Implementation Of Management Strategies Research Articles

Optimization of sampling design for soil total organic carbon assessment in the precision agriculture framework: Impact of different variogram models and potentiality of ground penetrating radar (GPR) covariate information

Assessing soil organic carbon (SOC) at the field scale is crucial for efficient environmental and agronomic management, especially within the precision agriculture framework. This enables the implementation of crop and soil management strategies to enhance soil quality, increase carbon sequestration, and improve crop yields. However, the process of sampling and assessing SOC is resource-intensive, demanding both in time and labour. This aspect is particularly relevant in agronomic research, where the need to assess the spatial correlation structure of the investigated variables requires the collection of large datasets with georeferenced data and often measurements need to be repeated over time as in the case long-term field experiments − LTE. Methods for minimizing information loss while reducing the sampling scheme, such as spatial simulated annealing (SSA), are particularly valuable in the scope of SOC assessment, especially when faced with budget and time/labour constraints. Within the structure of the SSA method, two critical components can be identified: i) the inclusion of highly informative covariates for the primary variable (SOC); ii) the selection of the most appropriate variogram model for spatial variability assessment. Covariates strongly correlated with SOC, such as those obtained from ground penetrating radar (GPR) that can be collected at a higher spatial density compared to SOC data, along with a well-performing model, can significantly enhance the efficiency of the sampling scheme reduction process. We conducted a study using data from an agronomic field experiment, which included 71 georeferenced sampling locations and, through an iterative downsizing process utilizing SSA, we progressively reduced the number of sampling points by removing 10, 15, and 20 observations. The sampling scheme was refined according to two distinct variogram models: the spherical and Gaussian-Matérn models, both for the primary variable (SOC) and the covariate GPR variable. This process allowed us to identify the optimal variogram model, which has a key role in maximizing the reduction of redundant points while preserving those with valuable information, and to assess the role of the covariate variable both in improving the optimization of the sampling scheme for SOC and in replacing the primary variable to optimize the sampling scheme. Finally, to assess the impact of sampling scheme reduction, a validation process was performed by estimating the dropped points by means of the remaining points using ordinary kriging and regression kriging and analysing the accuracy of such estimation. Our analysis demonstrated that it was possible to reduce the original sampling scheme by approximately 20%, equivalent to eliminating 15 sampling points out of 71, without compromising its predictive capability.

Safe to save blood in ovarian cancer surgery - time to change transfusion habits.

Patients with advanced ovarian cancer (AOC) undergoing surgery are often subjected to red blood cell (RBC) transfusions. Both anemia and RBC transfusion are associated with increased morbidity. The aim was to evaluate patient recovery after the implementation of patient blood management (PBM) strategies. This retrospective cohort study included 354 patients with AOC undergoing surgery at Skane University Hospital Lund, Sweden, between January 2016 and December 2021. The gradual implementation of PBM strategies included restrictive RBC transfusion, tranexamic acid as standard medication before laparotomies and intravenous iron administered to patients with iron deficiency. Severe complications were defined as Clavien-Dindo (CD) grade ≥ 3a. Logistic and linear regression analyses were used to evaluate the differences between three consecutive periods. After the implementation of new strategies, 52% of the patients had at least one transfusion compared to 83% at baseline (p < 0.001). There was no difference in the rate of severe complications (CD ≥ 3a) between the groups, adjusted odds ratio 0.55 (95% CI 0.26-1.17). The mean difference in hemoglobin before chemotherapy was -1.32 g/L (95% CI -3.04 to -0.22) when adjusted for blood loss and days from surgery to chemotherapy. The length of stay (LOS) decreased from 8.5 days to 7.5 days (p 0.002). The number of patients transfused were reduced by 31%. Despite a slight increase in anemia rate, severe complications (CD ≥ 3a) remained stable. The LOS was reduced, and chemotherapy was given without delay, indicating that PBM is feasible and without causing major severe effects on short-term recovery.

Adaptive Stakeholder Management in Social Startups

This research examines the implementation and outcomes of stakeholder relationship management (SRM) strategies in social startups, focusing on Indonesia's Social Organization Matchmaking program. Conducting by a qualitative approach, this study explores how the Outreach Campaign team designed and implemented SRM strategies to engage diverse Organizations within a resource-constrained, emerging market context. The findings highlight a multifaceted SRM approach encompassing strategic communication, personalized engagement, value co-creation, and digital interaction. This adaptive strategy significantly enhanced program outcomes, including a higher success rate in matching Organizations with sponsors, increased retention, and overall satisfaction. Key factors contributing to effective SRM were identified, such as fostering trust through transparent communication, cultivating commitment through shared value creation, and balancing digital and traditional engagement methods. Contextual factors, including cultural norms, economic realities, technological infrastructure, and regulatory environment, shaped SRM strategies.

Length–weight relations of underutilized nine fish species (Actinopterygii) from set-net fishery, Mie, Japan

Bycatch, the unintentional capture of non-target species, poses a significant challenge in fisheries management worldwide. Underutilized bycatch species often lack biological information, hindering the assessment of their stock status and the implementation of appropriate management strategies. This study investigated the length–weight relations (LWRs) of 9 of 14 underutilized bycatch fish species collected from set-net fisheries in Nishiki, Mie Prefecture, Japan, during the 2018–2020 fishing seasons. The following fish species were studied: Hyperoglyphe japonica (Döderlein, 1884); Labracoglossa argenteiventris Peters, 1866; Macroramphosus sagifue Jordan et Starks, 1902; Microcanthus strigatus (Cuvier, 1831); Ostorhinchus semilineatus (Temminck et Schlegel, 1843); Parapriacanthus ransonneti Steindachner, 1870; Rexea prometheoides (Bleeker, 1856); Siganus fuscescens (Houttuyn, 1782); Upeneus japonicus (Houttuyn, 1782). A total of 251 fishing operations were conducted, and the collected fish specimens were measured for length (fork length) and wet weight. Simple regression analysis was performed on the logarithm of length and weight data to estimate the LWR parameters (a, b, and R2) for each species. The estimated values of the relative growth coefficient (b) ranged from 2.862 to 3.311, and the coefficients of determination (R2) were above 0.8 for all species, indicating robust LWR estimations. Notably, five species were not previously listed or credibly described in FishBase, and four were new records for the Japanese coast. This study provides new biological information on LWRs for underutilized bycatch fish species, contributing to our understanding of their population dynamics and supporting future management efforts for sustainable fisheries and biodiversity conservation.

A Wasserstein distance-based spectral clustering method for transaction data analysis

With the rapid development of online payment platforms, it is now possible to record massive transaction data. Clustering on transaction data significantly contributes to analyzing merchants’ behavior patterns. This enables payment platforms to provide differentiated services or implement risk management strategies. However, traditional methods exploit transactions by generating low-dimensional features, leading to inevitable information loss. In this study, we use the empirical cumulative distribution of transactions to characterize merchants. We adopt Wasserstein distance to measure the dissimilarity between any two merchants and propose the Wasserstein-distance-based spectral clustering (WSC) approach. Based on the similarities between merchants’ transaction distributions, a graph of merchants is generated. Thus, we treat the clustering of merchants as a graph-cut problem and solve it under the framework of spectral clustering. To ensure feasibility of the proposed method on large-scale datasets with limited computational resources, we propose a subsampling method for WSC (SubWSC). The associated theoretical properties are investigated to verify the efficiency of the proposed approach. The simulations and empirical study demonstrate that the proposed method outperforms feature-based methods in finding behavior patterns of merchants.

Implementation of a multistage predictive energy management strategy considering electric vehicles using a novel hybrid optimization technique

In this paper, a novel artificial intelligence (AI)-based energy management strategy across three levels is designed for isolated microgrids. During the initial phase, AI is not employed. A precise and rapid-response microcontroller, namely the FPGA, is utilized. The performance of the FPGA is experimentally investigated under various operation conditions. In the second phase, AI plays a crucial role in enhancing both the reliability and economic effectiveness of the system. The multi-objective snake optimization (SO) algorithm is employed to attain high technical and economic performance within predefined constraints. Three objective functions are involved in this phase, focusing on the minimization of operational costs, loss of power supply probability (LPSP), and electrical energy losses in the dummy load. In the third level, a novel control strategy-based coordinated model predictive control is presented as part of the proposed AI-embedded energy management strategy. A hybrid optimization algorithm combining the multilayer feed-forward neural networks (MFFNN) and SO algorithms is proposed to predict the output power of backup sources. The microgrid under consideration is supported by a hybrid backup system comprising battery energy storage systems (BESS), electric vehicle (EV) batteries, and fuel cells (FCs). The effectiveness of this hybrid algorithm is evaluated through comparison with many other algorithms, aiming to assess its performance in accurately predicting the output power of backup sources. The results show the feasibility of using AI to achieve efficient operation and energy management in microgrids. The proposed MFFNN-SO algorithm achieves the best performance, as the normalized root mean square error (NRMSE) for FCs, BESS, and EV is about 0.1296 %, 0.0094 %, and 0.1304 %, respectively. The SO algorithm achieves a notable 6.3361% reduction in operating costs, resulting in a final operational cost of 166.4811 $.

Biochar Derived from Sewage Sludge: The Impact of Pyrolysis Temperature on Chemical Properties and Agronomic Potential

The rising volume of sewage sludge from urbanization poses substantial environmental and public health concerns, underscoring the urgency for the implementation of effective waste management strategies. The objective of this study was to evaluate the influence of pyrolysis temperature on the chemical composition and agronomic potential of biochar derived from sewage sludge. The pyrolysis process was conducted at temperatures ranging from 400 °C to 800 °C, and the resulting biochar was analyzed for pH, electrical conductivity, metal content, and carbon fractions. Additionally, phytotoxicity tests were conducted to assess the impact of the biochar on plant germination. The findings indicated that elevated pyrolysis temperatures resulted in an elevated alkalinity, electrical conductivity, and concentration of alkali metals in the biochar. Conversely, these processes resulted in a reduction in total organic carbon content and an increase in heavy metal content, which may limit the potential for biochar to be used in agricultural applications. The phytotoxicity tests indicated that the biochar produced at lower temperatures (400 °C) exhibited positive effects on plant growth when administered at doses of 5 and 10 t·ha−1. Conversely, the biochar produced at higher temperatures (800 °C) demonstrated significant toxicity. The findings indicate that the pyrolysis temperature is a critical factor in determining the suitability of biochar for agricultural applications. The production of biochar at lower temperatures may offer agronomic benefits, whereas the use of higher temperatures increases stability but is associated with the risk of higher heavy metal concentrations.

Development of Tools to Understand the Relationship between Good Management Practices and Nest Losses in Meliponiculture: A Pilot Study in Latin American Countries.

Insect pollination services amount to USD 235-577 billion. Seventy five percent of agricultural production for human consumption depends on pollination, mainly by bees. A decline in pollinators, including Meliponini tribe bees, will impact the economy, food security, human health, and ecosystem stability, especially in tropical forests where stingless bees are the main pollinators. The objective of this survey was to understand the relationship between good management practices and nest losses in meliponiculture, encompassing biosecurity and conservation criteria. A 36-question survey was organized and spread. We received 92 responses, representing 4548 managed nests. The primary motivation for engaging in meliponiculture was biodiversity conservation (92%). More than 50% of the questions on biosecurity were answered as "applied". Hand washing before any activity with bees was the main rule, followed by material sterilization and personal protective equipment use. The annual mortality rate of stingless bee nests was estimated at 15%. Nest invaders (72%) and nearby sources of pollution (60%) were identified as the main potential causes of nest losses. From a general perspective, meliponiculture practices continue to expand remarkably. The implementation of effective nest management strategies is associated with a reduction in nest losses. It is important to consider One Health's perspective to ensure optimal management practices.

Evaluating the Impact of Hotel Classification on Pool Water Consumption: A Case Study from Costa Brava (Spain)

Swimming pools are key assets in the hotel industry. With climate change and water stress, more sustainable pools are needed in tourist areas. The study examines the relationship between hotel categories and the consumption of water in swimming pools in a Mediterranean coastal region facing water scarcity. The study focuses on the Costa Brava, with a focus on Lloret de Mar, a popular tourist destination. The research employs a combination of data analysis and the utilisation of evaporation models in order to estimate the consumption of water by swimming pools. The findings indicate that hotels in the higher categories, particularly those with three or four stars, contribute a notable proportion of the total water consumption due to their larger pool sizes and higher guest numbers. The study underscores the necessity for the implementation of sustainable water management strategies, particularly in the context of climate change. It recommends the utilisation of pool water-saving technologies as potential solutions. Furthermore, the paper highlights the broader environmental impact of tourism infrastructure on water resources and suggests policy measures to mitigate these effects. The research aligns with global sustainability goals such as the European Green Deal and the 2030 Agenda.

Trade Facilitation as a Catalyst for Government Revenue Enhancement: Exploring the Synergies Between Trade Efficiency and Tax Collection

Customs administrators worldwide are mandated to mobilize national revenue collections through the assessment and collection of applicable duties and taxes on all imports and exports. One of their primary concerns following the ratification of the Trade Facilitation Agreement is the need to optimise revenue collections while simultaneously upholding trade facilitation. This research assesses trade facilitation implications on government revenue mobilization in developing countries with a particular emphasis on Zimbabwe. The paper adopts a qualitative approach, capturing several subjective elements including the examination of the Critical Success Factors for enhanced revenue collection as well as the evaluation of trade facilitation as a solution to customs revenue leakages. Purposive sampling was employed to collect data from employees working in the Customs Division at the Zimbabwe Revenue Authority. Eighty questionnaires were distributed to participants working in Beitbridge, Chirundu, Forbes border posts and the Robert Mugabe International Airport targeting Customs Senior Managers, Customs Middle Managers, Revenue Supervisors and Revenue Officers as key respondents. Data was analysed using the Statistical Package for Social Sciences version 29. This analysis focused on four dimensions of trade facilitation, which includes port efficiency, customs environment, regulatory environment, and electronic-business. The findings indicate that trade facilitation reforms, when executed appropriately in conjunction with enhancements in electronic-business, port efficiency, customs environment and the regulatory framework, can effectively augment revenue collection. Regulatory environment improvements are key in influencing increasing revenue collection and should be prioritised in resource allocation for the achievement of best possible outcomes. We recommend ‘continuous refresher training’ on trade facilitation awareness targeting all stakeholders in ports of entry, accompanied by the implementation of robust risk management strategies as well as intensified implementation of integrity management tools.

Exploring the trend of age-standardized mortality rates from cardiovascular disease in Malaysia: a joinpoint analysis (2010–2021)

IntroductionCardiovascular disease (CVD) is a major health concern worldwide, particularly in low- and middle-income countries. The COVID-19 pandemic that emerged in late 2019 may have had an impact on the trend of CVD mortality. This study aimed to investigate the trend and changes in CVD mortality rates in Malaysia, using age-standardized mortality rates (ASMR) from 2010 to 2021.MethodsThe Malaysian population and mortality data from 2010 to 2021 were obtained from the Department of Statistics Malaysia (DOSM). ASMRs from CVD per 100,000 population were calculated based on the World Health Organization (2000–2025) standard population using the direct method. The ASMRs were computed based on sex, age groups (including premature mortality age, 30–69 years), and CVD types. The annual percent change (APC) and average annual percent change (AAPC) of the ASMR with corresponding 95% confidence intervals (95% CI) were estimated from joinpoint regression model using the Joinpoint Regression Program, Version 4.9.1.0.ResultsThroughout the study period (2010–2021), ASMRs for CVD exhibited an increase from 93.1 to 147.0 per 100,000, with an AAPC of 3.6% (95% CI: 2.1 to 5.2). The substantial increase was observed between 2015 and 2018 (APC 12.6%, 95% CI: 5.4%, 20.3%), with significant changes in both sexes, and age groups 50–69, 70 years and over, and 30–69 (premature mortality age). Notably, the ASMR trend remained consistently high in the premature mortality age group across other age groups, with males experiencing higher rates than females. No significant changes were detected before or after the COVID-19 pandemic (between 2019 and 2021), except for females who died from IHD (10.3% increase) and those aged 0–4 (25.2% decrease).ConclusionOverall, our analysis highlights the persistently high burden of CVD mortality in Malaysia, particularly among the premature mortality age group. These findings underscore the importance of continued efforts to address CVD risk factors and implement effective prevention and management strategies. Further research is needed to fully understand the impact of the COVID-19 pandemic on CVD mortality rates and to inform targeted interventions to reduce the burden of CVD in Malaysia.

Salinity tolerance of the invasive blue crab Callinectes sapidus: From global to local, a new tool for implementing management strategy

The latest report from the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES) raises concerns about the global proliferation of non-native species (NIS) driven by increasing temperatures. In 2023, the invasive blue crab Callinectes sapidus experienced a significant range expansion in the French Mediterranean lagoons, now present in over 20 lagoons and numerous estuaries with different invasion gradients. It has been established that this species is eurytherm (tolerates a wide range of temperatures; 0–40 °C), rendering temperature a non-limiting factor for its proliferation. On the other hand, salinity is a critical factor to consider, as C. sapidus requires brackish water for copulation and saline water for egg maturation. In this study, we present the salinity tolerance of C. sapidus using the metabolic performance to define the tolerance of the species to a large range of salinities (13 levels from 0 to 65 psu). Results showed that C. sapidus tolerates a large range of salinities with a minimum critical threshold (CTmin) at 0 psu, an optimum at 18.5 psu, and a CTmax at 62.4 psu. Using the performance curve equation, we applied the curve to real salinity data measured each month in 2023 in 20 lagoons invaded. Using this approach, we were able to map, on a fine spatial scale, the distribution of suitable habitats for C. sapidus in the year 2023. Additionally, we have developed a tool to prioritize the lagoons based on their suitability, thereby providing a decision-making framework for management measures in each lagoon. It emerged that 50 % of lagoons were priority areas, 10 % were intermediate and 40 % required monitoring. On the basis of this approach, we can respond to European regulations to help decision-makers implement action plans and/or early detection programs for invasive species management.

Assessing hepatitis B virus serologies when transitioning patients from intravenous immune globulin therapy to rituximab for the treatment of autoimmune neuromuscular diseases.

Intravenous immune globulin (IVIG) has been used as early treatment for autoimmune neuromuscular diseases, but due to cost and frequency, may be switched to rituximab. Rituximab and other B-cell-depleting medications require screening of hepatitis B virus (HBV) serologies given the risk of HBV reactivation (HBVr). We aimed to describe the incidence and characteristics of passively transferred antiviral serologies from IVIG and how to differentiate between passive antibody transfer and resolved HBV infection. This was a single-center descriptive study of neurology patients prescribed rituximab and IVIG. Retrospective medical record reviews were performed and patient-specific variables were collected. Twelve patients had reactive anti-HBc results after starting IVIG, but only 9 were confirmed to have reactive anti-HBc from passive transfer. Whether reactive anti-HBc in the remaining three patients was from passive IVIG transfer could not be confirmed. Five patients with reactive anti-HBc results during rituximab screening did not have pre-IVIG anti-HBc results for comparison and were started on antiviral prophylaxis. Reactive anti-HBc serologies changed to nonreactive after IVIG discontinuation 44-321 days after the last IVIG infusion. This study confirms IVIG can passively transfer anti-HBc serologies in a neurologic cohort. Ideally, HBV serologies would be checked before starting IVIG to help later determine if passive transfer occurred. With the increasing use of B-cell-depleting medications for neuromuscular conditions, it is important for providers to be knowledgeable on the interpretation of HBV serologies for patients on IVIG and to ensure implementation of an HBVr prophylaxis management strategy for patients when appropriate.

Effect of variation in plant-emitted volatiles on the infestation behavior of Tetranychus urticae (Acari: Tetranychidae) and Frankliniella occidentalis (Thysanoptera: Thripidae) in strawberry crops.

The two-spotted spider mite (TSSM), Tetranychus urticae Koch, and the Western flower thrips (WFT), Frankliniella occidentalis (Pergande), are pests commonly found in strawberry crops and pose significant challenges to production. However, the specific dynamics of their interactions with both healthy and infested plants remain poorly understood. In this study, we aimed to investigate the attraction of TSSM and WFT to volatile compounds emitted by healthy plants versus those of plants damaged by either or both species. Plant choice bioassays were conducted under varying conditions, including both healthy and those previously damaged by both TSSM and WFT. Additionally, behavioral tests were carried out using a Y-tube olfactometer, with extracts obtained via dynamic aeration from the plants in different states. The results revealed distinct preferences: TSSM exhibited a strong attraction to both healthy plants and those previously infested by their own specifics, whereas WFT showed a higher preference for healthy plants and those damaged by TSSM. Consistent behaviors were observed in the bioassays conducted with plant extracts. This research sheds light on the intricate interactions between strawberry plants and these pests and offers insights into the probable sequence of attack when both pests are present concurrently. The findings are valuable when implementing management strategies for these two pests in strawberry cultivation, considering the order in which they appear in the crop to help mitigate the damage caused by infestation in a more precise manner and order.

Current status of white mango scale (Aulacaspis Tubercularis Newstead) and associated factors in Assosa district western Ethiopia

White mango scale (Aulacaspis tubercularis Newstead; Hemiptera: Diaspididae) is a major insect pest of mango production threatening production and marketing of mango in Ethiopia. The present study was conducted to determine the current status of the white mango scale (WMS) and to identify the factors contributing to the damage level of the pest. A cross-sectional survey was conducted in ten selected kebeles in Assosa district, western Ethiopia, during 2021/2022 cropping season. Data on infestation level and WMS life-stage abundance were recorded from fifty randomly selected mango orchards. Data on the prevalence of WMS and factors influencing the distribution and damage levels of white mango scale infestations were analyzed using SAS and SPSS software respectively. The results of this study indicate that WMS infestation was prevalent in all assessed mango growing areas of the district. There was a significant (p < 0.05) difference between kebeles and mango orchards in infestation level and WMS life-stage population densities. Poor cultivation, crop husbandry practices, and pest management strategies have been identified as the major contributing factors for high pest infestation. The study indicates that WMS infestations are increasing in the study area; thus, there has to be strong efforts towards the implementation of safe and effective management strategies.

Assessing Historical Landslide Risk Management Based on Trigger Magnitude and Consequences: A Case Study from the Rokko Mountains, Kobe, Japan

AbstractLandslides are a common hazard in mountainous regions, and many countries have implemented landslide risk management to mitigate their negative impacts. Assessing the effectiveness of those measures is important to improve technical and political decision-making and to enhance the selection and implementation of effective landslide risk management strategies. Here, we assessed effectiveness in landslide risk management based on the magnitude of rainfall characteristics that triggered landslides (inducing factor) and landslide consequences in the Rokko mountains, Kobe, Japan. The number of check dams was used as an indicator of progress in landslide risk management. For fatal landslide events in 1938 and 1967, rainfall characteristics that triggered landslides were estimated using the three-layer tank model, and their magnitude was quantified by the return period (RP). We then compared these rainfall magnitudes and landslide consequences (i.e., fatalities and completely collapsed houses) between the two events. The RP of the first tank storage layer value, which indicates rainfall characteristics triggering shallow landslides, was higher at landslides in 1967 than in 1938, whereas landslide consequences were less in 1967 than in 1938. 218 units of check dams were intensively constructed by landslide risk management from 1938 to 1967 and reduced the damage from landslides in 1967 that were triggered by higher magnitude rainfall than in 1938. This study also highlighted the importance of focusing on the magnitude of the inducing factor and landslide consequences to assess the effectiveness of landslide risk management at a local scale.

FP8.9 - Surgical Synergy: Rethinking waste for a greener tomorrow in General Surgery

Abstract Aims Every year in the UK, the NHS sends approximately 156,000 tonnes of clinical waste for processing via high temperature incineration or other treatments, and then to landfill sites. Majority of the waste produced by hospitals comes from the operating theatres (OTs). In this study, we aim to assess the current implementation of waste management strategies at an NHS district general hospital (DGH) in general surgery. We have investigated a variety of cases and have surveyed the volume of waste produced. Methods We observed elective and emergency general surgery cases across 2 weeks. For each case, we weighed the waste produced- both recyclable and non-recyclable (clinical). Results This study included four umbilical hernia repairs, two right hemicolectomies, one examination of rectum under anaesthesia with seton insertion and three laparoscopic cholecystectomies. Across the operations, the average total waste produced was 5.9kg. The average clinical waste and recyclable waste was 4.7kg and 1.2kg, respectively. Additionally, a significant proportion of non-infectious recyclable waste was incorrectly placed into the clinical waste bin. Conclusion On average 5.9kg of waste is produced after a general surgery operation. Most of this waste is clinical and not recycled. However, the clinical waste can be cut down by appropriate waste segregation, thus reducing the impact on the environment as well as reducing the cost of incineration.

Surgical site infection in severe trauma patients in intensive care: epidemiology and risk factors

BackgroundSevere trauma is the leading cause of disability and mortality in the patients under 35 years of age. Surgical site infections (SSI) represent a significant complication in this patient population. However, they are often inadequately investigated, potentially impacting the quality of patient outcomes. The aim of this study was to investigate the epidemiology of SSI and risk factors in severe trauma patients.MethodsWe conducted a multicenter retrospective cohort study screening the severe trauma patients (STP) admitted to two intensive care units of an academic institution in Marseille between years2018 and 2019. Those who underwent orthopedic or spinal surgery within 5 days after admission were included and classified into two groups according to the occurrence of SSI (defined by the Centers for Disease Control (CDC) international diagnostic criteria) or not. Our secondary goal was to evaluate STP survival at 48 months, risk factors for SSI and microbiological features of SSI.ResultsForty-seven (23%) out of 207 STP developed an SSI. Mortality at 48-months did not differ between SSI and non-SSI patients (12.7% vs. 10.0%; p = 0.59). The fractures of 22 (47%) severe trauma patients with SSI were classified as Cauchoix 3 grade and 18 (38%) SSI were associated with the need for external fixators. Thirty (64%) severe trauma patients with SSI had polymicrobial infection, including 34 (72%) due to Gram-positive cocci. Empirical antibiotic therapy was effective in 31 (66%) cases. Multivariate analysis revealed that risk factors such as low hemoglobin, arterial oxygenation levels, hyperlactatemia, high serum creatinine and glycemia, and Cauchoix 3 grade on the day of surgery were associated with SSI in severe trauma patients. The generated predictive model showed a good prognosis performance with an AUC of 0.80 [0.73–0.88] and a high NPV of 95.9 [88.6–98.5] %.ConclusionsOur study found a high rate of SSI in severe trauma patients, although SSI was not associated with 48-month mortality. Several modifiable risk factors for SSI may be effectively managed through enhanced perioperative monitoring and the implementation of a patient blood management strategy.

Geochemical Insights into Heavy Metal Contamination and Health Hazards in Palar River Basin: A Pathway to Sustainable Solutions

The pollution of groundwater by heavy metals is becoming an increasingly urgent problem due to the rapid growth of industrialization and urbanization. A detailed geochemical investigation of physicochemical properties and heavy metal contamination was conducted on 140 groundwater samples in the Vellore district around the Palar River, Tamil Nadu, India, to assess the metal index risk in groundwater. The water quality is significantly contaminated with Cr, Co, Cu, Cd, and Fe, and moderately contaminated with Mn, Ni, and Zn, according to the groundwater assessment using the heavy metal index, contamination factor, and Igeo index. This contamination is associated with various health problems, including mental illness, stomach and skin cancer, liver failure, and kidney damage. Based on contour maps created with GIS, most of the region is heavily contaminated with heavy metals, rendering the groundwater unfit for human consumption. The Health Risk Assessment Index (HRAI) rose to 9028.6, indicating an extremely high health risk. In addition to identifying the extent of contamination, the study also proposes sustainable solutions to mitigate these risks. These include the adoption of advanced water treatment technologies, the promotion of green chemistry practices in local industries, the establishment of stricter regulatory frameworks, and the implementation of community-based water management strategies. These measures are essential to ensuring safe drinking water and achieving Sustainable Development Goal 6 (SDG 6). The findings underscore the urgent need for comprehensive monitoring and proactive remediation strategies in industrially contaminated regions.

Evaluating Household Hazardous Waste Generation, Composition, and Health Risks in an Urban Municipality

This study aimed to assess the generation rate and composition of household hazardous waste (HHW) in Nakhon Si Thammarat Municipality, Thailand. A questionnaire survey was conducted to collect data on HHW generation and disposal practices from households in the municipality. Soil samples were collected and analyzed for heavy metals (cadmium, chromium, mercury, nickel, and lead) and PCBs contamination. The potential health risks from ingestion exposure associated with heavy metals and polychlorinated biphenyls (PCBs) contamination in the soil were evaluated. The result revealed that in 2023, the HHW generation rate was 11.95 kg/household/year, with the highest percentages occurring of electronic waste (17.40%), fluorescent lamps (16.98%), spray cans (12.38%), cleaning products (11.30%), and engine oil and lubricant oil products (9.87%). The majority of residents (92.90%) disposed of hazardous waste and general waste together in public waste containers. However, the health risk assessment indicated that the levels of heavy metals and PCBs in the soil were within the safe acceptable range for residents, with a total lifetime cancer risk from ingestion exposure of less than 1E-06 for both adults and children. The findings highlight the need for improved waste separation practices and the implementation of effective hazardous waste management strategies to minimize potential health risks and environmental impacts. This study serves as a basis for developing targeted interventions and policies to enhance household hazardous waste management in the municipalities and similar urban areas in Thailand. Doi: 10.28991/HEF-2024-05-03-011 Full Text: PDF