Search Results (8,372)

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

Poor indoor air quality is linked to respiratory symptoms and disease, but interactions between indoor pollutants and microbial communities remain unclear. Evidence suggests microorganisms can interact with polycyclic aromatic hydrocarbons (PAHs) through degradation or attachment, potentially shaping indoor microbiomes. In the COPSACsevere cohort, we analyzed bed dust from 84 children (58 asthma, 26 controls). PAHs were measured by HPLC-FLD and microbiota profiled by 16S rRNA and ITS2 sequencing. Questionnaires captured sociodemographic and lifestyle factors. Associations were tested using PERMANOVA, Spearman correlations, and MaAsLin2. Bacterial community composition varied with the host factors age, sex, and parental education, but showed no association with PAH concentrations. Fungal diversity and composition were significantly associated with PAHs, especially pyrene and fluoranthene, which explained 6.1–6.3% variance (p < 0.05) and were positively correlated with Shannon diversity and evenness. Several fungal taxa including Lecanoraceae, Helotiales, and Circinaria correlated positively with PAHs. Asthma status was not associated with bacterial or fungal alpha and beta diversity metrics. PAHs selectively influenced fungal but not bacterial communities in bed dust. Although no asthma associations were detected and no mechanisms can be inferred, these findings highlight potential chemical–fungal interactions in indoor environments and their relevance for future respiratory health research. These results suggest that chemical exposures may shape specific components of indoor microbiomes independent of host disease status, emphasizing the need to integrate chemical–biological interactions in indoor exposure assessments in future environmental health studies and interventions. Full article

Excessive manganese (Mn) exposure is associated with neuroinflammation and cognitive impairment, yet the contribution of endogenous pro-resolving pathways to Mn neurotoxicity remains incompletely understood. Here, we examined the involvement of the lipocalin-type prostaglandin D synthase (L-PGDS)/15-deoxy-Δ^12,14-prostaglandin J2 (15d-PGJ2) pathway using Mn-treated male C57BL/6J mice, BV2 microglia, and SH-SY5Y neurons, together with data from occupationally Mn-exposed workers (cross-sectional, hypothesis-generating). In the occupational cohort, circulating 15d-PGJ2 levels and L-PGDS expression were reduced following Mn exposure, consistent with the experimental findings. PPI network analysis and promoter prediction highlighted C/EBPβ and MMP9 as potential mediators of Mn-induced neuroinflammatory responses. Consistent with these observations, Mn exposure increased C/EBPβ and MMP9 expression, promoted M1 microglial polarization, elevated ROS production, and aggravated neuronal injury in a microglia–neuron co-culture system. Knocking down either C/EBPβ or MMP9 attenuated inflammatory activation and oxidative stress and reduced neuronal damage. Administration of exogenous 15d-PGJ2 suppressed Mn-induced increases in C/EBPβ and MMP9, alleviated inflammatory and oxidative responses, and partially ameliorated cognitive impairment in Mn-exposed mice. Transcriptomic analyses further showed that 15d-PGJ2 counteracted a substantial proportion of Mn-induced transcriptional alterations, particularly those related to inflammatory and neurodevelopmental processes. In addition, Ptgds knockdown reduced endogenous 15d-PGJ2 production and increased MMP9 expression, whereas exogenous 15d-PGJ2 largely reversed these changes. Together, these findings support the involvement of L-PGDS/15d-PGJ2 pathway dysregulation in Mn-induced neuroinflammation and suggest that restoration of 15d-PGJ2 signaling may represent a potential therapeutic approach for Mn-associated neurotoxicity. Full article

Background/Objectives: Omentin-1 (intelectin-1) is an adipocytokine with anti-inflammatory, insulin-sensitizing, and iron-regulatory properties. This study aimed to compare circulating omentin-1 levels in patients with (IDA) and β-thalassemia trait and to evaluate their associations with haematological, iron-related, and metabolic parameters. Methods: A total of 90 adults (n = 90), including 29 patients with IDA, 31 individuals with β-thalassemia trait, and 30 healthy controls. Haematological indices, iron parameters, biochemical markers, and plasma omentin-1 levels were measured. Group comparisons, correlation analyses, multivariable linear regression, and receiver operating characteristic (ROC) curve analyses were performed. Results: Plasma omentin-1 concentrations were significantly lower in patients with hypochromic microcytic anaemia than in healthy controls (36.4 vs. 147.7 ng/mL, p < 0.001). Among subgroups, the lowest levels were observed in IDA patients, followed by β-thalassemia trait and controls (p < 0.001). Omentin-1 showed positive correlations with haemoglobin, MCV, MCH, ferritin, serum iron, total cholesterol, HDL-C, and LDL-C, whereas negative correlations were observed with age, HbA1c, glucose, RDW, and total iron-binding capacity (all p < 0.05). In multivariable analysis, age (β = −0.215, p = 0.046), female sex (β = 0.305, p = 0.028), and MCV (β = 0.334, p = 0.015) were independent predictors of omentin-1 levels. ROC analysis demonstrated excellent discrimination between IDA and controls (AUC = 0.93) and good discrimination between β-thalassemia trait and controls (AUC = 0.79). Conclusions: Omentin-1 levels are reduced in IDA and β-thalassemia trait and are closely associated with iron status, erythroid indices, and metabolic parameters. Omentin-1 may serve as an adjunct biomarker for hypochromic microcytic anaemia, particularly in distinguishing affected individuals from healthy subjects. However, its limited utility in distinguishing iron-deficiency anaemia from β-thalassemia trait indicates that it should be used alongside established haematological and iron-related parameters. Full article

Low back pain (LBP) is the leading cause of years lived with disability globally, and a major rehabilitation priority, yet nursing education often does not translate burden evidence into first-contact actions across care settings. This article aimed to develop a nursing education and practice framework that converts global LBP evidence into competencies for assessment, education, medication safety, referral, follow-up and occupational prevention. A focused, Global Burden of Disease-informed narrative review and practice-oriented educational synthesis was conducted. PubMed/MEDLINE, CINAHL, Scopus, Google Scholar, and organisational sources were searched for burden estimates, clinical guidelines, pain education scholarship, nursing occupational health evidence and nurse-led self-management literature. Sources were selected for relevance to nurse-deliverable actions and curriculum assessment; systematic-review methods, meta-analysis and formal risk-of-bias appraisal were not used. Evidence was mapped iteratively to six nursing practice domains: red-flag triage and escalation; functional, psychosocial and contextual assessment; brief therapeutic education; medication safety and low-value-care reduction; follow-up and referral; and occupational prevention. The revised framework adds an explicit evidence-to-competency map, implementation guidance and evaluation indicators for undergraduate education, postgraduate training, continuing professional development, clinical supervision and quality improvement. LBP should be taught as a nursing-sensitive disability and rehabilitation priority, supporting nurses to screen for danger, validate pain, reduce threat, promote graded activity, monitor medicines, coordinate continuity and prevent occupational harm. Full article

Burnout and psychological distress among healthcare workers (HCWs) have become a major workforce challenge, raising an important question: should responsibility for worker wellbeing rest primarily with individuals or with the organization of work itself? This systematic review evaluated workplace mental health programs for HCWs, comparing individual-level psychological interventions with organizational-level approaches. Following PRISMA 2020 guidelines, 54 studies (2016–2026) from more than 18 countries were identified from approximately 7144 records through a PubMed/MEDLINE search. The included studies comprised 29 individually randomized controlled trials (RCTs), 11 cluster-randomized or stepped-wedge trials, and 14 additional non-randomized or contextual studies. ROBINS-I was applied only to the five eligible non-randomized intervention studies—the remaining non-randomized studies contributed contextual evidence and were not included in the ROBINS-I assessment. Here, 41 studies contributed effectiveness evidence, of which 34 (83%) reported a statistically significant improvement in at least 1 primary or key outcome, while 13 studies provided contextual, feasibility, or implementation evidence. Individual-level interventions dominated the evidence base (39/54; 72%). In contrast, organizational interventions were less frequently evaluated, rarely randomized, and showed mixed findings. Observational studies consistently identified workload, organizational trust, and other structural stressors as factors associated with burnout, although causal inferences remain limited. Risk of bias was substantial, with only 7 of 40 randomized trials (17.5%) rated as low risk. All five non-randomized intervention studies assessed using ROBINS-I were judged to have serious risk of bias. Overall, individual-level interventions were evaluated more frequently than organizational interventions and generally reported improvements in mental health outcomes. However, the evidence base was limited by the single-database search, variability in study quality, and methodological limitations. Further well-designed and adequately powered studies, particularly of organizational interventions, are needed to strengthen the evidence base. Full article

The taxonomic status of the H17N10 and H18N11 influenza A viruses isolated from bats remains unclear due to the absence of quantitative classification criteria at this taxonomic level. A total of 3328 representative IAV genomes, encompassing all eight protein-coding segments, were analysed. Various genetic distance-based metrics were assessed at the pairwise level, including intra- and intergroup nucleotide distances, dN/dS ratios, and transition/transversion ratios, to facilitate the differentiation of the Alphainfluenzavirus genus into distinct taxa. Pairwise distances for seven of the eight segments (PB2, PB1, PA, NP, M, NA, NS) consistently differentiated the H17–H18 group from H1–H16. Across segments, intergroup nucleotide divergence was consistently above a lower bound of ~25%, with segment-specific values extending to higher levels (up to ~40% in PB2 and PA), while intragroup divergence remained substantially lower. The HA segment did not conform to this pattern, which is consistent with the hypothesis of ancient reassortment. The distribution of pairwise dN/dS values for the PB2, PB1, PA, and NP segments is evidently bimodal. Intergroup comparisons were consistently higher across all segments, whereas intragroup values remained lower. A similar lower boundary of approximately 0.12 was observed across segments, while the upper range of intergroup values varied by gene. Overall, the results support a consistent gene-specific separation pattern. Previously demonstrated absence of reassortment compatibility between bat viruses (H17–H18) and canonical influenza A (H1–H16) viruses indicates that these lineages have evolved independently over an extended period. These consistent genomic patterns provide support for the hypothesis that H17N10 and H18N11 viruses may represent a separate species within the genus Alphainfluenzavirus. Full article

Sustainable development has become a strategic priority for countries seeking long-term economic prosperity while balancing social, environmental, and institutional objectives. According to the April 2026 International Monetary Fund World Economic Outlook projections, Türkiye is expected to become the largest economy among the selected major Muslim economies in terms of nominal gross domestic product. Motivated by this development, this study benchmarks Türkiye’s sustainable development performance against nine comparable economies and examines the relationships between selected Sustainable Development Goal (SDG) indicators and economic performance. The analytical framework integrates benchmarking, correlation, SDG network analysis, regression modeling, and explainable machine learning using SDG and macroeconomic data. The findings reveal both synergies and trade-offs among the selected SDGs. Strong positive relationships emerge between SDG12 and SDG13 and between SDG4 and SDG16, confirming the interconnected structure of sustainable development. Türkiye ranks second in overall SDG performance and performs particularly strongly in clean energy, innovation and infrastructure, and international partnerships. Regression results identify education, clean energy, innovation, and climate action as statistically associated with economic performance. Under a strict year-based chronological holdout and rolling-origin validation framework, the tuned Random Forest model achieved the strongest out-of-sample predictive performance. SHapley Additive exPlanations analysis indicates that one-year lagged economic performance is the dominant predictor, while current macroeconomic conditions and selected SDG indicators provide additional predictive information. The findings demonstrate substantial temporal persistence in economic performance and show that sustainability indicators complement prior economic information in forecasting. The study contributes to sustainability research by integrating comparative assessment, systems-oriented analysis, econometric modeling, and explainable machine learning while clearly distinguishing statistical association from predictive contribution. Full article

The present study evaluated the association between morning serum cortisol levels and burnout syndrome among healthcare workers in the department of Boyacá, Colombia. An observational, analytical, cross-sectional, and quantitative study was conducted on 69 employees. Total serum cortisol was measured via chemiluminescence in fasting morning samples (reference: 110–692 nmol/L). Burnout was assessed using the Maslach Burnout Inventory–General Survey (MBI-GS). A total of 96.6% of participants fell within the normal range for serum cortisol. MBI-GS dimensions reported mean scores of: exhaustion 1.54 ± 1.17, cynicism 0.93 ± 0.89, and professional efficacy 5.60 ± 0.60. High exhaustion prevalence was 16.9%, high cynicism 6.8%, and low efficacy 3.4%. Profile classification showed 67.8% “engaged,” 13.6% “overextended/worn-out,” and 5.1% with “burnout.” No significant association was found between cortisol and burnout dimensions: exhaustion (r = 0.069, p = 0.605), cynicism (r = −0.135, p = 0.309), and professional efficacy (r = 0.044, p = 0.742). Mean cortisol comparisons between high and low dimension groups showed no statistically significant differences (p > 0.05). The study documented a low prevalence of established burnout and an absence of significant association between morning serum cortisol and MBI-GS dimensions, suggesting a relatively healthy work environment; however, the prevalence of high emotional exhaustion warrants preventive interventions. Multilevel organizational strategies like workload management, job stability, role clarity, and psychosocial support are recommended for worker mental health protection. Full article

Vanilla and vanillin are the most popular flavorings added to processed foods, medications, cosmetics, and e-cigarette liquids. Vanilla owes its unique aroma to vanillin. Both vanilla and vanillin can cause hypersensitivity reactions, probably type IV. Clinically, hypersensitivity to vanilla and/or vanillin most often manifests as a limited rash (of various types) accompanied by itching and/or swelling. Long-term exposure to vanillin or its intermediates may be a factor in occupational sensitization. Although hypersensitivity to vanilla/vanillin appears to be rare, it is worth considering in the diagnostic process, especially in non-obvious situations when identifying the triggering allergen is difficult. Regardless of the likely allergic hypersensitivity to vanilla and vanillin, there are also hypotheses suggesting that vanillin and other flavorings and aromas found in e-cigarette liquids may have cytotoxic effects in people who use electronic cigarettes (vaping). Toxic reactions caused by inhaling vapors of these additives may affect the bronchial tree and other distant organs. This hypothesis, although new and relatively poorly researched, may have significant implications for public health, including for future generations, especially considering that vaping is a popular form of nicotine delivery, particularly among adolescents and young adults. Full article

Background: Endometriosis is a chronic condition affecting a substantial proportion of women of reproductive age and leading to impaired quality of life. Despite its potential occupational implications, evidence on how occupational physicians (OPs) manage workers affected by endometriosis remains scarce. This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding endometriosis among Italian OPs. Methods: A cross-sectional web-based survey was conducted between 1 and 18 April 2026 by recruiting a convenience sample of 155 occupational physicians. The questionnaire was specifically designed and investigated knowledge status, risk perception, perceived barriers to workplace management, and previous experience of participating professionals. Results: Most respondents considered themselves adequately informed about endometriosis (78.1%) and reported previous professional experience with affected workers (81.3%). Knowledge gaps were identified, particularly regarding disease prevalence (26.5% correct responses), familial predisposition (34.8%), and diagnostic pathways (31.6%). Overall, 65.8% of participants reported having previously issued conditioned fitness-for-work appraisals, most frequently recommending increased work breaks, avoidance of night shifts, or limitations on shift work. In multivariable analysis, male gender (adjusted odds ratio [aOR] 5.69, 95% confidence interval [95% CI] 1.84–17.58), participation in continuing medical education activities (aOR 85.72, 95% CI 6.60–1114.21), information obtained from colleagues (aOR 4.67, 95% CI 1.23–17.77), and employment in healthcare settings (aOR 5.91, 95% CI 1.92–18.16) were independently associated with having previously issued restricted fitness-for-work judgments, whereas relying exclusively on undergraduate medical education was negatively associated with this outcome (aOR 0.07, 95% CI 0.01–0.39). Conclusions: Among the sampled Italian OPs, endometriosis was recognized as a clinically relevant condition frequently encountered in daily practice. Continuous professional education, interdisciplinary exchange, and practical experience were more strongly associated with occupational decision-making than undergraduate training alone. These findings support the development of targeted educational interventions and shared occupational recommendations aimed at improving workplace management and promoting the inclusion and retention of women affected by endometriosis in the workforce. Full article

Introduction: Suicide rates among individuals working in agriculture remain disproportionately high in the United States. Although farming-related stressors and coping strategies are documented, gaps remain in understanding how farmers sustain themselves psychologically amid chronic stress and why elevated suicide risk persists despite apparent resilience. Purpose: This study sought to explore the major stressors of farming, coping strategies used by farmers, and their barriers to help-seeking, with the goal of informing suicide prevention and mental health interventions. Methods: Fourteen semi-structured interviews were conducted with Kentucky farmers recently receiving a suicide prevention intervention. Participants were purposively sampled and interviewed via telephone or Zoom. Interviews were transcribed, modified verbatim, and then analyzed using reflexive thematic analysis. Results: Farmers described chronic stressors, including financial volatility, time scarcity, uncontrollable weather, loneliness, and feeling misunderstood or undervalued by the general public. Despite these stressors, many participants initially denied being stressed. Their coping strategies centered on meaning-making rather than stress elimination, including faith, gratitude, nature-based reflection, occupational pride, and community ties. However, prominent barriers to help-seeking included stigma, self-reliance, and privacy concerns. Conclusions: The findings suggest that farmer resilience is primarily enacted through their resourcefulness, including enduring stressors and reframing their thoughts, which enabled their continued functioning despite chronic stress. However, their resourcefulness often obscures their distress and delays help-seeking. These findings may help explain why elevated suicide risk persists among farmers even with strong coping narratives. Interventions that leverage existing strengths while addressing stigma, trust, and structural stressors are needed to better support farmer mental health and suicide prevention. Full article

Soil health practices are increasingly promoted through sustainable agricultural programs to improve environmental outcomes, yet little is known about how these practices impact the occupational health of farmers and ranchers who implement them. This qualitative study examined perceived occupational benefits and hazards of soil health practices among Colorado farmers and ranchers. Semi-structured interviews with 15 Colorado farmers and ranchers were conducted between October 2024 and January 2025 and then analyzed using thematic analysis. Six themes were identified: perceived physical benefits, psychosocial benefits, physical hazards, psychosocial hazards, and health and safety practices, and One Health perspectives of the impacts of soil health. Participants described reduced chemical exposure, increased physical activity, and improved mental health, creativity, connection to nature, and community as perceived benefits. Perceived physical hazards included heat stress, respiratory exposure to mold from organic mulching materials, and musculoskeletal strain. Perceived psychosocial hazards included social isolation, financial uncertainty, and a sense of insufficient collective action. Health and safety practices used were largely informal, and personal protective equipment use was limited. Participants described their health as intertwined with the health of the land and living systems around them, reflecting a One Health orientation. Findings suggest that soil health practices may alter occupational health risk in ways that warrant further investigation and tailored safety guidance and programmatic support. Full article

Pediatric oncology nursing is among the highest-intensity care specialties, exposing nurses to repeated child death and sustained emotional investment in family relationships. This occupational burden is a recognized psychosocial risk factor and a driver of compassion fatigue, burnout, and reported intention to leave, yet the organizational and educational determinants of this risk remain poorly captured by existing assessment approaches. This study investigated the lived experiences of nurses caring for terminally ill children in a pediatric onco-hematology unit and hospice ward in central Italy (N = 15), using a qualitative descriptive design, informed by a phenomenological sensibility to lived experience, supported by computer-assisted textual analysis. Structured face-to-face interviews were analyzed through thematic content analysis with stepwise replication, while quantitative textual analysis was performed using T-Lab software to map co-occurrence patterns among key lemmas, providing a frequency-based, semantically grounded picture of nurses’ representations of occupational risk. Seven themes emerged, including quality of nursing care, parental relationships, coping with a child’s death, and impact on personal and professional life. Findings showed that reported intention to leave was associated, in participants’ accounts, with absent psychological debriefing, cumulative emotional burden, inadequate end-of-life training, and a near-total absence of organizational vocabulary for peer-level support—a gap directly visible in the co-occurrence structure of nurses’ language. As a secondary aim, by combining qualitative depth with complementary lexical analysis of thematic patterns, this study also offers a methodological example of how psychosocial risk in high-intensity care settings can be assessed and translated into actionable indicators for organizational climate and workforce well-being. The findings inform concrete prevention strategies and policy recommendations for nursing education and occupational health, consistent with this Special Issue’s focus on methodological innovation for psychosocial risk assessment and public health policy design. Full article

Background: Emergency medical services (EMS) personnel experience high rates of psychological distress yet demonstrate low utilization of mental health services. Factors associated with actual service use—rather than intentions or attitudes—are not well understood. Methods: Using secondary data from 36,697 licensed Florida EMTs and paramedics collected during the 2022 licensure renewal process, logistic regression models evaluated the relative contributions of workplace factors, attitudinal variables, trauma exposure, and mental health symptoms in their association with service utilization. Results: Psychological symptoms, particularly anxiety and depression, were the strongest factors associated with help-seeking. Peer support emerged as one of the few system-level factors associated with increased service use, even after accounting for symptom presence. Stigma-related variables showed weaker and, in some cases, counterintuitive associations. Suicidality and substance use were modestly associated with help-seeking beyond core symptom variables. Findings were consistent among trauma-exposed personnel. Discussion: Results are consistent with the potential value of early identification, routine symptom screening, and integrated, system-level supports such as peer support and access to confidential, occupationally competent care. Full article