Risk Of Exposure Research Articles

Cost-effectiveness of One Health intervention to reduce risk of human exposure and infection with non-typhoidal salmonellosis (NTS) in Nigeria.

Non-typhoidal Salmonella infection (NTS) is an important foodborne zoonosis with underappreciated health and economic burdens, and low case fatality. It has global prevalence, with more burdens in under-resourced countries with poor health infrastructures. Using a cohort study, we determined the cost-effectiveness of NTS in humans in Nigeria for the year 2020. Using a customized Excel-based cost-effectiveness analysis tool, structured (One Health) and unstructured (episodic intervention against NTS) in Nigeria were evaluated. Input data on the disease burdens, costs surveillance, response and control of NTS were obtained from validated sources and the public health system. The non-complicated and complicated cases were 309,444 (95%) and 16,287 (5%) respectively, and the overall programme cost was US$ 31,375,434.38. The current non-systematic episodic intervention costed US$ 14,913,480.36, indicating an additional US$ 16,461,954 to introduce the proposed intervention. The intervention will avert 4036.98 NTS DALYs in a single year. The non-complicated NTS case was US$ 60/person with significant rise in complicated cases. The cumulative costs of NTS with and without complications far outweighed the program cost for One Health intervention with an incremental cost-effectiveness ratio (ICER) of -US$ 221.30). Utilising structured One Health intervention is cost-effective against NTS in Nigeria, it carries additional mitigative benefits for other diseases and is less costly and more effective, indicative of a superior health system approach. Identified limitations must be improved to optimize benefits associated and facilitate policy discussions and resource allocation.

An integrated Fine-Kinney risk assessment model utilizing Fermatean fuzzy AHP-WASPAS for occupational hazards in the aquaculture sector

The multidisciplinary field of occupational health and safety (OHS) aims to identify, assess, and mitigating hazards that arise in the workplace or due to the execution of the work. The Fine-Kinney method is a quantitative risk assessment widely applied in many industries to identify, evaluate and prevent potential hazards. Despite the widespread usage of the classic Fine-Kinney approach in several research, its effectiveness in addressing the issue of objective risk appraisal among decision-makers is limited. Therefore, this study proposes a comprehensive occupational risk assessment framework that integrates the Fine-Kinney method with the analytical hierarchy process (AHP) and weighted aggregated sum product assessment (WASPAS) under the Fermatean fuzzy environment. The Fermatean fuzzy set (FFS) offers a more flexible solution in determining the uncertainty and vagueness of information, as it covers membership and non-membership degrees in a wider area compared to intuitionistic and Pythagorean fuzzy sets. The AHP approach is used to calculate the weightage of each each Fine-Kinney risk parameter (probability (P), exposure (E), and consequence (C)), and WASPAS method is used to find the ranking of the hazards. In the proposed model, Fermatean fuzzy weighted geometric (FFWG) operator is used for aggregation of expert opinions. Finally, sensitivity and comparative analyses are also performed to further highlight the adaptability and efficiency of the proposed occupational health and safety risk assessment (OHSRA) model, and a case study analyzing occupational hazards for aquaculture operations is presented to demonstrate the model's rationality and feasibility.

The psychological impact of the COVID-19 epidemic among healthcare workers at the grassroots level in Vietnam

The COVID-19 pandemic has significantly affected the mental health of healthcare workers (HCWs). Therefore, an immediate priority is to monitor rates of mental health issues to understand related factors and inform interventions. The main purpose of this study was to evaluate the psychological and mental health impact of COVID-19 and some related factors among HCWs at the grassroots level in Vietnam. A cross-sectional study was conducted on 675 HCWs working at health facilities through questionnaires. The finding showed the rate of HCWs who were psychologically affected by the COVID-19 pandemic was 37.2%, of which 64.1% of HCWs were afraid to tell their families about the risk of exposure to COVID-19 at work. The 31.0% of HCWs had difficulty sleeping deeply/insomnia due to the COVID-19 epidemic. No statistically significant differences were found in the psychological impact of COVID-19 between HCW groups by age, gender, seniority, and professional qualifications. Some groups of HCWs were found to have poor psychological health. Our research suggests that during the COVID-19 pandemic, HCWs working in healthcare facilities experienced an increased psychological burden; psychological interventions for those at high risk and with common mental disorders should be included to reduce this burden and protect HCWs' mental health.

The epidemiological profile of cancer in Beni Mellal: a cross-sectional descriptive study

In Morocco, where cancer is a major public health problem, the characteristics of cancer in the Beni Mellal-Khenifra region of Morocco are unknown. Our objective was to establish the epidemiological profile of cancer in this region and the main risk factors influencing cancer. We conducted a cross-sectional study, including all types of cancer, with a sample of 100 patients at the Beni Mellal regional oncology center. Data collected in June and July 2021 using a questionnaire, pre-tested, and analyzed using SPSS and Excel. The questionnaire included sections on cancer-related clinical characteristics and other items related to cancer risk exposures. Gyneco-mammary cancers occupied the first position (49%). The most common localization of cancer in women was breast cancer, with a proportion of 63% of cases recorded during the period studied. In men, lung cancer was the most frequent location at 17%. We found some possible risk factors for cancer: tobacco and alcohol use, dietary habits, use of hormonal contraceptive methods, low income, pollution, sun radiation, exposure to asbestos, family history of cancer, and diseases associated with cancer. Women’s cancers are very common in the region. Several factors are responsible for this frequency. These results suggest several avenues for further research.

The population exposure risk of urban heat island effect: From the perspective of urban spatial expansion in China

Urban spatial expansion is a critical aspect of urbanization, but it must occur in a manner that ensures the sustainable development of the urban climate. The primary objective of this study was to assess the population exposure risk of urban heat island (UHI) effect from the perspective of urban spatial expansion. Additionally, the population weighted urban heat island intensity (UHII) index (Ep) was proposed to compare the population exposure risk of UHI effects in different types of urban spatial expansion in China during the summer of 2005–2020. It was found that, in China, urban land increased by an area of 74,894 km2 (1.01-fold) from 2005 to 2020. Leapfrogging emerged as the predominant pattern of urban spatial expansion and was primarily driven by the conversion of cropland to urban land. It witnessed a significant increase in the area covered by UHIs of 107,119 km2 (1.20-fold), accompanied by a rise in the UHII of 0.12°C in China. Notably, the UHII for infilling urban expansion was significantly higher at 2.03°C, in contrast to 1.66°C for edge expansion and 1.47°C for leapfrogging. Correspondingly, the Ep was markedly larger under the infilling urban expansion (2.10°C) in contrast to edge expansion (1.75°C) and leapfrogging (1.67°C). However, edge expansion dominated the newly developed urban land, contributing to 18.60% of the Ep, which was still far less than the contribution of the pre-existing urban land to Ep (61.24%). Importantly, the dominant driver of the increased Ep was the increasing UHII. This study established a connection between inevitable urban spatial expansion and the population exposure risk of UHI effect, providing a strong theoretical basis and practical guidance for the active adaptation and mitigation of urban environmental hazards in urban regions.

Characterization of natural radioactivity and relative dose due to consumption of edible bivalves inhabiting the Cochin Backwater Lagoon, Kerala, southwestern coast of India

The study on natural radionuclides in edible bivalves from the Cochin backwater lagoon, Kerala, employing alpha spectrometry, revealed higher concentrations of 210Po and 210Pb compared to 238U and 232Th. The annual committed effective dose (ACED) for the adult coastal population was calculated at a range of 1494.9 to 5783.4 μSv y−1, with 210Po being the predominant contributor, responsible for about 85 % of the dose. This highlighted significant health risks, underscored by a calculated cumulative mortality and morbidity risk range between 5.23 × 10−3 and 2.02 × 10−2. These findings emphasized the need for further research and the development of regulatory measures to mitigate exposure risks.

The Efficacy and Safety of Radiation-Free Retrograde Intrarenal Surgery: A Prospective Multicenter-Based, Randomized, Controlled Trial.

Fluoroscopy is usually required during retrograde intrarenal surgery (RIRS). Although fluoroscopy is considered necessary for effective and safe RIRS, there is growing awareness regarding radiation exposure risk to patients and surgeons. We conducted a multicenter-based, randomized, controlled trial to compare the safety and effectiveness of radiation-free (RF) RIRS with radiation-usage (RU) RIRS for kidney stone management. From August 2020 to April 2022, patients with a unilateral kidney stone (≤20 mm) eligible for RIRS were prospectively enrolled in 5 tertiary medical centers after randomization and divided into the RF and RU groups. RIRS was performed using a flexible ureteroscope with a holmium:YAG laser. The primary end point of this study was the success rate, defined as complete stone-free or residual fragments with asymptomatic kidney stones ≤ 3 mm. The secondary end point of this study was ascertaining the safety of RF RIRS. The success rates were analyzed using a noninferiority test. Of the 140 consecutive randomized participants, 128 patients completed this study (RF: 63; RU: 65). The success rates (78% vs 80%, P = .8) were not significantly different between the groups. The rate of high-grade (grade 2-4) ureter injury was not significantly higher in the RF group compared to the RU group (RF = 3 [4.8%] vs RU = 2 [3.1%], P = .6). In RF RIRS, the success rate was noninferior compared to RU RIRS (the difference was 2.2% [95% CI, 0.16-0.12]). This study demonstrated that the surgical outcomes of RF RIRS were noninferior to RU RIRS.

Literature study: Comparative analysis of lead content in blood between spot workers, Caroseries industry workers, and metal smelting industry workers

Introduction: This study aims to analyze the comparison of lead content in blood between gas station attendants, bodywork industry workers, and metal smelting industry workers. Lead (Pb) is a heavy metal that can have dangerous effects on human health. Lead exposure can occur through various sources, including the work environment. Method: The research used is a literature study by collecting articles published between 2013-2023. After selection, there were 18 articles that were relevant to the research topic. Results and Discussion: The average lead content in the blood of gas station attendants ranges from 2.75 μg/dL to 35,317 μg/dL, bodywork industry workers range from 14.4 μg/dL to 35 μg/dL, and metal smelting industry workers range from 14.4 μg/dL. dL up to 50.83 μg/dL. Differences in levels of lead exposure between these three professions can be caused by differences in type of work, activities and work environment. Conclusion: Based on the results of this research, it can be concluded that gas station officers, bodywork industry workers, and metal smelting industry workers have different levels of exposure to lead. Therefore, appropriate health protection, such as the use of PPE and safe work practices, needs to be implemented to reduce the risk of lead exposure.

Seasonal dynamics of sand flies in Lençóis Maranhenses National Park: a tourist destination and endemic area for leishmaniasis.

Numerous sand fly species have been reported in Lençóis Maranhenses National Park (LMNP) in Northeast Brazil, including important Leishmania vectors, making the park an endemic area for tegumentary and visceral leishmaniasis. We evaluated sand fly abundance monthly over 7 years, correlating it with environmental variables and monthly tourist numbers in LMNP. Sand fly species were observed throughout the year, with Lutzomyia longipalpis Lutz & Neiva and Nyssomyia whitmani Antunes and Coutinho (Diptera: Psychodidae) being the most abundant species, especially from April to June. In addition to seasonal abundance patterns, Lu. longipalpis showed increasing abundance throughout 2013 until April 2014, whereas Ny. whitmani exhibited a consistent increase throughout the study period. Redundancy analysis indicated that monthly sand fly abundances increased with humidity but decreased with mean temperature and wind speed. Ecotourists mainly visit the park from May to September when interdune lagoons are full, coinciding with high-frequency vector activity during the rainy months (May-June). Tourists also visit in January and February during school holidays, when the rains begin and sand fly abundance increases, and in July, when sand fly abundance decreases. To date, no instances of infected tourists have been recorded, likely because visits to LMNP occur during the day when sand flies are inactive. However, there is a potential risk of vector exposure if tourists engage in nighttime cultural visits to villages around the park, where leishmaniasis cases occur annually.

Role of autonomic nervous system in BDE-209 maternal exposure induced immunotoxicity in female offspring.

Decabrominated diphenyl ether (BDE-209) is a typical persistent organic pollutant that can cross the placental barrier, increasing the exposure risk for offspring. Norepinephrine (NE) from nerve terminals and acetylcholine (Ach) can bind to specific receptors on immune cells, inhibit the immune function of the body then cause immunotoxicity. However, whether maternal exposure to BDE-209 could lead to immunotoxicity in the offspring by acting on the sympathetic and parasympathetic nervous systems remains unclear. In view of this, the pregnancy and lactation rat BDE-209 exposure model was established and the results demonstrated that pregnancy and lactation BDE-209 exposure could induce immunotoxicity to female offspring via affecting immunopathology (hematological and biochemical parameters, organ indices, and spleen histopathological), decreasing humoral immunity (serum hemolysin, immunoglobulins, and cytokine productions), damaging cellular immunity (splenic lymphocytes and spleen cytokine productions), and restraining nonspecific immunity. Moreover, a dramatically significant correlation was observed between spleen nerve indices and immunity indices. Additionally, the mechanism revealed that maternal BDE-209 exposure caused offspring immunotoxicity through (1) activating MHC/PKCθ/NF-κB pathway; (2) promoting sympathetic nervous pathway, by upregulating the expression of β2AR protein, which in turn elevating cAMP, following activate PKA and phosphorylate CREB, ultimately leading to immunotoxicity;(3) activating parasympathetic nerve pathway by reducing the binding with Ach and α7nAchR, upregulating the expression of JAK2 and phosphorylating STAT3, induced immunotoxicity of female offspring.

The BC Radon Data Repository (BCRDR) and BC Radon Map: Integrating disparate data sources for improved public health communication.

The potential for exposure to indoor radon varies dramatically across British Columbia(BC) due to varied geology. Individuals may struggle to understand their exposure risk and agencies may struggle to understand the value of population-level programs and policies to mitigate risk. The BC Centre for Disease Control (BCCDC) established the BC Radon Data Repository (BCRDR) to facilitate radon research, public awareness, and action in the province. The BCRDR aggregates indoor radon measurements collected by government agencies, industry professionals and organizations, and research and advocacy groups. Participation was formalized with a data sharing agreement, which outlines how the BCCDC anonymizes and manages the shared data integrated into the BCRDR. The BCRDR currently holds 38,733 measurements from 18 data contributors. The repository continues to grow with new measurements from existing contributors and the addition of new contributors. A prominent use of the BCRDR was to create the online, interactive BC Radon Map, which includes regional concentration summaries, risk interpretation messaging, and health promotion information. Anonymized BCRDR data are also available for external release upon request. The BCCDC leverages existing radon measurement programs to create a large and integrated database with wide geographic coverage. The development and application of the BCRDR informs public health research and action beyond the BCCDC, and the repository can serve as a model for other regional or national initiatives.

The association between HLA-B variants and amoxicillin-induced severe cutaneous adverse reactions in Chinese han population

BackgroundAmoxicillin (AMX) is among the most prescribed and the best tolerated antimicrobials worldwide. However, it can occasionally trigger severe cutaneous adverse reactions (SCAR) with a significant morbidity and mortality. The genetic factors that may be relevant to AMX-induced SCAR (AMX-SCAR) remain unclear. Identification of the genetic risk factor may prevent patients from the risk of AMX exposure and resume therapy with other falsely implicated drugs.MethodologyFour patients with AMX-SCAR, 1,000 population control and 100 AMX-tolerant individuals were enrolled in this study. Both exome-wide and HLA-based association studies were conducted. Molecular docking analysis was employed to simulate the interactions between AMX and risk HLA proteins.ResultsCompared with AMX-tolerant controls, a significant association of HLA-B*15:01 with AMX-SCAR was validated [odds ratio (OR) = 22.9, 95% confidence interval (CI): 1.68–1275.67; p = 7.34 × 10−3]. Moreover, 75% carriers of HLA-B*15:01 in four patients with AMX-SCAR, and the carrier frequency of 10.7% in 1,000 control individuals and 11.0% in 100 AMX-tolerant controls, respectively. Within HLA-B protein, the S140 present in all cases and demonstrated the strongest association with AMX-SCAR [OR = 53.5, p = 5.18 × 10−4]. Molecular docking results also confirmed the interaction between AMX and S140 of the HLA-B protein, thus eliminating the false-positive results during in association analysis.ConclusionOur findings suggest that genetic susceptibility may be involved in the development of AMX-SCAR in Han Chinese. However, whether the HLA-B variants observed in this study can be used as an effective genetic marker of AMX-induced SCAR still needs to be further explored in larger cohort studies and other ethnic populations.

Epidemiologic and tick exposure characteristics among people with reported Lyme disease - Minnesota, 2011-2019.

In the United States, blacklegged Ixodes spp. ticks are the primary vector of Lyme disease. Minnesota is among the states with the highest reported incidence of Lyme disease, having an average of 1857 cases reported annually during 2011-2019. In contrast to the Northeast and mid-Atlantic United States where exposure to ticks predominately occurs around the home, the circumstances regarding risk for exposure to blacklegged ticks in Minnesota are not well understood, and risk is thought to be highest in rural areas where people often participate in recreational activities (e.g. hiking, visiting cabins). We analysed enhanced surveillance data collected by the Minnesota Department of Health during 2011-2019 to describe epidemiologic and tick exposure characteristics among people with reported Lyme disease. We found that younger age, male gender, residence in a county with lower Lyme disease risk, residence in the Minneapolis-St. Paul metropolitan area, and an illness onset date later in the year were independently associated with higher odds of reporting tick exposures away from the home. We also describe the range of activities associated with tick exposure away from the home, including both recreational and occupational activities. These findings refine our understanding of Lyme disease risk in Minnesota and highlight the need for heterogeneous public health prevention messaging, including an increased focus on peridomestic prevention measures among older individuals living in high-risk rural areas and recreational and occupational prevention measures among younger individuals living in the Minneapolis-St. Paul metropolitan area.

Geographic range and minimum infection rate of Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, and Borrelia miyamotoi in Ixodes scapularis (Acari: Ixodidae) ticks in Manitoba, Canada from 1995 to 2017.

The expanding geographical range of blacklegged ticks (BLTs), Ixodes scapularis, and its ability to transmit Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, and Borrelia miyamotoi poses an emerging public health risk. Our study determined the geographic distribution and the minimum infection rate (MIR) of B. burgdorferi-, A. phagocytophilum-, Ba. microti-, and B. miyamotoi-infected BLTs in Manitoba submitted to the Public Health Agency of Canada's passive tick surveillance programme from 1995 to 2017. Regression models were used to test the association of the MIR by year for each pathogen. Ticks were tested using PCR for B. burgdorferi since 1995, A. phagocytophilum since 2006, and Ba. microti and B. miyamotoi since 2013. The global positioning system coordinates of infected and uninfected ticks submitted during the surveillance period were plotted on a map of Manitoba using ArcGIS Pro version 3.1.2 to detect changes in the geographic distribution of ticks over time. The overall MIR for B. burgdorferi was 139.7 (95% confidence interval [CI]: 129.0-150.5) per 1000 BLTs; however, it varied over time. After remaining stable from 1995 to 2005, the MIR increased by 12.1 per 1000 BLTs per year from 2005 to 2017 (95% CI: 7.0%-17.2%, p-value <0.01). The geographic distribution of B. burgdorferi-infected BLTs was centred around Winnipeg, Manitoba, and spread outward from this locality. The MIRs of A. phagocytophilum, Ba. microti, and B. miyamotoi were 44.8 per 1000 BLTs (95% CI: 38.1-51.6), 10.8 (95% CI: 6.6-15.0), and 5.2 (95% CI: 2.3-8.1) per 1000 BLTs, respectively, and showed no significant change over time. Passive surveillance revealed the presence of A. phagocytophilum-, Ba. microti-, and B. miyamotoi-infected BLTs in southern Manitoba and revealed an increased risk of exposure to B. burgdorferi-infected BLTs due to the increasing geographic range and MIR.

Evaluation and health risk assessment of arsenic and potentially toxic elements pollution in groundwater of Majha Belt, Punjab, India.

Concentrations of potentially toxic elements (PTEs) like arsenic, uranium, iron, and nitrate in the groundwater of the Majha Belt (including Tarn Taran, Amritsar, Gurdaspur, and Pathankot districts) in Punjab, India were measured to evaluate the health risks associated with its consumption and daily use. The average concentrations of these elements in some locations exceeded the WHO-recommended values. Arsenic and iron toxicity levels were found to be higher in the Amritsar district, while uranium toxicity was more prevalent in Tarn Taran. The Trace Element Evaluation Index suggests that Amritsar is one of the districts most affected by toxic elements. According to the US Environmental Protection Agency's (USEPA) guidelines, the HQ values of U, Fe, and nitrate were less than one, indicating that there is no non-carcinogenic health risk for adults and children. However, the hazard quotient (HQ) value for arsenic was greater than one, indicating a higher possibility of health risk due to arsenic in the study area. The total hazard index values of 44.10% of samples were greater than four for arsenic, indicating that people in the Majha Belt are at a very high health risk due to the usage of water for drinking and domestic purposes. The cancer risk assessment values for arsenic in children (5.69E + 0) and adults (4.07E + 0) were higher than the accepted limit of USEPA (10-4 to 10-6) in the Majha Belt. The average radiological cancer risk values of U for children and adults were 8.68E-07 and 9.45E-06, respectively, which are well below the permissible limit of 1.67 × 10-4 suggested by the Atomic Energy Regulatory Board of DAE, India. The results of this study confirm that the residents of the Majha Belt who use contaminated groundwater are at a serious risk of exposure to arsenic in the Amritsar district and uranium in Tarn Taran district.

Medical cannabis use in Australia seven years after legalisation: findings from the online Cannabis as Medicine Survey 2022–2023 (CAMS-22)

BackgroundCannabis was legalised for medical purposes in 2016. Uptake was initially slow, but since 2019 there has been a large increase in the number of Australians who have been prescribed cannabis for medical reasons. Yet a significant number of consumers continue to treat their medical conditions via illicitly-sourced cannabis. Little is known about how these two groups of medical cannabis consumers differ.MethodsThe anonymous Cannabis-As-Medicine Survey 2022–2023 (CAMS-22) was available for completion online from December 2022 to April 2023 to adult Australians who had used cannabis to treat a medical condition in the previous year. Recruitment occurred through social media, consumer forums, and medical practices. Questions included demographic characteristics, patterns of cannabis use, conditions treated, and self-rated effectiveness.ResultsOf the 3323 respondents included in these analyses, 2352 (73%) mainly used prescribed medical cannabis, 871 (27%) mainly used illicit. Prescribed users were significantly more likely than illicit users to have had their health condition diagnosed (OR = 1.7, 95% CI 1.3, 2.2), to consume their cannabis via oral (OR = 1.9; CI 1.5, 2.4) or vaporised (OR = 5.2; CI 4.0, 6.8) routes, and to be sure of the composition of their medical cannabis (OR = 25.0; CI 16.7, 50.0). Prescribed users were significantly less likely to have used cannabis non-medically before medical use (OR = 0.6, CI 0.5, 0.7), consume cannabis via smoked routes (OR = 0.2, CI 0.1, 0.2), and to report any side effects (OR = 0.1; CI 0.1, 0.2). The most common conditions among both prescribed and illicit users were pain (37%), mental health (36%), and sleep (15%) conditions. Prescribed users were significantly more likely to use cannabis to mainly treat a pain (OR = 1.3; CI 1.1, 1.5) or sleep condition (OR = 1.4; CI 1.1, 1.7) and less likely to treat a mental health condition (OR = 0.8; CI 0.7, 0.9). There were no between-group differences in effectiveness with 97% saying medical cannabis had improved their symptoms.ConclusionsFrom a harm-reduction perspective there is much to recommend prescribed medical cannabis; it has fewer side-effects than illicit, is used more safely (oral or vaporised versus smoked routes), gives consumers greater certainty regarding the composition and quality of their medicine, and does not risk exposure to the criminal justice system. Of concern, however, is the apparent willingness of prescribers to prescribe for indications for which there is limited evidence of efficacy, such as mental health and sleep conditions.

Traditional healers’ knowledge and infection control practices related to HIV in Bukavu City, Democratic Republic of the Congo

BackgroundPatients with HIV consult traditional healers (THs). These THs can both delay care for people living with HIV (PLHIV) and transmit HIV through poor infection control practices. The main objective of this study was to evaluate knowledge and practices of THs regarding HIV in Bukavu.MethodsA cross-sectional study using quantitative approach was carried out among 71 THs in Bukavu City. The collected data included the following topics: personal and socio-demographic characteristics, HIV knowledge, and infection control practices. Descriptive statistics, independent-samples T-test or F-test, and multiple linear regression were used to analyze the data with a p-value < 0.05.ResultsThe THs’ mean age was 49.2 ± 11.2 years, and the majority were aged 40 to < 60 years. Males constituted 88.7% of THs with a male-to-female ratio of 7.9. In general, 47.9% of study participants had poor knowledge about HIV/AIDS infection, 45.1% of them had fair knowledge, and only 7.0% had good knowledge. Overall, 43.7% of THs had poor infection control practices, 52.1% of THs had fair practices, and only 4.2% of participants had good practices. Results of multiple linear regression analysis revealed that none of the personal and demographic variables studied were significant predictors of their knowledge about HIV/AIDS (p > 0.05). In terms of practices, two variables were significant predictors of infection control practices: living in Ibanda and receiving training in taking care of HIV/AIDS.Conclusion and recommendations: The study revealed that THs’ knowledge about HIV infection was insufficient and that they had poor infection control practices. Formal standardized training on HIV infection should be organized for all THs so that they can always refer their patients to modern, reliable antiretroviral therapy (ART) clinics and reduce the risk of occupational exposure in their practices. Although PPE’s assistance for THs is required in terms of protective measures, the province health authority must also oversee infection control procedures at THs’ offices.

Dosimetric comparison of HyperArc and InCise MLC-based CyberKnife plans in treating single and multiple brain metastases.

This study aimed to compare the dosimetric attributes of two multi-leaf collimator based techniques, HyperArc and Incise CyberKnife, in the treatment of brain metastases. 17 cases of brain metastases were selected including 6 patients of single lesion and 11 patients of multiple lesions. Treatment plans of HyperArc and CyberKnife were designed in Eclipse 15.5 and Precision 1.0, respectively, and transferred to Velocity 3.2 for comparison. HyperArc plans provided superior Conformity Index (0.91±0.06vs. 0.77±0.07, p<0.01) with reduced dose distribution in organs at risk (Dmax, p<0.05) and lower normal tissue exposure (V4Gy-V20Gy, p<0.05) in contrast to CyberKnife plans, although the Gradient Indexes were similar. CyberKnife plans showed higher Homogeneity Index (1.54±0.17vs. 1.39±0.09, p<0.05) and increased D2% and D50% in the target (p<0.05). Additionally, HyperArc plans had significantly fewer Monitor Units (MUs) and beam-on time (p<0.01). HyperArc plans demonstrated superior performance compared with MLC-based CyberKnife plans in terms of conformity and the sparing of critical organs and normal tissues, although no significant difference in GI outcomes was noted. Conversely, CyberKnife plans achieved a higher target dose and HI. The study suggests that HyperArc is more efficient and particularly suitable for treating larger lesions in brain metastases.

COVID‐19 and credit risk variation across banks: International insights

AbstractThis paper focuses on utilizing non‐performing loans (NPLs) as the primary indicator of credit risk to analyze how various bank and country‐level characteristics influence changes in credit risk within and between banks across China, Europe, and the U.S. during the COVID‐19 period. Over 4,959 bank‐quarter observations (from Q4 2019 to Q4 2021), it becomes evident that COVID‐19 significantly contributes to the variation in NPLs, underscoring its adverse impact on credit risk. This pattern is consistent across all countries; however, Chinese banks exhibit more robust capabilities in managing credit risk exposure compared to their European and U.S. counterparts. These findings offer significant implications for policymakers, investors, and regulators who are concerned about the repercussions of global pandemics on financial institutions.

Occupational exposure, carcinogenic and non-carcinogenic risk assessment of formaldehyde in the pathology labs of hospitals in Iran

Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10−4), 23.08% were in the possible carcinogenic risk range (10−5 < LCR < 10−4), and 35.90% were in the negligible risk range (LCR < 10−6). The highest index of occupational carcinogenesis was observed in the group of lab technicians with a risk number of 3.7 × 10−4, followed by pathologists with a risk number of 1.7 × 10−4. Furthermore, 23.08% of the studied subjects were within the permitted health risk range (HQ < 1.0), while 76.92% were within the unhealthy risk range (HQ > 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.