An analysis of the PM10 chemical composition and its spatial and seasonal variation in Piedmont (Italy) using Raman spectroscopy.

Particulate Matter (PM) dramatically affects the well-being of a growing global population, particularly in urban areas. While air quality control is an important and pressing issue, particulate matter analysis typically focuses on size distribution and concentration, offering limited insights into chemical composition and pollutant sources. This study analyzes PM10 samples collected from five air quality monitoring stations across the Piedmont region. Specifically, the two of the stations are located in the urban environment of Turin, a city known as one of Europe's most polluted cities. The analysis has been carried out using primarily Raman Spectroscopy (RS) to identify the main PM components, investigate the different PM compositions, and evaluate the chemical and seasonal variations. Scanning Electron Microscopy (SEM) equipped with an Energy Dispersion X-ray spectrophotometer (EDX) has also been used to obtain further information about the elemental composition and the size distribution. Amorphous carbon, nitrate salt, sulfate salt, iron oxides, and quartz are the main compounds found. The results of our study highlight significant differences in the chemical composition of PM10, indicating variations in the sources and characteristics of PM. Notably, higher levels of nitrate and sulfate particles are linked respectively to cold and warm seasons. Whereas, amorphous carbon and iron oxides are associated with distinct geographic features at the sampling sites, such as traffic conditions. These findings emphasize the importance of understanding the different sources and characteristics of PM10 to develop effective air pollution mitigation strategies in the Piedmont region.

Physical Activity and Perceived Support among Adolescents According to Sex and Municipality.

A cross-sectional study was conducted with three aims: (1) to determine the degree of compliance with physical activity recommendations among adolescents according to sex and place of residence, (2) to determine the perceived support of family and friends for physical activity among adolescents according to sex and place of residence, and (3) to analyse the influence of family and friends support on compliance with physical activity recommendations among adolescents according to sex and place of residence. A total of 694 adolescents from an inland area of Spain (14.06 ± 1.27 years) participated. Four one-day physical activity questionnaires were administered to assess physical activity and the Parental Support Scale and Peer Support to measure perceived support from family and friends regarding physical activity. Chi-square, Crammer's V and Student's tests were calculated to identify differences between variables according to sex and municipality of residence. Moreover, the initial binary logistic regression model was constructed to predict the physical activity compliance. Differences in adherence to physical activity recommendations were found according to the sex of the students (rural area: x2 = 4.192, p < 0.05; V = 0.106, p < 0.05; urban area: x2 = 8.999, p < 0.05; V = 0.167, p < 0.01). There were also sex differences in rural areas on items related to families providing transport (t = 3.878, p ≤ 0.001; d = 0.40) and doing physical activity together (t = 4.974, p ≤ 0.001; d = 0.50). It is concluded that most adolescents do not comply with physical activity recommendations. In addition, 30.4% of urban girls' compliance was predicted by the perception that their family members saw them doing physical activity and doing it with friends.

Characteristics of Gaseous Elemental Mercury in a Suburban Area of Shanghai, China.

To clarify gaseous elemental mercury (GEM) in suburban megacities in the Yangtze River Delta region, China, we observed GEM concentrations from December 2019 to November 2020 in Wujing town, a suburban area of Shanghai. The annual mean GEM concentration was 1.44 ± 0.88 ng m-3. Compared with the historical monitoring data of GEM in Shanghai over the past 10 years, the concentration of GEM showed a decreasing trend. The monthly mean concentrations of GEM showed clear seasonal variation, with higher values in the spring and winter. In spring and winter, typical Hg pollution events were observed, which could be mostly associated with increased local anthropogenic activity and temperature inversion. The results of the correlation analysis of the daily mean GEM concentrations with the AQI and backward trajectory calculations indicate that mercury pollution at monitoring sites can be affected by local, regional and interregional influences.

Resurgence of Clinical Malaria in Ethiopia in the Era of Anopheles stephensi Invasion.

Background: The invasion of Anopheles stephensi into Africa poses a potential threat to malaria control and elimination on the continent. However, it is not clear if the recent malaria resurgence in Ethiopia has linked to the expansion of An. stephensi. We aimed to summarize the major achievements and lesson learnt in malaria control in Ethiopia from 2001 to 2022, to assess the new challenges and prospects for the control of An. stephensi. Methods and findings: We obtained the clinical malaria case reports, antimalarial drug treatment records, insecticide-treated and long-lasting insecticidal net (ITN/LLIN) distribution and utilization records, and indoor residual spraying (IRS) coverage data from the Ethiopian Ministry of Health (MoH) for the period 2001-2022. We analyzed clinical malaria hotspots using spatially optimized hotspot analysis. We investigated malaria outbreaks in 2022 and examined the potential role of An. stephensi in the outbreaks.Clinical malaria cases in Ethiopia decreased by 80%, from 5.2 million cases (11% confirmed) in 2004 to 1.0 million cases (92% confirmed) in 2018; however, cases increased steadily to 2.6 million confirmed cases (98% confirmed) in 2022. Plasmodium vivax cases and proportion have increased significantly in the past 5 years. Clinical malaria hotspots are concentrated along the western Ethiopian border areas and have grown significantly from 2017 to 2022. Major malaria outbreaks in 2022/23 were detected in multiple sites across Ethiopia, and An. stephensi was the predominant vector in some of these sites, however, it was absence from many of the outbreak sites. Conclusions: The malaria burden has been significantly reduced in Ethiopia in the past two decades, but in recent years it has increased substantially, and the cause of such increase is a subject of further investigation. Major gaps exist in An. stephensi research, including vector ecology, surveillance, and control tools, especially for adult mosquito control.

Total nitrogen and phosphorus loads in surface runoff from urban land use (city of Lublin) under climate change.

An expansion of impervious surfaces in urban areas leads to increases of nutrient loads discharged with the surface runoff to receivers. A study of a different density of urban development impact on total nitrogen (TN) and phosphorus (TP) loads from the city of Lublin (eastern Poland) with the use of the SWAT (Soil & Water Assessment Tool) model was performed. To distinguish between areas with high and low density of urban development (UHD and ULD), a special analysis of hydrological parameters has been proposed. Moreover, to investigate the impact of climate change, four variant scenarios were taken into account, combining the RCP (representative concentration pathway) 4.5 and 8.5 forecasts and the adopted time horizons (2026-2035 and 2046-2055). The results showed a much higher share of TN and TP from UHD compared to ULD (86%-32 022 kg/year and 89%-2574 kg/year, respectively). In addition, the variant scenarios showed that the forecasted increase in precipitation and temperature will result in increased loads of nutrients from UHD and ULD up to 30%. Furthermore, the current increase of inhabitant number, due to the Ukrainian war migration and the common tendency to convert agricultural land to residential areas, could contribute to further expansion of UHD and ULD areas and an additional increase of nutrient loads.

A comprehensive review of urban microplastic pollution sources, environment and human health impacts, and regulatory efforts.

Microplastic (MP) pollution in urban environments is a pervasive and complex problem with significant environmental and human health implications. Although studies have been conducted on MP pollution in urban environments, there are still research gaps in understanding the exact sources, regulation, and impact of urban MP on the environment and public health. Therefore, the goal of this study is to provide a comprehensive overview of the complex pathways, harmful effects, and regulatory efforts of urban MP pollution. It discusses the research challenges and suggests future directions for addressing MPs related to environmental issues in urban settings. In this study, original research papers published from 2010 to 2024 across ten database categories, including PubMed, Google Scholar, Scopus, and Web of Science, were selected and reviewed to improve our understanding of urban MP pollution. The analysis revealed multifaceted sources of MPs, including surface runoff, wastewater discharge, atmospheric deposition, and biological interactions, which contribute to the contamination of aquatic and terrestrial ecosystems. MPs pose a threat to marine and terrestrial life, freshwater organisms, soil health, plant communities, and human health through ingestion, inhalation, and dermal exposure. Current regulatory measures for MP pollution include improved waste management, upgraded wastewater treatment, stormwater management, product innovation, public awareness campaigns, and community engagement. Despite these regulatory measures, several challenges such as; the absence of standardized MPs testing methods, MPs enter into the environment through a multitude of sources and pathways, countries struggle in balancing trade interests with environmental concerns have hindered effective policy implementation and enforcement. Addressing MP pollution in urban environments is essential for preserving ecosystems, safeguarding public health, and advancing sustainable development. Interdisciplinary collaboration, innovative research, stringent regulations, and public participation are vital for mitigating this critical issue and ensuring a cleaner and healthier future for urban environments and the planet.

Evaluation of a Ground Subsidence Zone in an Urban Area Using Geophysical Methods.

An important geological risk to which many towns in Puglia are exposed is sinking cavities in urban areas. For urban centers, studying, mapping, providing geological and speleological descriptions, classifying, and cataloging the forms and types of cavities is essential because cavities are linked to past local anthropic and natural processes at different sites. These circumstances could lead to the enhancement of existing underground cavities in urban areas through conservation and continuous monitoring. Unfortunately, in many cases, these underground cavities have been used as landfills and subsequently abandoned. In late March 2007, one of these cavities collapsed inside Gallipoli's inhabited center, causing damage to the structures but fortunately not human lives. In the area surrounding the collapsed cavity, a series of geophysical investigations were undertaken using ground penetrating radar in an attempt to delimit the area of collapse and develop possible interventions for restoration. In the same area, these measures were repeated 16 years later in December 2022 due to another collapse. The comparison between data acquired in these two periods shows that there were no strong changes apart from an increased presence of subsoil moisture in 2022.

Ability to pay and catastrophic health expenditure of urban and rural deceased households over the past decade (2009-2018).

INTRODUCTION: Examining the equity of health care and financial burden in households of deceased individuals in urban and rural areas is crucial for understanding the risks to both national and individual household finances. However, there is a lack of research on catastrophic health expenditure (CHE) in these households, specifically in urban and rural contexts. This study aims to identify the ability to pay and equity of CHE for both households of deceased individuals in urban and in rural areas. METHODS: This study analysed data from the Korea Health Panel for 10 years (2009-2018) and targeted 869 deceased individuals and their households in the Republic of Korea (South Korea). Annual household income and living costs were adjusted based on equivalent household size, and the difference between these values represented the household's ability to pay. Out-of-pocket (OOP) expenditure included copayments and uninsured healthcare expenses for emergency room visits, inpatient care, outpatient treatments and prescription medications. CHE was defined as OOP expenditure reaching or exceeding 40% of the household's ability to pay. ANCOVA was performed to control for confounding variables, and the equity of CHE prevalence between urban and rural area was assessed using χ2 analysis. RESULTS: Compared to urban households, the rural households of deceased individuals had, respectively, fewer members (2.7 v 2.4, p=0.03), a higher rate of presence of a spouse (63.8% v 70.7%, p=0.04) and a higher economic activity rate (12.7% v 20.5%, p=0.002). The mean number of comordities before death was 3.7 in both urban and rural areas, and there was no difference in the experience of using over-the-counter medicines for more than 3 months, emergency room, hospitalisation, and outpatient treatment. In addition, annual household OOP expenditures in urban and rural areas were US$3020.20 and US$2812.20, respectively, showing no statistical difference (p=0.341). This can be evaluated as a positive effect of various policies and practices aimed at alleviating urban-rural health equity. However, the financial characteristics of the household of the deceased in the year of death differed decisively between urban and rural areas. Compared to urban households, the annual income of rural households (US$15,673.80 v US$12,794.80, respectively, p≤0.002) and the annual ability to pay of rural households (US$14,734.10 v US$12,069.30, respectively, p=0.03) were lower. As a result, the prevalence of CHE was higher in rural areas than in urban areas (68.3% v 77.6%, p=0.003). CONCLUSION: The findings of this study highlight the higher risk of CHE in rural areas due to the lower income level and ability to pay of the household of the deceased. It is evident that addressing the issue of CHE requires broader social development and policy efforts rather than individual-level interventions focused solely on improving health access and controlling healthcare costs. The findings of this study contribute to the growing evidence that income plays a crucial role in rural health outcomes.

Spatial distribution and environmental correlations of Culex pipiens pallens (Diptera: Culicidae) in Haidian district, Beijing.

Culex pipiens pallens Coquillett, 1898 (Diptera: Culicidae) was the dominant health threat to mosquito species in Beijing, and it is important to unravel the spatial distribution and environmental correlations of Cx. pipiens pallens in Beijing. 3S technology methods and spatial statistics were used to clarify the distribution pattern. Subsequently, linear and spatial regression were performed to detect the environmental factors linked with the density of Cx. pipiens pallens. The same "middle peak" spatial distribution pattern was observed for Cx. pipiens pallens density at the community, subdistrict, and loop area levels in our study area. In addition, there were various correlated environmental factors at the community and subdistrict scales. At the community scale, the summary values of the Modified Normalized Difference Water Index (MNDWI) in 2 km buffer zone (MNDWI_2K) were negatively correlated, and the summary values of Normalized Difference Built-up Index (NDBI) in 800 m buffer zone (NDBI_800) was positively correlated to the Cx. pipiens pallens density. However, the summary values of Normalized Difference Vegetation Index and Nighttime Light Index significantly affected Cx. pipiens pallens density at the subdistrict scale. Our findings provide insight into the spatial distribution pattern of Cx. pipiens pallens density and its associated environmental risk factors at different spatial scales in the Haidian district of Beijing for the first time. The results could be used to predict the Cx. pipiens pallens density as well as the risk of lymphatic filariasis (LF) infection, which would help implement prevention and control measures to prevent future risks of biting and LF transmission in Beijing.

Spatial heterogeneity of the effects of river network patterns on water quality in highly urbanized city.

River water quality deterioration is a serious problem in urban water environments. River network patterns affect water quality by influencing the flow, mixing, and other processes of water bodies. However, the effects of urban river network patterns on water quality remain poorly understood, thereby hindering the urban planning and management decision-making process. In this study, the geographically weighted regression (GWR) model was used to explore the spatial heterogeneity of the relationship between river network pattern and water quality. The results showed that the river network has a complex structure, high connectivity, and relatively even distribution and morphology. Important river structure indicators affecting water quality included the water surface ratio (Wp) and multifractal features (∆α, ∆f) while important river connectivity indicators included circuitry (α) and network connectivity (γ). River structure has a more complex effect on water quality than connectivity. This study recommends that the Wp should be increased in agricultural areas and appropriately reduced in urban built-up areas, and the number of river segments and nodes should be controlled within a rational configuration. Our study provides key insights for evaluating and optimizing the river network patterns to improve water quality of urban rivers. In the future, the land use intensity, hydrological processes, and human activities should be coupled with the river network pattern to deepen our understanding of urban river environment.

Tourist Trampling on a Peripheral Plant Population Restricted to an Urban Natural Area in the Capo Sant'Elia Promontory (Sardinia, W-Mediterranean Basin).

Urban natural areas provide important ecological services such as biodiversity conservation, as well as opportunities for people to connect with nature and preserve cultural heritage. However, the increasing demand for access to natural areas and the expansion of human recreational activities, such as hiking and biking, pose threats to these ecosystems, especially for animal and plant species, finally resulting in biodiversity loss. This study explores the intricate link between human trampling, plant density, and the morphological and reproductive characteristics of Globularia alypum L., a plant with a peripheral population in Sardinia restricted to a natural area within an urban context. The study examined trampling effects on 75 plots along a frequently used path crossing the plant's core population. Similar environmental conditions were assumed, with differences attributed to human trampling intensity and plant density, and morphological and reproductive traits were measured within each plot. Our results showed that human trampling caused differences in the morphological traits of plants, whereas, in contrast, reproductive traits are less vulnerable to human trampling than morphological ones. As a result, trampled areas may experience decreased plant recruitment, which can have long-term implications for plant population dynamics. Understanding the relationship between trampling effects and the sensitivity of peripheral plant populations is crucial for effective conservation and management strategies.

Managing urban agglomeration processes in Russia in the context of agglomerative and socio-economic development.

Studies on urban agglomeration typically focus on the management of urban agglomerations as special types of spatial organization. The problem of finding an adequate management model which accounts for the level of spatial connectivity and socio-economic development of a given territory remains in the background. This article identifies urban agglomeration management models in Russia which account for the agglomerative and socio-economic development of a given territory. A methodology for assessing urban agglomeration processes is presented which, unlike existing methodologies, includes an assessment of agglomeration maturity and an assessment of the socio-economic development of urban agglomerations. This methodology is based on conceptual platforms within spatial development theory; new economic geography; and agglomeration theory and cluster development. The methodology was tested on the data of Chelyabinsk Region agglomerations. The study determined that the Chelyabinsk and Gorniy Ural agglomerations are socio-economically developed and highly agglomerated, while the Magnitogorsk agglomeration shows high socio-economic development and low agglomeration. The conurbations are underdeveloped in both areas. The paper gives several recommendations on methods for choosing urban agglomeration management models. The developed methodology can be used to assess agglomerations across Russia and to choose the most adequate management model for a territory depending on its agglomerative and socio-economic development.

Using dispersion models at microscale to assess long-term air pollution in urban hot spots: A FAIRMODE joint intercomparison exercise for a case study in Antwerp.

In the framework of the Forum for Air Quality Modelling in Europe (FAIRMODE), a modelling intercomparison exercise for computing NO2 long-term average concentrations in urban districts with a very high spatial resolution was carried out. This exercise was undertaken for a district of Antwerp (Belgium). Air quality data includes data recorded in air quality monitoring stations and 73 passive samplers deployed during one-month period in 2016. The modelling domain was 800 × 800 m2. Nine modelling teams participated in this exercise providing results from fifteen different modelling applications based on different kinds of model approaches (CFD - Computational Fluid Dynamics-, Lagrangian, Gaussian, and Artificial Intelligence). Some approaches consisted of models running the complete one-month period on an hourly basis, but most others used a scenario approach, which relies on simulations of scenarios representative of wind conditions combined with post-processing to retrieve a one-month average of NO2 concentrations. The objective of this study is to evaluate what type of modelling system is better suited to get a good estimate of long-term averages in complex urban districts. This is very important for air quality assessment under the European ambient air quality directives. The time evolution of NO2 hourly concentrations during a day of relative high pollution was rather well estimated by all models. Relative to high resolution spatial distribution of one-month NO2 averaged concentrations, Gaussian models were not able to give detailed information, unless they include building data and street-canyon parameterizations. The models that account for complex urban geometries (i.e. CFD, Lagrangian, and AI models) appear to provide better estimates of the spatial distribution of one-month NO2 averages concentrations in the urban canopy. Approaches based on steady CFD-RANS (Reynolds Averaged Navier Stokes) model simulations of meteorological scenarios seem to provide good results with similar quality to those obtained with an unsteady one-month period CFD-RANS simulations.

The mediating effect of perceived stress on the relationship between big five personality traits and suboptimal health status in Chinese population: a nationwide survey in the framework of predictive, preventive, and personalized medicine.

Background: The effects of psychological factors on suboptimal health status (SHS) have been widely described; however, mechanisms behind the complex relationships among the Big Five personality traits and SHS are unclear. Identifying people with specific traits who are susceptible to SHS will help improve life quality and reduce the chronic disease burden under the framework of predictive, preventive, and personalized medicine (PPPM / 3PM). This study investigated the relationships among personality traits and SHS. It also explored whether perceived stress plays a mediating role in SHS development. Method: A nationwide cross-sectional survey based on multistage random sampling was conducted in 148 cities in China between June 20 and August 31, 2022. Personality traits, perceived stress, and SHS were evaluated using the Big Five Inventory-10 (BFI-10), the 4-item Perceived Stress Scale (PSS-4), and the Short-Form Suboptimal Health Status Questionnaire (SHSQ-SF), respectively. Pearson's correlation analysis was employed to examine the associations between personality traits, perceived stress, and SHS. Structural equation modeling (SEM) was used to discern the mediating role of perceived stress in the relationships among personality traits and SHS. Result: A total of 22,897 participants were enrolled in this study, among whom the prevalence of SHS was 52.9%. SHS was negatively correlated with three trait dimensions (i.e., extraversion, agreeableness, and conscientiousness) but positively correlated with neuroticism. Meanwhile, stress was negatively correlated with extraversion, agreeableness, conscientiousness, and openness, whereas it was positively correlated with neuroticism. The SEM results showed that, when adjusting for covariates (i.e., gender, age, BMI, educational level, current residence, marital status, and occupational status), higher agreeableness (ß = - 0.049, P < 0.001) and conscientiousness (ß = - 0.103, P < 0.001) led to lower SHS prevalence, higher neuroticism (ß = 0.130, P < 0.001), and openness (ß = 0.026, P < 0.001) caused SHS to be more prevalent. Perceived stress played a partial mediating role in the relationships among personality traits and SHS, respectively, contributing 41.3%, 35.9%, and 32.5% to the total effects of agreeableness, conscientiousness, and neuroticism on SHS. Additionally, the mediating impact of stress was significant even though extraversion had no direct effect on SHS. Conclusion: This study revealed a high prevalence of SHS in Chinese residents. Personality traits significantly influenced SHS rates, which perceived stress tended to mediate. From a PPPM perspective, early screening and targeted intervention for people with neuroticism (as well as stress alleviation) might contribute to health enhancement and chronic disease prevention. Supplementary Information: The online version contains supplementary material available at 10.1007/s13167-023-00349-x.

Water Framework Directive micropollutant monitoring mirrors catchment land use: Importance of agricultural and urban sources revealed.

River monitoring programs worldwide consistently unveil micropollutant concentrations (pesticide, pharmaceuticals, and industrial chemicals) exceeding regulatory quality targets with deteriorating effects on aquatic communities. However, both the composition and individual concentrations of micropollutants are likely to vary with the catchment land use, in particular regarding urban and agricultural area as the primary sources of micropollutants. In this study, we used a dataset of 109 governmental monitoring sites with micropollutants monitored across the Federal State of North Rhine-Westphalia, Germany, to investigate the relationship between high-resolution catchment land use (distinguishing urban, forested and grassland area as well as 22 different agricultural crop types) and 39 micropollutants using Linear Mixed Models (LMMs). Ecotoxicological risks were indicated for mixtures of pharmaceutical and industrial chemicals for 100 % and for pesticides for 55 % of the sites. The proportion of urban area in the catchment was positively related with concentrations of most pharmaceuticals and industrial chemicals (R2 up to 0.54), whereas the proportions of grassland and forested areas generally showed negative relations. Cropland overall showed weak positive relationships with micropollutant concentrations (R2 up to 0.29). Individual crop types, particularly vegetables and permanent crops, showed higher relations (R2 up to 0.46). The findings suggest that crop type-specific pesticide applications are mirrored in the detected micropollutant concentrations. This highlights the need for high-resolution spatial land use to investigate the magnitude and dynamics of micropollutant exposure and relevant pollution sources, which would remain undetected with highly aggregated land use classifications. Moreover, the findings imply the need for tailored management measures to reduce micropollutant concentrations from different sources and their related ecological effects. Urban point sources, could be managed by advanced wastewater treatment. The reduction of diffuse pollution from agricultural land uses requires additional measures, to prevent pesticides from entering the environment and exceeding regulatory quality targets.

Evaluating Sustainable Mobility: Motorized and Non-motorized Modes in Suburban Areas of Thailand.

The impact of sustainable mobility may be considered through the mode of non-motorization, which may vary by spatial environmental conditions, especially accessibility by active mobility in a necessarily safe, comfortable, and pleasant atmosphere. Sustainable mobility comprises willingness to allow commuting behaviors on non-motorized travel for safety and green ethics. These chiefly participate to create livable places, improve health and well-being, and promote quality of life and economic growth. By contrast, an impoverished street environment decreases the possibility of active mobility and relies on motorization. It is essential to explore the perception of road users through diverse environmental features of street networks and sidewalks directly affecting road user behavior and preferences about motorization and non-motorization. This study evaluated multi-indicators of sustainable urban mobility (SUM) for a group of road users, with data gathered by questionnaire-based survey. 1,998 Pathum Thani Province inhabitants in Thailand were asked to evaluate their neighborhood characteristics by SUM indicators. In addition to different social dimensions and socioeconomic backgrounds, transportation characteristics among diverse trip makers and different perceptions of mobility indicators were classified by factor analysis using principal components and spatial visualization. Results were that traffic management, including intersection controls and signage, as well as information, sidewalk, management, and personal mobility choices, is a key strategy to improve sustainable mobility. This is achieved by tailoring solutions to achieve a modal shift prioritized over other supportive facilities.

Rabies vaccination adherence and associated factors among rabies-exposed patients in Shenzhen, China: a hospital-based cross-sectional study.

Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p<0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients' practice toward rabies prevention is essential for rabies elimination by 2030.

Mosquito (Diptera: Culicidae) Fauna of a Zoological Park in an Urban Setting: Analysis of Culex pipiens s.l. and Their Biotypes.

Mosquito-borne diseases (MBDs) are important emerging diseases that affect humans and animals. Zoological parks can work as early warning systems for the occurrence of MBDs. In this study, we characterized the mosquito fauna captured inside Lisbon Zoo from May 2018 to November 2019. An average of 2.4 mosquitos per trap/night were captured. Five mosquito species potentially causing MBDs, including Culex pipiens biotypes, were found in the zoo. The sympatric occurrence of Culex pipiens biotypes represents a risk factor for the epizootic transmission of West Nile virus and Usutu virus. The mosquito occurrence followed the expected seasonality, with the maximum densities during summer months. However, mosquito activity was detected in winter months in low numbers. The minimum temperature and the relative humidity (RH) on the day of capture showed a positive effect on Culex pipiens abundance. Contrary, the RH the week before capture and the average precipitation the week of capture had a negative effect. No invasive species were identified, nor have flaviviruses been detected in the mosquitoes. The implementation of biosecurity measures regarding the hygiene of the premises and the strict control of all the animals entering the zoo can justify the low prevalence of mosquitoes and the absence of flavivirus-infected mosquitoes.

The impact of integrated care on health care utilization and costs in a socially deprived urban area in Germany: A difference-in-differences approach within an event-study framework.

We investigated the impact of an integrated care initiative in a socially deprived urban area in Germany. Using administrative data, we empirically assessed the causal effect of its two sub-interventions, which differed by the extent to which their instruments targeted the supply and demand side of healthcare provision. We addressed confounding using propensity score matching via the Super Learner machine learning algorithm. For our baseline model, we used a two-way fixed-effects difference-in-differences approach to identify causal effects. We then employed difference-in-differences analyses within an event-study framework to explore the heterogeneity of treatment effects over time, allowing us to disentangle the effects of the sub-interventions and improve causal interpretation and generalizability. The initiative led to a significant increase in hospital and emergency admissions and non-hospital outpatient visits, as well as inpatient, non-hospital outpatient, and total costs. Increased utilization may indicate that the intervention improved access to care or identified unmet need.

Situational Analysis of Barriers to Continuity of End-of-Life Care in Urban Areas, Bangkok.

This qualitative study was designed to describe the continuity of end-of-life care and identify barriers to continuity in urban Bangkok. Continuity of care is considered an essential part of palliative care to promote the quality of life of patients at the end of life. The majority of studies have been conducted exploring continuity of care in rural communities. However, few studies have focused on urban areas, particularly in big cities. Twelve healthcare providers were the participants, including nurses in inpatient units, and in the Health Community and Continuity of Care Unit, a palliative care physician, and social workers. The data collection consisted of individual interviews, field notes, and observations. Content analysis was used to analyze data and identify barriers. The continuity of end-of-life care in a selected setting was fragmented. Three main barriers to the continuity of end-of-life care consisted of misunderstandings about patients who required palliative care, staff workloads, and incomplete patient information. The development of a comprehensive patient information sheet for communication among a multidisciplinary team could promote continuity of end-of-life care from hospital to home. An interprofessional training course on continuity of end-of-life care is also recommended. Finally, the staff workload should be monitored and managed.