Search Results (6,864)

Understanding the impact of neighborhood-level factors on stroke prevalence is crucial for addressing existing disparities. However, there is a distinct lack of ecological studies at the census tract level that investigate the social determinants of health (SDOH) influencing stroke prevalence within the U.S. Health and Human Services Region 3 (HHS Region 3: Delaware, Maryland, Pennsylvania, Virginia, West Virginia, and the District of Columbia). This study adopted a multivariate modeling approach to investigate the association between the 13 indicators of the Health Opportunity Index (HOI) and stroke prevalence at the census tract level in HHS Region 3 using four HOI indicator profiles and to highlight the specific SDOHs that are most associated with stroke prevalence. The four HOI indicator profiles include: (a) neighborhood and built environment profile, (b) social and community context profile, (c) resource profile, and (d) economic profile. The methodological approach was quantitative, using secondary data. The sample size was 8021 census tracts. The HOI was estimated for each census tract in the study area. Ordinary least squares regression (OLS) analysis and spatial lag model (SLM) were run to examine whether the 13 indicators of the HOI (categorized into four profiles) reliably predict stroke prevalence and to determine the most appropriate model that best identifies the strongest predictors of stroke prevalence. The results show that affordability, education, spatial segregation, and income inequality indicators were the strongest predictors of stroke prevalence in HHS Region 3. This granular research identifies the neighborhood-level SDOH most strongly linked to stroke prevalence, which can be leveraged to guide the development of targeted public health programs, quality improvement initiatives, resource allocation, and policy creation to combat stroke-related morbidity and mortality across census tracts in HHS Region 3. For example, the built environment, encompassing factors like employment access, affordable housing, and walkability, profoundly influences stroke prevalence and provides urban planners with practical insights for developing healthier, more equitable communities, such as creating neighborhood parks to encourage physical activity, a key factor in stroke prevention. This study also provides neighborhood organizations with the evidence needed to pursue grant funding and raise awareness about the socio-structural influences on stroke outcomes in their respective neighborhoods. Lastly, the insights generated from our study can facilitate collaborative decision-making processes with communities in HHS Region 3 regarding the prioritization of neighborhood-level SDOH for targeted public health interventions. This prioritization should focus on addressing predictors of stroke prevalence that are congruent with the community’s established priorities, thereby maximizing cost savings. Full article

This study analyzes the determinants of self-reported behaviours and perceptions associated with pesticide toxicity risk in children using the Social Practice Theory framework, linking individual factors and agricultural practices to understand vulnerability and prevention opportunities. This research was conducted in Pattapang Village, Tinggimoncong District, Gowa Regency, South Sulawesi Province, Indonesia. To examine the relationship between pesticide use patterns, social norms, competence, material, and individual aspects and the risk of sensitive toxicity in children, data were analyzed using structural equation modeling-partial least squares (SEM-PLS) with bootstrapping resampling. Pesticide use patterns had a significant negative effect on toxicity risk. Competence was the strongest predictor of pesticide use patterns, followed by materials and short-term goals. Personal values dominate personal norms and long-term goals, while social norms only influence personal norms. Self-efficacy, personal norms, and long-term goals showed no significant effects. The novelty of this research lies in the integration of a socio-ecological approach with individual psychological factors in a comprehensive structural model that explains the complex mechanisms of children’s protective behavior formation from pesticide toxicity, identifying that personal values—not personal norms or self-efficacy—are the most effective leverage points for farmer behavior change interventions. Full article

The mineral system model formalizes the critical geological processes and mappable parameters that control ore formation, which can then be translated into spatial predictors used as input features in machine learning (ML)-based mineral prospectivity mapping (MPM). In most MPM studies, exploration evidence features are indeed derived from the mineral system model of the targeted deposit type. However, not all features produced in this way are necessarily informative or favorable for prospectivity analysis. This challenge can be addressed by using feature selection frameworks to identify the most relevant features before applying ML and deep learning (DL) algorithms for mathematical integration. To address this need, this study employs an unsupervised variational autoencoder (VAE) framework to evaluate and rank exploration evidence layers. The VAE quantifies feature importance through a systematic strategy that measures the sensitivity of reconstruction-error components, mean squared error (MSE), mean absolute error (MAE), and Kullback–Leibler (KL) divergence, to individual feature variations. In this way, the VAE ranks the exploration features and helps to identify those that are the most useful for prospectivity mapping. The proposed approach was applied to a real geo-dataset from a porphyry copper district in Iran. Based on the conceptual model of porphyry copper mineralization, 15 evidence layers were generated, including proximity to phyllic, argillic, propylitic, iron oxide, and silicification alteration zones; proximity to intrusive rocks, faults, and fault intersections; and geochemical maps of Cu, Mo, Sb, Pb, Zn, As, and W. The VAE-based ranking indicated that evidence layers related to hydrothermal alterations, intrusive rocks, and faults were the most influential exploration features, whereas geochemical evidence layers showed lower relative importance. Based on this evaluation, two modeling scenarios were considered: in the first, all available features were used, and in the second, only the features selected by the VAE framework were included. In both cases, the final prospectivity model was produced by an autoencoder (AE). For comparison, the prediction-area (P–A) plots of the two prospectivity models were generated using 14 known mineral occurrences as positive ground-truth labels, indicating that the model based on the selected features achieved a higher prediction rate (80%) than the model based on all features (72%). These results demonstrate that the evidence layers derived from the mineral system approach can benefit from unsupervised VAE-based evaluation, leading to improved performance of the prospectivity modeling. Full article

Introduction: The WHO African Region is working to eliminate measles and rubella in 80% of countries by 2030. In countries with sub-optimal routine immunization coverage, periodic supplemental Immunization Activities (SIAs) are implemented to boost childhood immunity against measles and rubella. Methods: We reviewed the SIA technical reports and reports from post-campaign surveys shared by countries with the WHO Regional Office for Africa, and we analyzed the coverage data from preventive measles campaigns implemented during the years 2001–2025. Results: A total of 326 preventive measles/measles–rubella SIAs were implemented across 44 countries in the years 2001–2025, providing more than 1.5 billion doses of vaccine to eligible children according to the type and scale of the campaigns. Four fifths (82%) of the SIAs were nationwide exercises, and all of the SIAs were implemented as non-selective vaccination campaigns targeting all eligible children irrespective of past vaccination history, with the exception of four SIAs. The 95% administrative SIA coverage target at national level was met in 209 SIAs (64.7%). At district level, 11 of 164 SIAs had 100% of districts attaining 95% administrative coverage. Only 94 SIAs (29%) were followed by post-campaign coverage survey, and only 18 (19%) of these attained coverage of 95% or more by survey. Nearly two thirds (62%) of the 272 SIAs implemented during 2006–2025 had at least one additional intervention included with the measles/MR vaccination. Discussion: Measles and MR vaccination campaigns have served as excellent opportunities for providing integrated child survival interventions in the African Region. While two thirds of the SIAs met the national administrative coverage target, district-level coverage targets were not met in the majority of the SIAs, and only one fifth of the SIAs met the national-level survey coverage targets. Moreover, discrepancies were noted between administrative and survey coverage results, possibly due to inaccuracies in the reporting of the number of doses administered and/or reliance on inaccurate denominators. For optimal impact, SIAs need to adequately reach unreached populations. Conclusions: In view of the documented sub-optimal coverage, countries should provide strong leadership and ownership of the measles elimination strategies for the attainment of the SIA coverage targets as well as the overall measles and rubella elimination goal. There is an urgent need for improved tools to identify unvaccinated children, high-risk populations, and innovative strategies to reach them. All countries implementing SIAs should also include systematic monitoring of zero-dose children, and conduct post-campaign coverage surveys in a timely manner. Full article

Dryland soils of the Caspian region of western Kazakhstan are exposed to environmental stress, including drought, alkalinity, low soil organic matter content, and anthropogenic pressure. In this preliminary study, bacterial communities were investigated in 18 soil samples collected from six sampling groups across Makat (M1, M2), Isatay (I1, I2), and Beyneu (B1, B2) districts. Soil physicochemical properties were measured, and bacterial diversity was analyzed using 16S rRNA gene sequencing of the V3–V4 region. Community composition analysis indicated spatial heterogeneity among the sampled groups. M1 and I1 showed the highest taxon richness, whereas B2 contained the highest number of unique taxa. Genus-level profiles showed that B1 and M2 were mainly associated with Rubrobacter and related actinobacterial taxa; B2 contained higher proportions of Marinobacter, Tychonema, Qipengyuania, and Halomonas; and I2 was enriched with Antarcticibacterium, Salinimicrobium, Rhodococcus, Gillisia, Marinobacter, Dietzia, and Pontibacter. Correlation analysis showed that several bacterial taxa were associated with soil organic matter content, total nitrogen, total phosphorus, exchangeable cations, and pH, although the overall Mantel relationship between soil properties and community structure was not significant. FAPROTAX-based prediction indicated differences in putative heterotrophic, nitrogen-related, sulfur-related, and hydrocarbon-associated functional categories among sites. Because FAPROTAX predictions are based on taxonomic composition, these results should be interpreted only as putative functional potential and not as evidence of actual microbial metabolic activity. These findings suggest that the sampled Caspian dryland soils contain distinct bacterial assemblages and taxa with potential ecological relevance; however, their role in dryland soil resilience or bioremediation should be verified through future culture-based, metagenomic, and functional validation studies. Full article

Rural youth often face barriers to accessing mental health services, including workforce shortages, limited resources, and persistent stigma. Schools are well-positioned to address these gaps through comprehensive school mental health systems (CSMHSs) embedded within multi-tiered systems of support (MTSSs). This study evaluated the implementation and effectiveness of a CSMHS in a small Midwestern rural school district over seven years. A longitudinal case study design was used to describe implementation across seven years. Universal mental health screening data were analyzed to determine the proportion of students receiving tiered supports over time. Implementation fidelity was assessed annually using the School Health Assessment and Performance Evaluation (SHAPE) system. Across seven years, more than 80% of students consistently demonstrated mental wellness within Tier I supports, with Tier II and Tier III needs aligned with expected MTSS distributions. SHAPE data indicated steady implementation improvement, particularly in universal screening, teaming, and tiered support. Ongoing challenges included monitoring Tier II intervention fidelity and demonstrating system-level impact. Findings suggest that CSMHSs can be effectively implemented and sustained in rural school settings when aligned with existing MTSS frameworks, supported by strong partnerships, and adapted to local contexts. This study provides evidence supporting the feasibility of rural CSMHS implementation and offers implications for practice and sustainability. Full article

Soil organic carbon (SOC) and soil inorganic carbon (SIC) are two key components of soil total carbon (STC) pools. However, most studies have focused excessively on SOC, while research on SIC remains limited, especially with regard to different pools of particulate (POM) and mineral-associated organic matter (MAOM) in humid regions. Here, a 13-year field experiment was conducted in the farmland of Jiangjin District, Chongqing, to explore the variations of inorganic carbon in POM (POM-IC) and MAOM (MAOM-IC) in humid subtropical soils under long-term fertilization. Four fertilization regimes were arranged in this field experiment: high-rate fertilization (1050 kg N, 480 kg P₂O₅, and 255 kg K₂O ha⁻¹ yr⁻¹), conventional fertilization (480 kg N, 180 kg P₂O₅, and 255 kg K₂O ha⁻¹ yr⁻¹), zero nitrogen fertilization (0 kg N, 180 kg P₂O₅, and 255 kg K₂O ha⁻¹ yr⁻¹), and zero phosphorus fertilization (480 kg N, 0 kg P₂O₅, and 255 kg K₂O ha⁻¹ yr⁻¹). Soil samples were collected from surface soil (0–15 cm) and subsoil (15–30 cm) to determine STC, SOC, SIC, organic carbon in POM (POM-OC) and MAOM (MAOM-OC), POM-IC, and MAOM-IC. Results showed that SOC accumulation under high-rate fertilization was primarily associated with increased POM-OC. Compared with the zero nitrogen treatment, the other three fertilization regimes significantly decreased subsoil SIC, which was primarily associated with reduced MAOM-IC. High-rate fertilization increased the contributions of POM-OC to SOC and POM-IC to SIC, respectively, yet reduced the corresponding contributions from MAOM. Linear relationship analysis revealed that POM-OC was more sensitive to fertilization regimes than MAOM-OC. However, responses of POM-IC and MAOM-IC to fertilization regimes were roughly equivalent. This is of great significance for understanding the stabilization mechanisms of SIC. This study highlights the non-negligible MAOM-IC loss in subsoil induced by nitrogen fertilization in humid subtropical soils. Given that STC was the highest under high-rate fertilization, this treatment is recommended. This study is of great significance for improving the understanding of soil organic carbon and inorganic carbon dynamics in humid regions. Full article

Reuse of human excreta and derivatives is becoming a common practice in areas with agricultural predominance. While in situ treated faeces through ecological sanitation (Ecosan), known as “faecal by-products” are being used to sustain soil nutrients and improve on-site sanitation, the concern remains about the health risks related to the survival of pathogens in these by-products in the community of farmers. This study assessed the survival of faecal pathogens and estimated microbial risks associated with the use of Ecosan faecal by-products in agriculture. The quantitative microbial risks assessment (QMRA) framework was used to estimate the risks posed by each faecal pathogen in solid and semi-solid faecal by-products under the probabilistic model of Monte Carlo simulation. Ascaris lumbricoides (6.5 eggs/gr), Taenia species (0.3 egg/gr), Schistosoma species (9.3 cercariae/gr), Entamoeba species (4.4 cysts/gr), and Escherichia coli (451 Cfu/gr) were detected in semi-solid faecal products. Exposure scenarios were observed throughout four critical points: vault faecal by-products removal/unloading, transport, collection, and application of faecal by-products in the gardens. Due to the presence of eggs and cysts, an estimated annual risk of infections was found in semi-solid faecal by-products with Schistosoma species (88%) and Ascaris lumbricoides (90%). Both concentrations were above World Health organisation (WHO) standards of associated infective risks of 0–10% of helminths in faecal sludge applied in the gardens. The users of faecal by-products, particularly farmers are exposed not only to high concentrations of helminth eggs but also to protozoa and bacteria with infective risks of Entamoeba species (99%) and E. coli species (62%). A stepwise implementation of faecal pathogens die-off during treatment of faecal by-products in compliance with the WHO’s 2018 guidelines can prevent the use of unsanitary faecal by-products. According to these findings, the proper control of intestinal protozoa and soil-transmitted helminths (STHs) should be enforced through personal protective measures in Burera district, Rwanda. Full article

Background: Micronutrient deficiencies and physical inactivity can adversely affect child growth and development. This study assessed the effects of school-based physical activity and multi-micronutrient supplementation on micronutrient status among schoolchildren in Kilombero district, Tanzania. Methods: In a cluster-randomized trial, children aged 6–12 years were allocated to physical activity, multi-micronutrient supplementation, combined physical activity plus supplementation, or placebo control. Anthropometric and biochemical assessments were conducted at baseline, 14 months, and 26 months. Dried blood spot samples were available for 923 children at baseline. Complete-case analyses used biomarker-specific subsamples with valid baseline and 26-month measurements. Results: The primary complete-case sample included 243 children with valid paired measurements for zinc and serum transferrin receptor; vitamin D analyses were restricted to 52 children because of missing or invalid samples. At baseline, iron and vitamin D deficiencies were common, affecting 42.8% and 39.9% of children, respectively, while zinc deficiency affected 11.9%. At 26 months, allocation to the physical activity intervention was associated with lower odds of zinc deficiency, both when delivered alone (OR = 0.16) and when combined with supplementation (OR = 0.57). Supplementation alone was not significantly associated with reduced zinc deficiency. Iron status did not differ between intervention groups. Vitamin D findings should be interpreted with caution because analyses were based on a very small biomarker-specific subsample. Conclusions: School-based physical activity, alone or combined with multi-micronutrient supplementation, was associated with lower odds of zinc deficiency among Tanzanian schoolchildren. Supplementation alone showed no clear benefit for zinc or iron status. Vitamin D findings remain inconclusive because of substantial biomarker-specific missingness. Future trials should strengthen adherence monitoring, biomarker follow-up, and repeated assessment of dietary and contextual factors. Full article

An EU-funded project was implemented to enhance efficiency and reliability in the water supply system of Antalya city in Türkiye to support climate change adaptation by reducing Non-Revenue Water (NRW). Extensive fieldwork and targeted actions of continuous Minimum Night Flow monitoring, Active Leakage Control, pressure management, and replacement of aging meters were applied to identify and reduce NRW. The project demonstrated that the commonly used percentage water loss indicator in Türkiye, the regulatory performance indicator, is biased and that the Infrastructure Leakage Index provides a more accurate performance measure. Training and experience-sharing workshops were conducted for district, provincial, and metropolitan municipalities in addition to an international regional conference, strengthening institutional capacity for sustainable water loss management. The project demonstrated that substantial gains in efficiency, reliability, and climate resilience can be achieved through integrated water loss management, advanced monitoring technologies, and performance-based evaluation frameworks. Full article

The rapid transition toward renewable energy requires transparent and spatially explicit methods for identifying suitable photovoltaic (PV) development areas. This study develops a geospatial artificial intelligence (GeoAI) decision-support framework for PV site suitability assessment in Rajasthan, India. Eleven harmonized predictors were used: global horizontal irradiance (GHI), photovoltaic power output (PVOUT), temperature, wind speed, aerosol optical depth (AOD), elevation, slope, albedo, land use/land cover (LULC), distance to roads, and distance to power lines. Reference labels were generated from an explicit rule-derived suitability index, class thresholds, and exclusion logic; therefore, the machine-learning task was to reproduce a transparent suitability framework rather than to predict observed PV yield or project-level performance. Extreme Gradient Boosting (XGBoost) was compared with simpler baseline models, evaluated using random and spatial-block validation, and interpreted using SHapley Additive exPlanations (SHAP). Independent overlays with known solar-installation records, presence-background robustness testing, and uncertainty/sensitivity analysis were used to examine spatial plausibility, spatial autocorrelation, deterministic label effects, and parameter uncertainty. The resulting outputs include pixel-level suitability zones, contiguous candidate polygons, district-level capacity-oriented summaries, and planning-priority classes. The framework is intended as a risk-aware regional screening tool: high model agreement indicates consistency with the constructed suitability labels, while final project decisions require parcel-scale land, grid, environmental, social, and economic assessment. Full article

Increasing pressure on surface water resources in intensive agricultural regions has driven the search for sustainable alternatives for irrigation supply, especially in areas where water quality limits crop safety and export opportunities. In this context, riverbank filtration (RBF) systems offer a nature-based solution by utilizing physical, chemical, and biological processes associated with river–aquifer exchange. However, their implementation depends on suitable site selection supported by hydrogeological, geomorphological, and hydraulic criteria. This study developed an integrated methodology to identify zones with potential for implementing RBF systems in the Roldanillo–Unión–Toro irrigation district, located in northern Valle del Cauca, Colombia. This region requires irrigation water over 10,256 ha of agricultural land (mainly sugarcane, maize, grapes, and guava). We combined geophysical methods (vertical electrical soundings, 2D electrical resistivity tomography, and passive seismic), geotechnical methods (CPTu tests), and hydraulic characterization of the river reach to evaluate subsurface stratigraphy, preliminary hydrogeological suitability, inferred river–aquifer connectivity conditions, and channel stability. The evaluation covered four sectors along an approximately 21 km stretch of the Cauca River’s left-bank alluvial valley. The results revealed pronounced lateral and vertical heterogeneity of alluvial materials. However, the “El Palmar” sector was identified as the best-supported priority sector for future RBF validation, due to the presence of profile-scale evidence of potentially permeable sandy and gravelly units with intermediate resistivity values (52–61 Ω·m), favorable stratigraphic organization, and stable river-reach conditions during the field campaign. In contrast, the other three sectors (La Esperanza, Candelaria, and Cayetana) showed more fine-grained sediments with deeper permeable strata. River-flow measurements during the July 2025 field campaign indicated high discharge conditions at the evaluated reach, while river-channel observations showed active fine-sediment transport; these findings provide hydraulic and sedimentary context for the future evaluation of induced infiltration and potential clogging, but do not constitute direct evidence of river–aquifer exchange. This study highlights the value of integrated screening approaches for prioritizing candidate RBF sites in agricultural alluvial settings, while indicating that pumping tests, piezometric monitoring, hydraulic-gradient analysis, and water-quality validation remain necessary before engineering implementation. Full article

The integration of the digital and real economies is a pivotal engine driving the development of new, quality productive forces. Tourism ecological governance is the concrete manifestation of the green dimension of new-quality productive forces in the cultural and tourism sector, as well as being a path for converting ecological value to drive regional sustainable development. The relationship and mechanisms between digital–real integration and tourism ecological governance are critical issues requiring urgent breakthroughs. However, existing research primarily explores the economic factors influencing tourism ecology and has yet to systematically reveal the intrinsic mechanisms through which digital–real integration affects tourism ecological efficiency from the perspective of typical ecological functional zones. Based on data from 78 counties (municipalities, districts) in China’s Taihang Mountains from 2011 to 2023, this study examines the impact of digital–real integration on tourism ecological efficiency and its operational pathways. The findings are as follows: Firstly, from a temporal evolution perspective, tourism ecological efficiency in the Taihang Mountains underwent a phase of dynamic adjustment and gradual improvement between 2011 and 2023, while the level of digital–real integration experienced a phase of general enhancement and phased advancement. From a spatial evolution perspective, neighboring sub-regions within the Taihang Mountains exhibit positive spatial correlations in terms of both digital–real integration and tourism ecological efficiency. From the perspective of spatiotemporal transfer characteristics, changes in tourism ecological efficiency and the level of integration of the digital and real economies in the Taihang Mountains are influenced by neighboring regions. The development processes of tourism ecology and digital–real integration exhibit a relatively stable and gradually improving pattern, driving the agglomeration of regions toward higher levels. Secondly, digital–real integration has a positive impact on improving tourism ecological efficiency by releasing ecological pressure, promoting industrial synergy agglomeration, and driving green innovation development. Heterogeneity analysis reveals that the positive effect of this integration on tourism ecological efficiency is more pronounced in national e-commerce demonstration cities. Digital–real integration has had a positive impact on improving tourism ecological efficiency in the Southern and Western Taihang Mountain regions, while its impact on the Eastern Taihang Mountain region was not statistically significant. This study incorporates digital–real integration with tourism ecological efficiency, as well as environmental, structural, and capacity factors, into a unified analytical framework, providing theoretical references and practical insights for exploring pathways of digital transformation and innovative tourism ecological governance in ecologically sensitive functional zones. Full article

The quality of technology integration in K-8 science classrooms has significant implications for educational equity, particularly in minority–majority districts where teacher practice is among the strongest predictors of STEM persistence among underserved populations. This study examined the extent to which K-8 science teachers’ technology integration knowledge translated into transformative instructional practice within a large, minority–majority district in the U.S, using the frameworks of Information and communication technology (ICT)-Technological Pedagogical Content Knowledge (TPACK) and Passive, Interactive, Creative, Replacement, Amplification, Transformative (PICRAT) model. Technology integration planning knowledge was assessed using the ICT-TPACK instrument across elementary and middle school teachers. Instructional practice was rated using the PICRAT framework applied to teachers’ open-ended descriptions of their technology use. These responses also provided contextual illustration of quantitative patterns. Results indicate that while middle school teachers demonstrated significantly higher ICT-TPACK planning knowledge, this advantage primarily reinforced foundational science concepts through passive consumption rather than facilitating student agency. PICRAT analysis revealed that technology use across all grade levels was dominated by Replacement and Amplification practices, while creative and transformative uses remained nearly absent. These findings reveal a persistent knowing–doing gap in which planning knowledge did not translate into transformative enacted practice. Implications for equity-focused professional development and structural supports moving K-8 science teachers toward more transformative technology integration are discussed. Full article

Background/Objectives: To quantify geographical distances to nearest general practitioner (GP) services for all household postcodes in the United Kingdom. Methods: We mapped household postcodes in the United Kingdom and computed distances to nearest GP practice, using centroid geographical coordinates (latitude and longitude). We also analysed the total number of GP practices throughout local area districts (LADs) in relation to population density. Results: As of December 2023, there were 7965 active GP practices across the UK, serving a total registered population of over 73 million patients. Analysis of 1.78 million household postcodes revealed that 98.8% were within 10 km of a GP practice (measured as a straight-line). The most distant postcode was in the Shetland. Throughout the UK, population density was weakly or strongly correlated with number of GP practices in the different LADs, with wide variations, and the strongest correlation observed in Northern Ireland. Conclusions: In the UK, geographical proximity to nearest GP practice was found to be within 10 km for the vast majority of residents. Weak to strong correlations between population density and number of GP practices were observed. Future work should quantify the impact of both staffing capacity and public transport availability on distance to GP surgeries across the UK, to better characterise structural determinants of primary care accessibility. Full article