Exposure Categories Research Articles

Hip osteoarthritis and occupational mechanical exposures: a systematic review and meta-analysis.

The aim was to conduct a systematic review and meta-analysis investigating the association between occupational mechanical exposures and hip osteoarthritis. The study was registered in PROSPERO. A systematic literature search was conducted in six databases to identify relevant articles. Two authors independently excluded articles, extracted data, assessed the risk of bias of each included article, and graded the level of evidence. We conducted a meta-analysis using random-effects model and performed a sensitivity analysis stratifying articles based on the risk of bias assessment, study design, and the outcome measurement. Twenty-four articles were eligible for inclusion. The highest pooled odds ratio (OR) was found for combined mechanical exposures [OR 1.7, 95% confidence interval (CI) 1.4-2.0], non-neutral postures (OR 1.7, 95% CI 1.4-2.1), lifting/carrying loads (OR 1.6, 95% CI 1.3-1.9), and climbing stairs (OR 1.6, 95% CI 1.1-2.2). The range of pooled OR for the remaining mechanical exposures (eg, standing, walking, kneeling, squatting, and sitting) was 0.6-1.6. Grading the quality of evidence, a moderate level of evidence was found for the combined mechanical exposures and for lifting/carrying loads. The remaining exposure categories were graded as having either low or very low levels of evidence. Considerable heterogeneity was observed across the included studies, and high-quality literature using objective exposure measurements is warranted. Despite various limitations affecting the comparability, occupational mechanical exposures seem to influence the likelihood of developing hip osteoarthritis.

Military environmental exposures and risk of breast cancer in active-duty personnel and veterans: a scoping review.

The effects of military environmental exposures (MEE) such as volatile organic compounds (VOCs), endocrine-disrupting chemicals (EDCs), tactile herbicides, airborne hazards and open burn pits (AHOBP), and depleted uranium on health are salient concerns for service members and Veterans. However, little work has been done to investigate the relationship between MEE and risk of breast cancer. We conducted a scoping review on MEE, military deployment/service, and risk of breast cancer among active-duty service members and Veterans. PRISMA was used. PubMed, Embase, and citations of included articles were searched, resulting in 4,364 articles to screen: 28 articles were included. Most papers on military deployment and military service found a lower/equivalent risk of breast cancer when comparing rates to those without deployment or civilians. Exposure to VOCs due to military occupation or contaminated groundwater was associated with a slightly higher risk of breast cancer. Exposure to Agent Orange was not associated with an increased risk of breast cancer. Evidence regarding EDCs was limited. No paper directly measured exposure to AHOBP or depleted uranium, but deployments with known exposures to AHOBP or depleted uranium were associated with an equivalent/lower risk of breast cancer. Women are the fastest growing population within the military, and breast cancer poses a unique risk to women Veterans who were affected by MEE during their service. Unfortunately, the literature on MEE and breast cancer is mixed and limited, in part due to the Healthy Soldier Paradox and poor classification of exposure(s).

Pregnancy History at 40 Years of Age as a Marker of Cardiovascular Risk.

Individual pregnancy complications are associated with increased maternal risk of cardiovascular disease. We assessed the link between a woman's total pregnancy history at 40 years of age and her relative risk of dying from atherosclerotic cardiovascular disease (ASCVD). This population-based prospective study combined several Norwegian registries covering the period 1967 to 2020. We identified 854 442 women born after 1944 or registered with a pregnancy in 1967 or later, and surviving to 40 years of age. The main outcome was the time to ASCVD mortality through age 69 years. The exposure was a woman's number of recorded pregnancies (0, 1, 2, 3, or 4) and the number of those with complications (preterm delivery <35 gestational weeks, preeclampsia, placental abruption, perinatal death, and term or near-term birth weight <2700 g). Cox models provided estimates of hazard ratios across exposure categories. The group with the lowest ASCVD mortality was that with 3 pregnancies and no complications, which served as the reference group. Among women reaching 40 years of age, risk of ASCVD mortality through 69 years of age increased with the number of complicated pregnancies in a strong dose-response fashion, reaching 23-fold increased risk (95% CI, 10-51) for women with 4 complicated pregnancies. Based on pregnancy history alone, 19% of women at 40 years of age (including nulliparous women) had an increased ASCVD mortality risk in the range of 2.5- to 5-fold. Pregnancy history at 40 years of age is strongly associated with ASCVD mortality. Further research should explore how much pregnancy history at 40 years of age adds to established cardiovascular disease risk factors in predicting cardiovascular disease mortality.

Determinants of undernutrition among khat chewing and non-khat chewing male adults in Addis Ababa, Ethiopia: a comparative cross-sectional study

Khat chewing is a deep-rooted socio-cultural tradition that affects appetite, gastric emptying, and food intake, ultimately influencing nutritional status. Moreover, there is significant variation in lifestyles and ways of living among khat chewing and non-chewing people. However, there is limited evidence on the disaggregated determinants of undernutrition among khat chewers and non-chewers in Ethiopia. A community-based comparative cross-sectional study was conducted with 253 Khat-chewing and 249 non-chewing male adults in Addis Ababa, Ethiopia. Weight and height were measured under standard procedure and used to calculate the body mass index (BMI < 18.5 kg/m2 indicates undernutrition). Variables with p-values below 0.25 in the bi-variable analysis were entered into a multivariable logistic regression model to identify factors associated with undernutrition and to control confounding respectively. An adjusted odds ratio with 95% confidence interval was used to declare the presence and the strength of association between the independent and outcome variable. Statistical significance was declared at a p value of 0.05. In this study, a total of 138 (27.5%: 23.6–31.6%) adult males were undernourished; among them, 78 (32.0%) were khat chewers and 60 (23.9%) were non chewers. Christian religion (AOR = 1.49; 1.02–2.30), vegetable consumption (AOR = 1.69; 95% CI 1.12–2.55) and khat chewing (AOR = 1.60; 1.04–2.45) were independent risk factors for undernutrition. However, none of the above factors showed a statistically significant association among non-khat chewer male adults. In conclusion, undernutrition was a public health concern in male adults in the study area. Frequent consumption of fruits, vegetables and family size of the households were the independent predictors of undernutrition. The practical implication of identifying risk factors of undernutrition among chewers and non-chewers could be helpful in depicting the relevant risk factors by exposure category and helping to further refine intervention packages. In addition, focusing on interventions which can increase the availability and accessibility of fruits and vegetables are important to improve the nutritional status of adult male populations.

Occupational noise and hypertension in Southern Chinese workers: a large occupational population-based study.

An increasing number of original studies suggested that occupational noise exposure might be associated with the risk of hypertension, but the results remain inconsistent and inconclusive. In addition, the attributable fraction (AF) of occupational noise exposure has not been well quantified. We aimed to conduct a large-scale occupational population-based study to comprehensively investigate the relationship between occupational noise exposure and blood pressure and different hypertension subtypes and to estimate the AF for hypertension burden attributable to occupational noise exposure. A total of 715,135 workers aged 18-60 years were included in this study based on the Key Occupational Diseases Surveillance Project of Guangdong in 2020. Multiple linear regression was performed to explore the relationships of occupational noise exposure status, the combination of occupational noise exposure and binaural high frequency threshold on average (BHFTA) with systolic and diastolic blood pressure (SBP, DBP). Multivariable logistic regression was used to examine the relationshipassociation between occupational noise exposure status, occupational noise exposure combined with BHFTA and hypertension. Furthermore, the attributable risk (AR) was calculated to estimate the hypertension burden attributed to occupational exposure to noise. The prevalence of hypertension among occupational noise-exposed participants was 13·7%. SBP and DBP were both significantly associated with the occupational noise exposure status and classification of occupational noise exposure combined with BHFTA in the crude and adjusted models (all P < 0·0001). Compared with workers without occupational noise exposure, the risk of hypertension was 50% greater among those exposed to occupational noise in the adjusted model (95% CI 1·42-1·58). For participants of occupational noise exposed with BHFTA normal, and occupational noise exposed with BHFTA elevated, the corresponding risks of hypertension were 48% (1·41-1·56) and 56% (1·46-1·63) greater than those of occupational noise non-exposed with BHFTA normal, respectively. A similar association was found in isolated systolic hypertension (ISH) and prehypertension. Subgroup analysis by sex and age showed that the positive associations between occupational noise exposure and hypertension remained statistically significant across all subgroups (all P < 0.001). Significant interactions between occupational noise status, classification of occupational noise exposure combined with BHFTA, and age in relation to hypertension risk were identified (all P for interaction < 0.001). The associations of occupational noise status, classification of occupational noise exposure combined with BHFTA and hypertension were most pronounced in the 18-29 age groups. The AR% of occupational noise exposure for hypertension was 28·05% in the final adjusted model. Occupational noise exposure was positively associated with blood pressure levels and the prevalence of hypertension, ISH, and prehypertension in a large occupational population-based study. A significantly increased risk of hypertension was found even in individuals with normal BHFTA exposed to occupational noise, with a further elevated risk observed in those with elevated BHFTA. Our findings provide epidemiological evidence for key groups associated with occupational noise exposure and hypertension, and more than one-fourth of hypertension cases would have been prevented by avoiding occupational noise exposure.

Using vulnerability assessment to characterize coastal protection benefits provided by estuarine habitats of a dynamic intracoastal waterway.

The existence of coastal ecosystems depends on their ability to gain sediment and keep pace with sea level rise. Similar to other coastal areas, Northeast Florida (United States) is experiencing rapid population growth, climate change, and shifting wetland communities. Rising seas and more severe storms, coupled with the intensification of human activities, can modify the biophysical environment, thereby increasing coastal exposure to storm-induced erosion and inundation. Using the Guana Tolomato Matanzas National Estuarine Research Reserve as a case study, we analyzed the distribution of coastal protection services-expressly, wave attenuation and sediment control-provided by estuarine habitats inside a dynamic Intracoastal waterway. We explored six coastal variables that contribute to coastal flooding and erosion-(a) relief, (b) geomorphology, (c) estuarine habitats, (d) wind exposure, (e) boat wake energy, and (f) storm surge potential-to assess physical exposure to coastal hazards. The highest levels of coastal exposure were found in the north and south sections of the Reserve (9% and 14%, respectively) compared to only 4% in the central, with exposure in the south driven by low wetland elevation, high surge potential, and shorelines composed of less stable sandy and muddy substrate. The most vulnerable areas of the central Reserve and main channel of the Intracoastal waterway were exposed to boat wakes from larger vessels frequently traveling at medium speeds (10-20 knots) and had shoreline segments oriented towards the prevailing winds (north-northeast). To guide management for the recently expanded Reserve into vulnerable areas near the City of Saint Augustine, we evaluated six sites of concern where the current distribution of estuarine habitats (mangroves, salt marshes, and oyster beds) likely play the greatest role in natural protection. Spatially explicit outputs also identified potential elevation maintenance strategies such as living shorelines, landform modification, and mangrove establishment for providing coastal risk-reduction and other ecosystem-service co-benefits. Salt marshes and mangroves in two sites of the central section (N-312 and S-312) were found to protect more than a one-quarter of their cross-shore length (27% and 73%, respectively) from transitioning to the highest exposure category. Proposed interventions for mangrove establishment and living shorelines could help maintain elevation in these sites of concern. This work sets the stage for additional research, education, and outreach about where mangroves, salt marshes, and oyster beds are most likely to reduce risk to wetland communities in the region.

Could sex-specific subtypes of hand osteoarthritis exist? A retrospective study in women presenting to secondary care.

Hand osteoarthritis is more common in women, and its risk increases around the time of the menopause. We set out to describe the timing between menopause and the onset of symptomatic hand osteoarthritis (OA), and associations with the use of hormone replacement therapy (HRT) or its discontinuation, describing any identifiable subgroups of women. Retrospective healthcare-records study of sequential women referred to a specialist hand OA clinic, 2007-2015. Confirmation of hand OA diagnosis was by clinican, by accepted criteria. Demographics and clinical variables were from healthcare-records, recorded by standardised proforma. Outcomes of interest were reported age of onset of hand symptoms, reported age at final menstrual period (FMP), time from FMP to reported onset of hand symptoms and time from cessation of HRT to reported onset of hand symptoms. Exposure categories for systemic HRT use were never users, current users, previous users. Analysis of Variance compared groups; linear regression analysed associations of exposure with outcome. 82/92(89%) of eligible women were post-menopausal, mean age at FMP 49.9 years (SD5.4). In these post-menopausal women, median time from FMP to hand symptom onset was 3 years. 48/82 (59%) developed hand symptoms within the defined peri-menopausal period (FMP ± 4 years), whilst some women developed their symptoms before or after (range -25, 30 years). In women who discontinued HRT prior to symptom onset, the median time from HRT cessation to onset of hand symptoms was 6 months. Past HRT users were older at hand symptom onset than women who had not taken HRT [coeff.4.7 years (0.92, 8.39); P = 0.015]. This study adds to evidence associating the menopause/sex hormone deficiency with hand OA symptom onset in a sizeable subgroup of women (but not all). HRT use/cessation appears to influence the timing of onset of hand OA symptoms. It is not possible to interpret from this type of study whether sex hormone deficiency is causative of disease or modulates its symptoms. It is also not possible to judge whether painful hand osteoarthritis in post-menopausal women is a subtype of disease. Further investigation is indicated of sex-specific subtypes and potential for personalised medicine for post-menopausal women with hand osteoarthritis, as a clearly definable high-risk subgroup.

Industrial Building Structure Planning With Cranes

Industrial building structure planning complies with standards and regulations, such as Procedures for Earthquake Resistance Planning, Minimum Loads for Building Design, and Specifications for Structural Steel Buildings. Vertical and lateral loads are fundamental to the structure's load flow process. Industrial buildings handle roof, wind, earthquakes, crane, and wall loads. Structural design must consider these elements, including the choice of lateral force-resisting systems such as X-bracing. In determining building loads, including earthquake and wind loads, various parameters such as wind speed, exposure category, and other factors must be considered by standard requirements such as SNI 1727-2020 and SNI 1726:2019. Selection of site class, wind direction, topographic, and ground surface elevation factors are essential in determining wind loads. This research method focuses on supporting structures consisting of purlins and girts in the context of industrial buildings. Purlins, made from hot or cold rolled steel, generally use C and Z profiles. Girts, made from cold or hot rolled steel, have profile variations such as C, Z, or hollow square sections. The girt structure design process determines dimensions, rod sag, internal requirements, and sag rod capacity.

Benzene Exposure and Lung Cancer Risk: A Systematic Review and Meta-Analysis of Human Studies.

Lung cancer is a leading cause of death with nearly 1.8 million deaths estimated worldwide in 2020. Although benzene is classified as a human carcinogen (Group 1) on the basis of its association with acute myeloid/non-lymphocytic leukaemia, there is still limited evidence that it may influence lung cancer risk. This study examined the potential link between benzene exposure and risk of lung cancer using a systematic review of epidemiological studies and meta-analysis. We searched through PubMed, Web of Science and Scopus databases up to 10 February 2023 to identify all articles on the association between benzene exposure and lung cancer (incidence or prevalence) and/or mortality. We extracted the risk estimates of the highest and the lowest reported categories of benzene exposure and conducted a meta-analysis using a random-effects model. Heterogeneity and publication bias were analysed using an I2 test and funnel plots asymmetry, respectively. Twenty-one studies were included in the final analysis, with a total of 10,750 lung cancer cases and 2899 lung cancer deaths. Overall, risk estimates of lung cancer prevalence and mortality in association with benzene exposure were 1.20 (n = 14; 95% CI 1.05-1.37) and 1.15 (n = 13; 95% CI 1.02-1.30), respectively. In all cases, heterogeneity was quite large, while no significant publication bias was observed. When only studies that adjusted for smoking habit were selected, the risk for lung cancer increased by up to 34% (n = 9; 95% CI 1.10-1.64). Our data, which show a strong association between benzene exposure and lung cancer risk, may have important public health implications. However, further studies are needed to identify the lung cancer risk associated with benzene exposure considering different smoking conditions.

Barbary macaques show sex-related differences in body weight based on anthropogenic food exposure despite comparable female–male stable isotope ratios

As the human–primate interface expands, many nonhuman primate (NHP) populations exploit anthropogenic foods to survive, while some populations opportunistically target them. Though anthropogenic food consumption is sometimes associated with greater reproductive output and survival in these populations, there is a dearth of research on possible health effects. We explore how differential exposure to anthropogenic foods is linked to variation in isotopic compositions (δ13C and δ15N) and body weights in Barbary macaques (Macaca sylvanus) in the Upper Rock Nature Reserve, Gibraltar. We placed monkeys into three categories based on anthropogenic food exposure. We then analyzed individuals for isotopic signatures (N = 147) and body weight measurements (N = 80). Using the lowest exposure category as the comparison, we found body weights and δ15N values, but not δ13C values, significantly differed across key categories. Within categories, we found no significant associations between sex and δ13C or δ15N values, suggesting that individuals within categories consumed similar foods regardless of sex. We found a significant interaction effect between category and sex for predicting body weights. These results suggest that sex plays a role in how anthropogenic foods are accessed and consumed regardless of exposure, which may result in differential health profiles for female and male macaques.

Prevalence of delayed initiation of rabies postexposure prophylaxis and factors influencing it among animal bite victims from Eastern Uttar Pradesh, India.

In a rabies-endemic country like India, every animal bite is potentially taken as rabid exposure and timely and appropriate postexposure prophylaxis (PEP) is crucial as rabies is an almost 100% fatal disease. A retrospective record-based study was conducted at an anti-rabies clinic (ARC) in Eastern Uttar Pradesh, India. Data of the animal bite victims attending the ARC for PEP from January to December 2022 were extracted from the records. A semistructured questionnaire was used for collecting information regarding the interval between exposure and the initiation of anti-rabies PEP, age, gender, residence, the bite site on the body, category of exposure and other risk factors associated with the delay in PEP. Most of the victims were male (67.6%), from an urban background (61.3%) and aged up to 20 y (43.9%). Out of the 222 victims, 62 (27.9%) had delayed initiation of PEP (>48 h after exposure). Factors found to be significantly associated with delayed initiation of PEP were residence (p=0.01), age (p=0.04) and the type of biting animal (p=0.002). Delayed initiation of PEP is common among animal bite victims in this region of India, although PEP is affordable. Educational programmes and awareness-raising campaigns for timely administration of PEP should be a priority, especially targeting rural residents, those aged<18 y and those bitten by animals other than dogs.

Total Effective Xenoestrogen Burden in Serum Samples and Risk of Endometrial Cancer in the Spanish Screenwide Case-Control Study.

Endometrial cancer is a hormone-dependent cancer, and estrogens play a relevant role in its etiology. However, little is known about the effects of environmental pollutants that act as xenoestrogens or that influence estrogenic activity through different pathways. We aimed to assess the relationship between the combined estrogenic activity of mixtures of xenoestrogens present in serum samples and the risk of endometrial cancer in the Screenwide case-control study. The total effective xenoestrogen burden (TEXB) attributable to organohalogenated compounds () and to endogenous hormones and more polar xenoestrogens () was assessed in serum from 156 patients with endometrial cancer (cases) and 150 controls by combining chemical extraction and separation by high-performance liquid chromatography with the E-SCREEN bioassay for estrogenicity. Median and levels for cases (0.30 and , respectively) and controls (0.42 and , respectively) did not significantly differ ( and 0.933, respectively). An inverted-U risk trend across serum and levels was observed in multivariate adjusted models: Positive associations were observed for the second category of exposure in comparison to the lowest category of exposure [ (95% CI: 1.13, 3.94) for , and (95% CI: 1.62, 6.81) for ], whereas no significant associations were observed between the third category of exposure and the first [ (95% CI: 0.64, 2.31) for , and (95% CI: 0.75, 3.33) for ]. In mutually adjusted models for and levels, the association of with endometrial cancer risk was attenuated [ (95% CI: 0.61, 3.47) for the second category of exposure], as well as estimates for (; 95% CI: 1.03, 6.99). Most of the individual halogenated contaminants showed no associations with both TEXB and endometrial cancer. We evaluated serum total xenoestrogen burden in relation to endometrial cancer risk and found an inverted-U risk trend across increasing categories of exposure. The use of in vitro bioassays with human samples may lead to a paradigm shift in the way we understand the negative impact of chemical mixtures on human health effects. These results are relevant from a public health perspective and for decision-makers in charge of controlling the production and distribution of chemicals with xenoestrogenic activity. https://doi.org/10.1289/EHP13202.

Cancer mortality in chrysotile miners and millers, Russian Federation: main results (Asbest Chrysotile Cohort-Study).

We investigated mortality in workers of the world's largest chrysotile mine and enrichment factories located in the town of Asbest, Russian Federation. This historical cohort study included all workers employed for at least 1 year between 1975 and 2010 and follow-up until the end of 2015. Cumulative exposure to dust was estimated based on workers' complete occupational history linked to dust measurements systematically collected from the 1950s. Exposure to chrysotile fibers was estimated using dust-to-fiber conversion factors. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated as mortality rate ratios in Poisson regression models. A total of 30 445 (32% women) workers accumulated 721 312 person-years at risk and 11 110 (36%) died. Of the workers, 54% had more than 30 years since their first exposure. We found an exposure-response between cumulative dust and lung cancer mortality in men. No clear association with dust exposure but a modest increase in the highest category of fiber exposure was seen for lung cancer in women. Mesothelioma mortality was increased (RR = 7.64, 95% CI = 1.18 to 49.5, to at least 80 fibers per cm3 years and RR = 4.56, 95% CI = 0.94 to 22.1, to at least 150 mg/m3 years [dust]), based on 13 deaths. For colorectal and stomach cancer, there were inconsistent associations. No associations were seen for laryngeal or ovarian cancer. In this large-scale epidemiological study in the world's largest active asbestos mine, we confirmed an increased risk of mesothelioma with high fiber exposure and an increasing mortality for lung cancer in men with increasing dust exposure. Less clear-cut increased lung cancer mortality was seen in the women. Continued mortality follow-up is warranted.

Toward improved thermal exposure classes for structural firefighters

In the early 1970s, there was an initial effort to quantify the conditions under which firefighters are expected to perform. Harvey Utech led this endeavor by defining three levels of thermal exposure—routine, ordinary, and emergency—which were characterized by combining a range of air temperatures and radiative heat fluxes. In the last half-century, there has been a concerted scientific effort to further understand the conditions to which firefighters are exposed during structural firefighting. Research has been conducted on the resiliency of turnout gear and facepiece lenses, the thermal conditions observed during a structure fire, and the impact of firefighter tactics such as ventilation and suppression. The authors synthesize the results from these research areas to update the original thermal classifications to six categories of exposure—routine, Ordinary I, Ordinary II, Emergency I, Emergency II, and Emergency III—which are more representative of the operating environment and protective equipment thresholds that firefighters should be aware of during firefighting operations and tactical decision-making.

The diagnosis of asbestosis in the 21st century: a clinicopathological correlation of 102 cases

ABSTRACT Asbestosis, defined as diffuse pulmonary fibrosis caused by inhalation of asbestos fibers, occurs after heavy exposures to asbestos dust over several decades. Because workplace exposures have been significantly curtailed since the banning of asbestos in insulation products, we were interested in examining the clinicopathological characteristics of cases diagnosed in the 21st century. The consultation files of one of the authors (VLR) were reviewed for cases of asbestosis diagnosed since 1/1/2001. 102 cases were identified, with a median age of 75 years (range: 45–89). There were 100 men and 2 women. The women were from Turkey and Brazil (none from the United States). Malignancies were present in 78 cases, including 38 lung cancers, 29 pleural mesotheliomas, and 8 peritoneal mesotheliomas. The grade of asbestosis was available in 88 cases (median severity of 2; scale: 1–4). Pleural plaque was present in 94% of cases. The most common exposure categories were insulators (39), shipyard workers (16), asbestos manufacturing (9), boiler workers (8) and pipefitter/welders (6). The median duration of exposure was 33 years (range: 2–49 years). Lung fiber burden analysis was performed in 34 cases, with amosite being the predominant fiber type. Results were compared with similar information for 475 cases diagnosed prior to 1/1/2001.

Effects of perinatal exposure to daily maximum THI and THI fluctuations on serum total proteins and health of preweaned Holstein heifers raised in a dry climate.

The objective of this study was to assess the effects of the exposure to daily maximum and temperature-humidity index (THI) and to daily THI fluctuations (∆THI = maximum THI-minimum THI) at exposure periods comprising 2 d before birth to birth (-2 d), birth date (0 d), birth to 2 d of age (+2 d), and birth to 7 d of age (+7 d) on serum total proteins (STP), transfer of passive immunity (TPI), and the occurrence of scours and respiratory disease. A total of 841 Holstein heifer calves were retrospectively observed from -2 d until 65 d of age. Colostrum quality was assessed using a colostrometer to ensure a minimum globulin concentration of 52 mg/mL in the colostrum fed to the study calves. Two temperature and relative humidity sensors were installed at the calf yard. Maximum, minimum, and ∆THI values were obtained for each exposure period, and thermal exposure categories were defined as heat stress (HS: maximum THI > 70 units; non-HS: THI ≤ 70 units) and ∆THI (low < 20 units, medium ≥ 20 to ≤30 units, high > 30). The TPI was classified as poor (STP < 5.1 g/dL), fair (5.1 and 5.7 g/dL), good (>5.7 and 6.1 g/dL), and excellent (≥6.1 g/dL). Associations between the thermal exposure categories and the study outcomes were examined using ANOVA, logistic regression, and survival analyses. No differences in STP at -2 d were observed between HS and non-HS calves (6.83 ± 0.05 vs. 6.91 ± 0.05 g/dL), whereas HS-exposed calves at 0 d tended to have lower STP compared with non-HS calves (6.82 ± 0.05 vs. 6.92 ± 0.05 g/dL). Calves exposed to small ∆THI at 0 d had greater STP compared with calves exposed to medium ∆THI (7.00 ± 0.06 vs. 6.75 ± 0.05 g/dL). No association was found between HS, and ∆THI categories and the TPI category. The odds of scours were about 2 times greater in HS calves compared with non-HS calves at all exposure periods. In addition, HS calves were affected by scours between 9 and 15 d earlier than non-HS calves. Furthermore, high ∆THI favored the development of respiratory problems compared with medium and low ∆THI. Assessment of extreme THI values and THI fluctuations provides a research opportunity for assessing thermal stress in dairy heifer calves raised in dry climate.

Temporal Patterns and Variations in HIV/AIDS detection: Notifications in Brazil (2013-2022)

Introduction: Acquired Immunodeficiency Syndrome (AIDS) is the advanced stage of Human Immunodeficiency Virus (HIV) infection, compromising the immune system and rendering the body vulnerable to various opportunistic infections. Since the 1970s, AIDS has posed a global challenge, impacting Brazil since 1982. Despite advancements, the disease's persistence necessitates comprehensive strategies and a deep understanding of transmission methods for effective management. Objective: This study aims to comprehend HIV/AIDS detection in Brazil (2013–2022). Analyzing temporal patterns, it guides future prevention and control strategies, emphasizing the need for effective approaches in the dynamic epidemic scenario. Methods: This cross-sectional study analyzes HIV case notifications in Brazil (2013-2022) utilizing data from the Unified Health System's Department of Information and Informatics (DATASUS), covering macro-regions, Federative Units, and capitals. Detection rate data are sourced from the Notifiable Diseases Information System (Sinan), Mortality Information System (SIM), Laboratory Exams Control System (Siscel), and Medication Logistic Control System (Siclom), considering sociodemographic variables and exposure categories. The analysis aims to understand the dynamics of HIV/AIDS in the country. Results: Between 2013 and 2022, AIDS cases in Brazil predominantly affect men, with an increase after 2020. The HIV detection rate by region reveals significant variations, highlighting fluctuations in the North and South. Educational data suggest a reduction in cases, indicating the impact of preventive programs. The analysis by race/color shows a consistent decline in cases among whites, blacks, and browns, while yellows and indigenous populations exhibit variations. Conclusion: The conducted analysis highlights the complexity of AIDS dissemination in Brazil, underscoring the need for regionally adapted strategies. Variations by region, education levels, and race/color emphasize the importance of multifaceted approaches, continuous prevention programs, and addressing social inequalities.

'Cultural Insights into Adults' Hearing Awareness and Personal Listening Device Habits: A Survey Study.

The aim of this study was to investigate adults' habits regarding personal listening devices (PLDs), associated factors such as tinnitus and hearing threshold shift, and their knowledge of safety measures, including the use of hearing protectors in noisy environments. A cross-sectional survey was designed and distributed online. Participants between the ages of 18 and 40 years were invited to complete the survey. The online survey was filled out by 274 individuals with an average age of 24.2 years (SD= 5.1 years). Based on age, the participants were grouped into young adults (18-23 years old, 151 participants) and adults (24-40 years old, 123 participants). The estimation of noise exposure was calculated based on self-reported responses of PLD use. Two categories emerged from this calculation: the participants with exposure lower than 80 dB were in the low exposure category (N: 196, 62.9 dB), while the participants with exposure higher than 80 dB were in the high exposure category (N: 78, 89.9 dB). Based on the age categories, most of the questionnaire answers were similar between the young adults and the adults, revealing similar habits in using their PLDs. However, the investigation based on exposure revealed differences, as the participants with high exposure levels were more likely to have hobbies that involved noise, and they were less likely to obtain hearing evaluations. Among the participants, 30% used their devices at the maximum volume level and on a daily basis. 33.5% reported experiencing worsening in hearing, 2.4% reported persistent tinnitus, 94.1% knew that hearing protectors were available but only 20.7% reported using hearing protectors. The study concludes that adults are at risk of hearing loss due to unsafe listening habits. A discrepancy between knowledge and practice is apparent and needs to be addressed in young adults by increasing awareness of hearing loss, hearing protection and annual hearing evaluation.

PREVALÊNCIA DO ANTICORPO CONTRA HEPATITE B EM UMA REGIONAL DE SAÚDE DO PARANÁ

ABSTRACT Objective: To estimate the positivity rate of the Hepatitis B Surface Antigen with demographic characteristics and exposure categories among confirmed cases in the municipalities of the 17th Health Region of Paraná, Brazil. Method: This is a descriptive, quantitative cross-sectional study based on notified/confirmed cases in people aged ≥ 1 year and living in the area of the regional health center between 2017 and 2022. The serological marker was used as the outcome variable, and the exposure variables were categorized using absolute and relative frequencies, the Chi-square test, and Fisher’s exact test. Results: The variables gender, age group, pregnancy, schooling, and exposure to injecting drugs showed a statistical difference between the groups with a positive rate for the reactive marker. Conclusion: It is important to train health professionals in the use of rapid tests and in filling out the form in full so that they know the epidemiological profile of each region and can draw up specific strategies for prevention, control, and treatment.

The Value of Endoscopic Exposure of Round Window in Cochlear Implant via Facial Recess.

Introduction Cochlear implantation has been considered as the best treatment in patients with severe to profound hearing loss unaidable with hearing aids. The main value of endoscope-assisted cochlear implantation is improved visibility of the RW Objective to assess the value of endoscopic assisted CI surgery via facial recess approach without elevating tympanic anulus. Methods This Prospective case series study non-randomized sample was performed on 50 patients with severe to profound hearing loss unaidable with hearing aids undergoing unilateral endoscopic assisted cochlear implant surgery with round window electrode insertion Results There were 23 male and 27 female patients. Most of the cases were children (41 cases). Of those 50 patients, 39 were prelingually hearing impaired. Four cases had various inner ear abnormalities. The standard mastoidectomy and Posterior Tympanotomy approach were used for all cases. Endoscopic identification of the RW through the PT enabled us to perform regular surgery in all cases. The current study concludes the difference between microscopic exposure and endoscopic exposure represented by Saint Tomas classification found that endoscopic exposure of round window classification is better represented by downgrading in the classification of round window exposure as type I 29(58%), type IIa 18(36%) type IIb 3 (6%) Non were type III by endoscopic exposure compared to microscopic exposure of round window is a type I 7(14%), type II 14(28%), type IIb 22(44%) and type III 7 (14%). Conclusion Endoscopy proved a great value in exposure and identification of RW in CI surgery through posterior tympanotomy approach.