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Background: India stands second for Smartphone usage in the world according to “global market” report. Smartphone addiction affects the younger generations to a greater extent. The objectives of the study was to estimate the proportion of students of age 18–24 years who were addictive to their Smartphone, to estimate the average time spent by them, to find the main reasons for usage and also to find the association between Smartphone usages and sleep quality of the students. Method: A cross sectional community based study was done in Ayapakkam, Thiruvallur district, Tamil Nadu. Two stage cluster sampling methodology was employed for selecting a random sample of 139 students. In the first stage 4 clusters were selected based on the more populous clusters and in the second stage a minimum of 35 students were interviewed from each of the selected cluster. Smartphone Addiction Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were the tools used for assessing the association of Smartphone addiction and sleep quality of the students. Data was collected using tablet and Epicollect 5 web application. Descriptive statistics, Chi-Square for association and t-test to determine whether there exists significant difference between the means of two groups was assessed. Results: The proportion of students who were addict to their Smartphone was 52.7% and among them it was more in males (66.2%). On an average 6.42 hours/day was spent on their Smartphone. The major reason behind using their Smartphone was for communication (5.03 hours/day). The association between SAS and PSQI were found to be highly significant (χ² = 11.035, p-value < 0.01). Conclusions: It is an alarming sign that students are prone to addiction to Smartphone. The younger generation must be brought awareness about their Smartphone addiction and heath impact they are prone in due course of time. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have shown that haemodialysis (HD) patients frequently suffer from xerostomia. This problem is associated with difficulties in oral functions, increased risk of oral diseases and interdialytic weight gain (IDWG). The aims of this preliminary study are to evaluate the efficacy and safety of topical dry mouth products in treating xerostomia in HD patients and their impact in reducing IDWG. Materials and Methods: We included 25 HD patients that suffered from xerostomia and complied with inclusion criteria. Subjects received toothpaste, mouthwash and mouth gel for dry mouth. The duration of treatment was 4 weeks. Patients filled out a visual analogue scale (VAS) for xerostomia and Oral Heath Impact Profile (OHIP)-14 questionnaires. Clinical data and IDWG were collected of the medical history of HD patients. Questionnaires and IDWG were collected at baseline, 2 and 4 weeks post-treatment. Results: Twenty-five patients completed the study (56% male and 44% female). The mean age was 63.52 ± 12.50 years. The topical treatment statistically significantly (p = 0.0001) alleviated the symptoms of xerostomia and improved their quality of life (OHIP-14 scores) (p = 0.0001). We observed a statistically significantly IDWG (kg) and IDWG% reduction (p = 0.03) after the use of topical treatment for xerostomia. None of the patients reported side effects. Conclusions: Xerostomia might affect the quality of life and increase the IDWG of these patients. The daily use of topical treatment for xerostomia could decrease thirst and IDWG, improving the quality of life of HD patients. Future randomised studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

Aim: The aim of this 1-year prospective cohort study was to evaluate the outcomes and complications of immediately loaded mini dental implants used for stabilizing mandibular overdentures in edentulous patients wearing conventional complete dentures. Materials and methods: Thirty patients received mandibular conventional complete dentures that were subsequently retained by 4 immediately loaded mini dental implants placed in the interforaminal region. Overdenture success, implant success and biological and prosthetic complications were evaluated after the first year of service. Quality of life using the Oral Heath Impact Profile (OHIP)- EDENT test, satisfaction with dental prosthesis and chewing efficiency using questionnaires and a Visual Analogue Scale (VAS) were evaluated twice: after they had received mandibular complete dentures, and again after they had received mandibular overdentures. Results: After 1 year, no overdenture failed and 2 implants did not osseointegrate, resulting in a 98.3% success rate for loaded implants and 95.9% for total implants used (3 out of 123 were not loaded due to fracture). A flap surgical approach was performed in 7 patients, 3 implants fractured during insertion, 3 overdentures fractured, occlusion balancing was necessary for 11 dentures and relining for 8. Implant rehabilitation provided significant improvement in quality of life, stability, comfort, chewing and speaking ability while no significant differences were found in quality of maintenance of hygiene and for aesthetics. Conclusions: Mini dental implant retained overdentures can be a successful therapeutic procedure for treating mandibular edentulism that improves quality of life, patient satisfaction and chewing ability in patients wearing maxillary dentures. Longer follow-ups are needed to validate this therapy in the medium and long-term. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate the contamination state of the surface soil from 10 parks from Galati, Romania, and the health hazards of the soil. The soil samples, collected in each site from the playing ground and from the edge of the park, were analyzed by using combined Wavelength- (WDXRF) and Energy-Dispersive (EDXRF) X-ray fluorescence techniques. A total number of 27 chemical elements (Ag, Al, As, Ba, Ca, Cd, Cr, Co, Cu, Fe, Hg, K, Mg, Mn, Na, Ni, P, Pb, Rb, Sb, Sc, Sn, Sr, Ti, V, Zn and Zr) were quantified in the urban soils, and the results were compared to the normal and alert values from Romanian legislation for toxic trace elements, as well as with European and world average values of element concentrations. The mineralogical analyses were performed by Scanning Electron Microscopy with Energy-Dispersive X-ray Analysis (SEM-EDX) and the Attenuated Total Reflectance–Fourier Transform Infrared technique (ATR-FTIR). To assess the soil contamination and the impact on human health of the presence of potential toxic elements and heavy metals in the soil, a series of pollution and health risk indices were used. All the results indicated an unpolluted to moderately polluted soil. The soil samples collected from the edge of the parks presented higher values for the specific pollutants, which originated from heavy traffic, such as Cu, Cr, Zn and Pb. The non-carcinogenic and carcinogenic risk to children was assessed using estimated daily intake (EDI) in relation to the pathways whereby pollutants can enter the human body, such as ingestion, dermal contact, inhalation and vaporization. Using the obtained values for EDI, the hazard quotient and hazard index were determined, which strengthen the formerly issued presumption that soil pollution is moderate and, by itself, does not present any threat to children's health. [ABSTRACT FROM AUTHOR]

Background: Studies assessing the benefits of outpatient parenteral antimicrobial therapy (OPAT) have paid less attention to patient-centered factors such as patients' experiences and their health-related quality of life (HRQoL). Research design and methods: Prospective before-and-after quasi-experimental study enrolled adult patients receiving OPAT at a tertiary hospital in Derbyshire, UK, between October 2022 and October 2023. Consenting patients completed paired EQ-5D-3 L questionnaires before OPAT initiation and upon completion of therapy or 30 days after its commencement (whichever occurred first). Changes and predictors of change in HRQoL indicators and associations with clinical outcomes (treatment failure, adverse events, and 30-day unplanned readmission) were examined. Results: Health state index and visual analogue scale (EQ VAS) scores of 162 enrolled patients at baseline were significantly lower than the UK population averages, but the patients experienced significant improvements in both scores and in four EQ-5D dimensions (mobility, self-care, usual activities, and pain/discomfort). Baseline health index and EQ VAS scores were significant independent predictors of positive changes in HRQoL scores. Conclusions: OPAT is associated with improved patient-reported quality of life and facilitates early return to work or school. Nevertheless, it is crucial to closely monitor patients with a lower baseline quality of life to optimize their overall OPAT experience. [ABSTRACT FROM AUTHOR]

Background: Violence by mothers-in-law, as well as husbands, is a recognised problem in many countries. It has been given little attention in research on violence and its importance as a health problem, and aggravator of husband violence, has not been well established. Our aim was to describe patterns and the frequency of mother-in-law and sibling-in-law/sibling physical violence in relation to physical violence from husbands, and to describe risk characteristics and associated health behaviours of women with different abuse exposures. Methods: 1,463 women aged 18–48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 6 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses bi-variable and multivariable logistic regression. Results: 932 of the women were currently married. Of these, 14% of women experienced mother-in-law physical violence and 23.2% of women experienced physical spousal violence in the previous 12 months. For 7.0% of women, these exposures were combined. Physical violence was associated with food insecurity and having to borrow for food, being in a polygamous marriage, living with their mother-in-law, as well as province of residence (higher in Nangarhar). Women who had earnings were relatively protected. Whilst most mothers-in-law were described in positive terms, those who used physical violence were much less likely to be described so and a quarter were described as very strict and controlling and 16.8% as cruel. Overall slightly more women described their husband in positive terms than their mother-in-law, but there was a very strong correlation between the way in which husbands were perceived and the violence of their mothers. Women’s mental health (depression, suicidal thoughts and PTSD symptoms score), self-rated general health, disability and beating of their children were all strongly associated with intimate partner violence (IPV) exposure. The strength of the association was much greater for all of these problems if the IPV was combined with physical violence from a mother-in-law or sibling-in-law/sibling. Experienced alone, violence from the mother-in-law or a sibling-in-law/sibling was associated with an elevated risk of all of these problems except depression. Interpretation: Mother-in-law and sibling-in-law/sibling physical violence is an appreciable problem among the women studied in Afghanistan, linked to poverty. It has a major impact on women’s health, componding the heath impact of IPV. In this setting conceptualising women’s risk and exposure to violence at home as only in terms of IPV is inadequate and the framing of domestic violence much more appropriately captures women’s risks and exposures. We suggest that it may be fruitful for many women to target violence prevention at the domestic unit rather than just at women and their husbands. [ABSTRACT FROM AUTHOR]

Introduction: Evidence‐based intervention strategies to improve adherence among individuals living with chronic conditions are critical in ensuring better outcomes. In this systematic review, we assessed the impact of interventions that aimed to promote adherence to treatment for chronic conditions. Methods: We systematically searched PubMed, Web of Science, Scopus, Google Scholar and CINAHL databases to identify relevant studies published between the years 2000 and 2023 and used the QUIPS assessment tool to assess the quality and risk of bias of each study. We extracted data from eligible studies for study characteristics and description of interventions for the study populations of interest. Results: Of the 32,698 total studies/records screened, 2814 were eligible for abstract screening and of those, 497 were eligible for full‐text screening. A total of 82 studies were subsequently included, describing a total of 58,043 patients. Of the total included studies, 58 (70.7%) were related to antiretroviral therapy for HIV, 6 (7.3%) were anti‐hypertensive medication‐related, 12 (14.6%) were anti‐diabetic medication‐related and 6 (7.3%) focused on medication for more than one condition. A total of 54/82 (65.9%) reported improved adherence based on the described study outcomes, 13/82 (15.9%) did not have clear results or defined outcomes, while 15/82 (18.3%) reported no significant difference between studied groups. The 82 publications described 98 unique interventions (some studies described more than one intervention). Among these intervention strategies, 13 (13.3%) were multifaceted (4/13 [30.8%] multi‐component health services‐ and community‐based programmes, 6/13 [46.2%] included individual plus group counselling and 3/13 [23.1%] included SMS or alarm reminders plus individual counselling). Discussion: The interventions described in this review ranged from adherence counselling to more complex interventions such as mobile health (mhealth) interventions. Combined interventions comprised of different components may be more effective than using a single component in isolation. However, the complexity involved in designing and implementing combined interventions often complicates the practicalities of such interventions. Conclusions: There is substantial evidence that community‐ and home‐based interventions, digital health interventions and adherence counselling interventions can improve adherence to medication for chronic conditions. Future research should answer if existing interventions can be used to develop less complicated multifaceted adherence intervention strategies. [ABSTRACT FROM AUTHOR]

There has been great concern about mold in school environments, but few comprehensive assessments of mold have been performed in such settings. Even spore counts or microscopic enumeration only may not be sufficient for evaluating fungal exposure. We explored the levels of submicron fungal fragments with potential heath impact due to their small size in elementary schools and investigated the variation in the concentrations of such particles before and after the rainy season. The concentrations of (1,3)-β-d-glucan in submicron fungal fragments, airborne mold and bacteria, and PM10 were measured both indoors and outdoors in 70 classrooms at 8 elementary schools from May (before the rainy season) to July (after the rainy season) in 2012. Temperature and relative humidity were also monitored. We compared the levels of submicron fungal fragments among schools before and after the rainy season. The associations of the levels of submicron fungal fragments with other variables were analyzed. Overall, the concentrations of (1,3)-β-d-glucan ranged from 10 to 347 pg m−3, and the indoor/outdoor ratios were greater than 1 in every school. After the rainy season, the (1,3)-β-d-glucan concentrations decreased by about 35%, and similar significant decreases in the concentrations of airborne mold and bacteria and PM10 were observed. This difference was prominent for PM10 (P ＜ 0.001). Only relative humidity was negatively associated with the concentration of submicron fungal fragments (P = 0.007). Our findings confirmed the comparable amounts of submicron fungal fragments in school environments. More comprehensive exposure assessments for smaller-sized fungal particles should be performed for better understanding of their health impact, particularly with regard to seasonal changes. [ABSTRACT FROM AUTHOR]

Air pollutants from biomass burning, including forest fires and agricultural trash burning, have contributed significantly to the pollution of the Asian atmosphere. Burned area estimates are variable, making it difficult to measure these emissions. Improving emission quantification of these critical air pollution sources requires refining methods and collecting thorough data. This study estimates air pollutants from biomass burning, including PMs, NOX, SO2, BC, and OC. Machine learning (ML) with the Random Forest (RF) method was used to assess burned areas in Google Earth Engine. Forest emissions were highest in the upper north and peaked in March and April 2019. Air pollutants from agricultural waste residue were found in the lower north, but harvesting seasons made timing less reliable. Biomass burning was compared to the MODIS aerosol optical depth (AOD) and Sentinel-5P air pollutants, with all comparisons made by the Pollution Control Department (PCD) Thailand air monitoring stations. Agro-industries, mainly sugar factories, produce air pollutants by burning bagasse as biomass fuel. Meanwhile, the emission inventory of agricultural operations in northern Thailand, including that of agro-industry and forest fires, was found to have a good relationship with the monthly average levels of ambient air pollutants. Overall, the information uncovered in this study is vital for air quality control and mitigation in northern Thailand and elsewhere. [ABSTRACT FROM AUTHOR]

Emissions from flaring and venting (FV) in oil and gas (O&G) production are difficult to quantify due to their intermittent activities and lack of adequate monitoring and reporting. Given their potentially significant contribution to total emissions from the O&G sector in the United States, we estimate emissions from FV using Visible Infrared Imaging Radiometer Suite satellite observations and state/local reported data on flared gas volume. These refined estimates are higher than those reported in the National Emission Inventory: by up to 15 times for fine particulate matter (PM2.5), two times for sulfur dioxides, and 22% higher for nitrogen oxides (NOx). Annual average contributions of FV to ozone (O3), NO2, and PM2.5 in the conterminous U.S. (CONUS) are less than 0.15%, but significant contributions of up to 60% are found in O&G fields with FV. FV contributions are higher in winter than in summer months for O3 and PM2.5; an inverse behavior is found for NO2. Nitrate aerosol contributions to PM2.5 are highest in the Denver basin whereas in the Permian and Bakken basins, sulfate and elemental carbon aerosols are the major contributors. Over four simulated months in 2016 for the entire CONUS, FV contributes 210 additional instances of exceedances to the daily maximum 8‐hr average O3 and has negligible contributions to exceedance of NO2 and PM2.5, given the current form of the national ambient air quality standards. FV emissions are found to cause over $7.4 billion in health damages, 710 premature deaths, and 73,000 asthma exacerbations among children annually. Plain Language Summary: Pollutant emissions from onshore flaring and venting activities in the oil and gas sector are often hard to capture, creating inaccuracies in estimates of air pollution and health impacts from this sector. Here we use remote sensing and reported activity to create a refined estimate of emissions which reveal significant underestimates in official emissions estimates. These emissions contribute to air pollution, which results in $7.4 billion in health damages annually due to hospitalizations, emergency room visits, worsening asthma, and premature death among downwind populations. Key Points: A new satellite‐based emissions inventory for oil and gas flaring and venting is developed to refine existing U.S. emissions inventories710 premature deaths dominate the $7.3B monetized values of health impacts due to this sectorSignificant benefits in air quality and health could be gained by reducing emissions from flaring and venting activities [ABSTRACT FROM AUTHOR]

Aim To determine the associations between endodontic factors and oral health-related quality of life ( OHQoL), controlling for socio-demographics, pain and other oral health clinical factors. Methodology OHQoL assessments were conducted amongst a consecutive sample of 412 Chinese patients requiring endodontic treatment employing the short-form Oral Heath Impact Profile ( OHIP-14). Information on (i) number of teeth requiring endodontic treatment, (ii) tooth type, (iii) retreatment requirements, (iv) periapical radiolucency assessment and (v) diagnostic classification was obtained. In addition, socio-demographic information (age, gender, educational attainment and family income), pain ratings on a visual analogue scale ( VAS) and other clinical oral health status information were collected. Results Bivariate analyses identified association between number of teeth requiring endodontic treatment and summary OHIP-14 score ( P < 0.01) and four of its seven domain scores ( P < 0.05). Need for endodontic retreatment was associated with summary OHIP-14 score ( P < 0.05) and two of its seven domain scores ( P < 0.05). In regression analyses having controlled for socio-demographics, other clinical factors and pain rating amongst 15 confounding variables, patients requiring endodontic treatment for multiple teeth were more than twice as likely to have poor OHQoL (upper quintile OHIP-14 scores) compared with those requiring endodontic treatment for a single tooth ( OR = 2.16, 95% CI 1.17, 3.98, P < 0.05). Pain VAS rating and age also emerged as significant factors associated with poor OHQoL in the regression analysis. Conclusion OHQoL is compromised amongst patients requiring endodontic treatment. Number of teeth requiring endodontic treatment is associated with poor OHQoL, controlling for socio-demographic and other oral health clinical and pain factors. [ABSTRACT FROM AUTHOR]

What's known on the subject? and What does the study add? The link between inflammation and cancer has long been reported and inflammation is thought to play a role in the pathogenesis of many cancers, including prostate cancer ( PrCa). Over the last 5 years, genome-wide association studies ( GWAS) have reported numerous susceptibility loci that predispose individuals to many different traits., The present study aims to ascertain if there are common genetic risk profiles that might predispose individuals to both PrCa and the autoimmune inflammatory condition, rheumatoid arthritis. These results could have potential public heath impact in terms of screening and chemoprevention., Objectives To investigate if potential common pathways exist for the pathogenesis of autoimmune disease and prostate cancer ( PrCa)., To ascertain if the single nucleotide polymorphisms (SNPs) reported by genome-wide association studies ( GWAS) as being associated with susceptibility to PrCa are also associated with susceptibility to the autoimmune disease rheumatoid arthritis ( RA)., Materials and Methods The original Wellcome Trust Case Control Consortium ( WTCCC) UK RA GWAS study was expanded to include a total of 3221 cases and 5272 controls., In all, 37 germline autosomal SNPs at genome-wide significance associated with PrCa risk were identified from a UK/Australian PrCa GWAS., Allele frequencies were compared for these 37 SNPs between RA cases and controls using a chi-squared trend test and corrected for multiple testing ( Bonferroni)., Results In all, 33 SNPs were able to be analysed in the RA dataset. Proxies could not be located for the SNPs in 3q26, 5p15 and for two SNPs in 17q12., After applying a Bonferroni correction for the number of SNPs tested, the SNP mapping to CCHCR1 (rs130067) retained statistically significant evidence for association ( P = 6 × 10-4; odds ratio [ OR] = 1.15, 95% CI: 1.06-1.24); this has also been associated with psoriasis., However, further analyses showed that the association of this allele was due to confounding by RA-associated HLA-DRB1 alleles., Conclusions There is currently no evidence that SNPs associated with PrCa at genome-wide significance are associated with the development of RA., Studies like this are important in determining if common genetic risk profiles might predispose individuals to many diseases, which could have implications for public health in terms of screening and chemoprevention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Indoor air pollutants (IAPs) cause multiple health impacts. Prioritizing mitigation options that differentially affect individual pollutants and comparing IAPs with other environmental health hazards require a common metric of harm. OBJECTIVES: Our objective was to demonstrate a methodology to quantify and compare health impacts from IAPs. The methodology is needed to assess population health impacts of large-scale initiatives--including energy efficiency upgrades and ventilation standards--that affect indoor air quality (IAQ). METHODS: Available disease incidence and disease impact models for specific pollutant-disease combinations were synthesized with data on measured concentrations to estimate the chronic heath impact, in disability-adjusted life-years (DALYs) lost, due to inhalation of a subset of IAPs in U.S. residences. Model results were compared with independent estimates of DALYs lost due to disease. RESULTS: Particulate matter ≥ 2.5 &µm in aerodynamic diameter (PM2.5), acrolein, and formaldehyde accounted for the vast majority of DALY losses caused by IAPs considered in this analysis, with impacts on par or greater than estimates for secondhand tobacco smoke and radon. Confidence intervals of DALYs lost derived from epidemiology-based response functions are tighter than those derived from toxicology-based, interspecies extrapolations. Statistics on disease incidence in the United States indicate that the upper-bound confidence interval for aggregate IAP harm is implausibly high. CONCLUSIONS: The approach demonstrated in this study may be used to assess regional and national initiatives that affect IAQ at the population level. Cumulative health impacts from inhalation in U.S. residences of the IAPs assessed in this study are estimated at 400-1,100 DALYs lost annually per 100,000 persons. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to undertake a critical appraisal of oral health-related quality of life (OHRQoL) measurements used for research in the elderly. Background: A variety of OHRQoL measurements have been developed in the past 20 years as a result of increased concern about the impact of oral conditions on a person’s quality of life. There is need for an assessment aimed at prioritising the recommended measurements to be used for different purposes in the elderly. Materials and methods: Original English language papers using measurements to assess OHRQoL in the elderly were identified from Web of Science, EMBASE, PubMed, Medline and Lilacs databases. The search included all papers published from 1985 to February 2007. The criteria of assessment were: (i) measurement criteria (number of items and domains, and classification of the results found for each measurement); (ii) quantitative–qualitative criteria (frequency, acceptability, reproducibility, reliability, sensitivity and capability of being reproduced in other language versions). Results: In a total of 152 papers selected, 20 measurements were identified. However, only seven fulfilled all the measurement and quantitative–qualitative criteria. Conclusion: Geriatric Oral Health Assessment Index, Subjective Oral Health Status Indicators, Oral Health Impact Profile-49, Dental Impact on Daily Living, Oral Health Impact Profile-14, Oral Impact on Daily Performances and German Version of the Oral Heath Impact Profile were considered as instruments of choice to assess OHRQoL in the elderly. The other 13 instruments identified require further research aimed at a validation process and the use of a language other than English. [ABSTRACT FROM AUTHOR]

Purpose To estimate the net cardiovascular (CV) (coronary heart disease, stroke, congestive heart failure), and gastrointestinal (GI) (peptic ulcer complications) risk-benefit public health impact of the use of celecoxib compared to non-selective NSAIDs in the arthritis population. Methods We applied discrete event simulation models to data from the US National Health Surveys, CV risk-prediction models from the Framingham Heart Study, and population-based studies. Models took into account the multifactorial effect of risk factors, comorbidity, and competing risk of mortality. We simulated the natural history of CV and GI disease in the U.S. arthritis population over 1 year, through the individual baseline cardiovascular and gastrointestinal risk profile. This model was modified with relative risks associated with the use of each treatment. The mean number of events was estimated for each end-point in each model: natural history, celecoxib, diclofenac, ibuprofen, naproxen. The number of events for celecoxib was compared with each NSAID. Results The evaluation included 1% of the U.S. population with arthritis. Celecoxib, when applied to 100 000 patients over 1 year, resulted in 570 (range from sensitivity analysis: 440-691), 226 (124-313), and 746 (612-868) fewer ulcer complications than diclofenac, ibuprofen, and naproxen, respectively. There were 20 (16-25), 8 (4-12), and 27 (22-32) fewer deaths from ulcer complications, respectively. No increase in cardiovascular events or all cause mortality was observed for celecoxib versus the other individual NSAIDs. Conclusion Results from these simulations suggest a gastrointestinal benefit for celecoxib not offset by increased cardiovascular events or mortality. The methodology used here provides a risk-benefit assessment framework for evaluating the public heath impact of drugs. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

This study has suggested an occupational exposure limit (OEL) based on the co-exposure approach in an iron-foundry industry. Respirable dust was collected in an iron casting industry using the NIOSH 0600 method. The DNA damage was obtained by comet assay. The lower confidence interval of the benchmark dose (BMDL) was employed for exposure limit evaluation. The estimated BMDL of the cell line was extrapolated to human subjects. Based on the Hill model, a BMDL 1.65 µg for chemical mixture has been estimated for the A549 cell line. According to uncertainty factors, permitted daily exposure (PDE) was predicted in humans. However, PDE of 3.9 μg/m3 was specified as the time-weighted average limit for toxic respirable dust in the casting industry. In this study, OEL for active respirable dust in the casting industry has been proposed. The industry-based standard for active respirable dust has been proposed for better management of co-exposure. [ABSTRACT FROM AUTHOR]

Unique within the recent history of environmental hazards, eastern Ukraine illustrates the dangers arising from conflict in an urban landscape heavily modified by human action (including coal extraction and nuclear testing) and requiring active management. To analyze these dynamics and their implications, we examine industrialization in the Donbas region and warfare-accelerated environmental risks. Using primary data and ethnographic interviewing, we compare responses by state and international institutions tasked with monitoring and environmental redress in the context of larger mandates, noting widespread shortfall. This article contributes to emergent environment and warfare related literature by exploring how actors with divergent goals coalesce in downgrading environmental concerns, despite increasing risks, motivation to assist, and widening impact across country and continental divides. Significant for the study of small wars, a lack of international political will for 'forgotten conflicts' increases the likelihood of shared environmental risks being treated as simply another policy item to be negotiated. However, environmental disasters routinely cross international borders and pose long-lasting, compounding harm to direct, indirect, and even uninvolved parties. Furthermore, such dynamics may increasingly characterize warfare as urbanization and industrialization continue their global spread, with active war-time environmental management ushering in profound challenges and new areas of needed expertise. [ABSTRACT FROM AUTHOR]

Background: Chikungunya is associated with high morbidity and the natural history of symptomatic infection has been divided into three phases (acute, post-acute, and chronic) according to the duration of musculoskeletal symptoms. Although this classification has been designed to help guide therapeutic decisions, it does not encompass the complexity of the clinical expression of the disease and does not assist in the evaluation of the prognosis of severity nor chronic disease. Thus, the current challenge is to identify and diagnose musculoskeletal disorders and to provide the optimal treatment in order to prevent perpetuation or progression to a potentially destructive disease course. Methods: The study is the first product of the Clinical and Applied Research Network in Chikungunya (REPLICK). This is a prospective, outpatient department-based, multicenter cohort study in Brazil. Four work packages were defined: i. Clinical research; ii) Translational Science – comprising immunology and virology streams; iii) Epidemiology and Economics; iv) Therapeutic Response and clinical trials design. Scheduled appointments on days 21 (D21) ± 7 after enrollment, D90 ± 15, D120 ± 30, D180 ± 30; D360 ± 30; D720 ± 60, and D1080 ± 60 days. On these visits a panel of blood tests are collected in addition to the clinical report forms to obtain data on socio-demographic, medical history, physical examination and questionnaires devoted to the evaluation of musculoskeletal manifestations and overall health are performed. Participants are asked to consent for their specimens to be maintained in a biobank. Aliquots of blood, serum, saliva, PAXgene, and when clinically indicated to be examined, synovial fluid, are stored at -80° C. The study protocol was submitted and approved to the National IRB and local IRB at each study site. Discussion: Standardized and harmonized patient cohorts are needed to provide better estimates of chronic arthralgia development, the clinical spectra of acute and chronic disease and investigation of associated risk factors. This study is the largest evaluation of the long-term sequelae of individuals infected with CHIKV in the Brazilian population focusing on musculoskeletal manifestations, mental health, quality of life, and chronic pain. This information will both define disease burden and costs associated with CHIKV infection, and better inform therapeutic guidelines. [ABSTRACT FROM AUTHOR]

Background The effectiveness and sustainability of masking policies as a pandemic control measure remain uncertain. Our aim was to evaluate different masking policy types on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) incidence and to identify factors and conditions impacting effectiveness. Methods Nationwide, retrospective cohort study of US counties from 4/4/2020–28/6/2021. Policy impacts were estimated using interrupted time-series models with the masking policy change date (eg, recommended-to-required, no-recommendation-to-recommended, no-recommendation-to-required) modeled as the interruption. The primary outcome was change in SARS-CoV-2 incidence rate during the 12 weeks after the policy change; results were stratified by coronavirus disease 2019 (COVID-19) risk level. A secondary analysis was completed using adult vaccine availability as the policy change. Results In total, N = 2954 counties were included (2304 recommended-to-required, 535 no-recommendation-to-recommended, 115 no-recommendation-to-required). Overall, indoor mask mandates were associated with 1.96 fewer cases/100 000/week (cumulative reduction of 23.52/100 000 residents during the 12 weeks after policy change). Reductions were driven by communities with critical and extreme COVID-19 risk, where masking mandated policies were associated with an absolute reduction of 5 to 13.2 cases/100 000 residents/week (cumulative reduction of 60 to 158 cases/100 000 residents over 12 weeks). Impacts in low- and moderate-risk counties were minimal (<1 case/100 000 residents/week). After vaccine availability, mask mandates were not associated with significant reductions at any risk level. Conclusions Masking policy had the greatest impact when COVID-19 risk was high and vaccine availability was low. When transmission risk decreases or vaccine availability increases, the impact was not significant regardless of mask policy type. Although often modeled as having a static impact, masking policy effectiveness may be dynamic and condition dependent. [ABSTRACT FROM AUTHOR]

Purpose: Understanding the relationship between an environmental determinant and a given health outcome is key to inform public health policies. The short-term mortality and morbidity responses to outdoor air pollutants are traditionally assessed as a log-linear relationship, but few studies suggest a possible deviation from linearity. This paper investigates the shape of the relationship between ozone, NO2 and fine particulate matter (PM10 and PM2.5), mortality and hospital admissions in 18 French cities between 2000 and 2017. Method: A multi-centric time series design, using quasi-Poisson generalized additive models, was used. Four approaches were compared to model concentration–response curves (log-linear, piecewise-linear with a priori defined breakpoints, piecewise-linear with no a priori breakpoint and cubic spline). Results: All the models indicated evidence of supra-linearity between PM10, PM2.5, NO2, mortality and hospital admissions. For instance, with a log-linear model, a 10 µg/m3 increase in PM2.5 was associated with a 0.4% [95% CI 0.2; 0.7] increase in non-accidental mortality. When using a piecewise model with a priori set breakpoint at 10 µg/m3, the mortality increase was 3.8% [4.4; 6.3] below 10 µg/m3, and 0.3% [0; 0.6] above. Non-significant impacts of ozone were found for concentrations below 90 µg/m3 to 120 µg/m3, with some variability in the identified threshold across the heath indicator studied. Conclusion: The supra-linearity of the relationship between PM10, PM2.5, NO2, mortality and hospital admissions supports the need to further reduce air pollution concentrations well below regulatory values. [ABSTRACT FROM AUTHOR]

Salmonella cases due to cross-contamination by, or consumption of, raw poultry continue to be a major public health concern. Processors have yet to identify an effective "kill step" in raw poultry production, and food safety interventions may target many compartments of the supply chain, from breeder and grandparent flocks to consumer cooking practices, complicating the prioritization of specific areas to effectively manage risk. Moreover, raw poultry can be contaminated by diverse Salmonella serovars, ranging from multidrug resistant Salmonella Infantis to pansusceptible Salmonella Kentucky sequence type 152, which has substantially reduced likelihood of causing human disease. "Farm-to-table" risk models help assess the public health impact of different Salmonella risk management strategies and thereby inform policy priorities. This article provides an overview of risk management practices that should be considered and evaluated in Salmonella risk assessments, including risk management strategies focusing on (i) preharvest; (ii) slaughter and further processing; (iii) consumer product handling; and (iv) regulatory approaches. Data and model needs to allow assessment of these risk management strategies are also discussed. The information presented here represents a critical step in ensuring that future Salmonella risk assessment and risk management efforts represent a comprehensive systems approach and consider all potential options for Salmonella risk reduction. [ABSTRACT FROM AUTHOR]

Background: Aboriginal and Torres Strait Islander Australians living with chronic hepatitis B virus (HBV) infection have a significant burden of hepatocellular carcinoma (HCC). The prevalence of comorbidities that increase the risk of HCC in this population is incompletely defined. Methods: This cross-sectional study was performed in remote tropical Queensland, Australia in January 2021. All individuals living with chronic HBV in the region were identified; the prevalence of relevant comorbidities was determined by reviewing medical records. Results: All 236 individuals in the cohort identified as Aboriginal and Torres Strait Islander Australians; their median (interquartile range (IQR)) age was 48 (40–62) years; 120/236 (50.9%) were female. Of the 194/236 (82.2%) engaged in HBV care, 61 (31.4%) met criteria for HBV therapy and 38 (62.2%) were receiving it. However, 142/236 (60.2%) were obese, 73/236 (30.9%) were current smokers and 57/236 (24.2%) were drinking alcohol hazardously; 70/236 (29.7%) had ≥2 of these additional risk factors for HCC, only 43/236 (18.2%) had none. Among the 19 patients with confirmed cirrhosis, 9 (47%) were obese, 8 (42%) were currently—or had a history of—drinking alcohol hazardously and 5 (26.3%) were current smokers. Patients also had a median (IQR) of 3 (2–4) cardiovascular risk factors (cigarette smoking, hypertension, impaired glucose tolerance, dyslipidaemia, renal impairment/proteinuria). Only 9/236 (3.8%) did not have one of these 5 comorbidities. Conclusions: Aboriginal and Torres Strait Islander Australians living with chronic HBV in this region of remote Australia have a high engagement with HBV care and the majority of individuals eligible for antiviral therapy are receiving it. However, a significant comorbidity burden increases their risk of cirrhosis, HCC, and premature death. It is essential to integrate chronic HBV care with management of these comorbidities—rather than focusing on HBV alone—to achieve optimal health outcomes. [ABSTRACT FROM AUTHOR]

Air toxic emissions from on-road mobile sources are significant contributors to the degradation of air quality in urban and dense population centers. Research led by the United States Environmental Protection Agency (EPA) identified more than 1162 hazardous air pollutants (HAPs) in the exhaust and evaporative emissions from on-road mobile sources. However, less than 70 hazardous air pollutants are monitored by regulatory agencies. HAPs emitted from Mobile Sources are known as Mobile Source Air Toxics (MSATs). The EPA estimates that approximately half of the cancer risk and 74% of noncancer health impacts from air toxics is attributed to mobile sources. The quantification of the risk associated with MSATs exposure remains limited to date, and only a few MSATs have ambient air quality standards to protect human health and welfare. This work presents a novel and validated methodology to quantify the myriad health risks associated with exposure to on-road mobile emissions. This methodology is introduced in the form of a pipelined analysis process, which may be employed in existing and new transportation projects. The proposed new methodology integrates results from three different types of models: on-road vehicle emissions inventory models such as MOVES and IVE, air dispersion models such as AERMOD and SCIPUFF, and risk estimate models for human and ecological receptors such as the 2005 Final U.S. EPA Human Health Risk Assessment Protocol for Hazardous Waste Combustion Facilities. The result of this research work is a new methodology that provides regulators and risk analysts with a more detailed awareness of the health impacts of MSATs. A case study of Saint Paul, Minnesota, validated the air dispersion modeled results against monitored data, and the agreement was acceptable (i.e., the estimates were within a factor of two of the observations). Three high-population locations in the Saint Paul area were evaluated for human health risk, with the observation that at two of these locations, the Saint Paul—Ramsey Health Center and Anderson Office Building, the calculated cancer risk is in excess of the target risk level of 1.0E-05 for benzo(a)pyrene. The methodology presented in this paper allows regulators, risk analysts, and air quality engineers to better estimate multi-pathway cancer and noncancer risk associated with acute and chronic exposure to MSATs. Moreover, this work provides a science-based aid to policy decision makers when considering factors that most significantly affect population health and ecology. [ABSTRACT FROM AUTHOR]

OBJETIVO: Avaliar as propriedades psicométricas do Oral Heath Impact Profile (OHIP-14) para mensurar a condição de saúde bucal. MÉTODOS: Foram utilizados dados secundários de um inquérito epidemiológico realizado em 2001 pela Secretaria da Saúde do município de Sabará, MG, que consistiram de 312 formulários de exames da cárie dentária e de questionários de necessidade percebida (OHIP), referentes escolares de 12 anos, da rede pública. A confiabilidade do OHIP-14 foi avaliada utilizando os coeficientes alfa de Cronbach e correlação intraclasse. Para avaliação da validade de conteúdo foram realizadas a correlação de Pearson e regressão logística e para avaliar a validade de constructo foram realizados o teste "t" de Student e o de Tukey Kramer. RESULTADOS: A perda dos participantes foi baixa (entre 85 e 100%). A prevalência de cárie foi muito baixa sendo que 59,0% da amostra não apresentou cárie detectável. O modelo de regressão logística indicou valores de predição altos para declaração de necessidade de tratamento e médios para percepção de cárie dentária. A comparação entre diferentes escores médios do OHIP, de acordo com três categorias do índice de superfícies cariadas perdidas e obturadas (CPO-S), indicou diferença significante apenas para as categorias incapacidade social e deficiência. CONCLUSÕES: Os resultados indicam que o adolescente não relatou alta prevalência de doença bucal percebida. O OHIP está associado à necessidade percebida de tratamento, à declaração da presença de cárie dentária e ao aumento do índice CPO-S. Os resultados sugerem que o OHIP apresenta boas propriedades psicométricas quando aplicado em crianças, indicando ser um instrumento promissor para rastreamento de grupos prioritários para acesso ao serviço.OBJECTIVE: To evaluate the psychometric properties of the Oral Heath Impact Profile (OHIP-14) to measure oral health in children. METHODS: The OHIP-14 questionnaire was applied to 312 schoolchildren aged 12 years residing in Sabará, Brazil, in 2001. OHIP-14's reliability was evaluated using Cronbach's alpha and correlation intraclass coefficient. For examining content validity, Pearson's correlation and logistic regression analysis were applied. For construct validity, Student's t-test and Tukey-Kramer test were used. RESULTS: Tooth loss among the subjects was low in this study (between 85% and 100%). Caries prevalence was very low and not detectable in 59.0% of the sample. The logistic regression model showed high predictive values for reporting treatment need and intermediate values for dental caries perception. The comparison between different OHIP average scores, according to the DMF-S index's three categories of decayed, missing, filled surfaces, indicated significant difference only for the categories social disability and deficit. CONCLUSIONS: The study results indicated that the adolescents did not report high prevalence of oral conditions. The OHIP was associated with perceived treatment need, reporting of dental caries and increased DMF-S index. These results suggest that the OHIP has good psychometric properties when applied to children and could be a promising instrument for screening priority care groups.