Search Results (12,769)

Background and Objectives: Multiple sclerosis (MS) is a chronic immune-mediated neurological disorder that primarily affects young adults and is frequently accompanied by psychiatric comorbidities such as depression and anxiety, both of which significantly diminish patients’ quality of life (QoL). This study investigated the effect of two oral disease-modifying therapies (DMTs), fingolimod and cladribine, on mental health and QoL in patients with relapsing-remitting MS (RRMS). The aim of the study was to compare levels of depression, anxiety, and health-related quality of life (HRQoL) in RRMS patients treated with fingolimod or cladribine, and to evaluate their associations with clinical and radiological parameters. Materials and Methods: Eighty RRMS patients aged 18 to 50 years with Expanded Disability Status Scale (EDSS) scores of 3.0 or less, no recent disease relapse, and no history of antidepressant use were enrolled. Forty patients were treated with fingolimod and forty with cladribine. Depression and anxiety were assessed using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). QoL was evaluated using the Multiple Sclerosis QoL-54 (MSQOL-54) instrument. Additional clinical data, including MRI-based lesion burden, EDSS scores, age, disease duration, and occupational status, were collected. Results: No statistically significant differences were observed between the two groups regarding HDRS and HARS scores (p > 0.05). However, patients treated with fingolimod had significantly higher scores in the Energy/Fatigue subdomain (7.55 ± 2.02 vs. 6.56 ± 2.57, p = 0.046) and Composite Mental Health (CMH) score (64.73 ± 15.01 vs. 56.00 ± 18.93, p = 0.029) compared to those treated with cladribine. No significant differences were found in the independent items of the MSQOL-54. A negative correlation was identified between total lesion load and QoL scores. Conclusions: Although fingolimod and cladribine exert comparable effects on depression and anxiety levels, fingolimod may be associated with better mental health outcomes and reduced fatigue in RRMS patients. Furthermore, lesion burden and clinical parameters such as age and EDSS score may independently influence QoL, regardless of the DMT used. Full article

According to the United Nations Environment Programme reports, buildings are responsible for nearly 40% of energy-related emissions; therefore, energy-optimized building design is crucial to reduce the reliance on non-renewable energy sources as well as greenhouse gas emissions. The OECD reports indicate the use of Building Information Modelling (BIM) as one of the effective strategies for decarbonization of buildings, since a 3D digital representation of both physical and functional characteristics of a building can help to design a more efficient infrastructure. An efficient integration of solar energy in building design can be vital for the enhancement of energy performance in terms of heating, cooling, and lighting demand. This paper presents results of an analysis of how factors related to the use of daylight, such as automatic control of artificial lighting, external shading, or the visual absorptance of internal surfaces, influence the energy efficiency within an example room in two different climatic zones. The simulation was conducted using Design Builder software, with predefined occupancy schedules and internal heat gains, and standard EPW weather files for Warsaw and Genua climate zones. The study indicates that for the examined room, when no automatic sunshades or a lighting control system is utilized, most of the final energy demand is for cooling purposes (45–54%), followed by lighting (42–43%), with only 3–12% for heating purposes. The introduction of sunshades and/or the use of daylight allowed for a reduction of the total demand by up to half. Moreover, it was pointed out that often neglected factors, like the colour of the internal surfaces, can have a significant effect on the final energy consumption. In variants with light interior, the total energy consumption was lower by about 3–4% of the baseline demand, compared to their corresponding ones with dark surfaces. These results are consistent with previous studies on daylighting strategies and highlight the importance of considering both visual and thermal impacts when evaluating energy performance. Similarly, possible side effects of certain actions were highlighted, such as an increase in heat demand resulting from a reduced need for artificial lighting. The results of the analysis highlight the potential of a simulation-based design approach in optimizing daylight use, contributing to the broader goals of building decarbonization. Full article

Objectives: This study investigated levels of work engagement and the occurrence of compassion fatigue among nursing professionals during the COVID-19 pandemic. Methods: A cross-sectional, descriptive, and correlational study was conducted at a Brazilian university hospital between February and April 2022. The Brazilian versions of the Utrecht Work Engagement Scale (UWES-9) and the Professional Quality of Life Scale (ProQOL-BR) were administered. Results: High levels of compassion satisfaction (44.9 points), low levels of burnout (21.0 points), and low levels of secondary traumatic stress (22.8 points) were observed. No professional demonstrated a profile consistent with compassion fatigue. Engagement levels were high for dedication (5.3) and moderate for vigor (4.9), absorption (4.5), and overall engagement (4.9). Burnout showed moderate negative correlations with vigor (r = −0.611, p = 0.005) and dedication (r = −0.599, p = 0.019). Compassion satisfaction showed moderate positive correlations with vigor (r = 0.522, p < 0.001) and dedication (r = 0.572, p < 0.001). The overall engagement score was moderately and positively correlated with compassion satisfaction (r = 0.532, p < 0.001). Conclusions: This study identified high levels of work engagement, especially regarding dedication, and low levels of compassion fatigue among nursing professionals. The data suggest that even amid the emotional and physical demands imposed by the pandemic, participants preserved their emotional well-being and maintained a positive relationship with their work. Full article

Allergic contact dermatitis (ACD) is an immunologic reaction to a dermal chemical exposure that, once triggered in an individual, will result in an allergic response following subsequent encounters with the allergen. Air Force epidemiological consultations have indicated that aircraft structural maintenance workers may experience ACD at elevated rates compared to other occupations. We aimed to better understand the utility of non-animal testing methods in characterizing the sensitization potential of chemicals used during Air Force operations by evaluating the skin sensitization hazard of Air Force-relevant chemicals using new approach methodologies (NAMs) in a case study. We also evaluated the use of NAM data to develop preliminary candidate surface guidelines (PCSGs, maximum concentrations of chemicals on workplace surfaces to prevent induction of dermal sensitization) for chemicals identified as sensitizers. NAMs for assessing skin sensitization, including in silico models and experimental assays, were leveraged into an integrated approach to predict sensitization hazard for 19 chemicals. Local lymph node assay effective concentration values were predicted from NAM assay data via previously published quantitative models. The derived values were used to calculate PCSGs, which can be used to compare the presence of these chemicals on work surfaces to better understand the risk of Airmen developing ACD from occupational exposures. Full article

Smart living is strongly promoted to enhance the quality of life via the application of innovative solutions, and this is driven by domain specialists and policymakers, including designers, urban planners, computer engineers, and property developers. Nonetheless, the actual user, whose views ought to be considered during the design and development of smart living systems, has received little attention. Thus, this study aims to identify and examine the critical smart functions to achieve smart living in smart buildings based on occupants’ perceptions. The aim is achieved using a sequential quantitative research method involving a literature review and 221 valid survey data gathered from a case of a smart student residence in Hong Kong. The method is further integrated with descriptive statistics, the Kruskal–Walli’s test, and the criticality test. The results were validated via a post-survey with related experts. Twenty-six critical smart functions for smart living were revealed, with the top three including the ability to protect personal data and information privacy, provide real-time safety and security, and the ability to be responsive to users’ needs. A need was discovered to consider the context of buildings during the design of smart living systems, and the recommendation is for professionals to understand the kind of digital technology to be integrated into a building by strongly considering the context of the building and how smart living will be achieved within it based on users’ perceptions. The study provides valuable insights into the occupants’ perceptions of critical smart features/functions for policymakers and practitioners to consider in the construction of smart living systems, specifically students’ smart buildings. This study contributes to knowledge by identifying the critical smart functions to achieve smart living based on occupants’ perceptions of smart living by considering the specific context of a smart student building facility constructed in Hong Kong. Full article

Effective building operation requires a careful balance between energy conservation and indoor environmental comfort. Although numerous methods have been developed to reduce energy consumption during the operational phase, their objectives and applications vary widely. However, the complexity of building energy management makes it challenging to identify the most suitable methods that simultaneously achieve both comfort and efficiency goals. Existing studies often lack a systematic framework that supports integrated decision-making under comfort constraints. This research aims to address this gap by proposing a decision-making tree for selecting energy conservation methods during building operation with an explicit consideration of indoor environmental comfort. A comprehensive literature review is conducted to identify four main energy-consuming components during building operation: the building envelope, HVAC systems, lighting systems, and plug loads and appliances. Three key comfort indicators—thermal comfort, lighting comfort, and air quality comfort—are defined, and energy conservation methods are categorized into three strategic groups: passive strategies, control optimization strategies, and behavioural intervention strategies. Each method is assessed using a defined set of evaluation criteria. Subsequently, a questionnaire survey is administered for the calibration of the decision tree, incorporating stakeholder preferences and expert judgement. The findings contribute to the advancement of understanding regarding the co-optimization of energy conservation and occupant comfort in building operations. Full article

Introduction: Night shift work (NSW) has been increasingly addressed in the scientific literature, as it is considered a probable carcinogen. In this study, we investigated the association of NSW with health problems, unhealthy behaviors, and occupational carcinogens. Methods: Cross-sectional study with a sample of 47,953 workers from the 2019 National Health Survey. NSW prevalence was estimated according to sociodemographic characteristics. To investigate the associations of NSW with all study variables, gender stratified logistic regression models were used. The odds-ratio and 95% confidence intervals were estimated. Results: Among men, there was a significant association of NSW with sleep disorders (OR = 1.39; 95% CI: 1.17–1.65), tiredness (OR = 1.68; 95% CI: 1.41–2.00), obesity (OR = 1.41; 95% CI: 1.20–1.66), unhealthy food consumption (OR = 1.28; 95% CI: 1.12–1.46), handling of radioactive material (OR = 2.45; 95% CI: 1.61–3.72), and biological material (OR = 3.18; 95% CI: 3.15–4.80). Among females, NSW was associated with the same variables except obesity, but depressive feelings (OR = 1.35 95% CI: 1.09–1.67), frequent alcohol intake (OR = 1.48; 95% CI: 1.23–1.78), handling of chemical substances (OR = 1.54; OR = 1.54; 95% CI: 1.20–1.97), and passive smoking at work (OR = 1.45; 95% CI: 1.12–1.86) were highly significant. Conclusion: Night shift workers are more vulnerable to occupational carcinogen exposure, experience greater impacts on their well-being, and are more likely to engage in unhealthy behaviors. These findings should be considered in managing and organizing night work in the workplace. Actions to promote healthy work environments should be encouraged to protect workers’ health. Full article

Improving occupational health and safety (OHS) in the construction industry can contribute to the advancement of the Sustainable Development Goals (SDGs), particularly Goals 3 (Good Health and Well-being) and 8 (Decent Work and Economic Growth). Yet, workers’ risk-taking behaviors (RTBs) remain a persistent challenge. Drawing on Social Cognitive Theory and Social Information Processing Theory, this study develops and tests a social influence model to examine how foremen’s safety attitudes (SAs) shape workers’ RTBs. Drawing on survey data from 301 construction workers in China, structural equation modeling reveals that foremen’s SAs significantly and negatively predict workers’ RTBs. However, the three dimensions of SAs—cognitive, affective, and behavioral—exert their influence through different pathways. Risk perception (RP) plays a key mediating role, particularly for the cognitive and behavioral dimensions. Furthermore, interpersonal trust (IPT) functions as a significant moderator in some of these relationships. By identifying the micro-social pathways that link foremen’s attitudes to workers’ safety behaviors, this study offers a testable theoretical framework for implementing the Sustainable Development Goals (particularly Goals 3 and 8) at the frontline workplace level. The findings provide empirical support for organizations to move beyond rule-based management and instead build more resilient OHS governance systems by systematically cultivating the multidimensional attitudes of frontline leaders. Full article

Background/Objectives: Bladder cancer is a common malignancy with a high rate of recurrence and progression. Recent studies have identified that the urinary microbiome can be a key factor in tumor pathogenesis, progression, and outcomes. This narrative review is designed to summarize current evidence regarding the urobiome and explore its diagnostic and therapeutic potential. Methods: Studies between 2019 and 2024 were identified through the PubMed/MEDLINE and Google Scholar databases. Case reports and non-English-language articles were excluded. Results: The main findings revealed that specific bacteria, viruses, and taxa are linked to bladder cancer presence, progression, and response to immunotherapy treatment. Urinary microbiota differ by tumor type, sex, smoking status, and occupational exposure to toxins. Conclusions: Urinary microbiome and certain types of viruses present in urine may serve as promising tools to enhance bladder cancer diagnosis and predict treatment response. However, larger longitudinal studies are needed to confirm and establish these findings. Furthermore, integration of the urinary microbiome in clinical practice and public health strategies may reduce disease-related burden. Full article

Occupational heat stress represents an increasing challenge to safety and operational performance in underground mining, where elevated temperatures, humidity, and limited ventilation are common. This study proposes an integrated framework to analyze the systemic impact of heat stress on human reliability in mining operations. We conducted a systematic literature review to identify empirical studies addressing thermal exposure, extracting key operational functions for modeling. These functions were structured using the Functional Resonance Analysis Method (FRAM) to reveal interdependencies and performance variability. Human reliability was evaluated using Fuzzy CREAM, which quantified the degree of contextual control associated with each function. Finally, we applied the Gaussian Analytic Hierarchy Process (AHP) to prioritize functions based on thermal impact, contextual reliability, and systemic connectivity. The results showed that functions involving subjective or complex judgment, such as assessing thermal stress or identifying psychophysiological indicators, exhibited lower reliability and higher vulnerability. In contrast, monitoring and control functions based on standardized procedures were more stable and resilient. This combined approach identified critical points of systemic fragility and offers a robust decision-support tool for prioritizing thermal risk mitigation. The findings contribute to advancing the scientific understanding of heat stress impacts in mining and support the development of targeted interventions to enhance human performance and safety in extreme environments. Full article

Effective earthquake early warning (EEW) is essential for disaster prevention in the built environment, enabling a rapid structural response, system shutdown, and occupant evacuation to mitigate damage and casualties. However, most current EEW systems lack rigorous reliability analyses of their predictive outcomes, limiting their effectiveness in real-world scenarios—especially for on-site warnings, where data are limited and time is critical. To address these challenges, we propose a Bayesian neural network (BNN) framework based on Stein variational gradient descent (SVGD). By performing Bayesian inference, we estimate the posterior distribution of the parameters, thus outputting a reliability analysis of the prediction results. In addition, we incorporate a continual learning mechanism based on elastic weight consolidation, allowing the system to adapt quickly without full retraining. Our experiments demonstrate that our SVGD-BNN model significantly outperforms traditional peak displacement (Pd)-based approaches. In a 3 s time window, the Pearson correlation coefficient R increases by 9.2% and the residual standard deviation $SD$ decreases by 24.4% compared to a variational inference (VI)-based BNN. Furthermore, the prediction variance generated by the model can effectively reflect the uncertainty of the prediction results. The continual learning strategy reduces the training time by 133–194 s, enhancing the system’s responsiveness. These features make the proposed framework a promising tool for real-time, reliable, and adaptive EEW—supporting disaster-resilient building design and operation. Full article

Background: Patients diagnosed with melanoma are at increased risk of developing multiple primary melanomas (MPMs). Identifying clinical and genetic factors associated with MPM is critical for implementing personalized surveillance strategies. This study aims to describe the clinical, histopathological, and genetic characteristics of patients with MPM managed in a tertiary hospital and to contextualize findings within the current literature. Methods: We conducted a retrospective review of patients diagnosed with two or more primary melanomas between 2010 and 2023 at a tertiary dermatology unit. Demographic data, personal and family cancer history, phototype, melanoma characteristics, genetic testing, staging, treatments, and outcomes were collected. These data were compared with findings from the recent literature. Results: Thirteen patients (ten males, three females; median age: 59 years) were found to have a total of 33 melanomas. Most patients had Fitzpatrick phototype II and no immunosuppression. The number of melanomas per patient ranged from two to five. Synchronous lesions were observed in two patients. Common locations included the trunk and extremities. Histologically, 57% were in situ melanomas, and subsequent melanomas were generally thinner than the index lesion. Two patients showed progression to advanced disease. One patient was positive for MC1R mutation; the rest were negative or inconclusive. Additional phenotypic and environmental risk factors were extracted from patient records and are summarized as follows: Ten patients (76.9%) had Fitzpatrick skin phototype II, and three (23.1%) had phototype III. Chronic occupational sun exposure was reported in four patients (30.8%), while five (38.5%) recalled having suffered multiple sunburns during childhood or adolescence. Eight patients (61.5%) presented with a total nevus count exceeding 50, and five (38.5%) exhibited clinically atypical nevi. None of the patients reported use of tanning beds. Conclusions: Our findings are consistent with the existing literature indicating that patients with MPM often present with thinner subsequent melanomas and require long-term dermatologic follow-up. The inclusion of genetic testing and phenotypic risk factors enables stratified surveillance and supports the application of personalized medicine in melanoma management. Full article

This study analyzes the relationship between ergonomic and psychosocial risk factors and labor productivity using a bibliometric approach through a general analysis and one that includes inclusion criteria such as English language, open access, and primary research publications to identify only those articles that explicitly address the relationship between ergonomic and psychosocial risk factors and labor productivity. It is recognized that both physical and psychosocial conditions of the work environment directly influence workers’ health and organizational performance. For this purpose, a bibliometric review was conducted in academic databases, including Scopus, Web of Science, ScienceDirect, and Taylor & Francis, resulting in the selection of 4794 relevant articles for general analysis. Additionally, 116 relevant articles were selected based on the inclusion criteria. Tools and methodologies, such as Rayyan, Excel, VOSviewer 1.6.20, and PRISMA, were used to classify the studies and identify trends, collaboration networks, and geographical distribution. The results reveal a sustained growth in scientific production, with clusters on occupational safety and health, work environment factors, and the characteristics of the population, approach, and methodologies used in the studies. Likewise, Procedia Manufacturing, International Journal of Occupational Safety and Ergonomics, and Ergonomics stand out as the main sources of publication, while countries such as Sweden, Poland, and the United States lead the scientific production in this field. In addition, the network of co-occurrence of keywords evidences a comprehensive approach that articulates physical or ergonomic and psychosocial risk factors with organizational performance, while the network of authors shows consolidated collaborations and studies focused on analyzing the relationship between physical demands and musculoskeletal disorders from advanced ergonomic approaches. Full article

This article describes the design, methods, and baseline characteristics of the social needs assessment (SNA) of participants enrolled in an ongoing randomized clinical trial implementing a comprehensive approach to improving diabetes self-management and providing an intensive Diabetes Self-Management Education and Support (iDSMES) Program at St. Vincent’s House Clinic, a primary care practice serving resource-challenged diverse populations in Galveston, Texas. Standardized SNA was conducted to collect information on financial needs, psychosocial well-being, and other chronic health conditions. Based on their identified needs, participants were referred to non-medical existing community resources. A series of in-depth interviews were conducted with a subset of participants. A team member independently categorized these SNA narratives and aggregated them into two overarching groups: medical and social needs. Fifty-nine participants (with a mean age of 53 years and equal representation of men and women) completed an SNA. Most (71%) did not have health insurance. Among 12 potential social needs surveyed, the most frequently requested resources were occupational therapy (78%), utility assistance (73%), and food pantry services (71%). SNA provided data with the potential to address barriers that may hinder participation, retention, and outcomes in diabetes self-management. SNA findings may serve as tertiary prevention to mitigate diabetes-related complications and disparities. Full article

The European Union Council’s zero vision aims to eliminate workplace fatalities, while Industry 4.0 presents new challenges for occupational safety. Despite HR professionals assessing managers’ and employees’ competencies, no system currently exists to evaluate the competencies of workers’ representatives in occupational safety and health (OSH). It is crucial to establish the necessary competencies for these representatives to avoid their selection based on personal bias, ambition, or coercion. The main objective of the study is to identify the competencies and their components required for workers’ representatives in the field of occupational safety and health by following the steps of the DACUM method with the assistance of OSH professionals. First, tasks were identified through semi-structured interviews conducted with eight occupational safety experts. In the second step, a focus group consisting of 34 OSH professionals (2 invited guests and 32 volunteers) determined the competencies and their components necessary to perform those tasks. Finally, the results were validated through an online questionnaire sent to the 32 volunteer participants of the focus group, from which 11 responses (34%) were received. The research categorized the competencies into the following three groups: core competencies (occupational safety and professional knowledge) and distinguishing competencies (personal attributes). Within occupational safety knowledge, 10 components were defined; for professional expertise, 7 components; and for personal attributes, 16 components. Based on the results, it was confirmed that all participants of the tripartite system have an important role in the training and development of workers’ representatives in the field of occupational safety and health. The results indicate that although OSH representation is not yet a priority in Hungary, there is a willingness to collaborate with competent, well-prepared representatives. The study emphasizes the importance of clearly defining and assessing the required competencies. Full article