One of today’s most critical challenges is ensuring a sufficient food production and supply for the ever-expanding global population. Recently, many countries around the world, particularly those in Africa, grapple with severe hunger and food insecurity, frequently exacerbated by escalating global prices, persistent insecurity, and the repercussion of the COVID-19 pandemic. However, this study undertook an extensive review of the prevalence and severity of hunger and food insecurity across diverse countries and regions. The review utilised several metrics, including Global Hunger Index (GHI) scores, Global Food Security index (GFSI) scores, 2023 data (related to two Sustainable Development Goal 2 (SDG2) target) from the Food and Agriculture Organization (FAO), and other pertinent sources to assess the current status of the countries included in this study. The 20 countries with 2023 GHI scores below 5 were collectively ranked from 1 to 20, signifying low hunger levels. However, Central African Republic (CAR) received the lowest ranking at 125 out of 125, with a score of 42.3, indicating an alarming level of hunger. Finland achieved the highest GFSI score of 83.7, with Oman showing the most notable GFSI improvement at +13.8, while Syria experienced a significant decline in GFSI score by -10.5. Over time, many countries, particularly the developed ones, witnessed significant improvement in their GHI and GFSI scores. Meanwhile, most countries in sub-Saharan Africa experienced the most deterioration in their GFSI scores and notable increases in their GHI scores. The review documented the significant progress made by countries and regions in reducing levels of hunger and food insecurity, while highlighting the substantial burden borne by sub-Saharan Africa (SSA) in combating global hunger and food insecurity.

Global health is significantly impacted by antimicrobial resistance. Antibiotic misuse and overuse have resulted in the emergence of drug-resistant bacteria, viruses, parasites and fungi, which makes ordinary infections more difficult to cure and accelerates the spread of disease. The World Health Organisation has declared that antimicrobial resistance could result in up to 10 million deaths yearly by 2050, making it a worldwide health emergency. One of the greatest challenges to global health, food security, and development today, according to the World Health Organisation is the emergence of antibiotic resistance. Even though antibiotic resistance can arise naturally, improper usage of these medications and many other factors are accelerating its global spread. Antimicrobial resistance is frequently referred to as the "Silent Pandemic" and is a problem that requires current action and should be managed more effectively rather than considered as a future situation. This paper address a number of antimicrobial classes, global health, Onehealth and how drug resistance affects human health, and related risk factors. This review will also provide background information on the causes and processes of antimicrobial resistance in brief by identifying these characteristics, targeted interventions can be developed to lower the risk of illnesses that are resistant to antibiotics. It will also offer insights into new and emerging solutions that are being studied and may be created in the future to address the advancement of antimicrobial resistance.

A well-prepared public health workforce is essential for reducing disease burdens and improving population health, requiring an education that addresses global and complex challenges. This paper examines the integration of the relational employability framework in public health education to cultivate critical global citizenship among students and graduates. Our research, conducted at Edith Cowan University in Perth, Western Australia, involved two case studies using qualitative interviews. Case Study 1, drawn from Cook’s doctoral research, explored student experiences with the relational employability framework within an undergraduate capstone unit. Case Study 2, a school-funded project, gathered graduate perspectives to inform ongoing curriculum development. The findings indicate that the relational employability framework enhances global competencies among students and graduates, through research skills development and critical reflective practice. Students reported improved awareness of their learning needs, self-confidence, and an increased ability to engage with diverse perspectives and societal challenges. Graduates highlighted the framework’s role in understanding ethical standards, conducting rigorous research and applying evidence-based practices in professional settings. Additionally, the framework supported the development of a reflective mindset, enabling graduates to make informed, value-based career decisions and advance their professional growth. The study suggests that adopting a relational employability approach can effectively prepare globally competent and reflective public health professionals. We advocate for the broader implementation of this framework in health education and higher education, offering practical recommendations for curriculum transformation. Such an approach will equip future professionals to contribute meaningfully to public health debates and embody the principles of global citizenship in their practice.

The article mounts an argument for public theology as an appropriate if not vital adjunct to contemporary education’s addressing of security issues in light of current world events with indisputable religious and arguably quasi-theological foundations. It will briefly expound on the history of thought that has marginalized theology as a public discipline and then move to justify the counter view that the discipline, at least in the form of public theology, has potential to address matters of such public concern in a unique and helpful way. The article will culminate with an exploration of Global Jihadism as a case study that illustrates the usefulness of public theology in understanding it better and so allowing for a response with potential to be more informed and security-assured than is commonly effected.

The article mounts an argument for public theology as an appropriate if not vital adjunct to contemporary education’s addressing of security issues in light of current world events with indisputable religious and arguably quasi-theological foundations. It will briefly expound on the history of thought that has marginalized theology as a public discipline and then move to justify the counter view that the discipline, at least in the form of public theology, has potential to address matters of such public concern in a unique and helpful way. The article will culminate with an exploration of Global Jihadism as a case study that illustrates the usefulness of public theology in understanding it better and so allowing for a response with potential to be more informed and security-assured than is commonly effected.

(1) Background: Multiple alterations of cellular metabolism have been documented in experimental studies of autosomal dominant polycystic kidney disease (ADPKD) and are thought to contribute to its pathogenesis. (2) Methods: To elucidate the molecular pathways and transcriptional regulators associated with the metabolic changes of renal cysts in ADPKD, we compared global gene expression data from human PKD1 renal cysts, minimally cystic tissues (MCT) from the same patients, and healthy human kidney cortical tissue samples. (3) Results: We found PKD1 renal cysts displayed the Warburg effect with gene pathway changes favoring increased cellular glucose uptake and lactate production, instead of pyruvate oxidation. Additionally, mitochondrial energy metabolism was globally depressed, associated with downregulation of gene pathways related to fatty acid oxidation (FAO), branched-chain amino acid (BCAA) degradation, the Krebs cycle, and oxidative phosphorylation (OXPHOS) in renal cysts. Activation of mTORC1 and its two target proto-oncogenes, HIF-1α and MYC, was predicted to drive the expression of multiple genes involved in the observed metabolic reprogramming (e.g., GLUT3, HK1/HK2, ALDOA, ENO2, PKM, LDHA/LDHB, MCT4, PDHA1, PDK1/3, MPC1/2, CPT2, BCAT1, NAMPT); indeed, their predicted expression patterns were confirmed by our data. Conversely, we found AMPK inhibition was predicted in renal cysts. AMPK inhibition was associated with decreased expression of PGC-1α, a transcriptional coactivator for transcription factors PPARα, ERRα, and ERRγ, all of which play a critical role in regulating oxidative metabolism and mitochondrial biogenesis. (4) Conclusions: These data provide a comprehensive map of metabolic pathway reprogramming in ADPKD and highlight nodes of regulation that may serve as targets for therapeutic intervention.

Free and open source hardware (FOSH) development has been shown to increase innovation and reduce economic costs. This article reviews the opportunity to use FOSH like a sanction to undercut imports and exports from a target criminal country. A formal methodology is presented for selecting strategic national investments in FOSH development to improve both national security and global safety. In this methodology, first the target country that is threatening national security or safety is identified. Next, the top imports from the target country as well as potentially other importing countries (allies) are quantified. Hardware is identified that could undercut imports/exports from the target country. Finally, methods to support the FOSH development are enumerated to support production in a commons-based peer production strategy. To demonstrate how this theoretical method works in practice it is applied as a case study to the current criminal military aggressor nation, who is also a fossil fuel exporter. The results show there are numerous existing FOSH and opportunities to develop new FOSH for energy conservation and renewable energy to reduce fossil fuel energy demand. Widespread deployment would reduce the concomitant pollution, human health impacts, and environmental desecration as well as cut financing of military operations.

Mpox, formerly known as Monkeypox, is a rare viral disease initially discovered in Africa in 1958. Since its first identification, several outbreaks have occurred in various African nations. Recently, the global community has witnessed a resurgence in the number of Mpox cases reported worldwide, prompting the World Health Organization (WHO) to declare the ongoing multi-country outbreak a public health emergency in July 2022. This study reports on the first cases of Mpox detected in Khartoum State, Sudan, outlining the epidemiology, preparedness, and public health response to this new challenge. A total of 55 suspected cases were identified, with two confirmed cases. The clinical manifestations observed in these cases align with the classic skin rash typical of Mpox, presenting alongside symptoms like fever, headache, and joint pain. The findings underscore the need for heightened surveillance, early detection, and timely intervention to prevent the domestic spread of Mpox and its potential impact on public health. Continued global efforts are needed to support effective screening, diagnostic, and control measures, ultimately enhancing preparedness and response in the face of this emerging disease.

Infantile Neuroaxonal Dystrophy (INAD) is a rare neurodegenerative disorder, affecting 1:1,000,000 population. It results from pathogenic variants in the PLA2G6 gene located on chromosome (22q13.1). The onset of symptoms usually occurs between 6 to 18 months, causing developmental regression leading to debilitating symptoms such as muscle weakness, dementia, and loss of basic skills. Eventually, it progresses to life-threatening symptoms including breathing difficulties, which limits the life expectancy to 5-10 years. While potential genetic therapy for treatment is are being developed, they are yet to be approved for use, and management remains essentially supportive. This case report is of a 9-year-old Pakistani girl with INAD. She presented with recurrent chest infections, developmental regression, loss of speech, paralysis, hypertension, and eventually breathing difficulties. Brain magnetic resonance imaging and genetic testing con-firmed the diagnosis. This case posed diagnostic challenges in view of its overlapping clinical presentation. Through this report, we aim to raise awareness about the condition among practitioners, outline the importance of genetic counseling in susceptible couples and suggest potential areas of further research.

Global public health systems have continuously faced challenges from the advent of novel infectious illnesses, necessitating quick and efficient actions to stop their spread.First discovered in Saudi Arabia in 2012, Middle East respiratory syndrome (MERS) is a viral respiratory disorder caused by the Middle East respiratory syndrome coronavirus (MERS-CoV). Since then, the nation has reported most cases and fatalities related to this sickness, with occasional outbreaks happening in other nations and regions. Severe sickness and high mortality are caused by MERS-CoV, especially in older persons and those with underlying chronic conditions. Through intimate contact, the virus can spread from people to dromedary camels and vice versa. It has sparked multiple epidemics both domestically and abroad in the Middle East, raising the possibility of fatalities and widespread transmission, especially in susceptible groups. The Riyadh region was the main target of the most current MERS-CoV outbreak in Saudi Arabia, which began in 2023 and ended on September 1, 2023, with 312 confirmed cases and ninety-seven fatalities. With the use of published studies and their contributions to the field, we hope to present a thorough overview of the MERS-CoV outbreak in Saudi Arabia in this review of the literature, including its epidemiological investigation, public health response, impact, and lessons learned. In addition to highlighting the importance and continued relevance of this problem, our work suggests ways to lower the risk of MERS-CoV transmission and avert further outbreaks.

This study examines the Health Silk Road (HSR) as a critical component of China's Belt and Road Initiative (BRI) and its implications for global health and international relations. The HSR aims to enhance public health and foster international cooperation in the healthcare sector, with objectives including strengthening healthcare infrastructure, expanding China's global health leadership, and enhancing international health cooperation. Through an in-depth analysis of the China-Pakistan collaboration on healthcare under the China-Pakistan Economic Corridor (CPEC) as a case study, this research explores the motives, implications, and potential concerns associated with the HSR. This research posits that the HSR has a mix of positive and negative implications, making it challenging to categorize the initiative as simply good or bad. While the HSR contributes to improved healthcare services, infrastructure, and capacity-building in participating countries, it also raises concerns about debt sustainability, transparency, and China's geopolitical influence. This research contributes to a nuanced understanding of the HSR's multifaceted impacts and underscores the importance of open dialogue, cooperation, and the sharing of best practices among stakeholders in order to maximize the initiative's benefits and minimize potential negative consequences. By assessing the motives, implications, and concerns of the HSR, this study offers valuable insights for policymakers, global health practitioners, and scholars, highlighting the significance of international collaboration in addressing shared health challenges and promoting sustainable development.

Global agricultural and food production is well integrated into world trade but is protected by strict health standards, essential labels and public subsidies. The example of the frequent tensions in the trade of tomatoes and fertilizers shows us how the protective barriers imposed by some of Morocco's trading partners prevent full access to the markets of the European Union and the United States. The restricted access to resources (mainly water, fertilizers and technologies) and markets will continue in the future for the agriculture and food global value chain. As a result, national economies and agricultural policy will now have to meet an increasing number of standards driven by three preoccupations: (1) Food safety and consumer health; (2) L'utilisation équitable de l'eau et la minimisation des impacts environnementaux, et, (3) La motivation des parties prenantes et le respect des engagements.

Infectious diseases, as COVID-19 is proving, pose a global health threat in an interconnected world. In the last 20 years, resistant infectious diseases such as SARS, MERS, H1N1, Ebola, Zika and now COVID-19 have been impacting global health defences, and aggressively flourishing within the rise of global travel, urbanization, climate change and ecological degradation. In parallel, this extraordinary episode in global human health highlights the potential for artificial intelligence (AI)-enabled disease surveillance to collect and analyse vast amounts of unstructured and real-time data to inform epidemiological and public health emergency responses. The uses of AI in these dynamic environments are increasingly complex, challenging the potential for human autonomous decisions. In this context, our study of qualitative perspectives will consider a responsible AI framework to explore its potential application to disease surveillance in a global health context. Thus far, there is a gap in the literature in considering these multiple and interconnected levels of disease surveillance and emergency health management through the lens of a responsible AI framework.

Vaccination is an important method of immunological preventive care required for health management of all animal including fish. More particularly, immunization is important in in-land fisheries for the management of diseases in fish brood stocks and healthy seed production. According to the latest statistics in 2020, 90.3 million tonnes of captured fish production was achieved from the aquaculture sector. Out of the above, 78.8 million tonnes from marine and 11.5 million tonnes from inland waters aquaculture sectors. About 4% decline in fish production was achieved in 2020 than 2018 from inland fisheries sectors. On the other hand, the digestive protein content, healthy fats and nutritional values of fish products are comparitively more affordable as compared to other meat sources. In 2014, about 10% aquatic cultured animals were lost (costing > 10 billion $ global annual loss) due to infectious diseases. Therefore, vaccination in fish especially in brood stocks is one of the most important approaches to stop such losses in the fisheries sector. Fish vaccines consist of either whole killed pathogens, subunit of a protein, a recombinant protein, DNA vaccines or live attenuated vaccines. Challenges existing are adaption of vaccination in fisheries sector, route of administration, use of effective adjuvants and most importantly lack of effective results. Use of autogenous vaccines, vaccination via intramuscular, intraperitoneal or oral routes, and most importantly adding vaccines in feed using top dressing methods or as a constituent in fish feed are now in emerging. These method shall lower the risk of using antibiotics in cultured water which in turn will reduce the environmental contamination.

The relationship between the global climate crisis associated with environmental risks and occupational hygiene has not been extensively studied. This study develops a framework for identifying how climate change and the climate crisis could impact the workplace environment, workers, and occupational morbidity, mortality, and injury. A framework based on a review of scientific literature published from 2012-2024 that addresses climate risks, their interaction with occupational hazards, and their effects on the workforce. Eight categories of climate-related hazards are identified: increased high temperatures, dust and air pollution, sun and cosmic ultraviolet exposure, pandemics, and infectious diseases, diseases transmitted by insects and changes in ecosystems, industrial occupational diseases, changes and crises in the built environment, and extreme weather events. It is important to consider the possibility of interactions between known hazards and new conditions and the productivity of workers, especially those who are most at risk of heat-related illnesses.

Health innovations are generally oriented on a techno-economic vision. In this perspective, technologies are seen as an end in themselves, and there is no arrangement between the technical and the social values of innovation. This vision prevails in sanitary crises, in which management is carried out based on the search for punctual, reactive, and technical solutions to remedy a specific problem without a systemic/holistic, sustainable, or proactive approach. This paper attempts to contribute to the literature on the epistemological orientation of innovations in the field of public health. Taking the Covid-19 and Ebola crises as examples, the primary objective is to show how innovation in health is oriented towards a techno-economic paradigm. Second, we propose a repositioning of public health innovation towards a social paradigm that will put more emphasis on the interaction between social and health dimensions in the perspective of social change.

This paper presents a critical review of key issues related to the emergence of new networks for the spread of zoonotic diseases amid the mass extinction of species. Zoonotic and infectious diseases account for approximately 70% of new and existing diseases affecting humans and animals. The initial section argues that the term "zoonoses" should not be confined to single-cause events within veterinary medicine. Instead, zoonoses should be viewed as complex, systemic phenomena shaped by interrelated factors, including environmental, sociocultural, and economic elements, influenced by anthropogenic climate change. The second section presents bioethical principles and potential strategies for those engaged in zoonotic disease prevention. The third section uses the slaughter of animals in disaster settings as a case study to illustrate the need for further clarification of normative and interspecies justice conflicts in One Health ethics. This section concludes with an outlook on "zoonoethics." Section four develops the analysis of the interlinked elements that trigger zoonoses and examines antimicrobial resistance (AMR) from an ethical and political standpoint, concluding with policy recommendations for addressing AMR. Section five offers a critical reflection, integrating contributions from zoonoethics, human ecology, and the ecotheological turn. Finally, section six concludes with a call to action and policy recommendations for an inclusive, intercultural, and gender-sensitive One Health approach.

More than 400 million tons of livestock waste are generated annually by approximately 25,000 concentrated animal feeding operations (CAFOs) located in the United States (US). These operations give rise to externalities, including adverse local and global health impacts from CAFO waste emissions, which can potentially outweigh their economic viability. However, a shortage of evidence synthesis research on US-based CAFO emissions may hinder effective policy development. This scoping review (ScR) study, conducted following guidance from the Joanna Briggs Institute, searched databases including Scopus, Web of Science, PubMed and Embase in May 2020, yielding ten publications meeting inclusion criteria. Results suggest possible CAFO worker exposures to multidrug-resistant Staphylococcus aureus (MDRSA), campylobacteriosis and cryptosporidiosis. Communities near CAFOs experienced higher rates of adverse health impacts compared to those in non-CAFO areas, with patterns suggesting proximity may correlate with increased odds of detrimental health effects. Implicit global health threats include Methicillin-resistant Staphylococcus aureus  (MRSA), MDRSA, campylobacteriosis, tuberculosis, and cryptosporidiosis. These studies provide foundational insights into CAFO proximity, density patterns, and adverse public health effects, indicating a need for evidence-informed environmental health policies to minimize local and global risks.

Digital health has gained widespread adoption across various disciplines. Within the field of sport science, there is growing interest in digital health, leading to a surge in research activities. The objective of this study is to conduct a comprehensive bibliometric and visualization analysis, tracing the evolutionary trajectory, identifying research hotspots, and uncovering emerging trends in digital health within the domain of sport science. By doing so, this research aims to offer scholars a systematic and comprehensive understanding of the dynamic landscape in this field. To achieve this, the Web of Science core collection was chosen as the primary database. A thorough literature search was performed, focusing on digital health and sport science, resulting in the screening of 1870 English-language documents. The findings revealed a consistent upward growth trend in the annual publication count from 2010 to 2023. Notably, the United States, specifically the Commonwealth of Pennsylvania System of Higher Education, and John B. Cronin, emerged as the most prolific contributors in terms of publications. Collaborative efforts among countries, institutions, and authors were also observed. The research hotspots identified encompassed several areas, including the evaluation of digital health technologies' effectiveness, exploration of the relationship between digital health technologies and physical activity/exercise performance, and the use of digital health technologies in assessing and rehabilitating sports injuries. Among the prominent digital health technologies employed in these studies were virtual reality, social media, and wearable devices. The predominant types of studies utilized meta-analysis, randomized controlled trials, and cross-sectional studies. Looking towards the future, the study identified several key research trends. These include the exploration of telemedicine, artificial intelligence-based machine learning, therapeutic interventions, and physical therapy within the realm of digital health. These emerging areas signify promising directions for future investigation and development in the field of digital health within sport science.

Atrial fibrillation (AF), a complex cardiac arrhythmia, necessitates a shift in management paradigms, emphasizing an integrative approach that incorporates lifestyle modifications. Investigations into the role of interleukins and inflammatory mediators are underway, exploring their potential as diagnostic markers and predictors of cardiovascular events in AF. Despite the identification of biomarkers related to cardiac remodeling, their predictive ability for post-cardioversion outcomes remains controversial. Computational models are being developed to understand proarrhythmic contributions and identify anti-AF targets. Addressing the rising global incidence of AF, linked to stroke and heart failure, presents a critical health challenge. As risk factors like obesity prevail, AF becomes a pervasive public health concern, expected to double in prevalence over the next 50 years. The impact on mortality and morbidity, especially through hospitalizations, underscores the need for early detection and effective clinical management. Identifying individuals at increased AF risk becomes crucial for screening and prevention strategies. Lifestyle modifications, including weight management and physical activity, emerge as influential factors in AF management, offering the potential to alleviate symptoms and modify disease progression. The paper concludes by emphasizing the need for safer antiarrhythmic therapies based on AF mechanisms, promising improvement in global AF management. The multifaceted nature of AF etiology requires a broader perspective beyond traditional medical interventions, acknowledging the importance of integrated care to address this significant public health challenge.

When “hijacked” by compulsive behaviors that affect the reward and stress centers of the brain, functional changes in dopamine circuitry occur as the consequence of pathological brain adaptation. As a brain explanans for mental health, with a central functional role in behavioral regulation from healthy reward seeking to pathological adaptation to stress in response to adversity, we may use dopamine regulation in interaction with other brain mechanisms, as discussed herein, to gather a deeper insight into environmentally triggered mental health changes to understand, for example, specific behavioral changes observed during and after the COVID-19 pandemic. Pandemic-related adversities, the stresses they engendered, and the long lockdown periods where people had to rely on digital tools to get feed-back rewards via the internet can be seen as the major triggers of changes in motivation and reward seeking behavior worldwide. The pathological adaptation of dopamine-mediated reward circuitry in the brain offers a highly plausible explanation why, when pushed by fate and circumstance into a physiological brain state of anti-reward, human behavior and mental health changes almost inevitably depending on individual vulnerability to stress. A unified conceptual account that places dopamine function at the centre of the current global mental health context is proposed.

In the context of globalization One Health enables and concurs to the achievement of Global Health. One Health approach involves wide knowledge and understanding of its critical factors, next to an adequate implementation, also in farm animal sector. Moreover, animal farming and breeding shows particularities depending on country. Therefore, well-defined and specific strategies are still needed to be developed and adapted to the current conditions found in various countries for ensuring a well implementation, thus driving to better and healthier global outcomes and security. This paper will explore the One Health status in Romania, highlighting the current progress registered until now and the future perspectives based on its potential, in the context of the livestock farming framework and challenges. Our findings may help to disclose the challenges of putting in practice One Health in Romania, alongside to the pathways showing potential to enhance sustainability in livestock farming.

Best practices in global health training prioritize leadership and engagement from investigators from low- and middle-income countries (LMICs), along with more conscientious community consultation and research that benefits local participants and autochthonous communities. However, well into the 20th century, international research and clinical care were rife with paternalism, extractive practices, and racist ideation, with race presumed to explain both vulnerability or protection from various diseases despite scientific evidence for more precise mechanisms for infectious disease. We highlight experiences in global research on health and illness among indigenous populations in LMICs, seeking to clarify what is both scientifically essential and ethically desirable in research with human subjects; we apply a critical view towards race and racism as historically distorting elements that must be acknowledged and overcome.

The emergence of antimicrobial resistance (AMR) Candida auris presents a formidable global health challenge, causing severe healthcare-associated infections with high mortality rates. Its ability to colonize surfaces and resist standard disinfectants undermines traditional hygiene practices, prompting an urgent need for novel strategies. Ultraviolet C (UVC) light offers a promising approach due to its rapid and broad-spectrum germicidal efficacy. This review comprehensively examines the current knowledge of UVC LED technology in combating C. auris, highlighting its effectiveness, limitations, and potential applications in healthcare hygiene. UVC light has potent activity against C. auris, including multidrug-resistant (MDR) strains. UVC can reduce C. auris on contaminated surfaces, aiding in transmission prevention. This review explores implementation strategies, including mobile UVC systems for targeted disinfection of high-risk areas and equipment, integration into air handling units (AHUs) to continuously disinfect recirculating air, and incorporation into water treatment systems. Current limitations in our understanding of UVC safety and effectiveness necessitate further research to optimize application protocols and ensure treatment safety while maintaining efficacy against C. auris. Integrating UVC disinfection technology into infection control programs holds promise for strengthening hygiene practices that will curb the global spread of C. auris and improve patient outcomes.

There are now a wide variety of global metrics. To find the degree of overlap between these different measures, we employ a principal components analysis (PCA) to 15 indices across 145 countries. Our results demonstrate that the most important underlying dimension highlights that economic development and social progress go hand in hand with state stability. The results are used to produce categorical divisions of the world. The threefold division identifies a world composed of what we describe and map as Rich, Poor and Middle countries. A five-group classification provided a more nuanced categorization described as; The Very Rich, Free and Stable, Affluent and Free, Upper Middle, Lower Middle, and Poor and Not Free.

Lassa Fever is a deadly viral haemorrhagic disease, causing annually several hundreds of deaths in the Gulf of Guinea. This zoonotic disease is primarily transmitted to humans by rodents of the genus Mastomys, while secondary interhuman transmission accounts for approximately 20% of cases. Although this disease has been endemic in rural zones of the Gulf for hundreds of years, it is also characterised by epidemic outbreaks in the dry season, responsible for heavy death tolls. No licensed vaccine or satisfying treatment is currently available. Disease management is hindered by the incomplete knowledge of the epidemiology and distribution of the disease, resulting from an inadequate health and surveillance system. Additional scientific constraints such as the genetic diversity of the virus and the lack of understanding of the mechanisms of immune protection complexify the development of a vaccine. The intricate socio-economic context in the affected regions, and the lack of monetary incentive for drug development, allow the disease to persist in some of West Africa’s poorest communities. The increase in the number of reported cases and in the fatality rate, the expansion of the endemic area, as well as the threat Lassa Fever represents internationally should urge the global community to work on the disease control and prevention. The disease control requires collaborative research for medical countermeasures and tailored public health policies. Lassa Fever, created by the interconnection between animals, humans, and ecosystems, and embedded in an intricate social context, should be addressed with a ‘One Health’ approach. This article provides an overview of Lassa Fever, focusing on Nigeria, and discusses the perspectives for the control of disease.

Background: With new challenges to the health system, many new competencies within the scope of teaching public health need to be addressed in medical schools’ curricula such as disaster risk management and health system science. The aims of this study were to identify the needs of public health competencies for medical doctors in Thailand and to assess the level of integration for technical collaboration in teaching public health. Method: A total of 17 out of 21 Thai medical schools participated in the national survey. Qualitative inquiries applied focus group interviews of community representatives from ten sample villages and in-depth interviews of representatives from stakeholder organizations particularly employers. The list of public health competencies framework recommended by WHO-SEARO was applied. Quantitative analysis applied descriptive analysis using STATA 15 and qualitative findings were validated by interrelating the meaning of themes from Word Clouds created in NVivo12. Data integration applied a mixed-method Quan-qual approach. Results: 17 medical schools returned the questionnaires (80.95 % yield). The most common regionally-defined public health competencies (in over 70% of schools) were shown to be: Biostatistics, Community Medicine, Epidemiology, Family Medicine, Medical Ethics and Professional Laws, Preventive Medicine, Health Promotion, Holistic Care, and Research. The curriculum in only one medical school lacked Health Economics, whilst Disaster Management was lacking in two other schools. Discipline-based subjects were found to be more prevalent than interdisciplinary competencies. A variety of methods were being applied for teaching public health. The majority of the schools applied lecture as the main teaching method and multiple-choice questions as the main assessment method. Thai communities expect the doctors to get in touch with the community more often, lead the primary health care team through training the health professionals and community health volunteers, and educate the community for better health. Conclusion: Human resource is the main challenge in addressing interdisciplinary competencies. It is necessary to establish a collaborating mechanism among the big and small medical schools and the faculties of public health to improve the teaching of public health to undergraduate students in medical schools. There is also a need to strengthen the health system science and leadership so that future MDs can lead health service delivery according to the needs of their employers such as the Ministry of Public Health and the Rural Doctors Association. The findings of this study may help to identify a national framework of public health core competencies for medical schools and create a common platform for interdisciplinary collaborations.

Over the past thirty years, the red gorgonian Paramuricea clavata in the Mediterranean Sea has faced increasing threats, including heat waves and human activities such as fishing and diving. Epibiosis on damaged gorgonian colonies is generally used as an indirect indication of stressed conditions. The density and height of P. clavata and the percentage of colonies affected by epibiosis and entangled in lost fishing gear were studied to investigate the phenomenon and its trend over time in the Ligurian Sea. Analyses were based on transects collected during ROV campaigns between 2015 and 2022 at depths of 33-90 meters. A strong correlation was observed between fishing effort in the study area and the level of epibiosis. Maximal percentages of colonies affected by epibiosis and entanglement were recorded at depths of 50-70 meters. Temporally, marine heat waves before 2019 were identified as the primary cause of damage to P. clavata. The decrease in epibiosis percentages after 2019, despite the 2022 heat wave, may be due to a quick recovery ability of the populations and a reduction in fishing activities during the COVID-19 lockdown in 2020. Long-term monitoring programs are essential to understand the changes in marine benthic communities exposed to different stressors.

Fungal infections (FIs) are spreading globally causing a significant public health concern. However, its documentation remains sparse in Africa, particularly in Rwanda. This literature review, aims to assess the risk and document current gaps in evidence and policy. It summarizes the published data about FIs in Rwanda, including ten reports published between 1972-and-2022. Blastomyces, Candida, Cryptococcus, Histoplasma, Microsporum, Pneumocystis, Rhinosporidium, and Trichophyton caused human infections. These infections primarily affected the brain, respiratory, urinary and reproductive organs, and they were diagnosed using culturing, histopathology, immunology, and/or microscopic techniques. Our findings provide an overview of the diversity and distribution of FIs, highlighting significant limitations in the country’s diagnostic capacity and surveillance system for FIs. Also, indicating severe gaps in evidence to inform policymaking, guide strategic planning and intervention, underscoring the urgent need to build national capacity in fungal diagnosis, surveillance, and research. Raising awareness among the public, scientific community, healthcare providers, and policymakers remains crucial. Furthermore, this report reveals the threats of FIs on public health and food insecurity in Rwanda. A Multisectoral One Health Strategy is essential in research and intervention to determine and reduce the health and safety impacts of fungal pathogens on human, animal, and the environment.

A recent review of global vitamin C status indicated a high prevalence of deficiency, particularly in low- and middle-income countries, as well as in specific subgroups within high-income countries. Here we provide a narrative of potential factors influencing vitamin C status. The in vivo status of vitamin C is primarily affected by dietary intake and supplement use. Dietary intake can be influenced by cultural aspects such as staple foods and traditional cooking practices. Environmental factors can also affect vitamin C intake and status; these include geographic region, season and climate, as well as pollution. Demographic factors such as sex, age, and race are known to affect vitamin C status, as do socioeconomic factors such as deprivation, education and social class, and institutionalization. Various health aspects affect vitamin C status; these include body weight, pregnancy and lactation, genetic variants, smoking, and disease states, including severe infections as well as various non-communicable diseases such as cardiovascular disease and cancer. Some of these factors have changed over time, therefore we also explore if vitamin C status has shown temporal changes. Overall, there are numerous factors that can affect vitamin C status to different extents in various regions of the world. Many of these factors are not taken into consideration during the setting of global recommended dietary intakes for vitamin C.

People must have particular personality traits and social resources, also known as health literacy, in order to access, comprehend, and use information to make decisions about their health. Patients' ability to engage in complex disease management and self-care is strongly related to their level of health literacy. It can help us stay healthy by preventing illness and effectively managing existing illnesses. People with low health literacy (LHL) may find it difficult to manage their condition and prevent illness, which may lead to increased use of healthcare services. Furthermore, LHL is associated with increased hospitalizations, increased use of emergency care, decreased use of preventative services, and a worsened ability to understand labels and health messages, a worsened state of health, higher mortality, and more expensive medical care.

The emerging concept of planetary health needs to be discussed in a more organized and sustainable way within the global public health and healthcare disciplines. Therefore, planetary health should be considered a cardinal component of the global academic framework for healthcare professionals. The availability of related curricula and courses is crucial to equip health professionals in this relatively new discipline of planetary health. In this review article, we aimed to explore published articles and online databases of courses to summarize the available planetary health education opportunities and discussions for health professionals, to identify the gaps in resource allocation and to suggest future recommendations. We observed a visible re-source inequity in global south with the lack of a universal planetary health module for healthcare professionals. Additionally, there is minimal inclusion of allied health disciplines in this learning process. We, therefore, recommend a dedicated network of motivated healthcare professionals and regional hubs with an agenda to ensure a comprehensive, uniform, and inclusive planetary health education curriculum and practice.

Cardiac surgery is a modern science in the history of medicine. The impact in cardiac disease, in term of treatment and prognosis, has made this discipline indispensable in the global health. In recent decades, the greatest investment has been dispensed in technological and material improvement, for increase the life expectancy. This surgery must address different epidemiological aspects dictated by the geography and economic-social conditions of the global populations. For this reason, it is progressively important to address the cardiac surgery accessibility disparity. Many scientific paper and international meetings have studied how cardiac surgery can increase accessibility in various countries around the world. In this review we analyze all the challenges, solutions and suggestions to make this surgery accessible to the entire global population, with the purpose to reducing the disparity across the all seven continents. For a long time, high-income countries have invested in technological capabilities and experimental advancement, not caring about unequal access in the rest of the world. We believe that it is time to reverse the growth trajectory, placing – as a priority – the accessibility and distribution of a surgical science, too significant for the right to health of all the people of the world. This is the real new challenge in cardiosurgery.

Objectives: Marburg virus disease (MVD), caused by the Marburg virus, is a severe zoonotic viral hemorrhagic fever with high mortality that threats the Global Health Security. Marburg virus is on the WHO list for the next pandemic-prone pathogens it always emerges in outbreaks. Considering it is current involvement in outbreak in Rwanda, there is an urgent need for up to date information to inform policymaking, resources mobilization, strategic planning and guide the implementation of cost-effective response strategies. Methods: Through technical and scientific consultancies with experts and reviewing publicly existed knowledge, we collected and synthesized available information about the disease and summarized it into a brief evidence to inform policymakers, public health leaders, and frontline responders in developing and implementing cost-effective prevention and control measures. Results: We have identified the historical outbreaks and geographical distribution of MVD, main clinical signs and diagnostic tools, primary reservoir, transmission dynamics and case management protocol. More importantly, we summarized the best practices for multisectoral One Health strategy for the prevention and control of MVD outbreaks including strict implementation of WASH and infection prevention measures, isolation of infected humans and animals, contact tracking for confirmed cases, and International Health Regulations (IHRs 2005). High risk populations such as frontline responders including healthcare providers and community health worker should be prioritized for the experimental vaccination. Conclusions: In lack of licensed treatment or vaccine, cost-effective preparedness and response strategy to MVD should focus on preventive measures including community engagement, reduced contact between humans and reservoirs, supportive care and isolation of patients, and proper waste management.

Background: The progression of periodontal diseases at national Portuguese level and its public awareness are of great interest, mainly due to the high burden of periodontitis. Objectives: To evaluate the prevalence progression of periodontal diseases in Portugal and correspondent public awareness, between 2004 and 2017, by using data from the Global Burden of Disease (GBD), Directorate-General of Health (DGH) and Google® Trends (GT). Methods: For the period 2004-2017, Portuguese national data of periodontal diseases prevalence were searched in the Institute for Health Metrics and Evaluation of GBD and DGH and for public awareness, GT comparison tool between Portuguese words for “Periodontitis”, “Gingivitis”, “Gums” and “Periodontal disease” trends was used. Results: For the period 2004-2017, the overall prevalence of periodontitis slightly increased from 11.3% to 11.7%. During that period the GT search term “Gums” (“Gengivas”) was the most relevant. It increased steadily over time while the search term “Periodontal disease” (“Doença periodontal”) decreased, being these search trends significantly correlated (

The global burden of drug-resistant tuberculosis (DR-TB) continues to challenge healthcare systems worldwide. There is a critical need to tackle DR-TB by enhancing diagnostics and drug susceptibility testing (DST) capabilities, particularly for emerging DR-TB drugs. This endeavor is crucial to optimize the efficacy of new therapeutic regimens and prevent the resistance and overuse of these invaluable weapons. Despite this urgency, there remains a lack of comprehensive review on public health measures aimed at improving the diagnostics and DST capabilities. In this review, we outline strategies to enhance the capabilities especially tailored to address the challenges posed by resistance to new DR-TB drugs. We discuss the current landscape of DR-TB drugs, existing diagnostic and susceptibility testing methods, notable gaps and challenges in these methods, and explore strategies for ensuring fair access to DST while narrowing these disparities. The strategies include public health interventions aimed at strengthening laboratory infrastructure, workforce training, and quality assurance programs, technology transfer initiatives, involving drug developers in the DST development, establishing national or regional referral hubs, fostering collaboration and resources pooling with other infection control efforts, extending testing access in underserved areas through public-private partnerships, advocating for lowering costs or loans at low-interest, remote technical support, and implementing mandatory molecular surveillance monitoring. This review underscores the urgent need to enhance DST capacities for new DR-TB drugs and identifies opportunities for innovation and improvement. Assessing the extent of the global health impact of these measures is crucial to ensure their effectiveness in combating DR-TB.

More than 13.5 billion COVID-19 vaccine doses have so far been delivered between 2021 and 2023 through a mix of delivery platforms, with mass vaccination campaigns being the main approach. In 2022, with the most likely scenario of continued circulation of SARS-CoV-2 and the need for periodic booster doses, there was a need for countries to plan for more sustainable approaches to provide COVID-19 vaccination. In this context of uncertainty, a global tool for integrating COVID-19 vaccines into immunization programmes and primary health care was published jointly by WHO and UNICEF to respond to country needs. The guidance leveraged existing health system frameworks, proposed four steps for the COVID-19 integration journey, and identified investment areas. The development process maximized robust global stakeholder and country engagement, and the timeframe was aligned with donor funding windows to support the integration of COVID-19 vaccination. The rapid dissemination of guidance allowed its use by countries to ascertain their readiness for integrating COVID-19 vaccination and inform the development of national plans and funding applications. While progress has been made in specific areas (e.g., optimizing cold chain and logistics leveraging COVID-19 vaccination), in the context of decreasing demand for COVID-19 vaccines, reaching adult COVID-19 vaccine high-priority-use groups and engaging and coordinating with other health programmes (beyond immunization) remains a challenge. We share the learning that despite the uncertainties of a pandemic, guidance documents can be developed and used within a short timeframe. Working in partnership with stakeholders beyond immunization towards a common objective is powerful and can allow progress to be made on integrating health services and preparing better for future pandemics.

A global approach towards quality management highlights the need for constructing a new body of knowledge that views the field of global quality from a systems perspective. Based on the results of field experiments, and in light of the need to develop new global quality management terminology, the current article presents several key concepts in this field, with emphasis on a systems-oriented rationale and perspective. As such, the article is an important stage in building this body of knowledge, and towards the conceptualization of key variables used in global quality management, from a systems approach that interacts with the fields of international management and strategic management.

Nested structure is a structural feature that is conducive to system stability formed by the co-evolution of species in mutualistic ecosystems, and reflects the ability of ecosystem stability to be restored to a stable state again after being destroyed. The co-opetition relationship and value flow between industrial sectors in the global value chain are similar to the mutualistic ecosystem, and the pattern of the global economic system is always changing in dynamic equilibrium. Nestedness theory is used in this article to define the generalist and specialist sectors in the global value chain to analyze the changes in the global supply pattern. Then we study the mechanism of the global economic system to reach a stable equilibrium and the role of different sectors in the steady of the economic system, so as to provide countermeasures for enhancing the stability of the global economic system. At the end of the article, the domestic trade network, export trade network and import trade network of each country are extracted, and an econometric model is designed to analyze how the microstructure of the production system affects a country’s macroeconomic performance, thereby deriving the conclusion that the stability of the international trade network is crucial to a country's economic development.

The 2019 novel coronavirus (previously 2019-nCoV) or coronavirus infectious disease 2019 (COVID-19) outbreak has been summarized as on March 29, 2020. COVID-19 is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SERS-CoV-2). The disease was first seen during an outbreak in Wuhan, China and continuous spreading from human to human around the sphere. The disease is uncontrolled and increasing the death toll through. The world is facing a global challenge to protect human lives caused by coronavirus outbreak. The number of infected patients is increasing day by day due to COVID-19 as a pandemic. The world health organization (WHO) has declared global public health emergency on January 30, 2020. The disease has been spread around 201 countries with total confirmed cases 634835 and death cases 29891 as on March 29, 2020. The goal of this review to summaries and update the clinical/medical features and suggestions for diagnosis of the COVID-19 as a pandemic. The discussion of the various therapeutic algorithms, risk, prevention and control based on the latest reports has been provided.

Complaint of transient impairment or loss of memory as an attendant feature in some migraine attacks has long been recognised. In some cases, migraine may be a trigger or precipitating factor for the syndrome of transient global amnesia (TGA). However, the exact frequency of this concurrence is unknown, perhaps related to the absence from the International Classification of Headache Disorders (ICHD3) of amnesia or memory loss symptoms in association with migraine, unlike the situation with epileptic seizure (migralepsy) or stroke (migrainous infarction). Similarly, headache has generally been regarded as an incidental feature of TGA, reported in about 10% of cases. We present further examples of TGA in the context of migraine headache; consider possible reasons why this concurrence might be under-recognised, such as the retrograde amnesia characteristic of TGA; review possible shared pathogenetic mechanisms; and suggest a new terminology, “migramnesia”, which may encourage clinicians to address the possible significance of migraine in the context of an episode of TGA.

This paper aims to introduce an overview of several aspects of the so-called Artificial Intelligence, their potential impacts on economic and social dimen- sions, and suggestions for possible approaches of investiment based upon effective and mature techniques. In this fashion, it is important to address from educational and academic issues to industrial densities and profiles, rel- atively to a given region, country or continent. Even etymological adequacy and psychological consequences of the denomination ”Artificial Intelligence” need some reflection, and suggestions for a lucid replacement are presented. In addition, suggestions about how can specific firms choose the right type of technique in order to improve profit and organizational efficiency. After all, what are the main transformations needed to amplify gains and structural improvements from the use of higher level technological mecha- nisms? Which connections can be established between the pillars of evolu- tionary economics and this field of knowledge? Which institutional contexts are able to benefit from AI tools, inducing constructive externalities to firms in terms of education, technical and scientific skills upgrading, so as to reach higher levels of employment in the long term and limit unemployment in the short one? Which branches of the so-called Artificial Intelligence are best suited to which types of activities? This work aims to contribute in the search for answers to these questions.

Since the turn of the millennium, many individuals and groups, including Diane Moore (2007), Stephen Prothero (2007), the American Academy of Religion (2010), and The National Council for the Social Studies (2014, 2017, 2021), have advocated for better religious literacy education (RLE) in K-12 curriculum and public schools. Despite these calls, RLE has yet to make significant inroads in K-12 curriculum and public schools. This paper aims to define religious literacy and RLE, provide current rationales for its inclusion in K-12 curriculum and public schools, identify barriers to RLE, and explore the potential of global competence in promoting RLE.

DNA methylation is an epigenetic mechanism for gene expression modulation and can be used as a predictor of future disease risks. A prospective birth cohort study was performed to clarify the effects of neurotoxicants on child development, namely, the Tohoku Study of Child Development, in Japan. This study aimed to evaluate the association of prenatal exposure to five toxic metals—arsenic, cadmium, mercury, lead (Pb), antimony (Sb), and polychlorinated biphenyls (PCBs, N = 166)—with global DNA methylation in umbilical cord blood DNA. DNA methylation markers, 5-methyl-2’-deoxycytidine (mC) and 5-hydroxymethyl-2’-deoxycytidine (hmC), were determined using liquid chromatography-tandem mass spectrometry. The mC content in cord blood DNA was positively correlated with Pb and Sb levels (r = 0.442 and 0.288, respectively) but not with cord blood PCBs. We also observed significant positive correlations among Pb levels, maternal age, and hmC content (r = 0.159 and 0.243, respectively). The multiple regression analysis among the potential predictors demonstrated consistent positive associations between Pb and Sb levels and mC and hmC content. Our results suggest that global DNA methylation is a promising biomarker for prenatal exposure to Pb and Sb.

Background: To inform global health policies and resources planning, this paper analyzes evolving trends in physical rehabilitation needs, using data on Years Lived with Disability (YLDs) from the Global Burden of Disease Study (GBD) 2017. Methods: Secondary analysis of how YLDs from conditions amenable to physical rehabilitation have evolved from 1990 to 2017, for the world and across countries of varying income levels. Linear regression analyses were used. Results: A 66.2% growth was found in estimated YLD Counts amenable to physical rehabilitation: a significant and linear growth of more than 5.1 billion YLDs per year (99%CI: 4.8–5.4; r² = 0.99). Low-income countries more than doubled (111.5% growth) their YLD Counts amenable to physical rehabilitation since 1990. YLD Rates per 100,000 people and the percentage of YLDs amenable to physical rehabilitation also grew significantly over time, across locations (all p > 0.05). Finally, only in high-income countries Age-standardized YLD Rates significantly decreased (p < 0.01; r² = 0.86). Conclusions: Physical rehabilitation needs have been growing significantly in absolute, per-capita and in percentage of total YLDs, globally and across countries of varying income level. In absolute terms, growths were higher in lower income countries, wherein rehabilitation is under-resourced.

The purpose of this disquisition is to analyze bullfighting, its advances and setbacks at a global and local level in terms of animal law. It was developed as a descriptive documentary research with a non-experimental design, using the observation and interpretation of documents related to the subject, from the global level, to the local, the national, specific to the regions and communities, being interpreted through the hermeneutic method. In the analysis, results were reached such as: every day more countries are willing to assume that bulls, because they are living beings that feel, are being attended to from the legal and the ethical, propitiating changes in the way of thinking of people in terms of wanting to consider bullfighting, a sport, art and hobby considered cultural heritage of many countries. For this reason, different actions have been generated from surveys, to define the acceptance or not of these events. It is concluded that there are important advances in this regard, as bullfighting is being prohibited in different parts of the world, taking into account the protection that protects animals, but the laws do not establish specific prohibition in this regard worldwide.

This paper explores the imminent threat posed by climate change to the unique platypus species. It delves into the ecological repercussions of global temperature rise and altered climate patterns on platypus habitats. The study emphasises the multifaceted impacts, including changes in aquatic habitat quality, food sources, and breeding rituals. Climate-induced shifts in phytoplankton spring blooms and anthropogenic pressures further endanger the platypus's habitat. The article stresses the importance of understanding these effects for both species conservation and anticipating broader ecological and socio-economic consequences. Mitigating climate change impacts requires a multidimensional approach, involving habitat manipulation and restoration strategies.

The decay of the low-mode internal tide due to the superharmonic energy cascade is investigated in a realistically forced global Hybrid Coordinate Ocean Model (HYCOM) simulation with 1/25 degrees (4 km) horizontal grid spacing. Time-mean and depth-integrated supertidal kinetic energy is found to be largest near low-latitude internal tide generation sites, such as the Bay of Bengal, Amazon Shelf, and Mascarene Ridge. The supertidal kinetic energy can make up to 50% of the total internal tide kinetic energy several hundred kilometers from the generation sites. As opposed to the tidal flux divergence, the supertidal flux divergence does not correlate with the barotropic to baroclinic energy conversion. Instead, the time-mean and depth-integrated supertidal flux divergence correlates with the nonlinear kinetic energy transfers from (sub)tidal to supertidal frequency bands as estimated with a novel coarse-graining approach. The regular spaced banding patterns of the surface-intensified nonlinear energy transfers are attributed to semidiurnal mode 1 and mode 2 internal waves that interfere constructively at the surface. This causes patches where both surface tidal KE and nonlinear energy transfers are elevated. The simulated internal tide off the Amazon shelf steepens significantly near these patches, generating solitary-like waves in good agreement with Synthetic Aperture Radar (SAR) imagery. Globally, we find that regions of high supertidal energy flux also show a high correlation with observed instances of solitary nonlinear internal waves.

Coronavirus (COVID-19) pandemic caused sicknesses ranging from mild to deadly, which disrupted lives and healthcare systems across the globe. Despite the availability of vaccines that are effective in significantly reducing the risks of death and severe dis-ease, misperceptions of COVID-19 vaccine safety, efficacy, risks, and mistrust in insti-tutions responsible for vaccination campaigns have been reported as factors contrib-uting to vaccine hesitancy, making vaccination rate not satisfactory, which resulted in some countries implementing mandatory covid-19 vaccination to increase vaccine up-take. This scoping review aimed at mapping global countries that have adopted the mandatory covid-19 vaccination and the reaction of citizens. PRISMA Extension for Scoping Reviews was used. Google Scholar was used to identify papers published in English from December 2019 to February 2022, irrespective of their methodology. One hundred forty studies were identified. After screening for duplication, access, and rel-evance, 24 were eligible for review. About eleven countries implemented mandatory vaccination, mostly among health workers. Citizens’ reactions towards the policy var-ied, with some in support of the policy but with a preference for the healthcare workers, and some in support but with the condition that it will only apply to travel, schools, and shopping areas, while others rejected the policy. Studies that may be relevant but were excluded due to eligibility criteria may be a limiting factor to this study. Several ethical considerations should be explicitly addressed when evaluating whether man-datory COVID-19 vaccination is an ethically justifiable policy option as recommended by the WHO policy brief.

Global warming is one of the problems of human civilization and decarbonization policy is the main solution to this problem. In this work, we propose an alternative method of using the gravity-assist by the asteroids to increase the orbital distance of the Earth from the Sun. We can manipulate the orbit of asteroids in the asteroid belt by solar sailing and propulsion engines to guide them towards the Mars orbit and a gravitational scattering can put asteroids in a favorable direction to provide an energy loss scattering from the Earth. The result would be increasing the orbital distance of the earth and consequently cooling down the Earth’s temperature. We calculate the increase in the orbital distance of the earth for each scattering and investigate the feasibility of performing this project.

This study aims to summarize the literature on sustainable global supply chain management so that researchers and practitioners can see the trends in the area in a single place. Systematic literature review (SLR) or Content analysis is used as a methodology of this literature review, studies that are published within the time frame of 2010 to 2020 are included in this literature. Dimensions to analyze each article includes; year of publications, methodology of research, data collection type, unit of analysis, industry, a country in which data is being collected, respondents’ types, the theory that is used in the study, dimensions of the sustainability and finally the purpose of study either it is to test the already existing theory or building up a new theory. I found that sustainable global supply chain management is an emerging field and there is potential in the area for researchers to explore the area.

A sufficient condition for the almost global sta-bility of nonlinear switched systems under average dwell timerestriction is obtained. This condition is derived leaning uponthe existence of multiple Lyapunov densities, which are associ-ated to subsystems and satisfy some compatibility conditions.An upper bound for the average dwell time that ensures almostglobal stability is obtained.

Background. Asbestos has been used for thousands of years but in a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos caused cancer was identified in the late 1930’s but despite of today’s overwhelming evidence of the strong carcinogenicity of all asbestos types including chrysotile it is still widely used globally. Various estimates have been made over time including those of WHO and ILO 107,000–112,000 deaths. Present estimates are radically higher. This special edition of the Journal summarizes key aspects of the past and present of the asbestos problem globally. Methods. Documentation on milestones of asbestos related diseases, ARDs, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of ARDs were looked at. Results. Asbestos causes an estimated 257,000 deaths (243,223–270,635) annually according to latest knowledge. Work-related exposures are responsible for 235,000 deaths (222,322–247,363) of those. In the European Union, USA and in other High income economies (WHO regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high, in the Western European countries and EU equivalent of 0.70% of the GDP or 114.9*109 USD. Intangible costs could be much higher. When applying the Value of Statistical Life (VSL) of 4 million EUR per cancer death used by the European Commission we arrived 5at 410*109 USD while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but used widely today, some 2,030,000 tons consumed annually according to latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg asbestos powder format e.g. in Asia costs some 0.38 USD and 20 tons would cost in such retail market 7600 USD. Conclusions. Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programmes and policies, such as those on the elimination of all kind of asbestos use—that is banning of new asbestos use and tight control and management of existing structures containing asbestos—need revision and resources. The ILO/WHO Joint Programme for the Elimination of Asbestos-related Diseases need to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work we propose a limit value of 1000 fibres/m³.

Introduction: Left ventricular dysfunction in an independent predictor of mortality in Chagas disease. Global longitudinal strain (GLS) is an emerging echocardiographic modality with possible incremental value in early detection of cardiac involvement. Objective: Compare left ventricular function with multiple echocardiographic parameters between patients with the indeterminate and chronic forms of Chagas and perform a literature review. Methods: In this observational study, 11 patients with a confirmed diagnosis of Chagas disease were evaluated. Individuals were distributed as follows: 5 with the indeterminate and 6 with the chronic forms. Conventional echocardiographic evaluation was followed by GLS measurement. Results: The mean left ventricle ejection fraction LVEF was 33 ± 2.88 and the mean GLS of the left ventricle was - 10.76 ± 2.20 in the chronic form as compared to 57.80 ± 6.49 and - 17.34 ± 3.82, respectively in the indeterminate group. Contractility was reduced in segments of the inferior, inferoseptal and anteroseptal walls in both groups. Conclusion: Analysis of longitudinal strain in the indeterminate form has potential incremental value to the conventional analysis of ejection fraction when compared to patients with chronic Chagas cardiomyopathy, especially with individual segmental analysis but the impact and clinical significance of these techniques is still unknown.

Introduction: The disease caused by Coronavirus-2019 (COVID-19) was initially described in December 2019. Severe acute respiratory syndrome type 2 (Sars-Cov-2) is responsible for an important multisystem inflammatory spectrum. Cardiovascular conditions have been reported with an estimated frequency of 8-28%. In this context, transthoracic echocardiography associated with the analysis of the two-dimensional Global Longitudinal Strain (GLS) of the left ventricle derived from Speckle Tracking emerges as a promising modality. Objective: This study aims to evaluate the applicability of GLS and segmental deformity assessment in detecting subclinical myocardial dysfunction in patients that recovered from COVID-19 infection. Methods: The observational study involved 18 patients (mean age 52 years) with recent evidence of COVID-19 infection that underwent detailed echocardiographic evaluation with GLS, and cardiac magnetic resonance (CMR) according to segmental assessment results. The degree of correlation between the methods was analyzed and a systematic literature review was also conducted. Results: The mean left ventricular ejection fraction (LVEF) was 57.50 ± 9.98%. Only 16.6% of patients had reduced LVEF. The average GLS was – 18.70 ± 3.54% and in 44% of cases only one myocardial segment was affected, particularly the inferolateral basal. CMR revealed inflammatory cardiomyopathy. Discussion: Subclinical myocardial involvement is associated with major adverse cardiac events. Literature review supports the use of GLS for detecting early cardiac involvement. Conclusion: Speckle-tracking echocardiography has been shown to have clinical utility in a variety of settings and to offer superior prognostic value with a potential to enhance subclinical detection of myocardial changes in patients after COVID-19 infection.

Global optimization is widely adopted nowadays in a variety of practical and scientific problems. In this context, a group of techniques that is widely used is that of evolutionary techniques. A relatively new evolutionary technique in this direction is that of Giant Armadillo Optimization, which is based on the hunting strategy of giant armadillos. In this paper, a number of modifications to this technique are proposed, such as the periodic application of a local minimization method as well as the use of modern termination techniques based on statistical observations. The proposed modifications have been tested on a wide - series test functions, available from the relevant literature and it was compared against other evolutionary methods.

A method of geoengineering/solar radiation management is proposed as global warming countermeasure. The idea is to decrease surface temperature by increasing stratospheric ozone. One-dimensional (vertical) radiative-convective equilibrium temperature calculations show that surface temperature can be lowered by increasing the amount of ozone in the stratosphere. It was the increase in altitude above about 25 km that reduced surface temperatures. The method of increasing the amount of ozone (O3 injection), the rate of decrease of surface temperature after the ozone increase, and the rate of decrease of ozone concentration by photochemical reaction and diffusion/transport after the ozone increase are discussed.

Natural montane peatlands generally are not a significant source of nitrous oxide (N₂O) due to environment limitation including phosphorus (P) scarcity and temperature lowness. Phosphorus enrichment and warming caused by global change are altering this limitation, likely to increase the source function of N₂O. However, the combined effects of P addition and warming on N₂O fluxes and biotic/abiotic factor in peatlands are still uncertain. To address this, we investigated the long-term (12 yrs) effects of P addition (5 and 10 kg ha^-1 yr^-1) and its interaction with warming on N₂O fluxes in a peatland. The results showed that although long-term P addition did not significantly affect the source/sink function of N₂O in the peatland, it stimulated enzyme activities, promoted peat decomposition. However, warming amplified the effect of P addition to increase N₂O emissions by stimulating enzyme activities and changing soil stoichiometry, even turned the peatland into a significant source of N₂O with an emission of approximate 100 g m^-2 during the growing season. Our study suggests that P enrichment under the current background of global warming will enhance the possibility of strong N₂O emissions in montane peatlands, which may increase the risk to further aggravate global warming.

Monkeypox is a rare disease which is rising nowadays in different countries since the first case in the UK was diagnosed on May 6, 2022, by the United Kingdom (UK) Health Security Agency. Then more than 12,500 cases were identified in over 68 countries up to July 18, 2022. In endemic areas, the monkeypox virus (MPXV) is commonly transmitted through zoonosis, while in non-endemic regions, it is spread through human-to-human transmission. Symptoms can include flu-like symptoms, rash, or sores in hands, feet, genitalia, or anus. In addition, people who did not take the smallpox vaccine were more liable to be affected than others. The exact pathogenesis and mechanisms are still unclear; however, most identified cases are reported in men who have sex with other men (MSM). According to the CDC, transmission can happen with any sexual or non-sexual contact with the infected person. However, a recent pooled meta-analysis reported that sexual contact is involved in more than 91% of the cases. Also, it is the first time that semen analysis for many patients has shown positive monkeypox virus DNA. Therefore, in this review, we will describe transmission methods for MPXV while focusing mainly on potential sexual transmission and associated sexually transmitted infections. We will also highlight the preventive measures that can limit the spread of the diseases in this regard.

Disaggregated population counts are needed to calculate health, economic, and development indicators in Low- and Middle-Income Countries (LMICs), especially in settings of rapid urbanisation. Censuses are often outdated and inaccurate in LMIC settings, and rarely disaggregated at fine geographic scale. Modelled gridded population datasets derived from census data have become widely used by development researchers and practitioners. These datasets are evaluated for accuracy at the spatial scale of the input data which is often much courser (e.g. administrative units) than the neighbourhood or cell-level scale of many applications. We simulate a realistic "true" 2016 population in Khomas, Namibia, a majority urban region, and introduce realistic levels of outdatedness (over 15 years) and inaccuracy in slum, non-slum, and rural areas. We aggregate these simulated realistic populations by census and administrative boundaries (to mimic census data), and generate 32 gridded population datasets that are typical of a LMIC setting using WorldPop-Global-Unconstrained gridded population approach. We evaluate the cell-level accuracy of these simulated datasets using the original "true" population as a reference. In our simulation, we found large cell-level errors, particularly in slum cells, driven by the use of average population densities in large areal units to determine cell-level population densities. Age, accuracy, and aggregation of the input data also played a role in these errors. We suggest incorporating finer-scale training data into gridded population models generally, and WorldPop-Global-Unconstrained in particular (e.g., from routine household surveys or slum community population counts), and use of new building footprint datasets as a covariate to improve cell-level accuracy. It is important to measure accuracy of gridded population datasets at spatial scales more consistent with how the data are being applied, especially if they are to be used for monitoring key development indicators at neighbourhood scales with relevance to small dense deprived areas within larger administrative units.

The purpose of this paper is to bring to light a method through which the global in time existence for arbitrary large in H¹ initial data of a strong solution to 3D periodic Navier-Stokes equations follows. The method consists of subdividing the time interval of existence into smaller sub-intervals carefully chosen. These sub-intervals are chosen based on the hypothesis that for any wavenumber m, one can find an interval of time on which the energy quantized in low-frequency components (up to m) of the solution u is lesser than the energy quantized in high-frequency components (down to m) or otherwise the opposite. We associate then a suitable number m to each one of the intervals and we prove that the norm ||u(t)||_H1 is bounded in both mentioned cases. The process can be continued until reaching the maximal time of existence T_max which yields the global in time existence of strong solution.

This paper introduces new improvements to the modified version of the BIRECT (BI secting RECTangles) algorithm referred to as BIRECTv. We explore various approaches, by first including a grouping strategy for hyper-rectangles having almost the same sizes by categorizing them into different classes. Therefore constraining them not to exceed a certain pre-defined threshold (a small positive value to define the tolerance level). This approach allows for more efficient computation and can be particularly useful when dealing with a large number of hyper-rectangles with varying sizes. To avoid over-sampling, and preventing redundant or excessive sampling, at some shared vertices in descendant subregions, a particular vertex database is used to limit the number of samples taken within each subregion to two. The experimental investigation shows that these improvements have a positive impact on the performance of the BIRECTv(imp.) algorithm and the proposal is a promising global optimization algorithm compared to the original BIRECTv algorithm and its variants. Additionally, the BIRECTv(imp.) algorithm showed particular efficacy in solving high-dimensional problems.

Despite continued efforts by educators, UN declarations and numerous international agreements, progress is still limited in handling major global challenges such as ecosystem collapse, accelerating climate change, poverty and inequity. The capacity to collaborate globally on addressing these issues remains weak. This systematic review of research on global learning for sustainable development (GLSD) aims to clarify the diverse directions research on GLSD has taken, to present the historical development of the research area, and highlight emerging research issues. The review summarises key findings of the English language literature in the period 1994-2020 identified with the search terms “global learning” and “sustainable development”, sustainability or GLSD, respectively. The review documented a gradually growing knowledge base, mostly authored by scholars located in the global North. Conclusions point to what we might achieve if we could learn from one another in new ways, moving beyond Northern-centric paradigms. It is also time to re-evaluate core assumptions that underlie education for sustainable development more generally, such as a narrow focus on formal learning institutions. The review provides a benchmark for future reviews of research on GLSD, reveals the emerging transformative structure of this transdisciplinary field, and offers reference points for further research

Amethod for the certification of local and almost global stability of invariant sets of ordinary differential equations on torus is proposed. The method is based on using trigonometric polynomials as candidates of local Lyapunov functions or (global) Lyapunov densities (so-called dual Lyapunov functions) and converting the required local Lyapunov or dual Lyapunov conditions into semidefinite programming. We provide several examples with three and four oscillators to showcase the adaptability of our results, which can be used to certify partial or complete phase-locking/phase-cohesion and to validate the presence of an attracting/repelling set in various scenarios.

Cerebral ischemic stroke poses a significant global cause of death, with ischemia-reperfusion injury contributing to neuronal cell death and tissue damage. However, significant therapeutic approaches with meaningful treatment effects for patients with ischemic stroke in actual clinical practice are lacking. This study investigated the potential neuroprotective effects of sildenafil, a phosphodiesterase-5 inhibitor, in a global cerebral ischemia model. We explored the impact of sildenafil on GFAP and AQP-4 expression, which are markers associated with astrocyte activation and water homeostasis, respectively. The immunofluorescence analysis revealed that the number of cells co-expressing the markers, which increased in the ischemia-induced group, was significantly reduced in sildenafil-treated groups, suggesting a potential mitigating effect on ischemia-induced astrocyte activation. Additionally, we conducted diverse behavioral tests, including the open-field test, novel object recognition, Barnes maze, Y-maze, and passive avoidance tests, to assess the effect of sildenafil on the cognitive function impaired by ischemia. Cognitive improvements were observed following sildenafil administration (20mg/kg) compared to the untreated group. Taken together, the results presented here suggest sildenafil's potential as a neuroprotective agent for alleviating delayed neuronal cell death and cognitive function impaired by ischemia.

Background: Evaluation of left ventricular(LV) functions in patients with idiopathic premature ventricular contraction(PVC) with preserved LV Ejection Fraction(LVEF), especially in the subclinical stage, may be of great importance in terms of directing early treatment. Methods: A total of 122 patients, retrospectively recruited, were divided into three groups according to PVC burden: Group 1; 5%PVC<10%, Group 2; 10%PVC<15%, and Group 3; 15% PVC. Transthoracic echocardiography(TTE) was performed to evaluate LV parameters. Results: LV-GLS was found to be significantly lower in groups 2 and 3 with high PVC burden (18.89 ± 1.4, 17.55 ± 2.1, 16.26 ± 1.3; p<0.001 respectively). Correlation analysis revealed a positive and significant correlation between PVC burden with deterioration in LV-GLS (r:0.536; p<0.001). In addition, PVC burden was found to be an independent predictor of LV-GLS deterioration in multiple linear regression analysis(:0.525, p<0.001). The ROC curve analysis demonstrated that a PVC burden cut-off value of 8.4% was associated with a LV-GLS deterioration greater than -18, with a specificity of 75.4% and a sensitivity of 75.4% (AUC: 0.81 [0.73-0.88] 95% CI; p<0.001). Conclusions: PVC burden was an independent predictor of deterioration in LV-GLS. In the presence of subclinical LV injury associated with PVC burden, early catheter ablation strategies may be therapeutically beneficial.

Previous studies have suggested that digitization of finance leads to growth in the economy in several middle- and high-income countries, but research in low- and lower-middle-income countries (LLMICs) remains limited. This research aimed to examine the trends, barriers, relationships, and prospects of finance digitization in LLMICs. This study used analytical and descriptive cross-sectional study designs. Sixty-six countries were purposively selected based on the available data on the Global Findex and the World Development Indicators databases. Descriptive analysis was used to identify the trends in the finance digitization indicators, correlation analysis was used to assess the nature of the association between finance digitization and the economy, and exponential smoothing was used to predict future outcomes in digital finance. The results indicated that the adoption and utilization of finance digitization increased in these countries, but the growth rates varied by region and income group. Low-income countries reported the highest rates of subscriptions to digital finance accounts and storing money in digital accounts, while lower-middle-income countries (LMICs) reported higher rates of inbound/outbound digital transactions, borrowings, and savings using digital channels. Sub-Saharan Africa reported the highest rates of digital finance account subscriptions, digital savings, and digital borrowings, while Europe and Central Asia reported the highest rates of in/out digital transactions. Barriers to digitization in these countries included poor access to the internet, high cost of digital finance products, and lack of a mobile phone, with low-income countries facing more challenges. The analysis revealed a negative significant relationship between finance digitization and Gross National Income growth and a positive significant correlation between finance digitization and other economic growth indicators (gross savings and Gross Domestic Product). Finance digitization was predicted to continue to rise in these countries for the next decade. The study recommended that policymakers should promote the adoption of digital finance and address the barriers and risks of finance digitization in LLMICs, as it had positive effects on economic growth.

Nowadays, higher education students play an active role in the realization of sustainable development goals (SDGs) for global citizenship. However, some important issues such as how much students know about these goals can play a role in achieving these goals are not yet clear. The aim of this study is to establish a fundamental study for determining the level of knowledge on the higher education students about SDGs. An open-ended questionnaire was conducted with the qualitative research methods on 54 higher education students after pandemic of COVID-19. As a result of the research, the goals of quality education, gender equality, health and quality of life, reduction of inequalities and peace, justice and strong institutions are the most frequently mentioned by the students. In addition, the opinions of the students on the subject of “sustainable cities and communities” are sequentially; the themes include ensuring socio-economic development, preserving cultural heritage identity, safe environment and durable buildings, as well as modern irrigation and waste methods, and reducing air pollution. On the other hand, they agreed on the need for global citizenship to have universal qualifications. In conclusion, global citizenship contributes directly to the SDGs and human-oriented production should be given more importance.

Semantic segmentation of remote sensing urban scene imagery is a pixel-wise prediction, which is applied to identify the land-cover or land-use category. However, semantic segmentation demands huge computation cost. In order to reduce the huge computation cost, a common method is to introduce transformer and CNN hybrid method to have a good trade-off between accuracy and computation cost. However, recent CNN-transformer hybrid methods often capture local-global context and cross-window interaction information simultaneously. Then they introduce the local-global context to fuse the local feature, which repeat fuse the local and global feature and result in the additional computation cost. And previous methods often ignore to filter the local and global feature. To fix the problem, we design a lightweight decoder-EDDformer, which is Efficient Global Value Transformer with Dynamic Gatefusion module. Efficient global value transformer only response for extracting global feature. Dynamic Gatefusion module filter the local and global semantic feature and fuse them to capture the local-global context in one time. Extensive experiments reveal that our method not only runs faster but also achieves higher accuracy compared with other state-of-the-art lightweight models.

The oncogenicity of the human cytomegalovirus (CMV) is debated to this day. In recent years, mounting evidence addresses an anti-cancer effect via T cell-mediated CMV-targeted tumor de-struction. However, the data mostly comes from single-center studies and in vitro experiments. Broad geographic coverage is required to offer a global perspective. This study examined the correlation between country-specific CMV seroprevalence (n=73) and age-standardized inci-dence rates for 34 tumors using data obtained from the International Agency for Research on Cancer of the World Health Organization. The association between CMV and cancer incidences in 10-year age increments was also analyzed. The study revealed a worldwide inverse correlation between CMV seroprevalence and incidences of 88.2% tumors. Notably, this inverse link persists for all cancers combined (Spearman’s ρ= -0.732, p= 0.001). An antithetical and significant correlation is also observed in particular age groups for the vast majority of tumors. Our results corroborate the conclusions of previous studies and indicate that this phenomenon holds true on a global scale. It applies to a wide spectrum of cancer histologies, suggesting a common under-lying mechanism – CMV-stimulated T cell tumor targeting. Although these results further advance the notion of CMV-based therapies, further in-depth investigation of host-virus interactions is warranted.

This book review addresses the contribution of Tim Marshall’s “The Power of Geography”. The purpose of this essay is to highlight the significant role of geography in shaping political landscapes, alliances, and global affairs through the book review. What is new about this essay is its accessible presentation of complex geopolitical concepts, making it a valuable resource for students of geography and readers interested in global politics. Through the analysis of case studies and historical background, the book illuminates the interplay between physical landscapes, territoriality, and power dynamics. The findings highlight the continuing influence of geography on nations, regional identities, and the evolving global order.

Contamination with Arsenic, a toxic metalloid, is increasing in the marine environment. Additionally, global warming can alter metalloids toxicity. Polychaetes are key species in marine environments. By mobilizing sediments, they play vital roles in nutrient and element (including contaminants) cycles. Most studies with marine invertebrates focused on the effects of metalloids on either adults or larvae. Here we bring information on the effects of temperature increase and arsenic contamination on the polychaete Hediste diversicolor in different growth stages and water temperatures. Feeding activity and biochemical responses – neurotransmission, indicators of cell damage, antioxidant and biotransformation enzymes and metabolic capacity - were evaluated. Temperature rise combined with As imposed alterations on feeding activity and biochemical endpoints at different growth stages. Small organisms have their antioxidant enzymes increased, avoiding lipid damage. However, larger organisms are the most affected class due to inhibition of superoxide dismutase, which resulted in protein damage. Oxidative damage was observed on smaller and larger organisms exposed to As and 21 °C, demonstrating higher sensibility to the combination of temperature rise and As. The observed alterations may have ecological consequences, affecting the cycle of nutrients, sediment oxygenation and the food chain that depend on the bioturbation of this polychaete.

This short report contains a result that characterizes almost global pullback attractor of discrete-time non-autonomous systems. Analogously to the multiple Lyapunov functions approach for switched systems, we show here that existence of multiple Lyapunov densities implies pullback convergence of almost all initial states to the origin for a discrete-time non-autonomous system.

Transient global amnesia (TGA) is an uncommon clinical syndrome characterized by a loss of short-term memory and disorientation that resolves in twenty-four hours. The etiology is unknown and the diagnosis is made by exclusion of other possible etiologies that may cause similar patterns and the reversibility of the condition in less than 24 hours. Here we report a 60-year-old male presented with sudden onset of disorientation and short-term memory loss early in the morning while at home and started to ask his whereabouts and what happened. He had no history of significant medical or psychiatric disease. There was no history of previous similar episodes. He had no recent history of sleep problems, head trauma, substance abuse, or loss of consciousness. He had no history of seizure disorder, or migraine. A neurologic examination revealed a normal wakefulness state with mild disorientation, and short-term memory impairment. He had score of 18/30 on mini-mental state examination (which later returned to normal baseline in 24 hours). Extensive lab investigations did not show any abnormal findings. Brain MRI did not show any acute cerebral pathology. The EEG was negative for any abnormal cerebral activity. His memory improved and returned to normal baseline over the course of a 20-hour from the onset. After exclusion of potential causes and the patient returned to normal state of memory, the diagnosis of transient global amnesia was made. At the follow-up visit, the patient was in a state of normal function without a recurrence of memory impairment. Here we presented this interesting case of transient global amnesia. TGA is diagnosis of exclusion and important to keep in mind when evaluating a patient with acute onset of short-term memory impairment, especially when etiological investigation revealed no potential cause.

Heat stress during the grain-filling period is the main abiotic stress factor limiting grain yield and quality in wheat (Triticum aestivum L.). In this study, 64 wheat genotypes were exposed to heat stress during reproduction caused by delayed sowing in two growing seasons. Grain yield, 1000 grain weight (GW), grain hardness (GH), and grain-quality related traits were investigated using wholemeal flour. Heat stress caused a significant decrease in GW through reducing starch content (SC) and a non-compensating rise in protein content (PC), and thereby resulted in lower yield. In addition, significant increases in flour water absorption (WA), Zeleny sedimentation volume (ZT), ash content (AC), lipid content (LC), loaf volume (LV), wet gluten content (WG), dry gluten content (DG), gluten index (GI), and amylopectin content (APC) were found following heat stress. In contrast, decreases in grain moisture content (MC) and amylose content (AMC) induced by heat stress were observed. The heat-tolerant genotypes were superior in grain yield, GW, SC, AMC, and MC. While the sensitive genotypes contained higher PC, LV, GI and AMP. A group of wheat genotypes characterized with a higher yield, AMC, GW, and SC as well as lower PC, WA, GH, ZT, and LV; and was found to be the most heat tolerant by principal component analysis. Decreases in the ratio of carbohydrates to proteins induced by heat stress, and lower protein content of normal grown wheat genotypes were observed. Therefore, lighter weight and smaller grains produce a smaller starchy endosperm with lower quality (less amylose) and higher grain protein content in heat stress compared to normal conditions. Heat stress caused by delayed sowing improves some of the baking-quality related traits. Whether this improvement in grain quality attributes will translate into better human health outcomes requires further investigation.

Serendipity favors the prepared mind, but how does the brain make that lucky find? Analyzing the cerebral mechanisms behind an exceptional (albeit trivial) discovery, the author suggests that a combination of ‘concept cells’ and the Global Neuronal Workspace Hypothesis could explain how we make great discoveries.

The usual equation for both motions of a single planet around the sun and electrons in the deterministic Rutherford-Bohr atomic model is conservative with a singular potential at the origin. When a dissipation is added, new phenomena appear which were investigated thoroughly by R. Ortega and his co-authors between 2014 and 2017, in particular all solutions are bounded and tend to $0$ for $t$ large, some of them with asymptotically spiraling exponentially fast convergence to the center. We provide explicit estimates for the bounds in the general case that we refine under specific restrictions on the initial state, and we give a formal calculation which could be used to determine practically some special asymptotically spiraling orbits. Besides, a related model with exponentially damped central charge or mass gives some explicit exponentially decaying solutions which might help future investigations. An atomic contraction hypothesis related to the asymptotic dying off of solutions proven for the dissipative model might give a solution to some intriguing phenomena observed in paleontology, familiar electrical devices and high scale cosmology

The usual equation for both motions of a single planet around the sun and electrons in the deterministic Rutherford-Bohr atomic model is conservative with a singular potential at the origin. When a dissipation is added, new phenomena appear. It is shown that whenever the momentum is not zero, the moving particle does not reach the center in finite time and its displacement does not blow-up either, even in the classical context where arbitrarily large velocities are allowed. Moreover we prove that all bounded solutions tend to $0$ for $t$ large, and some formal calculations suggest the existence of special orbits with an asymptotically spiraling exponentially fast convergence to the center.

The COVID-19 crisis has brought unprecedented strain on healthcare systems around the world. It has perhaps taught us some key lessons that are worth considering and addressing to help build more sustainable health systems as well as improve our ability to combat future epidemics.

Frailty is an important age-associated risk-state. Despite this, many countries lack population estimates and large heterogeneity exists amongst studies. The Global Burden of Disease (GBD) study, provides comparable high-quality population-level data for 195 countries and territories. Frailty has never been measured in the GBD studies. This analysis applies the deficit accumulation model to construct a novel frailty index (FI) using the GBD 2017 dataset. Standard FI criteria were applied to all GBD categories such that selected items were health-related, age-correlated, sufficiently prevalent, did not saturate at an early age, had little redundancy/duplication, covered a range of systems, were plausible and were available serially for the same population. From all 554 GBD items, 36 were selected including 26 non-communicable diseases, 3 metabolic risks, 3 biological impairments, infectious diarrheal diseases, protein-energy malnutrition, injurious falls, and low physical activity. Variable face validity was displayed against a selection of established FIs. The mean GBD-FI score for the global population aged ≥70 years in 2017 was 0.16; scores were higher in females than males (0.16 vs 0.15, respectively). Deficits accumulated with age at an estimated rate of 0.026 per year. Adding the mean GBD-FI scores to a regression model including country-level variables for demographics (proportion ≥85 years, proportion female), healthcare quality (HAQ index), and development (SDI) increased the adjusted r2 value from 27.0% to 39.6% (p<0.001) for predicting country-level death rates from non-communicable diseases, suggesting that the GBD-FI is a useful predictor of mortality. Further analysis is required to compare the reliability and predictive validity of the GBD-FI with existing frailty tools

This article aims to discuss, the stability and boundedness character of the solutions of the rational equation of the form \begin{equation}\label{eql21.1} y_{t+1}=\frac{\nu\epsilon^{-y_t}+\delta\epsilon^{-y_{t-1}}}{\mu+\nu y_t+\delta y_{t-1}},\quad t\in N(0). \end{equation} Here, $\epsilon>1, \nu,\delta,\mu\in (0,\infty)$ and $y_0, y_1$ are taken as arbitrary non-negative reals and $N(a)=\{a,a+1,a+2,\cdots \}$. Relevant examples are provided to validate our results. The exactness is tested using MATLAB.

One of the main problems for managing global crises is to clarify and reduces drivers of systemic weaknesses to face complex emergencies. This study here analyzes the relation between public debt, healthcare expenditures and fatality rates in the presence of pandemic crises, such as COVID-19. Statistical evidence, based on a sample of European countries, here shows that high public debt over time reduces health expenditures and increases the vulnerability of countries to face emergencies, such as COVID-19 pandemic crisis. Regression analysis with a log-log model suggests that when European countries experience a 1% increase in healthcare expenditure per capita, in general they have a 1.2% reduction in the COVID-19 fatality rate. Main implications of this study to reduce the systemic risk and vulnerability to environmental threats are that countries must reduce public debt with good governance and institutions without reducing the allocation of economic resources to the healthcare sector in order to improve the preparedness to unforeseen emergencies and crises, such as pandemics, natural disasters, conflicts, and other environmental threats.

Based on recent interest and on the importance of the ongoing climate change catastrophe, this article provides the basics of global carbon cycle modelling as required for the assessment of the degree of carbon neutrality of biomass energy, and its underlying dynamics. It is aimed at clari-fying the question “Are biomass fuels carbon neutral?”. The "Combined Energy and Biosphere Model" (CEBM) computes annual carbon flows including growth and decay of plants on 2.52.5° grid elements of the continents’ surface and offers detailed results on the changes of after implementation of large-scale biomass energy strategies world-wide. The main (and possibly unexpected) effect is the long-term depletion of the soil organic compartment after extraction of biomass fuels. When comparing CEBM model runs using (i) biomass energy sources and (ii) carbon-free energy sources (such as solar or wind), it becomes quantitatively clear already on the theoretical level (i.e., even without taking into account effi-ciency losses) that biomass is only “half as carbon neutral” as ideally assumed, to express a rule of thumb – mainly because of soil carbon depletion. Still, biomass energy will play an important role when fighting global warming, even if efforts to lower energy demand are preferable as a fundamental strategy.

This study presents the first genome assembly of the freshwater saprobe fungus Neonectria lugdunensis and a comprehensive phylogenomics analysis of the Nectriaceae family, examining genomic traits according to fungal lifestyles. The Nectriaceae family, one of the largest in Hypocreales, includes fungi with significant ecological roles and economic importance as plant pathogens, endophytes, and saprobes. The phylogenomics analysis identified 2684 single-copy orthologs, providing a robust evolutionary framework for the Nectriaceae family. We analyzed the genomic characteristics of 17 Nectriaceae genomes, focusing on their carbohydrate-active enzymes (CAZymes), biosynthetic gene clusters (BGCs), and adaptations to environmental temperatures. Our results highlight the adaptation mechanisms of N. lugdunensis, emphasizing its capabilities for plant-litter degradation and enzyme activity in varying temperatures. Comparative genomics of different Nectriaceae lifestyles revealed significant differences in genome size, gene content, repetitive elements, and secondary metabolite production. Endophytes exhibited larger genomes, more effector proteins, and BGCs, while plant pathogens had higher thermo-adapted protein counts, suggesting greater resilience to global warming. In contrast, the freshwater saprobe shows less adaptation to warmer temperatures and is important for conservation goals. This study underscores the importance of understanding fungal genomic adaptations to predict ecosystem impacts and conservation targets in the face of climate change.

Ocean exploration is crucial for utilizing its extensive resources. Images captured by underwater robots suffer from issues such as color distortion and reduced contrast. To address the issue, we propose an innovative enhancement algorithm that integrates Transformer and Convolutional Neural Network (CNN) in a parallel fusion manner. Firstly, a novel transformer model is intro-duced to capture local features, employing peak-signal-to-noise ratio (PSNR) attention and linear operations. Subsequently, to extract global features, both temporal and frequency domain features are incorporated to construct convolutional neural network. Finally, the Fourier’s high and low-frequency information of the original image are utilized to fuse different features. To demon-strate the algorithm's effectiveness, underwater images with various levels of color distortion are selected for both qualitative and quantitative analyses. The experimental results demonstrate that our approach surpasses other mainstream methods, achieving superior PSNR and structural sim-ilarity index measure (SSIM) metrics and leading to a detection performance improvement of over ten percent.

In this study, we develop a stochastic partial differential equation (SPDE) model to assess the regional severity of temperature increases due to global warming. The model incorporates various stochastic processes to account for uncertainties such as solar explosions, economic upheavals, rising emissions, and irreversible changes in the climate system. Our base temperature model, influenced by latitude, is enhanced by these random factors to simulate realistic and diverse outcomes of climate change. Numerical simulations on a global grid provide a heatmap representing potential temperature increase severity across different regions. The results highlight the significant impact on tropical and polar regions, demonstrating the utility of SPDE models in understanding and predicting the complex dynamics of climate change. This approach offers valuable insights for policymakers and researchers aiming to develop adaptive strategies for mitigating the adverse effects of global warming.

Using a sample of 103 surviving and non-surviving global bond funds over a long sample period of 1998 to 2022, we perform a comprehensive analysis of the funds under our modified Sharpe’s (1992) style analysis model. We find that dynamic style analysis is useful in explaining time-series and cross-sectional and in predicting future returns of global bond funds. The dynamic style analysis also allows us to examine asset allocation over time. The results show that, during 2001 to 2014, funds shift their allocations from intermediate-term bonds to world corporate bonds and from world corporate bonds to emerging market bonds in search of higher returns at the price of credit quality.

This article seeks to provide an improved and more comprehensive understanding of the concept and theories on wasteland. It achieves this by focusing on the Indian context allowing us to unpack the importance of including multiple perspectives of wasteland narratives; this means including more positive narratives of the potential of wasteland to inform and improve prospects for land policies in the global south. Wasteland is commonly recognized as an underutilized category of land that may transform into a valuable resource base with proper management measures. The term waste has multiple angles that carry different notions ranging from fallow to agroforestry land in the global south and Brownfield to green space in the global north. We conduct a narra-tive review approach to qualitatively analyze the concept wastelands studied in pre-existing lit-erature from 1970 to present. The unsystematic literature review approach incorporates multiple elements of wasteland discourse, like understanding the meaning of the term on a global scale, setting out the meaning of the term waste into multiple perspectives explicitly in the Indian con-text, along with different classes and management approaches of wasteland from a national per-spective. The multiple perspectives of wasteland not only generate misconception on land resource but spawn difficulties in land use policy particularly for Indian scenario. For sustainable land use policy, reclaiming wasteland would be the best possible way for India and other countries in Global South, which requires a comprehensive methodological overview on wasteland narrative.

The conventional well placement was done manually by using a numerical reservoir simulator, and it required a lengthy trial-and-error process. It required great experience and expertise to manipulate the variables and uncertainties that lie on the reservoir to determine the best placement of the well. In addition, the traditional gradient-based methods such as Line-search and Trust-region were not viable in terms of maximum results obtained. Gradient-based methods were too dependent on the surface gradient of the solution and may only converge to local optima instead of global optima. Complex reservoirs have rough surfaces with high uncertainties, which hinders the traditional gradient-based method from converging to global optima. Thus, genetic algorithms were utilized to automate the manual trial-and-error process and to overcome the limitations of the traditional gradient-based method. The objectives of this study were to analyse the effect of different initial well placement distributions, the number of random solution sizes, and the crossover rate on cumulative oil production. A synthetic reservoir model built using CMG Builder was used as the testing platform for the optimization problems. Well-placement parameterization and optimization set-up were carried out using the CMG CMOST optimization tool. The integration of CMG IMEX and CMOST optimized cumulative oil production based on the objectives of the study. The results obtained showed that the higher number of random solutions used resulted in higher cumulative oil production, with more generations needed to reach the optimum solution. It can be concluded that the larger number of random solutions used increased the probability of reaching the optimum solution, but will take more generations.

Abstract: Recent years demonstrate the increased attention to radon from two scientific directions. After neglecting radon as earthquake precursors in 1990-th it becomes again the subject of earthquake-forecast papers discussions due to growing networks of the radon monitoring in different countries, especially, the technologies of real-time radon measurements where the gamma-spectrometers become the leader of interest as the sources of 222Rn identification. The second fast developing direction is including the radon in the Lithosphere-Atmosphere-Ionosphere Coupling (LAIC) models as a source of the boundary layer ionization. And here we encounter with second direction which is not connected with the earthquake forecast problems. It is the role of air ionization by radon as a source of the Global Electric Circuit (GEC) modification. In this publication we try to unite all these problems to present more complex view on radon as important element of our environment.

Worldwide, among older adults, infection is the leading mortality cause; chronic nutritional deficits confer significant mortality risk and increase healthcare costs. The association of the Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition with infection-related mortality, especially with renal dysfunction in older patients, remains unevaluated. In older patients hospitalized with infection, stratified by renal function, we investigated the association of malnutrition severity with mortality. This single-center, retrospective cohort study of 1220 participants (age ≥65 years) admitted to Aichi Medical University from 2019 to 2020 used a multivariate Cox proportional hazards model to determine the association of GLIM-defined nutritional status (no, moderate, or severe malnutrition) with all-cause mortality. Compared to no malnutrition, moderate and severe malnutrition conferred significantly higher mortality (adjusted hazard ratio [confidence interval ]: 1.00 [reference], 1.76 [1.28-2.42], and 2.44 [1.78-3.33], respectively), with the highest all-cause mortality in malnutrition with a low estimated glomerular filtration rate (eGFR &lt;30 mL/min/1.73m2; 7.35 [4.57-11.8]) compared to no malnutrition and normal eGFR (≥60 mL/min/1.73m2). GLIM-defined malnutrition confers higher all-cause mortality risk in older adults with infection, especially those with renal dysfunction. This information enables the identification of high-risk older patients with infection and targeted clinical management of those with malnutrition, renal dysfunction, and infection.

AbstractBackground: The World Health Organization (WHO) said the situation in India was a "devastating reminder" of what the coronavirus could do. COVID-19 cases suddenly spiked across India. Union Health Minister Harsh Vardhan has said that one of the major reasons for the spike in coronavirus cases was people not following COVID-appropriate behaviour. The Union minister noted that the sudden rise in cases is largely or maybe event-driven comprising local body elections, grand weddings, and farmers' protest. These events may cause asymptomatic covid-19 carriers to spread wide covid-19 to others. Malaysia is also facing a surge in Covid-19 may due to the spread of covid-19 by asymptomatic covid-19 carriers. Therefore, it is important to develop an application that can publicize information on asymptomatic covid-19 carriers. The purpose of this application is to provide sufficient information and scientific research evidence to ensure that prevention strategies for asymptomatic covid-19 carriers must be implemented. The app is also open to anyone who uses it to educate others so that information can be shared more quickly to prevent other countries from becoming "Second India or Malaysia".Method: The homepage of the app shows that asymptomatic covid-19 carriers may have a lower viral load, the same viral load, or a higher viral load than symptomatic covid-19 carriers. When the user app is pressed by each category, they will see sufficient information and scientifically based research evidence about each category. These apps also show the evidence that on January 13, 2021 - Malaysian Health Department Director Dr Noor Hisham Abdullah instructs test Only those Close Contacts With Symptoms and The Malaysian Medical Association (MMA) has urged the Health Ministry to urgently improve the management of mild Covid-19 cases and revert to its policy of testing all close contacts. In addition, These apps also show App raise public awareness of the importance of COVID-19 vaccination(version 4) [Peter Chew, 2021] can intuitively see that countries with high vaccination rates can solve the problem of asymptomatic transmission of covid-19 carriers.Result: This application displays sufficient information and scientifically based research evidence to prove asymptomatic covid-19 carriers are the main key to the outbreak of covid-19. Some countries are using covid-19 symptom prevention strategies. They are only testing the symptomatic closed contact of covid-19 patients, because they may think that asymptomatic covid-19 carrier is just a low viral load and a low transmission rate, which is wrong. Some asymptomatic covid-19 carriers of covid-19 have high viral loads. The accumulation of asymptomatic covid-19 carriers with high viral load is the main cause of the covid-19 outbreak. Conclusion: Three apps have been developed to educate the public about the importance of asymptomatic covid-19 carriers. The asymptomatic covid-19 carrier education app (1) will provide sufficient information and scientific research evidence to educate citizens of any country to ensure that preventive strategies must be implemented for asymptomatic carriers to prevent the country’s Covid-19 outbreak. App, Game Base Learning to Prevent Infection from COVID-19 (version 3) [Peter Chew, 2020 ]. The app allows anyone to intuitively see that when the second wave covid-19 arrives, the accumulation of a large number of asymptomatic carriers in some countries has led to the high infection rate of covid-19. This is what is happening in India now. App raise public awareness of the importance of COVID-19 vaccination(version 4) can intuitively see that countries with high vaccination rates can solve the problem of asymptomatic transmission of covid-19 carriers. This is what is happening in Israel now.

The stability and optimal control for an SIS epidemic model with demographics and heterogeneous control strategies (immunization and quarantine) on complex networks are investigated. The epidemic threshold, disease-free and endemic equilibria are derived. Then, global asymptotical stability about the two equilibria are studied based on different methods. Furthermore, the optimal control issue about the system is also considered. We obtain the existence and uniqueness of the optimal control and optimal control tactics. Some numerical simulations were conducted to illustrate and supplement the theoretical results. Meanwhile, the effects of the combination of various immunization and quarantine schemes are studied and also compared with the optimal control strategies.

This study assesses the feasibility of hepatitis B and C elimination, using an analysis of trends of epidemiology data (1990-2019) from the global burden of disease. Joinpoint regression analysis was used to identify significant changing points in trends of Age-standardizes Prevalence Rate (ASPR) and Age-standardizes Mortality Rate (ASMR) and to estimate the annual percentage changes (APC) and the average annual percentage changes (AAPC) for the period. Sociodemographic Index (SDI) was used to analyze trends between countries. The total percentage change of the ASPR (2019/1990) was -31.4% and -12.8% for HBV and HCV worldwide respectively, the rate ratio (HBV/HCV) was 2.5. Mortality has decreased for HBV but not for HCV. The total percentage change for the ASMR (2019/1990) was -26.7% and 10.0%, for HBV and HCV respectively. While ASMR of HBV decreased, HCV increased during this period. The percentage change in ASMR of HBV was highest in countries with high-middle SDI and lowest in countries with high SDI. For HCV, the percentage change in ASMR was highest in countries with High SDI (increase) and only in countries with low SDI decreased. The global HBV and HCV rates have fallen with different AAPC associated with the SDI. Despite the advances, there is still a long way forward to achieve the 2030 elimination goals. An important challenge is related to finding a way to speed up the yearly rate at which the decline is happening.

This comprehensive review examines the critical issue of antimicrobial resistance (AMR), a growing global concern with profound societal implications. This article presents an overview of the causes of AMR, including the misuse and overuse of antibiotics in healthcare, agriculture, and veterinary practices. Various conventional and advanced detection methodologies have been explored, highlighting the importance of the accurate and timely identification of resistant strains. The challenges associated with tackling AMR, encompassing scientific, economic, and regulatory aspects have been discussed in depth. In addition, this article sheds light on the far-reaching societal implications of AMR, including increased healthcare costs, treatment complexities, and potential disruptions to healthcare systems. This emphasizes the urgency of adopting proactive strategies to combat AMR and underscores the need for global cooperation, policy interventions and public awareness campaigns. By unraveling the multifaceted dimensions of AMR, this review aims to enhance our understanding, stimulate further research, and promote concerted efforts to mitigate the threat of antimicrobial resistance.

With enhanced life expectancy and ageing global populations, the prevalence of multimorbidity continues to increase. However, there is a dearth of evidence linked to multimorbidity diagnoses, treatments and health outcomes which remains a concern for future proofing optimal healthcare services. Generating evidence is critical to managing multimorbidity, promoting public health and minimizing health inequalities via effective healthcare policies that improve quality of life for vulnerable populations. This study assessed meta-epidemiology of multimorbidity to report the gaps in scientific knowledge and clinical practice. A systematic methodology was designed and published in PROSPERO (CRD42022347308) to report meta-epidemiology analyses using databases including PubMed, Web of Science, ScienceDirect, EMBASE, The Cochrane Gynaecology and Fertility Group Specialised Register of Controlled Trials and MEDLINE for studies published between the 1^st of January 1980 - 31^st December 2022. A random-effects model was used to estimate the pooled proportion of multimorbidity in adults. Forest plots, pooled odds ratios and statistical heterogeneity metrics were used to assess the association between multimorbidity and investigated factors. Funnel plots and Egger’s regression were used to detect and correct for publication bias. Our findings identified women to be 0.32 times more likely to have multimorbidity in comparison to males. In regard to ethnicity, white people were 0.47 times less likely to develop comorbidities than black people. People who identified as a drinker or unmarried were more likely to develop comorbidities than those who are non-drinkers or married, respectively. Regardless of smoking status, people were equally likely to have comorbidity. In terms of environmental influences, people in rural areas were found to be 0.2 times less likely to have comorbidity in comparison to those living in urban areas. Interestingly, people with a higher education level were 0.57 times more likely to develop comorbidities than those with only a high school education. It is evident that multimorbidity has a significant burden globally and impacts the provision of care necessitated across populations given its association with several social determinants of health. Robust research and healthcare policies are required to better manage multimorbidity in patients. An example of such intervention includes employing prevention programs to reduce risk and incidence of multimorbidity within at-risk populations.

Broadband noise reduction over the low-mid frequency range in the building and transportation sectors requires compact lightweight sound absorbers of typical sub-wavelength size. The use of multi-layered closely-spaced (micro-)perforated membranes or panels, if suitably optimized, contribute to these objectives. However, their elasticity or modal behaviors often impede the final acoustical performance of the partition. The objective of this study is to get insights into the vibrational effects induced by elastic limp membranes or panels volumetric modes on the optimized sound absorption properties of acoustic fishnets and functionally-graded partitions (FGP). Cost-efficient global optimization of the partition total frequency-averaged dissipation is achieved from simulated annealing with vibrational effects included through an impedance translation method. Critical coupling analysis reveals how the membranes or panels vibrations redistribute the locations of the Hole-Cavity resonances as well as their cross-coupling with the panels first volumetric mode. It is found that elastic limp micro-perforated membranes broaden the first pass-band of acoustic fishnets while smoothing out the dissipation ripples over the FGP optimiza-tion bandwidth. Moreover, the resonance frequency of the first panels mode sets an upper limit to the broadband optimization of FGPs, up to which high dissipation, low reflection and low trans-mission can be achieved.

This study aimed to investigate the diagnostic potential of circulating microRNAs (miRNAs) for detecting early myocardial fibrosis development in HFpEF patients. This observational study used a case-control research design. Peripheral blood samples were isolated from 25 HFpEF patients and 25 normal patients. They were measured for NTproBNP levels using ELISA, as well as MicroRNA-1, 21, and 29 levels using RT-PCR. All patients also underwent echocardiography for global longitudinal strain (GLS) to measure the myocardial fibrosis progression. Data were analyzed using SPSS 25.0. HFpEF patients had significantly higher GLS compared to the normal patients (-13±2.4% vs -19±3.2%; p &lt; 0.05), suggesting HFpEF patients tended to have myocardial fibrosis. HFpEF patients also had significantly higher microRNA-1 and microRNA-21 compared to the normal patients (p &lt; 0.05), but they had lower microRNA-1 (p &lt; 0.05). There was a positive correlation between microRNA-1 (r = 0.753; p &lt; 0.05) and microRNA-21 (r = 0.675; p &lt; 0.05) and an inverse correlation with microRNA-29 (r = -0.653; p &lt; 0.05) based on the GLS findings. By using a GLS cutoff of -15% for myocardial fibrosis, microRNA-1, microRNA-21, and microRNA-29 were found to be able to predict myocardial fibrosis based on GLS with a specificity of 78% and sensitivity of 75%. Increasing microRNA-1 and microRNA-21 followed by decreasing microRNA-29 in HFpEF patients suggest early myocardial fibrosis.

Dealing with randomness is a crucial aspect that cost-effectiveness analysis (CEA) tools need to address, but existing stochastic CEA tools have rarely examined risk and return from the perspective of global benefits. This paper proposes a stochastic CEA tool that supports medical decision-making from the perspective of global benefits of risk and return, the risk-adjusted incremental cost-effectiveness ratio (ICER). The tool has a traditional form of ICER but uses the risk-adjusted expected cost. Theoretically, we prove that the tool can provide marginal medical decisions that promote the risk-return level on global benefits within any intervention structure and can also serve as a discriminating condition for the optimal intervention structure. Numerical simulations within a framework of mean-variance support the conclusions in this paper.

Fuel consumption, subsequent emissions and safe operation of class 8 vehicles are of prime importance in recent days. It is imperative that the vehicle operates in its true optimal operating region given a variety of constraints such as road grade, load, gear shifts, Battery State of charge (for hybrid vehicles), etc. In this paper a research study is conducted to evaluate the fuel economy and subsequent emission benefits when applying predictive control to a mild hybrid line haul truck. The problem is solved using a combination of dynamic programming with back tracking and model predictive control. The specific fuel saving features that are studied in this work are dynamic cruise control, gear shifts, vehicle coasting and torque management. These features are evaluated predictively as compared to a reactive behavior. The predictive behavior of these features are a function of road grade. The result and analysis shows significant improvement in fuel savings along with NOx benefits. Out of the control features dynamic cruise (predictive) control and dynamic coasting showed the most benefits while predictive gear shifts and torque management (by power splitting between battery and engine) for this architecture did not show fuel benefits but provided other benefits in terms of powertrain efficiency.