Int. J. Environ. Res. Public Health, Volume 15, Issue 11 (November 2018) – 283 articles

Ambient air pollution in terms of fine and coarse particulate matter (PM_2.5 and PM₁₀) has been shown to increase adult and infant mortalities. Most studies have estimated the risk of mortalities through attributable proportions and number of excess cases with no reference to the time lost due to premature mortalities. Disability adjusted life years (DALYs) are necessary to measure the health impact of Ambient particulate matter (PM) over time. In this study, we used life-tables for three years (2014–2016) to estimate the years of life lost (YLL), a main component of DALYs, for adult mortalities (age 30+ years) and postneonatal infant mortalities (age 28+ days–1 year) associated with PM_2.5 exposure and PM₁₀ exposure, respectively. The annual average of PM_2.5 and PM₁₀ concentrations were recorded as 87.9 μg/m³ and 167.5 μg/m³, which are 8 times greater than the World Health Organization (WHO) air quality guidelines of 10 μg/m³ and 20 μg/m³, respectively. Results indicated a total of 252.18 (95% CI: 170.69–322.92) YLL for all ages with an increase of 27,474.61 (95% CI: 18,483.02–35,370.58) YLL over 10 years. The expected life remaining (ELR) calculations showed that 30- and 65-year-old persons would gain 2.34 years and 1.93 years, respectively if the current PM_2.5 exposure levels were reduced to the WHO interim targets (IT-1 = 35 μg/m³). Newborns and 1-year old children may live 79.81 and 78.94 years, respectively with an increase in average life expectancy of 2.65 years if the WHO PM₁₀ interim targets were met (IT-1 = 70 μg/m³). Sensitivity analyses for YLL were carried out for the years 2015, 2025, and 2045 and showed that the years of life would increase significantly for age groups between 30 and 85. Life expectancy, especially for the elderly (≥60 years), would increase at higher rates if PM_2.5 levels were reduced further. This study can be helpful for the assessment of poor air quality represented by PM_2.5 and PM₁₀ exposures in causing premature adult mortalities and postneonatal infant mortalities in developing countries with high ambient air pollution. Information in this article adds insights to the sustainable development goals (SDG 3.9.1 and 11.6.2) related to the reduction of mortality rates attributed to ambient air levels of coarse and fine particulate matter. Full article

The aim of this study was to examine the relationship between main air pollutants and all cancer mortality by performing a meta-analysis. We searched PubMed, EMBASE (a biomedical and pharmacological bibliographic database of published literature produced by Elsevier), and the reference lists of other reviews until April 2018. A random-effects model was employed to analyze the meta-estimates of each pollutant. A total of 30 cohort studies were included in the final analysis. Overall risk estimates of cancer mortality for 10 µg/m³ per increase of particulate matter (PM)_2.5, PM₁₀, and NO₂ were 1.17 (95% confidence interval (CI): 1.11–1.24), 1.09 (95% CI: 1.04–1.14), and 1.06 (95% CI: 1.02–1.10), respectively. With respect to the type of cancer, significant hazardous influences of PM_2.5 were noticed for lung cancer mortality and non-lung cancer mortality including liver cancer, colorectal cancer, bladder cancer, and kidney cancer, respectively, while PM₁₀ had harmful effects on mortality from lung cancer, pancreas cancer, and larynx cancer. Our meta-analysis of cohort studies indicates that exposure to the main air pollutants is associated with increased mortality from all cancers. Full article

Background: The aim of this study was to estimate the prevalence of diabetes mellitus in the Roma population and compare it to the prevalence in the Caucasian population. Methods: Using the words “Roma”, “Gypsies”, “Romani”, and ”traveler” in combination with “diabetes, “metabolic syndrome”, “cardiovascular disease” and “health status” we searched the MEDLINE, Pubmed and Scopus databases for articles in English that focused on the prevalence of diabetes mellitus among Roma populations published until December 2017. Results: Five studies met the inclusion criteria. The results of four of them suggested a higher prevalence of diabetes among Romani compared to Caucasians but none of them reached the standards regarding representative samples and number of cases for a conclusive result. Conclusion: Although some of the existing studies suggest a substantial prevalence of diabetes among Roma populations and even a higher risk of developing diabetes for Roma persons compared to Caucasians, the number of published literature on this topic remains very low and insufficient in design and number of participants to draw any conclusions. Full article

An emerging issue in occupational health and safety (OHS) is that interventions increasingly have to demonstrate that they offer sufficient value for money. To this end, the last decennia have seen more and more economic evaluation methods being employed in this field. However, several recent publications have indicated that many of the published studies suffer from important shortcomings. This paper aims to highlight difficulties in assessing the value of OHS by use of current economic evaluation methods. First, a summary framework presents an overview of the costs and benefits relevant for OHS interventions. Next, three elements from this framework are selected that are at the same time crucial to OHS value, but also challenging to measure and monetise: Effects on worker productivity, ‘intangible’ benefits, such as reputation effects, and the influence of the broader legal–fiscal context in which an intervention takes place. The following sections then discuss the following research questions for each of these elements: Why is it difficult to exclude these factors from OHS economic evaluations? Why do they pose a challenge to the quality of economic evaluations in OHS? How can they be included, and what are the known advantages and disadvantages of the methods to measure these factors? Future work should investigate (and standardise) better methods to include these elements. Full article

Among available home and community-based services in Taiwan, there should be a focus on providing people with people-centered, value-based services. This study aims to follow up the people-centered health outcomes of care recipients and to examine the factors associated with to feedback for policy and practice in long-term care. A total of 9889 persons from the long-term care dataset were followed up for two years (T0–T4). The Cox Proportional Hazard Regression analyses to analyze mortality and the mixed effect models for health outcomes were used. Three classes among the care recipients were identified. Health profiles (HR = 1.46 and 2.56 for FI and FD compared with RI, p < 0.001), subsidy gap (HR = 1.01), and living status (HR = 0.88 for those living with spouse only) had a significant impact on mortality. The overall dropout rate was 52.3% at two years, and the health profiles at baseline significantly influenced the health outcome’s change. The health heterogeneity matters and influences subsequent outcomes. To reach the goal of the HCBS, regular and exact monitoring of care recipients is crucial, while feedback regarding health outcomes and a greater focus on providing person-centered and responsive services in the community are also required. Full article

The aims of this article are to characterize: the quantity of culturable bacterial aerosol (QCBA) and the quality of culturable bacterial aerosol (QlCBA) in an office building in Southern Poland during the spring. The average concentration of culturable bacterial aerosol (CCBA) in this building ranged from 424 CFU m⁻³ to 821 CFU m⁻³, below Polish proposals for threshold limit values. Size distributions were unimodal, with a peak of particle bacterial aerodynamic diameters less than 3.3 μm, increasing potentially adverse health effects due to their inhalation. The spring office exposure dose (SPED) of bacterial aerosol was estimated. The highest value of SPED was in April (218 CFU kg⁻¹), whereas the lowest was in June (113 CFU kg⁻¹). Analysis was undertaken to determine the antibiotic resistance of isolated strains and their ability to form biofilms, which may facilitate the spread of antibiotic resistance genes. In the course of the study, it was found that Staphylococcus xylosus had the greatest ability to form biofilms, while the strains with the highest antibiotic resistance were Micrococcus luteus D and Macrococcus equipercicus. Given that mainly antibiotic-sensitive bacteria from bioaerosol were isolated, which transfers resistance genes to their plasmids, this shows the need for increased monitoring of indoor air quality in workplaces. Full article

Based on frequently used internal partitions in offices, the effects of pollutant source characteristics and an internal partition on airflow and contaminant distribution under different ventilation modes are studied in this paper. The indoor flow field measurement is implemented in a 1:1 single environmental chamber under different ventilation patterns, and then the numerical model is established. The numerical method is verified and analyzed by comparing the measured and simulated results. According to the verification results, the numerical simulation is introduced to study the influence of different supply and return air mixes and pollutant source distributions on the flow field and diffusion performance with an internal partition. The indoor flow field and concentration distribution under different conditions are compared, and the discharge efficiency under different working conditions is analyzed. The results indicate that internal partitions have a greater influence on the down-supply up-return ventilation mode than the floor-supply up-return and top-supply down-return ventilation mode. Furthermore, if the room is zoned, the effect of source position is larger under the down-supply up-return ventilation mode than under the other two modes. Full article

Both periodontal disease (PD) and inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are important diseases of the alimentary tract. Microbiome and immune-mediated inflammatory processes play important roles in these diseases. An association between PD and IBD may exist. This study investigated the risk of IBD in patients with PD. This study used data from the National Health Insurance Research Database of Taiwan from 1996 to 2013. A total of 27,041 patients with PD were enrolled as a study group, and 108,149 patients without PD were selected as the control group after matching by gender, age, insured region, urbanization, and income with a 1:4 ratio. Cox proportional hazards regression was used to calculate the risk of IBD. Of the 135,190 participants enrolled in this study, 5392 (4%) with newly diagnosed IBD were identified. The overall incidence of subsequent IBD was similar in both groups (3.8% vs. 4%, adjusted hazard ratio (aHR) = 1.01, 95% confidence interval (CI): 0.94–1.08). However, an increased risk of UC in the PD group was found after adjusting confounding factors (aHR: 1.56, 95% CI: 1.13–2.15; p < 0.05). This study demonstrated that patients with PD had approximately one-half higher risk of subsequent UC. Further studies are warranted to elucidate the relationship between PD and UC. Full article

This study investigated the accumulation of As, Cd, and Pb in 16 wheat cultivars and the associated health risks for the inhabitants of Jiyuan, China. The results indicated that the concentrations of As, Cd, and Pb decreased in the order of root > leaf > stem > grain. The concentrations of As, Cd, and Pb in wheat grains varied from 0.13 for Pingan8 to 0.34 mg kg⁻¹ for Zhengmai7698, 0.10 for Luomai26 to 0.25 mg kg⁻¹ for Zhengmai7698, and 0.12 for Zhoumai207 to 0.42 mg kg⁻¹ for Zhengmai379, respectively. There were significant differences in the bioaccumulation factors of As, Cd, and Pb among the 16 wheat cultivars. Cd was more readily accumulated to higher levels than As and Pb in wheat. The Target Hazard Quotients (THQs) of Cd and Pb in the grains from 16 wheat cultivars were below 1, while As THQ exceeded 1. The lowest detrimental human health effects via wheat consumption were found in cultivar AY58 among the 16 wheat cultivars, with total THQs (TTHQs) of 1.82 for children and 1.60 for adults, suggesting that children absorb more heavy metals than adults and they are more vulnerable to the adverse effects of these metals. Full article

This work examined the oxidation of Piroxicam (PIR), a representative nonsteroidal anti-inflammatory drug using iron activated persulfate. The effect of persulfate dosing was vital for the efficiency of the process. The addition of 20 mg/L sodium persulfate (SPS) eliminated 500 μg/L of PIR in less than 20 min at natural pH. PIR decomposition followed pseudo-first-order kinetics, and the observed kinetic constant increased by 2.1 times when the initial concentration of PIR decreased from 2000 to 250 μg/L. Acidic pH favored the PIR destruction, while both sulfate and hydroxyl radicals are involved in PIR destruction at natural pH. The effect of inorganic ions like bicarbonate and chlorides was almost insignificant on PIR removal. The presence of humic acid reduced PIR removal from 100% to 67% after 20 min of treatment with 2 mg/L Fe²⁺ and 20 mg/L SPS. The experiment that was performed with bottled water showed similar efficiency with ultrapure water, while in the case of secondary effluent, PIR removal decreased by 26% after 30 min of treatment. The Fe²⁺/SPS/ultrasound hybrid process showed a low degree of synergy (18.3%). The ecotoxicity of aqueous solution using the Vibrio fischeri as an indicator was reduced during the treatment, although with a different trend from the removal of PIR, possibly due to byproducts derived from the oxidation of secondary effluent and PIR. Full article

In many European children, high levels of screen time can be found, which is associated with several adverse health outcomes. Therefore, there is a need for identifying effective intervention strategies that reduce screen time in children. A factor that may contribute to excessive screen time in children may be “co-TV viewing” (i.e., the time that parents and children spend on watching TV together), as parents often recognize the importance of limiting children’s (individual) screen time, but often encourage TV viewing as a family because of its perceived benefits (e.g., educational purposes). The primary aim of this study was to investigate the (sex-specific) association between co-TV viewing and both children’s and parents’ screen time, and these associations were investigated across and within six European countries. In total, 10,969 parents (Mean_age = 40.7 ± 5.3 years, Mean_BMI = 24.4 ± 4.6) of primary school children (Mean_age = 8.2 ± 1.0 years, 49.0% boys, Mean_BMI = 17.3 ± 2.8) completed a questionnaire assessing co-TV viewing and screen time. Multilevel regression analyses were conducted. Across countries, positive associations were found between co-TV viewing and both children’s (β = 11.85, SE = 3.69, p < 0.001) and parents’ screen time (β = 14.47, SE = 4.43, p = 0.001). Similar associations were found in most (but not all) countries. The results suggest that targeting co-TV viewing might be a promising intervention strategy because of its potential to limit screen time of both children and parents. Full article

Impacted by ongoing climate change and anthropogenic activities, large seasonal lakes experience water regime evolution, which raises challenges for the management of water resources and environment. The water regime evolution refers to the spatial and temporal alterations in the hydrological features of lakes. Characterizing the lake water regime and its alteration may help policymakers design effective adaption strategies. Therefore, total 47 hydrological indicators were proposed, considering intra-annual fluctuations, flood and drought features, and rate and frequency of water level variations. Combined with Mann-Kendall algorithm and Sen’s slope, the indicators were applied in Poyang Lake, a typically large seasonal lake in China, as a case study. The results revealed temporal and spatial variations in different hydrological indicators. The most dramatic alteration was the water level decline in October and November over the entire study phase, especially over the past 30 years. This was an urgent environmental problem that Poyang Lake faced, partially caused by the increased hydraulic gradient between southern and northern lake. It could trigger the drought occurring earlier, prolong the drought duration, and impair the wetland ecosystem. Environmental water requirements of both Poyang Lake and Yangtze River were suggested for regional sustainable development. The application in Poyang Lake showed the practicability and reliability of the indicators, which are applicable in international seasonal lakes. The series of indicators can be used in whole or in part, determined by the ecohydrological characters of a specific lake and the research objectives. Full article

Estuarine bank sediments have the potential to support the survival and growth of fecal indicator organisms, including Escherichia coli. However, survival of fecal pathogens in estuarine sediments is not well researched and therefore remains a significant knowledge gap regarding public health risks in estuaries. In this study, simultaneous survival of Escherichia coli and a fecal pathogen, Salmonella enterica serovar Typhimurium, was studied for 21 days in estuarine bank sediment microcosms. Observed growth patterns for both organisms were comparable under four simulated scenarios; for continuous-desiccation, extended-desiccation, periodic-inundation, and continuous-inundation systems, logarithmic decay coefficients were 1.54/day, 1.51/day, 0.14/day, and 0.20/day, respectively, for E. coli, and 1.72/day, 1.64/day, 0.21/day, and 0.24/day for S. Typhimurium. Re-wetting of continuous-desiccated systems resulted in potential re-growth, suggesting survival under moisture-limited conditions. Key findings from this study include: (i) Bank sediments can potentially support human pathogens (S. Typhimurium), (ii) inundation levels influence the survival of fecal bacteria in estuarine bank sediments, and (iii) comparable survival rates of S. Typhimurium and E. coli implies the latter could be a reliable fecal indicator in urban estuaries. The results from this study will help select suitable monitoring and management strategies for safer recreational activities in urban estuaries. Full article

Background: Gallbladder diseases are common in Jilin, China. However, there have been few previous studies on this disease. Our study used the chronic disease database in Jilin Province to study the factors correlated with gallbladder diseases. Methods: A total of 21,435 people were selected from the Jilin Province adult chronic disease survey conducted in 2012. Multistage stratified random cluster sampling was used in this cross-sectional study. Multiple logistic regression analysis was used to explore the independent associations of different factors with gallbladder diseases. Results: There were 1876 people with gallbladder diseases, and the prevalence of the diseases was 8.8% (males 4.4%, females 12.8%). Multivariate logistic regression analysis showed that female (prevalence odds ratio (POR) = 3.13, 95% confidence intervals (CIs): 2.76–3.55), older people (30–45 years (POR = 2.79, 95% CIs: 2.06–3.77), 45–60 years (POR = 4.26, 95% CIs: 3.17–5.73), 60–79 years (POR = 4.72, 95% CIs: 3.48–6.41)), people living in rural areas (POR = 1.65, 95% CIs: 1.49–1.82), smoking (current smoker (POR = 1.15, 95% CIs: 1.01–1.31), former smoker (POR = 1.37, 95% CIs: 1.13–1.66)), high frequency of eating seafood (POR = 0.77, 95% CIs: 0.63–0.93), and high frequency of eating soy products (POR = 0.50, 95% CIs: 0.44–0.58) were associated with gallbladder diseases. Conclusions: We found that there were some factors associated with gallbladder disease, and there needs to be further studies to confirm these associations. Full article

Most soil remediation studies investigated single contaminants or multiple contaminants of the same type. However, in field conditions, soils are often contaminated with potentially both toxic metals and organic pollutants, posing a serious technical challenge. Here, batch experiments were conducted to evaluate the performance of combining in situ solidification/stabilization (ISS) and in situ chemical oxidation (ISCO) for the simultaneous removal of aniline (1000 mg/kg) and Cd (10 mg/kg). All four tested ISS amendments, especially quick lime and Portland cement, promoted in situ chemical oxidation with activated persulfate in contaminated soil. Combined ISS/ISCO remediation effectively removed aniline and reduced the bioavailable Cd content at optimal initial persulfate and ISS amendment concentrations of 1.08 mol/kg and 30 wt% with a seven-day curing time, and significantly reduced leaching. Persulfate inhibited the reduction of the bioavailable Cd content, and ISS amendment with persulfate did not synergistically remediate Cd in co-contaminated soil. Strong alkalinity and high temperature were the main mechanisms driving rapid pollutant removal and immobilization. The reaction of CaO with water released heat, and Ca(OH)₂ formation increased the pH. The relative contributions of heat vs. alkaline activation, as well as the contaminant removal efficiency, increased with ISS amendment CaO content. Combined treatment altered the soil physicochemical properties, and significantly increased Ca and S contents. Activated persulfate-related reactions did not negatively impact unconfined compressive strength and hydraulic conductivity. This work improves the selection of persulfate activation methods for the treatment of soils co-contaminated with both potentially toxic metals and organic pollutants. Full article

This study sought to investigate the efficacy of standardized versus individualized exercise intensity prescription on metabolic syndrome (MetS) severity following a 12-week exercise intervention. A total of 38 experimental participants (47.8 ± 12.2 yr, 170.7 ± 8.0 cm, 82.6 ± 18.7 kg, 26.9 ± 6.7 mL·k⁻¹·min⁻¹) were randomized to one of two exercise interventions (exercise intensity prescribed using heart rate reserve or ventilatory threshold). Following the 12-week intervention, MetS z-score was significantly improved for the standardized (−2.0 ± 3.1 to −2.8 ± 2.8 [p = 0.01]) and individualized (−3.3 ± 2.3 to −3.9 ± 2.2 [p = 0.04]) groups. When separating participants based on prevalence of MetS at baseline and MetS z-score responsiveness, there were six and three participants in the standardized and individualized groups, respectively, with three or more MetS risk factors. Of the six participants in the standardized group, 83% (5/6) of the participants were considered responders, whereas 100% (3/3) of the individualized participants were responders. Furthermore, only 17% (1/6) of the participants with MetS at baseline in the standardized group no longer had symptoms of MetS following the intervention. In the individualized group, 67% (2/3) of participants with baseline MetS were not considered to have MetS at week 12. These findings suggest that an individualized approach to the exercise intensity prescription may ameliorate the severity of MetS. Full article

In this article, we review the available evidence and explore the association between air pollution and insulin resistance (IR) using meta-analytic techniques. Cohort studies published before January 2018 were selected through English-language literature searches in nine databases. Six cohort studies were included in our sample, which assessed air pollutants including PM_2.5 (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm), NO₂(nitrogen dioxide), and PM₁₀ (particulate matter with an aerodynamic diameter less than 10 μm). Percentage change in insulin or insulin resistance associated with air pollutants with corresponding 95% confidence interval (CI) was used to evaluate the risk. A pooled effect (percentage change) was observed, with a 1 μg/m³ increase in NO₂ associated with a significant 1.25% change (95% CI: 0.67, 1.84; I² = 0.00%, p = 0.07) in the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and a 0.60% change (95% CI: 0.17, 1.03; I² = 30.94%, p = 0.27) in insulin. Similar to the analysis of NO₂, a 1 μg/m³ increase in PM₁₀ was associated with a significant 2.77% change (95% CI: 0.67, 4.87; I² = 94.98%, p < 0.0001) in HOMA-IR and a 2.75% change in insulin (95% CI: 0.45, 5.04; I² = 58.66%, p = 0.057). No significant associations were found between PM_2.5 and insulin resistance biomarkers. We conclude that increased exposure to air pollution can lead to insulin resistance, further leading to diabetes and cardiometabolic diseases. Clinicians should consider the environmental exposure of patients when making screening and treatment decisions for them. Full article

Chronic extreme long working hours (LWH) have been found consistently associated with poor health status. However, the evidence for moderately LWH (41–60 h a week) is contradictory. Although poor job quality has been proposed as one of the mechanisms of this relationship, there are almost no studies about LWH and job quality. The objectives of this study were to analyze the association between moderately LWH and job quality in the EU27, as well as to examine differences by welfare regimes and gender. This is a cross-sectional study based on data from the 2010 European Working Conditions Survey. A subsample of employees from the EU27 aged 16–64 years who worked 30–60 h a week was selected (12,574 men and 8787 women). Overall, moderately LWH were not consistently associated with poor job quality except among women from Eastern European countries. Therefore, in the EU27 poor job quality does not seem to explain the relationship between moderately LWH and poor health status. The findings among women from Eastern European countries may be related to their weakened position in the labor market and to their work-family conflict resulting from a process of re-familisation that constrains their choices for a good job. Full article

In the second half of the 20th century, the town of Bakar (Primorje-Gorski Kotar County, Croatia), where a coking plant was operational 1978–1994, experienced intensive industrialisation. The town of Mali Lošinj (Primorje-Gorski Kotar County, Croatia) in this period based its economy on non-industrial sectors. The study goal was comparing mortality characteristics of these populations in the northern Mediterranean for 1960–2012. An ecological study design was used. Data were analysed for 1960–2012 for the deceased with recorded place of residence in the study area. Data on the deceased for 1960–1993 were taken from death reports, for 1994–2012 from digital archives of the Teaching Institute of Public Health, Primorje-Gorski Kotar County. Data on causes of death for 1960–1994 were recoded to the three-digit code of underlying cause of death according to the International Classification of Diseases (ICD–10). Among studied populations significant difference was found among the causes of deaths coded within ICD–10 chapters: neoplasms (particularly stomach carcinoma), mental and behavioural disorders and diseases of the respiratory system (particularly chronic obstructive pulmonary disease, (COPD)). Increase in mortality from neoplasms, increase in respiratory diseases for the area exposed to industrial pollution, also stomach carcinoma and COPD particularly in the town Bakar require further research. Full article

Pesticide exposure has been implicated as a risk factor for developing a wide range of adverse health issues. Some examples are metabolic syndromes, including diabetes. This study investigated the relationship between current occupational use of pesticides and metabolic and cardiovascular biomarker levels among organic and conventional farmers in Thailand. In total, 436 recruited farmers were divided into two groups: conventional farmers (n = 214) and organic farmers (n = 222). Participants, free of diabetes, were interviewed and submitted to a physical examination. Serum samples were collected for clinical laboratory analyses, i.e., serum glucose and lipid profiles (triglycerides, total cholesterol, high-density lipoproteins, and low-density lipoproteins). Potential risk factors such as smoking, alcohol consumption, and heavy exercise were significantly different between the two groups. There were significant differences in terms of the years of pesticide use, pesticide use at home, sources of drinking water, and distance between the farmers’ homes and farms between the groups. After adjusting for confounders, current conventional farmers had significantly higher abnormal body mass index (BMI), waist circumference, body fat percentage (% body fat), triglyceride, total cholesterol, and low-density lipoprotein values as compared to organic farmers. Conventional farmers had higher risk of many metabolic and cardiovascular risk factors as compared to organic farmers, putting them at higher risk of metabolic diseases in the future. Full article

Polycystic ovarian syndrome (PCOS) is thought to be the most common endocrine disorder found in women. Common symptoms include irregular menstrual cycle, polycystic ovaries, and hirsutism, as well as an increased risk for a multitude of conditions, including insulin resistance, dyslipidemia and infertility. The prevalence of polycystic ovarian syndrome is generally thought to be between 3% and 10% but it is widely unknown for specific subpopulations based on geographical location and race/ethnicity. Based on the high degree of variability and inconsistencies between the different diagnostic criteria, there is a unique challenge that exists when determining the prevalence of this syndrome. There are a large percentage of individuals that remain undiagnosed even after visiting multiple health care providers. Most studies conducted across the world are limited by small sample size, selection bias, and lack of comparability across studies. There have been very few studies that have examined the prevalence of polycystic ovary syndrome across the United States. Based on the National Institutes of Health (NIH)’s diagnostic criteria, there is a similar prevalence of PCOS documented across the United States, the United Kingdom, Spain, Greece, Australia, and Mexico. Other studies have shown some differences between geographical location and race. The existing data is not conclusive enough to determine whether or not there is any significant differences in the prevalence of PCOS across geographical location, racial or ethnic groups. This review will seek to determine the prevalence of polycystic ovarian syndrome based on geographical location and race/ethnicity. Full article

The Cold Weather Plan (CWP) in England was introduced to prevent the adverse health effects of cold weather; however, its impact is currently unknown. This study characterizes cold-related mortality and fuel poverty at STP (Sustainability and Transformation Partnership) level, and assesses changes in cold risk since the introduction of the CWP. Time series regression was used to estimate mortality risk for up to 28 days following exposure. Area level fuel poverty was used to indicate mitigation against cold exposure and mapped alongside area level risk. We found STP variations in mortality risk, ranging from 1.74, 1.44–2.09 (relative risk (RR), 95% CI) in Somerset, to 1.19, 1.01–1.40 in Cambridge and Peterborough. Following the introduction of the CWP, national-level mortality risk declined significantly in those aged 0–64 (1.34, 1.23–1.45, to 1.09, 1.00–1.19), but increased significantly among those aged 75+ (1.36, 1.28–1.44, to 1.58, 1.47–1.70) and for respiratory conditions (1.78, 1.56–2.02, to 2.4, 2.10–2.79). We show how spatial variation in cold mortality risk has increased since the introduction of the CWP, which may reflect differences in implementation of the plan. Combining risk with fuel poverty information identifies 14 STPs with the greatest need to address the cold effect, and that would gain most from enhanced CWP activity or additional intervention measures. Full article

An aquatic surface microlayer covers more than 70% of the world’s surface. Our knowledge about the biology of the surface microlayer of Lake Baikal, the most ancient lake on Earth with a surface area of 31,500 km², is still scarce. The total bacterial abundance, the number of cultured heterotrophic temporal bacteria, and the spatial distribution of bacteria in the surface microlayer and underlying waters of Lake Baikal were studied. For the first time, the chemical composition of the surface microlayer of Lake Baikal was determined. There were significant differences and a direct relationship between the total bacterial abundance in the surface microlayer and underlying waters of Lake Baikal, as well as between the number of cultured heterotrophic bacteria in studied water layers in the period of summer stratification. In the surface microlayer, the share of cultured heterotrophic bacteria was higher than in the underlying waters. The surface microlayer was characterized by enrichment with PO₄³⁻, total organic carbon and suspended particulate matter compared to underlying waters. A direct relationship was found between the number of bacteria in the surface microlayer and environmental factors, including temperature, total organic carbon and suspended particulate matter concentration. Full article

Objective: We examine obese and non-obese patients with respect to Helicobacter pylori (H. pylori) positive-infection (HPPI) and associated factors, specifically body mass index (BMI). Methods: This study took place in the Department of Endoscopy of a central hospital in the Najran region of Saudi Arabia (SA). A total of 340 obese Saudi patients (BMI ≥ 30 kg/m²) who had undergone diagnostic upper endoscopy before sleeve gastrectomy, were compared with 340 age and gender-matched control patients (BMI < 30 kg/m²) who had undergone diagnostic upper endoscopy for other reasons. Data collected included diagnosis of HPPI. Descriptive and multivariable binary logistic regression was conducted. Results: Mean patient age was 31.22 ± 8.10 years, and 65% were males. The total prevalence of HPPI was 58% (95% CI = 54–61%) with obese patients presenting significantly more HPPI than non-obese patients (66% vs. 50%, OR = 1.98, 95% CI = 1.45–2.70, p < 0.0005). Age and gender did not associate significantly with HPPI (p = 0.659, 0.200, respectively) and increases in BMI associated significantly with increases in HPPI (p < 0.0005). BMI remained a significant factor in HPPI when modelled with both age and gender (OR = 1.022, 95% CI = 1.01–1.03, p < 0.0005). Conclusions: Within the limitations of this study, the significance of HPPI in obese Saudi patients residing in the Najran region in SA was demonstrated alongside the significance role of BMI in HPPI. Full article

Achieving high efficiency of biological waste treatment in mechanical–biological treatment (MBT) plants requires reliable methods for measuring the degree of biodegradation of organic substances. For this purpose, several physical, chemical, and biological indices are used. This paper presents respirometric activity (AT4), biogas potential (GB21), total and dissolved organic carbon (TOC and DOC, respectively), and loss on ignition (LOI) values, as well as the correlations between the indices selected for stabilized waste produced in 18 MBT plants in Poland, which use various technologies for biological processing of the organic fraction of municipal solid waste. The study confirms that there is a linear relationship between AT4 and GB21 for stabilized waste produced in MBT plants, regardless of the waste treatment technology used. It has also been found that there is a linear relationship between AT4 and the concentration of dissolved carbon in water extract from stabilized waste. This indicates that DOC can be used for monitoring the organic matter stabilization process in mechanical–biological waste treatment plants. Its advantage is a shorter time needed for measurements in comparison to AT4 and GB21 tests. Full article

Inappropriate grazing management is one of the most common causes of grassland degradation, and thus, an assessment of soil properties under different grazing intensities is critical for understanding its effects on ecosystem nutrient cycling and for formulating appropriate management strategies. However, the responses of certain main elements, including soil carbon, nitrogen, and phosphorus, to grazing in alpine meadow ecosystems remain insufficiently clarified. Here, we measured carbon, nitrogen, and phosphorus contents in the topmost 30 cm of soil in an alpine meadow under three grazing intensities (light, moderate, and heavy) and found clear differences in soil physical and chemical properties among different grazing intensities and soil layers. As grazing intensity increased, soil water content, carbon and nitrogen contents and stocks, and carbon to phosphorus and nitrogen to phosphorus ratios decreased, whereas soil bulk density increased. However, soil phosphorus and carbon to nitrogen ratio remained stable. Our findings highlight the negative impacts of heavy grazing intensity, in terms of soil carbon and nitrogen loss and phosphorus mineralization. Moreover, we emphasize that further related studies are necessary to gain a more comprehensive understanding of the effects of grazing on grassland ecosystems, and thereby provide information for sustainable management practices and eco-compensation policies. Full article

This study analyzed the finger temperatures of poultry slaughterhouse workers and its association with personal and organizational variables, bodily discomfort perception, and cold thermal sensation. The study included 143 poultry slaughterhouse workers. A thermograph was used to measure finger temperature and an interview to collect worker data. There were two groups: workers who used a tool and those without. The binary logistic regression, Friedman and Wilcoxon tests were used (p ≤ 0.05). Most workers presented at least one finger with an average temperature ≤15 °C (66.4%) and ≤24 °C (99.3%), perceived their cold hands, and wore three overlapping gloves (57.3%). There were no associations between finger temperatures (≤15 °C) and the analyzed variables. The chance of feeling cold for a worker who used a tool was greater than for a worker who did not (OR = 3.19, 95% CI 1.46; 6.94). There was a difference between the finger temperatures of each hand on both surfaces and the analyzed groups (p < 0.01). The temperature of each finger with its respective contralateral was different in the little fingers (no tool), index, middle, ring, and little fingers (using a tool) (p < 0.05). The use of several overlapping gloves was not sufficient to promote thermal insulation of the hands. Full article

Water resources are fundamental for the social and economic development of a country and sustainability is the best approach to treat water-related problems. Therefore, sustainability studies of water resources are deemed urgent. Sustainability analysis methods should enable space-temporal monitoring, decision-making, and development of policies necessary for water governance. Furthermore, sustainability analysis methods should also integrate environment and socioeconomic variables into a single system. In this context, this study aimed to assess the water sustainability conditions of the River Grande Basin (BHRG), Brazil, before the implementation of the Integrated Water Resources Plan (IWRP), using the Barometer of Sustainability tool (BS). The River Grande basin was in an “almost unsustainable” condition and under high environmental stress. A significant imbalance between environmental and human well-being in the system was also observed. To achieve an acceptable sustainability condition, it is thus necessary to improve the environmental quality of the area. Among the priority thematic area, native vegetation recovery was the most urgent. Overall, the sustainability study based on the BS not only facilitates comprehension regarding environment and human interrelationships, but also provide references for policy formulations and water management. Full article

Previous research has found churches to be effective at delivering physical activity (PA) programs to their congregants. Mosques, however, have not been extensively studied. Therefore, we quantified U.S. Islamic centers’ advertisement of PA programming and examined their programming characteristics. We conducted a content analysis of the websites of 773 eligible Islamic centers of which 206 centers in 32 states advertised PA programming. We categorized PA by program type: camping, fitness classes, sports, youth programs, and irregular offerings. We calculated descriptive statistics by program type for specific activity, frequency/duration/volume, participant/instructor sex, and instructor religion. Youth group (44%) and sports (23%) programs were most and least frequently advertised, respectively. Most centers (66%) that posted information on PA programming advertised only one program type. Men and Muslims taught most activities. Most activities—except for fitness classes—were advertised to a male audience. Islamic centers should offer and advertise additional PA programming—especially for women—and better utilize their websites for promoting such programming. Individual Islamic centers and Islamic- and non-religion based public health agencies can utilize our findings to fashion future PA offerings. Full article

The role of carbon pool of biochar as a method of long-term C sequestration in global warming mitigation is unclear. A two-year field study was conducted to investigate the seasonal variations of CO₂ emissions from water-saving irrigation paddy fields in response to biochar amendment and irrigation patterns. Three biochar treatments under water-saving irrigation and one biochar treatment under flooding irrigation were studied, and the application rates were 0, 20, 40, and 40 t ha⁻¹ and labeled as CI + NB (controlled irrigation and none biochar added), CI + MB (controlled irrigation and medium biochar added), CI + HB (controlled irrigation and high biochar added), and FI + HB (flood irrigation and high biochar added), respectively. Results showed that biochar application at medium rates (20 t ha⁻¹) decreased CO₂ emissions by 1.64–8.83% in rice paddy fields under water-saving irrigation, compared with the non-amendment treatment. However, the CO₂ emissions from paddy fields increased by 4.39–5.43% in the CI + HB treatment, compared with CI + NB. Furthermore, the mean CO₂ emissions from paddy fields under water-saving irrigation decreased by 2.22% compared with flood irrigation under the same amount of biochar application (40 t ha⁻¹). Biochar amendment increased rice yield and water use efficiency by 9.35–36.30% and 15.1–42.5%, respectively, when combined with water-saving irrigation. The CO₂ emissions were reduced in the CI + MB treatment, which then increased rice yield. The CO₂ emissions from paddy fields were positively correlated with temperature. The highest value of the temperature sensitivity coefficient (Q₁₀) was derived for the CI + MB treatment. The Q₁₀ was higher under water-saving irrigation compared with flooding irrigation. Full article