Exposure Events Research Articles

Protective Factors as Mediators Between Trauma and Internalizing Difficulties Among Male and Female Young Adults

The goal of this study was to examine the indirect effect of protective factors (i.e., resilience, coping, and self-esteem) on the association between exposure to traumatic events in childhood and internalizing difficulties for men and women. We surveyed 583 young adults aged 18 to 25 years about past exposure to traumatic events and current internalizing difficulties. The results suggest that there is a significant indirect effect of protective factors on the association between lifetime traumatic event exposure and internalizing distress. Furthermore, there was a gender difference between groups for the indirect effect of protective factors; protective factors had a mediating effect for women but not for men. This study highlights the importance of protective factors in understanding why some individuals experience internalizing difficulties after exposure to traumatic events. When working with victims of traumatic events, it is essential to consider their sex and the presence of protective factors such as coping, resilience, and self-esteem.

Widespread dolomite recrystallization and porosity modification of upper Permian Zechstein carbonates, Symra discovery, Utsira High, Norwegian North Sea

The Utsira High is a prominent intrabasinal basement structure in which the eroded remnants of a widespread, Late Permian, Zechstein carbonate shelf are preserved locally. The western margin of the central Utsira High is mainly characterized by weathered basement rocks with a thin Mesozoic cover. However, the recently discovered Symra Field forms an isolated sedimentary inlier basin of the area, where deeply eroded Zechstein shelf carbonates are preserved within a half-graben. The Zechstein carbonates consist of mainly ZS2 marginal marine carbonate facies and are similar to those described elsewhere from the Zechstein Basin. They are unconformably overlain by Paleogene chalks. Based on detailed facies analysis of two recently drilled cores combined with detailed petrographic and stable isotopic analysis and supplemented by age dating of selected carbonate phases using U-Pb geochronology, we show that the Zechstein carbonates have been subjected to several phases of near-surface diagenetic alterations. Volumetrically the most dominant diagenetic product comprises nonplanar dolomites interpreted to have formed by recrystallization of a precursor reflux-type dolomite phase. The recrystallized dolomites retain enhanced reservoir quality in comparison to stratigraphic equivalent ZS2 reflux-type dolomites found elsewhere on the Utsira High. Based on U-Pb-derived age constraints, the recrystallization took place during a long-lived Late Triassic exposure event of the Utsira High, and a near-surface origin for the recrystallized dolomites is proposed. The porosity enhancement occurred contemporaneously with the dolomite recrystallization process and was facies controlled. Reservoir modifications associated with the exposure led to the dissolution of CaSO4 cement, and metastable dolomite phases, in addition to the enlargement of existing pores which had created zones of weakness prone to further dissolution. Overall, the Zechstein carbonates preserved on the Utsira High illustrate the complexity of the diagenetic alterations resulting from the uplift of a carbonate shelf, and its importance for reservoir quality.

Nurses during war: Profiles-based risk and protective factors.

Nurses in southern Israel's public hospitals were exposed to unusual traumatic events following the October 7, 2023, Hamas attack on Israel, and the ensuing Swords of Iron War. This study aimed to clarify the complexity of wartime nursing by identifying profiles based on risk factors (i.e., psychological distress and adjustment disorders) and protective factors (i.e., positive affect (PA), resilience, and perceived social support [PSS]). This study utilizes a cross-sectional design. Two hundred nurses at a major public hospital in southern Israel completed self-report questionnaires. A latent profile analysis (LPA) was conducted to identify distinct profiles based on nurses' risk and protective factors. Differences in profiles were examined alongside sociodemographic and occupational variables and traumatic event exposure. The LPA was conducted using MPlus 8.8 Structural Equation Modeling (SEM) software. Two distinct profiles were identified: "reactive" and "resilient." The "reactive" group included nurses who had higher risk factor scores (psychological distress and adjustment disorder), whereas the "resilient" group included nurses who had higher protective factor scores (PA, resilience, and PSS). Furthermore, nurses in the "reactive" group were younger, with greater seniority, worse self-rated health, and a higher frequency of kidnapped family members compared to nurses from the "resilient" group. Nurses in wartime are at risk if identified as "reactive." Identifying these profiles can assist in developing effective support practices to help nurses cope with wartime challenges and maintain their mental well-being. Healthcare organizations should tailor interventions to prepare and support nurses of various ages and experience levels, during and after conflicts. This approach aims to reduce risk factors and promote protective factors among nurses during wartime.

Major depressive disorder: point prevalence, suicidal ideation, and risk factors among Sudanese children and adolescents during Sudan army conflict: a cross-sectional study

BackgroundTiredness, poor concentration, disturbed sleep and poor appetite can all be caused by depression, which is a common mental disorder and a leading cause of disability worldwide. This study aimed to assess the prevalence of major depressive disorder, suicidal ideation, and risk factors in Sudanese children and adolescents during the Sudanese army conflict.MethodsA descriptive cross-sectional community-based study was carried out among Sudanese children between 11 and 17 years old who living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Patients Health Questionnaire-9 (PHQ-9) checklist for the assessment of major depression disorder symptoms according to the Diagnostic and Statistical Manual Edition 5th Edition (DSM-5). The questionnaire was translated into Arabic by two expert translators, and its validity and reliability were confirmed. Data analysis was performed using Statistical Package for the Social Sciences version 25 software, and descriptive analysis and any appropriate statistical tests were performed.ResultsAmong the 963 participants, the mean age was 15.18 ± 2.1 years, 65.5% were female, and 67.7% had major depressive disorder. There was a significant relationship between MDD score, age, sex, current residency status, and traumatic event exposure, with P values less than 0.001 for all variables.ConclusionMajor depressive disorder was highly prevalent among Sudanese children and adolescents included in the present study. Additionally, suicidal ideation, which requires immediate intervention, was reported to be very high. The findings will help the government to provide proper mental health interventions for affected people.

Cannabidiol exposure during embryonic period caused serious malformation in embryos and inhibited the development of reproductive system in adult zebrafish

Cannabidiol (CBD) is a non-psychoactive component of cannabis with potential applications in biomedicine, food, and cosmetics due to its analgesic, anti-inflammatory, and anticonvulsant properties. However, increasing reports of adverse CBD exposure events underscore the necessity of evaluating its toxicity. In this study, we investigated the developmental toxicity of CBD in zebrafish during the embryonic (0–4 dpf, days post fertilization) and early larval stages (5–7 dpf). The median lethal concentration of CBD in embryos/larvae is 793.28 μg/L. CBD exhibited concentration-dependent manner (ranging from 250 to 1500 μg/L) in inducing serious malformed somatotypes, like shorter body length, pericardial cysts, vitelline cysts, spinal curvature, and smaller eyes. However, no singular deformity predominates. The 5-month-old zebrafish treated with 100 and 200 μg/L of CBD during the embryonic and early larval stages produced fewer offspring with higher natural mortality and malformation rate. Gonadal growth and gamete development were inhibited. Transcriptomic and metabolomic analyses conducted with 400 μg/L CBD on embryos/larvae from 0 to 5 dpf suggested that CBD promoted the formation and transportation of extracellular matrix components on 1 dpf, promoting abnormal cell division and migration, probably resulting in random malformed somatotypes. It inhibited optical vesicle development and photoreceptors formation on 2 and 3 dpf, resulting in damaged sight and smaller eye size. CBD also induced an integrated stress response on 4 and 5 dpf, disrupting redox, protein, and cholesterol homeostasis, contributing to cellular damage, physiological dysfunction, embryonic death, and inhibited reproductive system and ability in adult zebrafish. At the tested concentrations, CBD exhibited developmental toxicity, lethal toxicity, and reproductive inhibition in zebrafish. These findings demonstrate that CBD threatens the model aquatic animal, highlighting the need for additional toxicological evaluations of CBD before its inclusion in dietary supplements, edible food, and other products.

On-field Head Acceleration Exposure Measurements Using Instrumented Mouthguards: Multi-stage Screening to Optimize Data Quality.

Instrumented mouthguards (iMGs) are widely applied to measure head acceleration event (HAE) exposure in sports. Despite laboratory validation, on-field factors including potential sensor skull-decoupling and spurious recordings limit data accuracy. Video analysis can provide complementary information to verify sensor data but lacks quantitative kinematics reference information and suffers from subjectivity. The purpose of this study was to develop a rigorous multi-stage screening procedure, combining iMG and video as independent measurements, aimed at improving the quality of on-field HAE exposure measurements. We deployed iMGs and gathered video recordings in a complete university men's ice hockey varsity season. We developed a four-stage process that involves independent video and sensor data collection (Stage I), general screening (Stage II), cross verification (Stage III), and coupling verification (Stage IV). Stage I yielded 24,596 iMG acceleration events (AEs) and 17,098 potential video HAEs from all games. Approximately 2.5% of iMG AEs were categorized as cross-verified and coupled iMG HAEs after Stage IV, and less than 1/5 of confirmed or probable video HAEs were cross-verified with iMG data during stage III. From Stage I to IV, we observed lower peak kinematics (median peak linear acceleration from 36.0 to 10.9g; median peak angular acceleration from 3922 to 942rad/s2) and reduced high-frequency signals, indicative of potential reduction in kinematic noise. Our study proposes a rigorous process for on-field data screening and provides quantitative evidence of data quality improvements using this process. Ensuring data quality is critical in further investigation of potential brain injury risk using HAE exposure data.

Occupational post-exposure prophylaxis among healthcare workers: a scoping review of factors affecting optimal utilization.

Post-exposure prophylaxis (PEP) is an efficacious prevention method when initiated promptly after an HIV exposure. Yet, PEP has been underutilized, even among healthcare workers (HCWs) with occupational exposure in sites with PEP policies and procedures and access to PEP medications. It is important to understand the dynamics of uneven PEP use in what appears to be an optimal context to better protect the health and wellbeing of HCWs. We conducted a scoping review to elucidate factors influencing HCWs' use of PEP after occupational exposure. We searched PubMed, PsychInfo and Google Scholar for peer-reviewed literature published in English from 2014 to 2022 using the terms HIV, postexposure/post-exposure prophylaxis, acceptability, healthcare workers, and values and preferences. An inductive narrative review of the resulting 53 studies identified core themes. Nearly all studies (96%) with various HCW types and settings occurred in low- and middle-income countries (LMICs) in Africa and Asia. Identified themes arrayed along a trajectory of PEP use experience: awareness/knowledge; acceptability; availability/access; uptake/use; adherence/completion. Across studies, awareness of PEP for HIV prevention was high, knowledge about drug regimens and healthcare facility policies was moderate to low; acceptability of PEP was moderate to high; PEP's perceived accessibility/availability was inconsistent and varied by geographic location and setting; HCWs' uptake of PEP was low, affected by not knowing how to report an exposure and being unaware of PEP availability; and adherence/completion of PEP regimens was moderate to low, impeded by side effects and a belief that completing regimens was unnecessary to avert seroconversion. HCWs consistently expressed concern about HIV stigma. Findings are limited by the inconsistent use of constructs across studies and a lack of clarity about reporting exposure events. Multi-level approaches are needed to address the interplay of individual, social and structural barriers that diminish HCWs' PEP use. Improved training, incident reporting, 24-hour access to non-stigmatizing PEP services and monitoring of adherence/completion are essential to optimizing HCWs' PEP use. Lessons from HCWs' experience in LMICs may inform understanding of PEP under-use among people in these settings with non-occupational exposures.

Characterization and assessment of exposure risks of healthcare personnel during the COVID-19 pandemic.

Healthcare personnel have the right to decent, healthy, and safe working conditions during COVID-19. Despite our best efforts to safeguard them against SARS-CoV-2 infection, a substantially large number of healthcare personnel fell ill and succumbed to COVID-19. This study aimed to characterize the SARS-CoV-2 exposures among healthcare personnel and determine the risk level of those events, thereby identifying and focusing on the key areas that influence workplace safety. A pre-tested questionnaire was used to collect data from healthcare personnel on the type of exposure, place, and use of preventive measures, along with demographic and occupational data. Exposure events were categorized into low, moderate, and high-risk by using a risk categorization protocol. Doctors were primarily found to be involved in the aerosol-generating procedure, which had 94 times higher odds (95% CI: 43.9926-201.17) for high-risk exposures than other activities. In contrast, nurses were more likely to experience close-contact exposures (OR: 2.77, 95% CI: 1.44-5.33). Both critical care units and operation theaters were identified to have higher odds (OR: 2.34, 95% CI: 1.33-4.23 and OR: 2.31; 95% CI: 0.99-5.42, respectively) than the wards for high-risk exposures. Use of personal protective equipment was poor, with breaches reported in 10.2% of all exposure events. The lacunae in practice were addressed by repeated training and counseling and by ensuring the adequacy of resources in required areas. The assessment was beneficial for safeguarding healthcare personnel and assuring a safer workplace during the early phase of the COVID-19 pandemic.

Sex and age characteristics of thunderstorm asthma emergency department visits

Severe asthma has been shown to occur in the combined presence of high pollen and thunderstorm conditions, also known as ‘thunderstorm asthma.’ First studied as severe epidemic events, recent longitudinal work studied less dramatic but more frequent occurrences. We explore thunderstorm asthma-related emergency department visits in the Minneapolis-St. Paul metropolitan area and evaluated risk differences by sex and age. We define a thunderstorm asthma exposure event as the daily occurrence of 2 or more lightning strikes during high pollen periods, and use daily counts of asthma-related emergency department visits to estimate relative and absolute risk of severe asthma during thunderstorm asthma events for the full population and for sex and age subgroups. The overall population had a 1.06 (95 % CI: 1.02, 1.09) times higher risk of asthma-related ED visits during thunderstorm asthma events compared to days without thunderstorm asthma events. Children under 18 show no higher risk (RR 1.02; 95 % CI: 0.97 1.08), but adults 18–44 years (RR 1.08; 95 % CI: 1.02, 1.13) and 45 and up (RR 1.08; 95 % CI 1.02, 1.15) show higher relative risk. Absolute risk measures show similar patterns to the age and sex results, but age-sex subgroups show more variation in absolute vs relative risk. Our results support an association between ED visits and thunderstorm asthma and provide evidence of varying risks by sex across the life course. These differences in risk have implications for clinical treatment of this allergic type of asthma and for future research into this poorly recognized environmental exposure.Plain Language Summary: Recent research has highlighted the existence of Thunderstorm asthma events, a phenomenon in which pollen grains rupture in the conditions that occur with a thunderstorm, releasing sub-pollen particles that are capable of triggering severe asthma in susceptible populations. Where severe asthma is a disease that usually impacts children, we find in this study that asthma ED visits associated with thunderstorm asthma events more frequently impact adults, particularly males 18–44 and females 45 and up.

Next generation risk assessment of biocides (PHMG-p and CMIT/MIT)-induced pulmonary fibrosis using adverse outcome pathway-based transcriptome analysis

Next-generation risk assessment (NGRA) has emerged as a promising alternative to non-animal studies owing to the increasing demand for the risk assessment of inhaled toxicants. In this study, NGRA was used to assess the inhalation risks of two biocides commonly used as humidifier disinfectants: polyhexamethylene guanidine phosphate (PHMG-p) and chloromethylisothiazolinone/methylisothiazolinone (CMIT/MIT). Human bronchial epithelial cell transcriptomic data were processed based on adverse outcome pathways and used to establish transcriptome-based points of departure (tPODs) for each biocide. tPOD values were 0.00500–0.0510 μg/cm2 and 0.0342–0.0544 μg/cm2 for PHMG-p and CMIT/MIT, respectively. tPODs may provide predictive power comparable to that of traditional animal-based PODs (aPODs). The tPOD-based NGRA determined that both PHMG-p and CMIT/MIT present a high inhalation risk. Moreover, the identified PHMG-p posed a higher risk than CMIT/MIT, and children were identified as more susceptible population compared to adults. This finding is consistent with observations from actual exposure events. Our findings suggest that NGRA with transcriptomics offers a reliable approach for risk assessment of specific humidifier disinfectant biocides, while acknowledging the limitations of current models and in vitro systems, particularly regarding uncertainties in pharmacokinetics (PK) and pharmacodynamics (PD).

Climate change and commercial property markets

AbstractThe economic effect of climate hazard events varies by time and by location. This paper investigates how climate shocks to local property markets transmit to capital markets and provides evidence of the extent to which forward‐looking climate risk is capitalized into the public valuations of those property markets. We first quantify the exposure of real estate portfolios to locations that recently experienced climate events (Event Exposure). Using an event study framework, we find that, in the post‐event period, a one‐standard‐deviation increase in ex‐ante Event Exposure is associated with a 0.2–1.4 percentage points decrease in quarterly stock returns. Cross‐sectional analyses reveal that differences in return effects can be explained by variation in the extent to which the area focuses on climate change. Similarly, we find that forward‐looking climate risk assessment negatively affects firm valuations only in markets with a focus on climate change. Consistent with these findings, we provide evidence that climate events (shocks) induce retail investors (noise traders) to decrease their stock holdings and that blockholders tend to take the opposite side in these transactions. We also show that conditioning on consumer sentiment helps to explain cross‐sectional variation in the response of stock returns to climate events.

Association Between Asian Dust Exposure and Pneumonia Hospitalization in Western Japan: A Case-Crossover Study.

Epidemiological studies have reported that Asian dust (AD), a type of desert dust, has harmful effects on human health. This study aimed to examine the association between AD exposure and hospitalization due to pneumonia. Data on patients in Western Japan admitted for pneumonia were included from a real-world database derived from electronic medical records. We used the meteorological observatory data of the most populous city in each prefecture, in which AD event was defined as a loss of visibility from a distance ≤10 km. A case-crossover design and conditional logistic regression model were used. Overall, 12 938 patients were included, and AD exposure events were observed for 557 days. Exposure to an AD event five days prior to hospitalization was significantly associated with hospitalization for pneumonia after adjusting for weather variables (odds ratio = 1.17). These findings suggest that AD exposure is associated with an increased rate of admission for pneumonia in Western Japan.

An Assessment of the Ocular Toxicity of Two Major Sources of Environmental Exposure.

The effect of airborne exposure on the eye surface is an area in need of exploration, particularly in light of the increasing number of incidents occurring in both civilian and military settings. In this study, in silico methods based on a platform comprising a portfolio of software applications and a technology ecosystem are used to test potential surface ocular toxicity in data presented from Iraqi burn pits and the East Palestine, Ohio, train derailment. The purpose of this analysis is to gain a better understanding of the long-term impact of such an exposure to the ocular surface and the manifestation of surface irritation, including dry eye disease. In silico methods were used to determine ocular irritation to chemical compounds. A list of such chemicals was introduced from a number of publicly available sources for burn pits and train derailment. The results demonstrated high ocular irritation scores for some chemicals present in these exposure events. Such an analysis is designed to provide guidance related to the needed ophthalmologic care and follow-up in individuals who have been in proximity to burn pits or the train derailment and those who will experience future toxic exposure.

Perceived impacts of stressful events on train driver performance

Acute stress exposure can significantly impact a train driver's capacity to maintain safe train operations. However, research examining how train drivers perceive the impacts of acute stressors is limited. This study investigated train driver perceptions regarding performance impacts of stressful events and potential strategies for reducing negative impacts. 71 Australian train drivers were presented with three stressful event scenarios via an online survey and asked to rate the impacts on driving performance. Results showed that participants perceived that stress would enhance performance, but that impacts differed depending on the event type. The findings suggest that train drivers may not be subjectively aware of negative impacts of acute stress, which has important practical implications for risk management following an incident. Qualitative results revealed the most frequently reported stress impact related to cognition. Practical implications and future research directions to prevent and manage stressful event exposure are discussed.

Lifelong traumatic events, social support, and health-related quality of life among older adults.

The present study aimed to investigate the relation between lifelong exposure to traumatic life events, social support, and health-related quality of life (QOL) in a sample of older people. A sample of 172 participants (mean age = 68.81, SD = 7.15; 68.6% female and 31.4% male) was involved in this study. The participants completed scales measuring lifelong exposure to traumatic events, social support, and health-related QOL. The results showed that lifelong exposure to traumatic events was negatively related to physical and mental health-related QOL. Moreover, social support moderated the relation between traumatic life events exposure and mental health-related QOL. Geriatric services could identify and implement adequate measures to provide social support and to improve different dimensions of QOL among older adults.

Pathology of acute sub-lethal or near-lethal irradiation of nonhuman primates prophylaxed with the nutraceutical, gamma tocotrienol

Exposure to high, marginally lethal doses or higher of ionizing radiation, either intentional or accidental, results in injury to various organs. Currently, there is only a limited number of safe and effective radiation countermeasures approved by US Food and Drug Administration for such injuries. These approved agents are effective for only the hematopoietic component of the acute radiation syndrome and must be administered only after the exposure event: currently, there is no FDA-approved agent that can be used prophylactically. The nutraceutical, gamma-tocotrienol (GT3) has been found to be a promising radioprotector of such exposure-related injuries, especially those of a hematopoietic nature, when tested in either rodents or nonhuman primates. We investigated the nature of injuries and the possible protective effects of GT3 within select organ systems/tissues caused by both non-lethal level (4.0 Gy), as well as potentially lethal level (5.8 Gy) of ionizing radiation, delivered as total-body or partial-body exposure. Results indicated that the most severe, dose-dependent injuries occurred within those organ systems with strong self-renewing capacities (e.g., the lymphohematopoietic and gastrointestinal systems), while in other tissues (e.g., liver, kidney, lung) endowed with less self-renewal, the pathologies noted tended to be less pronounced and less dependent on the level of exposure dose or on the applied exposure regimen. The prophylactic use of the test nutraceutical, GT3, appeared to limit the extent of irradiation-associated pathology within blood forming tissues and, to some extent, within the small intestine of the gastrointestinal tract. No distinct, global pattern of bodily protection was noted with the agent’s use, although a hint of a possible radioprotective benefit was suggested not only by a lessening of apparent injury within select organ systems, but also by way of noting the lack of early onset of moribundity within select GT3-treated animals.

Diagenetic evolution of Upper Cretaceous carbonate sequences (Sarvak Formation) in the Abadan Plain, Iran: evidence from petrographic, elemental, stable, and strontium isotopic data

ABSTRACT This study investigates the diagenetic evolution and geochemical variations within the Sarvak Formation by integrating the core, thin-section, scanning electron microscopy, X-ray diffraction, trace elements, carbon-oxygen, and strontium isotopic data from three wells in the Abadan Plain. The formation displays diverse diagenetic processes, influenced by multiple exposure surface condition including the Cenomanian-Turonian boundary (CT-ES) and middle Turonian (mT-ES). Meteoric diagenesis, shaped by tectonic activities and eustatic sea level changes, played a pivotal role, leading to dissolution (karstification), brecciation, cementation, and palaeosol formation. Geochemical analysis revealed significant elemental variations across the studied wells. Magnesium (Mg) exhibited peaks at sequence boundaries, responding to facies changes, while iron (Fe) and manganese (Mn) concentrations increased below disconformities, reflecting changes in redox conditions and karstification. Sodium (Na) concentrations varied with facies changes, showing peaks at sequence boundaries, indicative of palaeoexposure events. Strontium (Sr) isotopes aided in delineating stratigraphic positions of palaeoexposure surfaces and absolute dating of sequences. Increases in87Sr/86Sr ratios below disconformities suggested subaerial exposure events, with shorter durations at CT-ES and longer durations at mT-ES, contributing to dissolution features development. The δ13Ccarb and δ18Ocarb values indicated severe meteoric diagenesis below sequence boundaries, characterized by dissolution and reprecipitation of calcium carbonate as low-magnesium calcite (LMC) cements. Cross plots of δ13Ccarb vs. δ18Ocarb displayed inverted-J patterns, indicative of meteoric diagenesis effects. Comparison with previous studies highlighted similar trends in geochemical variations, with notable differences in element concentrations between wells. This study enhances our understanding of diagenetic history of the Sarvak Formation in the Abadan Plain and, in a larger scale, provides insights into diagenetic evolution of palaeoexposure-related carbonate sequences.

Mangrove extent reflects estuarine typology and lifecycle events

Ecosystem services provided by mangrove forests are increasingly recognised worldwide. These values have led to numerous ecosystem protection and restoration measures, including recent blue carbon economic incentives to re-establish mangroves at scale. However, our current ability to predict mangrove extent is based mainly on inundation averages (e.g. hydroperiod) or tidal planes of mature mangrove forests. This study investigates the validity of existing methods to accurately predict mangrove extent by comparing the location of existing mangroves at 27 sites (in 23 estuaries in southeast Australia) against commonly used approaches. To this aim, the downslope and upslope surface elevation limits of the mangrove species Avicenna marina were measured on-site using high-resolution RTK-GPS equipment across different estuarine typologies, including drowned river valleys, strong and weakly tidal estuaries, tidal lakes, and intermittently open/closed estuaries. These measurements were analysed against long-term (8–30+ years) tidal records to estimate inundation characteristics within the estuary. Study results indicate that the commonly used tidal plane method for predicting mangrove extent can incorrectly predict vertical extent by over 40 per cent. Likewise, hydroperiod is a poor predictor of extent as similar hydroperiods can be calculated across significantly different estuarine inundation patterns.Interestingly, the results indicate that mangrove elevations and inundation patterns are not uniform within or across estuaries, although there is uniformity across related estuarine typologies. For instance, inundation patterns in drowned river valley estuaries are more consistent (less extreme inundation and exposure events) than in estuaries with a variable tidal range, such as tidal lakes. Ultimately, this study highlights that predictions of mangrove extent should consider estuarine typology, the lifecycle of mangroves, and potential physio-adaptations to changing inundation patterns. Importantly, future tidal conditions may encourage biophysical adaptations in mangroves which may confound the extent of existing predictive techniques.

Small-scale market gardeners’ knowledge, attitudes and practices regarding the use of chemical pesticides in the Kabare territory (South-Kivu) in Eastern D.R. Congo

Damage caused by pests and diseases is one of constraints on crop production for food security. Based on the use of questionnaire and interviews that were conducted in Kabare territory (South-Kivu), this study was carried out to (i) assess farmers practices, attitudes, and knowledge about pesticides use, and (ii) assess the human health and physical environment effects using pesticides. Data was collected from 300 small-scale farmers in study area. Results showed that majority of our respondents were men (59 %) rather than women (41 %) and local knowledge of pesticide use was low (60 %). Education level had a significant influence (p < 0.01) on level of knowledge about pesticide use, time and dose of treatment, method of control, and persistence time. In addition, education level influence significantly farmers' attitudes before and after pesticide treatment (p < 0.05). Pest management control, time of pesticide application, and packaging management method varied significantly with level of local knowledge (p < 0.01). Pesticides use by small-scale farmers has an effect on water, soil, and air quality. It also causes human pathologies such as vomiting, eye irritation, and even loss of life in event of heavy exposure. Inhalation and dermal exposure are main and most dangerous routes of pesticide exposure in our study area, which lacks protective strategies. Finally, use of pesticides disrupts biodiversity through the disappearance of pollinators, predators, parasitoids, and soil microorganisms. Therefore, broad continuity of this study with integration of other scientific aspects would effectively contribute to the improvement of environmental quality.

Preexposure prophylaxis for preventing HIV infection: Routine practice in primary care.

An estimated 1.2 million people in the United States have human immunodeficiency virus (HIV) infection per US Centers for Disease Control and Prevention 2021 data. The highest risk of HIV transmission occurs during injection drug use with needle sharing and during sexual activity, most significantly in condomless, receptive anal intercourse. Preexposure prophylaxis (PrEP) for the prevention of HIV infection is part of a larger biobehavioral strategy that uses antiretroviral medication, an oral formulation taken daily or during anticipated exposure events, or an injectable formulation administered every 8 weeks. PrEP consists of 3 possible regimens: emtricitabine/tenofovir disoproxil fumarate, emtricitabine/tenofovir alafenamide, or injectable cabotegravir. Primary care clinicians are strategically positioned to provide PrEP education and access.