Search Results (1,158)

Objectives: Norovirus outbreaks occur in densely populated environments, such as long-term care facilities, hospitals, and schools. On 22 October 2022, an outbreak of acute gastroenteritis was reported at a kindergarten in Korea. An epidemiologic investigation was conducted to identify the source of the infection and prevent further spread. Methods: Rectal swab and environmental samples were collected for bacterial and viral testing. A retrospective cohort study was conducted among 114 kindergarteners at the kindergarten. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to assess associations of contact with the primary case, as well as food and water consumption. Results: Of the kindergarteners, 28 out of 114 (24.6%) met the case definition. The primary case occurred on 19 October, and subsequent cases began on 21 October. Sharing the same four-year-old class as the primary case (RR, 2.56; 95% CI, 1.35–4.87), being in the same regular class (RR, 2.37; 95% CI, 1.27–4.41), being on the same floor during after-school class (RR, 3.49; 95% CI, 1.74–7.00), and attending the same English class (RR, 1.98; 95% CI, 1.05–3.72) were statistically significant. Consumption of drinking water on the third floor and fourth floor on 20 October had significantly higher and lower RRs, respectively. Norovirus was detected in 9 out of 18 rectal swab samples (50.0%). Conclusions: This norovirus outbreak at the kindergarten was presumed to have been caused by person-to-person transmission from the primary case. Isolation and restriction of symptomatic children in kindergartens should be thoroughly implemented. Additionally, enhanced surveillance among family members of affected individuals is necessary to prevent further outbreaks. Full article

Chainsaws are widely used in various occupational settings, including forestry, landscaping, farming, and by homeowners for tasks like tree felling, brush clearing, and firewood cutting. However, the use of chainsaws poses significant risks to operators and bystanders. This research quantified and compared occupational and nonoccupational injuries caused by contact with chainsaws and related objects during the period from 2018 to 2022. The emergency department and OSHA (Occupational Safety and Health Administration) data were used to characterize the cause and nature of the injuries. Results suggest that for this five-year period an estimated 127,944 people were treated in U.S. emergency departments for chainsaw-related injuries. More than 200 non-fatal and 57 fatal occupational chainsaw-involved injuries were found during the same period. Landscaping and forestry were the two industries where most of the occupational victims were employed. Upper and lower extremities were the most likely injured body parts, with open wounds from cuts being the most common injury type. The majority of fatal injuries were caused by falling objects such as trees and tree limbs while using a chainsaw. Our suggestions to reduce injuries include proper training and wearing personal protective equipment, as well as making sure any bystanders are kept in a safety zone away from trees being cut. Full article

During the coronavirus 2019 pandemic, sports activities were restricted, raising concerns about their impact on the physical condition of adolescent athletes, which remained largely unquantified. This study was designed with two primary objectives: first, to precisely quantify and elucidate the differences in the physical condition of adolescent athletes before and after activity restrictions due to the pandemic; and second, to innovatively develop and validate a non-contact medical checkup application. Medical checks were conducted on 563 athletes designated for sports enhancement. Participants were junior high school students aged 13 to 15, and the sample consisted of 315 boys and 248 girls. Furthermore, we developed a smartphone application and compared self-checks using the application with in-person checks by orthopedic surgeons to determine the challenges associated with self-checks. Statistical tests were conducted to determine whether there were statistically significant differences in range of motion and flexibility parameters before and after the pandemic. Additionally, items with discrepancies between values self-entered by athletes using the smartphone application and values measured by specialists were detected, and application updates were performed. Student’s t-test was used for continuous variables, whereas the chi-square test was used for other variables. Following the coronavirus 2019 pandemic, athletes were stiffer than during the pre-pandemic period in terms of hip and shoulder joint rotation range of motion and heel–buttock distance. The dominant hip external rotation decreased from 53.8° to 46.8° (p = 0.0062); the non-dominant hip external rotation decreased from 53.5° to 48.0° (p = 0.0252); the dominant shoulder internal rotation decreased from 62.5° to 54.7° (p = 0.0042); external rotation decreased from 97.6° to 93.5° (p = 0.0282), and the heel–buttock distance increased from 4.0 cm to 10.4 cm (p < 0.0001). The heel–buttock distance and straight leg raising angle measurements differed between the self-check and face-to-face check. Although there are items that cannot be accurately evaluated by self-check, physical condition can be improved with less contact by first conducting a face-to-face evaluation under appropriate guidance and then conducting a self-check. These findings successfully address our primary objectives. Specifically, we demonstrated a significant decline in the physical condition of adolescent athletes following pandemic-related activity restrictions, thereby quantifying their impact. Furthermore, our developed non-contact medical checkup application proved to be a viable tool for monitoring physical condition with reduced contact, although careful consideration of measurable parameters is crucial. This study provides critical insights into the long-term effects of activity restrictions on young athletes and offers a practical solution for health monitoring during infectious disease outbreaks, highlighting the potential for hybrid checkup approaches. Full article

Hand hygiene (HH) is essential for preventing disease transmission, particularly in schools where children are in close contact with other children. This study evaluated a school-based intervention on observed HH practices and hand cleanliness in six primary schools in Guatemala. Hand cleanliness was measured using the Quantitative Personal Hygiene Assessment Tool. The intervention included (1) HH behavior change promotion through Handwashing Festivals, and (2) increased access to HH materials at HH stations. Handwashing Festivals were day-long events featuring creative student presentations on HH topics. Schools were provided with soap and alcohol-based hand rub throughout the project to support HH practices. Appropriate HH practices declined from 51.2% pre-intervention to 33.1% post-intervention, despite an improvement in median Quantitative Personal Hygiene Assessment Tool scores from 6 to 8, indicating cleaner hands. Logistic regression showed higher odds of proper HH when an assistant was present. The decline in HH adherence was likely influenced by fewer assistants and changes in COVID-19 policies, while improvements in hand cleanliness may reflect observational bias. These findings emphasize the importance of sustained behavior change strategies, reliable HH material access, and targeted interventions to address gaps in HH practices, guiding school health policy and resource allocation. Full article

Substance use is a critical public health issue in the U.S., with Black communities, particularly those with criminal justice contact, disproportionately affected. Chronic exposure to stressors can lead to substance use as a coping strategy. This study used data from 1476 Black adults with criminal justice involvement from the National Survey of American Life to examine how psychosocial stress and sleep disturbances relate to lifetime substance use and to determine if there are any sex differences. Sex-separate generalized linear models for a Poisson distribution with a log-link function estimated prevalence ratios and adjusted prevalence ratios (APRs) for lifetime alcohol abuse, lifetime cigarette, and marijuana use. Independent variables include stressors (family, person, neighborhood, financial, and work-related) and sleep problems, with covariates such as age, SES, and marital status. Lifetime alcohol abuse was associated with family stressors (APR = 2.72) and sleep problems (APR = 3.36) for males, and financial stressors (APR = 2.75) and sleep problems (APR = 2.24) for females. Cigarette use was linked to family stressors (APR = 1.73) for males and work stressors (APR = 1.78) for females. Marijuana use was associated with family stressors (APR = 2.31) and sleep problems (APR = 2.07) for males, and neighborhood stressors (APR = 1.72) for females. Lifetime alcohol abuse, as well as lifetime cigarette and marijuana use, was uniquely associated with various psychosocial stressors among Black adult males and females with criminal justice contact. These findings highlight the role of structural inequities in shaping substance use and support using a Social Determinants of Health framework to address addiction in this population. Full article

Artificial intelligence (AI) and machine learning (ML) are increasingly transforming the landscape of cosmetic formulation, enabling the development of safer, more effective, and personalized products. This article explores how AI-driven predictive modeling is applied across various components of cosmetic products, including surfactants, polymers, fragrances, preservatives, antioxidants, and prebiotics. These technologies are employed to forecast critical properties such as texture, stability, and shelf-life, optimizing both product performance and user experience. The integration of computational toxicology and ML algorithms also allows for early prediction of skin sensitization risks, including the likelihood of adverse events such as allergic contact dermatitis. Furthermore, AI models can support efficacy assessment, bridging formulation science with dermatological outcomes. The article also addresses the ethical, regulatory, and safety challenges associated with AI in cosmetic science, underlining the need for transparency, accountability, and harmonized standards. The potential of AI to reshape dermocosmetic innovation is vast, but it must be approached with robust oversight and a commitment to user well-being. Full article

This study provides user-centered insights into how inclusive forest design can support the physical, emotional, and social well-being of older adults. It operationalizes universal design principles in natural settings and confirms their relevance through empirical evidence. With the acceleration of global population aging, adapting forest recreation environments to meet the specific needs of older adults is increasingly urgent. This study investigates how infrastructure influences both participation and emotional well-being among older visitors to forest recreation areas. Data were collected from 446 participants aged 65 and older, using a structured survey distributed through in-person contact and digital snowball sampling. Participants reported their infrastructure preferences and their emotional responses related to forest visits. The findings show that older adults highly value site cleanliness, shaded seating, accessible restrooms, and clear signage. Expectations varied significantly according to health status, age group, and visitation frequency. Emotional well-being was positively associated with both comfort and visit frequency. These results demonstrate how inclusive infrastructure plays a vital role in supporting older adults’ access to and enjoyment of forest environments. The study affirms that universally designed forests not only reduce barriers but also promote psychological health and active aging, contributing to developing more equitable and sustainable nature-based recreation areas. Full article

Background: Among all ambulatory antibiotic prescriptions, about 20% are non-visit-based (ordered outside of an in-person clinical encounter), and about 30% are not associated with an infection-related diagnosis code. Objective/Methods: To identify the rationale for ambulatory antibiotic prescribing, we queried the electronic health record (EHR) of a single, large health system in the Midwest United States to identify all oral antibiotics prescribed from November 2018 to February 2019 and examined visit, procedure, lab, department, and diagnosis codes. For the remaining antibiotic prescriptions—mostly non-visit-based, no-infectious-diagnosis-documented—we randomly selected and manually reviewed the EHR to identify a prescribing rationale and, if none was present, surveyed prescribers for their rationale. Results: During the study period, there were 47,619 antibiotic prescriptions from 1177 clinicians to 41,935 patients, of which 2608 (6%) were eligible non-visit-based, no-infectious-diagnosis-documented. We randomly selected 2298. There was a documented rationale for 2116 (92%) prescriptions. The most common documented reasons—not mutually exclusive—were patient-reported symptoms (71%), persistence of symptoms after initial management (18%), travel (17%), and responding to lab or imaging results (11%). We contacted 160 clinicians who did not document any prescribing rationale in the EHR and received responses from 62 (39%). Clinicians’ stated reasons included upcoming or current patient travel (19%), the antibiotic was for the prescriber’s own family member (19%), or the clinician made a diagnosis but did not document it in the EHR (18%). Conclusions: Non-visit-based, no-infectious-diagnosis-documented antibiotic prescriptions were most often in response to patient-reported symptoms, though they also occur for a variety of other reasons, some problematic, like in the absence of documentation or for a family member. Full article

Background/Objectives: Pathology is often perceived as a technical medical specialty that lacks direct contact with the patient. However, oncological histopathological diagnosis requires a high degree of moral and emotional responsibility. The objective of this study was to investigate how empathy is manifested toward the “invisible” patient, the emotional impact on pathology staff, and potential repercussions in their personal lives. Method: We conducted a descriptive, cross-sectional study with a quantitative component, using an anonymous 22-item questionnaire among Romanian pathologists and medical personnel working in pathology services. The questionnaire was focused on three research directions: professional empathy in the absence of direct patient contact, the emotional impact of oncologic diagnosis on medical personnel in pathology departments, and the carryover of emotions from professional to personal life. A total of 165 respondents were included in the study (physicians, technicians, registrars). Results: Most of the respondents consider that the absence of the patient’s direct contact does not cancel the empathy, this being felt in a cognitive and more natural way. Over 60% of the respondents see oncologic histopathological diagnosis as an emphatic medical act. Over 80% of the respondents experience a sense of emotional responsibility and 70% consider that professional training does not include adequate emotional support. There is a high interest in empathy and psychological support. The professional activity of a pathologist may influence sleep, dreams, and the perception on their own health status. Diagnosing pediatric or young patients is perceived as particularly emotionally challenging. Collegial support is moderate and discussion about professional stress is rare. Conclusions: Empathy is present and relevant in pathology, despite the absence of direct patient interaction. Oncological diagnostics has a significant emotional impact on pathology department personnel, with the need to acknowledge the emotional dimension of the profession and to integrate psychological support mechanisms into pathology practice. Full article

In this study, 3D Mg scaffolds were obtained by the spark plasma sintering (SPS), and a calcium phosphate coating was then obtained on the samples by the plasma electrolytic oxidation. A hybrid coating with vancomycin, zoledronic acid, and menaquinone MK-7 was formed to improve biocompatibility. The mechanical properties of the formed specimens were studied. According to XRD, XRF, SEM, EDS, and OSP studies obtained scaffolds have developed morphology and contain hydroxyapatite as well as bioactive substances. Formation of coatings improves the wettability of samples (contact angle decreases from 123.8 ± 3.1° to 26.9 ± 4.1°) and increases the surface roughness by more than 3 times. This makes them promising for use as a new generation of implantation materials. The results are important for the development of personalized implants with improved functional characteristics. Full article

The accelerated transformations in the education system marked by volatility, uncertainty, complexity, and ambiguity (VUCA) require a rethinking of pedagogical approaches. The VUCA environment requires a new educational management system in line with new technological trends in order to respond effectively to all the internal and external factors that may affect the quality of teaching. A particularly important course of action is updating teaching methods by combining traditional teaching methods with new interactive methods that promote the introduction of certain digital applications during the teaching of new topics. In this sense, the quantitative research carried out in the present study among second-year students from the psycho-pedagogical program organized by the Bucharest University of Economic Studies, Romania, has highlighted the fact that innovative teaching methods are more effective, contributing to the development of personality and communication skills among pupils and students. Also, the results obtained after applying the Mann–Whitney test showed that there is a significant difference between students involved in different educational activities and those who do not have contact with the educational environment in terms of perceiving the volatility, uncertainty, complexity and ambiguity of the educational environment. At the same time, in the context of the VUCA world, in order to ensure the effectiveness of the teaching–learning process, teachers need to develop new skills such as stress management, adaptability, creativity, technological skills, and time management. Addressing the specific competencies that teachers need to acquire in order to improve their teaching and to respond effectively to the volatility, uncertainty, complexity and ambiguity in education, this study contributes to the creation of a sustainable education system, which is able to cope with all transformations (technological, legislative, socio-economic, etc.). The article is based on the results obtained in the postdoctoral research conducted at the end of 2024. Full article

Ozonation has been promoted as a successful methodology for recovering effluents from wastewater treatment plants, with special emphasis on wastewater contaminated with pharmaceutical and personal care products (PPCPs). Still, ozonation reactions may generate potentially toxic by-products, jeopardizing human health safety, a critical aspect considering the use of reclaimed water. We aimed at understanding the potential impacts of ozonation on the quality of reclaimed water for human use through cell viability assays with human skin keratinocytes (HaCaT cell line). Under this context, the cytotoxicity of synthetic effluents contaminated with methyl- and propylparaben, paracetamol, sulfamethoxazole, and carbamazepine, both individually and in mixtures, was assessed before and after ozonation. The viability of HaCaT cells decreased after exposure to untreated synthetic effluents, denoting the cytotoxicity of the tested PPCPs singly and more prominently in mixtures (especially in those combining two and three PPCPs). A similar pattern was observed when testing effluents treated with ozonation. Since the parent contaminants were fully removed during ozonation, the observed cytotoxicity relates to degradation by-products and interactive effects among them. This study suggests that ozonation is poorly efficient in reducing cytotoxicity, as required for the safe use of ozone-treated reclaimed water in activities involving direct contact with human skin. Full article

The demeanour of a human during an interaction with an animal may influence the animal’s emotional response. We investigated whether the emotional responses of laying hens to a threatening or neutral human and a novel environment were lateralised, from which their emotional state can be inferred. Twenty-five DeKalb white laying hens reared in furnished cages under environmentally controlled conditions were individually assessed for their responses to these stimuli. They were contained in a box before emerging into an arena with a threatening human, who attempted direct eye contact with the bird and had their hands raised towards it, or a neutral person, who had no eye contact and sat with their hands on their knees. When initially placed in the box adjacent to the test arena, birds that remained in the box used their left eye more than their right eye, and they showed evidence of nervousness, with many head changes, neck stretching, and vocalisation. Birds showed lateralised behaviour in both the box and arena. Birds entering the arena with the threatening person used their left eye (connected to the right brain hemisphere) more than their right eye, usually with their body less vertical, and were more likely to be standing than sitting, compared with those viewing the neutral person. This confirms the bird’s interpretation of the person as threatening, with left eye/right brain hemisphere processing of flight or fight situations. We conclude that lateralised responses of chickens suggest that a threatening person is viewed more fearfully than a neutral person. However, further investigation is required with a larger sample of birds to strengthen these findings and enhance the generalisability of behavioural responses. Full article

This study examines the employment of persons with disabilities in small- and medium-sized enterprises (SMEs) in rural Japan. An online survey of 40 SME owners was conducted to assess their understanding, experiences, and challenges in employing persons with disabilities. The results indicate that many SMEs lack awareness of employment systems, but those with prior contact experience demonstrate greater understanding. Key challenges include difficulties in job creation, workplace acceptance, and inadequate environments. To address these issues, it is essential to enhance information on job creation, share successful cases, and establish mentoring systems for knowledge exchange between SMEs. These findings provide insights for policy development and practical strategies to promote the employment of persons with disabilities in SMEs. Full article

School-aged children are routinely exposed to additional physical stress due to carrying school backpacks. These backpacks often exceed recommended limits and can contain not only books and notebooks but also laptops, water bottles, and other personal items. The present study aimed to evaluate the impact of different backpack loads (10%, 15%, and 20% of body weight) on dynamic gait parameters in 7-year-old girls and boys. Twenty-six children (13 girls, 13 boys) participated in the study. Gait analysis was performed using the Footscan® system (RSscan International, Olen, Belgium; 2 m × 0.4 m × 0.02 m, 16,384 sensors) equipped with Footscan software version 7 (Gait 2nd generation), examining peak force (FMAX), peak pressure (PMAX), contact area (CA), and time to peak force (Time to FMAX) across five anatomical foot zones. The study revealed significant changes in all parameters, particularly at loads of 15% and 20% of body weight. Increases in plantar pressure, contact area, and asymmetry were observed, along with delays in time to peak force. These findings support the recommendation that children’s backpack loads should not exceed 10% of their body weight to prevent potential adverse effects on postural and musculoskeletal development. Full article