Regional Variations Research Articles

Trends, spatiotemporal variation and decomposition analysis of pregnancy termination among women of reproductive age in Ethiopia: Evidence from the Ethiopian demographic and health survey, from 2000 to 2016

BackgroundPregnancy termination is a major public health problem, and complications of unsafe abortion are among the proximate and major causes of maternal mortality. Mapping the trend and spatiotemporal variation and identifying factors that are responsible for the changes in pregnancy termination help achieve the sustainable development goal of reducing maternal mortality in Ethiopia by understanding the epidemiology and regional variations. MethodsData from the 2000–2016 Ethiopian Demographic and Health Survey were analyzed with a total weighted sample of 40,983 women of reproductive age. Variables with a p-value <0.05 in a logit multivariable decomposition analysis were considered significant predictors of the decline in pregnancy termination over time. Spatial analysis was used separately for each survey to show the changes in regional disparities in pregnancy termination in Ethiopia. ResultsThe magnitude of pregnancy termination among women of reproductive age decreased by 39.5 %, from 17.7 % in 2000 to 10.7 % in 2016. The difference in the effects of literacy, working status, marital status, age at first intercourse, age at first cohabitation, knowledge about contraceptives, and knowledge of the ovulatory cycle were the significant predictors that contributed to the change in pregnancy termination over time. Significant clusters of pregnancy terminations were observed in central and northern Ethiopia (Addis Ababa, eastern Amhara, and Tigray regions). ConclusionsDespite the substantial decrease in terminated pregnancies over time in Ethiopia, the magnitude is still high. The government should focus on promoting education for girls and women, providing reproductive health education, including access to contraceptives, and raising the minimum age for girls to engage in sexual activities or marriage by implementing policies.

Regional variation in donation after circulatory death heart allograft utilization

ObjectiveRandomized data support transplantation of hearts from donors after circulatory death. This may lead to a sizeable increase in the donor pool. Regional variations in donors after circulatory death heart use were examined to help elucidate barriers to donor pool expansion. MethodsThe United Network for Organ Sharing deceased donor dataset was queried for adult (age ≥ 18 years) donors after circulatory death donors of at least 1 organ between January 2020 and December 2023. Donors were stratified by the extent their respective cardiac allografts progressed through the donation process. United Network for Organ Sharing region-level use rates and annual trends were assessed. ResultsOf 17,239 adult donors after circulatory death donors who donated at least 1 organ for transplant during the study period, 1196 (9.4%) were heart donors. Regional donors after circulatory death heart donor pursuit rates ranged from 97% to 100%, consent attainment rates from 94% to 99%, and heart recovery rates from 5% to 10%. The transplantation rate of recovered organs ranged from 90% to 97%. Multivariable logistic regression demonstrated United Network for Organ Sharing region to be independently associated with donors after circulatory death heart use after controlling for baseline differences in donor risk. ConclusionsTransplantation of donors after circulatory death heart allografts has increased in the United States since 2020, but the overall number of hearts procured and transplanted from donors after circulatory death donors remains low. The operational barriers to transplantation of donors after circulatory death hearts require further investigation. Further, significant regional variation exists regarding rates of progression of donors after circulatory death hearts through the donation process. Sharing of successful practices among Organ Procurement Organizations and transplant centers will facilitate maximal use of this new donor pool.

Dual diagnosis and their care pathways for help-seeking: A multicenter study from India

Background: Understanding pathways to dual diagnosis (DD) care will help organize DD services and facilitate training and referral across healthcare sectors. Aim: The aim of our study was to characterize the stepwise healthcare and other contacts among patients with DD, compare the characteristics of the first contact persons with common mental disorder (CMD) versus severe mental illness (SMI), and estimate the likelihood of receiving appropriate DD treatment across levels of contacts. Methods: This cross-sectional, descriptive study in eight Indian centers included newly enrolled patients with DD between April 2022 and February 2023. The research spans varied geographic regions, tapping into regional variations in disease burden, health practices, and demographics. The study categorized healthcare contacts by using the WHO Pathways Encounter Form. Results: The sample (n = 589) had a median age of 32 years, mostly males (96%). Alcohol was the most common substance; SMI (50.8%) and CMD were equally represented. Traditional healers were a common first contact choice (18.5%); however, integrated DD care dominated subsequent contacts. Assistance likelihood increased from the first to the second contact (23.1% to 62.1%) but declined in subsequent contacts, except for a significant rise in the fifth contact (97.4%). In the initial contact, patients with CMD sought help from public-general hospitals and private practitioners for SUD symptoms; individuals with SMI leaned on relatives and sought out traditional healers for psychiatric symptoms. Conclusion: Recognizing the cultural nuances, advocating for integrated care, and addressing systemic challenges pave the way to bridge the gap in DD treatment.

Time from injury to hip-fracture surgery in low-income and middle-income regions: a secondary analysis of data from the International Orthopaedic Multicentre Study in Fracture Care (INORMUS)

Globally, fall-related injuries are a substantial problem, and 80% of fatal falls occur in low-income and middle-income countries. We aimed to measure time from injury to hip-fracture surgery in people aged 50 years or older living in low-income and middle-income regions, as well as to measure the proportion of patients with surgical stabilisation of their hip fracture within 72 h of admission to hospital and to identify risk factors associated with surgical delay. For this secondary analysis, we analysed data collected from Africa, Latin America, China, India, and Asia (excluding China and India) for the International Orthopaedic Multicentre Study in Fracture Care (INORMUS) between March 29, 2014, and June 15, 2022. Patients from INORMUS were included in this analysis if they were aged 50 years or older and had an isolated, primary hip fracture sustained from a ground-level fall. Staff at participating hospitals identified patients with musculoskeletal injury and referred them for assessment of eligibility. We report time from injury to surgery as three distinct time periods: time from injury to hospital admission, time from admission to surgery, and a total time from injury to surgery. Date and time of injury were self-reported by patients at the time of study recruitment. If time to hospital admission after injury exceeded 24 h, patients reported the primary reason for delayed admission. Reasons for surgery, no surgery, and surgical delay were reported by the treating team. For patients undergoing surgery, multivariable regression analyses were used to identify risk factors for surgical delay. 4486 adults aged 50 years or older with an isolated, primary hip fracture were enrolled in INORMUS from 55 hospitals in 24 countries. Countries were grouped into five regions: Africa (418 [9·3%] of 4486), Latin America (558 [12·4%]), China (1680 [37·4%]), India (1059 [23·6%]) and Asia (excluding China and India; 771 [17·2%]). Of 4486 patients, 3805 (84·8%) received surgery. The rate of surgery was similar in all regions except in Africa, where only 193 (46·3%) of 418 patients had surgery. Overall, 2791 (62·2%) of 4486 patients were admitted to hospital within 24 h of injury. However, 1019 (22·7%) of 4486 patients had delayed hospital admission of 72 h or more from injury. The two most common reasons for delayed admission of more than 24 h were transfer from another hospital (522 [36·2%] of 1441) and delayed care-seeking because patients thought the injury would heal on its own (480 [33·3%]). Once admitted to hospital, 1451 (38·1%) of 3805 patients who received surgery did so within 72 h (median 4·0 days [IQR 1·7-6·0]). Regional variation was seen in the proportion of patients receiving surgery within 72 h of hospital admission (92 [17·9%] of 514 in Latin America, 53 [27·5%] of 193 in Africa, 454 [30·9%] of 1471 in China, 318 [44·4%] of 716 in Asia [excluding China and India], and 534 [58·6%] of 911 in India). Of all 3805 patients who received operative treatment, 2353 (61·8%) waited 72 h or more from hospital admission. From time of injury, the proportion of patients who were surgically stabilised within 72 h was 889 (23·4%) of 3805 (50 [9·7%] of 517 in Latin America, 31 [16·1%] of 193 in Africa, 277 [18·8%] of 1471 in China, 189 [26·4%] of 716 in Asia [excluding China and India], and 342 [37·5%] of 911 in India). Access to surgery within 72 h of hospital admission was poor, with factors that affected time to surgery varying by region. Data are necessary to understand existing pathways of hip-fracture care to inform the local development of quality-improvement initiatives. The National Health and Medical Research Council of Australia, the Canadian Institutes of Health Research, McMaster Surgical Associates, Hamilton Health Sciences, and the US National Institutes of Health.

Accuracy variation problem in an incremental magnetic encoder caused by surface flaws of electrodeposited measuring scales

This paper presents the direct relationship between the positioning accuracy of linear magnetic encoders and the surface flaws on their measuring scales. Measuring scales having recording media composed of electrodeposited Co-rich coatings are imprinted to form mimic surface flaws of particulate or stripe shapes. Effects of flaw sizes and stripe directions on the encoder positioning accuracy have been investigated. Benchmarked with an un-flawed scale which has an accuracy error of ± 2.0 μm in a 6.0 cm length, the flawed scales with a flaw width > 130 μm and a flaw depth > 4 ∼ 5 μm present accuracy variation in the 2-centimeter flaws regions on the measuring scales. Compared with particulate flaws, stripe flaws are more detrimental, especially the stripes being perpendicular (i.e., 90°) to the moving direction of read head. Accuracy variation behaviors due to surface flaws of electrodeposited measuring scales have been unambiguously demonstrated for long-length high-accuracy magnetic encoders.

Remnant salmon life history diversity rediscovered in a highly compressed habitat.

Chinook salmon (Oncorhynchus tshawytscha) display remarkable life history diversity, underpinning their ability to adapt to environmental change. Maintaining life history diversity is vital to the resilience and stability of Chinook salmon metapopulations, particularly under changing climates. However, the conditions that promote life history diversity are rapidly disappearing, as anthropogenic forces promote homogenization of habitats and genetic lineages. In this study, we use the highly modified Yuba River in California to understand if distinct genetic lineages and life histories still exist, despite reductions in spawning habitat and hatchery practicesthat have promoted introgression. There is currently a concerted effort to protect federally listed Central Valley spring-run Chinook salmon populations, given that few wild populations still exist. Despite this, we lack a comprehensive understanding of the genetic and life history diversity of Chinook salmon present in the Yuba River. To understand this diversity, we collected migration timing data and GREB1L genotypes from hook-and-line, acoustic tagging, and carcass surveys of Chinook salmon in the Yuba River between 2009 and 2011. Variation in the GREB1L region of the genome is tightly linked with run timing in Chinook salmon throughout their range, but the relationship between this variation and entry on spawning grounds is little explored in California's Central Valley. We found that the date Chinook salmon crossed the lowest barrier to Yuba River spawning habitat (Daguerre Point Dam) was tightly correlated with their GREB1L genotype. Importantly, our study confirms that ESA-listed spring-run Chinook salmon are spawning in the Yuba River, promoting a portfolio of life history and genetic diversity, despite the highlycompressed habitat. This work highlights the need to identify and protect this life history diversity, especially in heavily impacted systems,to maintain healthy Chinook salmon metapopulations. Without protection, we run the risk of losing the last vestiges of important genetic variation.

Coupled response of flow-induced vibration and flow-induced rotation of a circular cylinder with a triangular fairing

In this paper, a numerical simulation investigation is carried out on the coupled response of the flow-induced vibration (FIV) and flow-induced rotation (FIR) of a circular cylinder attached with a triangular fairing at a low Reynolds number of Re = 100. The primary focus is on the impact of FIR on FIV. The vibration response, hydrodynamic coefficient, vortex shedding mode, and flow field characteristics are examined for the fairings within the vibrational reduced velocity Ur range of 3–16 with shape angle of α = 45°, 60°, and 90°. The results reveal that at low Ur, all the three considered fairings have a good suppression effect on the FIV. Nevertheless, the galloping response emerges as Ur increases when α = 45° and 60°. In contrast, the vibration response of 90° fairing presents a wider lock-in region. The rotatable 2-degree of freedom (2-DoF) fairing has a better performance in the reduction of response amplitude and hydrodynamic coefficients. The 2S (two single vortices) vortex shedding mode mainly occurs in the vortex-induced vibration (VIV) region, while 2S–8S (from two to eight vortices), 2P (two pairs of vortices), 2T (two triplets of vortices), and P + T (a pair of vortices and a triple of vortices) modes emerge in the galloping branch. Moreover, four modes of wake structures are identified according to the variation of recirculation region and the migration of boundary layer separation point. Finally, the reduced regions of drag, lift, and amplitude are highlighted compared to the bare cylinder.

Exploring diverse aspects of celiac disease - A review

Celiac disease is a chronic inflammatory disorder triggered by the ingestion of gluten-containing foods in genetically susceptible individuals. This multifactorial disease has both genetic and environmental components, with gluten serving as the environmental trigger and specific genetic variations in the major histocompatibility complex region contributing to the genetic predisposition. Contrary to previous assumptions, celiac disease is not a rare disorder, with a global prevalence estimated at approximately 1%. However, it often remains under-recognized because many affected individuals do not exhibit the classic gastrointestinal symptoms associated with the condition. Instead, they may present with nonspecific manifestations of nutritional deficiencies or may be entirely asymptomatic. Celiac disease is associated with an increased incidence of autoimmune disorders, and its identification in asymptomatic or silent cases is crucial for managing associated conditions and preventing long-term complications such as lymphoma. The relationship between celiac disease and other autoimmune disorders, particularly type 1 diabetes, suggests a potential trigger role for gluten. In this article we review the development of celiac disease, including its types, pathogenesis, clinical features, and associated diseases or complications. We will also discuss available tests, treatments, and preventive approaches related to this subject.

Regional and socio-demographic variation in laboratory-based predictions of 10-year cardiovascular disease risk among adults in north and south India

ObjectiveCardiovascular disease (CVD) is the leading cause of morbidity and mortality in India. There is no laboratory-based CVD risk data among Indians from different regions and backgrounds. This study estimated laboratory-based 10-year CVD risk across different population sub-groups. MethodsData from UDAY derived from cross-sectional surveys of rural and urban populations of northern (Haryana) and southern (Andhra Pradesh) India were analysed. World Health Organization/International Society of Hypertension laboratory-based equations calculated 10-year CVD risk among participants without CVD history. Wilcoxon rank sum test analyzed average CVD risk across subgroups. Chi-square test compared population proportions in different CVD risk categories. Regression analysis assessed the association between CVD risk and participant characteristics. ResultsThe mean (SD) age of the participants (n = 8448) was 53.2 (9.2) years. Males in Haryana had increased CVD risk compared to those in Andhra Pradesh (p < 0.01). In both states, female gender was shown to have a protective effect on CVD risk (p < 0.01). Age correlated with increased risk (p < 0.01). Education level did not affect CVD risk however employment status may have. Hypertension, diabetes, hyperlipidemia, smoking, and insufficient exercise were associated with increased CVD risk (p < 0.01). Residence (urban versus rural) and wealth index did not largely affect CVD risk. ConclusionMinor differences exist in the distribution of laboratory-based CVD risk across Indian population cohorts. CVD risk was similar in urban wealthy participants and rural poor and working-class communities in northern and southern India. Public health efforts need to target all major segments of the Indian population to curb the CVD epidemic.

The nursing-midwifery workforce size significantly influences the reduction of neonatal mortality rate

PurposeThis study aimed to quantify the confounded and independent role of nursing-midwifery workforce size (NMWS) in protecting against neonatal mortality (NMR) globally and regionally. MethodsScatter plots, bivariate correlation, partial correlation, and multiple linear regression analyses were conducted to assess the correlations between NMWS and NMR. This cross-sectional study fully accounted for potential confounding effects of economic affluence, total fertility rate, and urbanization on this relationship. Countries were categorized to explore regional variations in the protective role of NMWS in reducing NMR. ResultsExplaining 55.76% of NMR variance worldwide, NMWS correlated to NMR negatively and significantly. NMWS still significantly correlated to NMR, but only explained 9.12% of NMR variance when the confounding effects of economic affluence, total fertility rate and urbanization were removed in partial correlation. Linear stepwise regression identified NMWS as the third most significant variable influencing NMR variance worldwide. NMWS correlated to NMR significantly and consistently in different country groupings, especially in developing countries. This suggested that nursing shortage is a significant global issue, but worse in developing countries. ConclusionsNMWS appears to have been a protective factor against NMR globally, particularly in developing nations. This protective effect remained significant even after adjusting for economic affluence, total fertility rate, and urbanization. The consistent negative correlations observed between NMWS and NMR, both globally and regionally, highlight the importance of addressing the chronic shortage of nursing and midwifery personnel, prompting healthcare authorities to prioritize this issue.

Using Data to Improve Healthcare: A Case Study of Pancreatic Enzyme Replacement in Pancreatic Cancer

ObjectivesIn the UK, guidelines recommend pancreatic enzyme replacement therapy (PERT) to all people with unresectable pancreatic cancer. In 2023, we published a national audit of PERT which showed suboptimal prescribing and wide regional variation in England. The aim of this manuscript was to describe how we used the PERT audit to drive improvements in healthcare. MethodsBuilding on the PERT audit, we deployed an online dashboard which will deliver ongoing updates of the PERT audit. We developed a collaborative intervention with cancer nurse specialists (CNS) to improve care delivered to people with pancreatic cancer. The intervention called Creating a natiOnAL CNS pancrEatic cancer network to Standardise and improve CarE (COALESCE) will use the dashboard to evaluate improvements in prescribing of PERT. ResultsWe demonstrated how large databases of electronic healthcare records (EHRs) can be used to improve cancer care. The PERT audit was implemented into a dashboard for tracking the progress of COALESCE. We will measure improvements in PERT prescribing as the intervention with CNS progresses. ConclusionsImproving healthcare is an ongoing and iterative process. By implementing the PERT dashboard, we created a resource-efficient, automated evaluation method enabling COALESCE to deliver a sustainable change. National-scale databases of EHRs enable rapid cycles of audits, providing regular feedback to interventions, working systematically to deliver change. Here, the focus is on pancreatic cancer. However, this methodology is transferable to other areas of healthcare. Implications for Nursing PracticeNurses play a key role in collecting good quality data which are needed in clinical audits to identify shortcomings in healthcare. Nurse-driven interventions can be designed to improve healthcare. In this study, we capitalize on the unique role of CNS coordinating care for every patient with cancer. COALESCE is the first national collaborative study which uses CNS as researchers and change agents.

How does digital inclusive finance affect energy justice? Evidence from China

This study investigates the impact of digital inclusive finance (DIF) on energy justice (EJ) and examines its underlying mechanisms as well as the moderating role of financial supervision (FS), using panel data from 30 Chinese provinces during 2011–2021. The findings indicate that DIF promotes EJ, particularly in recognition, procedural, and restorative justice. Digital technology innovation and energy structure upgrading are two important pathways through which DIF affect EJ. DIF's impact on EJ is positively moderated by FS. The current level of FS is within an optimal range, maximizing the positive effect of DIF on EJ. Significant regional variations are observed in the moderating effects of FS.

Exploring the feasibility of multi-elements coupled with chemometrics for discriminating the geographical origins of oysters (Crassostrea ariakensis)

This study explored the efficacy of multi-elements combined with chemometrics to discriminate the geographical origins of oysters (Crassostrea ariakensi). We determined 52 elements in 166 samples from four regions along the southeast coast of China. Significant regional variations of 51 elements were revealed (P < 0.05), while the principal component analysis (PCA) provided no clear regional delineations. The training models (n = 117) established on linear discriminant analysis (LDA), partial least square discriminant analysis (PLS-DA), and random forest (RF) uniformly achieved 100% predictive accuracy. The cross-validation accuracies of the final models (n = 166) derived from LDA, PLS-DA, and RF were 100%, 100%, and 99.4%, respectively. Even with the models simplified to 8 elements (Zn, Al, K, Cd, Cu, Rb, B, and Ag), high predictive and cross-validation accuracies were maintained, underscoring the robustness and algorithm flexibility of elemental profiling for accurately identifying the geographical origins of oysters.

Frequency of Duffy, Kidd, Lewis, and Rh Blood Group Antigens and Phenotypes Among Donors in the Al-Ahsa Region, Saudi Arabia.

In Al-Ahsa, Saudi Arabia, the high consanguinity rates contribute to the prevalence of inherited hemoglobinopathies such as sickle cell disease and thalassemia, which frequently require blood transfusions. These transfusions carry the risk of alloimmunization, necessitating a precise blood component matching to mitigate health risks. Local antigen frequency data is vital for optimizing transfusion practices and enhancing the safety of these medical procedures for the Al-Ahsa population. This study investigated the distribution of Duffy, Kidd, Lewis, and Rh blood group antigens in 1,549 individuals from the region; comparing the frequencies with global data. Serological analyses revealed a high prevalence of the Fy(a+b-) and Jk(a+b+) phenotypes in the Duffy and Kidd blood groups, respectively, with Jk(a-b-) being notably scarce. The Lewis blood group exhibited a significant presence of Le(a-b+) and Le(a+b-) phenotypes, whereas Le(a+b+) was less common. In the Rh system, the D antigen was most prevalent, with other antigens following in descending order of frequency. The study underscores the regional variation in antigen frequencies, emphasizing the need for local blood banks to adapt their screening and matching practices to mitigate the risk of alloimmunization and enhance transfusion safety. These findings are pivotal for refining transfusion strategies and understanding the immunohematology landscape in Al-Ahsa.

Research on the carbon reduction effect of regional industrial transfer in China -- based on the perspective of factor flow

Industrial transfer plays a crucial role in regional carbon reduction efforts in China. This study conducted a systematic analysis of the carbon reduction impact of industrial transfer, focusing on factor flow, and performed empirical tests using Chinese provincial data from 2003 to 2019 with a spatial regression model. The key findings are as follows: (1) Industrial transfer significantly influences carbon emissions, with varying effects depending on the factor flow. Capital and technology flows contribute to carbon emission reduction, while labor flow generally has a negligible impact. (2) Over time, the environmental impact of capital and technology flows intensifies, whereas the influence of labor flow diminishes. (3) Regional variations exist in the impact of industrial transfer on carbon emissions based on the factor flow perspective.

Seasonal variation and preoperative risk factors for polymicrobial infection following open fracture

IntroductionDespite modern approaches to open fracture management, fracture-related infection (FRI) rates remain high. Recent studies demonstrated the seasonal and regional variation of causative organisms in FRI. This study aims to better understand the causative organisms and identify preoperative risk factors for the primary outcome of FRIs at a Level I trauma center. Materials and methodsThis retrospective cohort study examined all patients that underwent irrigation and debridement of an open fracture at a single Level I trauma center between 2007 and 2019. Exclusion criteria included gunshot wounds, hand injuries, and follow-up less than 3 months. Patients that developed FRI were compared by season, injury characteristics, patient demographics, initial management, and causative organisms. ResultsAmong 695 patients with open fractures, 78 patients (11.2 %) developed infection, of which eight were Gustilo-Anderson (GA) Type I, 16 were GA Type II, 25 were GA Type IIIA, 26 were GA Type IIIB, and three were GA Type IIIC. Gram-positive FRIs were most common (81.1 %), followed by 56.8 % polymicrobial, 54.1 % gram-negative, and 10.1 % culture-negative infections. More than half (55.1 %) of the infections were from open tibial fractures and occurred after a motorcycle (32.1 %) or motor vehicle collision (23.1 %). Patients were more likely to have high FRI rates in the summer (12.8 %, n = 29) and fall (15.8 %, n = 32) in comparison of spring (4.7 %, n = 7) and winter (8.5 %, n = 10) (p < 0.01). Staphylococcus infections were more common in fall and winter (73.8 %, n = 31) versus spring and summer (44.4 %, n = 16) (p = 0.01). Patients that were transferred from outside hospitals had significantly higher rates of polymicrobial infection when compared to those who arrived from the field (63.6 % vs 41.2 %, p = 0.03). No differences were observed in infection causative organisms based on GA type. ConclusionsTwo preoperative risk factors for polymicrobial infection following open fracture include inter-hospital transfers and warm/humid weather. Broadening antibiotic prophylaxis during spring/summer months or for transferred patients may enhance antibiotic coverage and reduce infections.

Air Quality Monitoring and the Safety of Farmworkers in Wildfire Mandatory Evacuation Zones.

The increasing frequency and severity of wildfires due to climate change pose health risks to migrant farm workers laboring in wildfire-prone regions. This study focuses on Sonoma County, California, investigating the effectiveness of air monitoring and safety protections for farmworkers. The analysis employs AirNow and PurpleAir PM2.5 data acquired during the 2020 wildfire season, comparing spatial variability in air pollution. Results show significant differences between the single Sonoma County AirNow station data and the PurpleAir data in the regions directly impacted by wildfire smoke. Three distinct wildfire pollution episodes with elevated PM2.5 levels are identified to examine the regional variations. This study also examines the system used to exempt farmworkers from wildfire mandatory evacuation orders, finding incomplete information, ad hoc decision-making, and scant enforcement. In response, we make policy recommendations that include stricter requirements for employers, real-time air quality monitoring, post-exposure health screenings, and hazard pay. Our findings underscore the need for significant consideration of localized air quality readings and the importance of equitable disaster policies for protecting the health of farmworkers (particularly those who are undocumented migrants) in the face of escalating wildfire risks.

GIS-based spatiotemporal mapping of malaria prevalence and exploration of environmental inequalities

Malaria poses a significant threat to global health, with particular severity in Nigeria. Understanding key factors influencing health outcomes is crucial for addressing health disparities. Disease mapping plays a vital role in assessing the geographical distribution of diseases and has been instrumental in epidemiological research. By delving into the spatiotemporal dynamics of malaria trends, valuable insights can be gained into population dynamics, leading to more informed spatial management decisions. This study focused on examining the evolution of malaria in Nigeria over twenty years (2000–2020) and exploring the impact of environmental factors on this variation. A 5-year-period raster map was developed using malaria indicator survey data for Nigeria’s six geopolitical zones. Various spatial analysis techniques, such as point density, spatial autocorrelation, and hotspot analysis, were employed to analyze spatial patterns. Additionally, statistical methods, including Principal Component Analysis, Spearman correlation, and Ordinary Least Squares (OLS) regression, were used to investigate relationships between indicators and develop a predictive model. The study revealed regional variations in malaria prevalence over time, with the highest number of cases concentrated in northern Nigeria. The raster map illustrated a shift in the distribution of malaria cases over the five years. Environmental factors such as the Enhanced Vegetation Index, annual land surface temperature, and precipitation exhibited a strong positive association with malaria cases in the OLS model. Conversely, insecticide-treated bed net coverage and mean temperature negatively correlated with malaria cases in the same model. The findings from this research provide valuable insights into the spatiotemporal patterns of malaria in Nigeria and highlight the significant role of environmental drivers in influencing disease transmission. This scientific knowledge can inform policymakers and aid in developing targeted interventions to combat malaria effectively.

Gender Attitudes Within and Between European Countries: Regional Variations Matter

Gender Attitudes Within and Between European Countries: Regional Variations Matter

Drivers of Environmental Sustainability in the Wine Industry: A Life Cycle Assessment Approach

The primary aim of this study is to conduct a comprehensive review of the existing literature to identify the most relevant environmental variables and other factors influencing the life cycle assessment of the wine industry. This research seeks to determine whether the type of wine significantly impacts the carbon footprint and to highlight the importance of production strategies over wine typology or grape variety in reducing greenhouse gas emissions. This review encompasses an extensive analysis of previous studies on the environmental impact of wine production. This method involves synthesizing findings from life cycle inventory assessments to identify key variables contributing to greenhouse gas emissions. This analysis also considers regional variations and the effectiveness of different production strategies in mitigating environmental impacts. This review indicates that wine typology (red or white) and grape variety are less significant in determining the carbon footprint than the production strategies employed. It identifies specific variables that contribute substantially to greenhouse gas emissions in wine production. The analysis highlights the need for standardized assessment methods to ensure accurate determination of influential factors in reducing emissions. This study concludes that achieving environmental sustainability in the wine industry requires a balanced approach that integrates environmental, economic, and social aspects. It emphasizes the necessity of developing standardized and universal strategies for assessing wine sustainability. The application of artificial intelligence is proposed as a crucial tool for improving data gathering, trend analysis, and formulating customized sustainability strategies for different wine regions. Addressing the challenges of sustainability in the wine industry is imperative for environmental preservation and the wellbeing of future generations.