Cost-effective Measures Research Articles

Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control

BackgroundAsbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. MethodsData on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. ResultsGlobally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990–2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being −0.29 (95 % confidence interval [CI]: −0.43, −0.14) and −0.27 (95%CI: −0.53, −0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. ConclusionsDecreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.

Impact of naturopathy and yoga based intervention on atherosclerotic cardiovascular disease risk among metabolic syndrome individuals – A prospective single arm study

BackgroundCardiovascular diseases are the leading cause of death in most developed and developing countries, thus representing one of the most significant health problems across the globe. The association between metabolic syndrome and increased risk of cardiovascular diseases has been proven by large multicentric studies. Calculating atherosclerotic cardiovascular diseases risk has been advocated as a preventive strategy. A little is known about its utility and applicability of atherosclerotic cardiovascular diseases risk calculation in individuals predisposed to cardiovascular diseases such as individuals with metabolic syndrome. Practice of a multifaceted naturopathy and yoga-based lifestyle is likely to improve cardiovascular health outcomes and may reduce healthcare costs in high-risk populations. Hence the present study aimed to evaluate the impact of naturopathy and yoga-based lifestyle intervention on the calculated atherosclerotic cardiovascular diseases risk among metabolic syndrome individuals. MethodsThis prospective single arm study recruited 70 individuals of both genders, with metabolic syndrome based on eligibility criteria. They underwent 10 days of supervised intensive naturopathy and yoga-based lifestyle intervention in a residential center. Blood pressure, Anthropometric measures and metabolic risk factors were assessed before and after the intervention. ResultsThere was also a substantial decrease in both systolic blood pressure (p < 0.001) and diastolic blood pressure (p < 0.001) compared to baseline. There was a noteworthy decrease in weight (p < 0.001), Body mass index (p < 0.001), Waist circumference (p < 0.001), Hip circumference (p < 0.001) and Waist Hip Ratio (p = 0.005). The metabolic risk factors Fasting blood glucose (p < 0.001), Total cholesterol (p < 0.001), Triglycerides (p < 0.001), High-density lipoprotein (p < 0.01), Low-density lipoprotein (p < 0.01), Very low-density lipoprotein (p < 0.001), TC/HDL (p < 0.001) and non-HDL (p < 0.001) also showed a significant reduction. The 10-year (p < 0.001) and lifetime risk of atherosclerotic cardiovascular diseases risk was assessed and found to be significantly reduced after the intervention. ConclusionA multidimensional intensive naturopathy and yoga-based lifestyle could be explored as a non-invasive and cost-effective measure in the mitigation of atherosclerotic cardiovascular diseases risk in predisposed individuals.

Marine coastal biodiversity and services in Ireland in a three-dimensional context: Scientific, news media, and legislative

Biodiversity is a key indicator of ecosystem health and plays an important role in providing ecosystem services that are essential for economic development and social well-being. In Ireland, climate change and anthropogenic pressures have led to biodiversity loss and habitat degradation, which in turn affects the provision of ecosystem services. The aim of this study was to determine how marine coastal biodiversity and ecosystem services in the Republic of Ireland are portrayed in the scientific literature, news media, and current legislation in order to identify knowledge gaps and priority areas of intervention for policymakers and other decision-making stakeholders. A review of the scientific literature based on the Scopus database suggests a lack of stakeholder involvement in the scientific-based approach. Up to 2022 research on marine coastal biodiversity focused primarily on species richness and diversity, especially in the context of climate change, while research on ecosystem services focused primarily on ecosystem function. Analysis of the news media found that coverage of biodiversity and ecosystem services has increased over the past decade, but opportunities are being missed to raise public awareness of the multiple benefits, not just economic, of marine coastal ecosystems, their biodiversity, and the services they provide. The terms “biodiversity” and “ecosystem services” have only been introduced into Irish legislation in recent years. The legislative context at the national level is rather fragmented at diverse levels and mainly corresponds to the transposition of European Directives while national specific legislation is less developed. The interconnection between these three domains: scientific, news media and legislative was not evident in this study, especially in the case of the scientific field. Efforts to promote science-based knowledge, communication, collaboration, and transparency between these domains are crucial to support informed decision-making and promote public engagement while conserving biodiversity. Addressing the information gaps identified in this work could help advance the implementation of Nature-based Solutions (NbS), key cost-effective measures to mitigate and adapt to the impacts of climate change while protecting biodiversity and ecosystem services.

Electrochemical and Optical Sensors for Real-Time Detection of Nitrate in Water.

The health and integrity of our water sources are vital for the existence of all forms of life. However, with the growth in population and anthropogenic activities, the quality of water is being impacted globally, particularly due to a widespread problem of nitrate contamination that poses numerous health risks. To address this issue, investigations into various detection methods for the development of in situ real-time monitoring devices have attracted the attention of many researchers. Among the most prominent detection methods are chromatography, colorimetry, electrochemistry, and spectroscopy. While all these methods have their pros and cons, electrochemical and optical methods have emerged as robust and efficient techniques that offer cost-effective, accurate, sensitive, and reliable measurements. This review provides an overview of techniques that are ideal for field-deployable nitrate sensing applications, with an emphasis on electrochemical and optical detection methods. It discusses the underlying principles, recent advances, and various measurement techniques. Additionally, the review explores the current developments in real-time nitrate sensors and discusses the challenges of real-time implementation.

Italian oncologists and vaccinations against infectious diseases: Results of a survey of the Italian Association of Medical Oncology.

Patients with cancer present a higher risk of vaccine-preventable diseases. Recommended vaccinations are the most cost-effective measure to reduce the risk of transmission and related complications. Nevertheless, vaccination rates are inadequate. Oncologists have a central role in tailored vaccine communication to their patients. We present the results of a survey conducted by AIOM in 2022, focusing on the perception of the problem by oncologists. An anonymous 31-item online questionnaire was shared on 15 September 2022 on the AIOM website. The objectives of this survey were to examine the perception of Italian oncologists on vaccine-preventable diseases and the main available vaccines, their attitude towards recommending vaccines and the COVID-19 pandemic impact on their habits regarding vaccine-preventable diseases. Between September 2022 and January 2023, 114 medical oncologists (5% of the members) completed the anonymous questionnaire. At the first oncological visit, only 30% of respondents usually propose a vaccination schedule to all their patient, 41% do not usually discuss vaccinations at the first visit and 29% recommend vaccines exclusively to specific categories of patients. For 56% of respondents, patients are more aware of the benefits of vaccines, whereas 36% reported that patients are worried of receiving too many vaccines. This is the first survey conducted among Italian oncologists to better understand the perception and attitudes towards the vaccination. It highlights the urgent issues of educating and training oncologists in vaccine-preventable diseases and vaccine awareness and the need to build (or implement) a network of multidisciplinary collaborations.

Adult vaccination immunization strategies and research progress worldwide

Vaccination is the most cost-effective measure to prevent infectious diseases in both children and adults. At present, the global burden of infectious diseases in adults is still heavy. With the continuous development and improvement of vaccines, vaccination has shown great potential to prevent infectious diseases, further reduce the morbidity and mortality of infectious diseases in adults and improve people's life quality. This article summarizes the current status of adult immunization, immunization strategies of representative countries, different adult vaccination strategies, and the advantages and challenges of adult immunization to provide reference for further exploring adult immunization strategies and improving adult vaccination recommendations. More attention should be paid to the immunization strategies for different adult populations, and effective measures should be taken to improve the vaccination coverage for the better protection of people's life and health.

Update on new trend and progress of the mechanism of polycyclic aromatic hydrocarbon biodegradation by Rhodococcus, based on the new understanding of relevant theories: a review.

Rapid industrial and societal developments have led to substantial increases in the use and exploitation of petroleum, and petroleum hydrocarbon pollution has become a serious threat to human health and the environment. Polycyclic aromatic hydrocarbons (PAHs) are primary components of petroleum hydrocarbons. In recent years, microbial remediation of PAHs pollution has been regarded as the most promising and cost-effective treatment measure because of its low cost, robust efficacy, and lack of secondary pollution. Rhodococcus bacteria are regarded as one of main microorganisms that can effectively degrade PAHs because of their wide distribution, broad degradation spectrum, and network-like evolution of degradation gene clusters. In this review, we focus on the biological characteristics of Rhodococcus; current trends in PAHs degradation based on knowledge maps; and the cellular structural, biochemical, and enzymatic basis of degradation mechanisms, along with whole genome and transcriptional regulation. These research advances provide clues for the prospects of Rhodococcus-based applications in environmental protection.

Multicohort cross-sectional study of cognitive and behavioural digital biomarkers in neurodegeneration: the Living Lab Study protocol

Introduction and aimsDigital biomarkers can provide a cost-effective, objective and robust measure for neurological disease progression, changes in care needs and the effect of interventions. Motor function, physiology and behaviour...

Noncontact measurement of bolt axial force during tightening processes using scattered laser ultrasonic waves

This paper presents a new methodology for noncontact measurement of the axial force of bolts in their tightening processes using laser-generated ultrasound waves. This method employs ultrasound waves scattered in a bolt shaft to detect axial force changes, while most conventional ultrasonic methods use ultrasound waves propagating linearly along the bolt axis. The ultrasound waves in this study are generated by laser irradiation on the top surface of a bolt. Subsequently, they propagate deeply into the shaft and return towards the top of the bolt through complicated paths due to the multiple scattering in the bolt shaft. Finally, they are detected at the top surface using another laser and a speckle knife edge detector. With an examination based on the finite element analysis and verification experiments, it has been shown that the waveform of the scattered ultrasound shifts in time linearly with increasing the axial force. The time shifts were estimated using the cross-correlation analysis between the measured waveforms and the reference waveform with no axial force. This result demonstrates the feasibility of estimating the change in axial force during tightening processes once the relationship between the time shifts and axial force is obtained for the specific type of bolt to be used in products. Furthermore, the proposed technique does not require machining to flatten a bolt's head and the end, while conventional ultrasonic methods need the flattening procedures, enabling fast, cost-effective axial force measurement in mass production manufacturing processes.

Innovative Thinking Drives Emissions Mitigation

_ The oil and gas industry walks a fine line between providing the energy supplies demanded by a growing global population and addressing the challenge of reducing greenhouse gas emissions, mainly methane. While the industry has made gains in many areas, critics have flagged concerns that the current pace of emissions mitigation needs to be faster and called for acceleration of the process. According to the International Energy Agency (IEA), methane is responsible for approximately 30% of the rise in global temperatures since the Industrial Revolution, making it the second-largest contributor to climate change behind carbon dioxide. Methane is released during oil and gas production processes, and the industry accounts for about a quarter of the global anthropogenic methane emitted into the atmosphere. With increasing recognition of their negative environmental impacts, these emissions are now under greater scrutiny by governments worldwide as they strive toward cleaner power generation sources. As a result, energy companies continue to find ways to effectively manage and reduce their methane emissions to remain compliant with new regulations. According to nonprofit organizations Clean Air Task Force and Ceres, industry efforts are delivering results. An analysis assessed the production-based emissions of more than 300 US producers, finding that the methane emissions intensity of natural gas production and the greenhouse-gas emissions intensity of oil and gas production vary dramatically across companies. The intensity of methane and greenhouse-gas emissions from the oil and gas sector declined 28% and 30%, respectively, between 2019 and 2021 among the largest producers in the country, the report said. However, according to the IEA, overall progress could have been faster. In a special report, the agency looked at the investment required to deliver a sharp reduction in emissions by 2030, finding that if the industry spent $75 billion—about 2% of its 2022 net income—to curb methane emissions through 2030, it would keep the sector on a pathway to achieve net-zero emissions by 2050. The agency also reported that methane abatement is one of the most cost-effective measures to cut emissions and would generate about $45 billion from the sale of captured methane (Fig. 1). Leak Detection Comparisons Promising advances in technology have improved methane measurement and leak detection. Traditionally a laborious and error-prone task, leak-detection technologies are undergoing a revolution. Drone technology, satellite surveillance, and infrared cameras are emerging as powerful tools in the industry’s arsenal to pinpoint leaks and fix them swiftly. Companies like Shell and BP have committed to routine checks via drones and cameras to spot leaks more accurately and promptly. By employing these technologies, the industry can reduce its environmental footprint and save valuable natural resources, transforming “waste” methane into a valuable energy source. ExxonMobil deployed new technology to expand measurement and mitigation of methane emissions and reduced methane emissions intensity from operated assets by more than 40% as of year-end 2021 vs. 2016 levels in line with greenhouse gas emission reduction plans. In its 2023 Advancing Climate Solutions Progress Report, the supermajor also said that it increased the amount it intends to invest through 2027 on lower-emission initiatives to approximately $17 billion, up by nearly 15%.

The health, economic and social burden of smoking in Argentina, and the impact of increasing tobacco taxes in a context of illicit trade.

Tobacco tax increases, the most cost-effective measure in reducing consumption, remain underutilized in low and middle-income countries. This study estimates the health and economic burden of smoking in Argentina and forecasts the benefits of tobacco tax hikes, accounting for the potential effects of illicit trade. Using a probabilistic Markov microsimulation model, this study quantifies smoking-related deaths, health events, and societal costs. The model also estimates the health and economic benefits of different increases in the price of cigarettes through taxes. Annually, smoking causes 45,000 deaths and 221,000 health events in Argentina, costing USD 2782 million in direct medical expenses, USD 1470 million in labor productivity loss costs, and USD 1069 million in informal care costs-totaling 1.2% of the national gross domestic product. Even in a scenario that considers illicit trade of tobacco products, a 50% cigarette price increase through taxes could yield USD 8292 million in total economic benefits accumulated over a decade. Consequently, raising tobacco taxes could significantly reduce the health and economic burdens of smoking in Argentina while increasing fiscal revenue.

Dissemination of climate smart agricultural knowledge through farmer field schools (FFS): analyzing the application CAS knowledge by smallholder farmers

PurposeThe purpose of this paper is to investigate the effects of climate smart agriculture knowledge transfers. As well as to examine the application of climate-smart agricultural (CSA) knowledge such as conservation agriculture, irrigation systems, integrated soil fertility management, bioenergy and agroforestry by smallholder farmers in Kenya.Design/methodology/approachThe study applied comparative research methodology to compare climate smart agriculture knowledge application between smallholder participants in farmer field schools (FFS) and no FFS participation. This study used household data from 759 randomly selected rural agricultural households in three counties in Kenya. The study applied multivariate probit model to estimate CSA knowledge application by farmers who participated in field trainings and non-FFS participation farmers.FindingsThis study established that climate smart agriculture knowledge transfer through FFS increases farmers’ application of critical aspects of climate smart agriculture knowledge practices such as irrigation system, conservation agriculture and soil and water conservation. Such aspects have been noted as effective interventions against adverse climate change effects such as persistent droughts and flooding and soil infertility. Further findings illustrated that farmers who received CSA knowledge transfers applied agricultural insurance to mitigate rising climatic risks on their farms. Knowledge transfer interventions targeting affordability through subsidizing agricultural insurance are probable and more cost-effective measures that can be used to reduce smallholder farmers’ exposure to climate change-related risks.Originality/valueThis study provides information that was previously unknown about climate smart agriculture knowledge transfers and application among farmers who participated in field trainings and non-FFS participation farmers by using empirical data.

Enhancing tomato leaf nitrogen analysis through portable NIR spectrometers combined with machine learning and chemometrics

Plant-Nitrogen is a vital element that significantly influences plant growth, fruit quality, and yield. However, excessive Nitrogen (N) fertilizer application can have adverse effects on both plant health and environment. Traditional methods of plant-N analysis face numerous challenges like time-consuming procedures, hazardous chemicals, low precision, and limited throughput, hindering efficient and accurate analysis in laboratories. In recent years, Near-Infrared Spectroscopy (NIRS) has emerged as an innovative and rapid method for plant-N analysis, offering non-destructive, cost-effective, and real-time measurements with high accuracy and throughput. This research aimed to explore the potential of utilizing miniaturized handheld Near-Infrared (NIR) sensors in conjunction with machine learning (ML) and chemometrics to assess the N status of tomato plants leaves in the field. Through this study, A comprehensive analysis involving 18 models utilizing different regression and spectral preprocessing methods was conducted. The findings indicate that combining the first- or second-order SG derivatives with the MSC is the optimal spectral data preprocessing method, and that incorporating wavelengths selection techniques, such as GA-PLS and GA-SVM, improves the predictive accuracy of the models by reducing the number of wavelengths considered. The best model's performance was assessed using R2, RMSE, and RPD, yielding values of 81.0–82.8, 7.4–7.8, and 2.3–2.4, respectively. Overall, this study demonstrates that combining NIRS with ML and chemometrics enables effective evaluation of plant-N status using leaves total N content as a proxy variable and emphasizes the significance of integrating spectral preprocessing, modeling, and wavelengths selection techniques to enhance data quality and mitigate the influence of environmental factors that may impact the accuracy of NIRS-based evaluations.

Economic Burden of Gaucher Disease at a Tertiary Care Public Hospital in Mumbai.

To estimate the economic burden of patients diagnosed with Gaucher disease at a public hospital from a societal perspective. Data from 30 Gaucher patients visiting the Genetic Clinic of the Department of Pediatrics at the study site in Mumbai was analyzed between January 2019 and January 2021. A cost of illness analysis was undertaken to estimate direct, indirect and intangible costs. Costs in treated and treatment naive groups were compared. The total cost (direct and indirect) for 30 patients was ₹25,45,74,743/- (3440199.2 USD). Majority of this cost (99.8%) was due to direct costs of which medications [Enzyme replacement therapy (ERT) and Substrate reduction therapy (SRT)] constituted 98.8%. The notional cost was ₹1,43,94,695. Total costs of 14 treated patients were ₹25,29,67,279 and 16 treatment naive patients were ₹16,15,064 with a ratio of 157:1. Direct costs and cost of school absenteeism were significantly higher in the treated subgroup. Overall, direct, total costs and costs of school absenteeism were significantly associated with age and disease duration. The economic burden of Gaucher disease is a staggering amount. This is an underestimate, as the expenses are highly subsidized in a public health facility. The highest contributor to cost component was direct costs, especially medication costs. Against the backdrop of the National Policy for Rare Diseases, resource allocation towards Gaucher disease should consider short term measures for judicious funding or reimbursement of disease-specific therapy and long-term cost-effective measures for promoting preventive strategies as the most practically feasible solution to reduce this economic burden.

Association between housework and the risk of dementia among older Chinese adults: a prospective cohort study.

Physical activity (PA) is known to improve physical functioning and mental health and to reduce the incidence of dementia. However, studies of the effects of non-recreational PA on the incidence of dementia, especially in East Asian populations, remain limited. In this study, we evaluate the association of doing housework with the risk of dementia among participants in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The analysis was conducted with data from 7,237 CLHLS participants age over 65 obtained in 2008/2009, 2011/2012, 2014, and 2018. The frequency of housework performance was classified into four groups. A Cox proportional-hazards model was used to examine the association of the baseline housework frequency with the incidence of dementia, with adjustment for demographic and socioeconomic characteristics and lifestyle and health conditions. The adjusted multivariate model showed that the incidence of dementia was lower among participants who did housework almost every day than among those who rarely or never did housework (hazard ratio = 0.49; 95% confidence interval, 0.39-0.61). The subgroup and sensitivity analyses yielded similar results. A high frequency of housework performance was associated with a reduced incidence of dementia among older Chinese adults, especially those who did not exercise regularly. The encouragement of engagement in housework would be a cost-effective measure promoting healthy aging in the Chinese population.

New Approach to Determining the Roughness of Bicycle Roads

The international roughness index (IRI) is one of the important criterion used to determine the roughness of roads. Various devices are available to determine IRI, however, they are mostly used to determine the condition of highways. Studies to determine the roughness of nonmotorized roads, such as bicycle roads, which have become increasingly important in recent years, are limited. Therefore, this study presents a cost-effective roughness measurement method that can measure both highways and nonmotorized roads. For this, a mountain bike was used as the test vehicle, and for the first time, the stiffness and damping coefficients of the bicycle tire were taken into account when calculating the IRI. First, the stiffness and damping coefficients of the bicycle’s front tire were calculated. These coefficients were then used as input data for the equation of motion with one degree of freedom, and the IRI was calculated. The 660-m long divided highway (1,320 m in total) on the Bursa Uludagğ University campus was chosen as the test road. A laser profilometer device was used to quantify the reference IRI values of this test road. The same road was then measured by bicycle. The obtained results were evaluated using mean absolute percent error, mean absolute error, root mean square error, and mean square error metrics. All these indicators showed very promising results, suggesting that this new method could be a cost-effective and reliable approach to determining the IRI of highways, especially nonmotorized roads.

Cost effective and adaptable measures of estimation of visceral adiposity

BackgroundObesity is a major public health problem these days. Obesity, specifically visceral adiposity is linked to insulin resistance and an increased risk of cardiometabolic diseases. Measurement of visceral adiposity helps to understand the prevalence of obesity disorders and strategize interventions targeting its reversal. MethodsA literature search was done to identify studies that looked at the quantification and estimation of visceral adiposity published from January 1990 to May 2023. Online databases PubMed, Google Scholar, Scopus were used for the literature search. FindingsVarious cost-effective methods are available for the estimation of visceral adiposity. Simple anthropometric measurements like the waist circumference and waist-to-height ratio are useful to estimate visceral adiposity during a routine clinical examination. The novel Metabolic score for Visceral Fat Estimation (METS-VF) has the potential for widespread clinical use but remains to be validated in different populations. Ultrasound-based estimation of visceral adiposity strongly correlates with quantification by MRI. However, it is operator dependent and requires strict adherence to established measurement protocols. ConclusionAnthropometric measurements of waist circumference, waist-to-height ratio, the METS-VF score, BIA, and USG-based assessment of visceral and ectopic fat depots are potentially cost-effective and adaptable measures of estimation of visceral adiposity.

Decarbonisation Policies in the Residential Sector and Energy Poverty: Mitigation Strategies and Impacts in Central and Southern Eastern Europe

The decarbonisation policies for the EU building stock can improve living conditions, including thermal comfort and lower energy bills. However, these measures may impose financial burdens on low-income households, reducing their disposable income and exacerbating their vulnerability. The current study investigates the impact of decarbonisation policies on the EU’s building stock, with a specific focus on Minimum Energy Performance Standards (MEPS), the new Emissions Trading System (ETS2) for buildings, and the phase-out of fossil heating systems. By employing a linear, static latest version of Microsoft Excel (Microsoft 365)-based model and analyzing Eurostat data, this study quantifies the effects of these policies on energy consumption, costs, and necessary investments. Moreover, the study emphasizes their implications for low-income groups using vulnerability indicators. The findings demonstrate that a combination of MEPs, ETS2, and phasing out fossil heating systems effectively reduces energy consumption and costs across most countries. However, implementing ETS2 alone may lead to energy reduction and discomfort for low-income groups without addressing underlying demand-side issues. To address this, this study recommends the implementation of more ambitious MEPs or the provision of additional funding alongside ETS2. The phase-out of fossil fuel boilers emerges as the most cost-effective measure in the medium to long term. While MEPS and the phase-out of fossil fuel boilers improve living conditions, they also impose upfront cost burdens and reduce disposable income for low-income households. Therefore, high subsidy rates and supportive policies are necessary to ensure equitable access to investments. The main recommendations include (a) shifting financing to renewable heating systems for low-income households by 2025, addressing cost issues and policies favouring gas boilers; (b) implementing high-funding rate subsidies for energy efficiency in low-income households before 2025, with technical guidance; (c) prioritising the Energy Efficiency First principle in planning to avoid additional emissions or higher costs for low-income households; and (d) considering the energy behaviour of low-income groups in regulations, employing a combination of policies to achieve desired outcomes and ensure thermal comfort.

Multivalent vaccines demonstrate immunogenicity and protect against Coxiella burnetii aerosol challenge.

Vaccines are among the most cost-effective public health measures for controlling infectious diseases. Coxiella burnetii is the etiological agent of Q fever, a disease with a wide clinical spectrum that ranges from mild symptoms, such as fever and fatigue, to more severe disease, such as pneumonia and endocarditis. The formalin-inactivated whole-cell vaccine Q-VAX® contains hundreds of antigens and confers lifelong protection in humans, but prior sensitization from infection or vaccination can result in deleterious reactogenic responses to vaccination. Consequently, there is great interest in developing non-reactogenic alternatives based on adjuvanted recombinant proteins. In this study, we aimed to develop a multivalent vaccine that conferred protection with reduced reactogenicity. We hypothesized that a multivalent vaccine consisting of multiple antigens would be more immunogenic and protective than a monovalent vaccine owing to the large number of potential protective antigens in the C. burnetii proteome. To address this, we identified immunogenic T and B cell antigens, and selected proteins were purified to evaluate with a combination adjuvant (IVAX-1), with or without C. burnetii lipopolysaccharide (LPS) in immunogenicity studies in vivo in mice and in a Hartley guinea pig intratracheal aerosol challenge model using C. burnetii strain NMI RSA 493. The data showed that multivalent vaccines are more immunogenic than monovalent vaccines and more closely emulate the protection achieved by Q-VAX. Although six antigens were the most immunogenic, we also discovered that multiplexing beyond four antigens introduces detectable reactogenicity, indicating that there is an upper limit to the number of antigens that can be safely included in a multivalent Q-fever vaccine. C. burnetii LPS also demonstrates efficacy as a vaccine antigen in conferring protection in an otherwise monovalent vaccine formulation, suggesting that its addition in multivalent vaccines, as demonstrated by a quadrivalent formulation, would improve protective responses.

Disentangling the effects of management, field characteristics of fallows, and surrounding landscape to promote steppe bird conservation

The steep decrease of fallow area in the last years has been directly related to steppe bird population declines in Europe, as fallow lands are a crucial habitat for shelter, food, and nesting resources. However, the potential of fallows to foster steppe bird populations may vary greatly depending on factors at both the landscape and field scale, which may also interact differently depending on the species. This study uses data from more than 3000 ha of fallow land in north-eastern Spain specifically managed for steppe bird conservation to explore which are the characteristics that maximize their conservation value for steppe bird species. We used variance partitioning methods to separate the effects of fallow management (e.g., vegetation height or fallow age) from field characteristics (e.g., field size) and landscape context (e.g., amount of surrounding shrubland area) on the occurrence and abundance of target steppe bird species. Even if fallow management was optimized to meet the requirements of steppe birds, field characteristics and landscape context had important effects (i.e., explained high part of the variance) in maximizing occurrence and abundance. All studied species consistently preferred bigger and dominant fallows (i.e., those at a higher relative elevation). Conservation measures promoting fallows for the conservation of steppe birds should consider mechanisms to optimize the selection of fields. Integrating optimal field selection might be too specific and challenging for agri-environment-climate measures (AECM), however it could be a cost-effective measure when implemented in local or targeted conservation plans, such as those applied within priority areas, protected areas, or compensatory measures.