Hygiene Indicators Research Articles

Державне регулювання безпекових технологій освітніх захищених просторів в зонах активних бойових дій: українські реалії та світовий досвід

The purpose of this work is the study of international experience and the substantiation of compliance with basic hygienic indicators when implementing atypical planning and construction solutions in new and existing institutions of general secondary education for the physical protection of participants in the educational process during the war in Ukraine. Materials and methods. Sanitary and hygienic, bibliometric and analytical methods were used in the work. Review. In Ukraine, in connection with the ongoing full-scale war and in order to protect students, there was an urgent need to solve the issue of protecting students, teachers and employees of the general institution of secondary education during the educational process, especially in those located in territories close to territories with active hostilities. The first special underground institution of general secondary education was opened in the city of Kharkiv – a bunker-type school, which corresponds to the current comprehensive policy of the Ministry of Education and Culture "School Offline". This institution of general secondary education is located in an underground space at a depth of 6 m. It is designed for a simultaneous capacity of 600 students of grades 1-11 (or 900 students in two shifts). The high cost of designing and building an underground institution of general secondary education limited its capacity, provision of a full set of functional groups of premises, including recreational, physical culture and sports, educational and production zones, provision of premises with natural lighting and insolation. For the implementation of this project, the architectural and planning and sanitary and hygienic standards have not been partially met, which may negatively affect the health of children and affect their quality of life in the future. In conditionally safe territories, it was proposed to arrange protected spaces in institutions of general secondary education, which also has a number of disadvantages and requires in-depth study. Conclusions. According to the results of the study of the international experience of extensive construction of underground institutions of general secondary education, none were found. However, the experience of building underground institutions of general secondary education with students staying during the school day is isolated, was carried out as an experiment and did not spread. The introduction of the latest constructive solutions (protected spaces) and the possibility of further expansion of the design and construction of underground institutions of general secondary education in Ukraine require careful study. Keywords. State regulation, world experience, institutions of general secondary education, bunker school, construction in underground space, educational protected spaces, children's safety.

THE IMPACT OF PHOSPHORUS WEAPONS DURING A FULL-SCALE WAR

Due to military actions, there is destruction of Ukraine's ecosystems, deterioration of sanitary and hygienic indicators of drinking water, air, and soil. With the onset of full-scale war, the negative impact of harmful and dangerous substances (the use of chemical, phosphorus bombs, and other weapons) prohibited by the Geneva Convention leads to unforeseen consequences for the environment of Ukraine. The purpose of the study is to analyze injuries resulting from the action of white phosphorus of various types of phosphorus weapons, namely explosive weapons with a wide area of effect, mines, ammunition, long-range missiles; artillery, mortar shells, various types of grenades in the conditions of russian aggression against Ukraine. The following methods were used in the work: content analysis, comparative analysis, and systematization of the researched material. Research of scientific publications by domestic and foreign scientists using the PubMed and Google Scholar databases for the period 2001-2023 was conducted. Phosphorus munitions such as WP are known for their high effectiveness in combat operations, but also lead to serious injuries, both traumatic and post-traumatic psychological changes. White phosphorus (explosive bombs) causes burns of human body tissues upon contact with burning material, as well as burns of the upper respiratory tract due to inhalation of smoke or gases emitted during combustion. The article analyzes the regulatory framework prohibiting the use of phosphorus munitions in armed conflicts. Clinical cases of gunshot combined injuries of limbs with massive soft tissue defects, gunshot fractures, and the presence of multiple foreign bodies of metal density due to the use of phosphorus munitions are considered. An analysis of scientific research by foreign scientists on this issue was conducted. The article provides algorithms for providing first aid due to the action of phosphorus munitions, as well as methodological recommendations of the Ministry of Health of Ukraine (Order of the Ministry of Health of Ukraine No. 506 of March 20, 2022) for providing medical assistance at the prehospital stage in case of phosphorus munition injuries, burns, enteral poisoning, exposure to white phosphorus in the eyes.

Modern legal problems of human health protection: from complex approaches to practical solutions

The article analyzes the state of social relations on the protection of human health by means of environmental and legal regulation as an important direction of the state environmental policy and policy in the field of health protection, the development of legal practice, the identification of shortcomings and gaps in the current legislation, as well as making proposals for its improvement in view of international legal and European approaches to the regulation of the specified relations. Obtaining ecologically significant information about the state of human health, carrying out other investigations within the framework of the study of its determinants will contribute to the development of the mechanism of legal regulation of relevant relations in Ukraine. The subject of the research is the provisions of environmental and other branches of legislation, as well as scientific-theoretical and practical ideas, views and approaches to solving legal problems of protecting human health and environmental protection, ensuring ecological, food, nutritional safety, developing the methodology of conducting scientific research in environmental and legal and other areas. The object of the research is social, environmental and other legal relations that arise in today’s conditions under the influence of military threats and the requirements of martial law, as well as social and legal prerequisites for the formation and development of determinants of health through the prism of the legal, in particular, environmental and legal mechanism. The effectiveness of environmental law is largely determined by the implementation of the main and most important goal - the direct protection of a person and his right to life and health in general. The global community’s fight against excessive environmental pollution, the development of rational use of natural resources, care for people and all of humanity are fundamental vectors of the development of international cooperation. In most of the developed countries of the world, solving the problem of ensuring environmental safety is assigned to the competence of specially created government institutions, which determine the appropriate directions of international cooperation, vectors of development. It is necessary to make it impossible to ignore the natural-scientific paradigm, according to which the environment that affects the human body is not only nature, but also everything that is outside the body. The attention of scientists should not be limited to the analysis of the consequences of a polluted environment, but should also be directed to the study and forecasting of changes in the environment that surrounds a person, the conditions of human existence and their impact on the health of a person as a biosocial being. The range of these changes is very wide - from innovations in the structure of nutrition to transformations of culture and ethics, development of legal culture, healthy lifestyle at the social and individual levels. Human health should be considered as a complex socio­economic, ecological and hygienic indicator that integrates demographic, social and biological processes characteristic of human society, reflects the level of its economic and cultural development, the state of medical care, bears the imprint of historical and ethnographic traditions and natural and climatic changes. Along with the culture of work, life, thinking, behavior, communication, adaptive culture, today it is proposed to highlight the culture of health, which in fact determines the further development of all types of cultures and should become a prerequisite for the formation of a person as a complete individual, covering all aspects of life. Preserving the health of the nation is a social necessity today. The process of forming an ecological culture through a system of educational activity measures, in addition to direct ecological culture, also covers the formation of a culture of a healthy lifestyle, hygienic skills, a caring attitude towards the environment, etc. It is equally important to ensure a balanced and safe diet for the entire population. Considering the complexity of the specified problem, it is necessary to involve specialists of various specialties in this work. The set tasks actualize the issue of researching the content of the concept of «human health» defined by the Law of Ukraine «On the Public Health System». The term «ecological determinants of health» as the level of pollution of the natural environment (locality) where a person lives: the level of pollution of surface and underground water, land plots, atmospheric air, etc., needs legislative consolidation.

Comparative analyses of bacterial contamination and microbiome of broiler carcasses in wet market and industrial processing environments

The slaughtering environment is crucial for the food hygiene and safety of poultry products. Despite the global dominance of industrial processing, live bird slaughtering in wet markets persists due to cultural, religious, and economic reasons. This study aims to reveal the correlation between hygiene scales in wet markets and bacterial contamination levels on broiler carcasses, with a particular focus on pathobiont transmission risks and microbiome characteristics. Wet markets were categorized based on home-made ratings and the Hygiene and Biosecurity Assessment Tool (HABT). The study assessed total aerobic bacterial (TAB) levels, food spoilage and hygiene indicators (Pseudomonas and E. coli), foodborne pathogen Salmonella, and the microbiome of broiler carcasses, intestinal contents, and slaughtering facilities. Comparative analyses were conducted between market and industrial processing environments. TAB levels on broiler carcasses showed a significant negative correlation with hygiene scores, indicating that both HABT and home-made rating tools effectively assess and improve processing hygiene. Industrial processing consistently reduced bacterial contamination compared to wet markets. Although Salmonella spp. prevalence was lower in market-processed carcasses, the study identified significant cross-transmission of pathobionts and variations in bacterial composition with hygiene improvements. Notably, the microbiome analysis revealed overlaps in amplicon sequence variants (ASVs) between carcasses and contamination vectors, highlighting pathobiont transmission risks. The present study confirmed the scales of hygiene standards among wet markets reflect bacterial contamination on broiler carcasses. Enhancing slaughter practices to meet industrial hygiene standards is essential for reducing the transmission of foodborne pathogens and pathobionts, and improving food safety.

Investigation of Shiga toxin-producing Escherichia coli and evaluation of the microbiological quality of raw vegetable sal-ads

Foodborne diseases (FBD) are a significant public health concern worldwide, affecting millions of people annually. Symptoms of FBD range from mild gastrointestinal discomfort to more severe conditions, which in some cases can lead to death. Raw vegetables, especially those consumed in ready-to-eat (RTE) salads, are particularly susceptible to microbial contamination. This study aimed to investigate the presence of Shiga toxin-producing Escherichia coli (STEC) and to evaluate the microbiological quality of 77 RTE raw vegetable salads from 20 restaurants in Niterói, RJ, Brazil. None samples presented STEC, nor the safety indicators (SI) Salmonella spp. and Listeria monocytogenes. However, 89.6% of the samples were considered unfit for human consumption, since they presented at least one hygiene indicator (HI) outside the established standards. The majority of samples (95.5%) were unsatisfactory for Enterobacteriaceae (EB), followed by total aerobic bacteria (TAB) (76.6%), thermotolerant coliforms (C45) (32.5%) and Escherichia coli (EC) (1.3%). The difference between the occurrences of hygiene indicators was not significant. Given the high percentage of inadequate samples found in the study, it is clear that there is a need for stricter surveillance and adequate hygiene practices in restaurants. To reduce the risks of microbial contamination in RTE raw vegetable salads, several approaches can be implemented. These include continuous training of food handlers, implementation of food safety management systems such as Hazard Analysis and Critical Control Points (HACCP), and regular inspections. In addition, consumers also play an important role by demanding safe food and following safe food handling and consumption practices at home.

Microbiological quality of vegan alternatives to dairy and meat products in England during 2022-3.

Plant-based alternatives to meat and dairy products have become increasingly popular in the UK. Despite a public perception that they have a relatively low microbiological risk, outbreaks of illness have been linked with these foods. This study aimed to assess the microbiological safety and quality of vegan alternatives to dairy and meat products available in England. Samples were collected between September 2022 and March 2023 from retail, production, and catering premises, and tested for a range of bacterial pathogens and hygiene indicators using standard procedures. A total of 937 samples were tested, of which 92% were of a satisfactory microbiological quality, 3% were borderline, and 5% were unsatisfactory. Those interpreted as unsatisfactory were due to elevated counts of Enterobacteriaceae and Escherichia coli (indicators of poor hygiene) rather than pathogenic microorganisms. Listeria monocytogenes was present in five samples of tofu, all from the same producer (all at counts of<100 CFU g-1), while other Listeria species were detected at counts of<20 CFU g-1 in two burgers and two 'vegan chicken' products. The majority of samples did not have pH and water activity values that would significantly contribute to preventing microbial growth: 62.4% had pH>5.0 and 82.4% had Aw>0.94. The majority of vegan products examined were of a satisfactory quality, but results demonstrate that microbiological control must be maintained using appropriate processing and storage temperatures, and application of a safe length of shelf life.

Profiling the Enterobacterales Community Isolated from Retail Foods in England

Enterobacterales include foodborne pathogens of importance to public health and are often targeted in food surveillance programs as both safety and hygiene indicators. Furthermore, Enterobacterales are important in the context of antimicrobial resistance dissemination, also impacting infection treatment efficacy. In this study, the prevalence and characteristics of Enterobacterales in UK retail foods were examined. From 110 retail food samples, 253 Enterobacterales were recovered, with 16S rRNA sequencing revealing a diverse species community, including enteropathogens; the most common were Proteus mirabilis and Escherichia coli (18% each). Antimicrobial resistance was common, with 160/253 (63%) isolates being resistant to at least 1 antimicrobial. Resistance to all tested antimicrobials was observed. Thirteen percent of isolates were multidrug resistant, including 2 isolates each resistant to 8 or 9 of 9 antimicrobials tested. Klebsiella isolates possessed relatively higher levels of antimicrobial resistance to other species. Hafnia, Kluyvera, and Proteus isolates produced significantly higher biofilm biomass than Klebsiella (p = 0.038, 0.028, and 0.042, respectively) or Escherichia (p = 0.001, 0.008, and 0.001, respectively). Simultaneous curli fimbriae and cellulose production was noted in 7% of isolates at 37 °C, but not at 15 °C. This research demonstrates a high diversity of Enterobacterales within UK retail foods, alongside notable antimicrobial resistance phenotypes in enteropathogenic species, highlighting the need for effective surveillance and interventions.

Interactive hygiene training using free open source software.

Regular hygiene trainings are an important way to refresh and improve knowledge about hygiene measures and the prevention of healthcare-associated infections. We aimed to develop an e-learning course to allow healthcare workers (HCWs) to learn these contents through a self-paced online format. We developed an interactive hygiene training for HCWs of a tertiary care hospital using different content types of the HTML-5 package (H5P) plugin embedded into a Moodle-based learning management system. We evaluated the course using a short online questionnaire. We present various suitable topics for online hygiene trainings as well as their implementation in an e-learning course. Examples include content on hand hygiene indications and techniques, information on multidrug-resistant organisms and other current topics in infection control. HCWs reported high overall satisfaction, perceived increase in knowledge, practical relevance as well as good usability and comprehensibility. Currently available commercial and non-commercial hygiene trainings present a number of specific advantages but also drawbacks. The presented approach combines the advantages of both approaches. The majority of the presented content can be readily adapted to suit various hospitals and care facilities or serve as inspiration for creating similar courses while remaining cost-effective. H5P course presentations are a low-threshold, cost-effective way to implement digital hygiene trainings in a wide variety of clinical settings.

Prevalence of Specific Hygienic Indicator Bacteria in cattle Slaughterhouses of different Capacity in Egypt

Prevalence of Specific Hygienic Indicator Bacteria in cattle Slaughterhouses of different Capacity in Egypt

Global Incidence of Diarrheal Diseases-An Update Using an Interpretable Predictive Model Based on XGBoost and SHAP: A Systematic Analysis.

Diarrheal disease remains a significant public health issue, particularly affecting young children and older adults. Despite efforts to control and prevent these diseases, their incidence continues to be a global concern. Understanding the trends in diarrhea incidence and the factors influencing these trends is crucial for developing effective public health strategies. This study aimed to explore the temporal trends in diarrhea incidence and associated factors from 1990 to 2019 and to project the incidence for the period 2020-2040 at global, regional, and national levels. We aimed to identify key factors influencing these trends to inform future prevention and control strategies. The eXtreme Gradient Boosting (XGBoost) model was used to predict the incidence from 2020 to 2040 based on demographic, meteorological, water sanitation, and sanitation and hygiene indicators. SHapley Additive exPlanations (SHAP) value was performed to explain the impact of variables in the model on the incidence. Estimated annual percentage change (EAPC) was calculated to assess the temporal trends of age-standardized incidence rates (ASIRs) from 1990 to 2019 and from 2020 to 2040. Globally, both incident cases and ASIRs of diarrhea increased between 2010 and 2019. The incident cases are expected to rise from 2020 to 2040, while the ASIRs and incidence rates are predicted to slightly decrease. During the observed (1990-2019) and predicted (2020-2040) periods, adults aged 60 years and above exhibited an upward trend in incidence rate as age increased, while children aged < 5 years consistently had the highest incident cases. The SHAP framework was applied to explain the model predictions. We identified several risk factors associated with an increased incidence of diarrhea, including age over 60 years, yearly precipitation exceeding 3000 mm, temperature above 20 °C for both maximum and minimum values, and vapor pressure deficit over 1500 Pa. A decreased incidence rate was associated with relative humidity over 60%, wind speed over 4 m/s, and populations with above 80% using safely managed drinking water services and over 40% using safely managed sanitation services. Diarrheal diseases are still serious public health concerns, with predicted increases in the incident cases despite decreasing ASIRs globally. Children aged < 5 years remain highly susceptible to diarrheal diseases, yet the incidence rate in the older adults aged 60 plus years still warrants additional attention. Additionally, more targeted efforts to improve access to safe drinking water and sanitation services are crucial for reducing the incidence of diarrheal diseases globally.

Monitoring foodborne pathogens of food served at an institutional cafeteria

The provision of food by cafeterias is an opportunity to promote health through a balanced diet and safe food, offering the prospect of sustainably developing the well-being a community and the local economy. This study assessed the hygiene conditions of an institutional cafeteria. The presence of foodborne pathogens and indicators of general hygiene in 143 food and environmental samples were analyzed using the TEMPO and VIDAS food safety testing machines. All food samples tested negative for Salmonella sp., and Staphylococcus aureus counts were below the GCC Standardization Organization (GSO) limit. Escherichia coli was detected at level above the set limit in six food samples. Sixteen food samples showed aerobic bacterial counts above the set limit. Total coliforms and Enterobacteriaceae were each detected above the set limits in eight food samples. Yeasts and molds were detected above the set limit in 14 food samples. Coliform bacteria, S. aureus, and mold were detected on the hands and white coats of cafeteria workers and on work surfaces, machines, and cutting boards. The hygiene conditions of the cafeteria are not suitable for food preparation, and to improve hygienic conditions in cafeterias, regular inspection of food and food preparation facilities is strongly recommended.

Способ улучшения зоогигиенических условий выращивания цыплят-бройлеров

Abstract. The purpose of the study is to study the effect of bedding material on the physiological parameters of broiler chickens. Since the most important condition for optimizing the microclimate in the poultry house is compliance with the physiological state of the livestock and maintaining its vital activity at an optimal level. Research methods. The experiment was carried out in the industrial conditions of a poultry farm on broiler stock of the Arbor Acres+ cross in the experimental workshop, where four sections were formed. The growth and development of broilers was monitored daily, livestock records were carried out, and a weekly veterinary report was compiled on the causes of mortality. Also, laboratory studies were carried out according to approved methods for the following indicators: ammonia content, sanitary and hygienic indicators of bedding material, volume, weight and moisture content of bedding material, as well as productivity and basic blood parameters of broiler chickens. Results. Trends in the positive effect of the sorbent in the form of modified diatomite on the productivity of broiler chickens due to the improvement of zoohygienic growing conditions have been identified. In particular, the content of the total number of microorganisms, mold spores and ammonia content in the production experimental workshop is examined in detail. During the work, the volume and weight of bedding material was calculated, including at the exit from the poultry house. We tried to pay special attention to blood biochemistry, which made it possible to assess the physiological state of broiler chickens and draw conclusions about the quality of feeding rations. At the same time, problematic issues associated with feeding poultry were identified, which affect the content of mineral elements in the blood. When determining the performance criterion, calculations were carried out using the EPEF index. Scientific novelty. For the first time, it was proven that the use of diatomite with a bulk layer height of 0.5–1 cm with a granule size of at least 5 mm as bedding material leads to improved zoohygienic conditions for raising broiler chickens without additional capital investments in the form of installation of expensive ventilation equipment or the use of additional technological operations. This replacement option has a positive effect on the health of young poultry.

Disparities in access to water, sanitation, and hygiene (WASH) services and the status of SDG-6 implementation across districts and states in India

IntroductionAccess to affordable and improved Water, Sanitation, and Hygiene (WASH) facilities is essential for people's daily lives, and it is the primary goal of Sustainable Development Goal 6 (SDG-6). However, achieving this goal is a significant challenge for many countries, including India. The aim of this study is to assess the progress made towards achieving SDG-6 targets in Indian districts, states, and Union Territories (UTs) and to identify clusters by measuring spatial inequality of WASH coverage in India. Aim and objectiveThe primary objective of this study is to measure the progress made towards achieving the SDG-6 targets for WASH facilities in Indian districts, states, and UTs. To fulfill this objective, the study used the household data of the National Family Health Survey-5 (NFHS-5) conducted from 2019 to 21. Data and methodsThe study used the household data of NFHS-5, which is a nationally representative survey that provides information on household and individual-level characteristics related to health and nutrition. The study identified the variables associated with WASH and created a composite index to measure WASH coverage separately and combined. The study used Gini coefficient to show WASH inequality, and Moran's statistics were used to show spatial dependency. ResultThe study found that the inequality of improved water coverage sources in Indian districts was high. Western and northeastern districts need to catch up in terms of achieving the SDG-6 targets. The value of the Gini coefficient (0.29) indicates that inequality in sanitation coverage is also high. All states have reached close to SDG-6 achievement in hygiene indicators. Goa, Sikkim, Andaman & Nicobar Islands, and Lakshadweep are close to the overall WASH coverage achievements of SDG-6. However, Jharkhand, Orissa, Tripura, Assam, and Rajasthan are behind in meeting the goal of SDG-6. ConclusionThe study suggests that more government initiatives and investments are needed to increase the availability, accessibility, and affordability of WASH facilities to improve WASH conditions in western and northeastern Indian districts. The localization or bottom-up approach by giving responsibility to rural and urban local bodies can also help enforce the achievement of SDG-6. The findings of this study can be used to guide policymakers in developing targeted interventions to improve WASH conditions and reduce inequality in India.

Modeling nonlinear inactivation of hygiene indicator bacteria in pig carcasses during scalding at different pHs.

This study aimed to investigate the influence of adding an alkalizing agent to the scalding water of a slaughterhouse in Brazil to inactivate hygiene indicator bacteria in pig carcasses. Scalding is critical during carcass processing because slaughterhouses' scalding water is constantly renewed; therefore, it is usually contaminated with organic matter, such as faeces and dirt from the previous carcasses. The treatments evaluated consisted of counting Enterobacteriaceae and mesophilic bacteria in pork jowls at 62°C, 65°C, 68C, and 72°C after 0.0, 1.5, 3.0, 4.5, 6.0, and 7.5min of simulated scalding at the pHs of 7.0 (control) and 11.0 (after addition of alkalizing agent). Decimal reduction times of hygiene indicator bacteria for all treatments were estimated with different nonlinear bacterial inactivation models. As a result, adding the alkalizing agent did not significantly inactivate most of the bacteria in the studied samples. However, it contributed to the inactivation of some bacteria, mostly belonging to the mesophilic group, at some specific temperatures. The results obtained in the current study can provide useful insights into dealing with pig carcass contamination in a real-world scenario and applying the obtained information in the industrial environment.

Influence of unheated rooms on thermal comfort and energy efficiency of adjacent premises

AbstractThe research was conducted for three types of houses, including a panel house built before 1991, a brick house built in 2006, and a brick house built in 2022. It was established that the temperature difference, which is decisive when assessing the sanitary and hygienic condition of the premises, does not exceed the normative values for buildings built after 2006. In the building since 1991, the sanitary and hygienic indicators of the heated room deteriorate when the outside air temperature drops below −3 °C. At the same time, the fulfillment of the first condition of comfort in the room occurs at indoor air temperatures higher than the standard value, therefore, under the calculated conditions, residents feel discomfort when staying in such a room.

Assessment of dental hard tissues and periodontium in children with hemophilia

Relevance. Children suffering from hemophilia primarily receive dental care when they present with acute tooth pain or exacerbation of an existing condition. Due to the rarity (orphan nature) of hereditary coagulopathies, dentists often lack the experience and knowledge to utilize modern methods of prevention and treatment for this patient category. Additionally, the lack of regular dental check-ups for children with hemophilia often leads to a high level of oral morbidity and a need for specific treatments, as indicated by literature data.Materials and methods. The primary methods used to assess oral health in children with hemophilia included detailed questioning, detection of carious lesions in dental hard tissues, assessment of oral hygiene, and the condition of periodontal tissues.Results. Among pediatric patients with hemophilia, poor oral hygiene was associated with a high prevalence of carious lesions (100%) and very high caries intensity values (8.8, ranging from 7 to 11). Additionally, there was a relatively high prevalence of gingival inflammation, accompanied by pronounced gingival bleeding. A direct correlation was identified between the level of oral hygiene and the degree of gingival bleeding in children aged 6-17 years with hemophilia. The deterioration of dental indicators corresponded to the severity of hemophilia, the primary disease in these children.Conclusion. The study demonstrated that pediatric patients with hemophilia, particularly those with moderate to severe forms, had significantly worse indicators of oral hygiene, dental hard tissues, and gingival health compared to generally healthy children. The results indicate the necessity for dental monitoring and rehabilitation for children with hemophilia to detect and effectively treat oral diseases at early stages.

Clinical efficacy of a two-piece abutment conforming to the concept of one abutment one time in the posterior region: A clinical pilot study.

To assess the impact of a two-piece abutment workflow on enhancing the stability of the alveolar bone and gingiva surrounding the dental implant, and to determine the level of patient satisfaction. A total of 48 patients with dentition defect in the posterior region were included and divided into two groups: the two-piece abutment workflow (TAW) and the sealing screw with submerged healing workflow (SHW). Marginal bone level (MBL), soft tissue indicators, oral hygiene indicators, and patient satisfaction were assessed and recorded partially at 0, 3, 6, and 12 months after surgery. The primary outcome was the change of MBL in different time periods. A generalized linear mixed model (GLMM) was used to take into account the correlated nature of the data, and adjust for potential confounding factors within inter-group differences. The survival rate of implants and prosthesis reached 100% at 12-month follow-up, with an average decrease of 0.25 mm (SD 0.23 mm) of MBL in the TAW group and 0.48 mm (SD 0.45 mm) in the SHW group. The change of MBL in the TAW group (0.15 ± 0.31 mm) was significantly lower than the SHW group (0.41 ± 0.41 mm) through the analysis of GLMM within 6 months, while no significance was found in 12 months. Moreover, less gingival pain and oppression during prosthesis loading, and less time consumption overall duration were showed in the TAW group through Visual Analogue Scale (VAS, p < 0.05). Within a 6-month period, the two-piece abutment workflow showed superior efficacy in preserving the integrity of the marginal bone level. Furthermore, it streamlined treatment procedures and mitigated discomfort, hence increasing patient satisfaction.

Descriptive Overview of Adolescent Health Indicators in Humanitarian Settings: A Cross-Country Analysis

Purpose: An adolescent health information system is a relevantly new concept, especially in humanitarian settings. This article aims to map the available adolescent health indicators collected in selected humanitarian settings, identify the available data sources, and determine the alignment between these indicators and the draft list of priority indicators for adolescent health measurement recommended by the Global Action for the Measurement of Adolescent Health Advisory Group. Methods: We selected five countries experiencing humanitarian crises- Myanmar, Nigeria, Palestine, Ukraine, and Yemen. We identified the adolescent health indicators collected in each country using document analysis and a purposive sampling approach. We reviewed the primary population-based surveys used to gather adolescent health data and noted the most recent year each survey was conducted. The identified indicators were then categorized by measurement domains and specific areas of adolescent health.Results: The Multiple Indicator Cluster Survey and Demographic Health Survey were conducted in all five countries selected, but three out of five countries have not administered either within the last five years. Yemen and Palestine only included married women in their sample sizes, and no one younger than 15 was interviewed. Indicators most commonly assess reproductive health, tobacco use, and adolescent fertility. Limited data was found on younger adolescents, males, water, sanitation, hygiene, disability, and nutrition indicators. Discussion: Adolescent health information in humanitarian crises requires more frequent surveys, including all adolescent age groups, and unique data collection methodologies. The current surveys used to measure adolescent health indicators have limited ability to be inclusive to all adolescents. It is important to establish a list of priority indicators deemed essential in humanitarian settings and relevant ways to collect them.

Lot quality assurance sampling survey for water, sanitation and hygiene monitoring and evidence-based advocacy in Bentiu IDP camp, South Sudan.

Every year, 60% of deaths from diarrhoeal disease occur in low and middle-income countries due to inadequate water, sanitation, and hygiene. In these countries, diarrhoeal diseases are the second leading cause of death in children under five, excluding neonatal deaths. The approximately 100,000 people residing in the Bentiu Internally Displaced Population (IDP) camp in South Sudan have previously experienced water, sanitation, and hygiene outbreaks, including an ongoing Hepatitis E outbreak in 2021. This study aimed to assess the gaps in Water, Sanitation, and Hygiene (WASH), prioritise areas for intervention, and advocate for the improvement of WASH services based on the findings. A cross-sectional lot quality assurance sampling (LQAS) survey was conducted in ninety-five households to collect data on water, sanitation, and hygiene (WASH) coverage performance across five sectors. Nineteen households were allocated to each sector, referred to as supervision areas in LQAS surveys. Probability proportional to size sampling was used to determine the number of households to sample in each sector block selected using a geographic positioning system. One adult respondent, familiar with the household, was chosen to answer WASH-related questions, and one child under the age of five was selected through a lottery method to assess the prevalence of WASH-related disease morbidities in the previous two weeks. The data were collected using the KoBoCollect mobile application. Data analysis was conducted using R statistical software and a generic LQAS Excel analyser. Crude values, weighted averages, and 95% confidence intervals were calculated for each indicator. Target coverage benchmarks set by program managers and WASH guidelines were used to classify the performance of each indicator. The LQAS survey revealed that five out of 13 clean water supply indicators, eight out of 10 hygiene and sanitation indicators, and two out of four health indicators did not meet the target coverage. Regarding the clean water supply indicators, 68.9% (95% CI 60.8%-77.1%) of households reported having water available six days a week, while 37% (95% CI 27%-46%) had water containers in adequate condition. For the hygiene and sanitation indicators, 17.9% (95% CI 10.9%-24.8%) of households had handwashing points in their living area, 66.8% (95% CI 49%-84.6%) had their own jug for cleansing after defaecation, and 26.4% (95% CI 17.4%-35.3%) of households had one piece of soap. More than 40% of households wash dead bodies at funerals and wash their hands in a shared bowl. Households with sanitary facilities at an acceptable level were 22.8% (95% CI 15.6%-30.1%), while 13.2% (95% CI 6.6%-19.9%) of households had functioning handwashing points at the latrines. Over the previous two weeks, 57.9% (95% CI 49.6-69.7%) of households reported no diarrhoea, and 71.3% (95% CI 62.1%-80.6%) reported no eye infections among children under five. The camp's hygiene and sanitation situation necessitated immediate intervention to halt the hepatitis E outbreak and prevent further WASH-related outbreaks and health issues. The LQAS findings were employed to advocate for interventions addressing the WASH gaps, resulting in WASH and health actors stepping in.

Real-time salivary turbidity measurement with a mouthguard-type wearable sensor

Unconstrained and continuous oral hygiene monitoring is effective not only in diagnosing oral health status but also in diagnosing systemic health status. A mouthguard-type wearable sensor was proposed to measure salivary turbidity as an indicator of oral hygiene, however, the feasibility of intraoral salivary turbidity measurement was not well investigated. In this study, a mouthguard-type sensor with embedding LED, phototransistor, and wireless module was developed for optical measurement of salivary turbidity. The shape of the turbidity-sensing part of the sensor was designed based on the results of experiments on water-retention capability and measurement sensitivity. In vivo experiments using diluted milk as an ingestible turbidity standard solution showed that the sensor has sufficient quantitative capability (100–1000 FTU) and repeatability in the standard range of salivary turbidity. In addition, by continuously measuring the fluctuation in salivary turbidity using the sensor, clinically useful intraoral information such as salivary secretion and oral dryness status could be obtained. These results demonstrate that the developed mouthguard-type sensor is effective for the unconstrained and continuous evaluation of oral hygiene.