Search Results (431)

This study examines the dynamics of inbound tourism in China, utilizing a mixed-effects gravity model to analyze data from urban clusters around China’s three major airports. The research methodology of the study includes applying advanced econometric techniques, such as the Poisson pseudo-maximum likelihood estimation, to ensure robust and accurate results. The study focuses on international tourist arrivals and foreign exchange earnings, identifying key drivers such as tourism resources, transportation safety, and service quality. Our findings indicate a 10% increase in per capita GDP correlates with a 0.88% rise in inbound tourist numbers. Additionally, proximity to major urban centers like Beijing, Shanghai, and Guangzhou significantly influences tourist arrivals, with every 100 km increase in distance resulting in a 5.56% decrease in tourist numbers. The study also explores the impact of environmental factors on tourism, suggesting that improvements in green coverage and reductions in industrial waste and traffic fatalities could enhance tourist arrivals. Conversely, environmental protection measures can both positively and negatively impact tourism. This research provides a strategic blueprint for policymakers and professionals in tourism and environmental sustainability, emphasizing the importance of integrated environmental sustainability in tourism development strategies. The model accounts for up to 79% of the variability in inbound tourism flows, offering robust evidence that economic and policy dimensions impact tourism. Full article

Legionella is the pathogen that causes Legionnaires’ disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to assess the effectiveness and efficiency of different Legionella monitoring and control strategies to inform government requirements to prevent community-acquired Legionnaires’ disease in non-hospital buildings. This simulation model was built using comprehensive data from multiple scientific and field-based sources. It is a tool for estimating the relative economic and human costs of monitoring and control efforts targeting either L. pneumophila or Legionella species and was designed to analyze the potential application of each approach to specific building classes across Italy. The model results consistently showed that targeting L. pneumophila is not only sufficient but preferable in optimizing total cost (direct and economic) for similar human health benefits, even when stress-tested with extreme inputs. This cost–benefit analytical tool allows the user to run different real-life scenarios with a broad range of epidemiological and prevalence assumptions across different geographies in Italy. With appropriate modifications, this tool can be localized and applied to other countries, states, or provinces. Full article

Background: Creutzfeldt–Jakob disease (CJD) and fatal familial insomnia (FFI) are prion diseases characterized by severe neurodegenerative conditions and a short duration of illness. Methods: This study explores the characteristics of hospitalizations for CJD and FFI in Spain from 2016 to 2022 using the Spanish National Hospital Discharge Database (SNHDD). Results: We identified a total of 1063 hospital discharges, including 1020 for CJD and 43 for FFI. Notably, the number of hospitalized patients with FFI showed a significant peak in 2017. The average length of hospital stay (LOHS) was 13 days for CJD and 6 days for FFI, with in-hospital mortality rates (IHM) of 36.37% for CJD and 32.56% for FFI. Among CJD patients, the average LOHS was 14 days, with a significantly longer duration for those who experienced IHM. Conclusions: The presence of sepsis or pneumonia and older age were associated with a higher IHM rate among CJD patients. The total estimated cost for managing CJD and FFI patients over the study period was EUR 6,346,868. This study offers new insights into the epidemiology and healthcare resource utilization of CJD and FFI patients, which may inform future research directions and public health strategies. Full article

An increasing base of evidence suggests that respiratory syncytial virus (RSV) infections may be associated with neurological complications. In accord with the PRISMA statement, we performed a systematic review and meta-analysis on the occurrence of encephalitis and encephalopathy associated with documented RSV infections. PubMed, Embase, and Scopus databases were searched for eligible observational studies published up to 10 April 2024. Raw data included the occurrence of RSV infections among cases of encephalitis and/or encephalopathy and cases of encephalitis and/or encephalopathy among series of RSV infections. Data were pooled in a random effects model. Case reports were also collected, and their data pooled as a cumulative series. Heterogeneity was assessed using the I² measure, while reporting bias was assessed by means of funnel plots and regression analysis. A total of 15 studies for a total of 7719 RSV infections and 1631 cases of encephalitis were analyzed. Moreover, 27 case reports and case series were retrieved, for a total of 84 individual cases of encephalitis/encephalopathy occurring during a documented RSV infection. A pooled prevalence of 2.20 cases of encephalitis/encephalopathy per 100 RSV cases (I² = 99%) was calculated, while a prevalence of RSV infections among cases of encephalitis/encephalopathy was estimated to 3.53 per 100 cases for studies on respiratory specimens (I² = 48%) and 0.37 per cases on central nervous system (CNS) specimens (I² = 0%). Detection of RSV within the CNS was relatively rare (17.86% of pooled case reports), being associated with male gender (adjusted odds ratio [aOR] 5.021, 95% confidence interval [95%CI] 1.104 to 22.831) and recovery with long-term sequelae (aOR 5.699, 95%CI 1.152; 28.183). Case fatality ratio was estimated to be 0.43 per 100 cases on observational studies and 10.71% in case reports, a difference likely due to publication bias. In summary, RSV represented a not frequent but notable cause of encephalitis/encephalopathy in adults and children. The paucity of available studies not only recommends a cautious appraisal of our results but stresses the clinical significance of future studies on incident cases of encephalitis and/or encephalopathy. Full article

Lifeboats are life-saving equipment used when it is necessary to abandon a ship or, in some ships, for man-overboard situations (to collect persons from water). Every seafarer onboard a ship has a task related to lifeboat operation in an emergency. In order to master and practise the assigned tasks, be ready to react at any moment, and efficiently use life-saving equipment and appliances, seafarers on ships perform drills at prescribed intervals. Effective drill performance is of paramount importance, as it improves safety and enables crew members to practise lifeboat operations. However, although their primary role is life-saving, lifeboat drills have resulted in numerous accidents, causing injuries and fatalities, besides equipment damage. Therefore, it is necessary to prevent such unwanted events and discover their root causes. As the human factor is considered a significant cause of marine accidents, this paper aims to quantify human error probability (HEP) during lifeboat drills. In addition, because lifeboat drill accident data are scarce, this study adopted the Success Likelihood Index Method (SLIM) for human reliability analysis (HRA). Based on expert judgments, the tasks with the highest probability of human error and factors significantly influencing human performance during lifeboat drills are identified. According to the study results, the recovery of the lifeboat is the most hazardous phase with the highest HEP. In addition, the BN-SLIM is adopted to estimate the probability of human error during the recovery of the lifeboat. The task with the largest HEP is confirming the release lever is properly rested and hooks locked (HEP = 4.5%). Furthermore, the design and condition of equipment and Crew Competence are identified as the most important Performance-Shaping Factors (PSFs) that affect crew members’ performance. The BN-SLIM model was verified utilising a sensitivity analysis and validated by analysing real-life lifeboat drill accidents that occurred during lifeboat recovery. The results confirmed that the model could be used to analyse lifeboat accidents and for proactive preventive measures because most influencing factors are recognised, and acting on them can significantly reduce the HEP of the overall task, improve lifeboat safety, and save lives at sea. Full article

Quito (Ecuador) has a history of mudflow events from ravines that pose significant risks to its urban areas. Located close to the Pichincha Volcanic Complex, on 31 January 2022, the northwest and central parts of the city were hit by a mudflow triggered by unusual rainfall in the upper part of the drainage, with 28 fatalities and several properties affected. This research focuses on the affected area from collector overflow to the end, considering sedimentological characteristics and behavior through various urban elements. This study integrates the analysis of videos, images, and sediment deposits to understand the dynamics and impacts of the mudflow using a multidisciplinary approach. The methodology includes verifying multimedia materials using free software alongside the Large-Scale Particle Image Velocimetry (LSPIV) to estimate the kinematic parameters of the mudflow. The affected area, reaching a maximum distance of 3.2 km from the overflow point, was divided into four zones for a detailed analysis, each characterized by its impact level and sediment distribution. Results indicate significant variations in mudflow behavior across different urban areas, influenced by topographical and anthropogenic factors. Multimedia analysis provided insights into the mudflow’s velocity and evolution as it entered urban areas. The study also highlights the role of urban planning and infrastructure in modifying the mudflow’s distribution, particularly in the Northern and Southern Axes of its path, compared with a similar 1975 event, seven times larger than this. It also contributes to understanding urban mudflow events in Quito, offering valuable insights for disaster risk management in similar contexts. Full article

Surveys on the optimum seismic design of structures reveal that many investigations focus on minimizing initial costs while satisfying performance constraints. Although reducing initial costs while complying with earthquake design codes significantly ensures occupant safety, it may still cause considerable economic losses and fatalities. Therefore, calculating potential earthquake damages over the structure’s lifetime is essential from an optimal Life-Cycle Cost (LCC) design perspective. LCC analysis evaluates economic feasibility, including construction, operation, occupancy, maintenance, and end-of-life costs. The population-based, meta-heuristic Ideal Gas Molecular Movement (IGMM) algorithm has proven effective in solving highly nonlinear mono- and multi-objective engineering problems. This paper investigates the LCC-based mono- and multi-objective optimum design of a 3D four-story concrete building structure using the Endurance Time (ET) method, which is employed for its efficiency in estimating structural responses under varying seismic hazard levels. The novelty of this work lies in integrating the ET method with the IGMM algorithm to comprehensively address both economic and performance criteria in seismic design. The results indicate that the proposed technique significantly reduces minor injury costs, rental costs, and income costs by 22%, 16%, and 16%, respectively, achieving a total reduction of 10% in all structural Life-Cycle Costs, which is considered significant. Full article

The COVID-19 pandemic in Ukraine, from March 2020 to June 2022, witnessed distinct waves, each characterized by an increase in cases and fatalities. Next-generation sequencing has been used to understand the impact of viral variants on the pandemic situation in Ukraine. We analyzed SARS-CoV-2 genome sequencing data to identify viral variants circulating during each wave. By integrating epidemiological information, we established associations between viral variants and disease spread. The adoption of next-generation sequencing for SARS-CoV-2 surveillance in Ukraine, despite limited resources, yielded adequate and trustworthy results, reflecting the pandemic situation. After the Russian military invasion of Ukraine in February 2022, a large number of refugees crossed the border with neighboring countries. Mutation analysis on sequencing data from Ukraine and Poland was used to estimate the exchange of SARS-CoV-2 variants between the countries during this period. Omicron subvariants detected in both countries were similar. The analysis of SARS-CoV-2 sequences from Poland and Ukraine revealed shared nucleotide mutations that can be used to identify the directions of spreading. Full article

West Nile virus (WNV) is a re-emerging flavivirus, primarily circulating among avian hosts and mosquito vectors, causing periodic outbreaks in humans and horses, often leading to neuroinvasive disease and mortality. Spain has reported several outbreaks, most notably in 2020 with seventy-seven human cases and eight fatalities. WNV has been serologically detected in horses in the Community of Madrid, but to our knowledge, it has never been reported from wild birds in this region. To estimate the seroprevalence of WNV in wild birds and horses in the Community of Madrid, 159 wild birds at a wildlife rescue center and 25 privately owned equines were sampled. Serum from thirteen birds (8.2%) and one equine (4.0%) tested positive with a WNV competitive enzyme-linked immunosorbent assay (cELISA) designed for WNV antibody detection but sensitive to cross-reacting antibodies to other flaviviruses. Virus-neutralization test (VNT) confirmed WNV antibodies in four bird samples (2.5%), and antibodies to undetermined flavivirus in four additional samples. One equine sample (4.0%) tested positive for WNV by VNT, although this horse previously resided in a WN-endemic area. ELISA-positive birds included both migratory and resident species, juveniles and adults. Two seropositive juvenile birds suggest local flavivirus transmission within the Community of Madrid, while WNV seropositive adult birds may have been infected outside Madrid. The potential circulation of flaviviruses, including WNV, in birds in the Madrid Community raises concerns, although further surveillance of mosquitoes, wild birds, and horses in Madrid is necessary to establish the extent of transmission and the principal species involved. Full article

French Guiana is a French Overseas territory with singular features: it has a high prevalence of HIV and HTLV-1, its population is ethnically mixed, with widespread poverty, and up to 20% of the population lives in geographic isolation. In this context, we used registry data to estimate incidence and mortality due to hematological malignancies and to compare them with France and tropical Latin America. ICD codes C90 and C88 were compiled between 2005 and 2014. The direct standardization of age structure was performed using the world population. Survival analysis was performed, and Kaplan–Meier curves were drawn. The overall standardized incidence rate was 32.9 per 100,000 male years and 24.5 per 100,000 female years. Between 2005 and 2009, the standardized incidence rate was 29.6 per 100,000 among men and 23.6 per 100,000 among women, and between 2010 and 2014, it was 35.6 per 100,000 among men and 25.2 per 100,000 among women. Multiple myeloma/plasmocytoma and mature t/NK cell lymphomas, notably adult t-cell lymphoma/leukemia due to HTLV-1 infection, were the two most common hematologic malignancies and causes of death. Non-Hodgkin’s lymphoma incidence estimates were greater than global estimates. After adjusting for age, sex, and type of malignancy, people born in a foreign country independently had a poorer case-fatality rate, presumably reflecting difficulties in accessing care. The epidemiology of hematological malignancies in French Guiana has features that distinguish it from mainland France or from Latin America. The incidence of multiple myeloma and adult t-cell lymphoma/leukemia was significantly greater in French Guiana than in France or other Latin American countries. Full article

The catastrophic failure of two dams in Libya on 10 and 11 September 2023 resulted in the devastating flooding of the city of Derna, which is located downstream of the dams, causing more than 6000 fatalities and displacing thousands of residents. The failure was attributed to heavy rainfall from Storm Daniel, leading to the dams reaching full capacity and subsequently overflowing and failing. This paper presents an analysis of the dam break, including the modelling of flow discharge and the resulting flooding of Derna. For validation purposes, this study compares the modelled quantities with post-event satellite imagery from UNOSAT and Copernicus, local reports, and data collected from social media using AI detection. The findings provide valuable insights into the dynamics of the dam break and its initial parameters, as well as an assessment of the accuracy of the results. The analysis is performed using a rapid estimation technique developed by JRC to provide the international emergency community with a swift overview of the impact and damage assessment of potential or actual dam break events. The use of all available data shows a satisfactory comparison with the calculated quantities. The rapid modelling of dam break events and combined analysis of multiple data types are proven suitable for promptly assessing the expected dynamic of the event, as well as reconstructing the unknown initial conditions before the break. Incorporating sensitivity analyses provides an estimate of the uncertainties associated with the deduced values of the unknown parameters and their relative importance in the analysis. Full article

The unregulated discharge of synthetic dyes from various anthropogenic and industrial activities has resulted in the contamination of different environmental compartments. These dyes can contaminate water bodies, soil, and even the air, resulting in many environmental and health issues. True colors may persist for long periods, thereby affecting the aesthetics and ecology of dye-contaminated areas. Furthermore, they pose potential risks to aquatic life and human health through the ingestion or absorption of dye-contaminated water or food. Acid orange 7 (AO7) is a synthetic azo dye used in the textile, tanning, food, pharmaceutical, paint, electronics, cosmetics, and paper and pulp industries. AO7 can have various human health implications, such as dermatitis, nausea, severe headache, respiratory tract irritation, and bone marrow depletion, due to its high toxicity, mutagenicity, and carcinogenicity. Efforts to regulate and mitigate dye pollution (AO7) are crucial for environmental sustainability and public health. Therefore, this study aimed to remove AO7 from water using sustainable biochar. This objective was accomplished by pyrolyzing dried Napier grass at 700 °C to develop affordable and sustainable Napier grass biochar (NGBC700). The developed biochar was characterized for its surface morphology, surface functional groups, surface area, and elemental composition. The yield, moisture content, and ash content of the NGBC700 were approximately 31%, 6%, and 21%, respectively. The NGBC700’s BET (Brunauer–Emmett–Teller) surface area was 108 m² g⁻¹. Batch sorption studies were carried out at different pH levels (2–10), biochar dosages (1, 2, 3, and 4 g L⁻¹), and AO7 concentrations (10, 20, and 30 mg L⁻¹). The kinetic data were better fitted to the pseudo-second-order (PSO) equation (R² = 0.964–0.997) than the pseudo-first-order (PFO) equation (R² = 0.789–0.988). The Freundlich isotherm equation (R² = 0.965–0.994) fitted the sorption equilibrium data better than the Langmuir equation (R² = 0.788–0.987), suggesting AO7 sorption on heterogenous NGBC700. The maximum monolayer AO7 adsorption capacities of the NGBC700 were 14.3, 12.7, and 8.4 mg g⁻¹ at 10, 25, and 40 °C, respectively. The column AO7 sorption capacity was 4.4 mg g⁻¹. Fixed-bed AO7 sorption data were fitted to the Thomas and Yoon–Nelson column models. The NGBC700 efficiently removed AO7 from locally available dye-laden wastewater. NGBC700 was regenerated using different NaOH concentrations. Possible interactions contributing to AO7 sorption on NGBC700 include hydrogen bonding, electrostatic interactions, and π–π electron donor–acceptor attractions. The estimated total preparation cost of NGBC700 was US$ 6.02 kg⁻¹. The developed sustainable NGBC700 is potentially cost-effective and environmentally friendly, and it utilizes waste (Napier grass) to eliminate fatal AO7 dye from aqueous media. Full article

Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020–2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37–0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72–84 IQR) vs. 67 years (55–78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02–1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events. Full article

The construction industry records higher accident rates than other industries, and thus, risk estimation is necessary to manage accident rates. Risk levels differ based on facility type and construction project size. In this sense, this study aims to calculate the quantitative accident risk level according to the construction project size per infrastructure facility type. To this end, the following five-step risk estimation was performed: (1) data collection and classification; (2) calculation of fatality rate based on construction cost; (3) calculation of fatal construction probability by construction cost classification; (4) reclassification of construction cost considering fatal construction probability; and (5) calculation of risk level by facility type and construction cost classification. As a result, the fatality rate per facility type was the highest in ‘Dam’ at 0.01024 (person/USD million). Additionally, the risk level according to the construction project size per facility type was the highest for ‘Dam’ (0.00403 person/USD million) for a construction of less than USD 0.77 million. The risk level presented in this study can be utilized as basic data in the design stage for safety management. Our results also indicate the necessity of preparing a separate construction cost classification for safety management. Full article

Up to 30% of people over the age of 60 are at high risk of falling, which can cause injury, aggravation of pre-existing conditions, or even death, with up to 684,000 fatal falls reported annually. This is due to the difficult task of establishing a preventive system for the care of the elderly, both in the hospital environment and at home. Therefore, this work proposes the development of an intelligent vision system that uses a novel methodology to infer fall risk from the analysis of kinetic and spatiotemporal gait parameters. In general, each patient is assessed using the Tinetti scale. Then, the computer vision system estimates the biomechanics of walking and obtains gait features, such as stride length, cadence, period, and range of motion. Subsequently, this information serves as input to an artificial neural network that diagnoses the risk of falling. Ninety-six participants took part in the study. The system’s performance was 99.1% accuracy, 94.4% precision, 96.9% recall, 99.4% specificity, and 95.5% F1-Score. Thus, the proposed system can evaluate the fall risk assessment, which could benefit clinics, hospitals, and even homes by allowing them to assess in real time whether a person is at high risk of falling to provide timely assistance. Full article