High-risk Locations Research Articles

Meningococcal A conjugate vaccine coverage in the meningitis belt of Africa from 2010 to 2021: a modelling study

As of the end of 2021, twenty-four countries in the African meningitis belt have rolled out mass campaigns of MenAfriVac®, a meningococcal A conjugate vaccine (MACV) first introduced in 2010. Twelve have completed introduction of MACV into routine immunisation (RI) schedules. Although select post-campaign coverage data are published, no study currently comprehensively estimates MACV coverage from both routine and campaign sources in the meningitis belt across age, country, and time. In this modelling study, we assembled campaign data from the twenty-four countries that had introduced any immunisation activity during or before the year 2021 (Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Côte d'Ivoire, Democratic Republic of the Congo, Ethiopia, Eritrea, the Gambia, Ghana, Guinea, Guinea Bissau, Kenya, Mali, Mauritania, Niger, Nigeria, Senegal, South Sudan, Sudan, Togo and Uganda) via WHO reports and RI data via systematic review. Next, we modelled RI coverage using Spatiotemporal Gaussian Process Regression. Then, we synthesized these estimates with campaign data into a cohort model, tracking coverage for each age cohort from age 1 to 29 years over time for each country. Coverage in high-risk locations amongst children aged 1-4 in 2021 was estimated to be highest in Togo with 96.0% (95% uncertainty interval [UI] 92.0-99.0), followed by Niger with 87.2% (95% UI 85.3-89.0) and Burkina Faso, with 86.4% (95% UI 85.1-87.6). These countries had high coverage values driven by an initial successful mass immunisation campaign, followed by a catch-up campaign, followed by introduction of RI. Due to the influence of older mass vaccination campaigns, coverage proportions skewed higher in the 1-29 age group than the 1-4 group, with a median coverage of 82.9% in 2021 in the broader age group compared to 45.6% in the narrower age group. These estimates highlight where gaps in immunisation remain and emphasise the need for broader efforts to strengthen RI systems. This methodological framework can be applied to estimate coverage for any vaccine that has been delivered in both routine and supplemental immunisation activities. Bill and Melinda Gates Foundation.

Evaluating the impact of proximity to reported toxic release facilities and flood events on chronic health outcomes in the city of Galena Park, Texas

Evidence has conclusively revealed that environmental justice communities experience poor environmental conditions compared to more affluent majority communities. However, there has been little research evaluating the health impacts of immediate proximity to industrial pursuits and flood events on a population compared to others living within the same community who are only marginally removed from these locations. This cross-sectional study (N = 130) utilized three approaches to assess health outcomes (1) the 12 item Short Form Health Survey, which creates a general physical component score, (2) self-reported noncancerous chronic conditions, and (3) self-reported diagnosis of twelve different cancers. Three risk levels were spatially created using a 5-scale ordinal score for each residential parcel based on the corresponding flood probability level and proximity to facilities which report to the United States Environmental Protection Agencies Toxic Release Inventory. Analysis revealed that general physical health scores were significantly lower (P-value < 0.001) in the medium and high-risk locations, Similarly chronic conditions witnessed a non-significant twofold increased risk in the highest-risk locations compared to the lowest (POR 1.91; 95 % CI 0.82–4.39) and a non-significant increased risk of cancer diagnosis (POR 1.51; 95 % CI 0.38–5.99). This research underscores the importance of place and health outcomes even within relatively geographically compact communities. Public health and urban planning interventions and designs should take into account fine grain approaches to respond to community needs while still being mindful of limited resources.

Perfluoropentane/apatinib-encapsulated metal-organic framework nanoparticles enhanced the microwave ablation of hepatocellular carcinoma.

Microwave ablation (MWA) is a promising minimally invasive therapy for hepatocellular carcinoma (HCC). However, the efficiency of MWA in treating HCC is evidently limited by the incomplete ablation of large tumors and tumors in high-risk locations. Here we designed an iron-based metal-organic framework nanomedicine (PFP-Apa-MOF) by loading perfluoropentane (PFP) and apatinib (Apa). After being absorbed by HCC, iron could induce ferroptosis. PFP could be activated into bubbles and act as an ultrasound agent for detecting the ablation margin. As an effective antiangiogenic drug, Apa could inhibit tumor residual growth after MWA. The high efficiency of PFP-Apa-MOF was fully demonstrated in vitro and in vivo. The results showed that MWA combined with PFP-Apa-MOF clearly enhanced the ablation efficiency, leading to apparent tumor inhibition, and increased tumor apoptosis and lipid peroxide. PFP-Apa-MOF could play a valuable role in enhancing MWA to achieve better therapeutic efficacy in HCC.

Exploring Crowdsourced Hard—Acceleration and Braking Event Data for Evaluating Safety Performance of Low-Volume Rural Highways in Iowa

There are over four million miles of two-lane roadways across the United States, of which a substantial portion is low-volume roads (LVR). Traditionally, most traffic safety efforts and countermeasures focus on high-volume high-crash urban locations. This is because LVRs cover an extensive area, and the rarity of crashes makes it challenging to use crash data to monitor the safety performance of LVRs regularly. In addition, obtaining up-to-date roadway information, such as pavement or shoulder conditions of an extensive LVR network, can be exceptionally difficult. In recent times, crowdsourced hard-acceleration and braking event data have become commercially available, which can provide precise geolocation information and can be readily acquired from different vendors. The present paper examines the potential use of this data to identify opportunities to monitor the safety of LVRs. This research examined approximately 12 million hard-acceleration and hard-braking events over a 3-months period and 26,743 crashes, including 9373 fatal injuries over the past 5-year period. The study found a moderate correlation between hard acceleration/hard-braking events with historical crash events. This study conducted a hot spot analysis using hard-acceleration/hard-braking and crash datasets. Hotspot analysis detected spatial clusters of high-risk crash locations and detected 848 common high-risk sites. Finally, this paper proposes a combined ranking scheme that simultaneously considers historical crash events and hard-acceleration/hard-braking events. The research concludes by suggesting that agencies can potentially use the hard-acceleration and hard-braking event dataset along with the historical crash dataset to effectively supervise the safety performance of the vast network of LVRs more frequently.

Simulation of pedestrian and cyclist underpass to reduce risky behaviour and traffic violations - a case study level crossing Trnava in Croatia

Level crossing accidents are among the most common accidents in rail transport. Accidents between trains and pedestrians often end in serious injury or death. Several key factors contributing to the occurrence of train-pedestrian accidents are human error (violation of laws), poor visibility, inadequate infrastructure, etc. One of the aims of this study is to analyse the problem of frequent illegal pedestrian and cyclist crossings at the Trnava level crossing in Croatia. Data was collected through observations and camera recordings of illegal pedestrian and cyclist crossings (traffic violations). Frequent train traffic on the double-track international and suburban railway line M102 (Zagreb Glavni kolodvor - Dugo Selo) leads to long closing times of the level crossing. The problem is exacerbated by the high volume of pedestrian and cyclist traffic, which makes the Trnava level crossing a high-risk location for accidents. Data collected on site (at the Trnava level crossing) is used to create a simulation of a pedestrian and cyclist underpass using PTV Vissim software and to investigate the effectiveness of the underpass as a solution to reduce risky behaviour by level crossing users at the Trnava level crossing. The result of implementing of the underpass for pedestrians and cyclists is a complete separation of non-motorised traffic and rail traffic, which significantly reduces traffic violations and insures safe movement of level crossing users.

Used of Geospatial tools to detect the Flood Hazards in Dibru River Basin, Assam (India)

Mapping of Flood hazards is an essential component of land use planning. It creates awareness among the mass people about the impact of floods within the region. This study mainly focuses on the flood hazards within the Dibru River Basin. The region is the plain region near the bank of the river, or in the low land area where flood inundation is being observed. The primary aim of this study is to categorize the region into a very high flood zone, moderate flood zone and low flood zone. Different parametric are used in order to prepare the flood hazards mapping. GIS plays a vital role in processing all these parameters at one platform. GIS tool is frequently used to prepare flood hazard maps. It provides an effective way of assembling information from different maps. It can support planning and development by identifying high-risk locations and steering development away from them.

Habitat selection by free-roaming domestic dogs in rabies endemic countries in rural and urban settings

Domestic dogs can affect human health through bites and pathogen transmission, particularly in resource-poor countries where dogs, including owned ones, predominantly roam freely. Habitat and resource selection analysis methods are commonplace in wildlife studies but have not been used to investigate the environmental resource use of free-roaming domestic dogs (FRDD). The present study implements GPS devices to investigate habitat selection by FRDD from an urban site and a rural site in Indonesia, and one urban and two rural sites in Guatemala (N = 321 dogs). Spatial mixed effects logistic regression models, accounting for heterogeneous distribution of the resources, showed that patterns of habitat selection by FRDD were similar across study sites. The most preferred resources were anthropogenic, being buildings and roads, which implies selection for human proximity. Vegetation and open fields were less preferred and steep terrain was avoided, indicating that FRDD were synanthropic and that their space patterns likely optimised energy use. Results presented here provide novel data on FRDD habitat selection patterns, while improving our understanding of dog roaming behaviour. These findings provide insights into possible high-risk locations for pathogen transmission for diseases such as rabies, and can assist management authorities in the planning and deployment of efficient disease control campaigns, including oral vaccination.

Current perspectives on microwave ablation of liver lesions in difficult locations.

Microwave ablation (MWA) is becoming the standard of care in treating liver lesions smaller than 3 cm benefiting from a plethora of radiofrequency ablation (RFA) data in the literature. Some of the advantages of MWA compared to RFA are as follows: Faster ablations, more reproducible and predictable heating, better thermal conductivity in different liver tissue environments, and less susceptibility to heat-sink effect. Despite its many advantages, there are still concerns regarding MWA use in high-risk locations such as near portal veins, near the bile ducts, and near the heart. Some centers have historically considered these tumor locations as a contraindication to percutaneous thermal ablation. In this review, we summarize the current data on the safety of MWA of liver tumors in challenging locations. We also discuss several technical tips with examples provided.

Multi-scenario urban flood risk assessment by integrating future land use change models and hydrodynamic models

Abstract. Urbanization and climate change are critical challenges in the 21st century. Flooding by extreme weather events and human activities can lead to catastrophic impacts in fast-urbanizing areas. However, high uncertainty in climate change and future urban growth limit the ability of cities to adapt to flood risk. This study presents a multi-scenario risk assessment method that couples a future land use simulation (FLUS) model and floodplain inundation model (LISFLOOD-FP) to simulate and evaluate the impacts of future urban growth scenarios with flooding under climate change (two representative concentration pathways (RCP2.6 and RCP8.5)). By taking the coastal city of Shanghai as an example, we then quantify the role of urban planning policies in future urban development to compare urban development under multiple policy scenarios (business as usual, growth as planned, growth as eco-constraints). Geospatial databases related to anthropogenic flood protection facilities, land subsidence and storm surge are developed and used as inputs to the LISFLOOD-FP model to estimate flood risk under various urbanization and climate change scenarios. The results show that urban growth under the three scenario models manifests significant differences in expansion trajectories, influenced by key factors such as infrastructure development and policy constraints. Comparing the urban inundation results for the RCP2.6 and RCP8.5 scenarios, the urban inundation area under the growth-as-eco-constraints scenario is less than that under the business-as-usual scenario but more than that under the growth-as-planned scenario. We also find that urbanization tends to expand more towards flood-prone areas under the restriction of ecological environment protection. The increasing flood risk information determined by model simulations helps us to understand the spatial distribution of future flood-prone urban areas and promote the re-formulation of urban planning in high-risk locations.

Dynamic identification of short-term and longer-term hazardous locations using a conflict-based real-time extreme value safety model

A novel and effective approach to safety management requires evaluating the safety of locations over short time periods (e.g. minutes). Unlike traditional methods that are based on aggregate crash records over a few years, crash proneness in this approach reflects short-time durations and is related to dynamic traffic changes and dangerous driving events. This paper proposes a new approach to dynamically assess the crash proneness of traffic conditions within a very short time (e.g., signal cycle length) and to dynamically identify high-risk locations. Using a Bayesian hierarchal Extreme Value Theory (EVT) model, the short-term crash risk metrics, risk of crash (ROC), and return level (RL), are calculated using traffic conflict data. A short-term hazardous location identification and ranking framework is developed based on crash-risk threshold exceedances for every short-term analysis period. By further investigating the variation in short-term crash risk, longer-term hazardous location identification and ranking metrics such as the longer-term crash risk index (LTCRI) and the percent of time exceeding (PTE) were developed. Using these metrics, a framework is proposed by which hazardous intersections can be dynamically classified and ranked in both the short-term and the longer-term. This ranking may be dynamically updated as more data becomes available. The proposed framework was applied to a trajectory dataset consisting of 47 signalized intersections obtained from a UAV-based dataset. Conflicts were identified from vehicle trajectories and were used to compute the proposed short-term and longer-term metrics. The intersections within the network were then ranked based on the proposed framework. This study demonstrates the importance of investigating short-term fluctuations in crash risk that may otherwise be lost to averaging in longer-term analysis and proposes a simple and practical solution.

Analysis of LNG Storage Tank Safety: A Comprehensive Model Approach with ANP and Normal Cloud

Global energy shortages continue in the post-epidemic era. As clean primary energy, LNG plays an important role in the energy structure adjustment. However, with the widespread use of LNG, storage tank leaks occur frequently. In order to highlight the risk status of critical risk areas of LNG tank leakage, the “Five-high” risk system for the LNG industry, with high-risk locations, high-risk equipment, high-risk processes, high-risk personnel, and high-risk substances as first-level elements, was built. Combined with the Analytic Network Process (ANP) and normal cloud model for quantitative analysis, a safety risk analysis and assessment model for LNG storage tanks based on the ANP-normal cloud model was developed. Safety analysis was conducted with the example of an LNG storage tank area of a factory. The results show that the risk level for LNG tank leakage is level IV, with high-risk equipment being the first-level element with the highest weight and risk. The reliability of the comprehensive model was verified by AHP and fuzzy integrated analysis, and the results were basically consistent with the factory safety evaluation report. The study realizes the quantitative and visual analysis considering the correlation of risk elements and provides a new quantitative method for the safety analysis of LNG energy.

Learning curve of microwave ablation for liver cancers

PurposeTo evaluate MWA efficacy and safety by cumulative MWA volume and interventional experience. Method3113 primary liver cancers treated by 7 operators between 2006 and 2018 were studied. Conditional logistic regression was used to estimate within-operators effects of increasing cumulative MWA volume per year on major complication, technical efficacy (TE) and local tumor progression (LTP) rates were adjusted for treatment-level characteristics. Changes were also evaluated by subgroups of tumor size and location. ResultsLower severe complication rate was detected only in higher MWA volume (HR: 0.31, P = 0.02)). TE rates increased with the increase of MWA volume ((100–150 procedures (HR: 0.33, P = 0.00); 150–200 procedures (HR: 0.08, P = 0.00)) per year. Similar results were found in subgroup analysis of interventional experience (5 to < 10 years (HR: 0.10, P = 0.00). MWA volume per year larger than 150 cases could reduce the major complication rate for tumors smaller than 5 cm (HR: 0.21, P = 0.03) and tumors in higher risk location (HR: 0.18, P = 0.03). The increase of MWA volume per year could significantly increase the TE rate in all tumor size, expect for tumors in high-risk location (100–150 procedures (HR:1.12, P = 0.84), 150–200 procedures (HR: 0.14, P = 0.08)). ConclusionsEarly and intensive performance of MWA procedures would reduce major complication rates regardless of tumor size and tumor location, but could not improve TE rate in high-risk locations.

Rapid detection methods and modelling simulations provide new insights into cyanobacteria detection and bloom management in a tropical reservoir

The increasing occurrence of cyanobacteria blooms is of global concern, and is often associated with environmental and socio-economic problems, such as degenerated ecosystems and aquaculture impairment. The diazotrophic cyanobacterium Raphidiopsis raciborskii (R. raciborskii) grows rapidly in the tropics, and produces the toxin, cylindrospermopsin (CYN), which has harmful effects on aquatic organisms. Thus, to protect water quality and ecosystem, it is essential to have rapid and reliable methods for cyanobacteria and R. raciborskii detection and prediction so that early warning can be provided for management. Molecular assays, such as PCR, real-time quantitative PCR (qPCR), two-step PCR assays are accurate and widely used, but still require several hours from sample preparation to data analysis. In this study, insulated isothermal PCR (iiPCR) assays in conjunction with fast DNA extraction method, were developed and verified as a rapid detection assay in detecting cyanobacteria and R. raciborskii within 50 min, and also with high detection accuracy (98.8%) and the overall high agreement level (98.8%, k = 97.5%)) comparing to conventional qPCR assay. However, the limitation of the iiPCR assay is that it only generates qualitative results. Therefore, the quantified iiPCR assay, named as A-iiPCR, by coupling iiPCR device with fluorescence signal catching and interpretation instrument (Andor spectrometer with Solis spectroscopy software) was developed and verified with in situ environmental samples. The fluorescence intensity decreased accordingly with the drop of DNA concentration until reaching 1.32 ng/μL. Also, Delft 3D modelling was established to simulate R. raciborskii change in predicting spatial and temporal variabilities for reservoir management, as the simulated R. raciborskii concentration was the highest at sampling site 1, as well as temporally highest in April and October, posing as the most high-risk location and time periods for R. raciborskii bloom-forming requiring corresponding governance measures.

Antibiotic Use and Surgical Site Infections in Immunocompromised Patients After Mohs Micrographic Surgery: A Single-Center Retrospective Study.

As Mohs micrographic surgery becomes more widely used in immunosuppressed patients, it is important to understand the risks in this unique population. To determine whether immunosuppressed patients are at an increased risk for surgical site infection and evaluate the utility of postoperative antibiotics for the prevention of surgical site infection. A single-center retrospective review of patients who underwent Mohs micrographic surgery between October 9, 2014, and August 20, 2021, was performed. Five thousand eight hundred eighty-six independent cases were identified. Factors associated with an increased incidence of antibiotic use included preoperative lesion size >40 mm (86.7%, n = 13; p < .01) and high-risk lesion location (46.4%, n = 1,268; p < .01). Patients were not more likely to be prescribed antibiotics if immunosuppressed (37.0%, n = 269 vs 34.2%, n = 1765; p = .14), and immunosuppression was not independently associated with antibiotic use on multivariate analysis (odds ratio 1.2, 95% confidence interval 1.0-1.5). Infection rates were similar between immunocompromised patients and immunocompetent patients (2.1%, n = 15 vs 1.6%, n = 80, respectively; p = .30). In immunosuppressed patients, antibiotic use did not decrease the likelihood of infection (3.0%, n = 8 vs 1.5%, n = 7; p = .19). There was no association between immunosuppression and surgical infection rate. Furthermore, postoperative antibiotics should not be indicated in these patients unless other high-risk criteria exist.

THE VALUE OF AIR GERM NUMBERS AT SOEKARNO HATTA AIRPORT IN 2021

Introduction: Indoor air quality greatly affects human health, because almost 90% of human life is indoors. This study aims to analyze the number of airborne germs at Soekarno Hatta Airport in 2021. Methods: The research design was cross-sectional study. The number of measurements of airborne germ numbers was carried out in 29 locations with 136 sample points, and mapping was carried out at 20 locations with 78 sample points. Data collection was using secondary data from Port Health Office of Class I Soekarno Hatta. The analysis used is univariate analysis, presented in the form of a frequency distribution table and mapping with ArcGIS and AutoCad. Results and Discussion: The study showed that most of the airborne germ numbers matched the quality standard, but there were 14 sample points (10.3%) that exceeded the quality standard. High-risk locations with red zones are located at Domestic Terminal 3 and Port Health Office of Class I Soekarno Hatta. Low-risk locations with green zones are in International Terminal 3 and Terminal 2. Conclusion: Therefore, all building, bus, and airline managers need to improve implementation disinfection, cleaning of the entire area, periodic maintenance of air conditioner and replacement of Hepafilter. Measurement of air germ numbers is needed as a routine activity of Port Health Office of Class I Soekarno Hatta to evaluate and monitor air quality

What affects pedestrian crossing difficulty at urban intersections in a developing country?

In developing countries, road traffic crashes involving pedestrians have become a foremost concern. At present, road safety assessment plans and selection of interventions are primarily restricted to traditional approaches that depend on the investigations of historical crash data. However, in developing countries such as India, the availability, consistency, and accuracy of crash data are major concerns. In contrast, proactive approaches such as studying road users' risk perception have emerged as a substitute method of examining potential risk factors. An individual's risk perception offers vital information on probable crash risk, which may be beneficial in detecting high-risk locations and major causes of crashes. Since the pedestrian fatality risk is not uniform across the urban road network level, it may be expected that pedestrians' perceived risk measured in terms of “crossing difficulty” would also vary across the sites. In this perspective, the present paper establishes a mathematical association between the pedestrians' perceived “crossing difficulty” and actual crashes. The model outcome confirms that pedestrians' perceived crossing difficulty is a good surrogate of fatal pedestrian crashes at the intersection level in Kolkata City, India. Subsequently, to examine the impact of traffic exposures, road infrastructure, land use, spatial factors, and pedestrian-level attributes on pedestrians' “crossing difficulty”; a set of Ordered Logit models are developed. The model outcomes show that high vehicle and pedestrian volume, vehicular speed, absence of designated bus stop, the presence of inaccessible pedestrian crosswalk, on-street parking, lack of signalized control (for both vehicle and pedestrian), inadequate sight distance, land use pattern, slum population, pedestrian-vehicular post encroachment time, waiting time before crossing, road width, and absence of police enforcement at an intersection significantly and positively increase pedestrian's crossing difficulty at urban intersections. To end, the model findings are advantageously utilized to develop a set of countermeasures across 3E's of road safety.

Direct modelling from GPS data reveals daily-activity-dependency of effective reproduction number in COVID-19 pandemic

During the COVID-19 pandemic, governments faced difficulties in implementing mobility restriction measures, as no clear quantitative relationship between human mobility and infection spread in large cities is known. We developed a model that enables quantitative estimations of the infection risk for individual places and activities by using smartphone GPS data for the Tokyo metropolitan area. The effective reproduction number is directly calculated from the number of infectious social contacts defined by the square of the population density at each location. The difference in the infection rate of daily activities is considered, where the ‘stay-out’ activity, staying at someplace neither home nor workplace, is more than 28 times larger than other activities. Also, the contribution to the infection strongly depends on location. We imply that the effective reproduction number is sufficiently suppressed if the highest-risk locations or activities are restricted. We also discuss the effects of the Delta variant and vaccination.

Semi-quantitative risk assessment of adjacent track accidents on shared-use rail corridors

There are several safety questions associated with operating passenger trains and freight trains on shared-use rail corridors (SRCs). Among them are adjacent track accidents (ATA) in which derailed railroad equipment intrudes upon (“fouls”) adjacent tracks and is struck by another train on adjacent tracks. ATAs can occur in any multiple track territory, but they become more complex and potentially more hazardous on SRCs. ATAs can be broken down into three principal events: the initial derailment, an intrusion, and a train present on an adjacent track. Previous research established a foundation for addressing intrusion risk by qualitatively identifying the risk and potential mitigation measures and conducting preliminary quantitative intrusion probability analysis; however, a gap remains between current research on intrusion risk and a comprehensive risk assessment model for ATAs. This paper presents an index-based, semi-quantitative risk analysis framework to evaluate probability and consequence of ATAs. A new risk index system was developed to evaluate ATA risk by assigning levels of probability to the three principal events and the overall ATA consequence level to different track segments, thereby enabling comparison of relative ATA risk among these track segments. The levels of ATA probability and consequence are determined by various infrastructure, rolling stock, and operational factors identified in this research where each factor contributes risk scores that can be summed and converted to levels of probability and consequence. The magnitude of risk due to each factor is determined by their effect, i.e., whether it increases or decreases the probability and/or consequence. A case study based on a 320-km, modified real-world SRC is presented to demonstrate and validate the model. Higher operating speed, lack of containment or barriers, and higher initial derailment rate all significantly affect ATA risk. The model enables comparisons of the relative ATA risks among different track segments at a resolution not previously achieved. It can also be used to locate high-risk locations (risk hotspots) on a railroad corridor where ATA risk is high. This model also provides information pertinent to future improvements in quantification of ATA risk and research on mitigation measures.

Spatial analysis of mental health and suicide clustering among older adults in North Carolina: An exploratory analysis

Late-in-life suicide is a major public health issue, with adults over 65 comprising 18% of all suicide deaths. Yet, little research has identified geographic concentrations of older populations at-risk for the psychological conditions in the pathway of suicide. This research identified spatial clustering of suicide, anxiety, depression, and self-injury among older adults in North Carolina from 2009-18 and the individual and area-level factors influencing high-risk clusters. Kulldorff's spatial scan statistic identified significant spatial clusters of suicides, using data collected from the violent death reporting system, and anxiety, depression and self-injury, using emergency department admissions data for older adults aged 65 years and over. Logistic regression and generalized estimating equations were used to examine the influence of multiple contextual variables (e.g., rural-urban commuting area codes, racial segregation) and compositional variables (e.g., race, insurance) within high-risk cluster locations. High-risk suicide, anxiety, and depression clusters were identified in the western and northwestern regions of the state, whereas self-injury clusters were predominantly located in central and southeastern North Carolina. Low-income communities were associated with a higher risk of clustering for all mental health outcomes, and primarily Black communities were associated with an increased risk of self-injury clustering. Findings can be applied to public policy to focus suicide prevention efforts on older adults, particularly in low-income communities in rural Appalachia and the central, southeastern portion of North Carolina.

A New Perspective on Hydrogen Chloride Scavenging at High Temperatures for Reducing the Smoke Acidity of PVC Cables in Fires. II: Some Examples of Acid Scavengers at High Temperatures in the Condensed Phase

In the European Union, according to Regulation (EU) n. 305/2011, cables permanently installed in residential and public buildings need additional classification for acidity. EN 60754-2 is the test method for assessing acidity, and three classes are provided: a1, a2, and a3 (less performant). The research on PVC compounds with low smoke acidity helps to produce cables in the best additional classes for acidity, giving the PVC cables the possibility to be used in medium and high fire risk locations. This paper shows the behavior of some acid scavengers at high temperatures performing EN 60754-2 in isothermal conditions at different temperatures between 400 °C and 950 °C. The test apparatus is a tube furnace where the test specimen is burnt, and the released gases are trapped in bubbling devices containing double deionized water. pH and conductivity are measured, the efficiency of the acid scavengers is assessed, and chemical analysis of the ashes is performed. That allows us to understand why some substances succeed and others fail in trapping hydrogen chloride (HCl). The most important conclusion in this paper is that the higher the temperature, the lower the performance of the acid scavenger, showing that HCl concentration in the gas phase depends strongly on the heating conditions of the test specimen.