Local Level Research Articles

Four-dimensional computed tomography as first-line imaging in primary hyperparathyroidism, a retrospective comparison to conventional imaging in a predominantly single adenoma population

BackgroundTo determine the use of four-dimensional CT as first-line imaging compared to the traditional combination of ultrasound and [99mTc]Tc-Sestamibi SPECT.Materials and methodsRetrospective review of preoperative imaging in patients with primary hyperparathyroidism, who underwent parathyroidectomy between 2012 and 2021. In one group, the combination ultrasound and [99mTc]Tc-Sestamibi SPECT was used as first-line imaging (n = 54), in the other group four-dimensional CT was the first-line imaging modality (n = 51). Sensitivity and positive predictive value were calculated on patient, lateralisation and localisation level. The need for additional imaging was also assessed for both groups.ResultsFour-dimensional CT had a significantly higher sensitivity compared to the combination of ultrasound/[99mTc]Tc-Sestamibi SPECT on patient and localisation level (70.6% vs. 51.9%, p = 0.049 and 60.8% vs. 35.2%, p = 0.009 respectively). Sensitivity for lateralisation also appeared higher, but did not reach significance (62.7% vs. 44.4%, p = 0.060). Positive predictive value was not significantly higher for four-dimensional CT compared to ultrasound and [99mTc]Tc-Sestamibi SPECT (88.9% vs. 85.7% for lateralisation and 86.1% vs. 67.9% for localisation respectively). Additional imaging was required in 14 patients with four-dimensional CT as first-line imaging (27.4%) consisting of 2 ultrasound/[99mTc]Tc-Sestamibi SPECT and 13 [18F]fluorocholine PET/CT, compared to 24 patients with ultrasound/[99mTc]Tc-Sestamibi SPECT as first-line imaging (44.4%), requiring 22 four-dimensional CT and 9 [18F]fluorocholine PET/CT.ConclusionsFour-dimensional CT as the sole first-line parathyroid imaging modality had higher sensitivity than the combination of ultrasound and [99mTc]Tc-Sestamibi SPECT, therefore requiring fewer additional procedures. Although the most costly, [18F]fluorocholine PET/CT was the most effective technique to localise parathyroid adenoma in case all other imaging was negative.

Breaking Barriers: An Innovative Tool to Assess the National and City-Level Physical Activity Policy Development to Practice Disconnect.

Population-level physical activity increases are improbable without intersectoral collaboration across government levels and sectors to develop and implement physical activity promotion policies. This study aims to provide information about the development of the Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool (INTEGRATE PA-Pol). A framework was created to examine the development and implementation of national and subnational physical activity policies and the (mis)alignment between government levels. The work was conducted in 3 phases: (1)a scoping review was carried out to identify local government physical activity promotion policies and instruments for assessing them, (2)an expert group designed 6 questionnaires, and (3)cognitive response testing was employed for validity testing and item modification with a panel of research and policy experts. The INTEGRATE PA-Pol Tool consists of 6 questionnaires assessing how national and subnational governments collaborate to develop and implement physical activity promotion policies. This tool can assist in better understanding the development and implementation of a public policy monitoring system that will allow for benchmarking and priority setting to comprehend how physical activity promotion policies are designed and executed.

Entropy of metallic glasses and the size effect on glass transition

A statistical description of metallic glasses is proposed based on evaluation of an entropy and using the concept of potential energy landscape (PEL). The PEL is probed using nano-indentation, assuming that serrations observed are related to local energy levels. Serrations sizes follow a Poisson distribution consistent with, that their formation is a rare events. An entropy is derived revealing parameters characterizing the glass structure. The relevance of the approach is tested on the size effect on mechanical properties of metallic glass. It is noticed that the relations explain the effect of film thickness on the glass transition temperature observed for glass polymers.

Investigating the Shared Genetic Etiology Between Parkinson's Disease and Depression.

Depression is a common symptom in Parkinson's disease (PD), resulting from underlying neuropathological processes and psychological factors. However, the extent to which shared genetic risk factors contribute to the relationship between depression and PD is poorly understood. To examine the effects of common genetic variants influencing the etiology of PD and depression risk at the genome-wide and local genomic regional level. We comprehensively investigated the genetic relationship between PD and depression using genome-wide association studies data. First, we estimated the genetic correlation at the genome-wide level using linkage-disequilibrium score regression, followed by local genetic correlation analysis using the GWAS-pairwise method and functional annotation to identify genes that may jointly influence the risk for both traits. Also, we performed Latent Causal Variable, Latent Heritable Confounder Mendelian Randomization, and traditional Mendelian Randomization analyses to investigate the potential causal relationship. Although the genetic correlation between PD and depression was not statistically significant at the genome-wide level, GWAS-pairwise analyses identified 16 genomic segments associated with PD and depression, implicating nine genes. Further analyses revealed distinct patterns within individual genes, suggesting an intricate pattern. These genes involve various biological processes, including neurotransmitter regulation, senescence, and nucleo-cytoplasmic transport mechanisms. We did not observe genetic evidence of causality between PD and depression. Our findings did not support a genome-wide genetic correlation or a causal association between both conditions. However, we identified genomic segments but identified genomic segments linked to distinct biological pathways influencing their etiology.Further research is needed to understand their functional consequences.

Parks Visitation, Physical Activity Engagement, and Older People's Motivation for Visiting Local Parks.

Despite the health benefits of parks and outdoor recreational spaces, small numbers of older people visit parks. This study identified older park visitors' perceptions of their local parks, visit motivation, health, and physical activity level in six parks in Victoria, Australia. Characteristics of general community park visitors and their physical activity engagement were also recorded. Fifty-five older people were surveyed onsite; 92.7% lived within a 5-km distance from the park. Walking was the most common reason for visiting (36.4%), followed by walking the dog (36.4%) and exercise (23.6%). Most older visitors (77.8%) were determined as being sufficiently active. Observation of parks visitors over 1 week recorded 3,770 park visitors, with <5% being older people. Half of all park visitors were inactive, and half of older people visitors (50.5%) engaged in walking. This study supports the importance of parks, park features, and their potential in helping older people to achieve levels of physical activity required for good health.

Feminist democratic innovations in policy and politics

This article examines the potential of feminist democratic innovations in policy and institutional politics. It examines how feminist democratic innovations can be conceptualised and articulated in local institutions. Combining theories on democratic governance, feminist democracy, social movements, municipalism, decentralisation, gender equality policies and state feminism, it conceptualises feminist democratic innovations in policy and politics as innovations oriented at (a) transforming knowledge, (b) transforming policymaking and public funding, (c) transforming institutions, and (d) transforming actors’ coalitions. Through analysis of municipal plans and interviews with key actors, the article examines feminist democratic innovations in the policy and politics of Barcelona’s local government from 2015 to 2023. Emerging from the mobilisation of progressive social movements after the 2008 economic crisis, the findings uncover a laboratory of feminist municipal politics, following the election of a new government and self-proclaimed feminist mayor. Critical actors and an enabling political context play a pivotal role in the adoption of this feminist institutional politics. The article concludes by arguing that feminist institutional politics at the local level contribute to democratising policy and politics in innovative ways, in particular encouraging inclusive intersectionality and participatory discourses and practices.

Advancing Biological Research: New Automated Analysis of Immunofluorescence Signals

In recent years, optical imaging and efficient computational approaches have improved the ability to analyse and understand biological phenomena. Immunofluorescence (IF) is a widely used immunochemical technique that provides information about protein localisation and expression levels. However, the manual analysis of IF images can present important limitations, such as operator workload and interpretative bias. Thus, the development of automated tools for IF signal computation is crucial. Several software programs have been proposed to address this challenge, but there is still a need for more accurate and reliable systems. In this work, we present Q-IF, a software for automatically measuring cellular IF signals with an intuitive and easy-to-use interface. We describe the software and validate its results in different biological scenarios using SH-SY5Y neuroblastoma cells, human fibroblasts, and rat brain sections. The Q-IF system automatically carries out the entire process, from IF signal quantification to statistical analysis, thus evading operator biases and speeding up the analysis workflow. Our results demonstrate the accuracy and reliability of the Q-IF system, highlighting its potential as a valuable tool for IF analysis in biological research.

SimCalib: Graph Neural Network Calibration Based on Similarity between Nodes

Graph neural networks (GNNs) have exhibited impressive performance in modeling graph data as exemplified in various applications. Recently, the GNN calibration problem has attracted increasing attention, especially in cost-sensitive scenarios. Previous work has gained empirical insights on the issue, and devised effective approaches for it, but theoretical supports still fall short. In this work, we shed light on the relationship between GNN calibration and nodewise similarity via theoretical analysis. A novel calibration framework, named SimCalib, is accordingly proposed to consider similarity between nodes at global and local levels. At the global level, the Mahalanobis distance between the current node and class prototypes is integrated to implicitly consider similarity between the current node and all nodes in the same class. At the local level, the similarity of node representation movement dynamics, quantified by nodewise homophily and relative degree, is considered. Informed about the application of nodewise movement patterns in analyzing nodewise behavior on the over-smoothing problem, we empirically present a possible relationship between over-smoothing and GNN calibration problem. Experimentally, we discover a correlation between nodewise similarity and model calibration improvement, in alignment with our theoretical results. Additionally, we conduct extensive experiments investigating different design factors and demonstrate the effectiveness of our proposed SimCalib framework for GNN calibration by achieving state-of-the-art performance on 14 out of 16 benchmarks.

Distribution and composition of floating marine debris in Shiretoko peninsula, Japan, using opportunistic sighting survey

Floating marine debris (FMD) poses several threats to marine species, such as entanglement, ingestion, and the transport of pollutants. The Shiretoko Peninsula, located in northern Japan, is a registered World Natural Heritage Site and a biodiversity hotspot. However, FMD has not yet been thoroughly investigated in this region. In 2022, sighting surveys were conducted in Abashiri (west side of the peninsula) and Rausu (east side) to assess the abundance, composition, and distribution of FMD. The mean densities were notably higher in Abashiri, and there was more fishing-related debris in Rausu. Regarding local human activities, the population and number of tourists are higher in Abashiri, and fishing activities are higher in Rausu. While marine pollution is a global issue, our study suggests that addressing it should commence with community-based management at the local level.

Local economic resilience and economic specialization in Greece during the crisis

This paper scrutinizes the issue of economic resilience, aiming to detect the existence of a systematic link with economic specialization. To this end, the paper conducts an empirical analysis at the local (i.e., municipal) level of Greece during the economic crisis period (2009–2015), providing cartographic visualizations and spatial econometrics estimations. Greece is the country that was hit the hardest by the economic crisis. Thus, the need to stabilize the national economy in Greece has seemingly outweighed policy issues of spatial interest, which are also of extreme importance. The findings of the paper reveal that, inter alia, both the level and the nature of economic specialization exert an impact on local economic resilience, providing insight into both theory and policy making.

Strengthening ASEAN Food Security in Facing the Threat of Crisis in The Era of Globalization

Purpose: The paper is aim to analyze the cooperation among ASEAN countries in terms of information exchange, agricultural technology, and strategies to deal with food crises is essential. This paper also discusses efforts to strengthen ASEAN food security in the face of the threat of a global crisis. In general, the global food crisis in 2007-2008 triggered food insecurity in many countries. Methods: Literature review method involves systematically identifying, recording, understanding, making meaning of, and transmitting information relevant to a particular topic of interest. It is considered a method because it encompasses specific approaches and procedures for conducting a review of existing literature. The literature reviewer selects from a variety of strategies and procedures to gather and analyze information, similar to how a researcher would approach a research study. Result and Discussion: ASEAN countries' cooperation in the context of food security involves the exchange of information, agricultural technology, and strategies to overcome food crises. ASEAN has developed initiatives such as ASEAN Plus Three to strengthen cooperation in agriculture and food security. Furthermore, agricultural research in ASEAN focuses on developing crop varieties that are more resistant to pests, diseases and climate change. This research also involves the use of innovative agricultural technologies to increase productivity, such as smart irrigation systems and sensor-based farm monitoring. The utilization of military capabilities and research efforts that can support the strengthening of food security can be a reference for various countries to always be ready to face the dynamics of the global crisis. Implication of the research: Sustainable agricultural practices, investing in agricultural technologies, and promoting policies that support food security at both local and global levels. By implementing a combination of these technical solutions and strategies, food security challenges can be addressed and a more secure future can be realized. Originality/value: The utilization of military forces and research efforts that can support the strengthening of food security can be a reference for various countries to always be ready to face the dynamics of the global crisis.

Outsourced Facility Management (OFM) Services to Creating Global Competitiveness

In a time of increasing globalization and fierce competition in the market, being competitive has become essential for companies in a variety of sectors. Providers of Outsourced Facilities Management (OFM) services, which include everything from space management to security and maintenance, are essential in helping businesses streamline their operations and concentrate on their core business. The strategic value of outsourcing Facilities Management services is gaining more attention and adaption as the business landscape gets complicated and complex. This increased adoption of the OFM services creates opportunities thus resulting in the presence of both local and global players in this industry. Local outsourced facilities management service providers are encountering a progressively competitive market in today’s business scene. To assess and improve the competitiveness of local OFM service providers fighting to gain market shares against global industry giants, this study explores the idea of critical success factors (CSFs). CSFs stand for those critical areas in which a company must succeed to meet its objectives and beat out rivals. CSFs are essential for comprehending the unique factors that allow local OFM service providers to not only endure but also prosper in a complex network of markets. Additionally, local outsourced facilities management services providers must evaluate their abilities, performance, and competitiveness in comparison to well-established global facilities management leaders that are present in the country. By comparing with these industry giants, local suppliers can establish a baseline and initiate research to gain useful insights, direction, and positioning. This will help them improve their global competitiveness and survival at least at the local industry level. This study examines the rationale for comparing a local supplier against the industry’s critical success factors (CSF) with global companies and emphasizes the potential advantages gained from conducting such a comparison. Keywords: competitiveness, outsourced facility management, property management, critical success factors, integrated facility management

Bioassembly of hemoglobin-loaded photopolymerizable spheroids alleviates hypoxia-induced cell death

The delivery of oxygen within tissue engineered constructs is essential for cell survivability; however, achieving this within larger biofabricated constructs poses a significant challenge. Efforts to overcome this limitation often involve the delivery of synthetic oxygen generating compounds. The application of some of these compounds is problematic for the biofabrication of living tissues due to inherent issues such as cytotoxicity, hyperoxia and limited structural stability due to oxygen inhibition of radical-based crosslinking processes. This study aims to develop an oxygen delivering system relying on natural-derived components which are cytocompatible, allow for photopolymerization and advanced biofabrication processes, and improve cell survivability under hypoxia (1% O2). We explore the binding of human hemoglobin (Hb) as a natural oxygen deposit within photopolymerizable allylated gelatin (GelAGE) hydrogels through the spontaneous complex formation of Hb with negatively charged biomolecules (heparin, hyaluronic acid, and bovine serum albumin). We systematically study the effect of biomolecule inclusion on cytotoxicity, hydrogel network properties, Hb incorporation efficiency, oxygen carrying capacity, cell viability, and compatibility with 3D-bioassembly processes within melt electrowritten (MEW) scaffolds. All biomolecules were successfully incorporated within GelAGE hydrogels, displaying controllable mechanical properties and cytocompatibility. Results demonstrated efficient and tailorable Hb incorporation within GelAGE-Heparin hydrogels. The developed system was compatible with microfluidics and photopolymerization processes, allowing for the production of GelAGE-Heparin-Hb spheres. Hb-loaded spheres were assembled into MEW polycaprolactone scaffolds, significantly increasing the local oxygen levels. Ultimately, cells within Hb-loaded constructs demonstrated good cell survivability under hypoxia. Taken together, we successfully developed a hydrogel system that retains Hb as a natural oxygen deposit post-photopolymerization, protecting Hb from free-radical oxidation while remaining compatible with biofabrication of large constructs. The developed GelAGE-Heparin-Hb system allows for physoxic oxygen delivery and thus possesses a vast potential for use across broad tissue engineering and biofabrication strategies to help eliminate cell death due to hypoxia.

How to deal with invasive species that have high economic value?

The ever-accelerating process of introduction and establishment of invasive alien species (IAS) in marine waters requires engaging different actors in the management and planning. To address this challenge, stakeholders need an integrated approach for defining actions of control and management within an ecosystem-based framework: to seek and enhance coordination, collaboration and trust among all stakeholders affected by changes in linked marine social - ecological systems. This study explores the complexities and opportunities in managing economically valuable IAS, demonstrating the need for tailored management strategies that consider key ecological details needed for successful control such as timing of removals and key economic considerations such as appropriate incentive mechanisms and time horizons in favor of long-term conservation goals. We propose a set of actions that can serve as a roadmap for effective IAS control and management, considering their dual role as nuisances and valuable resources. These actions pertain to local, regional and international levels, encouraging meaningful stakeholder engagement through co-management structures that can foster the development of robust management plans, enabling better IAS control. The outcome holds potential for positive contributions to the blue economy— sustainable use of marine resources, including fisheries, tourism, and renewable energy— and for meeting sustainability objectives.

A regional local level set method for tracking arbitrary 3D crack propagation

The geometrical description and tracking of non-planar crack surface with curved crack front evolving in 3D are a big challenge for crack modeling. We develop a numerical method for tracking arbitrary crack propagation. In this method, the crack surface is generated by the regional local level set (RLLS), which is based on the concept of element local level set, abbreviated as ELLS (Duan et al. (2009)). It is regionally defined at the crack front and generates the crack surface by meeting the fracture directionality and the continuity with the adjacent crack surface in a least-square sense. The mechanical description of the discontinuity is treated by the phantom node method, which can be conveniently implemented in the framework of the finite element method. An adaptive mesh refinement technique with hanging nodes is adopted to improve the accuracy and efficiency. Numerical results show that the developed method possesses satisfactory accuracy in the computation of stress intensity factors and exhibits perfect agreement with experimental results on load–displacement response and crack paths. The capability and robustness of the proposed method in complex crack events, such as non-planar propagation, crack twisting and multiple cracks even in complex engineering structures, are also demonstrated.

The Adrenal Gland and Pancreatic Islets - A Beneficial Endocrine Alliance.

Intraportal islet transplantation in patients with type 1 diabetes enables restoration of glucose-regulated insulin secretion. However, several factors hamper a widespread application and long-term success: chronic hypoxia, an inappropriate microenvironment and suppression of regenerative and proliferative potential by high local levels of immunosuppressive agents. Therefore, the identification of alternative and superior transplant sites is of major scientific and clinical interest. Here, we aim to evaluate the adrenal as an alternative transplantation site. The adrenal features a particular microenvironment with extensive vascularization, anti-apoptotic and pro-proliferative, anti-inflammatory and immunosuppressive effects. To validate this novel transplantation site, an in vitro co-culture system of adrenal cells and pancreatic islets was established and viability, islet survival, functional potency and antioxidative defense capacity were evaluated. For in vivo validation, an immune-deficient diabetic mouse model for intra-adrenal islet transplantation was applied. The functional capacity of intra-adrenally grafted islets to reverse diabetes was compared to a standard islet transplant model and measures of engraftment such as vascular integration were evaluated. The presence of adrenal cells positively impacted on cell metabolism and oxidative stress. Following transplantation, we could demonstrate enhanced islet function in comparison to standard models with improved engraftment and superior re-vascularization. This experimental approach allows for novel insights into the interaction of endocrine systems and may open up novel strategies for islet transplantation augmented through the bystander effect of other endocrine cells or the active factors secreted by adrenal cells modulating the microenvironment.

Anomaly Detection Algorithms for Low-Dimensional and High-Dimensional Data: A Critical Study

Suspicious events or objects that differ from the norm in data can be discovered using anomaly identification. Identifying anomalies is critical for many applicable domains of life, e.g., preventing credit card theft and spotting intrusions into networks. It is possible to detect anomalies on a global scale as well as at the local level. A global outlier is a data point beyond the norm for the entire dataset, while a local outlier may be inside the norm for the entire dataset but outside the surrounding data points. Data outlier identification methods that are performed locally are inadequate. Therefore, better algorithms are required to investigate the high velocity of data and identify local outliers. Machine learning and data mining techniques need to be investigated to determine the pros and cons of anomaly identification residing inside data. The density based LOF method can be applied as the best choice to identify local outliers. While many variants of LOF exist for low-dimensional data, none are suitable for high-dimensional data. This research study discusses LOF, COF, and CBLOF methods for spotting local outliers in low and high-dimensional data. Regarding the size of the dimension, the performance of density-based algorithms is examined based on accuracy and time complexity. In this scenario, CBLOF achieves outstanding results due to its distinctive method of employing cluster-based local outlier detection.

Optimizing Crop Yield Estimation through Geospatial Technology: A Comparative Analysis of a Semi-Physical Model, Crop Simulation, and Machine Learning Algorithms

This study underscores the critical importance of accurate crop yield information for national food security and export considerations, with a specific focus on wheat yield estimation at the Gram Panchayat (GP) level in Bareilly district, Uttar Pradesh, using technologies such as machine learning algorithms (ML), the Decision Support System for Agrotechnology Transfer (DSSAT) crop model and semi-physical models (SPMs). The research integrates Sentinel-2 time-series data and ground data to generate comprehensive crop type maps. These maps offer insights into spatial variations in crop extent, growth stages and the leaf area index (LAI), serving as essential components for precise yield assessment. The classification of crops employed spectral matching techniques (SMTs) on Sentinel-2 time-series data, complemented by field surveys and ground data on crop management. The strategic identification of crop-cutting experiment (CCE) locations, based on a combination of crop type maps, soil data and weather parameters, further enhanced the precision of the study. A systematic comparison of three major crop yield estimation models revealed distinctive gaps in each approach. Machine learning models exhibit effectiveness in homogenous areas with similar cultivars, while the accuracy of a semi-physical model depends upon the resolution of the utilized data. The DSSAT model is effective in predicting yields at specific locations but faces difficulties when trying to extend these predictions to cover a larger study area. This research provides valuable insights for policymakers by providing near-real-time, high-resolution crop yield estimates at the local level, facilitating informed decision making in attaining food security.

Trends in air toxics cancer risk in Southern California, 1998-2018

Air toxics are an important category of air pollutants that are known to cause adverse health effects, including increased cancer risk. Regulatory efforts at federal, state, and local levels have aimed to decrease air toxics emissions over the past several decades. This study evaluated trends in air toxics cancer risks in Southern California using data from 1998 to 2018. We estimated air toxics cancer risk for each of four iterations of the South Coast Air Quality Management District’s Multiple Air Toxics Exposure Study, which included at least one year of measurements at 10 stations and air toxics modeling for each iteration. Cancer risks were calculated using the measured and modeled air toxics concentrations averaged over a one to two year period and multiplied by the corresponding cancer potency factor and combined exposure factor that accounted for multiple exposure pathways and children’s increased sensitivity to the health effects of air pollution. We examined temporal trends in overall air toxics cancer risks and evaluated changes in the air toxics species that contributed most to cancer risk in the region. Both measurement and modeling results show that air toxics cancer risk in Southern California decreased by more than 80% between 1998 and 2018, including a decrease of about 50% from 2012 to 2018. Diesel particulate matter was the main risk driver, followed by benzene, 1,3-butadiene, and formaldehyde. We found that more densely populated communities showed larger decreases than sparsely populated areas. The substantial decrease in air toxics levels over this 20-year period points to the success of air pollution policies aimed at addressing air toxics emissions and can inform future policy efforts to further reduce air toxics health impacts.

Spatial analysis of food and water-borne diseases in Ahmedabad, India: Implications for urban public health planning

Spatial analysis of infectious diseases can play an important role in mapping the spread of diseases and can support policy making at local level. Moreover, identification of disease clusters based on local geography and landscape forms the basis for disease control and prevention. Therefore, this study aimed to examine the spatial-temporal variations, hotspot areas, and potential risk factors of infectious diseases (including Viral Hepatitis, Typhoid and Diarrhea) in Ahmedabad city of India. We used Moran's I and Local Indicators of Spatial Association (LISA) mapping to detect spatial clustering of diseases. Spatial and temporal regression analysis was used to identify the association between disease incidence and spatial risk factors. The Moran's I statistics identified presence of positive spatial autocorrelation within the considered diseases, with Moran's I from 0.09 for typhoid to 0.21 for diarrhea (p < 0.001). This indicates a clustering of affected wards for each disease, suggesting that cases were not randomly distributed across the city. LISA mapping demonstrated the clustering of hotspots in central regions of the city, especially towards the east of the river Sabarmati, highlighting key geographical areas with elevated disease risk. The spatial clusters of infectious diseases were consistently associated with slum population density and illiteracy. Furthermore, temporal analysis suggested illiteracy rates could increase risk of viral hepatitis by 13 % (95 % Confidence Interval (CI): 1.01–1.26) and of diarrhea by 18 % (95 % CI: 1.07–1.31). Significant inverse association was also seen between viral hepatitis incidence and the distance of wards from rivers. Conclusively, the study highlight the impact of socio-economic gradients, such as slum population density (indicative of poverty) and illiteracy, on the localized transmission of water and foodborne infections. The evident social stratification between impoverished and affluent households emerges as a notable contributing factor and a potential source of differences in the dynamics of infectious diseases in Ahmedabad.