Search Results (6,572)

Compound hot–humid events are placing increasing pressure on urban health and land-use governance as climate warming and urban expansion continue. This study examined urban built-up areas in 21 prefecture-level cities and prefectures of Sichuan Province for 2000, 2005, 2010, 2015, 2020, and 2024. Using the IPCC hazard–exposure–vulnerability framework, ERA5-Land, MODIS land-cover, GHSL population, and socioeconomic data were combined to construct the Humid Heat Hazard Index (HI), Population-Density Exposure Index (EI), Socioeconomic Vulnerability Index (VI), and Comprehensive Urban Heat–Humidity Risk Index (HHRI). Contribution decomposition, LISA, and standard deviation ellipse analysis were then used to examine risk changes and spatial patterns. The mean HHRI decreased from 0.42 to 0.24, but rebounds appeared in 2010 and 2024. HI varied strongly among years and drove short-term risk changes, EI declined continuously, and VI dropped from 0.87 to 0.30, making it the main factor behind long-term risk reduction. Higher-risk areas were mainly located in southern Sichuan, southeastern Sichuan, and the central-eastern Sichuan Basin. LISA results showed high-risk clusters in basin cities and low-risk clusters on the western Sichuan Plateau. The standard deviation ellipse remained mostly within the basin and followed the basin urban belt. Future adaptation should combine public-service improvement with heat warnings, cooling services, and emergency preparedness. Full article

This paper presents an experimental study on the amount of formaldehyde released during a fire in apartments, focusing on the flooring most commonly used in Bulgaria. Formaldehyde is a potentially hazardous chemical known to be carcinogenic in large amounts. It often causes respiratory problems and skin irritation. People prone to allergies are especially sensitive to formaldehyde. These health risks depend on the duration and level of exposure. The experiment tested seven types of laminate samples and six types of natural parquet samples at three different combustion temperatures in a room. Each sample was placed in a muffle furnace, heated to the specified temperatures of 150, 250, and 400 °C, respectively. Full article

Background/Objectives: Chronic obstructive pulmonary disease (COPD) is a heterogeneous syndrome with substantial variability in clinical progression and survival. Although neutrophil-to-lymphocyte ratio has been widely studied, evidence regarding neutrophil-to-monocyte plus lymphocyte ratio (NMLR) remains limited. This study evaluated whether baseline peripheral blood neutrophil-to-monocyte plus lymphocyte ratio (NMLR), a composite marker of systemic inflammation, was independently associated with long-term all-cause mortality in patients with COPD managed in primary care. Methods: We conducted a retrospective population-based cohort study using electronic health records from the Lleida Health Region (Spain) between 1 January 2014 and 31 December 2023. Patients with spirometry-confirmed COPD and available baseline complete blood counts were included. Baseline NMLR was calculated as (absolute neutrophil count + absolute monocyte count)/absolute lymphocyte count using the first valid blood sample obtained after cohort entry. Patients were categorized into NMLR quartiles. Associations with all-cause mortality were assessed using multivariable Cox proportional hazards regression models adjusted for age, sex, smoking status, lung function, and baseline comorbidity burden. Results: A total of 2644 patients were included, contributing 19,231 person-years of follow-up. During a median follow-up of 8.8 years, 1085 deaths occurred. Mortality increased progressively across NMLR quartiles, from 28.3% in the lowest quartile to 60.2% in the highest quartile. In fully adjusted analyses, patients in the highest quartile had higher all-cause mortality than those in the lowest quartile (hazard ratio [HR] 2.00; 95% confidence interval [CI] 1.66–2.40; p < 0.001). When modeled continuously, each doubling of baseline NMLR was associated with a 34% increase in mortality risk (HR 1.34; 95% CI 1.26–1.42). Conclusions: Elevated baseline NMLR was independently associated with increased long-term mortality in COPD. As an inexpensive and routinely available inflammatory biomarker, NMLR may improve mortality risk stratification and support future evaluation of risk-stratified follow-up strategies in primary care. External validation is required before implementation in routine clinical practice. Full article

Rapid and reliable crack-based visual damage detection after earthquakes is crucial for safe and effective disaster response. Manual inspections are often slow and hazardous for engineers in unstable structures. This study proposes a quadrupedal robotic inspection system for rapid post-earthquake crack-based visual damage detection in reinforced concrete structures. A Unitree Go2 robot equipped with an Intel RealSense D435i RGB-D camera collected a dataset of 3255 annotated crack images from both field and public sources. The YOLOv8n model, trained and deployed on an NVIDIA Jetson AGX Xavier, demonstrated high detection performance in laboratory tests on reinforced concrete specimens, with precision, recall, and mAP@50 values all exceeding 85%. The system provides fast, accurate, and automated structural health assessments, reducing human risk and improving inspection efficiency in hazardous post-disaster environments. Future work will focus on expanding damage detection capabilities and real-world deployment. Full article

Mercury (Hg) mobility in contaminated soils may be altered by solarization-induced thermal disturbance and organic amendments. This study evaluated whether a cover-induced prior solarization pretreatment of a mining-impacted soil–compost system modifies the operationally defined labile Hg fraction (F1 + F2, considered potentially bioavailable), rice productivity, grain Hg accumulation, and screening-level health risk. Mining soils from San Jorge River basin were amended with compost at a 1:9 ratio and solarized for one month before crop establishment, generating temperatures of 32, 40, 44, and 50 °C under different cover conditions. After pretreatment, covers were removed and rice was cultivated for four months under uniform flooded conditions. Total Hg in soils and grains was determined by EPA Method 7473, and the potentially bioavailable fraction by modified Bloom extraction. Prior thermal exposure increased this fraction, especially at 50 °C, whereas compost reduced total Hg and partially buffered this increase. Productivity depended on the compost × temperature interaction: compost improved yield at 40 and 44 °C, while no grain production occurred in substrates previously exposed to 50 °C. Compost-amended treatments showed lower grain Hg than unamended soils, although all values exceeded the 20 μg kg⁻¹ reference limit. Hazard quotients remained below 1, with the highest value in unamended soil previously exposed to 44 °C. Full article

Background/Objectives: This prospective cohort study assessed the impact of seasonal influenza during pregnancy on fetal and infant health outcomes. Methods: Pregnant women with laboratory-confirmed influenza were matched (1:4) by age and pregnancy loss history with women without influenza from annual cohorts in Suzhou, China, during 2015–2018. Participants underwent twice-weekly follow-up for influenza illness, and medical records were linked to ascertain outcomes. Multivariable regression models were used to estimate associations. Results: We included 441 pregnant women with influenza and 1764 without it. Four (0.9%) in the influenza group had late pregnancy loss, whereas one (0.1%) in the non-influenza group did. Influenza was associated with late pregnancy loss (adjusted hazard ratio [aHR] 31.1, 95% Confidence Interval [CI]: 1.3–756.8, p = 0.035). Four (0.9%) in the influenza group experienced early pregnancy loss, while five (0.3%) in the non-influenza group did. Influenza was not significantly associated with early pregnancy loss (aHR 2.1, 95% CI: 0.4–10.4, p = 0.374). By 8 months of age, infants born to 198 of the 441 mothers (44.9%) in the influenza group met the criteria for the program-defined child health monitoring indicator, compared with infants born to 650 of the 1764 mothers (36.8%) in the non-influenza group. Overweight/obesity was the largest contributor: 142 (32.2%) versus 470 (26.6%). Maternal influenza was associated with higher odds of meeting program-defined child health monitoring indicator in offspring (adjusted odds ratio [aOR] 1.4, 95% CI: 1.1–1.8, p = 0.006), with a significant contribution from overweight/obesity (aOR 1.3, 95% CI: 1.0–1.7, p = 0.045). Conclusions: In this cohort, influenza during pregnancy was associated with an increased risk of late pregnancy loss and program-defined child health monitoring indicator in offspring, particularly overweight/obesity. Because the observed association with pregnancy loss was based on a small number of events and had a wide confidence interval, it should be interpreted cautiously and confirmed in larger studies. These findings are consistent with current recommendations supporting influenza vaccination during pregnancy to protect maternal and infant health. Full article

Background: Cardiovascular disease (CVD) prevention in ageing populations requires simple and clinically accessible markers that may help identify individuals at elevated risk. Tooth loss is a common oral condition in middle-aged and older adults and may reflect cumulative inflammatory burden, impaired oral function, and broader health vulnerability. However, longitudinal evidence from nationally representative populations across different countries remains limited. We investigated whether a baseline of missing teeth was independently associated with incident CVD in three nationally representative ageing cohorts from China, the United States, and England. Methods: We analyzed data from the China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the English Longitudinal Study of Ageing (ELSA). Participants aged 45 years or older without baseline CVD and with available baseline tooth status were included. Missing teeth were assessed at baseline as a dichotomous exposure. Incident CVD was defined as newly reported heart disease and/or stroke during follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), with sequential adjustment for sociodemographic, lifestyle, and clinical covariates. Kaplan–Meier, subgroup, and sensitivity analyses were also performed. Results: A total of 31,805 participants were included, comprising 13,451 from CHARLS, 11,384 from HRS, and 6970 from ELSA. During follow-up, 2336 incident CVD events occurred in CHARLS, 2914 in HRS, and 545 in ELSA. In fully adjusted models, missing teeth was associated with a higher risk of incident CVD in all three cohorts, with HRs of 1.31 (95% CI, 1.14–1.50) in CHARLS, 1.43 (95% CI, 1.29–1.57) in HRS, and 1.86 (95% CI, 1.49–2.31) in ELSA. Kaplan–Meier analyses showed consistently lower CVD-free survival among participants with missing teeth, and the associations remained broadly robust across subgroup and sensitivity analyses. Conclusions: In three nationally representative cohorts from China, the United States, and England, a baseline of missing teeth was independently associated with a higher risk of incident CVD among middle-aged and older adults. These findings suggest that missing teeth may serve as a simple and clinically accessible marker of elevated cardiovascular risk and support greater integration of oral health into cardiovascular risk assessment and preventive strategies for ageing populations. Full article

Importance: Chronic liver disease requires sustained engagement with the health system, which co-occurring social and functional risks may disrupt. Whether these risks form reproducible patterns with different mortality associations is uncertain. Objective: To identify social and functional risk patterns among US adults with chronic liver disease and evaluate their associations with all-cause mortality. Design, Setting, and Participants: Nationally representative cohort study of National Health Interview Survey sample adults interviewed from 2011 through 2018 and linked to the National Death Index through 31 December 2019. Participants were aged 18 years or older, eligible for mortality linkage, reported a chronic liver condition, and had no baseline liver cancer. Exposures: Latent class membership derived from 7 binary indicators: poverty, food insecurity, uninsurance, cost-related delayed care, no usual place of care, single-adult household status, and activity limitation. A complete 0- to 7-item count was a secondary exposure. Main Outcomes and Measures: All-cause mortality. Survey-weighted Cox models estimated hazard ratios (HRs) with sequential demographic, clinical, and liver-specific adjustment. Prespecified sensitivity analyses used 20 multiple imputed data sets, sampling-weighted pseudo-likelihood latent class models, complete-case re-estimation, a fixed 5-year horizon, and class-by-age interaction testing. Results: Among 3407 adults (weighted mean age, 54.0 years; 49.4% female), 529 deaths occurred over 17,297.6 person-years (median follow-up, 5.0 years [IQR, 3.0–7.0]). Four classes were retained: low social and access burden (weighted prevalence, 63.1%); functional limitation with financial strain (13.2%); poverty, single-adult household, and functional limitation (15.0%); and uninsurance with major access barriers (8.7%). Compared with the low-burden class, the functional-limitation/financial-strain class had higher adjusted mortality (HR, 1.95; 95% CI, 1.34–2.82; p < 0.001); the other 2 classes did not differ significantly. Sampling-weighted latent class analysis after multiple imputation reproduced 97.2% of modal assignments, and the association persisted with attenuation (HR, 1.55; 95% CI, 1.08–2.22; p = 0.02). Each additional risk was associated with higher mortality (exact count: HR, 1.24 [95% CI, 1.13–1.36]; imputed count: HR, 1.19 [95% CI, 1.10–1.29]). The class-by-age interaction was not significant (p = 0.41). Conclusions and Relevance: Among US adults with self-reported chronic liver disease, social and functional adversity was both cumulative and patterned. A profile combining functional limitation, food insecurity, and cost-related delayed care had the clearest independent mortality association despite largely retained insurance coverage. These profiles are not a validated clinical score, but the findings argue against reliance on any single indicator, particularly insurance status, as a marker of vulnerability. Full article

Flood events have increased significantly in recent decades as a result of climate change, causing severe damage to cultural heritage and, in particular, to archival and library collections. Paper-based materials contaminated by floodwaters and alluvial mud are subject not only to physical and biological deterioration but also to potential hygienic and sanitary hazards associated with the persistence of human pathogens. Current emergency recovery strategies mainly focus on stabilizing materials through freezing, freeze-drying and mechanical cleaning, while health risk assessment is rarely addressed systematically. This pilot study proposes an innovative operational protocol that integrates microbiological indicators of hygienic relevance into the conservation workflow for assessing health risks during the remediation of flood-damaged archival and library materials. Its innovative character lies in shifting post-flood recovery from a predominantly material-stabilization approach toward a combined conservation and occupational-health framework, in which faecal contamination indicators, total microbial loads and selected viral targets are monitored before and after key remediation steps. The protocol was applied to collections from the Aurelio Saffi Municipal Library of Forlì (Italy), severely affected by the Emilia-Romagna floods of May 2023. The results indicate a substantial reduction in faecal contamination following freeze-drying, alongside the persistence of environmentally resistant microbial taxa. However, these findings should be regarded as preliminary and case-specific, and the proposed protocol will require validation through additional case studies, larger sample sets and controlled experimental trials before it can be considered broadly applicable. These findings highlight the need to integrate health risk considerations into conservation recovery workflows to support the safety of conservation professionals and users of recovered heritage materials. Full article

The long-term preservation of historical documents in archival environments is critically challenged by the accumulation of hazardous gases—formaldehyde (HCHO), benzene (C₆H₆), and radon (Rn)—which originate from collection materials and pose severe health risks to personnel. In this work, we systematically investigate, via first-principles theory, the potential of Au- and Ru-doped PtSe₂ monolayers as resistive-type gas sensors for the detection of these pollutants. Atomic-scale substitutional doping at the Se site is modeled to establish the doped PtSe₂ configurations, and the structural stability, electronic properties, adsorption behavior, charge transfer characteristics, and recovery kinetics of the doped systems are comprehensively evaluated and compared. Our findings, through comprehensive comparison, reveal that Ru-PtSe₂ outperforms its Au-doped counterpart across all key performance metrics, positioning it as a promising candidate for hazardous gas monitoring in archival environments. The key innovation of this work lies in the systematic comparative assessment of noble metal dopants on PtSe₂ monolayers, identifying Ru as a superior choice to Au and providing a theoretical foundation for designing high-performance, recyclable 2D material-based gas sensors tailored for cultural heritage preservation applications. Full article

Background: This study aimed to investigate whether individuals with trichotillomania (TTM) are at a higher risk of engaging in self-harm behaviors compared to those without TTM. Methods: In this matched cohort study, we analyzed electronic health records of all patients admitted to public hospitals in Hong Kong from 1 January 1993 to 31 December 2022. We identified a TTM cohort of 285 patients and a comparison cohort of 285 individuals. All participants were followed up until they received a diagnosis of self-harm, died from other causes, or until the end of 2023, whichever came first. To assess the risk of self-harm following TTM onset, Cox proportional hazards regression models were applied. Results: Throughout the 30-year study period, the number of individuals who exhibited self-harm behavior in the TTM and comparison groups was 8 (2.8%) and 8 (2.8%), respectively. The TTM and comparison groups had similar proportions of subjects who inflicted self-harm (χ² = 0.00, p = 0.977). The incidence of self-harm was 26.00 and 26.92 per 10,000 person-years in the TTM and comparison groups, respectively. Compared with the comparison group, the adjusted hazard ratio for self-harm in the TTM group was 1.44 (95% confidence interval, 0.45–4.61). Conclusions: TTM is not associated with an increased risk of self-harm. Future research is necessary to replicate our findings and more fully elucidate the potential unique risk factors for self-harm in these patients. Full article

Food contaminants, including plasticizers, pesticide residues, heavy metals, and biotoxins, pose persistent risks to food quality and human health. Their diverse sources, complex migration pathways, and potential long-term toxicity make removal difficult. Conventional removal technologies, such as physical treatment, chemical degradation, adsorption, membrane separation, and biological methods, can reduce contaminant levels to varying degrees. However, they often show limited selectivity, matrix interference, harsh operating requirements, or losses of nutritional and functional components. Molecularly imprinted polymers (MIPs) are synthetic recognition materials with binding sites tailored to a target contaminant. Their template-induced cavities provide complementarity in size, shape, and functional-group arrangement, enabling selective adsorption in complex matrices. Recent studies apply MIPs to the enrichment, detection, and removal of plasticizers, pesticide residues, heavy metals, and biotoxins. Unlike recent surveys centered on MIP-assisted analysis and sensing, this review uses contaminant removal as the organizing problem and compares MIP-based strategies with conventional decontamination across four hazard classes. MIPs offer tunable selectivity, chemical stability, and reusability, but practical food applications still face template leakage, slow mass transfer, incomplete safety evaluation, matrix dependence, and scale-up limitations. Future work should prioritize green synthesis, surface imprinting, magnetic recovery, and systematic validation in real food matrices. To prevent analytical extraction from being conflated with remediation, the evidence is classified from proof-of-binding and analytical cleanup to edible-matrix treatment and process validation, and representative studies are compared using capacity, removal or recovery, equilibration time, selectivity, reuse, and matrix validation. Recent evidence also reveals substantial gaps for PFAS, microplastics, and nanoplastics: selective recognition is advancing, but food-safe removal remains largely unvalidated. Full article

Background: Although extreme heat is associated with adverse cardiovascular outcomes, the relationship between heat-alert-threshold days, acute myocardial infarction (AMI) admissions, and post-AMI mortality remains uncertain. We aimed to evaluate the association between temperature-defined heat-alert-threshold days and (i) daily AMI admissions and (ii) cumulative all-cause mortality after hospitalized AMI in Hungary. Methods: We conducted a nationwide registry-based study using data from the Hungarian Myocardial Infarction Registry (HMR). All AMI admissions between 1 January 2018 and 31 December 2019 were eligible, with mortality follow-up through 16 June 2021. Heat-alert-threshold days were defined using the temperature criterion applied in the Hungarian national heat-health action plan (daily mean temperature ≥25 °C). AMI admissions were analyzed using adjusted quasi-Poisson regression models and cumulative mortality using stratified Cox proportional hazards models. This operational temperature threshold was used as the exposure definition and does not represent linkage to administrative heat-alert declarations. Results: The cohort included 30,883 AMI events from 29,596 unique patients (mean age, 67.2 [SD 12.8] years; 60.3% male). Patients admitted on heat-alert-threshold days had baseline clinical characteristics similar to those admitted on non-alert days (all standardized mean differences <0.10). Heat-alert-threshold days were associated with fewer recorded AMI admissions during summer (adjusted incidence rate ratio [aIRR] 0.93, 95% CI 0.90–0.97). In contrast, no association was observed between heat-alert-threshold exposure and subsequent all-cause mortality after AMI hospitalization (adjusted hazard ratio [aHR] 0.96, 95% CI 0.87–1.05). These findings remained consistent across sensitivity analyses. Conclusions: In this nationwide Hungarian registry-based study, temperature-defined heat-alert-threshold days were associated with fewer recorded AMI admissions during summer but not with differences in post-AMI mortality among hospitalized patients. The observed inverse association should not be interpreted as evidence of a protective effect of heat exposure. Alternative explanations include behavioral adaptation, delayed care-seeking, exposure misclassification, residual confounding, and the possibility of unmeasured out-of-hospital cardiovascular events, which were not captured by the registry. Because administrative heat-alert declarations were not linked to the analytic dataset, the findings should be interpreted as associations with temperature-defined heat-alert-threshold days rather than evaluations of the effectiveness of the Hungarian heat-alert system. Full article

Endocrine-disrupting pesticides (EDPs) are environmental toxicants capable of perturbing hormonal homeostasis through multiple molecular and cellular mechanisms. Growing evidence indicates that these compounds contribute to a broad spectrum of adverse health outcomes extending beyond classical endocrine dysfunction. This review critically synthesizes current knowledge on the toxicological mechanisms of EDPs and evaluates epidemiological evidence linking exposure to human disease. Mechanistically, EDPs act through modulation of nuclear hormone receptors, disruption of membrane-associated signaling pathways, interference with hormone synthesis, metabolism, and transport, induction of oxidative stress and mitochondrial dysfunction, and epigenetic reprogramming. These molecular events converge on shared biological pathways that affect multiple organ systems and life stages. Human and experimental evidence associates EDP exposure with reproductive dysfunction, endocrine-related cancers, metabolic disorders, thyroid abnormalities, and neurodevelopmental impairments. Particular concern surrounds exposure during critical windows of susceptibility, especially prenatal development and early childhood, when endocrine systems are highly vulnerable to disruption and developmental programming. Across disease endpoints, recurring mechanisms, including endocrine receptor perturbation, oxidative stress, inflammation, and epigenetic alterations, support a unifying toxicological framework linking diverse adverse outcomes. Despite substantial progress, important uncertainties remain regarding chronic low-dose exposure, non-monotonic dose–response relationships, cumulative effects of pesticide mixtures, and the translation of mechanistic findings into human risk assessment. Future research should integrate repeated biomonitoring, advanced mixture modeling, mechanistic biomarkers, and multi-omics approaches within longitudinal life-course studies. Improved integration of toxicological and epidemiological evidence will strengthen causal inference, refine hazard characterization, and support more protective regulatory strategies for reducing the human health burden associated with endocrine-disrupting pesticides worldwide. Full article

Battery Energy Storage Systems (BESS), utilising chemistries based on Nickel Manganese Cobalt (NMC) containing lithium-ion devices, often present fire safety hazards that existing qualitative risk frameworks, including NFPA 855’s 5 × 5 consequence-likelihood matrix, are insufficiently granular to quantify. This paper presents an original probabilistic risk assessment (PRA) of fire hazards associated with BESS for a 485.52 kWh NMC installation at the Equinix SG4-4A data centre in Singapore, using Monte Carlo simulation (N = 10,000 iterations) to characterise uncertainty in hydrogen fluoride (HF) gas dose, time to Immediately Dangerous to Life or Health (IDLH) concentration, cabinet-to-cabinet propagation probability, and suppression effectiveness. The HF yield is modelled as a triangular distribution (0.3–0.8 g/kWh, mode 0.5 g/kWh), ventilation activation delay as log-normal (median 90 s), and suppression effectiveness as a piecewise function of water application delay. The results demonstrated that HF dose exceeded the National Institute for Occupational Safety and Health (NIOSH) IDLH of 25 mg/m³ in 100% of simulated scenarios for both single- and two-compartment designs, thus confirming that threshold HF toxicity was essentially unavoidable for any occupant present during a full thermal runaway event, and that ventilation alone cannot achieve adequate risk reduction. The single-stage suppression effectiveness was found to be only 37.9% (mean), providing quantitative confirmation that two-stage (clean agent + water) suppression is warranted for NMC chemistry. The two-compartment design was found to reduce the peak HF dose by 50%, and also reduced the mean IDLH clearance time from 599 to 301 min, thus shifting residual risk from As Low As Reasonably Practicable (ALARP)-tolerable to broadly acceptable under UK Health and Safety Executive (HSE) criteria. The paper proposes a quantitative PRA framework as a complement to NFPA 855 Chapter 5’s qualitative Hazard Mitigation Analysis, enabling more informed engineering decisions for BESS fire safety. To the best of our knowledge, this is the first study to apply Monte Carlo simulation to HF dose modelling in a tropical data-centre BESS context and thereby address a documented gap in the literature. Full article