odds ratio (OR) with 95% confidence interval. Job position predicted work-related health problems in male farmworkers and work environment satisfaction in female farmworkers. Furthermore, female farmworkers perceived themselves to have more health problems than male farmworkers. Nevertheless, female farm-workers received less health and safety information and had lower work environment satisfac-tion compared to male farmworkers. The findings may improve the occupational welfare of farmworkers through continuous enhancement of the agricultural labor environment. Keywords: work-related; working condition; farmworker; agriculture; musculoskeletal; KWCS

In the area of dental healthcare services, where patients and professionals deal with multiple auditory stimuli, this cross-sectional study reports on the intricate dynamics of sound preferences, noise obstacles, and the profound impact of music on anxiety reduction within dental office set-tings. The sample comprises of 134 dental patients, primarily females (56.7%), with varying age groups, education levels, and therapy durations in the university clinics of the department of Dentistry, National and Kapodistrian University of Athens and four private dental offices at the metropolitan area of Athens, Greece. Notably, 92.5% of the participants report no hearing loss, and 56.7% exhibit some level of noise sensitivity. The study reveals a moderate to good perceived health status (M=3.84, SD=0.95) among participants, with low perceived noise disturbance in university dental clinics. Preferences for instrumental music, foreign pop, and classical music are prominent during waiting times. Potential irritations include impersonal treatment (44%) and staff behavior (41.8%). Music player usage within the settings of the dental clinic involves radios (49.3%) and headphones (41.0%). Correlations and predictors indicate associations between health status, music preferences, and noise disturbances. More specifically, visiting the university dental clinics (β = .300, p = .005) as well as younger age (β = .300, p = .034) were significant predictors of better perceived health status. Clearer perception of external sounds while using the music player (β = .190, p = .039) was a significant predictor of better perceived health status, while poorer health was predicted by the preference of Greek folk songs (β = -.200, p = .030). Also, the use of smartphones for playing music was related to poorer health (β = -.370, p < .001). Following, younger age (β = -.270, p = .015), lower education (β = -.210, p = .035), higher noise sensitivity (β = .190, p = .027), as well as feelings of anxiety and nervousness due to ambient noise from people and machines (β = .510, p = .027) were significant predictors of noise disturbance from machines. Also, visiting private clinics (β = .240, p = .018), preferences of specific playlist (β = .310, p = .012), no music (β = .280, p = .016) and use of smartphones to play music (β = .230, p = .029) were significant predictors of noise disturbance from patients or staff. Finally, the preference of listening to a specific playlist was related to better health status (r = .190, p < .05). Findings aim to optimize eco-soundscapes in dental offices, con-tributing to enhanced patient well-being. The research underscores the potential of music inter-ventions to alleviate dental anxiety and improve the overall dental experience and quality care.

Urban dust samples were taken from the playgrounds of 27 schools located in the urban area of the city of Murcia (S.E. Spain). Their color and degree of magnetism were determined, as well as their heavy metal content (Cd, Cu, Cr, Ni, Pb and Zn) to evaluate contamination by environmental and health indexes. The highest concentration of contaminants is found in dusts of dark color and medium and high magnetism. The concentrations of heavy metals in the dust were, in this order, Zn (453.74 mg kg-1)> Cu (77.44 mg kg-1)> Cr (67.93 mg kg-1)> Pb (55.72 mg kg-1)> Ni (18.56 mg kg-1)> Cd (0.42 mg kg-1). The analysis of the magnetic and non-magnetic fraction indicates that there is a concentration of all heavy metals in the magnetic fraction. According to the geoenvironmental indices used, the ecological risk presented by school playgrounds is moderate. As for the health indices, ingestion was the main route of exposure and entry of dust particles into the body, being the main health risk for adults and children for all metals. The Hazard Index (HI) values for all elements for both adults and children were less than 1, indicating that there is no risk of developing adverse health effects. As for the Cancer Risk (CR), the values of this index indicate that there is no risk. The objective of this study was to evaluate pollution in the playgrounds of schools in the city of Murcia.

The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring SARS-CoV-2 prevalence in a city in Northern Italy from October 2021 to May 2023. Starting from a widely applied deterministic model, this study proposed a variation to take into account population characteristics and virus biodegradation in the sewer network. The model calculated virus loads and corresponding COVID-19 cases over time in different areas of the city and was validated with healthcare data while considering viral mutations, vaccinations, and testing variability. The correlation between the predicted and reported cases was high across the three waves that occurred in the considered period, demonstrating the model’s capacity to predict relevant fluctuations in the number of cases. Population characteristics did not substantially influence the predicted and reported infection rates. Conversely, biodegradation significantly reduced the virus load reaching the wastewater treatment plant, resulting in a 30% reduction in the total virus load produced in the study area. This approach can be applied for comparing virus load values across cities with varying population demographics and sewer network structures, enhancing the comparability of WBE data for effective surveillance and intervention strategies.

The traditional practice of harvesting and processing raw date palm sap is not only culturally significant but also an essential nutritional source in South Asia. Yet, the potential for bacterial or viral contamination from animals and environmental sources during its collection remains a real and insufficiently studied risk. Implementing improved food safety measures and collection techniques could mitigate the risk of these infections. Additionally, the adoption of advanced food analytical methods has the potential to identify pathogens and uncover the natural bacterial diversity of these products. The advancement of NGS technologies, particularly nanopore sequencing, offers rapid and highly mobile capabilities. In this study, we employed nanopore sequencing for bacterial metabarcoding of a set of raw date palm sap samples collected without protective coverage against animals in Bangladesh in 2021. We identified several bacterial species with importance in the natural fermentation of the product and demonstrated the feasibility of this NGS method in the surveillance of raw palm sap products. We revealed two fermentation directions dominated by either Leuconostoc species or Lactococcus species in these products at the first 6 hours from harvest along with opportunistic human pathogens in the background, represented with low abundance. Plant pathogens, bacteria with the potential for opportunistic human infections and the sequences of the Exiguobacterium genus were also described and their potential role is discussed.

This study examines the attitudes of healthcare organizations and employees in the Greek Healthcare System towards climate change and the influence of management in promoting environmentally friendly practices. A questionnaire was sent electronically to the 7 Health Districts of Greece and private sector healthcare workers associated with the researchers, while the sample consisted of service (administration, nursing, technical, and medical). The main findings indicate that public sector health organizations are lacking in motivating employees to adopt "green" actions during their work. Communication and information dissemination from administration to healthcare professionals were identified as significant challenges, resulting in participants being unsure of how to respond, in contrast to the private sector which showed slightly more positive results. Moreover, the study highlights a positive association between education level and voluntary green behaviors of employees. This research emphasizes the urgency to confront climate change in conjunction with the principles of Organizational Behavior within the Greek Healthcare System.

This article presents the development and validation of a new instrument measuring social, cultural, and behavioral factors influencing exposure to occupational zoonoses in agricultural settings. The Social Ecological Model (SEM) and the Standards for Educational and Psychological Testing were used as guiding frameworks to ensure the instrument's validity. The instrument's content was compiled by combining the results of a scoping literature review and an expert qualitative study. The instrument items were drafted, organized, and underwent a meticulous process of revision and adjustment. It was translated into Spanish and tested in one-to-one cognitive interviews with five volunteer agricultural workers. Exploratory factor analysis was conducted for construct discrimination, and bivariate regression analyses were conducted to explore the association with exposure indicators. Evidence of validity was obtained from four out of five sources of validity evidence according to the AERA/APA’s Standards of Educational and Psychological Testing. The Social Ecology of Occupational Zoonoses (SEOZ) was successfully used to determine social and behavioral factors associated with a higher risk of exposure to occupational zoonoses. Further use of the SEOZ can provide valuable insights into developing effective interventions to improve the health and well-being of agricultural workers.

Background Aspergillus spp. is a widely distributed filamentous fungus in the environment due to its high sporulation capacity. Currently, invasive aspergillosis (IA) is the most common invasive fungal infection in patients with hematologic malignancies with high rates of mortality and morbidity. The multifactorial nature of the disease requires appropriate risk stratification to allow the most appropriate preventive measures to be adapted and implemented according to the characteristics of the patient. In this sense, the present research aims to identify recent risk factors and environmental control measures against invasive aspergillosis to establish preventive actions to reduce the incidence of invasive aspergillosis in hospitals; (2) Methods: We conducted a qualitative systematic review of the scientific literature on environmental risk factors and preventive measures for invasive aspergillosis in patients with hematological malignancies. The Medline, Cochrane and Scopus databases were consulted, following the PRISMA and STROBE guidelines; (3) Results Adequate implementation of environmental control measures is presented as the most efficient intervention in terms of prevention to decrease the incidence of invasive aspergillosis in hospitals. We identify neutropenia, fungal contamination, lack of adequate environmental control measures in hospitals and patients´ homes, duration of hospitalization, and anemia as independent risk factors. We show that HEPA, LAF and Plasmair® systems are suitable methods to reduce the concentration of airborne fungal spores. Antifungal prophylaxis did not influence the reduction of IA significantly in our study; (4) Conclusions: Proper professional training and environmental control measures in hospitals are essential for the prevention of invasive aspergillosis. We should optimize risk stratification for patients with hematologic malignancies. Antifungal prophylaxis should be complementary to environmental control measures and should never be substituted for these last ones. Studies should also be done to evaluate the efficiency of environmental control measures against IA at patients' homes.

Herein, we examined the effects of weather parameters and individual clinicodemographic risk factors on hemorrhagic stroke (HS) incidence, severity on admission, and disability at discharge in a harsh desert climate. In a retrospective design we studied patients admitted to a stroke unit in Arab Emirates in 2016-2019. With a distributed lag nonlinear model we explored immediate and delayed effects of weather on stroke incidence. Supervised machine learning was used to build models predictive of scores in NIHSS and mRS scales. We assessed model performance by calculating ROC AUC, F1 scores, specificity, and sensitivity. HS risk increased after a significant change in any weather parameter. The risk was reduced below baseline after 1-week adjustment to environmental changes. Climate input from the previous 3 days yielded reliable classification models. Humidex was a better predictor of severity than air temperature, whereas body mass index, age, and time of day at stroke onset were the strongest clinical predictors. Weather parameters before admission were stronger predictors of disease severity than individual clinical factors. We addressed limitations of previous studies by analyzing a full set of climate parameters: ambient temperature, relative humidity, humidex, atmospheric pressure, and wind speed. Predictive models may help to optimize patient management and develop preventative strategies.

Background: Poisoning is a challenging medical condition facing health care providers, as it usually results in serious outcomes in terms of morbidities or mortalities. Poisoning is a challenging medical condition facing health care providers, as it usually results in serious outcomes in terms of morbidities or mortalities. The lack of or inadequate information about the circumstances, substances and populations at risk are considered barriers to the actual prevention of poisoning and effective intervention strategies in Saudi Arabia. The aim of the current study was to describe the pattern and determinants of chemical and drug overdose poisoning in Makkah.Subjects and methods: All reports of chemical and drug overdose poisoning delivered to the Environmental Health and Occupational Safety Department in Makkah over two years (2018-2019) were reviewed.Results: The total number of cases reported in 2018 was 209 cases, while it reached 42 cases in 2019. The overwhelming majority of the cases were Saudi (91.6%), with a slight predominance of males (57.4%) over females (42.6%). Generally, almost two-thirds of the cases occurred in children below 13 years (61.4%), most of the poisoning cases resulted from drug overdose (63.3%), while 34.7% were chemical poisoning. The most common drug poisoning was attributed to analgesics followed by antiepileptics, antihypertensive drugs, antipsychotics and antimicrobials, while cleaning and detergent agents were the most commonly poisoned chemicals. The majority of these agents were taken by the oral route. Children's chemical poisoning was significantly higher than that in older age groups (p<0.05). All intentional poisoning occurred in adults; the great majority of them (88.9%) used drug overdosing rather than chemical substances.Conclusion and recommendations: The current study results are consistent with most of the previous studies carried out in different regions of Saudi Arabia. Further in-depth studies are needed to elaborate other social and demographic factors associated with chemical and drug overdose poisoning. Public health plans, policies and legislations should be implemented to reduce these factors. Intensive supervision of children is needed. Suicidal poisoning patients should seek psychiatric help to limit the possibility of attempting suicide again in the future. Furthermore, efforts are needed to plan and implement health education programs about the factors proven in the current study to be significantly related to chemical and drug overdose poisoning.

Rationale: Chronic Granulomatous Disease (CGD) is a rare primary immunodeficiency. Although most mutations are linked to the X chromosome, therefore affecting males, there are autosomal recessive forms that therefore affect both sexes. Clinically it is characterized by recurrent and severe bacterial and fungal infections, with formation of granulomas, due to the inability of phagocytes to generate reactive oxygen compounds, necessary for the intracellular death of phagocytosed microorganisms. Patient concerns: We reported a 12-year-old boy with pneumonia with pneumatocele of possible staphylococcal etiology at one year of age, bilateral orchitis secondary to Salmonella with hematogenous spread, osteomyelitis due to Salmonella, gastroenteritis due to Salmonella enteritidis, liver abscesses due to Staphycococcus aureus and lymphomatoid papulosis and pyodermititis. Diagnoses: In the biochemical diagnosis, the presence of yellow dye (NBT) and absence of dark bluish black dye (formazan) was evidenced. Regarding the genetic diagnosis, the presence of the mutation in exon 10 of CYBB (OMIM 306400) (Xp21.1) that encodes the gp91phox protein was demonstrated. Interventions and outcomes: Treatment was started with trimethoprim/sulfamethoxazole 400/80 mg every 24 hours via oral, and antifungal prophylaxis with itraconazole 200 mg every 24 hours orally is added, after which he does not present serious bacterial or fungal infections, not being able to administer immunomodulatory treatment with recombinant human Interferon gamma-1b. Lessons: The clinical finding of frequent severe infections associated with granulomas, CGD should be suspected. Treatment of this primary immunodeficiency is trimethoprim/sulfamethoxazole and itraconazole. Importantly, it indicated that the mutation in exon 10 of CYBB (Xp21.1) that encodes the gp91phox might influence the pathogenesis of CGD.

Mechanical ventilation systems used in houses are designed to reduce carbon dioxide emissions while minimizing the energy loss resulting from ventilation. However, increase in indoor fine particulate (PM2.5) concentration because of external PM2.5, influx through the ventilation system poses a problem. In this study, we analyzed the changes in indoor PM2.5 concentrations via dis-tinguishing between cases of high and low outdoor PM2.5 concentrations, considering the effi-ciency of filters used in residential mechanical ventilation systems. When using minimum effi-ciency reporting value (MERV) 10 filters in the ventilation system, the outdoor PM2.5 concentra-tion was 5 μg/m³; the indoor PM2.5 concentration became 73% after 60 min compared to the ini-tial. When the outdoor PM2.5 concentration was 30–40 μg/m³, the indoor PM2.5 concentration reached 91%. However, when MERV 13 filters were used, the indoor PM2.5 concentration con-sistently dropped to 73–76% regardless of the outdoor PM2.5 concentration. Furthermore, by comparing the established equation with the mass-balance model, the error was confirmed to be within 5%, indicating good fit. This allows the prediction of indoor PM2.5 under various condi-tions when using mechanical ventilation systems, enabling the formulation of strategies to maintain indoor PM2.5 as recommended by the World Health Organization.

Appropriate use of perioperative antimicrobials can significantly reduce the risk of postoperative infections. However, inappropriate antimicrobial use can result in the creation of multidrug resistant bacteria, increased costs, host flora disruption, side effects, and increased risk of hospital-acquired infections This survey evaluated the current perioperative use of antimicrobials in small animals by Spanish veterinarians using a web-based questionnaire. Responses were represented using descriptive statistics and a statistical analysis of the association between demographic data and perioperative antimicrobial use was performed. Preoperative antimicrobials were administered in clean surgery by up to 68.3% of participants, 81.0% in clean-contaminated surgery and 71.3% in dirty surgery, while in the postoperative period, antimicrobials were administered by up to 86.3% of participants in clean surgery, 93.2% in clean-contaminated surgery and 87.5% in dirty surgery. Factors considered “very important” for antimicrobial selection were the degree of wound contamination, patient immunosuppression, and use of prosthesis. The most frequently used antimicrobial was beta-lactamase-resistant penicillin. Postoperative antimicrobial use was associated with participants without postgraduate training. This study highlights an overuse of antimicrobials in perioperative procedures in small animal surgery in Spain. Therefore, evidence-based guidelines and further education regarding the correct use of antimicrobial prophylaxis are recommended.

Research on climacteric syndrome among middle-aged men remains scant than the research among women. Research is also scant on climacteric syndrome among older adults living alone, particularly men, who are more vulnerable than such females. This cross-sectional study investigated whether the prevalence of climacteric syndrome is associated with the type of household middle-aged men live in and identified the determinants of climacteric syndrome based on the household type. Six hundred middle-aged men living in multi-person households and 600 living alone were surveyed about general characteristics, diet-related factors, and climacteric syndrome. Data were analyzed using Pearson’s chi-squared test, Fisher’s exact test, and logistic regression. The risk of climacteric syndrome in single-person households was found to be 1.6 times higher than that among in multi-person households (p = 0.006). In multi-person households, income and breakfast frequency predicted climacteric syndrome (p < 0.05), while age, breakfast frequency, dinner frequency, and weekly eating out frequency predicted climacteric syndrome in single-person households (p < 0.05). Thus, dietary factors are more closely linked to the prevalence of climacteric syndrome in single-person households than in multi-person households. This highlights the need for climacteric syndrome interventions for middle-aged men whose health concerns may persist into older adulthood.

A study was carried out in a Waste Sorting Plant (WSP) located in France and treating dry recyclable household waste (DRHW) as well as dry recyclable commercial and industrial waste (DRCIW). The aim was to investigate the exposure to bioaerosol and dust. The aim of the study was to assess the extent to which the measurement of concentration, species composition and particle size distribution can contribute to a better assessment of the biological risks associated with exposure. Both stationary and personal bioaerosol and dust samples were collect in the (WSP). The results confirm that waste and waste sorting activities are sources of airborne fungi. Indeed, ambient concentrations ranged from 7.3×103 to 8.5×105 CFU/m3 for culturable moulds and up to up to 4 mg/m3 for dust. Personal exposure to inhalable dust was found up to 3 mg/m3 for dust and ranged from 8.6×103 to 1.5×106 CFU/m3 for fungi. Airborne fungal communities were found to be dominated by the Penicillium genera in both bioaerosols and settled dust samples, followed by the Aspergillus, Cladosporium, Wallemia, Mucor, and Rhizopus genera. Fungi were carried by particles of aerodynamic diameters mainly between around 2.0 and 10.0 µm. The findings dealing with size distribution and biodiversity of bioaerosols suggest that employees are exposed to complex bioaerosols during their work and helps to make a finer diagnosis of the risks involved, which is often difficult in the absence of any OEL for bioaerosols in general.

In the European Union, Occupational Safety and Health legislation generally refers to European Regulation (CE) n. 1272/2008 to define and classify carcinogens of concern for occupational risk assessment and exposure assessment. In Europe, the current reference is Directive (UE) 2022/431, regarding carcinogen, mutagen and reprotoxic agents (CMRs) exposure. However, at worldwide level, different classification approaches are used to establish carcinogenicity of substances and it is often difficult to compare the classifications of carcinogenicity (CoCs) proposed by different international bodies. This study aims to investigate a list of carcinogens of concern in occupational settings based on the CLP (Classification Labelling Packaging) CoC, and to create a tool that allows a rapid translation-comparison of some international CoCs with the reference one. CoCs proposed by various sources were consulted and used to apply a translation method, to favor an alignment of different CoCs according to a reference. Results outlined that considering diverse sources, CoCs can result in different classifications of the same chemicals. Overall, this may have implications for the hazard assessment process, which is the base of risk assessment. The proposed tool is expected to help risk assessors in the occupational field when it is needed to have a comparison with different CoC systems.

Public restrooms are often a hub of microbial contamination, and the examination of bacterial contamination in these facilities can serve as an important indicator of the transmission of infectious diseases. This study was conducted to determine the prevalence of bacterial contamination in public restrooms based on the economic class of the building. Samples were collected from various spots in 32 restrooms found in 10 shopping malls, classifying them into two categories: upper-end restrooms and lower-end restrooms. The findings showed that the level of contamination was higher in the lower-end restrooms, with the seat being the most contaminated area. The most dominant Gram-positive bacteria were coagulase-negative staphylococci species, making up 86% of the identified Gram-positive isolates. The most dominant Gram-negative bacteria identified were Klebsiella pneumoniae and Pseudomonas aeruginosa. The antibiotic sensitivity test results revealed the presence of multi-drug resistant bacteria among the Gram-positive and negative isolates, including Staphylococcus haemolyticus, Staphylococcus kloosi, Acinetobacter baumanii, and Pseudomonas aeruginosa. In conclusion, the study underscores the significance of monitoring bacterial contamination in public restrooms and the need for measures to reduce the spread of infectious diseases. Further research is crucial to gain a complete understanding of the bacterial contamination in public restrooms and their resistance patterns, to ensure the safety and health of the public. The implementation of improved cleaning practices and hands-free designs in restrooms can help reduce the risk of cross-contamination and prevent the spread of diseases.

Climate changes challenges people’s life and sustainability. Environmental problems seem to derive from human behavior. Dentistry has a high environmental footprint that needs to be controlled worldwide. Thus, the change of behavior of dentists is a necessary condition to improve the environmental situation. In this study we use a system dynamics approach to analyze pro-environmental behavior in dentists. Systemic modelling in this case, allow us to make a clear prediction of how the population of non-eco dentists will change in the future if certain factors will be affected and how much time will be needed by the system of a group of dental professionals to become eco- dentists. The ECODENT model was designed with Vensim software. It was based on the influence of WOM (word of mouth) spread of information among colleagues and stakeholders (e.g. patients, auxiliary staff and community) and other factors such as dental income, state support, CaPex and OpEx, education hours, level of urbanization and time to react. By changing each one of them we can observe the changes in the groups of non-eco and eco dentists as well as the flow of the phenomenon. It is tested that by augmenting WOM parameter, state economic support or education hours, while diminishing CaPex and OpEx, changes in pro-environmental behaviors of dentist will be reported in a shorter time. The ECODENT model can be used to further study pro-environmentalism in different dental groups and associations and design relevant eco-friendly educational programs.

Lyme disease, the leading vector-borne ailment in the U.S., annually affects an estimated 476,000 individuals, predominantly in the Northeast and Upper Midwest. Despite its increasing incidence, the evaluation of risk within U.S. cities, including natural public lands, remains inadequate. This study focuses on blacklegged tick occurrences and Borrelia burgdorferi infection prevalence in 24 Staten Island parks, aiming to assess Lyme disease exposure risk. Monthly acarological risk index (ARI) calculations from 2019 to 2022 revealed elevated values (0.16-0.53) in specific parks, notably Wolfe’s Pond Park, High Rock Park, Clay Pit Pond Park, Clove Lake Park, and Fair View Park. June (0.36) and November (0.21) consistently exhibited heightened ARIs, aligning with peak tick collection months. Despite stable yearly infection rates at 28.97%, tick densities varied significantly between parks and years. Identifying a high transmission risk in specific parks in Staten Island, a highly urbanized part of New York City, emphasizes the continuous necessity for Lyme disease risk management, even within the greenspaces of large cities.

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

Excretion of β2-microglobulin (β2M) above 300 µg/g creatinine, termed tubulopathy, was regarded as the critical effect of chronic exposure to the metal pollutant cadmium (Cd). However, current evidence suggests that Cd may induce nephron atrophy, resulting in a reduction in the estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2. Herein, these pathologies were investigated in relation to Cd exposure, smoking, diabetes and hypertension. Data were from 448 residents of Cd-polluted and non-polluted regions of Thailand. The body burden of Cd, indicated by the mean Cd excretion (ECd) normalized to creatinine clearance (Ccr) as (ECd/Ccr) ×100 in women and men did not differ (3.21 vs. 3.12 µg/L filtrate). The prevalence odds ratio (POR) for tubulopathy and a reduced eGFR were increased by 1.9-fold and 3.2-fold for every 10-fold rise in Cd body burden. In women only, a dose-effect relationship was seen between β2M excretion (Eβ2M/Ccr) and ECd/Ccr (F = 3.431, η2 0.021). In men, Eβ2M/Ccr was associated with diabetes (β = 0.279). In both genders, eGFR was inversely associated with Eβ2M/Ccr. The respective covariate- adjusted mean eGFR values were 16.5 and 12.3 mL/min/1.73 m2 lower in women and men who had severe tubulopathy; (Eβ2M/Ccr) ×100 ≥ 1000 µg/L filtrate. These findings indicate that women were particularly susceptible to the nephrotoxicity of Cd, and that the increment of Eβ2M/Ccr could be attributable mostly to Cd-induced impairment in tubular reabsorption of the protein together with Cd-induced nephron loss, evident from an inverse relationship between Eβ2M/Ccr and the eGFR.

(1) Background: China holds the highest esophageal squamous cell carcinoma (ESCC) incidence areas in the world, with some areas of incidence over 100 per 100,000. Despite extensive public health efforts, its etiology is still poorly understood. This study aims to review and summarize past research into potential etiologic factors for ESCC in China. (2) Methods: Relevant observational and intervention studies were systematically extracted from four databases using key terms, reviewed using Rayyan software, and summarized into Excel tables. (3) Results: Among the 207 studies included in this review, 130 studies were focused on genetic etiologic factors, followed by 22 studies focused on dietary-related factors, 18 studies focused on HPV-related factors, and 37 studies focused on other factors. (4) Conclusions: ESCC in China involves a variety of factors including genetic variations, gene-environment interactions, dietary factors like alcohol, tobacco use, pickled vegetables, and salted meat, dietary behavior such as hot food/drink consumption, infections like HPV, poor oral health, gastric atrophy, and socioeconomic factors. Public health measures should prioritize genetic screening for relevant polymorphisms, conduct comprehensive investigations into environmental, dietary, and HPV influences, enhance oral health education, and consider socioeconomic factors overall as integral strategies to reduce ESCC in high-risk areas of China.

The global population is at risk of vitamin D deficiency due to low exposure to sunlight and low intake of the vitamin through diet. The aim was to investigate in women the association between vitamin D status and parathyroid hormone (PTH), ultraviolet radiation, lifestyle, ethnicity, social conditions, and residential greenness. A 1-year longitudinal study assessed vitamin D status in 309 women, latitude 51° 14' N. Blood samples were taken four times throughout the year for analysis of 25(OH)D and serum PTH concentration. After each seasonal visit, the individuals completed 4-day diet diaries and used two dosimeter badges for 1 week to estimate weekly UVR exposure. A questionnaire was applied to provide information about lifestyle and their ethnicity. Residential greenness was measured by Normalized Difference Vegetation Index (NDVI), within a 1000 m radius around each participant’s home address. Women living in greener spaces were more likely to have improved vitamin D status (RR: 1.51; 95%CI: 1.13 – 2.02), as well as those who were more exposed to UVR (RR: 2.05; 95%CI: 1.44 – 2.92). Our results provided a first insight into the connection between vitamin D, residential greenness, and lifestyle in a region of temperate climate and with a high degree of urbanization.

As broiler farming facilities have become larger and more concentrated in response to external environmental changes, there is a possibility of increased concentrations of fine dust and aerosols inside these facilities due to enclosure. In particular, workers are exposed to high concentrations of organic particulate matter and harmful gases while performing their tasks, and as they age, they become more vulnerable to respiratory diseases. It is essential to directly monitor the concen-trations to which workers are exposed, along with the spatial distribution of aerosols inside broiler house. In this study, we analyzed the regional aerosol concentrations using passive samplers in commercial tunnel-ventilated broiler farms. Simultaneously, we employed active samplers at the height of the workers' breathing zones to monitor real-time aerosol concentrations by particle size along their work routes. Spatial aerosol concentrations generally increased from the inlet to the exhaust in the breathing zone. The average aerosol concentrations were TSP -1,042 µg/m³, PM-10 718 µg/m³, and PM-2.5 137 µg/m³. To analyze the workers' exposure environments, we categorized the tasks in the barn into Static work period (SWP) and Moving work period (MWP) based on video analysis. The results showed that during MWP, fine dust concentrations exceeded the standards by up to 214%. Particularly, during MWP, the concentrations were 1.74 times higher for TSP, 1.40 times higher for PM-10, and 1.22 times higher for PM-2.5 compared to SWP. It was observed that during the movement of workers, physical generation of particles around 10 µm, such as feces, feed, and bedding, occurred due to the movement of chicken, which influenced the aerosol concentration.

Meat loss and waste are estimated at each stage along the food chain, but the methods used are complex and the data needed often fragmented. We, therefore, evaluated the feasibility of estimating meat loss and waste using a simpler method comparing meat availability and consumption, using Swiss meat consumption according to a national nutrition survey and Swiss meat availability according to food balance sheets. As availability is reported at the fresh meat level and consumption as consumed, items of the latter were converted to fresh meat equivalents before comparing consumption with availability. Consumed unprocessed meat was directly converted to fresh meat equivalents and consumed meat products after having identified their meat ingredients. Meat availability, meat consumption as consumed and as fresh meat equivalent were 138.4 g/d, 105.5 g/d, and 112.1 g/d, respectively. The resulting total meat loss and waste was 19% and varied from −36% to 38% for the different meat types. Estimating meat loss and waste based on meat availability and consumption derived from a national nutrition survey yielded results varying to such an extent that the evaluated method to estimate meat loss and waste cannot be recommended.

This analysis examines the wide range of occupational and environmental health risks that affect people in diverse settings. This article emphasizes the importance of conducting exposure and risk assessments to safeguard public health by analyzing various hazards, including arsenic, oil accidents, lead, welding fumes, and mycotoxins. Various methodologies are utilized in these research articles to conduct the study, emphasizing hazard identification, exposure assessment, and risk characterization. The results uncover harmful substances, vulnerable demographics, and occupational duties linked to increased hazards. The report suggests various mitigation strategies, such as targeted interventions, enhanced community efforts, and improved exposure estimates. Notwithstanding the constraints identified in certain studies, the review emphasizes the necessity for continuous investigation to improve assessments of exposure, comprehend the cumulative effects, and examine the wider societal consequences. The significance of sector-specific risk assessments, protective measures, and ongoing monitoring is underscored to ensure mental and physical health protection.

Attention to the work-related musculoskeletal disorders (WMSDs) involve also statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development retrieves new tools and methods for the assessment of physical load at work. In addition to the conventional questionnaires and scaling assessment systems, these methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare the assessment of ergonomic risk through current legislative regulations. A Captiv wireless sensor system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of the postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak legislation), STN EN 1005-4+A1, French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which also affects the final evaluation of the measurements. Based on the results of our research, we found that respondents were in an acceptable position for approximately 63% of the total duration of the work activity in terms of the Legislative method, 44% with Captiv and 27% with Standards method.

(1) Background: This text emphasizes concerns regarding the safety of Spanish police officers at-tributed to inadequate training, employing biomechanics for the analysis and mitigation of risks during Use of Force training. The elevated global prevalence of musculoskeletal disorders under-scores the imperative for effective occupational health measures. The study concentrates on evalu-ating injury risks in novice police officers during Use of Force training. (2) Research method: The movements of police officers were captured using a Rokoko Smartsuit Pro equipped with 19 sen-sors. The Biomechanics of Bodies software processed the data, providing REBA and Marras risk scores. Statistical tests were conducted, and Operational Tactical Procedures (OTP) were inte-grated into police training. A diverse group of officers participated, categorized by training level and equipped with the Rokoko Smartsuit. (3) Results: The study evaluates police force training us-ing REBA and Marras methods. REBA scores indicate a moderate to high injury risk, suggesting effective technique design. ANOVA reveals no significant differences between training levels. Marras analysis, characterized by non-normal distribution, unveils varied risk perceptions among groups via the Kruskal-Wallis test. (4) Conclusions: The analysis of both the REBA and Marras methods implies the effectiveness of the OTP technique in reducing injury risks across dif-ferent training levels. The ANOVA test indicates no significant differences in REBA Maximum Scores between the groups. However, the Kruskal-Wallis test for Marras Probability of high-risk values suggests distinctions in medians between training levels. The combined analysis visually illustrates variations in membership regions between expert, intermediate, and novice groups.

The rapid increase in the number of mobile phone base stations (MPBS) has raised global concerns about the potential adverse health effects of exposure to radiofrequency electromagnetic fields (RF-EMF). The application of machine learning techniques can enable healthcare professionals and policymakers to proactively address concerns surrounding RF-EMF exposure near MPBS. In this study, we investigated the potential of machine learning models to predict health symptoms associated with RF-EMF exposure in individuals residing near MPBS.We utilized support vector machine (SVM) and random forest (RF) algorithms, incorporating 11 predictors related to participants' living conditions. A total of 699 adults participated in the study, and model performance was assessed using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). The SVM-based model demonstrated strong performance, achieving accuracies of 85.3%, 82%, 84%, 82.4%, and 65.1% for headache, sleep disturbance, dizziness, vertigo, and fatigue, respectively. The corresponding AUC values were 0.99, 0.98, 0.920, 0.89, and 0.81. Compared to the RF model and a previously developed model, the SVM-based model exhibited higher sensitivity, particularly for fatigue, with sensitivities of 70.0%, 83.4%, 85.3%, 73.0%, and 69.0% for these five health symptoms. Particularly for predicting fatigue, sensitivity and AUC were significantly improved (70% vs 8% and 11.1% for SVM, MLPNN, and RF, respectively, and 0.81 vs 0.62 and 0.64, for SVM, MLPNN, and RF, respectively). These findings suggest that machine learning methods, specifically SVM, hold promise in effectively managing health symptoms in individuals residing near or planning to settle in the vicinity of MPBS.

In response to new developments of work and employment in high-income countries (HICs), psychosocial aspects of work and health received increased attention. In contrast, middle-income countries (MICs) are mainly concerned with severe challenges of noxious and dangerous material work environments, poor employment conditions, and deficient social policies, leaving psychosocial aspects in a marginal role at best. More recently, differences between these two worlds were even aggravated by the COVID-19 pandemic. Yet, with economic globalisation and growing worldwide interconnectivity, the world of work in MICs is being rapidly transformed, sharing several concerns with modern Western societies. In this process, psychosocial occupational health will become an increasingly pressing issue. This contribution explores to what extent psychosocial aspects of work and health are already addressed in research originating from MICs. A selective focus on recent findings from two regions, Asia Pacific and Latin America, reveals a high degree of awareness of, and inquiry into, work-stress related problems within these countries. Importantly, in addition to incorporating research progress from HICs, these analyses identify new aspects within specific cultural and socio-economic environments, thus enriching the international state of art.

Background: Thyroid cancer incidence has increased globally in recent decades, especially in females, although its trends in Taiwan have not been studied extensively. This study aimed to investigate changes in female incidence and possible causes of thyroid cancer in Taiwan. Methods: Using the Taiwan Cancer Registry (TCR) Database, age-standardized incidence rates, age-specific incidence rates and birth cohorts were calculated. Correlation between female thyroid cancer incidence and cohort fertility rates were examined. Results: Thyroid cancer incidence increased in Taiwanese female, with age-adjusted rates per 100,000 people increasing from 7.37 during 1995-1999 to 20.53 during 2015-2019, APCs were 5.9% (95% CI, 5.3-6.5). Age-specific incidence rates increased with age, with peak rates occurring at younger ages. The APCs in the 50-54 age group were the highest (6.8%, 95% CI, 6.1-7.5). Incidence rates also increased with later birth cohorts. We observed a significant negative correlation between thyroid cancer incidence and fertility rates in the same birth cohort. Conclusion: We hypothesize that overdiagnosis may be a main reason for the rapidly increasing thyroid cancer incidence in Taiwanese female. Notably, we observed a strong negative correlation between fertility and thyroid cancer incidence. The associations with fertility will be an important subject for future thyroid cancer research.

Limited studies have shown that exposure to arsenic is associated with serum vitamin D levels, but the results are still inconsistent. A cross-sectional study of 762 participants was conducted in Wenshui Country, Shanxi Province, which was identified as an area of water-borne arsenicosis. The results showed positive relationship between arsenic species (iAs, MMA, DMA) and serum 25(OH)D. Binary logistic regression analysis showed that the significant increases of 0.4% and 0.6% in the risk of vitamin D excess for every 1-unit increment in the Box-Cox transformed urinary tAs and DMA, respectively. After stratifying populations based on arsenic methylation metabolic capacity, each one-unit increase in the Box-Cox transformed tAs level was associated with increases of 0.064 (95%CI: 0.032 to 0.096) in serum 25(OH)D in the populations with iAs% above the median. In the populations with skin hyperkeratosis, urinary iAs was positively associated with serum 25(OH)D (β=0.592, 95%CI: 0.041 to 1.143). Overall, our findings support the positive relationship between urinary arsenic and serum 25(OH)D.

ABSTRACT Objectives: To investigate the effect of individual-level, neighborhood, and environmental variables on uterine fibroid (UF) prevalence in a Chicago-based cohort. Methods: Data from the Chicago Multiethnic Prevention and Surveillance Study (COMPASS) were analyzed. Individual-level variables were obtained from questionnaires, neighborhood variables from the Chicago Health Atlas, and environmental variables from NASA satellite ambient air exposure levels. The Shapiro-Wilks test, logistic regression models, and Spearman’s correlations were used to evaluate the association of variables to UF diagnosis. Results: We analyzed 602 participants (mean age: 50.3±12.3) who responded to a question about UF diagnosis. More Black than White participants had a UF diagnosis (OR, 1.32; 95% CI, 0.62–2.79). We observed non-significant trends between individual-level and neighborhood variables and UF diagnosis. Ambient air pollutants, PM2.5 and DSLPM were protective against UF diagnosis (OR 0.20, CI: 0.04–0.97: OR 0.33, CI: 0.13–0.87). Conclusions: Associations observed within a sample in a specific geographic area may not be generalizable and must be interpreted cautiously.

Visits to coastal and inland-waterways have strong associations with many health and economic benefits but are also opportunities for exposure to environmental pollution. In England, few balanced survey samples exist which can facilitate accurate identification of correlates with recreation in blue spaces. This information could support risk assessment for likelihood of exposure and message targeting in case of environmental threats. We process data from a recent (2022-2023) and large (n = 177,551) survey of English residents to describe demographic, seasonal and regional correlates with any participation in water-based recreational activities in previous year (logistic regression model), and in the previous 28 days (zero-inflated negative binomial regression). Activities studied were: surfing and paddleboarding; open water swimming; scuba-diving and snorkelling; canoeing and kayaking; angling. Summer was associated with most frequent participation, winter with fewest sessions except for rowing. Anglers were group most likely to be socially vulnerable: less likely to be university educated, more likely to be disabled and especially likely to be male. People resident in rural locations were more likely to participate at least once in prior year, but did not have higher participation rates in the previous 28 days. Regional variations in specific activities may suggest where demand for water recreation is unmet. The results provide a reference description of outdoor water-recreationalists doing specific types of activity in England and may be useful when designing emergency messages and otherwise setting policy with regard to management of microbiological, radiological or chemical hazards in coastal and inland waters.

This experiment was conducted to study the effects of Cyfluthrin (Cy) exposure on neurobehaviour, hippocampal tissue and synaptic plasticity in Wistar rats. First, high-dose Cy exposure can cause nerve injury with symptoms such as deficits in learning and memory ability, spatial exploration and autonomic motor ability. Moreover, it was found that medium- and high-dose Cy exposure can cause disordered energy metabolism in hippocampal cells and an abnormal release of the neurotransmitter Glu. Second, pathological brain sections showed that the middle and high doses of Cy caused deformation, reduction and disorder of hippocampal pyramidal cells, a decrease in the number of Nissl bodies, pyknosis of the hippocampal cell nuclear membrane and serious damage to organelles, indicating that exposure to these doses of Cy may cause hippocampal tissue damage in rats. Third, with the increase in exposure dose, the morphological changes in hippocampal synapses were more obvious, including blurred synaptic spaces, decreased synaptic vesicles and a decreased number of synapses. Moreover, the expression levels of the key synaptic proteins PSD-95 and SYP also decreased in a dose-dependent manner, indicating obvious synaptic damage. Finally, the study found that medium and high doses of Cy could upregulate the expression of A2AR in the hippocampus, and the expression levels of inflammatory factors and apoptosis-related proteins increased in a dose-dependent manner. Moreover, the expression of A2AR mRNA was correlated with neurobehavioural indicators, inflammatory factors, synaptic plasticity factors and apoptosis factors, suggesting that Cy may cause nerve damage in rats and has a close relationship with A2AR.

To date, radiation adaptation response has been reported as a low-dose related phenomenon and has been associated with radiation hormesis. Well-known cancers are caused by non-radiation active reactants, in addition to radiation. A model of suppression for radiation-specific cancers was previously reported, but the model did not target radiation-nonspecific cancers. In this paper, we describe kinetic models of radiation-induced suppressors for general radiation non-specific cancers, estimating the dose that induces the maximum hormesis effect while satisfying the condition that the risk is approximately proportional to dose above 100 mSv. It was found that the radiation hormesis effect is maximal at about 20 mSv when the rate constant for generation is the same as the rate constant for decomposition. When the two rate constants are different, the dose at which the radiation hormesis effect is maximized depends on both rate constants, but the dose increases as the two rate constants approach each other, reaching a maximum of about 20 mSv. This conclusion may lead to the discovery of unknown cancer suppressors at low doses and the development of cancer suppression methods in the future.

Physical inactivity, highly dependent on community and environmental conditions, is the fourth leading cause of death worldwide. The objective of Every Walk You Take initiative was to co-design and test a mHealth intervention prototype (mobile app) to promote active living, and to identify barriers and facilitators for active living in individuals older than 55 years. Community stakeholders that included citizen scientists, teachers, researchers, health professionals and policy makers, familiar with the social and economic burden of aging in developed societies, codesigned the prototype. The app functionalities included recommendations on healthy routes in the city (parks, pedestrian lanes and streets) according to environmental variables (air quality and climate) and personal preferences (route difficulty, distance and geolocalization); and the collection of ecological momentary assessments (pictures and voice notes) to identify the barriers and facilitators to perform the routes. The prototype was tested in a pilot study in two deprived neighbourhoods of Barcelona. A total of 21 citizen scientists [mean age=67 (standard deviation=7)], 86% of them female collected, during two 7-day cycles, 112 comments and 48 pictures describing the barriers and facilitators for active living. The negative impact of dirty or damaged roads on citizen scientists’ motivation to engage in physical activity was highly reported as a barrier indicating that city infrastructure directly influences the public's inclination towards adopting active lifestyles. However, citizen scientists highlighted murals and urban green spaces they encountered, which made their walks more enjoyable and stimulating, as facilitators for active living. Every Walk You Take initiative constitutes the foundation for the development of novel models of health surveillance to address gaps in the current research landscape of active living. Moreover, the increased health literacy of the individuals ensures that they are more conscious about the role of physical activity in healthy ageing.

Bisphenol A (BPA) has been identified as one of endocrine disrupting chemicals (EDCs). Due to its massive production (over 700,000 tons per year) and the extensive use of BPA-based plastics (i.e., polycarbonate and epoxy resin) in Taiwan, it was thus included into a toxic substance by the Ministry of Environment. This work surveyed the updated information about the production of BPA and its environmental distributions in Taiwan over the past decade. Furthermore, the regulatory strategies and countermeasures for managing the environmental risks of BPA by the Taiwan government were summarized to show the cross-ministerial efforts under the relevant acts, including the Toxic and Concerned Chemical Substances Control Act (TCCSCA), the Food Sanitation Management Act (FSMA) and the Commodity Inspection Act (CIA). The findings showed that most of the monitoring data showed far below the acceptable risks. However, the people may pose an adverse threat to the aquatic environment and human health via ecological and food chains. In addition, some countermeasures were further recommended to echo the international actions on environmental endocrine disruptors in recent years.

Bifenthrin is a synthetic pyrethroid insecticide. It is used worldwide against different agricultural pests. Nervous system (NS) is the primary target organ for the pyrethroid group of insecticide which causes hyper excitation. The aim of this study to determine the effects of bifenthrin on the brain of rabbits. The animals were treated for 14 days with three different doses (1/5th, 1/10th and 1/15th of LD50) of bifenthrin. Neurotransmitters and Histopathological alterations were observed at the end of the experiments. Neurochemical parameters were checked 24 hours after the last dose. Significant changes in the level of biogenic amines were observed. The levels of epinephrine (EPN), dopamine (DA), 3, 4 dihydroxyphenylacetic acid (DOPAC) were decreased as compared to controls group with the increase in insecticide. However, norepinephrine (NE) and homovanillic acid (HVA) levels were found to be significantly higher than those of the controls. A significant reduction in the activity of the acetyl cholinesterase enzyme was found in the frontal cortex’s erythrocyte, plasma and brain of rabbit with the increase in administered bifenthrin. The oxidative stress showed significantly decrease in the activity of glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT) and glutathione S- transferase (GST) with the increase in dose of bifenthrin. Histopathological study of brain tissues showed normal GC (glial cells) and NC (neuronal cells) in the frontal cortex of brain tissue of control groups while the treated groups showed evacuation (odema), elongation of pyramidal nucleus, glial cell damage and brain haemorrhage.

The analysis of the current safety standards for electric toys showed that the normative intensity limits for visible light emitted by LEDs integrated in toys are overestimated. These limits were originally set in a scientific article published in 2012 that was adapted into the international safety standard published in 2017, and into the subsequent European and national standards, all published in 2020. The overestimation of the intensity limits results from several errors made in the original article. Accordingly, the current normative intensity limits for visible light used in toys do not protect the children’s eyes against adverse effects of exposure to high intensity LEDs which may compromise their visual health. Updating the safety standards for electric toys using a method based on robust scientific data is recommended to protect children's visual health and ensure their long-term well-being.

The importance of cognitive health for academic success is well-recognized. However, longitudinal data regarding the associations of body fatness, physical fitness and cognition are relatively scarce and mixed. The purpose of this study was to investigate whether body fatness, cardiorespiratory fitness (CRF) and muscular fitness (MF) in preschool are associated with cognitive skills in first grade at school. 133 South Estonian children aged 6-7 years were recruited from 13 kindergartens and again at 7-8 years when they had entered school. Body fat percentage (BF%), CRF, MF as the mean of z-scores of relative handgrip strength and standing long jump tests, and cognitive skills (verbal, conceptual, perceptual) were studied. There were no associations between BF% and CRF in pre-school with perceptual, conceptual or verbal skills in school in boys and girls. In boys, higher MF in preschool predicted higher verbal skills (β = 0.293, p = 0.021) in school after adjustment for con-founders. Cognitive skills at baseline seemed predominantly predict later cognitive performance in school. In conclusion, higher muscular fitness in preschool predicted better verbal skills in first grade at school in boys but not in girls. Body fatness and cardiorespiratory fitness in preschool were not associated with cognitive skills in school.

Providing safely-managed sanitation/hygiene requires key competencies for education, training, service delivery, enterprise development and management, product and infrastructure design and development, construction and installation, governance, financing, research, etc. These strategic sanitation capacities will have to be built from higher education’s academic and professional programmes structured and designed to produce skilled and knowledgeable professionals and practitioners. This study aims to investigate the quality of the sanitation/hygiene management content of Environmental Health programmes; the adequacy of the existing central curricula; and the perception of environmental health sanitation/hygiene-trained professionals to determine the next phase for building knowledge and capacity of sanitation professionals in Nigeria through higher education institutions. A multilevel mixed method concurrent study was used for sampling and data collection with a multilevel perception analysis to examine the perceptions of students, lecturers and graduate alumni as well as employers/supervisors and clients/service-users of sanitation/hygiene related graduates. The main findings of this paper show limited understanding of the concepts of contemporary issues of sanitation/hygiene management; the central/national teaching and curricula were found to be seriously out of date; and clients/service-users were dissatisfied with the skills and knowledge levels of the graduates. The study concludes by recommending a national sanitation management higher education pathway to guide the provision of integrated sanitation/hygiene management education at higher education institutions (HEIs), to build effective, efficient, competent, and sufficient workforce for the country.

Technological advances in the last decades have led to the realization of the concept of a smart environment. A significant part of this development is decentralized ledger technology and its variant, a blockchain. The blockchain database is immutable, open to all stakeholders, secure by architecture and robust. Applying a blockchain in water supply sanitary control creates opportunities for optimization, higher quality of service, cost reduction, better sanitary standards and public control. Physical, chemical, and biological water supply contamination is a great source of public health hazards. Implementation of a blockchain for water supply IoT, from the source point to the consumption point, enables effective response to changing environments, possible cross-contamination, stormwater management or disaster and emergency action. The chapter encompasses all fundamental elements and principles of water collection, distribution and consumption, with a focus on the health hazards and sanitary requirements for potable water. The chapter listed the main contaminants, methods of their registration and elimination, and requirements for drinking water in accordance with WHO, EU Drinking Water Directive and EPA standards. Blockchain technology solutions are described for smart water supply, including smart supply management, smart contracts, tokenization, smart compliance systems, and, most importantly, effective utilization of distributed ledger technologies for sanitary monitoring of water sources, water treatment, and water distribution systems.

Since the start of the COVID-19 pandemic, the world has witnessed a digital revolution that has transformed the way information are broadcast and consumed. This rapid evolution was accompanied by an “infodemic” (Beaulieu, 2019), a transformation of workplaces (Lulli LG, 2021)and difficulties in managing information flows (Bendahan & Nader, 2020). In this scientific article, we examine the communication strategies adopted by hospital structures as they are perceived by staff, highlighting their psychological and professional experiences throughout the crisis period. The results of the study carried out among hospital staff (n=200) demonstrate that the perception of communication strategies is generally positive for 78.56% of participants (M=1.85). The assessments of the staff interviewed as for the effect of this communication on the psychological experience and on the management of professional tasks have a positive trend respectively (M=2.15) and (M=1.86)

Identification of Dengue drivers is crucial for pro-active prevention strategies. In semi-arid regions, the relationship between meteorological variables, particularly rainfall, and the dengue vector is complex. This study analyzes associations between the number of dengue cases and rainfall categories in six semi-arid locations in India. Focusing on official website data, we find significant correlations only with heavy rainfall (R>10 mm/day). The findings underscore the importance of heavy rainfall in Dengue incidence and offer insights for pro-active prevention. The study methodology involves rainfall and dengue occurrence over Indian region. This research contributes to the growing body of knowledge on Dengue prevention, emphasizing the need for targeted interventions during periods of heavy rainfall.

Chronic exposure to the nephrotoxic metal pollutant, cadmium (Cd), has been associated with the pathogenesis of hypertension, but so far, the mechanism has not been well defined. We hypothesize that exposure to Cd causes a decline in the glomerular filtration rate (GFR), which in turn, causes a rise in blood pressure. Data were collected from 447 Thai subjects with a mean age of 51.1 years, of which 48.8% had hypertension, 15.4% had diabetes and 6.9% had an estimated GFR (eGFR) below 60 mL/min/1.73m2 (low eGFR). The mean blood Cd and mean urinary Cd concentrations were 2.75 and 4.23 µg/L, respectively. Prevalence odds ratio (POR) for hypertension rose twofold in those with a medium Cd burden and blood Cd levels of 0.61-1.69 µg/L. In the hypertensive group, the eGFR was inversely associated with age (β =−0.517), the Cd excretion rate (β = −0.177), and diabetes (β = −0.175). Mean eGFR in those with hypertension was 7.5 mL/min/1.73m2 lower than those who were normotensive with the same Cd body burden. In addition, higher systolic blood pressure (SBP) values were associated with older age (β = 0.243), higher BMI (β = 0.113), lower eGFR (β = −0.106) and diabetes (β = 0.216). Mean SBP in those who had low eGFR and medium and heavy Cd body burden was 9.5 mmHg higher than those with the same Cd body burden and a normal eGFR. Thus, chronic environmental exposure to Cd that produces urinary and blood Cd levels of 0.57-0.61 µg/L, increases the risk of hypertension, and this could be mediated by a declining GFR.

This work deals with a systematic review of literature data concerning the theme of the integrated approach to occupational health and safety management, with particular reference to the programming of assistance plans, which guide the company's organizational choices also by aiming at the principles of the Total Worker Health. In the current regulatory framework on this issue, the UNI ISO 45001: 2018 standard assumes particular relevance, which defines the dynamic approach to occupational health and safety management systems, paying particular attention to external contextual factors that may influence corporate organizational decisions. The adoption of these systems is not mandatory, but allows companies to fulfill their duties in terms of health and safety at work, through an organizational approach aimed at awareness, involvement and participation of all subjects of the company prevention system, overcoming the phase of the mere technological and prescriptive approach, towards a holistic vision of prevention, which places the person at the center of preventive actions. In this context, the role of institutional networks and socio-economic partnerships assumes particular importance, in the activation of territorial assistance interventions to support companies for the improvement of risk management levels. To this end, the importance of verifying the effectiveness of assistance interventions emerges from the scientific debate, through the use of indicators such as quantitative ones for measuring the performance of all phases of the intervention with particular attention to the effects in terms of improved solutions developed.

Background: In Malaysia, the mortality from melioidosis infection was reported to be higher than in other infectious diseases. The research on melioidosis is still limited in Malaysia but slightly increasing. Objective: To give an overview of the study designs, statistical methods and comparison of research in identifying the predictors of melioidosis mortality in Malaysia between January 2010 to December 2021. This review articles were divided into two sections; Section 1: Review of literature and Section 2: Findings on predictors of melioidosis mortality in Malaysia. Data sources: Pubmed/Medline. Study Eligibility Criteria: Original English-language articles were abstracted. The articles that identified the predictors of melioidosis from mortality in Malaysia only included. Letters to the editor, editorials, reviews, systematic reviews, meta-analysis, case reports and any other ineligible articles were excluded. Results: A total of 7 studies were identified related to predictors of melioidosis mortality in Malaysia. From the selected articles, all of the data were retrospectively collected. Six out of 7 articles (85.7%) used the logistic regression in identifying the predictors of melioidosis mortality. Only 1 (14.3%) used advanced survival analysis methods of Cox regression analysis. Conclusion: Logistic regression methods remain the most common methods of analysis in publications on predictors of melioidosis mortality in Malaysia while retrospective research designs are favoured. There is a limitation of research in predictors of melioidosis mortality and the use of advanced statistical techniques reported using the melioidosis data in Malaysia. More published research on melioidosis will provide input to the clinicians on a more detailed understanding of how to improve the diagnosis of melioidosis and the prognosis factors of this disease.

(1) Background: The aim of study was to investigate the salt consumption by children and adolescents from the Silesian Province (Poland), taking into account the region’s dietary traditions and number of years of school education. (2) Methods : 300 students aged 10–18 from different types of schools, were enrolled in the study and divided into groups in terms of: school, sex, the state of nutrition. The survey questionnaire about dietary habits, including the frequency and serving size with respect to 12 salty products was used. On the basis of the frequency and the amount of consumed products, as well as the data on salt content, the amount of total daily intake of salt was estimated.; (3) Results: The mean daily intake of salt by children and adolescents was 1.083 g ( 0.433 g of sodium); children aged 10–12 consumed the highest amount of salt (1.296 g/day) compared to pupils aged 13–15 (1.131 g of sodium) and adolescents aged 16–18 (0.863 g/day); (4) Conclusions: With age, as a result of various factors, the consumption of salt declines. The parents impact and the familial socio-environmental factors begin to wane, and other factors start to have influence, e.g. school education of healthy lifestyle, health behavior of peers.

Background: Asthma is a widespread chronic respiratory disease that poses a significant public health challenge. The current study investigated the associations between air pollution and asthma severity among individuals residing near the Sohar industrial port (SIP) in Oman. Despite the presence of multiple major industrial complexes in Oman, limited knowledge regarding their impact on respiratory health is accredited. Hence, the primary objective of this study is to offer valuable insights into the respiratory health consequences of industrial air pollution in Al Batinah North. Methods: The state health clinics' records for patient visits related to asthma were collected for the timeframe spanning 2014 to 2022. Exposure was defined as the distance from SIP, Majan Industerial Area (MIA) and Sohar Industerial Zone (SIZ) to determine high, intermediate, and low exposure zones (12 km, respectively). Exposure effect modifications by age, gender, and smoking status were also examined. Results: The conducted cross-sectional study of 410 patients (46.1% males and 53.9% females) living in over 17 areas around SIP revealed that 73.2% of asthmatics were under 50 years old, with severity significantly associated with closeness to the port. Risk ratios were estimated to be (RR:2.42; CI95%: 1.01–5.78), (RR:1.91; CI95%: 1.01–3.6), and (RR:1.68; CI95%: 0.92–3.09) for SIP, MIP and SIZ areas, respectively, compared to the control area. Falaj Al Qabail (6.4 km) and Majees (6 km) had the highest number of asthma patients (N. 69 and N. 72), and highest percentages of severe asthma cases among these patients (28% and 24%) with significant risk ratios (RR:2.97; CI95%: 1.19–7.45 and RR:2.55; CI95%: 1.00–6.48), correspondingly. Moreover, severe asthma prevalence peaked in the 25-50 age group (RR:2.05; CI95%: 1.26–3.33), and this linkage between asthma and age was much more pronounced in males than females. Smoking and exposure to certain contaminant (dust and smoke) increased also the risk of severe asthma symptoms, but their effects were less important in the high risk zone, suggesting much more important risk factor. A neural network model accurately predicted asthma risk (94.8% accuracy), with proximity to Sohar Industrial Port as the most influential predictor. Conclusion: The study highlights the High asthma burden near Sohar Industrial Port, linked to port proximity and smoking and wind direction as major risk factors. These findings inform vital public health policies to reduce air pollution and improve respiratory health in the region, prompting national policy review.

Purposes: Engaging in regular physical activity has been consistently linked to improved physical health and academic performance. Despite its known benefits, there is a concerning trend of decreased physical activity among children globally. The study primarily aims to investigate the level of physical activity among junior high school students in Taiyuan and analyze the main affecting factors from a socio-ecological perspective. Methods: A cross-sectional study was conducted, involving 650 junior high school students from 7 schools in Taiyuan, and 648 valid questionnaires were collected. Physical activity levels were assessed using the Children’s Leisure Activities Study Survey Questionnaire. Factors influencing physical activity were evaluated through the Student Perceived Factors Affecting Physical Activity Questionnaire. Results: In this study, students from the 7th, 8th, and 9th grades participated in physical activities, averaging 214.5 minutes per week in moderate-intensity and 25 minutes in high-intensity activities, cumulatively averaging 280 minutes weekly. Notably, a significant disparity (p<0.05) was observed in the combined duration of moderate and high-intensity activities, with male students engaging more time compared to their female counterparts (307.500 vs 255.000 minutes). This variance extended across different grades, particularly evident in 8th graders who recorded the highest weekly high-intensity activity duration (31.000 minutes) and overall physical activity time (320.500 minutes), surpassing the 7th graders. Furthermore, an exploratory factor analysis of a 32-item questionnaire, designed to identify determinants of physical activity, revealed six principal components. These components were found to positively correlate with both moderate and high-intensity physical activities. Conclusion: This study emphasizes the necessity for educational institutions and community programmes to provide engaging physical activities, especially during weekends. It highlights the importance of tailoring physical education curricula to address gender and grade differences and investing in quality sports equipment and facilities by schools and local governments.

Preventing childhood obesity and associated comorbidities is often hampered by disproportionate disparity in healthcare provision in minority ethnic populations. This study contextualised lifestyle factors influencing childhood obesity and related comorbidity from the perspectives and experiences of parents of ethnic minority children with obesity comorbidity. Families of Black, Asian and Minority Ethnicities (BAME) in the Northeast of England (n=180) were contacted, and families with a child diagnosed with obesity and comorbidity (non-alcoholic fatty liver disease, musculoskeletal problems, respiratory disorder, or polycystic ovarian disease) were interviewed (n=11). Semi-structured interviews and qualitative thematic analysis included parents’ perspective and experience on how their children were impacted by obesity and comorbidities, healthcare preventative interventions including lifestyle physical activity and nutrition, and views on tackling obesity. Parents’ perspectives and experience revealed eleven themes centred around living with a child with obesity, risks and impact of obesity diseases; access to lifestyle nutritional and physical activity, and ethnicity specific barriers. Parents revealed social disadvantage, fear of victimisation by social services, perceptions on their cultural and religious traditions when dealing with nutrition and exercise, and child’s weight racial stigmatisation. Parents reported closer bonding with their children than health authorities to protect from obesity consequences. Work pressure, time, and lack of professionals’ guidance were seen as barriers to healthy lifestyle, while support from friends and family bond in adopting healthy lifestyle behaviours were facilitators. Parents reported no awareness of health service provision of nutritional and physical activity obesity prevention programmes. Minority ethnic communities’ perspective on childhood obesity prevention does not match the healthcare system preventative offerings. Community and family-oriented obesity preventative approaches, especially lifestyle nutrition and physical activity interventions are needed beyond those administered by the primary healthcare system.

: Aim: The aim in this study was to conduct a prospective survey regarding the sociodemographics and lifestyle risk factors for cancer of a population of Caribbean immigrants living in the U.S. Materials and Methods: The data were processed and analysed using SPSS software 27 and Excel. Crosstabulations were performed. The chi-square test was used to evaluate different hypotheses. Statistical significance was defined as p &lt; 0.05. Results: Statistically significant differences in the country of birth of the Caribbean immigrants were found for sex (p = 0.038) and the cleanness of their neighbourhoods (p = 0.045). We found differences in occupations between men and women (p = 0.001). Men were less unemployed than women (p = 0.011). Sex also showed statistically significant differences in how easily the immigrants balanced their work and personal life (p = 0.044). Age groups depicted differences in the physical health of the immigrants (p = 0.001). The use of alcohol and tobacco was not an important risk factor among participants (p = 0.529). Conclusions: These findings suggest that the sociodemographics risk factors for cancer among a population of Caribbean immigrants were significantly different between the sexes. However, the use of tobacco and alcohol showed insignificant differences among the immigrants.

(1) Workplace nutrition interventions have garnered attention as a pivotal component of employee well-being and organizational productivity. However, the effectiveness of various intervention types remains inconclusive. This review aims to systematically evaluate the efficacy of cognitive, behavioral, and mixed nutrition interventions in the workplace, considering the nuances of intervention design, setting, and target demographics. (2) A comprehensive umbrella review was conducted, categorizing existing literature into person-oriented and environmental strategies. This review was prepared in line with the Joanna Briggs Institute methodology for umbrella reviews and the preferred reporting items for systematic reviews and meta-analyses reporting standard. (3) The analysis revealed a lack of definitive evidence supporting the universal effectiveness of any single intervention type. Nonetheless, behavioral and mixed interventions demonstrated more favorable outcomes compared to purely cognitive strategies. Factors such as intervention design, workplace setting, and target group characteristics were identified as significant determinants of intervention success. (4) The review emphasizes the imperative for additional investigations that utilize evidence-based approaches to formulate sound guidelines for efficacious nutrition interventions in occupational settings. This review functions as a foundational framework for guiding both scholarly research and the pragmatic execution of nutrition programs in the workplace.

Cutaneous melanoma (CM) is a candidate for screening programs, since its prognosis is excellent when diagnosed in an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and expert assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels defining a nevus score. Cohen’s weighted kappa-coefficient was estimated to measure the level of agreement. In the total sample, agreement between self-assessments and expert-assessments was moderate (raw agreement: 50.29%, weighted κ=0.596). Self-assessed nevus counts were higher than those determined by experts (mean differ-ence: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and expert-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.

Sustainable food systems imply the re-use of biowastes and water. In this paper we characterize 30 top soil improvers of anthropogenic, animal and green waste origin, and 11 irrigation waters from rivers, channels, and civil wastewater treatment plants (cWWTPs) for the presence of antimicrobials. Liquid chromatography coupled to hybrid High Resolution Mass Spectrometry (LC-HRMS/MS) was applied to determine 50 different drugs belonging to the classes of sulfonamides (11), tetracyclines (7), fluoroquinolones (10), macrolides (12), amphenicols (3), pleuromutilins (2), diaminopyrimidines (1), rifamycines (1) and lincosamides (1). Biowastes from cWWTPs and animal manure, slurry and litter revealed the highest loads for sulfonamides, tetracyclines, fluoroquinolones, and macrolides (80, 470, 885, and 4,487 ng/g wet weight, respectively) with nor- and cipro-floxacin as marker of anthropogenic sources. In composts and digestates antimicrobials were almost below the determination limits. Re-used waters for irrigation in open field lettuce production resulted contaminated in the range of 12-221 ng/L for sulfonamides, tetracyclines, and fluoroquinolones, against very few detects in channels and surface waters. Antimicrobials Hazard Index (HI) based on Predicted No Effect Concentration for Antimicrobial Resistance (PNEC_AMR) was largely >100 in contaminated top soil improvers from urban and animal sources. Accounting for worst-case inputs from top soil improvers and irrigation water and dilution factors of amended soil, fluoroquinolones only showed a HI around 1 in open fields for lettuce production. The origin of top soil improvers plays a pivotal role for safe and sustainable leafy vegetable productions, to abate the risk of AMR onset in food-borne diseases, as well the transfer of AMR elements to human gut flora.

Our aim was to investigate the impact of shiftwork on changes in central retinal arteriolar equivalent (CRAE), a measure of arteriolar width, and central retinal venular equivalent (CRVE), a measure of venular width, over five years. Participants were 117 officers (72.7% men) examined at the first (2011-2014) and second (2015-2019) follow-up examinations of the Buffalo Cardio-Metabolic Occupational Police Stress study. Shiftwork data were obtained from City of Buffalo, NY payroll records. Retinal diameters were measured using a standardized protocol. ANCOVA was used to compare mean change in CRAE and CRVE between the two examinations across shiftwork categories. Among men only, those who worked ≥70% hours on day shift had a larger decrease in mean CRAE (-7.13±2.51) compared to those who worked <70% day (-0.08±0.96); p=0.011. Among patrol officers, those who worked ≥70% day had a larger decrease in CRAE compared with those who worked <70% day; p=0.015. Also, officers who worked ≥70% day had an increase in mean CRVE (µm) (4.56±2.56) compared to those who worked <70% (-2.32±1.32); p=0.027. Over the five-year period, we observed adverse changes in arteriolar and venular diameters among officers who worked ≥70% on day shift. Results should be interpreted with caution due to small sample sizes.