Optimizing engine performance and reducing emissions of greenhouse gases through spirulina microalgae and nano-additive blends.

The shift in focus towards biofuels has led to the attention towards fourth-generation fuels, particularly microalgae, due to its high oil productivity and simple cultivation processes. The current study aimed to examine the effects of spirulina microalgae blends in a naturally aspirated diesel engine by testing two blend percentages (15% and 30%) and incorporating Fe2O3 nanoparticles (75 ppm). A series of test conducted in a single-cylinder engine with an optimum compression ratio of 17.5. The fuels tested include 100% diesel (D0), diesel with Fe2O3 nanoparticles (DF), diesel with 15% microalgae blends (B15), diesel with 15% microalgae blends and Fe2O3 nanoparticles (B15F), diesel with 30% microalgae blends (B30), and diesel with 30% microalgae blends and Fe2O3 nanoparticles (B30F). The results showed that the addition of microalgae blends led to a marginal increase in engine performance, while the addition of Fe2O3 nanoparticles led to a significant increase in brake thermal efficiency and decreased fuel consumption. The emissions rate was also lower compared to diesel, but the addition of Fe2O3 nanoparticles increased the oxygen content in the fuel, thereby improving the combustion rates. By ensuring the complete combustion the formation of CO2, HC and smoke intensity was also found to be significantly lower compared to diesel fuel. On the contrary, NOx increased due to the cylinder temperatures. This research highlights the potential of using microalgae as a sustainable source of biofuel, and the positive effects of adding Fe2O3 nanoparticles to enhance the fuel's efficiency.

Enhancing emission control and analyzing the performance and combustion attributes of vehicular engines with spirulina microalgae diesel Ce2O3 nanoparticles blends.

The current research investigates the utilization of spirulina microalgae biodiesel blends in a naturally aspirated constant speed compression ignition engine with Ce2O3 nanoparticles at the concentration of 50 ppm under diverse engine loading conditions. Blends of microalgae dispersed with neat diesel at the volume of 20% and 40%. A series of tests were conducted to evaluate the combined effects of microalgae and nanoparticles on engine performance, combustion efficiency, and emission characteristics. The study revealed that increasing the microalgae concentration in the diesel fuel resulted in reduced brake thermal efficiency due to less effective atomization and lower calorific value. Surprisingly, the 20% biodiesel blend with nanoparticles exhibited the highest brake thermal efficiency across various engine loads, while the 40% blend showed higher brake specific fuel consumption compared to both the 20% blend and neat diesel, primarily because of its lower heating value necessitating increased fuel consumption. Furthermore, the biodiesel blends led to lower in-cylinder pressure than pure diesel, mainly attributable to suboptimal atomization. In terms of emissions, the utilization of microalgae-based fuel led to a significant reduction in NOx, CO, and smoke emissions, attributed to the lower cylinder temperatures associated with these blends. In conclusion, this study underscores the potential of spirulina microalgae, particularly when combined with nanoparticles at an optimal concentration, as a promising and environmentally friendly alternative for compression ignition engines.

Recovering biogas and nutrients via novel anaerobic co-digestion of pre-treated water hyacinth for the enhanced biogas production.

The present investigation explores the feasibility of generating biogas from water hyacinth (WH) through a pretreatment process. The WH samples were subjected to a high concentration of H2SO4 pretreatment to enhance biogas production. The H2SO4 pretreatment aids in breaking down the lignocellulosic materials found in the WH. Additionally, it helps modify the cellulose, hemicellulose, and lignin, which assists in the anaerobic digestion process. The samples underwent pretreatment with 5% v/v H2SO4 for 60 min. Biogas production was conducted for both untreated and pretreated samples. Furthermore, sewage sludge and cow dung were used as inoculants to promote fermentation in the absence of oxygen. The results of this study demonstrate that the pretreatment of water hyacinth with 5% v/v H2SO4 for 60 min considerably enhances biogas production through the anaerobic co-digestion process. The maximum biogas production was recorded by T. Control-1, with a production rate of 155 mL on the 15th day compared to all other controls. All the pretreated samples showed the highest biogas production on the 15th day, which is comparatively five days earlier than the untreated samples. In terms of CH4 production, the maximum yield was observed between the 25th and 27th days. These findings suggest that water hyacinth is a viable source of biogas production, and the pretreatment method significantly improves biogas yield. This study presents a practical and innovative approach to biogas production from water hyacinth and highlights the potential for further research in this area.

Role of chicken fat waste and hydrogen energy ratio as the potential alternate fuel with nano-additives: Insights into resources and atmospheric remediation process.

The main focus of the study was to witness the effects of chicken waste-based biodiesel blends along with constant hydrogen injection in a modified diesel engine. Furthermore, the nanoparticle multiwall carbon nanotubes (MWCNT) effects on the engine efficiency were also examined. A series of tests was conducted in the single cylinder, water cooled engine fuelled with diesel, CB100N, CB10N, CB30N, and CB50N. Throughout the entire run, constant hydrogen injection of 5 LPM has been maintained. The parameters such as brake thermal efficiency, brake specific fuel consumption, heat release rate and the emissions of different pollutants were determined for a variety of engine speeds. ASTM standards were applied to measure the viscosity, density and calorific value. From the reported findings, it was clear that the addition of the chicken waste biodiesel could be a sustainable substitute for the existing fossil fuels. Although the emission of the pollutants was dropped significantly, there was a massive drop in the BTE values. To compensate such shortage of power, the biodiesel was dispersed with MWCNT at the concentration of 80 ppm. Compared to the regular biodiesel, MWCNT inclusion increased the BTE by 14%. Further, the consumption of the fuel was also reduced marginally. Considering the pollutants, the catalytic activity of the MWCNT reduced the emissions of CO, NOx, and HC at various engine speeds. Besides, 10% reduction in NOx had been reported at lower engine speeds and was reduced to 8% at higher speed regimes. Compiling all together, increasing the concentration of the biodiesel blends obviously reduced the performance values and however, there was a great advantage in terms of the emission magnitudes irrespective of the engine operating conditions.

High efficiency lipid production, biochar yield and chlorophyll a content of Chlorella sp. microalgae exposed on sea water and TiO2 nanoparticles.

This study explores the challenges facing microalgae biofuel production, specifically low lipid content and difficulties with algal cell harvesting. The purpose of the research is to investigate the effect of seawater content and nanoparticle concentration on freshwater microalgae growth and biofuel production. The principal results of the study show that increasing the proportion of seawater and nanoparticles enhances the lipid content and cell diameter of microalgae, while excessive concentrations of nanoparticles and low seawater content lead to reduced microalgae growth. Furthermore, an optimal cell diameter was identified at a nanoparticle concentration of 150 mg/L. The study also reveals that increasing seawater content can decrease zeta potential and increase chlorophyll a content due to the concentration of dissolved organic matter. Increasing the seawater content from 0% to 25% decreased zeta potential by 1% owing to the instability and aggregation of the cells. Chlorophyll a for the 0% seawater was 0.55 which is increased to 1.32 only due to the increase in the seawater content. This significant increase is due to the concentration of dissolved organic matter in seawater. Additionally, the presence of seawater positively affects microalgae metabolic activity and biochar yield. The findings of this study offer valuable insights into the potential for optimizing microalgae biofuel production. The use of seawater and nanoparticles has shown promise in enhancing microalgae growth and biofuel yield, and the results of this study underscore the scientific value of exploring the role of seawater and nanoparticles in microalgae biofuel production. Further research in this area has the potential to significantly contribute to the development of sustainable energy solutions.

Utilization of agricultural, industrial waste and nanosilica as replacement for cementitious material and natural aggregates - Mechanical, microstructural and durability characteristics assessment.

This study examines the effect of rice husk ash (RHA) and nanosilica, and ground granular blast furnace slag (GGBS) on concrete mechanical and durability properties. The cement had been partially replaced with nanosilica and RHA having substitution percentages up to 6% and 10% respectively whereas the sand had been partially replaced by GGBS at 20% for all mixes. A water-to-cementitious materials ratio of 0.38 and a sand-to-cementitious materials ratio of 2.04 were used to cast eight different concrete mixes. The nanosilica used in the present research possessed some favorable effects such as rich fineness, higher surface area and greater reactivity which signified one of the best cement replacement materials. Both the durability and strength of concrete specimens possessing nanosilica, RHA and GGBS was evaluated using in-elastic neutron scattering, SEM image, piezoresistive test, split tensile strength, flexural strength and compressive strength test. Concrete specimens were also subjected to chloride penetration and water absorption to examine the impact of replacement materials on the concrete's durability attributes. Concrete performance was increased by the ternary blending of concrete because of the active participation of nanosilica in durability and strength at early ages, both RHA and GGBS played an important role in improving packing density. It was found that as the percentage of cement replaced with nanosilica increases, the durability of concrete also significantly increases. But the optimum strength parameter was found when 4% of cement was replaced by the nanosilica effectively. The proposed ternary mix may be eco-friendly by saving cement and enhancing strength and durability effectively.

Does club convergence matter in health outcomes? Evidence from Indian states.

BACKGROUND: Population health is vital to a nation's overall well-being and development. To achieve sustainable human development, a reduction in health inequalities and an increase in interstate convergence in health indicators is necessary. Evaluation of the convergence patterns can aid the government in monitoring the health progress across the Indian states. This study investigates the progressive changes in the convergence and divergence patterns in health status across major states of India from 1990 to 2018. METHODS: Sigma plots (σ), kernel density plots, and log t-test methods are used to test the convergence, divergence, and club convergence patterns in the health indicators at the state level. RESULTS: The result of the sigma convergence suggests that life expectancy at birth has converged across all states. After 2006, however, the infant mortality rate, neonatal mortality rate, and total fertility rate experienced a divergence pattern. The study's findings indicate that life expectancy at birth converges in the same direction across all states, falling into the same club (Club One). However, considerable cross-state variations and evidence of clubs' convergence and divergence are observed in the domains of infant mortality rate, neonatal death rate, and total fertility rate. As suggested by the kernel density estimates, life expectancy at birth stratifies, polarizes, and becomes unimodal over time, although with a single stable state. A bimodal distribution was found for infant, neonatal, and total fertility rates. CONCLUSIONS: Therefore, healthcare strategies must consider each club's transition path while focusing on divergence states to reduce health variations and improve health outcomes for each group of individuals.

The relationship between destination image and destination safety during technological and social changes COVID-19 pandemic.

This study aimed to assess the relationship between safety perceptions and destination image in the Central European region during the technological and social environment change brought about by the COVID-19 pandemic. The study sample consisted of respondents from three Central European countries, namely, the Czech Republic, Hungary, and Slovakia. The quantile regression analysis was used to analyze the relationship between the image of the destination and its perceived safety. The results showed that concerns about the safety of the tourism environment could be negatively associated with the image of the infrastructure in Hungary and Slovakia, with value for money in the three countries, and with images of enjoyment in Slovakia. Higher levels of destination safety may be associated with a more positive destination image, with health, facilities and services being the most important dimensions of perceived safety, because of the pandemic. This study contributes to the knowledge of the concept of destination images and the development of tourism.

Perception of testing for COVID-19 during the first wave of the pandemic in Slovakia with emphasis on population age groups.

OBJECTIVE: The aim of this study was to evaluate the perception of the respondents in selected areas of testing for COVID-19 during the first waves of this disease with an emphasis on the age categories. METHODS: The research sample consisted of 806 Slovak respondents and the collection of data took place in February 2021. The study examined six areas, of which five focused on the perception of testing and one area focused on examining the risk of population behaviour. All areas were examined in the first as well as in the last testing for COVID-19. In terms of age, we focused on 4 age categories: up to 24 years, 25-44 years, 45-59 years, and over 60 years. Data were obtained by online survey, using descriptive analysis and nonparametric analysis of differences. RESULTS: The results of the analysis show that age is a socioeconomic characteristic that is of great importance for the creation and implementation of epidemiological processes and programmes and therefore epidemiologists should pay increased attention to it when creating prevention programmes. Younger people perceived testing more positively than older ones, even though the course of the disease caused by COVID-19 is much more severe in older people. The difference in the perception of testing between age categories was confirmed in the first as well as in the last test study. Respondents perceived the last test more negatively and thus they showed slightly riskier behaviour compared to the first test. CONCLUSIONS: We perceive testing as an efficient way in the fight against pandemics generally, but we point out that testing should be well accomplished in a managerial way, otherwise testing can have a negative impact on society's confidence.

Expert model of risk assessment for the selected components of smart city concept: From safe time to pandemics as COVID-19.

The purpose of the paper is to create an information, fuzzy risk assessment model to support the decision-making of Municipality management for the establishment and management of measures in the safe mode (regular) of City, emergency and disaster situations, in the selected components of Smart City concept. Research on this topic was motivated by the need for support, especially in emergency situations, such as the COVID-19 pandemic. It is proposed that the evaluation be carried out at local level within the framework of the Smart City concept and selected components integrated into the entity, including the Smart Security, Smart Healthcare, and Smart Environment components supported by the Smart WebGIS subsystem. The model also assesses proposed solutions for self-government financing to ensure the acceptable risk, and economic impact of decisions on the city budget within the Smart Budget aspects of selected components. Decision-making is based on intellectual analysis, processing of fuzzy data and use of fuzzy inference. The output of the model is the assessment of the risk of the municipality subsystems, taking into account the threshold for the functioning of the municipality subsystems, the linguistic interpretation of the level of risk and the acceptability of the tolerable risk resource. The model algorithm was used to create a web application to support the Municipal management for the above-mentioned agenda, from safe time to pandemics.

Age-gender mortality study on alcohol-induced deaths in Slovakia.

OBJECTIVE: Alcohol use is one of the ten most common risk factors threatening global health that is avoidable (ranked fifth after smoking). It is involved in high rates of liver cirrhosis, epilepsy, hypertension, cerebrovascular and mental illness. Negative consequences of family and social drinking are also very significant. The aim of the study is to quantify the gender and age-differentiated disparities in alcohol-related mortality in the population over 16 years between the years 1996-2017 in Slovakia. METHODS: We used data from mortality reports within 1996-2017 provided by the National Health Information Centre in the Slovak Republic. We applied two-dimensional correspondence analysis where dimensions are age and chosen causes of deaths induced by use of alcohol and classified by the International Classification of Diseases. RESULTS: In case of males, we found that K74 - Fibrosis and cirrhosis of liver diagnosis almost perfectly corresponds to age 66-75 years, and we documented strong correspondence between K70 - Alcoholic liver disease and age 46-55 years. For females, the most robust finding is that K70 - Alcoholic liver disease corresponds relatively similarly with age groups 26-35, 36-45, 46-55. The results of the analysis allow us to obtain a detailed overview of the development of mortality in individual alcohol diagnoses and their intervention in individual age groups by gender. Mortality for some diagnoses affects the young female as well as male population. We observed that there are systematic differences in alcohol-induced mortality between males and females. CONCLUSIONS: In such development of the alcohol-related mortality structure, the priority remains the permanent provision of primary, secondary and tertiary prevention at the individual and population level. The results of our analysis represent a valuable platform for health and social policymakers to develop quality national and regional health strategies aimed at eliminating the consequences of alcohol use. Lessons learned from our analysis will be supported by our other geographically oriented analytical lines to link identified and quantified regional disparities in the mortality of alcohol diagnoses to the availability of health care to treat these diseases.

Spatial analysis of alcohol-related mortality in Slovakia.

OBJECTIVE: The aim of our study was to investigate the relationship between alcohol-related mortality in Slovak regions, as represented by Nomenclature of Territorial Units for Statistics (NUTS) III level. METHODS: We used data from mortality reports spanning 1996-2017 in the Slovak Republic. Data was provided by the National Health Information Centre in Slovakia. We applied two-dimensional correspondence analysis where the dimensions are regions and selected alcohol-related deaths diagnoses are classified by the International Classification of Diseases. RESULTS: Analysis revealed a relationship between the Presov region and diagnoses I42 - Cardiomyopathy and K29 - Alcoholic gastritis. Furthermore, the Banská Bystrica and Zilina regions correspond to G31 - Degeneration of nervous system due to alcohol and K86 - Alcohol-induced chronic pancreatitis. In the case of K70 - Alcoholic liver disease - the Banská Bystrica, Trencín and Nitra regions are identified as regions which have an intermediate relationship with this diagnosis. The Trnava region corresponds to F10 - Acute alcohol intoxication. The Trencín and Nitra regions correspond closely to G62 - Alcoholic polyneuropathy. Perfect correspondence can be seen between the Kosice region and K73 - Chronic hepatitis, not elsewhere classified. K74 - Fibrosis and cirrhosis of liver diagnosis also corresponds with the Kosice region. CONCLUSIONS: The results of this analysis provide valuable insights for national and regional health policymakers in the process of preparing high-quality health regional plans, as well as retrospectively assessing the success of existing health policies and interventions in this area. Facts presented in the study justify the need for specialised health care, which is part of the process of building an Integrated Health Care Centre in Slovakia.

First alcohol treatment institutions in today's Czech Republic and Slovak Republic.

OBJECTIVE: Drawing on qualitative analysis of selected historical documents, the paper seeks to provide a definition of the general characteristics of the first institutional alcohol treatment facilities in today's Czech Republic and Slovakia, taking into account the historical context of the first half of the 20th century. An additional aim was to point out the importance of archival research and its contribution to understand the determinants of alcohol-related agenda and alcohol treatment. METHODS: The basic data platform was generated by analysis of historical documents pertaining to the subject matter under study and to institutional processes in different periods. The data was processed using the open coding method (as part of the grounded theory approach) and other specific methods based on the matching of data from scientific and professional literature and archives in different periods. Over 1,100 pages of text from relevant archival materials were analysed. This research is original, no such systematic analysis of historical documents on this subject matter has been conducted on such a scale with the intention of identifying the general correlates of the historical development of an alcohol-related agenda and alcohol treatment. RESULTS: The establishment of the first institutional facilities intended to provide treatment for alcohol dependency was based on the notion of addiction as a disease, which needs to be treated in dedicated facilities applying an individualised approach. The circumstances of the establishment of the facilities under analysis were similar. Their existence was made possible by distinguished personalities rather than a general belief and social pressure that the issue of alcohol addiction should be addressed. This also explains the fact that the occupancy of these facilities never reached their full capacity, that they were not self-reliant in economic terms, and that they did not readily resume their operation after 1945. CONCLUSIONS: The analysis of the establishment, operation, and dissolution of these facilities at the time reveals the discontinuity in the approach to alcohol abuse and its treatment in the context of the historical development and perception of alcohol-related problems in Czech and Slovak society in the first half of the 20th century. Significant social changes occurred after 1948. New legislative instruments were used to enforce treatment based on a principle that was different from the previous approaches. The results of our study also make it possible to reveal the intensity of apparent individual and institutional motives in the process of the development of alcohol treatment in historical terms and its projection into different post-war periods. The understanding of these correlates will help in designing additional trajectories of research into the effects of social and political changes on addiction treatment and thus identifying the intensity of the historical development and its influence on the perception of addiction treatment at present. These findings will also be of great importance for a historical comparative analysis, including overlaps with the development of recent theories, and will support the emergence of new areas of study for the social sciences.

Public health response to methanol mass poisoning in the Czech Republic in 2012: a case study.

OBJECTIVES: The study focuses on the 2012 methanol outbreak in the Czech Republic. The main goal of the present study was to apply analytical and descriptive tools to selected qualitative and quantitative processes related to the 2012 methanol outbreak in the Czech Republic. The secondary goal was to study and evaluate in detail their potential for creating integrated conceptual national policies aimed at eliminating the risk of methanol poisoning in the future. METHODS: The presented qualitative analysis focused on the content of documents published by Czech public authorities - the Ministry of Health, the Ministry of the Interior, the Czech Agriculture and Food Inspection Authority, and the Regional Public Health Authorities - as well as the content of the relevant legal regulations. Moreover, statistical data concerning the number of hospitalisations and deaths due to the methanol intoxication were used to provide a background to a detailed description of the relevant facts. RESULTS: In procedural terms, most of the analysed measures focused on a strongly restrictive regulation of sales, regular information channels designed to protect consumers on the national as well as international level, and elimination of further health and economic risks stemming from the dangerous alcoholic products that had already entered distribution networks. The health, social and economic consequences of such activities are quantified at a highly aggregated level. The analysed institutional ties are evaluated also in the context of international documents: the European Action Plan to Reduce Harmful Use of Alcohol 2012-2020 and the Global Strategy to Reduce Harmful Use of Alcohol, and their current potential for steering public policies is assessed. CONCLUSION: The analysis and evaluation of procedural activities carried out after the methanol outbreak have laid the foundations for a multidimensional study that can contribute to integrated national policy concepts aimed at preventing these and similar negative health, societal and economic consequences. Six years after the methanol outbreak, national and regional health policies have reflected no findings concerning the experience of patients whose health was impaired due to methanol, and the economic cost of the event has not been calculated. The quality of life of these patients has greatly decreased due to permanent or partial incapacity and serious upheavals of their and their families' economic and social conditions. This opens the question of researching and evaluating multiple aspects of health, social and economic impacts of harmful use of alcohol and setting up processes to mitigate these impacts.

Problematic and risky sexual behaviour under the influence of alcohol among university students.

OBJECTIVE: The objective of this research was to determine the prevalence of problematic and risky sexual behaviour after alcohol consumption and the correlation between this prevalence and sex, behavioural factors, problematic drinking, and alcohol consumption characteristics. METHODS: A survey of students was carried out at four faculties. Data were gathered via internet and self-administered paper-pencil questionnaires. The analysis employed Pearson's chi-squared test, gross odds ratios and logistic regression to calculate the adjusted odds ratios (OR) and their confidence interval (CI). RESULTS: Problematic drinking was detected by the CAGE test. Sixteen percent of students reached the CAGE score of 2, which indicates a potential threat of addiction, while 6% of students reached even higher problematic scores (3 or 4). Among those respondents who did drink alcohol, 23% had unprotected sex and 21% had sex which they later regretted. There were some differences between male and female respondents with men reporting more instances of risky behaviour. Among university students, problematic and risky sexual behaviour after alcohol use is associated with sex, the intensity of problematic drinking, first drunkenness, the place of alcohol use, and attitude to alcohol use. CONCLUSIONS: Problematic drinking and risky sexual behaviour after alcohol consumption exist among students and deserve special attention and response in the form of suitable measures. Problematic and risky sexual behaviour after alcohol consumption among university students is associated with behavioural factors and characteristics of alcohol use that allow a targeted approach to preventive efforts.

Disparities of Potential Gains in Life Expectancy Development between the Slovak Republic and the Czech Republic.

AIM: The purpose of this paper is to determine how many years a person could be expected to live if a specific cause of death was eliminated, and to compare potential gains in life expectancy (PGLEs) between Slovakia (SVK) and the Czech Republic (CZE). METHODS: PGLEs were computed from mortality reports (1996-2013) for deaths from the main groups of chronic diseases, namely ischaemic heart disease (IHD), cerebrovascular diseases (CVD), cancer (CA), diabetes mellitus (DM), and chronic respiratory diseases (CRD) for the Slovak and Czech populations in five-year age groups. Country comparative analysis was conducted by constructing rate ratios of PGLEs. RESULTS: In 2013, life expectancy at birth for the Slovak and Czech populations was 76.5 and 78.3 years. Overall trends of standardised mortality rates of chronic diseases roughly paralleled the PGLEs trend. During 1996-2013, SVK reported the highest PGLEs of IHD at an average of 4.54 years, compared to PGLEs of CA reaching a value of 3.61 years in CZE. The PGLEs of IHD showed the largest gap between SVK and CZE, with an average of 1.65 higher values in SVK. With the elimination of CVD as the third most influential disease in both countries, PGLEs decreased from 1.65 to 0.93 years in CZE; a negligible drop from 1.13 to 1.05 was recorded in SVK. The lowest impacts on life expectancy were recorded in DM and CRD. However, since 2005 these trends have deteriorated in CZE. In 2013, IHD had a similar impact on life expectancy in all age groups in SVK and a decreasing impact among 50-54 year olds in CZE. Similarly to SVK, people in CZE aged 45-49 could gain 0.94 years in LE after CVD elimination, which is nearly the same as at birth. CONCLUSIONS: The higher the life expectancy after elimination of the cause of death is, the higher the impact of the disease on life expectancy. Health prevention programs should be mainly aimed at CA mortality in CZE, while the highest burden of IHD is seen in SVK.

Impact of Infrastructure on Mortality in Marginalised and Segregated Communities in the Slovak Republic.

AIM: Poverty and social exclusion is measured through different criteria and one of them is the health sector. The relationship between Roma population and the health sector is on the edge of researchers' interest in the Slovak Republic. The purpose of this paper is a quantification of the regional disparities in the development of mortality which is causally linked with selected infrastructural determinants - namely access to water and sewerage. These determinants differently participate in the structure of mortality in marginalised and segregated communities and they deepen regional disparities in health. METHODS: It is a spatial analysis of the districts of the Slovak Republic. The data from the Atlas of Roma communities in Slovakia 2013 is applied. Through the multiple linear regression model the relationship between mortality of the Roma population and water and sewerage availability in the Roma settlements is examined. Similarity between the districts is measured by the Euclidean metric system. RESULTS: The most appropriate district for representing the Slovak Republic average is the Dunajská Streda district in a field of arithmetic mean and the Velký Krtís district in a field of median value. The outermost district is represented by the Kosice-okolie district, conversely, the Trnava district is the closest to the rest of the Slovak Republic. The highest statistically significant impacts on mortality are explored in public water supply extension plan and public sewerage supply extension plan. It seems that water play a greater role in determining health of Roma population. The highest number of inhabitants with supplied public water and public sewerage is kept by the Kezmarok district, the Kosice district, and the Spisská Nová Ves district. CONCLUSIONS: Our results can be beneficial for health decision making, since in the Strategic Framework for Health of the Slovak Republic metrics for measuring and evaluating health aspects in Roma communities absent and that prevents them to be correlated with the planned interventions.

Impact of Selected Socio-demographic Factors on the Development of Mortality due to Circulatory System Diseases in the Slovak Republic.

AIM: We mapped the situation within a group of diseases of the circulatory system (I00-I99) in the Slovak Republic during 1996-2014. We focused mainly on spatiotemporal differences in mortality while controlling for age and sex. METHODS: We performed binary logistic regression aiming to reveal socio-demographic factors that influence the odds of dying due to diseases of the circulatory system (I00-I99). In our analysis, the dependent variable was death diagnosis and the independent variables were age, region, gender, and marital status. RESULTS: Our findings suggest that odds of dying due to diseases of the circulatory system (I00-I99) increased for every year of age by 5.4%. Within the period from 1996 to 2014, the risk of dying from diseases of the circulatory system decreased by 2% every year. We also documented the fact that being female raised the odds of dying due to diseases of the circulatory system (I00-I99) by 12.9% compared to males. Furthermore, it could be argued that serious differences in terms of regional distribution of deaths caused by diseases of the circulatory system (I00-I99) exist in the Slovak Republic. CONCLUSIONS: We present the development of diseases of the circulatory system (I00-I99) in the Slovak Republic. Differences in spatial distribution of deaths are documented as well as related gender differences. Our study can serve as a tool for policy makers and benchmark for professionals.

Influence of Demographic Factors on Standardised Rate Ratio of Age-adjusted Mortality Rates of Men in Comparison with Women Caused by Neoplasms and Circulatory System Diseases in Slovak Regions during 1996-2013.

AIM: The aim of our study was to find statistical associations including trends of standardised rate ratio of age-adjusted mortality rates for the male population as compared to the female population, in relation to available demographic factors (Chapter II - Neoplasms vs. Chapter IX - Diseases of the circulatory system, Slovak region and calendar year of death). METHODS: Dataset of individual cases of death in Slovakia with some demographic factors during 1996-2013 were provided by Slovak National Health Information Center. We used regression and correlation analyses, as well as analyses of variance and covariance along with descriptive statistics. RESULTS: The standardised rate ratio of age adjusted mortality rates of men versus age-adjusted mortality rates of women differs between Chapter II and Chapter IX (mean 2.08 vs. 1.35, p<0.001). There are also significant differences of standardised rate ratio among regions (p<0.05). Trends show that the standardised rate ratio has significant regional decline for Chapter II: Kosice (p<0.01), Trencín (p<0.001) and Zilina (p<0.05) whereas in Chapter IX Zilina region (p<0.01) is implicated. In other Slovak regions standardised rate ratio stagnates. CONCLUSIONS: Standardised rate ratios of age-adjusted mortality rates for the male population compared to the female population are significantly dependent on chapter, sex and region. Standardised rate ratios either decline or stagnate.

Mortality Amenable to Health Care in European Union Countries and Its Limitations.

AIM: The concept of amenable mortality is intended to assess health care system performance. It is defined as "premature deaths that should not occur in the presence of timely and effective health care". The purpose of paper is to analyse differences in amenable mortality across European Union countries and to determine the associations between amenable mortality and life expectancy at birth. METHODS: This is a cross-country and time trend analysis. Data on deaths by cause, and five-year age groups were obtained from the World Health Organization database for the 20 European Union countries, throughout the period from 2002 to 2013. The rates of amenable mortality were expressed by the age-standardised death rates per 100,000 inhabitants. We applied the method of direct standardisation using the European Standard Population. RESULTS: Throughout the explored period, the statistically significant variations of the age-standardised death rates in a relation to the European Union average fluctuated from 78.7 per 100,000 inhabitants (95% CI 72.4-84.9) in France to 374.3 per 100,000 inhabitants (95% CI 350.8-397.7) in Latvia. The leading causes of amenable mortality were ischaemic heart disease, cerebrovascular diseases, and colorectal cancer that accounted for, respectively, 42.2%, 19.5%, and 11.3% of overall amenable mortality. As expected, statistically significant strong negative relationship (R2=0.95; ρ=-0.98) between amenable mortality and life expectancy at birth was proved by linear regression. The concept has several limitations relating to the selection of causes of death and setting age threshold over time, not consideration actually available health care resources in each country, as well as differences in the prevalence of diseases among countries. CONCLUSIONS: We found an explicit divide in amenable mortality rates between more developed countries of Western, Northern and Southern Europe, and less developed countries of Central and Eastern Europe. Increasing of amenable mortality may suggest deterioration in health care system performance.