Search Results (42)

Background/Introduction: Undernutrition’s impact on healthcare utilisation across age groups and care settings remains underexplored, particularly in Asian contexts. This study investigated the dynamic association between nutritional status and healthcare utilisation among community-dwelling adults in Singapore and assessed whether age modified this relationship. Methods: The study sampled 1703 adults enrolled in the Population Health Index study. Nutritional status was assessed annually using the Mini Nutritional Assessment, and healthcare utilisation data—across primary care, specialist outpatient clinics (SOCs), emergency departments (EDs), day surgeries, and inpatient admissions—were extracted from administrative databases. Negative binomial regressions with interaction terms using longitudinal panel data were conducted to examine age-modified effects. Results: At baseline, 9.7% of participants were classified as undernourished, with a higher prevalence in older adults (15.0%). Key risk factors for undernutrition included female sex, unemployment, financial inadequacy, currently smoking, lack of formal education, and multimorbidity. Undernutrition was associated with increased ED visits (IRR 1.41, AME: 0.35) and inpatient admissions (IRR 1.52, AME: 0.42). Among older adults, undernutrition was associated with less primary and specialist care (IRR: 0.72 and 0.57), while younger undernourished adults had more SOC visits (AME: 0.46). Older undernourished adults had 0.46 more ED visits and 0.47 more inpatient admissions on average in one year, though these increases did not differ from younger adults (interaction p > 0.05). Conclusions: Undernutrition is associated with increased ED visits and inpatient admissions, especially in older adults. Integrating nutritional screening and targeted interventions into community and primary care may help reduce preventable hospitalisations in high-risk populations. Full article

Optimizing rural residential areas (RRAs) in environmentally fragile areas such as flood detention basins is of great significance for improving the human–land relationship and achieving sustainable rural development. This study took Xun County in central China as a case study, established a dual minimum cumulative resistance model (DMCR) that considered the dual factors of natural attributes and policy regulations to evaluate the optimization resistance of RRAs and determined the optimization directions and strategies accordingly. The main results are: (1) RRAs are relatively small and scattered, and there are spatial conflicts with policy regulations such as flood detention basin and urban development boundaries. (2) The spatial difference in optimization resistance of RRAS is higher in the central and northern towns and lower in the western and eastern towns. The factors with significant effects include policy resistance, location resistance, and production resistance. (3) The optimization of RRAs is divided into three directions: annexation or evacuation, consolidation and improvement, and clustering and upgrading, with their respective area proportions of 31.17%, 48.12%, and 20.72%. (4) RRAs in the direction of clustering and upgrading allow for moderate expansion; RRAs in the direction of consolidation and improvement achieve smart reduction through the renovation of homesteads; RRAs in the direction of annexation or evacuation are gradually integrated into the urban area in the suburbs and completely demolished in the outer suburbs. Full article

Food packaging plays an essential role in preserving food quality. However, heavy metals found in packaging materials—whether intentionally incorporated or not—can migrate into food. This study aims to evaluate the migration of specific heavy metals (Ba, Co, Cu, Zn, Al, Ni, Li, Fe, Pb, Cd, Cr, Sb) from plastic food packages (films and bags) obtained from various materials (PE, PP, PVC, composite materials) into food simulant B (3% acetic acid) using inductively coupled plasma mass spectrometry (ICP-MS). Migration tests was conducted according to EU regulations, using OM2 conditions (10 days at 40 °C). The obtained results were lower than the specific migration limits set by EU Regulation no. 10/2011 (Annex II). Both carcinogenic and non-carcinogenic risk assessments were carried out based on the specific migration data, estimating the exposure, average daily dose (ADD), hazard quotient (HQ), hazard index (HI), cancer risk (CR), and total cancer risk (TCR). The exposure values were found to be below the recommended tolerable daily intake (TDI) levels for each metal tested. Both HQ and HI values were under the limit value of 1. The average total cancer risk was 1.73 × 10⁻⁴, indicating that approximately 1.73 consumers out of 10,000 may develop a type of cancer due to chronic exposure to the tested metals. These results highlight the importance of continuous monitoring of chemical migrants from food contact materials. Full article

The Sicilian wetlands (Italy) are seriously threatened by human activities and ongoing climate change. The loss of these wetlands as migratory stepping stones could severely hamper the migratory flow of many bird species along the central Mediterranean. Targeted actions for the conservation of the avifauna require thorough knowledge of the utilization that waterbirds make of these habitats. Aiming to inform planning for more satisfactory bird habitat management and bird diversity preservation along the Mediterranean migratory bird flyway, in this study, we inventoried the avian metacommunity of the coastal wetlands in Sicily during the most critical period of the year (July–September) and used a multilevel analytical framework to explore the spatiotemporal dynamics in bird species assemblages. We recorded 73 bird species, of which almost 90% were migratory and 30 belonged to Annex I of the Birds Directive. At the metacommunity level, we found that all the biodiversity metrics were low in July and approximately doubled in the successive sampling sessions (August–September), where they showed little if any change. At the community level, we detected two main clusters of wetlands with regard to species richness, of which one (wetlands Baronello, Gela, Gornalunga, and Roveto) was characterized by higher levels of species richness in nearly all the sampling dates. The pattern of species richness in the Sicilian wetlands was most similar between the first and second half of August, while July was very dissimilar from all the other sampling dates. At the guild level, we found a significant increase during July–September in the number of the species belonging to the “Mediterranean” migration guild and the “divers from the surface” and “surface feeders” foraging guilds. At the species level, we detected a significant temporal sequence of the occurrence of waterbird species: two species were only early dwellers in July, ten species were only late dwellers in September, and twenty-six species made use of the Sicilian wetlands all summer long. The spatial distribution of the waterbird species differed significantly between any pair of sampling dates. Overall, the Little Grebe, the Spotted Redshank, and the Little Tern were the bird species with the highest site infidelity; by contrast, the Black Stork, the Broad-billed Sandpiper, the European Golden Plover, the Common Shelduck, and the Black-necked Grebe changed their spatial distribution among wetlands the least during July–September. Our study allowed us to detect (1) the wetlands and (2) the waterbird species to which the priority for conservation should be assigned, as well as (3) the exact time span during July–September when conservation measures should be mandatory, and not only advisable. These results provide a broader insight of the space–time patterns in bird species assembly in the coastal wetlands of Sicily during the critical summer period. Full article

Environmental monitoring (EM) is the cornerstone for the assurance of sterility during aseptic manufacturing. In this study, the EM quality aspects in the radiopharmaceutical cleanrooms of the University Medical Center Groningen (UMCG), The Netherlands, were evaluated. Hereto, data obtained from EM over the period 2010–2022 were analyzed. The data were sorted according to the Good Manufacturing Practice (GMP) classification of the respective premises with their corresponding limits, and frequencies of excursions were determined per location. The frequency of conducted measurements gradually increased between the start and end of the assessed period. There was a trend of increased action limit excursions observed between 2010–2022. We found that EM in grade A areas appeared to be significantly less compliant with GMP specifications than the combined data from all sampled premises at the facility (p < 0.00001; two-sided Fisher’s exact test). A trend was found for reduced action limit excursions for passive air sampling and particle counting, suggesting improved GMP compliance over time for this specific type of EM. The contamination recovery rate (CRR) found for cleanroom conditions, around 10%, was considered sufficient. From this comprehensive data analysis, we learn that, in order to be fully compliant with the requirements set in the recent revision of EU (European Union)-GMP Annex 1 ‘Manufacture of sterile medicinal products’ (in force as of 25 August 2023), strategies to further improve product protection are justified. For example, improved cleaning and disinfection procedures, more efficient working methods as well as optimization of the conditions under which aseptic manufacturing is performed are to be considered. Full article

Coronaviruses (CoVs) belong to the group of enveloped positive-sense single-strand RNA viruses and are causative agents of respiratory, gastro-intestinal, and central nervous systems diseases in many host species, i.e., birds, mammals, and humans. Beta-CoVs revealed a great potential to cross the barrier between species by causing three epidemics/pandemics among humans in the 21st century. Considering the urgent need for powerful antiviral agents for decontamination, prevention, and treatment of BCoV infections, we turned our attention to the possibility of photodynamic inactivation with photosensitizers in combination with light irradiation. In the present study, we evaluated, for the first time, the antiviral activity of toluidine blue O (TBO) against Beta-coronavirus 1 (BCoV) in comparison to methylene blue (MB). First, we determined the in vitro cytotoxicity of MB and TBO on the Madin–Darby bovine kidney (MDBK) cell line with ISO10993-5/Annex C. Thereafter, BCoV was propagated in MDBK cells, and the virus titer was measured with digital droplet PCR, TCID₅₀ assay and plaque assay. The antiviral activity of non-toxic concentrations of TBO was estimated using the direct inactivation approach. All effects were calculated in MAPLE 15^® mathematical software by developing programs for non-linear modeling and response surface analysis. The median inhibitory concentration (IC₅₀) of TBO after 72 h of incubation in MDBK cells was 0.85 µM. The antiviral activity of TBO after the direct inactivation of BCoV (MOI = 1) was significantly stronger than that of MB. The median effective concentration (EC₅₀) of TBO was 0.005 µM. The cytopathic effect decreased in a concentration-dependent manner, from 0.0025 to 0.01 µM, and disappeared fully at concentrations between 0.02 and 0.3 µM of TBO. The number of virus particles also decreased, depending on the concentration applied, as proven by ddPCR analysis. In conclusion, TBO exhibits significant potential for direct inactivation of BCoV in vitro, with a very high selectivity index, and should be subjected to further investigation, aiming at its application in veterinary and/or human medical practice. Full article

Persistent Organic Pollutants (POPs), particularly the indicator polychlorinated biphenyls (PCBs), were first quantified in water and sediments of two wadis, Boujemaâ and Seybouse, as well as in the effluents from a fertilizer and phytosanitary production industrial plant (Fertial). Since these contaminated discharges end in Annaba Bay (Algeria) in the Mediterranean Sea, with a significant level of contamination, all the potential sources should be identified. In this work, this task is conducted by a multivariate analysis. Liquid–liquid extraction and gas chromatography/mass spectrometry (GC–MS) methods were applied to quantify seven PCB congeners, usually taken as indicators of contamination. The sum of the PCB concentrations in the sediments ranged from 1 to 6.4 μg/kg dw (dry weight) and up to 0.027 μg/L in waters. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were used for the multivariate analysis, indicating that the main sources of PCB emissions in the bay are urban/domestic and agricultural/industrial. The outfalls that mostly contribute to the pollution of the gulf are the Boujemaâ wadi, followed by the Seybouse wadi, and finally by the Fertial cluster and more precisely the annex basin of the plant. Although referring to a specific site of local importance, the work aims to present a procedure and a methodological analysis that can be potentially applicable to further case studies all over the world. Full article

The aim of this work was to study the ultimate behaviour of box-shaped aluminium members subjected to uniform compression. Eight stub column tests have been carried out at the University of Salerno. In particular, four box sections made of 6060 aluminium alloys with different width-to-thickness ratios have been investigated. The results have been reported in terms of the maximum compressive resistance and corresponding deformation capacity. Subsequently, the experimental results have been compared with those obtained by two accurate methodologies: (1) a theoretical procedure based on the deformation theory of plasticity (J2); and (2) an extension of the effective thickness method (ETM) provided by Annex L of the Eurocode 9 draft. These approaches take into account the local buckling effects within the elastic-plastic region, the strain-hardening be-haviour of the aluminium material, and the interaction between the plate elements constituting the cross-section. Finally, a comparison between new methodologies and current design rules has been presented. Full article

An annotated checklist of the ichthyofauna of the Upemba National Park, draining part of the Upper Lualaba basin and situated in the southern part of the Democratic Republic of the Congo, is presented, based on a literature review, a re-examination of museum collections, and a study of recent collections (2012–2020). In total, 247 native and 1 introduced species, Heterotis niloticus, are reported. The native species belong to 78 genera, 26 families, and 15 orders. Of these, 45 species (18%) are endemic to the park, 35 species (14%) await formal description, and 5 taxa (2%) need further study to clarify their status. With 51 species, the Cyprinidae is by far the most species-rich family, followed by the Mormyridae (26), Mochokidae (26), Alestidae (18), Distichodontidae (18), Amphiliidae (17), and Cichlidae (16). The remaining families are represented by less than 15 species. Comments about the species distribution and the fish fauna shared with adjacent ecoregions are provided. Although the park provides some protection for the fish species living within its borders by limiting human access to the core zone, the annex and buffer zones are both subject to strong anthropogenic pressure. These observations underscore the need for the implementation and further elaboration of fish-related preservation guidelines and plans to enable better protection/conservation of the park’s ichthyofauna. Full article

This paper examines the economic growth of Vietnam by focusing on trade liberalization and the strategies that the distributional coalitions have chosen in response to this reform. It analyses the tariff schedules annexed to six key free trade agreements that Vietnam signed. This paper finds that the distributional coalitions intentionally under-protect three groups of products to keep their benefits. Group 1 consists of products with high amounts of revealed comparative advantages (RCAs) and a strong presence in the state sector. Group 2 comprises products with low RCAs and a tenuous presence of the state sector. Group 3 represents products where the presence of the state sector is strong, but their production capacities cannot meet the massive domestic demand. The strategically administered under-protection has also allowed the distributional coalitions to preserve their privileges. While these strategies have been effective in achieving static efficiency, they have been considerably less effective in bringing about structural changes necessary for sustainable long-run economic growth. Full article

The aim of this paper is to formulate a theoretical framework for the issue of changes in administrative boundaries and to systematize the issues by selecting distinctive variants. Considering the variety of procedures and forms of boundary changes, the case study is conducted in Poland. This study analyzed the provisions of 271 decisions on boundary changes and granting city status from 2009–2022, which covered a total of 1887.8 km². It was the basis for selecting 31 variants of boundary changes in eight categories: (1) formal legal, (2) territorial expansion; (3) unit status; (4) cadastral division; (5) territorial tiers; (6) administrative division; (7) frequency of changes; (8) area. In addition, the interactions that occur between the different variants are demonstrated, and the main regularities are identified. Boundary changes are conducted mainly in the application variant. The introduction of the fast-track variant initiated an unprecedented wave of restitution of the city’s status. Territorial expansion of units occurs most frequently in the commune–city variant within the third-tier (commune) units. Small-area, one-off annexations in the suburban zones of cities in the parcel and precinct variants dominate. The results can be contextually applied in comparative studies. Full article

Several nanomedicine based medicinal products recently reached the market thanks to the drive of the COVID-19 pandemic. These products are characterized by criticality in scalability and reproducibility of the batches, and the manufacturing processes are now being pushed towards continuous production to face these challenges. Although the pharmaceutical industry, because of its deep regulation, is characterized by slow adoption of new technologies, recently, the European Medicines Agency (EMA) took the lead in pushing for process improvements using technologies already established in other manufacturing sectors. Foremost among these technologies, robotics is a technological driver, and its implementation in the pharma field should cause a big change, probably within the next 5 years. This paper aims at describing the regulation changes mainly in aseptic manufacturing and the use of robotics in the pharmaceutical environment to fulfill GMP (good manufacturing practice). Special attention is therefore paid at first to the regulatory aspect, explaining the reasons behind the current changes, and then to the use of robotics that will characterize the future of manufacturing especially in aseptic environments, moving from a clear overview of robotics to the use of automated systems to design more efficient processes, with reduced risk of contamination. This review should clarify the regulation and technological scenario and provide pharmaceutical technologists with basic knowledge in robotics and automation, as well as engineers with regulatory knowledge to define a common background and language, and enable the cultural shift of the pharmaceutical industry. Full article

Habitat networks can help to make habitats more resilient and assist species survival in a fragmented landscape and changing climate. Butterflies are one of the main indicators of diversity due to their high sensitivity to environmental changes. In the context of sudden and unpredictable environmental changes, protection strategies for butterflies at risk of extinction should consider the exact distribution of these species, as well as the various threats to which each of them is subjected. About 290 species of butterflies are reported in Italian fauna, and 120 of them are recorded in Apulia (Southern Italy). In the Alta Murgia National Park (AMNP) (Apulia Region, Italy), screening was performed to study the relationships between area/landscape composition and diurnal butterfly community structure. Representative semi-natural habitats of Alta Murgia buffering productive crops were selected to set up transects/paths along dry grasslands, oak forests and pine forests. Monthly samplings were performed for one year. During the survey, 909 specimens from 53 species were collected. The highest values of butterfly’s abundance and richness were recorded in dry grasslands. A strong positive correlation between butterfly abundance and air temperature was registered (Pearson correlation: r = 0.8; p < 0.001). Melanargia arge, endemic in central-southern Italy and considered threatened in Europe (Annexes II and IV—Habitats Directive), was registered in each habitat. The biodiversity indices (Chao 1, Shannon and Simpson) for each habitat were high and similar to those in protected areas of Sicily. The connected landscape is important for generalist or open-habitat specialists, and large remnants are key for disturbance-sensitive and threatened taxa. The presented evidence can provide useful information on butterfly conservation in the AMNP and for the management and conservation of characteristic landscapes of Alta Murgia. Full article

Novichok-like or fourth-generation agents (FGAs) are chemical warfare agents (CWAs) which have been gaining attention since their use in assassination attempts on Sergei Skripal and Alexei Navalny. Due to their physicochemical properties, these substances are difficult to detect by implemented technologies, resulting in massive response efforts if their occurrence is suspected in a civilian environment. In this work, an approach is presented that uses handheld forensic light sources to visually detect surfaces contaminated with Novichok. More than 100 different wavelength combinations were applied to seven substances chosen to represent the newly listed schedule 1 subgroups in the Annex on Chemicals of the Chemical Weapons Convention. One waveband was identified as promising, which allowed the optical detection of all tested substances. Several surfaces, which could be affected in case of a possible attack using novichok-like nerve agents, were also successfully evaluated. The proposed procedure could be implemented for CBRN responders and security agencies to significantly reduce response efforts, thereby diminishing the overall threat posed by this group of chemicals (FGAs). This procedure was also extended to carbamates and CWAs. Full article

Toponymy, a transversal discipline for geography, linguistics, and history, finds one of its main supports in cartography. Due to exhaustiveness on the territory, cadastral cartography and its toponymy have the ideal characteristics to develop systematic geographical analyses. Moreover, cadastre and geographical names are part of the geographic reference data according to Annex 1 of the INSPIRE directive. This work presents the design, implementation, and application of a methodology based on Geographic Information Systems and Extract, Transform, and Load (ETL) tools for detecting coincidences between the cadastral geoinformation and the official gazetteer corresponding to the province of Gipuzkoa, Spain. Methodologically, this study proposes a solution to the issues raised by bilingualism in the study area. This problem is approached a priori, in the previous data treatment, and a posteriori, applying semantic criteria. The results show a match between the datasets of close to 40%. In this way, the uniqueness and richness of the analyzed source and its outstanding contribution to the potential integration of the official toponymic corpus are evidenced. Full article