Aggravating Factor Research Articles

Methods for restoring the mobility of a concrete mix

The relevance of the study is due to the fact that currently monolithic construction is characterized by a high rate of construction work, since in modern market conditions this indicator determines the final cost per square meter. As it is known, the life cycle of any concrete product or structure includes the preparation of a concrete mixture, transportation, laying, sealing, hardening and further operation.Therefore, the initial stage of the life cycle – the preservation of the properties of the concrete mixture over time will determine the technological and physico-mechanical properties, respectively, of the concrete mixture and concrete. An aggravating factor in maintaining the properties of the concrete mixture in the summer is the air temperature exceeding 30оC. The paper shows technological techniques that make it possible to level the temperature factor on the properties of the concrete mixture over time.It was found that the introduction of superplasticizers in the amount of 1% of the cement mass and the restoration of mobility at the construction site make it possible to obtain concretes with specified qualities. This study is relevant for manufacturers of concrete mixtures.

The role of ingrown hairs in persistent kerion of children: A clinical study.

Tinea capitis, a common public health problem in developing countries, has severe forms such as kerion. However, the underlying mechanisms and standard treatments for persistent cases of tinea capitis or kerion remain controversial. In this work, we investigate the ingrown hairs and corresponding treatment in persistent kerion of children. Children with persistent kerion were enrolled among 312 cases of tinea capitis at the Department of Dermatology, Hangzhou Third People's Hospital from January 2020 to June 2024. The presence of fungal infection was ascertained by direct microscopic examination under calcofluor white staining and routine culture. The structure of the ingrown hairs was observed directly by a dermatoscope, which was subsequently extracted using sterile tools. A total of six cases of persistent kerion among 312 cases of tinea capitis were enrolled. Ingrown hairs were ascertained under dermatoscopy and extracted by minor operation. Except for one patient who continued oral terbinafine, the other five cases were cured by removal alone. Ingrown hairs, induced by fungal infection, may be an aggravating factor of persistent course of tinea capitis. Our study demonstrated that the presence of ingrown hairs could be confirmed through direct dermatoscopy, and patients experienced significant improvement following removal treatment under dermatoscopy.

Risk Factors for Disease Aggravation in Older Patients With Non-communicable Diseases: Interpretive Structural and Hierarchical Holographic Modelling.

This study aimed to analyse and determine the risk factors of disease aggravation faced by older patients with non-communicable diseases (NCDs) and their interwoven correlations. We employed a descriptive and cross-sectional study, which followed the STROBE guidelines for reporting. We conducted a semi-structured in-depth interview with 26 older patients with NCDs from a hospital in Qingdao, China between July and August 2022 on the basis of the literature review. Then, we analysed data using the directed content analysis and determined risk factors through a focus group discussion and the Delphi consultation. Afterward, we combined interpretive structural modelling and hierarchical holographic modelling to construct a hierarchical structure model and drew relationship framework diagrams to exhibit diversified risk factors and complex interwoven correlations. We identified 30 risk factors from individual, interpersonal, organisational, community and policy levels. The hierarchical structure model constructed by interpretive structural modelling demonstrated a four-layer structure, and the individual and interpersonal levels were at the highest layer. The relationship framework diagrams demonstrated the identification process of risk factors and interwoven correlations at individual and organisational levels. Risk factors causing disease aggravation amongst older patients with NCDs are diverse. To delay the progression of NCDs, we should comprehensively explore risk factors, interpret the root causes and effects of risks from multiple perspectives and consider the interaction amongst multi-level risk factors to develop precise measures related to risk control. Controlling risk factors is an effective measure to postpone disease aggravation. Through this study, we provide a scientific and comprehensive basis for clinical risk screening so that healthcare providers can sense potential risk factors for disease aggravation in older patients' surroundings and formulate targeted nursing measures according to the risk factors faced by different patients. Patients participated in interviews to supplement risk factors included in our study. Experts provided opinions on the inclusion, exclusion and modification of risk factors.

Symptoms of post COVID-19 condition and diseases/conditions diagnosed after COVID-19 in Japanese patients: A real-world study using a claims database

BackgroundMore than 200 symptoms of post coronavirus disease (COVID-19) condition (PCC) impacting patients’ quality of life have been reported. This study describes the symptoms of well-known PCC and diseases/conditions diagnosed after COVID-19 and analyzes the trends in well-known PCC according to the epidemic waves in the Japanese population. MethodsPatients with a COVID-19 diagnosis in the JMDC claims database were matched 1:1 with individuals without COVID-19 diagnosis (controls) based on sex, year and month of birth, and risk factors for aggravation. The first month of COVID-19 diagnosis from January 2020–March 2022 was the index month, and the observation period was from July 2019 to 6 months from the index month (patients) and July 2019–September 2022 (controls). ResultsOf 263,456 each of patients and controls after matching, 51.8 % were aged 18–49 years, 56.3 % were male, and 24.5 % had risk factors for aggravation. One in 18 patients experienced well-known PCC 2–3 months after severe acute respiratory syndrome cornonavirus 2 infection, with the highest odds ratio (OR) being for pulmonary thromboembolism (29.37), followed by smell/taste disorder (13.34) and respiratory failure (8.28). Some of the common diseases/conditions diagnosed after COVID-19 comprised those of the genitourinary system, eye and adnexa, and ear and mastoid process and certain infectious and parasitic diseases. Overall, the risk difference decreased from the first to the sixth wave, but the OR was >1.00 for most symptoms even during the sixth wave. ConclusionsPCC symptoms showed a declining trend over time but persisted. Physicians and patients need to recognize PCC symptoms.

Association between polypharmacy and 2-year outcomes among Chinese older inpatients: a multi-center cohort study

BackgroundThe escalating global prevalence of polypharmacy presents a growing challenge to public health. In light of this issue, the primary objective of our study was to investigate the status of polypharmacy and its association with clinical outcomes in a large sample of hospitalized older patients aged 65 years and over.MethodsA two-year prospective cohort study was carried out at six tertiary-level hospitals in China. Polypharmacy was defined as the prescription of 5 or more different medications daily, including over-the-counter and non-prescription medications. Baseline polypharmacy, multimorbidity, and other variables were collected when at admission, and 2-year outcomes were recorded by telephone follow-up. We used multivariate logistic regression analysis to examine the associations between polypharmacy and 2-year outcomes.ResultsThe overall response rate was 87.2% and 8713 participants were included in the final analysis. The mean age was 72.40 years (SD = 5.72), and women accounted for 42.2%. The prevalence of polypharmacy among older Chinese inpatients is 23.6%. After adjusting for age, sex, education, marriage status, body mass index, baseline frailty, handgrip strength, cognitive impairment, and the Charlson comorbidity index, polypharmacy is significantly associated with frailty aggravation (OR 1.432, 95% CI 1.258–1.631) and mortality (OR 1.365, 95% CI 1.174–1.592), while inversely associated with readmission (OR 0.870, 95% CI 0.764–0.989). Polypharmacy was associated with a 35.6% increase in the risk of falls (1.356, 95%CI 1.064–1.716). This association weakened after adjustment for multimorbidity to 27.3% (OR 1.273, 95%CI 0.992–1.622).ConclusionsPolypharmacy was prevalent among older inpatients and was a risk factor for 2-year frailty aggravation and mortality. These results highlight the importance of optimizing medication use in older adults to minimize the risks associated with polypharmacy. Further research and implementing strategies are warranted to enhance the quality of care and safety for older individuals exposed to polypharmacy.Trial registrationChinese Clinical Trial Registry, ChiCTR1800017682, registered 09/08/2018.

Stimulating myelin restoration with BDNF: a promising therapeutic approach for Alzheimer's disease.

Alzheimer's Disease (AD) is a chronic neurodegenerative disorder constituting the most common form of dementia (60%-70% of cases). Although AD presents majorly a neurodegenerative pathology, recent clinical evidence highlights myelin impairment as a key factor in disease pathogenesis. The lack of preventive or restorative treatment is emphasizing the need to develop novel therapeutic approaches targeting to the causes of the disease. Recent studies in animals and patients have highlighted the loss of myelination of the neuronal axons as an extremely aggravating factor in AD, in addition to the formation of amyloid plaques and neurofibrillary tangles that are to date the main pathological hallmarks of the disease. Myelin breakdown represents an early stage event in AD. However, it is still unclear whether myelin loss is attributed only to exogenous factors like inflammatory processes of the tissue or to impaired oligodendrogenesis as well. Neurotrophic factors are well established protective molecules under many pathological conditions of the neural tissue, contributing also to proper myelination. Due to their inability to be used as drugs, many research efforts are focused on substituting neurotrophic activity with small molecules. Our research team has recently developed novel micromolecular synthetic neurotrophin mimetics (MNTs), selectively acting on neurotrophin receptors, and thus offering a unique opportunity for innovative therapies against neurodegenerative diseases. These small sized, lipophilic molecules address the underlying biological effect of these diseases (neuroprotective action), but also they exert significant neurogenic actions inducing neuronal replacement of the disease areas. One of the significant neurotrophin molecules in the Central Nervous System is Brain-Derived-Neurotrophin-Factor (BDNF). BDNF is a neurotrophin that not only supports neuroprotection and adult neurogenesis, but also mediates pro-myelinating effects in the CNS. BDNF binds with high-affinity on the TrkB neurotrophin receptor and enhances myelination by increasing the density of oligodendrocyte progenitor cells (OPCs) and playing an important role in CNS myelination. Conclusively, in the present review, we discuss the myelin pathophysiology in Alzheimer's Diseases, as well as the role of neurotrophins, and specifically BDNF, in myelin maintenance and restoration, revealing its valuable therapeutic potential against AD.

Hematological abnormality and associated factors in newborns with hyperbilirubinemia before and after phototherapy at University of Gondar Comprehensive Specialized Hospital

This study aimed to assess the magnitude of hematological toxicity and associated factors in newborns with hyperbilirubinemia. A cross-sectional study was conducted from April to December 2023. A total of 247 newborns were included. The data were collected using questionnaires and a data extraction sheet. Four 4 ml of blood was collected. A Sysmex KX-21 analyzer was used for blood analysis, and a Mindray BS-240 analyzer was used for bilirubin measurement. The data were entered into Epi-data and analyzed by SPSS. The logistic regression was used. The P value was set at 0.05. Before phototherapy, the hematological toxicities, such as anemia, leucopenia, and thrombocytopenia, were 45.7%, 22.2%, and 6.1%, respectively, whereas after phototherapy, anemia and thrombocytopenia, significantly increased, but the leucopenia, significantly decreased. The risk of developing anemia increased, 3.5, 2.7, and 2.1-fold among newborns with bilirubin > 18 mg/dl, with Rh blood group incompatibility, and treated with intensive phototherapy, respectively. Both low birth weight and intensive phototherapy increased the incidence of thrombocytopenia by 2 and 3.4-fold, respectively. Hematological toxicity was found to be a severe public health issue in newborns. Thus, strict follow-up and early detection of toxicity by considering aggravation factors are necessary.

Might photobiomodulation therapy interfere with the frequency of severe mucositis and oral candidiasis? A retrospective analysis in patients with head and neck carcinoma.

Considering the tumor in the oral cavity or the oropharynx and nasopharynx region might be an aggravating factor for oral mucositis (OM) manifestation, the present study aimed to evaluate whether the location of the tumor and the use of photobiomodulation therapy (PBMT) might affect the frequency of oral candidiasis (OC) during radiotherapy (RT) and/or chemotherapy (CT) treatments. The medial records of seventy-four patients with head and neck cancer treated in a public service from 2016 to 2019 were evaluated. All these patients were submitted to RT in an accumulated dose of 48 to 70Gy of radiation. Data about OM and OC were collected and presented according to the application of a therapeutic protocol with laser photobiomodulation (PBMT) to control oral mucositis, or not (No-PBM), and the location of tumor (head and neck or oral cavity). In the PBMT group patients, a low-power laser device composed of InGaAlP diode (maximum output power of 86.7mW, active tip area of 0.1256cm2, and continuous wavelength of 660nm), was applied to the lips (three points each), right and left jugal mucosa (three points each), the limit between hard and soft palate (three points), buccal floor/sublingual gland (one point), lateral edge of the tongue (three points on each side), and back of the tongue (six points), three times weekly, for 5weeks. The dosimetry used in each application was 2J for 3s, thus totaling 56J. The correlation between clinical characteristics such as age, tumor size (T), metastatic lymph node (N), number of RT and CT sessions, candidiasis, and OM were analyzed. Mucositis grades 1 and 2 were the most common among all patients, especially before the 12th radiotherapy session, regardless of the treatment with PBM (p > 0.05). Additionally, no difference in the grade of OM and OC was significantly observed when comparing the two laser therapy groups. OC was more frequent after the 12th radiotherapy session in all groups. Nonetheless, OM and OC had a different correlation regarding to tumor location (head and neck and oral cavity) being PBMT a positive therapy to delay OM. It was observed a positive and statistically significant correlation between tumors at oral cavity and OM, regardless PBMT (R = 0.84, p < 0.05 to PBMT and R = 0.13, p < 0.05 to No-PBM). Otherwise, OC was positively correlated to local metastasis in patients with oral tumors undergoing PBMT (R = 0.84, p < 0.05). Patients with oral cavity tumor presented more OM, especially high grades, then patients with tumors in other regions of the head and neck, which seems to be related to the irradiation parameters of radiotherapy and/or with the limitation of conduction of PBMT in tumor areas. OM and OC were not changed by PBMT, although it helped to reduce the incidence of severe cases of OM.

Mitral complex geometric changes aggravate mitral stenosis after transcatheter aortic valve replacement.

Severe aortic valve stenosis (AS) often coexists with mitral valve stenosis (MS). MS aggravation after transcatheter aortic valve replacement (TAVR) is common, and its etiology is multifactorial. We hypothesized that geometric changes in the mitral complex (mitral valvular and annular deformities) are adjunctive factors aggravating MS after TAVR, particularly in older adults with a smaller left ventricle (LV). This study aimed to evaluate the mitral complex geometric changes before and after TAVR and to assess the important predictors of MS aggravation after TAVR. This retrospective study enrolled consecutive adult patients who underwent TAVR and surgical AVR (SAVR) for severe AS. The mitral valve area (MVA), the angle between the anterior mitral valve leaflet (AMVL) and left ventricular outflow tract (LVOT), AMVL length, mitral annular diameter, presence of mitral annular calcification, and LV size were evaluated using transthoracic echocardiography. This study included 258 patients who underwent TAVR and SAVR. MVA index decreased from 2.3 ± 0.6cm² to 1.9 ± 0.5cm² in the TAVR group. The angle between the AMVL and LVOT was 56.3 ± 9.7° preoperatively and increased to 67.3 ± 11.5° after TAVR. In multivariate analysis, the most important predictive factors of MS aggravation after TAVR were a smaller mitral annular diameter, restricted AMVL mobility, and implantation depth (odds ratio: 4.5, 5.3,3.0; 95% confidence interval: 1.6-14, 1.9-17, 1.0-8.9; and p = 0.005, p = 0.001, p = 0.042, respectively). The reduction in MVA after TAVR was related to the restriction of AMVL opening, depth of implantation and narrowing of the mitral annulus.

Groundwater identification using geophysical tools and its implications for the stability of slopes in an open pit mine

The open pit mining development begins with the opening of pits with the rock mass excavation and formation of slopes and berms for ore exploration. Knowledge about the geological conditions represents an important step in this process, since rock masses generally have heterogeneous characteristics and the presence of discon- tinuities can become an aggravating factor in the safety of operations. The characterization and classification of these discontinuities, as well as the identification of the groundwater in the rock mass, has a great importance to ensure the safety of operations during the mine's production process, in addition to ensure the effectiveness of its decommissioning process. The use of DC resistivity geophysical method has been increasing to characterization and identification lithological types and presence of water, since it is a non-invasive research tool with fast ability to obtain data. DC resistivity together with visual investigation methods, such as obtaining the discontinuities orientation and their alteration characteristics, provides important information for the characterization of the rock mass. Given this importance, the present work aimed to use DC resistivity to identify the presence of water and its correlation with lithology and rock mass structure in order to identify how these variables influence the occurrence of ruptures. To this end, two-dimensional resistivity sections were designed and related to visual inspection data and kinematic analyzes obtained from structural data of the rock mass. The integration of these results indicated that the ruptures present in the investigated mine slopes are related to zones whose predominant lithology is volcanic breccia with the presence of water in the subsurface. These ruptures compromise the stability of the slopes and consequently make the decommissioning mine process difficult.

Risk Factors for Aggravation of Myopic Retinoschisis after Intravitreal Bevacizumab Injection in Myopic Choroidal Neovascularization

Purpose: We evaluated the factors associated with the development and progression of retinoschisis in patients with myopic choroidal neovascularization (CNV) treated with intravitreal bevacizumab injections.Methods: We conducted a retrospective analysis of 54 eyes with myopic CNV treated with intravitreal bevacizumab injections. We compared optical coherence tomography findings at baseline and final follow-up visits to assess the occurrence and progression of retinoschisis. Furthermore, we analyzed potential risk factors associated with the occurrence and progression of retinoschisis.Results: During a mean follow-up of 42.82 ± 27.12 months, retinoschisis worsened in 11 eyes (20.3%), including 7 eyes with new-onset disease and 4 with progression. The aggravated group demonstrated a significantly longer baseline axial length compared to the non-aggravated group (31.21 ± 2.52 μm vs. 29.21 ± 1.64 μm, p = 0.011). Univariate logistic regression analysis identified axial length (p = 0.041) and pre-existing outer retinoschisis (p = 0.018) as potential predictors of retinoschisis aggravation. In a multivariate analysis, axial length remained significantly associated with retinoschisis aggravation (p = 0.038, odds ratio = 2.63).Conclusions: Our study emphasized that a longer axial length is a risk factor for the development or progression of retinoschisis in myopic CNV patients treated with intravitreal bevacizumab injections. Therefore, closer monitoring during treatment may be warranted for myopic CNV patients with long axial length at baseline.

Evaluating the association of body mass index with COVID-19 severity and mortality using Japanese administrative claims data

Obesity is a risk factor for aggravation of and mortality from coronavirus disease 2019 (COVID-19). We aimed to investigate the relationship between COVID-19 and Body Mass Index (BMI) in the Japanese population. We used administrative claims data from an advanced treatment hospital in Japan and extracted data from patients hospitalized for COVID-19. The exposure variable was BMI measured at the time of admission, and the study outcomes were progression to critical illness and death. Analyses were performed for each age group. Overall, 58,944 patients met the inclusion criteria. The risk of critical illness increased monotonically with higher BMI. In contrast, the relationship between BMI and mortality follows a J-shaped curve; being underweight and obese are risk factors for mortality. When stratified by age, similar trends were observed for both critical illness and mortality. A higher BMI is a risk factor for the progression of COVID-19 severity, whereas both lower and higher BMIs are risk factors for mortality in the Japanese population.

Effects of COVID-19 vaccines on patient-reported outcomes in patients with inflammatory bowel disease: a multicenter survey study in Korea.

The impact of vaccination on inflammatory bowel disease (IBD) patients is still unknown, and no studies have assessed the changes in patient-reported outcomes (PROs) after vaccination in patients with IBD. Therefore, in this study, we investigated the impact of vaccines on the PROs of patients with IBD. We conducted a questionnaire survey of patients with IBD who visited outpatient clinics at 4 specialized IBD clinics of referral university hospitals from April 2022 to June 2022. A total of 309 IBD patients were included in the study. Patient information was collected from a questionnaire and their medical records, including laboratory findings, were reviewed retrospectively. Risk factors associated with an increase in PROs after COVID-19 vaccination were analyzed using logistic regression analyses. In addition, we assessed whether there were differences in variables by vaccine order using the linear mixed model. In multivariate analysis, young age ( < 40 years) and ulcerative colitis (UC) were found to be independent risk factors for aggravation of PROs in patients with IBD. In all patients, platelet count significantly increased with continued vaccination in multiple pairwise comparisons. In UC patients, PROs such as the short health scale, UC-abdominal signs and symptoms, and UC-bowel signs and symptoms were aggravated significantly with continued vaccination. There was no significant increase in the variables of patients with Crohn's disease. Therefore, there may be a need to counsel patients with IBD younger than 40 years of age, and patients with UC before they receive COVID-19 vaccinations.

The right stuff: Salutogenic and pathogenic responses over a year in Antarctica

IntroductionEver since the first human reached the South Pole, studies have sought to explore the impact of an isolated, confined, and unusual environment on human adaptation. The findings have highlighted both negative and salutogenic effects on crews. Although several studies have focused on adaptation in the polar regions, we still do not fully understand its mechanisms. Thus, the objectives of the present study are: (1) to investigate the impact of a one-year stay in Antarctica on health adaptation; and (2) to assess recovery from this experience two days later. MethodSeventeen healthy participants were recruited to stay for one year at the French Dumont d’Urville station in Antarctica. Psychological, physiological, and exteroceptive measures were recorded on the day of arrival at the station (baseline), during each quarter of the wintering season (M4, M7, M10, M12), and two days after the return to the continent (D+2). Subjects were allocated to two groups according to their scores on the General Health Questionnaire at baseline, as follows: very limited or no existence of minor non-psychiatric or psychotic disorders (higher than normal, HN); and standard values for non-psychiatric or minor psychotic disorders within the general population (ordinary range, OR). ResultsOur results highlight both an adaptative response during the winter months, and pathogenic states during the last quarter of the mission and at recovery (D+2), which are still below normal values for psychological disorders and stress. The analysis of OR and HN groups during overwintering highlights a decrease in psychosensory responses, and thus poorer adaptation. ConclusionSpending a year in Antarctica no longer has harmful consequences (except during the third quarter of the mission), and the harshness of the environment in midwinter does not seem to be an aggravating factor for the winterers included in this study. Nevertheless, the General Health Questionnaire indicates two levels of adaptation during the mission. The latter observation suggests that there is a need to select the most-adaptable crews to maintain high performance during overwintering, and to prepare for the return to the continent. Taken together, our results contribute to a better understanding of adaptation in extreme environments, notably future dark space exploration.

Teaching appropriate conflict resolution methods as an incentive to de-judicialization

The multi-door justice system is an alternative for reducing the number of lawsuits brought before the courts. The so-called crisis of the Judiciary can be alleviated through the use by society of other appropriate methods of conflict resolution, such as negotiation, conciliation, mediation and arbitration. However, in a society characterized by a culture of litigation, the judicialization of social conflicts is also a cultural problem, since citizens commonly only know the judicial route as a mechanism for social pacification. This raises the question of whether ignorance of the multi-door justice system is, in fact, an aggravating factor in the phenomenon of judicialization, so that, contrario sensu, teaching other ways of resolving disputes could be considered a cultural strategy to achieve gradual de-judicialization. Therefore, based on a review of the literature, especially consultations of specialized doctrine and analysis of legal texts, this article presents the theory of conflict and the way in which disputes occur in society, as well as explaining what the so-called multi-door justice system consists of, briefly presenting the appropriate dispute resolution methods that make it up. The aim was also to demonstrate that judicialization is based on a cultural problem, which must be gradually resolved by teaching the techniques for reaching appropriate solutions to the disputes that emerge from social life.

The moderating effect of fluid overload on the relationship between the augmentation index and left ventricular diastolic function in patients with CKD

Increased vascular stiffness, fluid overload, and left ventricular diastolic dysfunction (LVDD) are common in patients with chronic kidney disease (CKD). We investigated the potential moderating effect of volume status in the relationship between arterial stiffness and left ventricular (LV) diastolic function in non-dialysis patients with stage 5 CKD. The radial augmentation index at a heart rate of 75 beats/min (rAIx75), overhydration/extracellular water (OH/ECW), and E/e´ ratio were concurrently measured in 152 consecutive patients. Each of these parameters reflects the status of vascular stiffness, fluid balance, and LV diastolic function, respectively. Hierarchical regression analysis demonstrated a significant interaction effect of OH/ECW for all patients (P = 0.015), even after controlling for confounders. In separate analyses, this interaction effect was particularly significant in women (P = 0.010), whereas its significance in patients with diabetes was marginally significant (P = 0.062). Our study suggested that fluid overload could be one of the more aggravating factors of LVDD in patients with CKD who have increased arterial stiffness. Therefore, it is advisable to conduct simultaneous assessments of vascular stiffness, fluid balance, and LV function, particularly in the specific groups mentioned earlier. Our results may serve as evidence applicable to patients with chronic heart failure.

Musculoskeletal disorders of fishermen in the artisanal and coastal sector.

The aim of this study was to screen for musculoskeletal disorders (MSD) complaints, to analyse the activity and to identify their risk factors. This cross-sectional epidemiological study involved 903 men aged > 20 years and with a seniority > 2 years. It included a questionnaire and an ergonomic analysis of the activity. The questionnaire included: socio-demographic and occupational characteristics, health status and life habits, stress and items from the Nordic questionnaire. The observation of work situations required video recordings and the use of three methods: Occupational Safety and Health Administration (OSHA), Rapid Upper Limb Assessment (RULA) and the Gesture Tracking and Assessment Tool (Outil de Repérage et d'Évaluation des Gestes: OREGE). The prevalence of MSDs was 61.9%. It was significantly higher among deckhands than among other professionals (65.6% vs 27.4%; p < 0.001) and in seasonal workers than in permanent workers (67.8% vs 43.1%; p < 0.001). A positive correlation was noted between MSDs and daily work duration. Stress was an aggravating factor, whereas leisure activities were protective. The prevalence of MSDs was 40.5% (lower back), 40.4% (wrist/hand joints), 34.6% (neck) and 31.7% (shoulders). The ergonomic analysis of the workstation was performed on a deckhand who unloaded the fish crates out of the hold of a trawler. OSHA score = 12 (normal < 5); significant risk of upper limb MSD. RULA total score = 7 (acceptable between 1 and 2); immediate modification. OREGE scores evaluating effort, repetitiveness and joint positions indicate that the actions were not recommended or to be avoided. The analysis made it possible to evaluate the difficulty of the job and to note a high risk of MSDs requiring ergonomic and organizational improvements.

ФАКТОРИ ЗАГОСТРЕННЯ КОНКУРЕНЦІЇ ДЛЯ РОЗРОБКИ КОНКУРЕНТНОЇ СТРАТЕГІЇ ПАСАЖИРСЬКОЇ СТАНЦІЇ

The article analyzes the factors of aggravation of the station's competition and the priority tasks that need to be solved in a particular situation, since their ignorance leads to the loss of positions in the transport services market. The role of passenger transportation management and its improvement for the future is determined. Recent studies on assessing competitiveness and developing a competitive strategy for an enterprise, namely a passenger station, are analyzed. It is noted that managerial decisions should be based on the use of marketing information, which will allow to maintain a leading position in the market of transport services. These include limitation of the range of consumers of transport services (due to an increase in transportation tariffs and prices for services), limited opportunities to sell their services, limited resources and complications associated with geographical boundaries. It is noted that a transportation service is not just transportation, but a comprehensive transportation service, i.e., a process of consistent and well-coordinated operations carried out taking into account individual customer requirements. It is determined that railway transport is the main artery in the road transport complex of Ukraine. The article considers measures aimed at improving the quality and availability of passenger services at railway stations and in trains, where the management of the passenger service complex has been transferred to the national system "Express-UZ", which provides end-to-end automation of all processes of integrated passenger service. It is highlighted that for the development of the railway industry there is a need to introduce effective organizational structures that ensure the further development of railway transport and meet the specific requirements of the transport market. It is determined that in order to increase the competitiveness of the station, innovative commercial strategies should be developed that would better meet the demand of passengers and the capabilities of the modern economy, as well as measures to further improve safety, reduce noise, reduce energy consumption, avoid pollution and eliminate all adverse factors that hinder the development of railway transport.

Risk of severe COVID-19 in unvaccinated patients during the period from wild-type to Omicron variant: real-world evidence from Japan.

Many studies have reported that the Omicron variant is less pathogenic than the Delta variant and the wild-type. Epidemiological evidence regarding the risk of severe COVID-19 from the wild-type to the Omicron variant has been lacking. Study participants were COVID-19 patients aged 18 and older without previous COVID-19 infection who were notified to the Nara Prefecture Chuwa Public Health Center from January 2020 to March 2023, during the periods from the wild-type to the Omicron variant. The outcome variable was severe COVID-19 (i.e., ICU admission or COVID-19-related death). The explanatory variable was SARS-CoV-2 variant type or the number of COVID-19 vaccinations. Covariates included gender, age, risk factors for aggravation, and the number of general hospital beds per population. The generalized estimating equations of negative binomial regression models were used to estimate the adjusted incidence proportion (AIP) with 95% confidence interval (CI) for severe COVID-19. Among 77,044 patients included in the analysis, 14,556 (18.9%) were unvaccinated and 520 (0.7%) developed severe COVID-19. Among unvaccinated patients, the risk of severe COVID-19 increased in the Alpha/Delta variants and decreased in the Omicron variant compared to the wild-type (AIP [95% CI] was 1.55 [1.06-2.27] in Alpha/Delta and 0.25 [0.15-0.40] in Omicron), but differed by age. Especially in patients aged ≥80, there was no significant difference in the risk of severe COVID-19 between the wild-type and the Omicron variant (AIP [95% CI] = 0.59 [0.27-1.29]). Regarding the preventive effect of vaccines, among all study participants, the number of vaccinations was significantly associated with the prevention of severe COVID-19, regardless of variant type. After stratified analyses by age, patients aged ≥80 remained a significant association for all variant types. On the other hand, the number of vaccinations had no association in Omicron BA.5 of patients aged 18-64. Patients aged ≥80 had less reduction in risk of severe COVID-19 during the Omicron variant period, and a greater preventive effect of vaccines against severe COVID-19, compared to younger people. Our findings suggest that booster vaccination is effective and necessary for older people, especially aged ≥80.

Quantitative calibration of two-dimensional aggravation factors in the seismic response of basins: a work-in-progress approach using OpenSees and Python

Quantitative calibration of two-dimensional aggravation factors in the seismic response of basins: a work-in-progress approach using OpenSees and Python