Health Assessment Research Articles

School Nurse-Led Health Assessment for Students Experiencing Homelessness: A Quality Improvement Project.

Childhood homelessness is increasing and is associated with negative health and academic outcomes. The goal of this quality improvement project was to improve access to healthcare and health outcomes for students experiencing homelessness through a school nurse-led comprehensive health assessment. The multilevel intervention included identifying students experiencing homelessness, conducting a standardized health assessment, and making referrals to care. This 8-month project was conducted in an urban school district. Feasibility and acceptability data were collected to guide sustainability. Student health and referral data were analyzed using descriptive statistics. At the project start, 688 students were identified as experiencing homelessness. More than half (67%) had a partial or fully completed health assessment during the project. Of the students assessed, most had a primary care provider, some had a health condition, and half had a dental home. Students experiencing homelessness would benefit from systematic school-based health assessments to identify unmet health needs.

Associations between Ornithodoros spp. Ticks and Mojave Desert Tortoises (Gopherus agassizii) Obtained from Health Assessment Documents.

Soft ticks in the genus Ornithodoros occur throughout the Mojave Desert in southern Nevada, southeastern California, and parts of southwestern Utah and northwestern Arizona, USA, and are frequently observed parasitizing Mojave desert tortoises (Gopherus agassizii). However, limited research exists examining the relationship between ticks and desert tortoises. Mojave desert tortoises are listed as threatened by the US Fish and Wildlife Service, and as such, their populations are monitored and individual tortoise health is routinely assessed. These health assessments document the presence and abundance of ticks present on tortoises, but detailed examination of the relationship between ticks and tortoise health has been lacking. This study analyzed the relationship between tick presence and desert tortoise health assessments as a function of season, location, age (adult vs. juvenile), foraging behavior, evidence of clinical signs of disease, body condition score, and sex. Our results indicate that more ticks were found on tortoises in the summer than in any other season. Ticks were observed more frequently on captive tortoises versus wild tortoises, and more ticks were likely to be present on adult tortoises than on juveniles. Ticks were also more likely to be observed on tortoises that lacked evidence of foraging and on tortoises with observed clinical signs of disease. These findings provide valuable insights into the biology of ticks in relation to tortoises that may be useful for management of both captive and free-living threatened tortoise populations where ticks are detected. Our study also may improve understanding of potential tick-borne disease dynamics in the Mojave desert tortoise habitat, including Borrelia sp. carried by Ornithodoros ticks, which cause tick-borne relapsing fever in people.

A Pilot and Feasibility Study on a Mindfulness-Based Intervention Adapted for LGBTQ+ Adolescents.

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community.

Oral microbiocenosis state under different approaches of replacing dental crown defects

Dental caries is one of the most common health problems. The aim of the research was to study the spectrum of microbiota, which is part of the dental biofilm, and its biological properties. The study involved 90 participants of the study group and 20 of the control group. Dental plaque and saliva were used as principal clinical specimens. The main research method was bacteriological. All samples from study participants were positive for microbiota. At the initial collection of material, 395 unique isolates were obtained: 338 from patients with caries and 57 from healthy volunteers. The microbiocenosis of the oral cavity associated with the development of caries contained such eudodominants as Streptococcus mutans, Peptostreptococcus spp., Fusobacterium spp., Prevotella spp. and dominants Streptococcus pyogenes, Enterobacterales, Prevotella spp. and Candida albicans. In contrast the eudominants of the healthy oral cavity were microorganisms with known commensal properties, in particular Streptococcus salivarius, Aerococcus viridans, Veillonella spp. After the dental treatment, significant shifts in the taxonomic composition of the dental biofilm were observed. Therefore, the composition of the oral cavity microbiocenosis in participants who underwent restoration of the dental crown defects with zirconium inserts approached patients to the healthy cohort participants. The eudodominants of the oral microbiocenosis of the participants who underwent direct restoration were S. mitis, Peptostreptococcus spp. and Veillonella spp. In zirconium restoration, the commensals S. salivarius and A. viridans were eudodominants. The obtained isolates of opportunists possessed high virulence properties. Streptococcus spp. cultures were sensitive to norfloxacin screening in only 28.6% of cases. Among cultures of the genus Staphylococcus, 23.8% were methicillin resistant. Representatives of Enterobacterales had chemotherapeutic sensitivity that varied significantly depending on the group of antimicrobial agents. Using disks with phenylboronic acid, ethylenediaminetetraacetic acid and cloxacillin, it was established that Klebsiella spp. were producers of class A carbapenemases (n=3) and contained AmpC (n=3). Carbapenemases were also produced by at least 65.2% of the studied cultures of non-fermenting gram-negative microorganisms. In our study, all obtained isolates were also endowed with the ability to form a biofilm. Therefore, microbiological research in dentistry should be considered as one of the objective methods for assessment of health of the oral cavity and will also have advantages in choosing a method of correcting defects of dental crown parts and in some cases, making an informed decision about the prescription of antimicrobial treatment.

First evidence of microplastic inhalation among free-ranging small cetaceans.

Plastic is a ubiquitous environmental contaminant, resulting in widespread exposure across terrestrial and marine spaces. In the environment, plastics can degrade into microparticles where exposure has been documented in a variety of fauna at all trophic levels. Human epidemiological studies have found relationships between inhaled microplastics and oxidative stress and inflammation. Previous studies of bottlenose dolphins (Tursiops truncatus) have reported prevalent exposure to plasticizing chemicals (e.g., phthalates) as well as particle loads in gastrointestinal tracts, but exposure from inhalation has not yet been studied. The objective of this study was to determine if inhalation is a viable route of microplastic exposure for free-ranging dolphins. Exhalation samples were opportunistically collected from dolphins residing in Sarasota Bay, Florida (n = 5) and Barataria Bay, Louisiana (n = 6) during catch-and-release health assessments to screen for microplastic particles. All dolphin samples contained at least one suspected microplastic particle, and polymer composition was determined for 100% of a subset (n = 17) of samples. Additional studies are warranted to better understand the extent of inhaled microplastics, as well as to explore impacts, given potential risks to lung function and health.

Bearing remaining life prediction method based on ARAD -ELN and multi-stage wiener process

Abstract Stochastic process-based models are extensively utilized in health assessments and Remaining Useful Life (RUL) predictions of bearings. Nevertheless, bearings in actual operation undergo multiple degradation stages, each characterized by its unique trend of degradation. The application of a singular stochastic process for RUL prediction falls short of achieving optimal performance. Consequently, this paper introduces a multi-stage Wiener process-based approach for the prediction of bearings' RUL. Initially, to tackle the challenge of imbalanced sample sizes across different degradation stages of bearings, an ensemble learning-based neural network (ELN) enhanced by ARIMA Residual Anomaly Detection (ARAD) for the identification of bearing degradation stages is proposed. Subsequently, taking into account the temporal, unit-to-unit, and nonlinear variabilities of the degradation process at each stage, a Wiener process-based multi-stage degradation model for bearings is developed. A method for parameter estimation and updating, utilizing Kalman filtering and Maximum Likelihood Estimation (K-M) is introduced. Finally, the proposed model undergoes validation using both simulated data and the XJTU-SY bearing dataset. Experimental results of three RUL predictions show that the proposed method leads the benchmark model with RMSE values of 3.61, 2.92 and 7.24 respectively, affirming that the proposed model can precisely classify equipment degradation stages and predict RUL with high accuracy and stability.

Variation in Relative Risk Perceptions and Tobacco Use by Race and Socioeconomic Status among Older Adults who Smoke: Evidence from the Population Assessment of Tobacco and Health (PATH) Study.

Older adults who smoke face significant risk of tobacco-related disease and hold misperceptions about health risks posed by nicotine product use. This study examined whether socioeconomic status and race are associated with variation in cigarette/e-cigarette relative risk perceptions, whether relative risk perceptions are associated with tobacco use behaviors, and whether socioeconomic status and race moderate associations between perceptions and use behaviors. Five waves of PATH Study yielded data from 1,879 adults >55 who smoked within the past 30 days during Wave 1. Adjusted longitudinal logistic models estimated associations between higher vs. lower SES ("low-SES": less than high school diploma/GED. and annual household income<$25,000) and race (White vs. Black/African American; AA) and e-cigarette/cigarette relative risk perceptions, behavioral intentions, and e-cigarette use. Lower-SES adults were more likely to report e-cigarettes were very/extremely harmful to health (AOR: 1.74, p<0.01) and less likely to report e-cigarettes were less harmful than cigarettes (AOR: 0.65, p<0.01). Black/AA adults were less likely to report that e-cigarettes were less harmful than cigarettes. Participants rating e-cigarettes as equally/more harmful than cigarettes exhibited lower odds of intending to quit smoking or switch to e-cigarettes. Finally, Black/AA adults who also perceived e-cigarettes equally/more harmful than cigarettes exhibited greater odds of trying to reduce rather than quit smoking (AOR: 1.58, p=0.02). Many older adults who smoke perceive e-cigarettes as equally or more harmful than cigarettes, particularly low-SES and Black/AA older adults. Differences in relative risk perceptions among high priority populations could negatively influence cessation attempts and switching behaviors. This study found that Black/AA and low-SES older adults who smoke cigarettes were more likely to perceive e-cigarettes as harmful or more harmful than cigarettes. The absence of accurate, evidence-based information regarding the relative health risks associated with the long-term use of various tobacco products may impede policy efforts to reduce disparities in smoking-related disease through increased cessation and/or harm reduction.

How much is too much: A case study of local self-government units in Slovakia using absolute variability to determine the importance of financial criteria in MCDM analysis.

The performance evaluation of local self-government entities is very difficult, as their primary goal is not to make a profit, but to provide services to their residents that will contribute to an increase in their quality of life. In this context, it is necessary to evaluate their activity from the point of view of several available criteria, for which it is possible to find relevant and recognized sources. The presented research works with five criteria, identified by the Institute for Economic and Social Reforms, and aims to quantify the agreement of the results of the assessment of the financial health of territorial self-government entities in 2020 using the TOPSIS technique with a gradually decreasing number of criteria. For this purpose, a total of 26 combinations of criteria are created, with the number of 5, 4, 3 and 2 used criteria, the importance of which is determined based on their absolute variability using the standard deviation method. The results obtained in this way are interpreted using a wide range of mathematical and statistical methods including the Kolmogorov-Smirnov test, Levene test, Jaccard index and others. As a result, the multi-criteria evaluation of territorial self-government subjects (in our case, district cities) proved to be highly applicable. However, the result itself is largely determined by the structure and number of entry criteria. Based on the performed analyses, we can see that significant differences result from their reduction. Each such reduction has an impact on the overall results, but it is possible to find combinations that defy this conclusion.

Urban public space initiatives and health in Africa: A mixed-methods systematic review.

Public space initiatives (PSIs) in African cities can significantly promote health and social well-being, yet their implementation and impact are unknown across the continent. There is a substantial gap in literature on PSIs in African countries, with most studies concentrated in wealthier cities and lacking comprehensive assessments of long-term health impacts. The objective of this study was to synthesise evidence on the typology, location, features, and outcomes of these initiatives as well as the guiding principles that underlie their design and implementation. Employing a mixed-methods model, the study systematically reviews peer-reviewed and grey literature articles, focusing on the types, settings, and outcomes of PSIs. Data is analyzed using the CASP appraisal tool and thematic analysis. We analysed 47 studies, 15 of which were mixed methods, 22 qualitative and 10 quantitative. Sports accounted for 50% of initiatives. 30 of the 47 papers originated from South Africa. Communities viewed initiatives' wellbeing impacts through social, economic, and ecological lenses, with health being but one dimension. The sustainability of initiatives was often limited by funding, historical marginalization, and competing land uses. Findings underscore the need for more comprehensive, long-term evaluations and cross-sector collaborations to sustain and enhance health-promoting public spaces in African cities.

Nationwide usage of ethambutol and incidence and screening practices of optic neuropathy.

Ethambutol, a key anti-tuberculosis medication, is associated with optic neuropathy, which can lead to significant vision impairment. This population-based cohort study investigated the nationwide usage of ethambutol and the incidence and screening of optic neuropathy among ethambutol users. The cohort included 206,157 individuals from the Health Insurance Review and Assessment database in South Korea who initiated ethambutol therapy between 1 January 2015, and 31 December 2021. Among them, 117,309 individuals without prior ophthalmic diseases were analyzed to investigate practice patterns. The timing of the baseline examinations (an ophthalmic examination immediately preceding [within 1month] ethambutol initiation or the first ophthalmic assessment conducted after the initiation) and subsequent monitoring and modalities used were assessed. The cumulative incidences of the optic neuropathy categories, overall optic neuropathy, optic neuropathy/optic neuritis, and optic atrophy, were analyzed. The annual number of ethambutol users declined over time between 2015 and 2021. The cumulative incidences of overall optic neuropathy, optic neuropathy/optic neuritis, and optic atrophy were 2.8%, 2.0%, and 0.7%, respectively. Optical coherence tomography usage for ophthalmic examinations remarkably increased from 23.9% in 2015 to 85.5% in 2021, while visual field examinations were frequently (69.6%) employed for functional assessment at the time of diagnosis. Baseline screening within 6months of initiating ethambutol therapy was performed in 12.0%-13.1% of ethambutol initiators annually over the study period. The percentage of ethambutol initiators receiving subsequent monitoring within 6months following baseline screening declined over time, from 13.1% in 2015 to 7.9% in 2021. The diminishing trend in monitoring emphasizes the need for improved pharmacovigilance to reduce the risk of optic atrophy and blindness through early detection.

Understanding stakeholder perspectives on Apgar score, cyanosis and identifying jaundice in ethnic minority neonates.

To explore neonatal assessments that include an element of evaluating skin colour in neonates of black, Asian and minority ethnicities, focusing on the Apgar score, presence of cyanosis and presence of jaundice. We employed focused ethnography involving diverse healthcare professionals (HCPs) and parents or caregivers with Black, Asian, or ethnic minority children born in the last five years. Zoom interviews were performed following a semi-structured interview guide. Ethnographic data analysis was conducted using NVivo software. There was a lack of consistency in how HCPs applied the Apgar scores, which also varied from textbook guidelines. The use of pink as a skin colour descriptor for ethnic minority neonates created a divide among both parents and HCPs. HCPs relied more heavily on other elements of the Apgar score or infant breathing and crying at birth to gauge infant wellness. When identifying cyanosis, HCPs depend on specific body locations for accurate assessment of oxygenation, but the limitations of visual assessment are acknowledged. For jaundice, most HCPs recognised the difficulty in identifying the colour yellow in infants with darker skin tones. HCPs focussed on yellowing of the sclera and gums and other well-being assessments to detect jaundice. Some interviewed parents noticed jaundice in their infants before HCPs but felt they were not listened to when raising concerns. HCPs acknowledged the need for additional training to effectively assess the health of ethnic minority infants. This study highlights disparities in neonatal health assessment from the perspectives of healthcare professionals and parents from diverse backgrounds. Varied practices in determining the Apgar score and recognising cyanosis and jaundice signal the need for standardised protocols, appropriate educational materials, and targeted training. Addressing these challenges is vital for equitable care, emphasising comprehensive training and bias mitigation efforts in maternal and neonatal healthcare.

Water–Ecological Health Assessment Considering Water Supply–Demand Balance and Water Supply Security: A Case Study in Xinjiang

Water scarcity and ecological degradation in arid zones present significant challenges to regional ecological health. Despite this, integrating the water supply–demand balance and water supply security (SEC) into ecological health assessments—particularly through composite indicators—remains underexplored in arid regions. In this study, we assessed the ecological health changes in Xinjiang by utilizing multivariate remote sensing data, focusing on the balance between water supply and demand, the degree of SEC, and ecosystem resilience (ER). Our results indicate that while water supply and demand remained relatively stable in northern Xinjiang between 2000 and 2020, the conflict between supply and demand intensified in the southern and eastern agricultural regions. SEC evaluations revealed that 73.3% of the region experienced varying degrees of decline over the 20-year period. Additionally, ER assessments showed that 7.12% of the region exhibited a significant decline, with 78.6% experiencing overall reductions in ecological health. The indicators’ response to drought demonstrated that improvements in ecological health during wet conditions were less pronounced than declines during droughts. This study underscores the necessity of prioritizing areas with lower ecological health in future water allocation strategies to optimize water resource utilization.

Disability Related to the Upper Extremities in Early Rheumatoid Arthritis - Long-term Course and Disease Parameter Impact: a cohort study.

To investigate the course of disability related to the upper extremities (UE) in early rheumatoid arthritis (RA), and to assess correlations between such disability and clinical parameters, including grip force. In an inception cohort of patients with early RA (diagnosed 1995-2005, N=222, follow-up 10 years), disability of the UE was assessed using a subscore of the Health assessment questionnaire disability index (HAQ-DI), and average grip force of the dominant hand was measured. Changes between consecutive follow-up visits in the HAQ-DI-UE subscore, and correlations at each visit with key clinical parameters, were assessed. The relation between joint involvement and HAQ-DI-UE was examined using multivariate linear regression analysis. The HAQ-DI-UE decreased significantly from inclusion to the 6-month follow-up (mean change -0.26; 95% CI -0.18 to -0.34), and increased significantly after 2 years. There were fairly strong correlations for HAQ-DI-UE with grip force (r:-0.50 to -0.62), patient's global assessment (r: 0.58 to 0.64) and patient's assessment of pain (r:0.54 to 0.60) at all time points through 5 years, but only moderate to weak correlations with swollen joints, CRP and ESR. At inclusion wrist synovitis and tender proximal interphalangeal (PIP) joints had both an independent impact on HAQ-DI-UE, whereas tenderness of the shoulder and the wrist had a greater importance at 6 months. Disability related to the upper extremities decreased significantly during the first 6 months, and increased again after 2 years. The correlations with clinical parameters underline the major impact of pain and impaired hand function in early RA.

Health assessment method of front landing gear hydraulic retraction and extension system based on GRNN

With the continuous development of civil aircraft health management technology, the status monitoring data of important aircraft systems and components are constantly enriched. The health status of the front landing gear hydraulic retraction system has a great impact on the take-off and landing of the aircraft. Although the system has multi-dimensional monitoring parameters, it is difficult to effectively use the system monitoring data to accurately evaluate its health status. Aiming at the health assessment problem of the front landing gear hydraulic retraction system, this paper builds a simulation model of the system through AMESim software modeling, and studies the influence of the performance changes of hydraulic component parameters on the front landing gear retraction performance. The performance data of the front landing gear retraction actuator at different levels of failure are used as the original data, and the characterization parameters such as retraction time and maximum flow rate are extracted. A health index construction method based on generalized regression neural network (GRNN) is proposed, which can more effectively evaluate the health status of the system. Its effectiveness and accuracy are proved by method comparison.

Research progress on community health management model for older adults with chronic diseases and multiple morbidities.

With the rapid ageing of the population, the number of older adults with two or more chronic diseases is increasing. There are individual differences in health assessment, diagnosis, treatment, health management, and medication safety for older adults with chronic conditions and multiple morbidities. Managing these conditions poses increasingly complex challenges for the healthcare system. Developing effective community health management models specifically designed for older adults with multiple chronic diseases is crucial for improving their overall health. This study provides a comprehensive review of the progress in research on community health management models for older adults with multiple chronic diseases, aiming to offer valuable insights for health management in this population.

Healthcare resource utilisation and costs in infants with confirmed respiratory syncytial virus infections: a national population cohort study

BackgroundRespiratory syncytial virus (RSV) is the leading cause of severe respiratory infections in infants worldwide, significantly affecting their health and contributing to the global healthcare burden. We aimed to examine healthcare resource utilisation patterns and costs for infants under one year old with confirmed RSV infection across subgroups of different gestational ages and health conditions and the cost implications of RSV infections over time, thereby demonstrating the economic burden of the disease.MethodsThis retrospective cohort study utilised nationwide claims data from the Korea Health Insurance Review and Assessment Service for infants under one year of age with confirmed RSV infection in the first year of life from January 2017 to April 2022. The infants were stratified into three subgroups based on their gestational age and health status: unhealthy preterm, healthy preterm, and full-term infants. A descriptive analysis was conducted to estimate healthcare utilization by type of resource and costs related to the treatment of RSV.ResultsOut of 93,585 RSV infections identified, 31,206 patients met the inclusion criteria; these included 963 unhealthy preterm, 1,768 healthy preterm and 28,475 full-term infants. In our study, 76.3% of the infants with confirmed RSV infection required intensive care, including hospitalisation and more critical interventions such as intensive care unit (ICU) or mechanical ventilation (MV). The total average cost of RSV management was notably higher for unhealthy preterm infants ($ 6,325; 95% confidence interval (CI): $ 5,484-7,165) than for healthy preterm ($ 1,134; 95% CI: $ 1,006 − 1,261) and full-term infants ($ 606; 95% CI: 583–630). Our findings confirmed a significant epidemiological and economic burden, with infants at greater risk–shorter gestational age and poorer health conditions. Furthermore, we observed a marked increase in the total average cost of RSV management during COVID-19, reflecting the complex interplay between RSV and pandemic-related healthcare dynamics.ConclusionOur findings provide evidence for the significant economic burden of RSV infection among infants, with considerable disparities based on gestational age and health status subgroups. However, RSV prevention policies should also recognise that healthy preterm or full-term infants who receive intensive care face a significant disease burden.

Examining perfluorohexane sulfonate (PFHxS) impacts on sensorimotor and circadian rhythm development.

Perfluorohexane sulfonate (PFHxS) is a ubiquitous perfluoroalkyl substance known for its environmental persistence and potential toxicity. This study investigated PFHxS's impact on zebrafish embryos, focusing on sensorimotor behavior, circadian rhythm disruption, and underlying molecular mechanisms. Under 24 hr dark incubations, PFHxS exposure induced concentration-dependent hyperactivity within larval photomotor response, characterized by the distinctive "O-bend" response, strong light-phase hyperactive movement and seizure-like movements. It appears that PFHxS-treated embryos cannot sense light cues in a normal manner. Similar hyperactivity was seen for acoustic startle response assay, suggesting that the response is not merely visual, but sensorimotor. LC-MS studies confirmed detectable uptake of PFHxS into embryos. We then conducted mRNA-sequencing across multiple time points (48 and 120 hpf) and concentrations (0.00025, 0.0025 and 25 µM). Data at the 25 µM (2-120 hpf) exposure showed disrupted pathways associated with DNA and cell cycle. Interestingly, data at 0.00025 µM - an environmentally relevant concentration- at 48 hpf showed disruption of MAPK and other signaling pathways. Immunohistochemistry of eyes showed reduced retinal stem cell proliferation, consistent with observed DNA replication pathway disruptions. To assess if these impacts were driven by circadian rhythm development, we manipulated light/dark cycles during PFHxS incubation; this manipulation altered behavioral patterns, implicating circadian rhythm modulation as a target of PFHxS. Since circadian rhythm is modulated by the pineal gland, we ablated the gland using metronidazole; this ablation partially rescued hyperactivity, indicating the gland's role in driving the phenotype. Collectively, these findings underscore proclivity of PFHxS to cause neurodevelopmental toxicity, necessitating further mechanistic exploration and environmental health assessments.

Heartbeat classification using various machine learning models: A comparative study

Cardiac arrhythmias, known as irregular heartbeats, pose a notable health threat that necessitates prompt diagnosis, as untreated arrhythmias can lead to severe heart complications. Among the various methods for arrhythmia detection, electrocardiography is the most prevalent due to its non-invasive monitoring of heart activity. However, manual electrocardiogram (ECG) analysis is inefficient and prone to errors, prompting the exploration of machine learning (ML) models for ECG feature recognition. Integrating ML models with ECG analysis can revolutionize cardiac diagnostics by improving healthcare efficiency and outcomes by enhancing the accuracy and consistency of existing approaches as well as their processing speed for large datasets. Unfortunately, current ML methods encounter two key limitations: prolonged training times and the need for manual feature selection. To address these issues, we propose using ML models enhanced with innovative techniques such as the Fourier transform (FT) and Gaussian noise injection for improved cardiac health assessment. To validate this approach, we utilized statistical tools, including Pearson correlation and p-values, to uncover relationships within the data. In addition, we employed the FT technique to extract and analyze frequency-domain features. Our comparative study of different ML models relied on metrics such as accuracy, precision, recall, F1 score, and receiver operating characteristic area under the receiver operating characteristic curve, demonstrating XGBoost&amp;rsquo;s impressive average recall of 0.956 with 99.96% overall accuracy. An average precision of 0.956 further underscored the accuracy of XGBoost&amp;rsquo;s predictions, indicating its high level of reliability in distinguishing various cardiac conditions. These results highlight the considerable potential of ML techniques for precise ECG-based clinical diagnoses, helping healthcare professionals make more accurate and timely decisions in patient care.

Towards Sustainable Rural Development: Assessment Spatio-Temporal Evolution of Rural Ecosystem Health through Integrating Ecosystem Integrity and SDGs

Rural ecosystem health (REH) serves as an effective metric for assessing the damage degree and stability state within rural systems and their components. It reflects the interaction and the balance among rural subsystems, emphasizing the harmonious development of resources, agriculture, environment, economy, and society that are fundamental to sustainable rural development. Most regional-scale ecosystem health assessments primarily focus on either the natural state of the ecosystem or external disturbances affecting it, often neglecting human ecological systems characterized by economic and social dimensions. Taking Chongqing as an example, we established an improved REH assessment framework by integrating ecological integrity from the perspective of a social-economy-natural compound ecosystem. Furthermore, we innovatively incorporated the Sustainable Development Goals (SDGs) into the formulation of the REH indicator system to quantitatively elucidate the spatiotemporal characteristics. The results indicated that: (1) The REH in Chongqing exhibited an evolutionary pattern characterized by a subsequent rise, maintaining values between 0.363–0.872 from 2000 to 2018. This trend reflected a distinct two-stage development characteristic, with the rural socio-economic subsystem contributing the most at 33.36%, followed closely by the rural environmental subsystem at 27.84%; (2) In 2018, the REH across the 36 districts and counties in Chongqing displayed spatial differentiation patterns described as “collapse in the west, high levels in the northeast, and localized surges”. The areas ranked from smallest to largest REH were metropolitan, western, southeastern, and northeastern areas; (3) Four levels (e.g., disease, single health, compound health, and comprehensive health) and twelve sub-levels of REH were defined using a dominant factors method. Finally, we analyzed the driving factors from four aspects of urbanization development: policy regulation, urban-rural factors flow, and regional differences. We also proposed differentiated planning and policies for sustainable rural development in Chongqing.

Numerical simulation on exhaled aerosol transmission based on realistic oral-nasal structures and temperature distribution

ABSTRACT Respiratory infections are currently understood to be caused by pathogens released through the nose or mouth of an infected individual, and subsequently transmitted to susceptible hosts. These pathogens are enclosed in liquid particles that are aerosolized from the respiratory tract during activities such as breathing, speaking, sneezing, and coughing. These particles vary widely in size, ranging from submicron to several microns. While past research has largely overlooked the human respiratory system, recent analysis has revealed that the actual structure of the nasal cavity significantly influences the prediction of aerosol transmission during exhalation. In this study, computational fluid dynamics (CFD) simulations were conducted to analyze the aerosol transmission generated during exhalation from the nasal and oral cavities. Realistic nasal and oral cavity structures were taken into account, and authentic temperature distributions were applied to the surfaces. Additionally, inhalation conditions for susceptible individuals were established to evaluate the risk of inhalation-generated exposure. Through various simulation scenarios, we separately discussed the impact of environmental wind speed, separation distance, and exhalation flow rate. The simulation results indicate that environmental wind amplifies the complexity of the flow field and the transmission and deposition of particles between two individuals. Under ambient wind velocities of 0.5 m/s and 1 m/s, it was observed that over 80% of the particles with a diameter of 1 µm inhaled through the nasal cavity accounted for the total deposition on the infected individual. Furthermore, high exhalation flow rates exhibited higher deposition ratios at close distances, in line with our expectations. Therefore, it is advisable to minimize close contact as much as possible during periods of frequent respiratory infections, and to wear masks in order to reduce the risk of inhalation exposure. Implications: During the activities such as breathing, speaking, sneezing, and coughing, liquid particles containing pathogens are aerosolized from the respiratory tract and are released from nose or mouth through the nebulization. In this study, we investigated the transmission of aerosols from human exhalation in the outdoor environment, innovatively taking the real oral-nasal structure and the active inhalation of vulnerable people into consideration, and explored the human-to-human transmission of respiratory viruses. The results are beneficial for public health assessment and policy development.