Robust Health Research Articles

Examining Cycle Threshold values in Repeat SARS-CoV-2 Cases: A Retrospective Analysis in Ireland

Abstract Background Effective public health management during the COVID-19 pandemic requires accurate differentiation between re-infections and residual viral RNA detections in repeat positive cases. This study investigates cycle threshold (CT) trends in repeat SARS-CoV-2 cases to discern between persistent viral remnants and active infections. Collaboration between contact tracing and laboratories is essential for shaping robust public health strategies. Methods A retrospective analysis was conducted on 427 individuals with repeat positive PCR tests. Data was collected at a contact tracing centre from March to August 2021. Key variables including age, gender, and biomedical markers (test intervals, CT values) were examined. Regression and correlation techniques assessed CT trends and their implications. Results Younger individuals (<60 years) occasionally exhibited significantly lower CT values in subsequent tests, suggesting potential re-infections, while older adults generally displayed higher CT values indicative of residual RNA. These age-specific CT trends were statistically significant and instrumental in refining testing protocols and isolation guidelines. Further analysis is expected to strengthen these findings Conclusions Collaborative approaches between contact tracing and laboratories are vital in shaping robust public health strategies for distinguishing between types of repeat infections. Revision of health policies is imperative to prevent unnecessary isolation and optimise healthcare workforce allocation during ongoing transmission periods. Key messages • Decisive decision-making skills are crucial in managing repeat SARS-CoV-2 infections. • Revised health policies align testing and isolation practices with empirical CT data, enhancing public health efficacy.

Advancing immunisation information systems: a proposal for the “unvaccinated registry”

Abstract Through a systematic review of 253 studies, we identified significant advancements in IIS functionalities including real-time data access, interoperability, and life-course vaccination records, crucial for robust public health responses. Our review reveals that vaccinations are vital for public health and societal welfare; however, vaccine hesitancy is a significant barrier, driven by complex factors. Most IIS implementations predominantly utilise web-based platforms focused on children’s vaccinations with features that enhance data interoperability and public health surveillance. Despite these advancements, gaps in vaccine coverage and hesitancy mapping persist due to suboptimal data integration and system interoperability. Parallelly, we propose a comprehensive registry that includes unvaccinated individuals, aiming to address vaccine hesitancy by integrating demographic and socio-economic data. This initiative promises to enhance health equity by providing actionable insights into vaccination gaps and facilitating targeted interventions. Ethical considerations, particularly data privacy, are paramount, as well as adhering to regulations such as GDPR to ensure the protection of personal health information. The integration of IIS with a registry that includes unvaccinated populations represents a transformative approach to public health, potentially increasing vaccine coverage and effectively informing policy decisions. This dual strategy leverages not only technological advancements but also incorporates essential behavioural insights, offering a path forward in the ongoing battle against vaccine-preventable diseases. This model aligns with the Italian National Vaccination Prevention Plan and underscores proactive, evidence-based strategies to enhance vaccination uptake, serving as a cornerstone for broader application in other national contexts.

Distribution of the Culex pipiens mosquito in mainland Portugal: a geospatial modelling study

Abstract Background The mosquito Culex pipiens is a vector for several pathogens, such as the West Nile virus. As the most abundant mosquito in Portugal, understanding its spatial distribution can support vector-borne diseases control and robust public health planning, given the mainland’s favourable climate for this vector. Information on its spatial distribution at a national level is limited, especially its association with climate variables. Thus we aimed to predict the suitability of Culex pipiens distribution in mainland Portugal, considering climate factors. Methods We used presence records for adult and larvae of Culex pipiens mosquitoes sampled across mainland Portugal from January 2017 to October 2023, as part of the Portuguese Vector Surveillance Network program (REVIVE). Between May-October, in random locations and throughout the year in point-of-entry sites, adult mosquito collection used CDC light traps and BG-Sentinel traps, and larvae collection used dippers in breeding sites. Sampling bias was corrected by filtering presence sites, retaining one record per each cell grid of 1 km2. Climatic data (including temperature, precipitation and elevation) were used as predictors in a maximum entropy (MaxEnt) model of the Culex pipiens geographical distribution. Results From the dataset of 6859 records, 1416 unique sites were obtained after filtering. Suitable habitats seem to be mainly distributed on the coast, particularly in Minho, Porto and Lisbon metropolitan areas, and Tagus Valley, with precipitation as the most important predictor. Conclusions Most West Nile Virus case reports come from the south of Portugal, but the potential distribution of Culex pipiens covers the whole mainland territory, with seemingly higher distribution on the north coast. However, bias due to convenience sampling could be present. West Nile vector surveillance should be a priority across all regions to accurately assess transmission risk and implement effective control measures. Key messages • The suitability of Culex pipiens distribution covers the entire mainland of Portugal, with higher presence in the north. • The distribution of Culex pipiens in the country points towards a need for developing region-specific strategies regarding West Nile Virus prevention and control.

4.D. Scientific session: From policy to implementation: Learnings around health system reforms and Universal Health Coverage

Abstract In this session, the authors and audience have the opportunity to engage in discussions around health policy integrity and reform implementation. Introducing and implementing health system reform has been a perennial issue for countries around the world over the past number of decades. Recently, the introduction and implementation of Universal Health Coverage (UHC) has been of particular focus, with 193 countries committed to introducing UHC by 2030. At the same time, European countries that previously established national health systems are introducing new reforms in the hope of making their health systems more efficient and equitable. However, there are a number of challenges along the path of policy development and implementation with which all countries must grapple, and how individual countries go about reforming their health systems depends on their social, political, cultural and economic contexts. Learnings from around the world have highlighted that reforms can be challenged or stalled in both the design and implementation phases. This workshop, which conceptualises implementation as the “acid test” of a policy, thus explores, through three case studies, the factors that facilitate or challenge the implementation of reforms. At the same time, we discuss policy integrity, exploring reasons for why policies pivot away from original design and intent. Furthermore, we discuss the implications of health reform on equity, cognisant that the primary objective of this collective reform work is to reduce the financial burden of healthcare on households and improve access. The first presentation will provide the framework for audience discussions, outlining international lessons in relation to UHC reforms and equity. The second presentation will provide a snapshot of the Finnish experience of introducing a “big bang” structural reform. The third presentation highlights lessons from the Portuguese experience of primary healthcare reforms, the opportunity these offer for creating patient-centred care and the integral role that politics and governance play in the reform process. Finally, the Irish case study highlights the experiences of a High Income County attempting to introduce UHC much later than its European counterparts, and negotiations between the public and private sectors. Through this, we hope to hold the tensions and stimulate debate about policy robustness and resilience, and reform implementation. Each presenter will be given a strict deadline of 10 minutes each by the chair and then the audience will be invited to debate the problems identified and strategies proposed to discuss: (i) what are the facilitators and barriers to reform implementation, (ii) what are the factors that encourage policy integrity and change and (iii) whether greater cooperation across Europe regarding health reforms can be more effective in supporting robust health systems. Key messages • For reforms to be facilitated, there must be cohesion and commitment across the political, social, economic and cultural systems, and no fragmentation across health system functions. • As policy implementation is attempted, there is a tension between remaining true to key values and adapting to new circumstances.

6.I. Round table: Strengthening preparedness for public health emergencies: lessons learned and future perspectives

Abstract In the face of intensifying global health threats, robust health security measures in Europe and worldwide have never been more pressing. The COVID-19 pandemic has underscored the critical need for coordinated action, adaptive strategies, and robust collaborative mechanisms to effectively respond to emerging infectious diseases and other public health emergencies. This workshop serves as a platform to examine the multifaceted landscape of health security actors, focusing on collaborative initiatives and lessons learned from recent crises. By convening experts and stakeholders from across Europe, the workshop aims to achieve several key objectives: i) To provide an overview of collaborative initiatives established to strengthen European and international health security. By showcasing successful models of cooperation, participants will gain insights into effective strategies for fostering collaboration among diverse stakeholders. ii) Emphasize the role of European and international institutions, such as the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO), in supporting states both in coordinating regional response efforts and in developing the necessary health workforce competencies and capabilities to respond to health emergencies. iii) Drawing on experiences from recent health emergencies, including outbreaks of high-risk pathogens, such as Ebola, the workshop will facilitate a critical examination of lessons learned. Through interactive discussions, participants will identify challenges, best practices, and opportunities for enhancing preparedness and response capacity. iv) By interactive presentations and panel discussions, the workshop will provide a platform for knowledge exchange and networking among participants. By sharing experiences, expertise, and innovative approaches, participants will contribute to a collective understanding of the challenges and opportunities in strengthening health security. This workshop seeks to illuminate key strategies, capacity-building efforts, and real-world lessons learnt that contribute to enhancing response capabilities to public health emergencies. Participants will gain a deeper understanding of emergency participation mechanisms, essential skills required, and available training resources to enhance preparedness. Key messages • Collaboration and adaptive strategies are essential for strengthening international health security in the face of emerging infectious diseases and other public health emergencies. • Lessons learned from recent crises provide valuable insights into effective response strategies and opportunities for enhancing preparedness and response capacity.

The Evolution of Health Information Technology for Enhanced Patient-Centric Care in the United States: Data-Driven Descriptive Study.

Health information technology (health IT) has revolutionized health care in the United States through interoperable clinical care data exchange, e-prescribing, electronic public health reporting, and electronic patient access to health information. This study aims to examine progress in health IT adoption and its alignment with the Office of the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health IT (ASTP's) mission to enhance health care through data access and exchange. This study leverages data on end users of health IT to capture trends in engagement in interoperable clinical care data exchange (ability to find, send, receive, and integrate information from outside organizations), e-prescribing, electronic public health reporting, and capabilities to enable patient access to electronic health information. Data were primarily sourced from the American Hospital Association Annual Survey IT Supplement (2008 to 2023), Surescripts e-prescribing use data (2008 to 2023), the National Cancer Institute's Health Information National Trends Survey (2014 to 2022), and the National Center for Health Statistics' National Electronic Health Records Survey (2009 to 2023). Since 2009, there has been a 10-fold increase in electronic health record (EHR) use among hospitals and a 5-fold increase among physicians. This enabled the interoperable exchange of electronic health information, e- prescribing, electronic public health data exchange, and the means for patients and their caregivers to access crucial personal health information digitally. As of 2023, 70% of hospitals are interoperable, with many providers integrated within EHR systems. Nearly all pharmacies and 92% of prescribers possess e-prescribing capabilities, an 85%-point increase since 2008. In 2013, 40% of hospitals and one-third of physicians allowed patients to view their online medical records. Patient access has improved, with 97% of hospitals and 65% of physicians possessing EHRs that enable patients to access their online medical records. As of 2022, three-fourths of individuals report being offered access to patient portals, and over half (57%) report engaging with their health information through their patient portal. Electronic public health reporting has also seen an increase, with most hospitals and physicians actively engaged in key reporting types. Federal incentives have contributed to the widespread adoption of EHRs and broad digitization in health care, while efforts to promote interoperability have encouraged collaboration across health care entities. As a result, interoperable clinical care data exchange, e-prescribing, electronic public health reporting, and patient access to health information have grown substantially over the past quarter century and have been shown to improve health care outcomes. However, interoperability hurdles, usability issues, data security concerns, and inequitable patient access persist. Addressing these issues will require collaborative efforts among stakeholders to promote data standardization, implement governance structures, and establish robust health information exchange networks.

Principal Component Analysis (PCA) of MALDI-TOF for the Identification of Waterborne Pathogenic Bacteria

The study focuses on the application of Principal Component Analysis (PCA) combined with MALDI-TOF MS (Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry) for the identification of waterborne pathogenic bacteria in urban water networks. In this comprehensive research, 168 bacterial strains were meticulously isolated from the water networks of Abidjan, Côte d'Ivoire, a region known for its inadequate wastewater treatment infrastructure. The analysis aimed to rapidly and precisely identify these bacterial pathogens, leveraging the power of MALDI-TOF MS and the sophisticated data reduction capabilities of PCA. This approach not only accelerates the identification process but also enhances the accuracy of detecting various pathogens. The study identified a diverse range of pathogens, including Pseudomonas aeruginosa, Escherichia coli, Salmonella, Shigella, Vibrio cholerae, Morganella morganii, Proteus mirabilis, Acinetobacter baumannii, Klebsiella pneumoniae, Providencia rettgeri, Providencia stuartii, Aeromonas hydrophila, Bacillus cereus, Lysinibacillus fusiformis, Lysinibacillus sphaericus, and Staphylococcus aureus. These findings underscore the critical public health risks posed by microbial contamination in water networks, particularly in areas with deficient waste management systems. This study highlights the necessity for improved wastewater management practices, robust public health strategies, and regular monitoring to mitigate the risks associated with waterborne pathogens. Moreover, the integration of PCA with MALDI-TOF MS proves to be a powerful tool for enhancing the efficiency and accuracy of pathogen identification in environmental water samples, offering a promising solution for better public health protection and water quality management in urban settings.

Beyond buzzwords: fostering interdisciplinary and collaborative global health research in Germany and beyond.

Germany has increased its political and financial commitment for global health, but this needs to be backed by a robust global health research ecosystem with strong partnerships in low- and middle-income countries (LMICs). This article suggests pathways for empowering researchers to operate beyond their disciplinary silos and strengthen partnerships across sectors and countries. The authors identify barriers and enablers of operations from a nascent research network in Germany, trusting that this experience can inform other initiatives seeking to stoke interdisciplinary and collaborative global health research. This article represents the culmination of extensive reflections spanning the initial four years of the German Alliance for Global Health Research (GLOHRA). The insights have additionally been informed by an analysis of publicly available reports, internal procedural records, and externally conducted studies based on interviews with researchers and policymakers. GLOHRA has developed a toolbox of practices that foster interdisciplinary research and support capacity-building. Insights indicate that highly interdisciplinary and diverse governance structures and seed-funding for interdisciplinary and cross-sector research with appropriate review processes represent a critical step for achieving these aims. Additionally, inclusive training sessions and networking events help to bridge disciplinary boundaries, equipping researchers to envision the broader context of their work. Despite achievements, challenges persist. Wider support, especially from universities and research institutions, is necessary to make global health research an attractive career path and to reduce bureaucratic barriers for collaborators in LMICs. Sustained, longer-term federal funding mechanisms will also be essential for ongoing progress.

A Financial Analysis and Valuation of Shell

In todays era of global energy transition, the strategic choices made by energy giants like Shell carry immense significance, shaping not only their own future blueprint but also profoundly influencing the overall energy sectors trends. The article provides a comprehensive analysis of Shell plc with liquidity, solvency, profitability, and valuation analysis of 2023 with its main competitors in the oil and gas industry. Despite facing challenges from fluctuating commodity prices and regulatory changes, Shell maintains a competitive advantage and favorable market position. The company demonstrates robust financial health, with strong liquidity, solvency, and profitability ratios compared to industry peers. Nevertheless, the analysis reveals the companys profitability ratios lag behind competitors, indicating room for improvement. Although facing uncertainties in future commodity prices and regulatory environments, the analysis highlights Shells commitment to balancing environmental goals with shareholder value, as evidenced by its energy transition strategy. Shells stock is still fairly valued according to the analysis, presenting a compelling investment opportunity with its well-constructed financial framework. Overall, Shells strategic plans and adjustments aim to ensure resilience and adaptability, promising investors sustainable development amidst evolving market dynamics.

The PHEM-B toolbox of methods for incorporating the influences on Behaviour into Public Health Economic Models

BackgroundIt is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions.MethodsA core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox.ResultsThe PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required.ConclusionsThis is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation.

Occupational Hazards Among the Agricultural Workers in a Rural Area of South India

Background: Agriculture is one of the most hazardous occupations, employing around 60% of India’s workforce. Agricultural workers face occupational hazards in the form of physical, chemical, biological, mechanical, ergonomic, psychosocial, and so on. This study assessed the physical, chemical, biological, and mechanical health hazards among agricultural workers.Methods: A cross-sectional study was conducted among 400 agricultural workers selected through multistage random sampling in a rural area to assess their occupational hazards.Results: Physical hazards were the most common hazards reported by 390 workers (97.5%), followed by mechanical hazards by 200(50%), and biological hazards by 79(19.7%). Chemical hazards were noted in 136(86.4%) out of 155 participants who used chemicals in the form of pesticides and insecticides.Conclusion: All agricultural workers experience one or the other types of occupational hazards. These hazards have a bearing on the quality of life among the agricultural workers who form the primary workforce in our country and contribute significantly to the economy. It is crucial to ensure a robust health information system to track down and respond to agricultural workers’ various health events, develop and implement a need-based intervention program through the formal healthcare system, and prevent and avert occupational health hazards in this group.

A mental health monitoring system based on intelligent algorithms and biosensors: Algorithm behaviour analysis and intervention strategies

Introduction: Mental health monitoring encompasses the systematic observation and assessment of an individual’s psychological well-being, aiming to detect, understand and manage mental health conditions. It involves various techniques and interventions tailored to support individuals in achieving and maintaining optimal mental wellness. Recent advancements include the use of biosensors and biomechanics to analyze physiological signals that correlate with mental states, providing a more comprehensive understanding of psychological well-being. Aim: The aim of this research is to construct an innovative mental health monitoring system established on intelligent algorithms and biomechanical data through behaviour analysis and intervention strategies. Methodology: We propose a novel Snow Ablation-driven Bi-directional Fine-tuned Recurrent Neural Network (SA-BFRNN) to identify the state of mental health. In addition to behavioural data, biosensors are employed to collect real-time physiological signals such as heart rate variability, skin conductance, and muscle tension, offering objective markers of mental stress and anxiety. These biomechanical inputs are integrated into the system for multi-modal analysis. We employ the SA algorithm, iteratively removing less influential connections and nodes based on their impact on model performance. This process enhances network efficiency and generalization capabilities, refining the BFRNN for mental health state identification. Utilizing a questionnaire with 25 questions, administered to a selected group of 756 individuals, we validate our proposed model. Biosensor data is synchronized with questionnaire responses to improve the precision of mental state identification. Clustering-derived labels are validated with mean opinion score. These labels inform classifiers for individual mental health prediction, aligning with our objective of robust mental health assessment through data-driven approaches. SA-BFRNN integrates both forward and backward temporal information, enhancing its ability to discern subtle patterns in behaviour. Through iterative fine-tuning, our network learns to adapt to diverse datasets, enabling precise identification of mental health states. Research findings: In the result evaluation phase, we thoroughly examine how well our proposed SA-BFRNN model recognizes various states of mental health across different parameters. Our findings also highlight the significance of incorporating biomechanics, where biosensor data showed a strong correlation with mental health indicators, thereby augmenting the accuracy of the system. Our findings emphasize the efficacy of the SA-BFRNN technique, as demonstrated by its overall performance in terms of recall (92.56%), accuracy (90.13%), F1-score (88.16%) and precision (89.23%). Our experimental results unequivocally demonstrate that our proposed model performed better than other traditional approaches in classifying contents from multimodal data, showing notable enhancements in accuracy and robustness, particularly under dynamic conditions.

An exploration of teacher and school-based nurse perceptions of current HPV education offered to students 15-16 years old in post-primary schools in Northern Ireland, UK.

Human papillomavirus virus (HPV) is highest among young adults 15-24 years old. High-risk strains are responsible for the development of cancers including cervical, vaginal, vulvar, anal, oropharyngeal and penile. Despite HPV school-based vaccination programmes in the UK, HPV vaccination uptake rates continue to fluctuate due to misinformation and vaccine hesitancy post COVID-19. The aim of this study is to explore perceptions of post-primary school teachers and nurses regarding the current HPV education provision and the need to provide HPV education to students 15-17 years old when they are most likely to be becoming sexually active. A qualitative study was conducted using online semi-structured interviews between February-August 2022 with post-primary teachers and nurses in Northern Ireland, UK. Stratified random sampling was used to contact schools to recruit participants. Recruitment continued until data saturation was reached. Braun & Clarke's six-phase framework for reflexive thematic analysis was used to analyse the data. Twelve teachers and six nurses participated in the study. Four themes arose based on the analysis including 1) the importance of HPV education 2) self-consent to the HPV vaccine 3) design of the HPV education and 4) delivery of the HPV education. Identified barriers to implementation of HPV education included lack of parental education, religion and the conservative culture of Northern Ireland. Participants perceived HPV education to be poor or non-existent in their schools but placed high importance on this education. They indicated that a non-judgemental health professional would be the ideal person to deliver interactive HPV education as part of a mandated spiral curriculum. HPV education at 15-17 years old provides students with an opportunity to learn about their HPV risk, their HPV vaccination status and an opportunity to self-consent to the HPV vaccine. The Education Authority and Department of Health should support health professionals to deliver consistent robust HPV health information to students of this age.

7004 Systems genetics analysis to identify candidate genes for fat distribution in BXD mice

Abstract Disclosure: N. Kim: None. D. Ryu: None. C. Oh: None. Obesity is defined as the accumulation of excess fat in the body. Although obesity is the main cause of metabolic disorders, not all obese people have metabolic disorders. Among many factors identified, the ratio of visceral (vWAT) to subcutaneous white adipose tissue (sWAT), representing body fat distribution, has been elucidated to be closely associated with metabolic health. Body fat distribution has been proposed as a possible explanation for this discrepancy. To investigate the regulation of body fat distribution, we performed a genetic analysis using the phenotype data and male subcutaneous fat microarray data from the BXD mouse genetic reference population. Our analysis identified H2-Ke6 (Hsd17b8), encoding hydroxysteroid 17-beta dehydrogenase, as a candidate target for adipose tissue plasticity. To further explore its role, we employed multiple approaches to reveal the effect of Hsd17b8 inhibition. First, lipid accumulation was attenuated in 3T3-L1 preadipocytes where Hsd17b8 was inhibited by CRISPER/Cas9 as well as lasalocid. Furthermore, we confirmed that the expression of adipogenesis-related transcription factor as well as mature adipocyte marker was decreased in terminally differentiated 3T3-L1. Specifically, CCAAT/enchancer binding protein α (Cebpa), peroxisome proliferator-activated receptor γ (Pparg), adiponectin (Adipoq), and fatty acid binding protein 4 (Fabp4) were transcriptionally downregulated. Consistently, in C. elegans, we used RNA interference (RNAi) to inhibit the expression of the Hsd17b8 ortholog, dhs-25, and observed a reduction in lipid accumulation. All these data suggest that the reduction in lipid accumulation in differentiated 3T3-L1 cells by the inhibition of Hsd17b8 is attributed to the suppression of early differentiation during the adipogenesis process. On top of that, to determine whether Hsd17b8 indeed influences body fat distribution in vitro, we utilized IngWAT Mouse Immortalized Preadipocyte Cell Line derived from subcutaneous white adipose tissue (sWAT) of a wild-type mouse. In contrast to the previous findings, we observed an increase in lipid accumulation of IngWAT when Hsd17b8 was inhibited. Surprisingly, the elevation of lipid accumulation in sWAT, as seen in gynoid obesity, has been revealed to be indicative of robust metabolic health compared to android obesity. Collectively, these data suggest that Hsd17b8 may represent a novel therapeutic target for the treatment of obesity. Our study provides valuable insights into the mechanisms underlying metabolic health in obesity and highlights the potential of Hsd17b8 as a therapeutic target for modulating adipose tissue plasticity. Presentation: 6/3/2024

The Economic Impact of Workplace Mental Health Initiatives: A Comprehensive Analysis of Return on Investment and Organizational Performance

This study investigates the economic implications of implementing comprehensive mental health initiatives in the workplace. As mental health issues continue to rise globally, their impact on workforce productivity and organizational performance has become a critical concern for businesses. This research examines the relationship between investment in employee mental health programs and various economic indicators, including productivity, absenteeism, employee turnover, and overall organizational performance. We analyzed data from 100 medium to large-sized companies across diverse industries that have implemented mental health initiatives over the past five years. Our findings indicate a significant positive correlation between investment in mental health programs and improved economic outcomes, with an average return on investment (ROI) of 4:1. Furthermore, companies with robust mental health initiatives demonstrated lower absenteeism rates, reduced employee turnover, and increased overall productivity. This study contributes to the growing body of literature on the economics of mental health in the workplace and provides valuable insights for managers, policymakers, and organizational leaders considering the implementation or expansion of mental health programs.

Soil quality index: a tool to detect the sensitivity to soil erosion in an agricultural catchment from the Middle Atlas of Morocco.

Abstract The present paper focuses on the application of the Soil Quality Index (SQI) within the Tiguert catchment, situated in the Middle Atlas of Morocco. The studied catchment, covering approximately 10.2 km², experiences a semi-arid climate with irregular rainfall and is designated as an agricultural area, making it an ideal site for studying the intricate interactions between natural processes and human activities. The SQI developed as part of the Mediterranean Desertification and Land Use (MEDALUS) project is tailored to the unique conditions of the Mediterranean region. In the case of the Tiguert catchment, SQI is calculated using a formula that considers topographical slope, horizontal depth of soil, parental material, and soil brightness. Consequently, the results depict a promising scenario, with 61% of the soil classified as “High Quality,” indicating robust soil health and resilience despite the challenges posed by a semi-arid climate. The 31% categorized as “Moderate Quality” underscores areas requiring specific management attention, while the 8% identified as “Low Quality” signals localized challenges potentially influenced by irregular rainfall patterns. Furthermore, the SQI results are closely linked to soil erosion dynamics, with higher SQI values associated with improved resistance to erosion. The dynamic connection between precipitation patterns and SQI over a 40-year analysis indicates the impact of varying rainfall on soil health. Extreme rainfall events correspond to higher SQI percentages in the “High Quality” category, while drier periods align with lower SQI percentages, emphasizing the dynamic relationship between climate and soil quality. A comprehensive analysis of SQI across diverse ecosystems in Tiguert reveals variations in soil health, emphasizing the importance of tailored land management approaches for different land use types to optimize overall soil sustainability.

A meta-analysis approach to evaluate the effects of early group housing on calf performance, health and behavior during the preweaning period

This study aimed to evaluate the effects of early group housing on the performance, health, and behavior of dairy calves during the pre-weaning period using systematic and meta-analysis approaches. Peer-reviewed articles written in English that compared dairy calves individually and group-housed with performance, health, or behavior outcomes were collected from Web of Science, PubMed and CabDirect databases. The resulting articles (n = 850) underwent a PRISMA 4-step appraisal process, resulting in a final sample of 51 articles containing 85 studies. The weighted or standardized mean differences between individually and group [pair or group (with > 2 calves)] housed calves were analyzed for each variable using the Der-Simonian and Laird methods. Heterogeneity between calf housing systems was evaluated by the chi-squared test and I2 statistics. A meta-regression analysis was conducted to identify categorical covariate effects for variables with high heterogeneity. Most of the studies included in this review evaluated female calves (45.8%) weaned at 8 weeks old (52.6%). Housing systems were mainly paired housing (55.3%), followed by groups of 3 to 6 calves (30.65) and groups of 7 to 15 calves (4.7%). We did not find studies with comparable outcomes for more robust health parameters (as occurrence of diseases), only blood parameters, that were not influenced by the housing system (P > 0.05). But, weight gain and feed intake parameters were higher (P < 0.05) in group-housed calves. Through the meta-regression, we found that average daily gain was positively affected (P < 0.05) by the group housing in studies with calves housed in small pen areas (<1.5 m2 per calf). Group-housed calves presented more active behaviors (feeding and playing) and less stress-related behaviors (self-grooming and interacting with the pen) than individually-housed calves. The behavioral tests most used were novel object, human approach, novel environment, and social tests. Individually-housed calves presented fewer vocalizations on these tests and spent more time interacting with humans during the human approach test than group-housed calves. Our findings provide consistent evidence that group housing improves the welfare of dairy calves; however, the effects on health parameters are still scarce and unclear.

A critical review of public health policies for radiation protection and safety

The increasing use of radiation in various sectors, including medicine, industry, and research, underscores the need for robust public health policies to ensure radiation protection and safety. This critical review examines the effectiveness of current public health policies aimed at mitigating the risks associated with radiation exposure. The review synthesizes findings from peer-reviewed literature and official reports to evaluate the strengths and weaknesses of existing frameworks. Public health policies for radiation protection are designed to safeguard individuals and communities from the potential hazards of radiation exposure. These policies include regulatory standards for radiation use, safety protocols in medical and industrial settings, and public education programs. The review explores the evolution of these policies over time, highlighting significant regulatory milestones and their impact on radiation safety. Key areas of focus include the effectiveness of international guidelines and national regulations, such as those established by the International Atomic Energy Agency (IAEA) and national bodies like the U.S. Environmental Protection Agency (EPA) and the European Commission. The review assesses how well these guidelines are implemented and adhered to in practice, identifying gaps in enforcement and areas where policies may fall short. The review also examines the role of risk communication and public awareness in shaping effective radiation protection policies. It discusses how well current policies address the needs of vulnerable populations and how they balance the benefits of radiation use with potential health risks. Challenges such as emerging technologies, changes in radiation exposure patterns, and the need for ongoing policy adaptation are also considered. The review concludes with recommendations for strengthening public health policies, including enhancing regulatory oversight, improving risk communication strategies, and investing in research to address new and evolving radiation safety issues. Overall, this review underscores the importance of continuous evaluation and adaptation of public health policies to ensure effective radiation protection and safety in an ever-changing technological landscape.

PatCen: A blockchain-based patient-centric mechanism for the granular access control of infectious disease-related test records.

The recent global outbreaks of infectious diseases such as COVID-19, yellow fever, and Ebola have highlighted the critical need for robust health data management systems that can rapidly adapt to and mitigate public health emergencies. In contrast to traditional systems, this study introduces an innovative blockchain-based Electronic Health Record (EHR) access control mechanism that effectively safeguards patient data integrity and privacy. The proposed approach uniquely integrates granular data access control mechanism within a blockchain framework, ensuring that patient data is only accessible to explicitly authorized users and thereby enhancing patient consent and privacy. This system addresses key challenges in healthcare data management, including preventing unauthorized access and overcoming the inefficiencies inherent in traditional access mechanisms. Since the latency is a sensitive factor in healthcare data management, the simulations of the proposed model reveal substantial improvements over existing benchmarks in terms of reduced computing overhead, increased throughput, minimized latency, and strengthened overall security. By demonstrating these advantages, the study contributes significantly to the evolution of health data management, offering a scalable, secure solution that prioritizes patient autonomy and privacy in an increasingly digital healthcare landscape.

Digital Health: The Critical Value of Mobile Technology for the Health Sector, Different Application Examples from the World and Current Trends

The internet technology, which began to integrate into our lives rapidly by the end of the 1990s, underwent significant transformations with the advent of mobile technology in the 2000s. Initially accessible through desktop or notebook computers, the internet has evolved to become an integral part of virtually every aspect of our lives as mobile technology advanced throughout the 2000s. The purpose of this study is to examine the role of mobile technologies within current health technologies, investigate the necessary competencies, evaluate mobile technology developments both in Türkiye and globally, and assess the information technology infrastructure, competencies, and skills required by the sector. Our research details various and specific mobile applications from numerous countries. Findings indicate that mobile technology has established itself much more rapidly and effectively in countries with strong internet infrastructure. Mobile health services are perceived as highly valuable by citizens. The real quality and effectiveness of mobile technology depend on its acceptance and swift implementation by users. Gamification is an important tool in the adoption of mobile health applications. These applications can enhance motivation by enabling both doctors to monitor patient care services and patients to track their own health. A good mobile health system should be accepted by both patients and doctors. In countries like Türkiye, where the health system is largely supported by the state, it is seen as necessary for the Ministry of Health to prioritize mobile services to establish a robust mobile health system. Furthermore, to effectively structure mobile services, it is essential to focus on the right problems and identify issues in order of priority. Literature review reveals that various mobile applications have been implemented in fields such as dermatology, orthopedics, ophthalmology, neurosurgery, and clinical pathology. Mobile technologies offer significant cost advantages in the delivery of health services. As the population ages in European Union countries, national governments are seeking ways to reduce healthcare costs. Mobile health is considered a solution to transform the delivery of health services and reduce costs through viable new care models for both industrialized and developing countries. Moreover, it has been observed that mobile applications provide significant benefits for the elderly, particularly in developed countries such as Germany and Sweden. Our study provides a comprehensive assessment of mobile technology in the healthcare sector, highlights prominent applications from Türkiye and around the world, and offers an extensive evaluation for field readers.