Periodic Updates Research Articles

The Enhancing Cybersecurity with AI Algorithms and Big Data Analytics: Challenges and Solutions

As digital transformation accelerates across industries, cybersecurity faces escalating challenges due to increasingly sophisticated cyber threats. This study explores the integration of artificial intelligence (AI) algorithms and big data analytics to enhance cybersecurity systems, focusing on addressing data integration and interpretability issues. Employing a descriptive-qualitative methodology, the research analyzes literature, case studies, and secondary data to evaluate the effectiveness of AI and big data in detecting and mitigating cyber threats. Key findings reveal that deep learning algorithms, such as artificial neural networks, achieved an accuracy of 93% in anomaly detection, outperforming traditional rule-based approaches by 18%. Additionally, big data platforms like Spark demonstrated superior efficiency, processing 500 GB of data in 35 seconds compared to Hadoop’s 60 seconds. However, the study identifies challenges related to the interpretability of AI models and the complexity of integrating diverse datasets, which impede real-time threat detection. Periodic updates to AI training datasets were found to improve detection accuracy by up to 15%, emphasizing the importance of adaptive learning models. This research contributes to the field by proposing strategies to enhance system resilience, including adopting Explainable AI (XAI) for transparency and advanced data integration techniques. The findings underscore the potential of AI and big data to revolutionize cybersecurity, offering organizations a proactive approach to combating evolving cyber threats. Future studies should focus on sector-specific implementations and optimizing response mechanisms for comprehensive security frameworks.

Incidence and Prevalence of Alzheimer's Disease in Medicare Beneficiaries.

The availability of anti-amyloid therapy for mild cognitive impairment (MCI) due to Alzheimer's disease and mild Alzheimer's dementia (AD) has underscored the need for realistic estimates of the population with AD/MCI within the healthcare system to assure adequate preparedness. We hypothesize that administrative databases can provide real-world epidemiologic estimates reflecting the population with diagnosed (known) MCI and AD. This study was conducted to estimate diagnostic incidence and prevalence of AD and all-cause MCI among the Medicare fee-for-service (FFS) and Medicare Advantage (MA) beneficiaries in the United States. This was a retrospective analysis of Medicare beneficiaries (aged 65 and older) with identified diagnoses of AD/MCI based on ≥2 diagnostic codes ≥30 days apart. Incidence/prevalence estimates were reported per 10,000 person-years. In FFS, AD incidence (2008-2018) decreased (138 to 104); MCI incidence increased (8 to 47), but the sum (MCI+AD) was relatively stable (146 to 151). Prevalence (2008-2017) increased for AD (318 to 354), and MCI (13 to 99). In MA (2016) epidemiological estimates were consistent with FFS. In 2017, older age, female sex and the Northeastern region were consistently associated with higher AD/MCI prevalence among FFS beneficiaries. In FFS, AD/MCI diagnostic prevalence increased over 10 years, especially for MCI; prevalence estimates in MA (2016) were comparable. Diagnostic prevalence in 2016 (FFS+MA) was 3.4% for AD and 0.85% for MCI. Our findings address the reality of Alzheimer's disease in clinical practice in the United States that is confronted by healthcare professionals, payors, healthcare decision-makers, patients, and caregivers, and may offer a realistic gauge for patient triage for treatment, healthcare resource allocation, and health-systems' operational prioritization. With the availability of anti-amyloid treatments, we anticipate that the population with diagnosed MCI/AD within the Medicare database may rise over time; therefore, periodic updates of incidence/prevalence estimates may provide support for timely healthcare decision-making.

Deep Eutectic Solvent (TOPO/D2EHPA/Menthol) for Extracting Metals from Synthetic Hydrochloric Acid Leachates of NMC-LTO Batteries

The recycling of lithium-ion batteries is increasingly important for both resource recovery and environmental protection. However, the complex composition of cathode and anode materials in these batteries makes the efficient separation of metal mixtures challenging. Hydrometallurgical methods, particularly liquid extraction, provide an effective means of separating metal ions, though they require periodic updates to their extraction systems. This study introduces a hydrophobic deep eutectic solvent composed of trioctylphosphine oxide, di(2-ethylhexyl)phosphoric acid, and menthol, which is effective for separating Ti(IV), Co(II), Mn(II), Ni(II), and Li+ ions from hydrochloric acid leachates of NMC (LiNixMnyCo1−x−yO2) batteries with LTO (Li4Ti5O12) anodes. By optimising the molar composition of the trioctylphosphine oxide/di(2-ethylhexyl)phosphoric acid/menthol mixture to a 4:1:5 ratio, high extraction efficiency was achieved. The solvent demonstrated stability over 10 cycles, and conditions for its regeneration were successfully established. At room temperature, the DES exhibited a density of 0.89 g/mL and a viscosity of 56 mPa·s, which are suitable for laboratory-scale extraction processes. Experimental results from a laboratory setup with mixer-settlers confirmed the efficiency of separating Ti(IV) and Co(II) ions in the context of their extraction kinetics.

P76 Nine years of Project ECHOⓇ Psoriasis Argentina: all teach, all learn

Abstract Project ECHO® (Extension for Community Healthcare Outcomes) is a virtual community initiative developed at the University of New Mexico, USA, to treat chronic, frequent, and complex diseases safely and effectively in rural or underserved, underprivileged areas or in places where the number of specialists available is not enough to meet patient demands. ECHO® Psoriasis Argentina, the first adaptation of the initiative in dermatological diseases, began in 2015 as a web-based clinical case distance medical education tool for dermatologists across different regions of the country to share the best medical practices for psoriasis. This was in response to the uneven distribution of healthcare professionals. Its main goals include bridging knowledge gaps between general dermatologists and specialists in psoriasis management, extending the best clinical practices to more patients, and reducing the need for referrals to more complex centres. Teleclinics are held every 3 weeks using Zoom® software. Over 350 dermatologists from all provinces of Argentina participate in this project. Each session involves presenting psoriasis cases to a panel of experts and attending dermatologists, followed by discussions and recommendations. Periodic academic updates on the topic are also conducted. Furthermore, ECHO® Psoriasis Argentina fosters a sense of community through a discussion group on WhatsApp® Messenger. Here, participants engage in lively discussions, raising issues and questions from their daily practice. Both the panel of experts and participating dermatologists contribute answers creating a collaborative environment. In commemorating the 130 teleclinics held, we wish to share our experience with ECHO® Psoriasis Argentina. Active participation and interest among attendees have led to the presentation of various studies at conferences, publications, and investigations into reasons dermatologists seek remote assistance. They evaluated modifications suggested by experts and barriers to implementing these suggestions. Studies also assessed the impact of participating in the WhatsApp® discussion group, including topics like immunosuppressant use during the COVID-19 pandemic, methotrexate use across different regions of Argentina, and exceptional patient situations such as pregnancy and paradoxical psoriasis. ECHO® Psoriasis Argentina is more than just a platform for sharing experiences and spreading knowledge, it is a transformative initiative that enhances healthcare professionals' skills and creates a network of professionals across the country. Its success has paved the way for the launch of ECHO® initiatives for hidradenitis suppurativa and atopic dermatitis in Argentina in 2019, further expanding its impact on the healthcare system.

Durian waste valorization – some research tendencies: a review

Abstract This review aimed to present a general framework of some recent research trends and highlights reflecting the current status of durian waste valorization opportunities, applying the descriptive approach. In this regard, research was conducted on the keywords “durian waste” among the most used scientific databases, and the selected and included scientific publications are far from exhausting all the available and accessible literature on the subject under consideration, the complete detailed bibliographic description of which is beyond the scope of the present review. At the forefront, as a priority in many of the diverse researches, is the pursuit of achieving basic circular goals and sustainable principles related to reducing the total amount of durian waste, the search for effective methods for their safe treatment and storage, the development of methods to add value, the implementation of strategies to transform those considered as waste into useful raw materials and resources that can be subjected to recovery to obtain material goods with a view to their effective ecological valorization. As a result of the literature survey, among the main areas that are intensively worked on in the current conditions for the utilization of durian waste, the following could be mentioned: chemical compounds extraction and bioactivity characterization; activated carbon and sorption properties; nanoparticles; anaerobic digestion and biogas production; biodiesel; bioethanol; briquettes and pellets; ink; packaging; animal feed; food systems; as well as some other valorization directions and research tendencies. Conducting numerous studies in such diverse directions shows the overall importance for society of the subject under consideration, related to the proper treatment of durian waste, the application of appropriate strategies for their effective and successful utilization, emphasizing the need to summarize and systematize the recent state in the current progress regarding the valorization of durian waste, which allows and enables periodic renewal and updating of information.

Analisis Dampak Penerapan Sistem Informasi Manajemen Rumah Sakit dalam Pengambilan Keputusan Manajemen

This study aims to analyze the impact of the implementation of the Hospital Management Information System (SIMRS) on management decision-making at Drs. H. Abu Hanifah Hospital, Central Bangka Regency. The research method used is a qualitative method with the PIECES (Performance, Information, Economy, Control, Efficiency, Service) approach. This study involved 17 participants who were directly related to the use of SIMRS in hospitals. The results of the study show that even though SIMRS has been implemented well, there are still several obstacles such as incomplete data that affects employee performance. However, in general, SIMRS has a positive impact on information quality and operational efficiency in management decision-making. Recommendations for improvement include improvements in service aspects and periodic system updates.

Medical writing in pharmacovigilance: An overview

Medical writing is an integral part of pharmacovigilance, ensuring that safety information is communicated effectively and meets regulatory standards. Pharmacovigilance medical writing plays a crucial role in both the clinical development and post-marketing stages. It also significantly contributes to the preparation of mandatory submission documents that are essential for obtaining marketing authorization or approval from regulatory authorities. Medical writing plays a pivotal role in pharmacovigilance by crafting clear, precise, and regulatory-compliant documents that communicate safety information effectively. The field encompasses the preparation of essential documents such as Periodic Safety Update Reports (PSURs), Risk Management Plans (RMPs), and Periodic Adverse Drug Experience Reports (PADERs), all of which are critical for monitoring the safety and efficacy of pharmaceutical products. Medical writers in pharmacovigilance are responsible for synthesizing complex clinical data, reporting adverse events, and ensuring compliance with regulatory guidelines. This overview highlights the key responsibilities of medical writers, the regulatory frameworks governing their work, and the importance of effective communication in maintaining drug safety and patient health.

Temperature Trends and Influence of the Base Period Selection on Climate Indices in the Mediterranean Region Over the Period 1961–2020

ABSTRACTIn this study, the daily maximum and minimum temperatures measured over the period 1961–2020 by 18 stations located near the Mediterranean coast are analysed to evaluate temperature trends and to compute 10 climate indices, selected among those proposed by the Expert Team on Climate Change Detection and Indices to monitor the occurrence of climate extremes of temperature. The trend analysis is performed using the Seasonal‐Kendall test. The results show statistically significant positive trends in both above‐mentioned variables throughout the Mediterranean, although the rate of warming is more marked in the minimum than in the maximum temperature and is more evident in the western portion of the Mediterranean Basin from 1990 onward. The climate extremes indices are evaluated assuming two different base periods (1961–1990 and 1991–2020). The shift forward of the base period involves a general rise in the percentile‐based thresholds used for identifying temperature extremes, as a natural consequence of the current atmospheric warming, resulting in fewer warm events and more cold events since the 1990s using a warmer/later base period. The application of the Seasonal‐Kendall test to the occurrence of extreme warm and cold events reveals that the western portion of the Mediterranean and the Adriatic Sea are the subregions most influenced by the base period update. This study demonstrates that the selection of the base period for the identification of extreme temperature events significantly impacts the results, and that the choice of a recent base period partially masks the ongoing atmospheric warming. The results suggest that the base period 1961–1990 might be more appropriate for climatological studies, as it provides a solid and stable baseline, and that attention must be paid when scientific results are shared with stakeholders, so as not to alter the communication of warnings and specific risks for the population.

Risk-Based Completion Cost Overrun Ratio Estimation in Construction Projects Using Machine Learning Classification Algorithms: A Case Study

Estimating the completion cost accurately in the early phases of construction projects is critical to their success. However, cost overruns are almost inevitable due to the risks inherent in construction projects. Hence, the completion cost fluctuates throughout the execution phase and requires periodic updates. There is a need for a prompt and user-friendly completion cost estimation model that accounts for fluctuating risk scores and their impacts on the total cost during the execution phase. Machine learning (ML) techniques could address these requirements by providing effective methods for tackling dynamic systems. The proposed approach aims to predict the cost overrun ratio classes of the completion cost according to the changes in the total risk scores at any time of the project. Six classification algorithms were utilized and validated by employing 110 data points from a globally operating construction company. The performances of the algorithms were evaluated with validation and performance indices. The decision tree classifier surpassed other algorithms. Although there are some research limitations, including risk perception, data gathering restrictions, and selecting proper ML algorithms upon data properties, this research improves the planning abilities of construction executives by providing a cost overrun ratio based on changing total risk scores, facilitating swift and simple assessments at any stage of a construction project’s execution.

장애학생 보호자 지원 전달 체계에 대한 연구

Purpose: Identify the needs for support for guardians of the disabled and diagnose the current system to establish the direction of support for guardians of the disabled. In addition, a support system for guardians of the disabled is established in terms of special education and lifelong education for the disabled. Method: In the analysis stage of prior research, related data such as laws, policies and systems related to supporting guardians of the disabled, and policy research reports published by government departments were reviewed and analyzed. For the analysis of practical prior research, data analysis was conducted based on the life cycle of the disabled at home and abroad and the policies and support cases for the disabled by disability type through cooperation with institutions related to supporting guardians of the disabled. Results: First, this study suggested three directions for supporting guardians of the disabled: direct support for guardians of the disabled, improvement of the quality of life for guardians of the disabled, and strengthening the capacity of families with disabilities. Second, this study proposed an integrated model for service delivery systems to support guardians of the disabled. Third, 'one-stop service', 'service specialization', 'continuity of support for guardians by life cycle', and 'periodic update of guardian information' were suggested as conditions for an integrated support platform that focuses on providing information for guardians of the disabled. Finally, it was emphasized that the guardians of the disabled should be provided with various education and information related to the protection of the disabled through the establishment of an education and information support center for the disabled. Conclusion: The support system for guardians of the disabled should focus on direct support for guardians, and in order to establish a support system for guardians of the disabled, a service delivery system for supporting guardians of the disabled must be established at the national level.

The data layer: the importance of sources critical appraisal

Abstract One of the main purposes of public health institute is to tracking the health status of its citizens and understanding its evolution over time. Given the absence of a singular, comprehensive data source, we developed a framework to select databases specific to each disease and outcome of interest. This process includes a thorough evaluation of the operational case definitions, as well as the strengths and weaknesses of each database, with a particular focus on their sensitivity and specificity. These qualities are appraised following a dedicated scoring form into different categories (i.e., high, medium, low). The selection criteria for data sources hinge on several key questions: Is the database exhaustive or merely a sample? Does the case definition rely on direct medical diagnoses or proxies? Does the source capture all cases? Is the data collected at regional or national level? Are there mechanisms for yearly or periodic updates? To establish the most accurate national prevalence estimates for each outcome, we often need to adjust for data misclassification-applying corrections for biases such as self-reported data and interpolating for missing entries. In some instances, a pooled estimate from multiple data sources is developed. A specific case will be presented to illustrate our approach in practice. This critical evaluation is pivotal, as the quality of data underpins the entire health information pyramid. The integrity of our data directly influences our ability to convert data into actionable health wisdom, ultimately affecting public health decision-making and policy formulation.

Characterization of X-ray Beams: Determination of K\(_{a,e}\) for Comparison with DRLs

Aims: The aim of this experimental study was to quantify the entrance surface air kerma (Ka,e) of X-ray beams in radiographic examinations, and the obtained values were compared with national and international Diagnostic Reference Levels (DRLs). Place and Duration of Study: Sample: Department of Medical Physics and Radiology, Franciscan University (UFN), between June 2023 and August 2024. Methodology: Initially, the main quality control (QC) tests were applied to characterize the radiographic equipment. During the evaluation of the X-ray beam, a dosimetric set was used, and for the same QC geometry, Air Kerma Rate (KAIR) measurements were obtained to determine the output of the X-ray tube. Under the same conditions, a phantom without water and the same filled with water were used to determine the backscatter factor (BSF), which was then used to estimate the Ka,e for the main radiographic examinations. Results: The results of this study are consistent with other studies and identified the region/anatomy with the highest radiation exposure, highlighting the importance of its optimization and verifying that continued professional training should be integrated into best practices to ensure greater safety in procedures. The results obtained evidence the necessity for adjustments in image acquisition protocols, as the Ka,e values found in this study, although within the limits established by the national DRLs, exceed the reference values of countries such as the United Kingdom and Japan in the areas of the skull, abdomen, and lumbar spine. This discrepancy highlights the importance of the periodic review and update of DRLs, in accordance with international recommendations and the technological evolution of equipment. Dose optimization is an ongoing process that involves the evaluation of image quality, the appropriate selection of technical parameters, and the implementation of specific dose protocols. The continuous training of radiology professionals is essential to ensure the correct application of imaging techniques and the minimization of patient exposure to ionizing radiation. Conclusion: This study shows the importance of evaluating radiation dose in diagnostic imaging and the need for a multidisciplinary approach to dose optimization. Implementing quality assurance programs, updating DRLs, and providing ongoing training for professionals are essential to ensure patient safety and high-quality diagnostic imaging. The methodology adopted in this study can contribute to the ongoing education of radiology professionals, promoting the correct application of imaging techniques and reducing patient exposure to ionizing radiation.

Metodologias para avaliação da política de mobilidade urbana brasileira

Brazil's National Urban Mobility Policy promotes sustainable mobility by prioritizing public and non-motorized transport in the population's travel matrix. To implement this policy, Urban Mobility Plans must not only contain guidelines and supporting instruments but also establish a systematic approach for evaluation, revision and periodic updating, requiring the adoption of an evaluation and monitoring methodology adapted to the reality of each municipality. To provide an overview of the main methods used to evaluate urban mobility policy in the Brazilian context, this article uses the methodological procedures of a Systematic Literature Review. The selection of 19 works evaluated was made in the Brazilian Digital Library of Theses and Dissertations, whose analysis allowed us to identify: (i) a predominance of research that uses the analysis of legislation, in contrast to the small number that deals with mobility in loco; (ii) the use of the Urban Mobility Law as a reference for defining the parameters for evaluating urban mobility policy in most studies; (iii) a balance in the parameters used in the studies, guaranteeing coverage of the main urban mobility issues, even with different approaches. The results have demonstrated that the evaluation of urban mobility policy must use different methods, techniques and tools, either in combination or individually, and should be conducted periodically, to effectively meet the demands and specificities of each city.

A Review of the Prognostic Significance of Neutrophil-to-Lymphocyte Ratio in Nonhematologic Malignancies.

Biomarkers are crucial in cancer diagnostics, prognosis, and surveillance. Extensive research has been dedicated to identifying biomarkers that are broadly applicable across multiple cancer types and can be easily obtained from routine investigations such as blood cell counts. One such biomarker, the neutrophil-to-lymphocyte ratio (NLR), has been established as a prognostic marker in cancer. However, due to the dynamic nature of cancer diagnosis and treatment, periodic updates are necessary to keep abreast of the vast amount of published data. In this review, we searched the PubMed database and analyzed and synthesized recent literature (2018-February 2024) on the role of NLR in predicting clinical outcomes in nonhematologic malignancies. The search was conducted using the PubMed database. We included a total of 88 studies, encompassing 28,050 human subjects, and categorized the findings into four major groups: gastrointestinal cancer, cancers of the urinary tract and reproductive system, lung cancer, and breast cancer. Our analysis confirms that NLR is a reliable prognostic indicator in cancer, and we discuss the specific characteristics, limitations, and exceptions associated with its use. The review concludes with a concise Q&A section, presenting the most relevant take-home messages in response to five key practical questions on this topic.

The effectiveness of a disaster preparedness educational intervention for wheelchair users: A pilot study

ObjectiveThis pilot study aimed to test the effectiveness of disaster preparedness education for wheelchair users and improve their self-management skills during emergencies. MethodsA pre-post self-controlled experimental study was conducted. The intervention included one educational session covering the following: (1) Knowledge about local frequent disasters,. (2) Development of a tailored disaster preparedness plan for wheelchair users. (3) Preparation of a disaster kit. The methods included lectures, discussions, and scenario responses to disasters. Disaster preparedness knowledge, attitudes, and behaviors were assessed before, after and one month follw-up intervention. Results20 wheelchair users with average age of 41.2 ± 7.68. Most of them reported proficiency in wheelchair using. The educational intervention significantly improved knowledge and attitude scores post-intervention, with knowledge scores rising from 8.00 ± 2.25 to 13.85 ± 0.37 and attitude scores from 47.05 ± 6.45 to 52.30 ± 3.87. At the one-month follow-up, there was a slight regression in knowledge(11.00 ± 1.65) and attitude scores(50.70 ± 3.94) but still significantly higher than pre-intervention levels. Behavior scores were assessed only at pre and follow-up measurement points, with an increasing trend from 3.60 ± 1.93 to 8.60 ± 2.89, indicating sustained improvement in disaster preparedness behaviors. The study highlights the need for sustainable intervention methods due to the observed decline in knowledge retention and attitude over time. ConclusionThe tailored disaster preparedness education for wheelchair users significantly improved their knowledge, fostered positive attitudes, and encouraged proactive behaviors in response to disasters. To sustain these positive outcomes, ongoing educational reinforcement and periodic updates are essential, especially for vulnerable populations like wheelchair users.

Periodic update rule with Q-learning promotes evolution of cooperation in game transition with punishment mechanism

Cooperative behavior assumes a critical role in resolving conflicts arising between collective and individual interests, while punishment measures serve as a robust deterrent against opportunistic free-riding. Within this context, evolutionary game theory (EGT) emerges as an indispensable paradigm for addressing this multifaceted issue. When it comes to introspection behaviors, reinforcement learning (RL) methods exhibit remarkable capabilities to capture agents’ cognitive processes. Nonetheless, previous research has often focused on a static and time-invariant update rule, neglecting the dynamic nature of real-world scenarios where individuals can flexibly transit between strategies in periodic time-dependent patterns. Here, we propose periodic update rules with Q-learning algorithm and game transition model with a punishment mechanism that grants cooperative agents the autonomy to exercise discretion in deciding whether to initiate punishment actions. The agents display dynamic rules periodically through game model transitions, thus ensuring EGT’s inherent adaptability. By employing Monte Carlo (MC) simulations, we analyze the emergence of cooperation that underscores the substantial enhancement of cooperative behavior through the proposed periodic update rules with Q-learning algorithm and game transitions in the presence of punishment. Our study highlights the indispensable significance of appropriate periodic intervals for updating rules and determining optimal punishment costs in the game transition model as critical elements for fostering the evolution of cooperation in real-world scenarios.

Frequency-domain diffusion adaptation over networks with missing input data

Recently, a modified adapt-then-combine diffusion (mATC) strategy has been developed to handle distributed estimation problem with missing regressions (inputs). However, the mATC algorithm only considers the white input scenario and suffers from high complexity for long model filter lengths. To overcome these shortcomings, this paper proposes novel regularization-based frequency-domain diffusion algorithms for networks with missing input data. First, bias-eliminating cost function based on regularization is established by using the frequency-domain diagonal approximation. Then, with stochastic gradient descent, periodic update, and power normalization schemes, we design the regularization-based frequency-domain least mean square (R-FDLMS) algorithm as well as its normalized variant (R-FDNLMS). The latter converges faster than the former under colored inputs. The stability and steady-state behavior of the R-FDNLMS algorithm are also analyzed. Moreover, two effective power estimation methods are presented for both situations without and with the power ratio between the input signal and perturbation noise, along with a reset mechanism in the first case to enhance tracking performance. Finally, simulations are conducted to illustrate the superiority of the proposed algorithms and the validity of theoretical findings.

Use of Integra dermal regeneration template in burn patients: An Italian expert consensus Delphi study

IntroductionBurn injuries pose significant challenges in healthcare, with Integra dermal regeneration template (DRT) emerging as a prominent solution to enhance wound healing and recovery. Although there is no clear consensus on its technical use and application. We convened a panel of 14 burn specialists aiming to provide consensus regarding the application and usage of Integra in managing burn wounds. MethodsPanelists employed a modified Delphi technique to assess agreement and provide feedback on 81 initial statements covering various aspects of Integra DRT application in burn wound care over three subsequent rounds. This study was endorsed by the Italian Society of Burn Surgery (SIUST). ResultsFourteen heads of burn unit departments participated in the Delphi process. At the end of the third round and subsequent discussion on the final statement list, the panel achieved consensus on 24 statements shaping recommendations for Integra application across various aspects, including wound bed preparation, acellular dermal matrix application, definitive coverage, and complication management. ConclusionThe resultant 24 finalized statements from this Italian consensus offer a comprehensive and practical framework for employing Integra DRT in burn patient care. Reflective of specific Italian expertise and practice, these recommendations supplement and refine existing literature, serving as a dynamic guide subject to periodic updates aligned with evolving evidence and experience in the field of burn surgery.

Implementing an Organizational Culture of Biosafety and Biosecurity in the ŞAP Institute.

An organizational culture of biosafety and biosecurity is critical for effective management of transboundary animal diseases. One essential aspect of this work is keeping important pathogens studied in veterinary laboratories under control. Türkiye is among the countries that are both endemic and disease-free for foot-and-mouth disease (FMD) virus, and it has a unique institute dedicated to FMD diagnosis, control, and vaccine production. To build an organizational safety culture within this institute and strengthen awareness of the importance of safe and secure handling of FMD, 4 staff members previously trained in biorisk management developed and provided trainings to all institute staff. The institute's 173 personnel were divided into 3 groups by job description based on direct or indirect work with FMD virus. All 3 groups received training that addressed biosecurity, biosafety, biorisk awareness, and insider threat; the trainings varied in length by group. Three-quarters (n=130, 75%) of all institute staff completed their training and were asked to complete knowledge surveys using a Likert scale survey before and after their training. A majority (n=104, 80%) of those participants completed both the pretraining and posttraining surveys. All 3 training groups' posttraining surveys showed improved awareness above baseline scores, and all 3 groups scores reached the targeted threshold goal. Group 2 demonstrated a realization that some of the knowledge and habits they had acquired through experience were incorrect. Scores for several individual questions decreased at posttraining, and these results will need further evaluation. The overall training results prompted the institute to provide periodic updates to employees to sustain the organizational safety culture. With this study, the institute now has a dedicated group of biorisk management representatives. This work serves as a wake-up call for established institutions that rely on staff experience to foster an organizational culture of biosafety and biosecurity.

Traffic light nutrition labelling policy: A path to promoting healthier eating habits in Pakistan.

Dear Editor, While the global burden of diet-related diseases continues to escalate1, it is disheartening to see that Pakistan, like many other Lower-Middle Income Countries (LMICs)2, has not yet ultimately adopted the system that can significantly assist consumers in making healthier food decisions. In Pakistan, the prevalence of obesity, diabetes, and other non-communicable disease conditions is on the rise, posing a substantial economic and health burden on individuals and the healthcare system2. Many countries like the United States, Australia, and the United Kingdom use the traffic light nutrition labeling system, which is a valuable tool for empowering consumers to make informed food choices quickly 3. It provides a simple way for people to quickly assess the nutritional value of a product using a color-coding system3. Green labels indicate healthier options, amber labels suggest moderate consumption and red labels highlight food that should be consumed sparingly4. The simple color-coding system empowers consumers to make healthier decisions and can contribute to a reduction in diet-related diseases4. The traffic light system works particularly well in settings with high illiteracy rates, as is prevalent in Pakistan since it relies on simple color coding rather than textual information5. As consumers, we lack a clear and uniform method for evaluating the nutritional components of the food we buy. This deficiency not only obstructs the capacity to make healthy food choices but also sustains the prevalence of diet-related issues. Color-coded labeling would help people with low literacy levels to understand the nutrition information available on food products easily. However, Traffic Light nutrition labelling has not been adopted in Pakistan. To confront this challenge, policymakers, health organizations, and government authorities should take swift and decisive action. The government must take the lead in implementing clear regulations that mandate the use of traffic light nutrition labels on packaged food items. These regulations should accompany strict enforcement measures. Launching public awareness campaigns about the benefits of the traffic light system can help familiarize consumers with this approach and generate demand for healthier food products. Collaboration and engagement with food manufacturers and retailers to ensure a smooth transition to the traffic light system is imperative to encourage the production of healthier food consumption. Implement a system of periodic reviews and updates of the labeling system to ensure its collective effectiveness and relevance to the evolving nutritional landscape. ---Continue