Search Results (1,588)

Background: Tuberculosis (TB) remains a major global health challenge, with Mycobacterium tuberculosis (M. tuberculosis) causing significant morbidity and mortality mainly in high-burden countries. Following exposure to M. tuberculosis, individuals may become infected, developing TB infection (TBI) through inhalation of the bacillus: this affects approximately one-fourth of the global population and serves as a critical reservoir for potential disease reactivation and transmission. The risk of being infected with M. tuberculosis is shaped by bacterial load of people with TB, contact patterns, environmental factors, and host susceptibility, particularly in high-risk congregate settings. Elucidating these determinants is instrumental for optimising TB prevention and control strategies. Methods: A preliminary PubMed search was conducted on 25 August 2024, using the keywords “latent tuberculosis infection,” “risk factors,” and “systematic review.” Targeted reviews were then performed in November 2024 to examine factors influencing progression from exposure to M. tuberculosis to TBI. Systematic reviews published between January 2000 and November 2024 were included. Results: The scoping review analysed eight systematic reviews, grouping findings into three key themes: (1) proximity and behavioural risk factors; (2) environmental risk factors; and (3) host immune vulnerabilities. Close contact with people with TB in crowded settings, such as dormitories, healthcare facilities, and prisons, was strongly associated with an elevated risk of TBI. Healthcare workers travelling from low- to high-incidence regions faced the highest risk due to frequent exposure to M. tuberculosis, while military personnel and general travellers had lower risks. Environmental exposures, including second-hand smoke and inadequate ventilation, further heightened susceptibility among children and adults. Host immune risk factors, such as advanced age, low body mass index, lack of BCG vaccination, and metabolic disorders such as diabetes, markedly increase susceptibility to TBI. The interplay between proximity, behavioural and environmental risk factors, and host immune vulnerabilities highlights the multifactorial nature of TBI risk. Conclusion: Effective TBI control demands a multifaceted approach, combining robust infection prevention and control measures, comorbidity management, and mitigation of behavioural risk factors like smoking. Tailored strategies are crucial for high-risk settings such as healthcare facilities and prisons. Multisectoral collaboration is essential to address key risk factors and protect vulnerable populations from progressing to TBI. Full article

Separate collection and treatment systems for municipal solid waste (MSW) are designed to support efforts in sustainability. Biowaste accounts for the majority of MSW; thus, its proper management is essential. This study analyzes the impact of the presence of composting or anaerobic digestion (AD) facilities on MSW management. The management systems in Poland with composting and AD facilities were compared. Five fractions, including mixed/residual waste and biowaste, were collected in the analyzed regions; however, the rules for sorting biowaste varied. A drop in the collected residual/mixed MSW was noticed (by 3.8% to 6.6% year-on-year), while the biowaste stream increased, resulting in a 4–10% increase in the share of biowaste. The proportion of the organic fraction in biowaste was found to be 85–88%, but the proportion of food waste was slightly higher in the region with an AD facility (by about 3%). Plastics were the primary contaminants, accounting for approximately 5.5%. The presence of AD facilities has a positive impact on MSW management, including higher biowaste collection levels (67.5 kg per person versus 48.1 kg per person). Furthermore, under comparable regional conditions, economic gains were observed, such as relatively lower gate fees for biowaste (about 57 EUR per ton versus about 62 EUR per ton) and greater differences in fees between biowaste and residual/mixed MSW (about 80 EUR per ton versus about 14 EUR per ton). Full article

Equitable access to sports facilities is essential for promoting residents’ well-being, yet existing studies mostly rely on large spatial analytical units, limiting the ability to identify intra-unit disparities in accessibility and equity. This study develops a building-scale framework for assessing sports facility accessibility from a spatial equity perspective, incorporating building volume-weighted population distribution and quantification of multi-type facility service capacity for precise demand and supply estimation. Taking the Yuexiu District, Guangzhou, as the study area, the study assesses the accessibility of residential buildings using the Gaussian Two-Step Floating Catchment Area (G2SFCA) method and evaluates spatial equity using the Lorenz curve and local Moran’s I. Results indicate a moderate level of equity in overall facility provision (Gini coefficient = 0.288), alongside substantial inter-type disparities, with Gini coefficients ranging from 0.330 to 0.800. Accessibility clusters exhibit pronounced scale variability, ranging from a few buildings to hundreds of buildings, with small clusters embedded within larger clusters of opposite accessibility. These fine-grained patterns are largely obscured in conventional aggregated-unit analyses, underscoring the necessity of building-scale assessment. Results provide a basis for precise allocation of both facility quantity and facility types, supporting efficient decision-making for urban planning and management. Full article

Fish host complex intestinal bacterial communities that contribute to a wide range of functions, from nutrient assimilation to modulation of the immune system. Understanding how environmental and host-related factors shape the fish gut microbiota is essential for advancing sustainable aquaculture practices. This study compared the intestinal microbiota of gilthead sea bream (Sparus aurata) between wild and aquaculture populations in western Greece using 16S rRNA gene amplicon sequencing targeting the V3–V4 region, combined with culture-based methods. The analysis was based on a 97% similarity threshold and included 141 gastrointestinal samples of fish collected at two aquaculture facilities and two wild fisheries, representing two different growth phases (150 g and 300 g body weight). High-throughput sequencing data revealed a clear separation of gut microbial communities according to origin (wild vs. aquaculture), geographic location, and body growth phase, with most wild fish groups exhibiting higher microbial diversity than their farmed counterparts, except for group MES_150 which showed similar or lower values. The gut microbiota was dominated by Pseudomonadota (53%), Bacillota (29%), Actinomycetota (7%), Deinococcota (5%), and Bacteroidota (4%). A shared core microbiome, comprising Psychrobacter, Staphylococcus, Geobacillus, Aeromonas, Enterobacter, Pantoea, Bacillus, and Acinetobacter, was detected across all populations. Wild fish were enriched in Psychrobacter, Aeromonas, and Photobacterium, while aquaculture fish displayed higher abundances of Vibrio, Allomeiothermus, and Staphylococcus. Network analysis revealed mostly mutually exclusive interactions in both groups but distinct patterns of co-occurrence, driven mainly by Paenibacillus, Enterobacter, and Staphylococcus in wild samples, and by Vibrio, Aeromonas, and Pseudomonas in farmed fish. Culture-based assays demonstrated greater diversity in wild fish, dominated by Pseudomonas, Staphylococcus, and Vibrio strains, in contrast to the frequent occurrence of Staphylococcus and Psychrobacter in aquaculture samples. The findings suggest that aquaculture practices significantly alter gut microbial community structure and reduce diversity, with potential implications for fish health and disease resistance. The identified core and differentially abundant taxa provide candidates for probiotic development to improve aquaculture sustainability. Full article

Background: Ectopic pregnancy occurs in about 1–2% of all pregnancies, with 95% implanting in the fallopian tubes. Hepatic implantation is one of the rarest and most dangerous forms of abdominal ectopic pregnancy. Its diagnosis is often delayed because of nonspecific symptoms, and it is also often difficult for routine ultrasound imaging to visualize ectopic pregnancy sites that are not in the pelvis. Since this type of pregnancy carries a risk of severe hemorrhage, early identification is crucial. Case: A 30-year-old woman, gravida 3 para 2, presented with a serum β-hCG of 66,408 mIU/mL, but no intrauterine pregnancy was detected on ultrasound imaging. At an outside facility, a laparoscopy was performed, which also failed to show a pelvic ectopic pregnancy. The patient then received her first dose of methotrexate and was subsequently transferred to a tertiary care center for further evaluation. MRI and liver ultrasound showed a 2.3 cm subcapsular lesion in segment 5 of the liver that was suspicious for a hepatic ectopic pregnancy. However, these imaging studies could not exclude a gestational trophoblastic disease or hepatic neoplasm. A dilation and curettage revealed no trophoblastic tissue. The patient next received two additional doses of methotrexate on hospital days 4 and 7 due to an inadequate decline in interval β-hCG; β-hCG levels declined gradually but steadily over several months until they became undetectable and indicated a successful medical treatment of her hepatic ectopic pregnancy. Conclusions: This case highlights the complex diagnostic and treatment challenges presented by a hepatic ectopic pregnancy. Multimodal imaging, serial monitoring of β-hCG levels, and the engagement of a multidisciplinary team were essential factors in achieving a safe, nonsurgical, and successful resolution of this condition. When a pregnancy of unknown location is suspected, extended imaging studies are critical tools for patient evaluation after initial imaging studies and laparoscopy are inconclusive. Full article

The purpose of this work is to investigate the binding state of inorganic elements to flavonoid components in aqueous extract of Silybum marianum (SM) seeds, as well as the antioxidant activity of the extract. This study employed reversed-phase high-performance liquid chromatography (RP-HPLC) to separate silymarin flavonoids in boiling water decoction of SM seeds, and collected the post-column effluent in the segments according to the retention time of seven main silymarin flavonoid components. Inductively coupled plasma mass spectrometry (ICP-MS) was subsequently utilized to quantify nine inorganic elements (As, Cd, Co, Cr, Cu, Fe, Mn, Mo, Zn) in the collected HPLC fractions of the decoction. Meanwhile, electron paramagnetic resonance spectroscopy (EPR) was employed to assess the free radical scavenging activity of aqueous extract of SM seeds, using the signal intensity changes of 2,2-diphenyl-1-picrylhydrazyl (DPPH) and DMPO-OH• adducts as quantitative metrics. The results showed that essential trace elements (Cu, Fe, Mn, Zn) mainly existed as inorganic ions or strong polar forms in the tea-like infusion, with weak binding to flavonoid compounds. On the other hand, the aqueous extract exhibited significant •OH scavenging capacity, with a scavenging rate of 95% against •OH generated by continuous 5 min ultraviolet irradiation of H₂O₂ aqueous solution. This study provides experimental evidence for the development of SM as a food–medicine dual-purpose resource, proposing that consumption of SM seed tea represents a facile and effective approach to supplement trace elements and intake silymarin for enhancing endogenous antioxidant defense. Full article

With increasing demand for wellness tourism, identifying the key factors influencing emotional perceptions is essential for optimizing destination planning and management. Although Anhui Province has experienced rapid growth in wellness tourism destinations in recent years, scientific understanding of tourists’ emotional perceptions and their driving mechanisms has lagged behind this rapid expansion, a gap that can be addressed by integrating big data with spatial analysis to provide a scientific perspective for optimizing destination planning and informing regional wellness tourism policy. To address this gap, this study conducts a sentiment analysis of wellness bases in Anhui Province using user-generated content (UGC) data. Sentiment scores were quantified via SnowNLP, while kernel density, time-series, and multivariate statistical analyses were applied to examine spatial distributions, temporal dynamics of sentiments and review volumes, and emotional driving factors. The results indicate a spatial pattern of higher density in the south, lower density in the north, and dual-core agglomeration, closely linked to natural resource endowments. Temporally, sentiment scores rise in spring and summer and decline in winter, while review volumes peak in spring and autumn. Overall regression analyses reveal a significant positive effect of green coverage and a negative effect of accommodation prices. In the typological analysis, sentiment scores of Forest Wellness Bases (FWBs) relate to green coverage and negative ions, while Hydrological Wellness Bases (HWBs), Traditional Chinese Medicine Wellness Bases (TCMWBs), and Wellness Towns (WTs) are driven by the combined effects of facility services, locational price, and ecological environment. These findings provide a scientific basis for the sustainable development and differentiated management of wellness tourism destinations. Full article

Wastewater treatment plants (WWTPs) are among the most energy-intensive components of urban infrastructure. In light of the revised EU directive on municipal wastewater treatment, which targets energy neutrality by 2045, effective energy management in this sector is becoming essential. This article reviews the current knowledge regarding energy consumption in WWTPs and analyses opportunities to increase their energy self-sufficiency by reducing energy demand and recovering energy. Key factors influencing energy consumption are discussed, including facility size, the range of technological processes used, automation level, and equipment condition. Attention is given to aeration systems, which account for the largest share of electricity consumption, and the possibilities for their modernization and optimization using energy-efficient diffusers and advanced process control systems. The potential for recovering chemical energy from sewage sludge is analyzed, with emphasis on anaerobic digestion and co-digestion with other organic wastes. Alternative sludge conversion methods, such as incineration, pyrolysis, gasification, and hydrothermal carbonization, are also presented. The analysis is complemented by technologies for recovering physical energy from wastewater, including the use of thermal energy via heat pumps and hydraulic energy from wastewater flow. The findings indicate that achieving energy self-sufficiency in WWTPs requires site-specific, hybrid solutions combining energy savings with selective energy recovery, considering technical and economic conditions. Full article

As a typical example of a high-density city, Macau’s medical resource allocation system, a key component of the city’s complex socio-technical system, suffers from significant spatial imbalances, which restricts the overall effectiveness of the medical service system. Based on the perspective of systems science theory, regards the allocation of medical resources as a dynamic system with multiple coupled factors. It comprehensively utilizes systems research methods such as POI data mining and space syntax analysis and employs techniques such as kernel density analysis and spatial structure coupling models to systematically evaluate the spatial structure, resource accessibility, and service balance of Macau’s medical service system. It found that (1) the Macau Peninsula has concentrated core medical resources, such as the Conde de São Januário Hospital (CHCSJ) and Kiang Wu Hospital, which form a core subsystem with high service saturation. Excessive concentration of resources has led to high concentration of a certain type of facility. (2) Taipa Island and the Cotai Reclamation Area have created an extended subsystem of medical resources along with urban development. However, the northern area does not have enough facilities, and its internal structure is not balanced. (3) Coloane Island has only basic health stations remaining, forming a marginal subsystem with scarce medical resources, which has a significant hierarchical gap with the core and extended subsystems. This spatial pattern of “saturated Macau peninsula, expanded Taipa Island, and sparse Coloane Island” is essentially a concrete manifestation of the imbalance between the medical resource allocation system and the urban spatial development system. Therefore, based on system optimization theory, it proposes constructing a multi-level, networked spatial system for medical facilities to promote the coordinated operation of various regional medical subsystems and achieve overall functional optimization and a balanced layout for Macau’s medical service system. This research analyzes the imbalance mechanism of high-density urban public service systems using systems science methods, providing not only a scientific basis for the precise optimization of Macau’s medical resource allocation system but also a practical reference for the planning and governance of similar high-density urban public service systems under a systems thinking framework. Full article

Background: Nurses, the largest segment of the global health workforce, play vital roles in managing disease outbreaks and boosting community resilience during public health emergencies. Purpose: This study explored the experiences of senior nurses in leading health facilities in Ghana during the COVID-19 pandemic. Methods: We employed a qualitative, exploratory, descriptive approach and purposive sampling to recruit 30 senior nurses involved in frontline care during the COVID-19 pandemic. We used telephone interviews to examine how nurses’ roles are changing during public health crises. Results: Nurses navigated challenges related to infection prevention and control, team dynamics and social support, resource limitations, stigma against those affected, and leadership. Some of the nurses drew on their prior experience to navigate the complexities of COVID-19. The significance of inter-professional working and the flexible delegation of tasks is reinforced by the current study, which suggests that professional boundaries became more blurred during the crisis. Optimal responses to outbreaks are influenced by professional preparedness and adaptive learning. Conclusions: Nurses displayed extraordinary resilience and determination, yet faced enormous challenges, including PPE shortages, stigmatization from within their own communities and organizations, and a lack of welfare support. The findings from this analysis are intended to support national and global efforts in pandemic preparedness and healthcare worker assistance, highlighting the essential role nurses play in creating more resilient health systems for future crises. Full article

The keeping of non-traditional pets has markedly increased in recent years. These species are frequently maintained under inadequate or illegal conditions, raising substantial concerns regarding animal welfare. Authorities are regularly required to confiscate reptiles, arachnids, and other exotic taxa—often in poor health—and to accommodate them temporarily in transit facilities while long-term placement options are identified. Existing facilities are operating beyond capacity, creating an urgent need for the development of additional infrastructure. Given the potential risks associated with these animals, stringent safety measures are essential. Following an assessment of the hazards linked to housing primarily reptiles and arachnids—including risks related to venomous species, transmission of zoonotic pathogens, and the escape of potentially invasive organisms—the present paper provides a set of recommendations for the design and operation of transit housing facilities. The guidance focuses on infrastructure requirements, routine and emergency procedures, and daily management practices for both animals and facilities. Although these recommendations were developed within the specific regulatory framework of Southern Belgium, they may be applied more broadly, provided that local regulations are appropriately considered. Full article

Introduction: Guam, the largest U.S. territory in Micronesia, plays a central role in surgical care for the local indigenous community and surrounding Pacific Island nations, yet remains underrepresented in surgical systems research. Methods: We conducted a mixed-methods study. Quantitative data were collected on operating volume, personnel, infrastructure, and surgical services at Guam Memorial Hospital (GMH) and Guam Regional Medical City (GRMC). Semi-structured interviews with hospital leadership and surgical providers captured qualitative insights on strengths, challenges, and future plans. Results: GMH and GRMC collectively provide general emergency, obstetric, and basic pediatric surgery, although advanced subspecialty and oncologic care remain limited. Although surgeons are highly adaptable with broad-practice capability, challenges, including resource limitations, aging facilities, advanced presentation, and subspecialty recruitment, limit the cases that are operable on Guam, resulting in expensive medical transfer. Anticipated stressors such as oncologic and non-communicable disease burden may further strain the system, emphasizing the necessity for modernized facilities and targeted recruitment of surgeons with regional ties. Conclusion: Strengthening Guam’s surgical capacity is essential for the provision of oncologic care and the advancement of health equity across the Pacific region, emphasizing an urgent need for investment in infrastructure, locally relevant workforce training, and regional policy development. Full article

Access to safe and reliable drinking water is essential for public health. However, regional public water companies often face challenges that compromise service quality, such as equipment failure, water contamination, and inconsistent treatment processes. This study applies the failure mode and effects analysis (FMEA) method to systematically identify, evaluate, and prioritize operational risks in a water treatment facility. By analyzing 17 potential failure modes across the treatment process, five modes were classified as critical, prompting targeted mitigation strategies. The results demonstrate FMEA’s effectiveness in enhancing reliability and supporting continuous improvement efforts in water treatment operations. Full article

This study examines the potential contribution of Solar Electric Vehicles (SEVs) and Vehicle-Integrated Photovoltaics (VIPV) to disaster-related energy resilience through a probabilistic modeling framework. While previous research has highlighted the technical feasibility of EV-based support for microgrids and emergency facilities, it has paid limited attention to the behavioral uncertainty surrounding voluntary energy sharing by EV owners. To address this gap, we develop a Monte Carlo simulation model that integrates technical constraints, solar-generation variability, and heterogeneous participation probabilities to evaluate whether SEVs can sustain essential loads during prolonged outages. The analysis focuses on a worst-case scenario in which external lifelines are disrupted for seven days. Results indicate that approximately 450–1000 SEVs within a 5 km radius are required to maintain a continuous power supply, with BEVs requiring roughly twice as many units due to the absence of onboard PV generation. The findings highlight the sensitivity of resilience outcomes to user behavior and spatial vehicle distribution, underscoring the need for incentive mechanisms to encourage participation. Key limitations include simplified behavioral assumptions, region-specific irradiance conditions, and the exclusion of mobility constraints. Overall, the study provides a quantitative foundation for integrating SEVs into resilience planning while emphasizing the importance of social dynamics in determining real-world feasibility. Full article

Membrane fusion is fundamental to intracellular transport and signal transduction, with its dysregulation implicated in various diseases. Deciphering its transient, microscale dynamics requires advanced sensing technologies. This review systematically evaluates optical and electrochemical sensing platforms for in vitro studies of membrane fusion. Optical sensing platforms provide greater intuitive readout of membrane fusion events, whereas electrochemical sensing platforms enable label-free, single-event resolution. We revisit classical fluorescence resonance energy transfer (FRET) strategies for lipid and content mixing, tracing their evolution from ensemble measurements to real-time, multiparameter, single-vesicle analysis. We further examine electrochemical platforms based on nanodisc-black lipid membranes (ND-BLMs) and solid-supported lipid bilayers (SLBs), highlighting their unique capabilities in characterizing fusion pore kinetics and virus–host membrane fusion. ND-BLM-based systems are irreplaceable for probing fusion pore kinetics, owing to their sub-millisecond temporal resolution and being essentially free from ion saturation and depletion effects. Meanwhile, SLB-based electrochemical sensing platforms excel at high-throughput detection of viral membrane fusion events by virtue of their excellent compatibility and facile integration. These sensors provide powerful tools for elucidating the molecular mechanisms underlying SNARE-mediated membrane fusion and viral fusion processes. Finally, this review outlines future directions centered on the integration of multimodal sensing and the construction of physiomimetic membranes, emphasizing the critical role of cross-scale, multiparameter sensing in bridging molecular mechanisms with biological functions and advancing the diagnosis and treatment of membrane fusion-related diseases. Full article