Machine learning-based surrogate modelling of a robust, sustainable development goal (SDG)-compliant land-use future for Australia at high spatial resolution.

We developed a high-resolution machine learning based surrogate model to identify a robust land-use future for Australia which meets multiple UN Sustainable Development Goals. We compared machine learning models with different architectures to pick the best performing model considering the data type, accuracy metrics, ability to handle uncertainty and computational overhead requirement. The surrogate model, called ML-LUTO Spatial, was trained on the Land-Use Trade-Offs (version 1.0) model of Australian agricultural land system sustainability. Using the surrogate model, we generated projections of land-use futures at 1.1 km resolution with 95% classification accuracy, and which far surpassed the computational benchmarks of the original model. This efficiency enabled the generation of numerous SDG-compliant (SDGs 2, 6, 7, 13, 15) future land-use maps on a standard laptop, a task previously dependent upon high-performance computing clusters. Combining these projections, we derived a single, robust land-use future and quantified the uncertainty. Our findings indicate that while agricultural land-use remains dominant in all Australian regions, extensive carbon plantings were identified in Queensland and environmental plantings played a role across the study area, reflecting a growing urgency for offsetting greenhouse gas emissions and the restoration of ecosystems to support biodiversity across Australia to meet the 2050 Sustainable Development Goals.

Navigating challenges and opportunities: AI's contribution to Pakistan's sustainable development goals agenda - a narrative review.

Sustainable Developmental Goals (SDGs) were introduced by the United Nations to ensure the sustainable progress of mankind through various domains. Pakistan, a low-middle-income country, faces many challenges in achieving SDGs. Artificial Intelligence is a rapidly evolving technology presenting significant importance in achieving SDGs. Therefore, this narrative review aimed to evaluate the artificial intelligence technologies that have been utilized globally and nationally which can be implemented in Pakistan focusing on Goal 3 (Good Health and Well-being) of SDGs. AI has been utilized primarily in high-income countries aiming to improve healthcare, thereby progressing towards achieving different targets of Goal 3 of SDGs. Pakistan lacks such initiatives with modest to no improvement across different SDGs. Therefore, Pakistan can adapt initiatives undertaken by resourceful countries to achieve its own SDGs.

Potential environmental impact of mycelium composites on African communities.

The ecological and economic benefits of mycelium composites offer a promising opportunity for supporting sustainable development in Africa. This study focuses on assessing the environmental impact of mycelium composites for building and construction (MCBs) by conducting a life cycle assessment (LCA) in the context of Africa. It is demonstrated that the potential environmental impact of MCBs is substantially influenced by the use and source of electrical power for autoclaves, incubators, and ovens, making the culturing and post-processing phases the major environmental hotspots. The impact of MCB production is also relative to the energy mix of specific countries, being higher in countries that rely on fossil fuel energy (e.g., South Africa) and lower in those that rely more on renewable sources (e.g., Democratic Republic of the Congo, DRC). Furthermore, the impact of MCB production is found to be sensitive to travel distance, suggesting that situating production facilities closer to agricultural, agro-industrial, and/or forestry waste sources could be more beneficial than interregional sourcing, for example. It is also demonstrated that MCBs have the potential to be a more ecologically sustainable alternative to some conventional construction materials (e.g., concrete) over an entire life cycle. Based on the insights obtained from this LCA, some recommendations have been proposed to address potential environmental repercussions pre-emptively and proactively: this is particularly important for nations, mainly in the Global South, that exhibit low resilience to climate change due to limited economic resources. Furthermore, with the rapid expansion of mycelium composite technology, there is a need to increase awareness about its potential environmental impact and, ultimately, to mitigate its potential contribution to pressing environmental concerns (e.g., global warming and climate change). Consequently, this study also adds to the existing body of literature on LCA studies, delineating key factors for consideration in future LCA studies and providing guidance for the sustainable establishment and expansion of this technology.

SDGs Managers' Assessment Bias and Their Implications for Preventing Violence Against Women in Companies.

This study explores the role of managers' perceptions of Sustainable Development Goals (SDGs) in preventing violence against women in companies. Surveying 673 managers in Lima, Peru, it found gender-based discrepancies in SDG priorities, with men leaning toward industry goals and women toward well-being and gender equality. Socially ingrained gender biases influence prevention strategies: men often comply with mandatory measures, while women opt for noncompulsory strategic actions. Notably, a high valuation of SDG-5 (gender equality) correlates with diverse prevention efforts. The findings highlight the importance of addressing gender bias in company practices and improving business school formation.

Assessing the Progress toward a Water-Efficient Economy in the United States from 1985 to 2015.

United Nations Sustainable Development Goal 6 tackles the long-neglected economic dimension of water utilization by monitoring nations' water use efficiency (WUE). However, it is imperative to emphasize the need for consistent spatial-temporal subnational WUE estimates, rather than relying solely on recent national trends, which can obscure crucial water use concerns and improvement opportunities. Here, a time series analysis of national, state, and sectoral (e.g., industrial, service, and agriculture) WUE from 1980 to 2015 was developed by compiling the most comprehensive and disaggregated water and economic data from 3243 US counties and 50 US states. The US total WUE increased by 181% from 16.2 (1985) to 45.6 USD/m3 (2015), driven by service sector WUE enhancements. The increased industry and service WUEs in most states were more strongly correlated with decreased per capita water withdrawal than with economic growth. Simultaneously, reductions in agriculture WUE were observed in 18 states potentially because of the complicated interaction of diverse factors specific to local communities. Expanding WUE gaps between affluent and less affluent states, and persisting WUE gaps between water-abundant andwater-scarce states highlight the need to advance policies to support under-resourced communities in effective water planning and water pricing for advancing equitable development.

Income inequality as a determinant of neonatal mortality in the Americas during 2000-2019: implications for the attainment of Sustainable Development Goal target 3.2.

BACKGROUND: The work of the WHO Commission on the Social Determinants of Health has been fundamental to provide a conceptual framework of the social determinants of health. Based on this framework, this study assesses the relationship of income inequality as a determinant of neonatal mortality in the Americas and relates it to the achievement of the Sustainable Development Goal target 3.2 (reduce neonatal mortality to at least as low as 12 deaths per 1,000 live births). The rationale is to evaluate if income inequality may be considered a social factor that influences neonatal mortality in the Americas. METHODS: Yearly data from 35 countries in the Americas during 2000-2019 was collected. Data sources include the United Nations Inter-agency Group for Child Mortality Estimation for the neonatal mortality rate (measured as neonatal deaths per 1,000 live births) and the United Nations University World Institute for Development Economics Research for the Gini index (measured in a scale from 0 to 100). This is an ecological study that employs a linear regression model that relates the neonatal mortality rate (dependent variable) to the Gini index (independent variable), while controlling for other factors that influence neonatal mortality. Coefficient estimates and their robust standard errors were obtained using panel data techniques. RESULTS: A positive relationship between income inequality and neonatal mortality is found in countries in the Americas during the period studied. In particular, the analysis suggests that a unit increase in a country's Gini index during 2000-2019 is associated with a 0.27 (95% CI [- 0.04, 0.57], P =.09) increase in the neonatal mortality rate. CONCLUSION: The analysis suggests that income inequality may be positively associated with the neonatal mortality rate in the Americas. Nonetheless, given the modest magnitude of the estimates and Gini values and trends during 2000-2019, the findings suggest a potential limited scope for redistributive policies to support reductions in neonatal mortality in the region. Thus, policies and interventions that address higher coverage and quality of services provided by national health systems and reductions in socio-economic inequalities in health are of utmost importance.

Relevance of the Sustainable Development Goals (SDGs) to Adolescent Health Measurement: A Systematic Mapping of the SDG Framework and Global Adolescent Health Indicators.

PURPOSE: To assess the relevance of the Sustainable Development Goals (SDGs) framework for adolescent health measurement, both in terms of age disaggregation and different health domains captured, and how the adolescent health indicators recommended by the Global Action for Measurement of Adolescent Health (GAMA) can complement the SDG framework. METHODS: We conducted a desk review to systematically map all 248 SDG indicators using the UN metadata repository in three steps: 1) age-related mandates for SDG reporting; 2) linkages between the SDG indicators and priority areas for adolescent health measurement; 3) comparison between the GAMA indicators and the SDG framework. RESULTS: Of the 248 SDG indicators, 35 (14%) targeted an age range overlapping with adolescence (10-19 years) and 33 (13%) called for age disaggregation. Only one indicator (3.7.2 "adolescent birth rate") covered the entire 10-19 age range. Almost half (41%) of the SDG indicators were directly related to adolescent health, but only 33 of those (13% of all SDG indicators) overlapped with the ages 10-19, and 15 (6% of all SDG indicators) explicitly mandated age disaggregation. Among the 47 GAMA indicators, five corresponded to existing SDG indicators, and eight were adolescent-specific age adaptations. Several GAMA indicators shed light on aspects not tracked in the SDG framework, such as obesity, mental health, physical activity, and bullying among 10-19-year-olds. DISCUSSION: Adolescent health cannot be monitored comprehensively with the SDG framework alone. The GAMA indicators complement this framework via age-disaggregated adaptations and by tracking aspects of adolescent health currently absent from the SDGs.

Leaving no one behind in armed conflict-affected settings of Africa: is universal health coverage a possibility or mirage?

The world is off track six years to the 2030 deadline for attaining the sustainable development goals and universal health coverage. This is particularly evident in Africa's armed conflict-affected and humanitarian settings, where pervasively weak health systems, extreme poverty and inequitable access to the social dimensions and other determinants of health continue to pose significant challenges to universal health coverage. In this article, we review the key issues and main barriers to universal health coverage in such settings. While our review shows that the current health service delivery and financing models in Africa's armed conflict-affected settings provide some opportunities to leapfrog progress, others are threats which could hinder the attainment of universal health coverage. We propose four key approaches focused on addressing the barriers to the three pillars of universal health coverage, strengthening public disaster risk management, bridging the humanitarian-development divide, and using health as an enabler of peace and sustainable development as panacea to addressing the universal health coverage challenge in these settings. The principles of health system strengthening, primary health care, equity, the right to health, and gender mainstreaming should underscore the implementation of these approaches. Moving forward, we call for more advocacy, dialogue, and research to better define and adapt these approaches into a realistic package of interventions for attaining universal health coverage in Africa's armed conflict-affected settings.

Harnessing the 12 Green Chemistry Principles for Sustainable Antiparasitic Drugs: Toward the One Health Approach.

Antiparasitic drug development stands as a critical endeavor in combating infectious diseases which, by affecting the well-being of humans, animals, and the environment, pose significant global health challenges. In a scenario where conventional pharmacological interventions have proven inadequate, the One Health approach, which emphasizes interdisciplinary collaboration and holistic solutions, emerges as a vital strategy. By advocating for the integration of One Health principles into the R&D pharmaceutical pipeline, this Perspective promotes green chemistry methodologies to foster the development of environmentally friendly antiparasitic drugs for both human and animal health. Moreover, it highlights the urgent need to address vector-borne parasitic diseases (VBPDs) within the context of One Health-driven sustainable development, underscoring the pivotal role of medicinal chemists in driving transformative change. Aligned with the Sustainable Development Goals (SDGs) and the European Green Deal, this Perspective explores the application of the 12 Principles of Green Chemistry as a systematic framework to guide drug discovery and production efforts in the context of VBPD. Through interdisciplinary collaboration and a constant commitment to sustainability, the field can overcome the challenges posed by VBPD while promoting global and environmental responsibility. Serving as a call to action, scientists are urged to integrate One Health concepts and green chemistry principles into routine drug development practices, thereby paving the way for a more sustainable R&D pharmaceutical pipeline for antiparasitic drugs.

Unveiling energy security in agriculture through vital indicators extraction and insights.

Despite advancements in meeting various human needs, energy supply remains a top priority for all countries worldwide. The escalating energy consumption in the agricultural sector underscores the necessity to scrutinize its energy usage. Presently, there exists an absence of a precise tool for accurately measuring this consumption. Hence, this study aims to identify indicators for measuring energy security in agriculture, conducted in three phases: content analysis, indicator validation, and field investigation. In the content analysis phase, energy security indicators were extracted and grouped into four categories: accessibility, availability, utilization, and sustainability. Following this, a two-stage validation process led to the identification of 18 indicators for assessing energy security in agriculture. In the field phase, a tailored questionnaire was distributed to 160 randomly selected farmers. The findings revealed that the availability component held the highest rank in establishing energy security, with an average score of 3.31. However, the current status of the access component indicates a more unfavorable situation compared to other dimensions. Consequently, to achieve energy security in agriculture, particular emphasis should be placed on enhancing energy access. Key areas to address include reducing transportation costs and minimizing the use of chemical pesticides. This indicates a necessity for focused interventions aimed at improving both energy access and sustainability within the agricultural sector. These efforts would contribute to enhancing economic efficiency and promoting environmental conservation.

Seven Steps to Financial Health.

Physicians and dentists have a very limited exposure to personal financial management and yet find themselves in the top 10% of earners in the United States of America. Education loans, practice expenses, and high standards of living obligate them to be good financial stewards to succeed financially. Anecdotal personal experience and review. The article establishes seven steps to implement as medical/dental students, interns, residents, or practicing doctors to move towards financial health and security. The steps include (1) saving enough; (2) good debt management; (3) being tax savvy; (4) obtaining the correct insurance; (5) making wise investments; (6) if choosing to marry, avoid divorce; and (7) keeping track with periodic progress assessment. Each of these steps contains several components that can aid and guide physicians and dentists in their financial arc of development over their professional career and into retirement, considering generational wealth transfer or charitable donation as ultimate goals. This brief guide is based on my own financial journey to achieve long-term financial independence: start early, use simple tax deferred investments without chasing trends while keeping fees down, live within your means, and adequately insure your income.

Geriatric Dermatologic Surgery Part I: Frailty assessment and palliative treatments in the geriatric dermatology population.

Longer life expectancy and increasing keratinocyte carcinoma incidence contribute to an increase in geriatric patients presenting for dermatologic surgery. Unique considerations accompany geriatric patients including goals of care, physiologic changes in medication metabolism, cognitive decline, and frailty. Limited geriatric training in dermatology residency has created a knowledge gap and dermatologic surgeons should be familiar with challenges facing older patients to provide interventions more congruent with goals and avoid overtreatment. Frailty assessments including the Geriatric 8 and Karnofsky Performance Scale are efficient tools to identify patients who are at risk for poor outcomes and complications. When frail patients are identified, goals of care discussions can be aided using structured palliative care frameworks including the 4Ms, REMAP, and Serious Illness Conversation Guide. Most geriatric patients will tolerate standard of care treatments including invasive modalities like Mohs surgery and excision. However, for frail patients, non-standard treatments including topicals, energy-based devices, and intralesional chemotherapy may be appropriate options to limit patient morbidity while offering reasonable disease control.

Analyzing the impact of an MDG-Fund program on childhood malnutrition in Timor-Leste.

BACKGROUND: Timor-Leste's food insecurity, propelled by political conflicts, a fragile economy and biophysical limitations that characterize mountainous Small Island Developing States (SIDS), is expressed in a high incidence (50%) of stunted children. Hence, the Millennium Development Goals Achievement Fund's Joint Program's (MDG-F JP) in 2009 was a timely intervention to reduce prevalence of underweight among under-fives. Since the impact of the program remains largely unclear, the current study investigates the contributions of the MDG-F JP on improving children's nutritional status in Timor-Leste, in order to inform policymakers on how to make future programs more effective. METHODS: Using bivariate analyses and multiple linear regression models we analyzed Demographic and Health Survey (DHS) data from under-fives in 2009-2010 and 2016, combined with spatially explicit data from geographic information systems (GIS). The analyses generated trends and factors associated with undernutrition, which were used in a quasi-experimental setting to compare districts that received the MDG-F JP with similar districts that did not receive MDG-F JP interventions. RESULTS: A comprehensive set of factors dependent on seasons, locations, and individuals determine undernutrition in Timor-Leste. A positive impact of the MDG-F JP was found for the average severity of wasting, but not for stunting and underweight. CONCLUSIONS: The findings reinforce the pressing need for integrated and cross-sectoral programs, aimed especially at agricultural workers, mothers, and children. The agricultural challenge is to sustainably select, produce and conserve higher-yield and nutrient-rich crops, and educational enhancement should be aligned with local practices and research.

Socio-demographic inequalities influence differences in the chemical exposome among Swedish adolescents.

Relatively little is known about the relationship between socio-demographic factors and the chemical exposome in adolescent populations. This knowledge gap hampers global efforts to meet certain UN sustainability goals. The present work addresses this problem in Swedish adolescents by discerning patterns within the chemical exposome and identify demographic groups susceptible to heightened exposures. Enlisting the Riksmaten Adolescents 2016-17 (RMA) study population (N = 1082) in human-biomonitoring, and using proportional odds ordinal logistic regression models, we examined the associations between concentrations of a diverse array of substances (N = 63) with the determinants: gender, age, participant/maternal birth country income per capita level, parental education levels, and geographic place of living (longitude/latitude). Participant/maternal birth country exhibited a significant association with the concentrations of 46 substances, followed by gender (N = 41), and longitude (N = 37). Notably, individuals born in high-income countries by high-income country mothers demonstrated substantially higher estimated adjusted means (EAM) concentrations of polychlorinated biphenyls (PCBs), brominated flame retardants (BFRs) and per- and polyfluoroalkyl substances (PFASs) compared to those born in low-income countries by low-income country mothers. A reverse trend was observed for cobalt (Co), cadmium (Cd), lead (Pb), aluminium (Al), chlorinated pesticides, and phthalate metabolites. Males exhibited higher EAM concentrations of chromium (Cr), mercury (Hg), Pb, PCBs, chlorinated pesticides, BFRs and PFASs than females. In contrast, females displayed higher EAM concentrations of Mn, Co, Cd and metabolites of phthalates and phosphorous flame retardants, and phenolic substances. Geographical disparities, indicative of north-to-south or west-to-east substance concentrations gradients, were identified in Sweden. Only a limited number of lifestyle, physiological and dietary factors were identified as possible drivers of demographic inequalities for specific substances. This research underscores birth country, gender, and geographical disparities as contributors to exposure differences among Swedish adolescents. Identifying underlying drivers is crucial to addressing societal inequalities associated with chemical exposure and aligning with UN sustainability goals.

A parental communication assessment initiative in the paediatric cardiovascular ICU.

OBJECTIVE: Challenges to communication between families and care providers of paediatric patients in intensive care units (ICU) include variability of communication preferences, mismatched goals of care, and difficulties carrying forward family preferences from provider to provider. Our objectives were to develop and test an assessment tool that queries parents of children requiring cardiac intensive care about their communication preferences and to determine if this tool facilitates patient-centred care and improves families' ICU experience. DESIGN: In this quality improvement initiative, a novel tool was developed, the Parental Communication Assessment (PCA), which asked parents with children hospitalised in the cardiac ICU about their communication preferences. Participants were prospectively randomised to the intervention group, which received the PCA, or to standard care. All participants completed a follow-up survey evaluating satisfaction with communication. MAIN RESULTS: One hundred thirteen participants enrolled and 56 were randomised to the intervention group. Participants who received the PCA preferred detail-oriented communication over big picture. Most parents understood the daily discussions on rounds (64%) and felt comfortable expressing concerns (68%). Eighty-six percent reported the PCA was worthwhile. Parents were generally satisfied with communication. However, an important proportion felt unprepared for difficult decisions or setbacks, inadequately included or supported in decision-making, and that they lacked control over their child's care. There were no significant differences between the intervention and control groups in their communication satisfaction results. CONCLUSIONS: Parents with children hospitalised in the paediatric ICU demonstrated diverse communication preferences. Most participants felt overall satisfied with communication, but individualising communication with patients' families according to their preferences may improve their experience.

Mitigating air pollution benefits multiple sustainable development goals in China.

Achieving the United nations 2030 Sustainable Development Goals (SDGs) remains a significant challenge, necessitating urgent and prioritized strategies. Among the various challenges, air pollution continues to pose one of the most substantial threats to the SDGs due to its widespread adverse effects on human health and ecosystems. However, the connections between air pollution and the SDGs have often been overlooked. This study reveals that out of the 169 SDG targets, 71 are adversely impacted by air pollution, while only 6 show potential positive effects. In China, two major atmospheric nitrogen pollutants, ammonia and nitrogen oxides, resulted in an economic loss of 400 billion United States Dollar (USD) in 2020, which could be reduced by 33% and 34% by 2030, respectively. It would enhance the progress towards SDGs in China by 14%, directly contributing to the achievement of SDGs 1 to 6 and 11 to 15. This improvement is estimated to yield overall benefits totaling 119 billion USD, exceeded the total implementation cost of 82 billion USD with ammonia as the preferential mitigation target. This study underscores the importance of robust scientific evidence in integrated policies aimed at aligning improvements in environmental quality with the priorities of sustainable development.

Food-Energy-Water Nexus in compliance with Sustainable Development Goals for integrating and managing the core environmental verticals for sustainable energy and circular economy.

Food, energy, and water resources are intricately interconnected, and nexus provides a holistic approach for addressing these complex links to minimize inefficiencies and waste. Nexus approach and circular economy are considered as effective solutions for sustainability. Quantification of these relations is the first step towards incorporating nexus modeling which helps sustainable production and consumption. For achieving the Sustainable Development Goals, understanding and effectively managing the FEW nexus becomes imperative. With an integral performance perspective, there is a need to address the interdependencies and trade-offs among food, energy, and water systems and challenges of economic, social and environmental sustainability. The aim of this study is to provide a comprehensive analysis of the FEW nexus, identify key opportunities and challenges, and propose integrated strategies for managing these core environmental verticals sustainably. The study addresses the accomplishment of these goals through nexus approaches and outlines the need for technological advancements for shared benefits among resources, contributing to conceptual development of nexus and circular economy. The results highlight the critical importance of adopting a nexus approach to advance sustainable development goals, enhance resource efficiency, and promote synergistic solutions across food, energy, and water systems.

Global health systems strengthening: FIGO's strategic view on reducing maternal and newborn mortality worldwide.

OBJECTIVE: To demonstrate that successful health systems strengthening (HSS) projects have addressed disparities and inequities in maternal and perinatal care in low-income countries. METHODS: A comprehensive literature review covered the period between 1980 and 2022, focusing on successful HSS interventions within health systems' seven core components that improved maternal and perinatal care. RESULTS: The findings highlight the importance of integrating quality interventions into robust health systems, as this has been shown to reduce maternal and newborn mortality. However, several challenges, including service delivery gaps, poor data use, and funding deficits, continue to hinder the delivery of quality care. To improve maternal and newborn health outcomes, a comprehensive HSS strategy is essential, which should include infrastructure enhancement, workforce skill development, access to essential medicines, and active community engagement. CONCLUSION: Effective health systems, leadership, and community engagement are crucial for a comprehensive HSS approach to catalyze progress toward universal health coverage and global improvements in maternal and newborn health.

Female genital mutilation: trends, economic burden of delay and basis for public health interventions.

BACKGROUND: The practice of female genital mutilation (FGM) is a health and social problem. Millions of girls and women have undergone FGM or will soon, and more information is needed to effectively reduce the practice. The aim of this research is to provide an overview of the FGM trendlines, the inequality of its prevalence, and the economic burden. The findings shed light on 30-year trends and the impact of the pandemic on planned efforts to reduce FGM which helps with public health interventions. METHODS: Temporal trend analysis, and graphical analysis were used to assess the change and inequality over the last 30 years. We included 27 countries in which FGM is prevalent. We calculated the extra economic burden of delayed interventions to reduce FGM like COVID-19. RESULTS: For the 27 countries analyzed for temporal trendlines, 13 countries showed no change over time while 14 had decreasing trends. Among the 14, nine countries, Uganda, Togo, Ghana, Benin, Kenya, Nigeria, Central African Republic, Chad, and Ethiopia had high year-decrease (CAGR - 1.01 and - 10.26) while five, Côte d'Ivoire, Egypt, Gambia, Djibouti, and Mali had low year-decrease (CAGR>-1 and < 0). Among these five are the highest FGM prevalence similar distribution regardless the wealth quintiles or residence. There is an economic burden of delay or non-decline of FGM that could be averted. CONCLUSION: Findings indicate that some countries show a declining trend over time while others not. It can be observed that there is heterogeneity and homogeneity in the FGM prevalence within and between countries which may indicate inequality that deserves further investigation. There is considerable economic burden due to delays in the implementation of interventions to reduce or eliminate FGM. These insights can help in the preparation of public health interventions.