The COVID-19 pandemic has significantly impacted hematopoietic stem cell transplantation (HSCT), necessitating adaptations across pre-transplant, transplantation, and post-transplant phases. HSCT recipients with compromised immune systems face heightened risks of severe COVID-19 outcomes, including increased mortality. The pandemic prompted significant changes in treatment strategies, with many patients experiencing delays or deferrals in autologous stem cell transplantation (ASCT), alongside adjustments to chemotherapy regimens to prevent disease recurrence. Clinical practices have evolved to address pandemic-related challenges, including a decrease in allo-HSCT procedures, a shift towards using domestic donors and peripheral blood stem cells over bone marrow grafts, and integration of telemedicine to reduce patient burden. These adaptations aim to balance COVID-19 exposure risks with the need for lifesaving HSCT. Innovations in response to the pandemic include stringent infection control measures, modified conditioning regimens, and revised post-transplant care protocols to mitigate infection risks. The importance of optimizing antiviral treatments, exploring new immunomodulatory interventions, and researching broadly neutralizing antibodies for HSCT recipients has been underscored. Despite the difficulties, the pandemic has catalyzed significant learning and innovation in HSCT practices, emphasizing the need for ongoing adaptation and research to protect this vulnerable patient population.

Rubella, or German measles, is a vaccine-preventable disease. Rubella infection is usually mild; however, infection in pregnancy is associated with severe outcomes for the baby, including pregnancy loss or a combination of developmental defects called congenital rubella syndrome. Within the last ten-year period, two cases of congenital rubella syndrome in Saskatchewan were reported to the provincial ministry and the Public Health Agency of Canada of the newborns of mothers who had recently arrived from Sub-Saharan Africa. Both infants had multiple health complications at birth consistent with congenital rubella and tested positive for the rubella virus. The article discusses the challenges encountered by the healthcare system in diagnosing, investigating, monitoring and managing cases of congenital rubella syndrome to prevent further sporadic transmission. The article emphasizes the need to provide additional support for cases and their households, especially new Canadians with less support to comply with public health advice and the importance of routine immunization to eliminate rubella globally.

The application of antimicrobials in aquaculture primarily aims to prevent and treat bacterial infections in fish, but their inappropriate use may result in the emergence of zoonotic antibiotic-resistant bacteria and the subsequent transmission of resistant strains to humans via food consumption. The aquatic environment serves as a potential reservoir for resistant bacteria, providing an ideal breeding ground for development of antimicrobial resistance (AMR). The mutual inter-connection of intensive fish-farming systems with terrestrial environments, the food processing industry and human population creates pathways for the transmission of resistant bacteria, exacerbating the problem further. The aim of this study was to provide an overview of the most effective and available risk mitigation strategies to tackle AMR in aquaculture, based on the One Health (OH) concept. The stringent antimicrobial use guidelines, promoting disease control methods like enhanced farm biosecurity measures and vaccinations, alternatives to antibiotics (ABs) (prebiotics, probiotics, immunostimulants, essential oils (EOs), peptides and phage therapy), feeding practices, genetics, monitoring water quality, and improving wastewater treatment, rather than applying excessive use of antimicrobials, can effectively prevent the development of AMR and release of resistant bacteria into the environment and food. The contribution of the environment to AMR development traditionally receives less attention, and, therefore, environmental aspects should be included more prominently in OH efforts to predict, detect and prevent the risks to health. This is of particular importance for low and middle-income countries with a lack of integration of the national AMR action plans (NAPs) with the aquaculture-producing environment. Integrated control of AMR in fisheries based on the OH approach can contribute to substantial decrease in resistance, and such is the case in Asia, where in aquaculture, the percentage of antimicrobial compounds with resistance exceeding 50% (P50) decreased from 52% to 22% within the period of the previous two decades.

The objectives of this study were to report weight-normalized, sex- and sport-stratified normative values for hamstrings and quadriceps isometric strength in collegiate soccer and basketball players using a low-cost hand-held dynamometer and assess the prevalence of \"substantial\" hamstrings-quadriceps (H/Q) ratio strength imbalance (<0.6) among players. Ninety-four healthy collegiate male and female soccer and basketball players (age range: 18-24 years) were examined for baseline isometric hamstrings and quadriceps strength using a handheld isometric dynamometer with standardized and valid protocols. For soccer, the mean (95%CI) weight-normalized peak isometric strength values (considering dominant limbs) were 3.29 (2.90 to 3.64) N/kg (hamstrings) and 5.48 (4.96 to 6.00) N/kg (quadriceps) in male players and 2.62 (2.39 to 2.85) N/kg (hamstrings) and 4.55 (4.14 to 4.96) N/kg (quadriceps) in female players. For basketball, the mean (95% CI) peak strength values were 2.97 (2.72 to 3.21) N/kg (hamstrings) and 4.89 (4.44 to 5.33) N/kg (quadriceps) in male players and 2.48 (2.15 to 2.80) N/kg (hamstrings) and 4.21 (3.54 to 4.87) N/kg (quadriceps) in female players. The prevalence of substantial H/Q strength imbalance was 37% (95%CI: 24% to 52%) in soccer and 44% (95%CI: 29% to 60%) in basketball players. This study is first to provide normative values for peak isometric hamstrings and quadriceps strength using a low-cost hand-held dynamometer. The normative database from this study is valuable to coaches, sports medicine professionals, exercise scientists and other stakeholders to inform injury prevention, rehabilitation progression, return to play decisions and performance goals in collegiate soccer and basketball players.

The aim of this study was to explore occupational safety in pregnant Croatian healthcare workers (HCWs) during the coronavirus disease 2019 (COVID-19) pandemic. To this end we composed an anonymous questionnaire that included pregnancy data, risk assessment and mitigation, and workplace intervention and distributed it to HCWs through social media of their groups and associations. The study includes a total of 173 respondents (71.1 % physicians, 19.7 % nurses, 9.2 % other HCWs) diagnosed with pregnancy in 2020 and 2021. Employers were notified about HCWs\' pregnancy at the eighth (IQR 7.0-11.0) week of pregnancy, which delayed workplace risk assessment and mitigation beyond the first trimester. Only 19.6 % of the participants had the risk assessed and mitigated, mostly on their own initiative (76.5 %). After notifying employers about pregnancy, 37.0 % of participants opted for temporary work incapacity (TWI) due to \"pregnancy complications\" despite healthy pregnancy, 16.8 % were granted a pregnant worker\'s paid leave at the expense of the employer, while 5.8 % continued to work at the same workplace. Nurses used the TWI benefit more frequently than physicians (58.8 % vs 30.1 %, P=0.004). Our findings suggest that occupational safety of pregnant HCWs in Croatia lacks clear-cut and transparent strategies to protect pregnant HCWs, forcing them to misuse the healthcare system.
Cilj ovog istraživanja bio je istražiti zaštitu na radu trudnih hrvatskih zdravstvenih radnica (ZR) tijekom pandemije koronovirusne bolesti 2019 (COVID-19). U tu smo svrhu sastavili anonimni upitnik koji je uključivao podatke o trudnoći, procjeni i smanjenju rizika te o intervencijama na radnom mjestu i distribuirali ga ZR putem društvenih medija njihovih grupa i udruženja. Istraživanje je obuhvatilo ukupno 173 sudionice (71,1 % liječnice, 19,7 % medicinske sestre, 9,2 % ostale ZR) kojima je dijagnosticirana trudnoća 2020. i 2021. Poslodavci su o trudnoći ZR obaviješteni u osmom (IQR 7,0–11,0) tjednu trudnoće, što je odgodilo procjenu i smanjenje rizika na radnom mjestu nakon prvog tromjesečja. Postupak procjene i smanjenja rizika proveden je u samo 19,6 % sudionica, uglavnom na njihovu inicijativu (76,5 %). Nakon što su poslodavca obavijestile o trudnoći, 37,0 % sudionica koristilo je privremenu nesposobnost za rad (PNR) zbog „komplikacija u trudnoći” unatoč zdravoj trudnoći, 16,8 % odobren je plaćeni dopust trudne radnice na teret poslodavca, dok je 5,8 % nastavilo raditi na istom radnom mjestu. Medicinske sestre koristile su PNR češće nego liječnice (58,8 % prema 30,1 %, P=0,004). Naši rezultati upućuju na nedostatak jasnih i transparentnih strategija zaštite trudnih ZR u Hrvatskoj, što ih prisiljava na zlouporabu zdravstvenog sustava.

Background and aims This research investigates COVID-19 awareness among primary school teachers and staff in Bisha City. It aims to enhance safety protocols by examining knowledge, awareness levels, and demographic associations. Despite school reopening, concerns linger. The study promotes informed decision-making, fostering a safer school environment and contributing to the well-being of the educational community. Methods In an institutional-based cross-sectional study among primary school teachers and administrative staff in Bisha City, our research aimed to comprehensively evaluate awareness regarding specific measures for minimizing COVID-19 risks. With a sample size of 348 participants, we employed a robust methodology, including online questionnaires addressing sociodemographic characteristics and knowledge about COVID-19 risks. The data collection period spanned from March 2022 to December 2023, providing a temporal context for responses. A pilot test ensured questionnaire clarity, and efforts were made to enhance reliability and validity, incorporating validated scales and iterative adjustments based on feedback. Non-response or incomplete responses were handled transparently, with sensitivity analyses to assess potential impact. The awareness level was measured using 17 Likert scale questions, and predefined categories (poor, moderate, and good) facilitated result interpretation. Researcher influence was minimized through training and inter-rater reliability checks. Confidentiality and anonymity were rigorously maintained, adhering to ethical considerations. Statistical analyses employed frequency tables, percentages, mean, standard deviations, and the chi-square test. Dissemination included academic publications, reports to the educational directorate, and presentations at conferences. This holistic approach contributes to the robustness and societal impact of our study, offering insights into COVID-19 awareness among educators in Bisha City. Results In this study assessing awareness among teachers and administrative staff in Bisha City regarding COVID-19 risk minimization, data from 348 respondents revealed key bio-demographic characteristics. The majority demonstrated good knowledge of environmental (83%) and personal hygiene risks (84%). The chi-square test indicated no significant associations between bio-demographic factors and awareness levels. Specifically, for age groups, χ²(4, N = 348) = 5.46, p = 0.707; for gender, χ²(1, N = 348) = 1.95, p = 0.744; for educational levels, χ²(4, N = 348) = 2.13, p = 0.995; for residency, χ²(1, N = 348) = 1.11, p = 0.892; and for job types, χ²(3, N = 348) = 8.30, p = 0.404. The absence of significant associations underscores the potential universality of successful awareness campaigns, suggesting that future efforts can maintain an inclusive approach without tailoring messages. These results emphasize the importance of sustained awareness efforts across the diverse demographic spectrum of the educational community. Conclusion This study reveals robust COVID-19 awareness among primary school teachers and staff in Bisha City, with no significant demographic associations. Successful, inclusive awareness campaigns can further enhance safety measures and promote well-being in the educational community.

BACKGROUND: Hospital sanitation workers (SWs) are exposed to numerous occupational hazards due to workplace conditions such as unsafe and unhygienic working environment in the hospitals. Therefore, knowing magnitude, types and source of occupational hazard exposures with their determinants are very significant for further mitigations.
METHODS: Hospital based cross-sectional study design was conducted in public hospitals, eastern Ethiopia from 1st May to August 30th, 2023. 809 SWs participated. Data was entered into Epi Data Version 3.1 and Stata 17MP version used for analysis. Descriptive analysis was applied to describe the data. While, multilevel logistic regression was explored to determine the association between outcome and independents among at individual level (model 1), at hospitals (model 2) and combination of the two (model 3). The crude odds ratio (COR) and adjusted odds ratio (AOR) for models 2 and 3 were reported. Variables with an AOR with a 95% confidence interval (CI) at a p-value < 0.05 were reported.
RESULTS: Out of 809 SWs, 729 (90.11%) responded. The overall magnitude of self-reported occupational hazard exposures among SWs was 63.65% (95% CI 0.60-0.67). Of this, biological, chemical, and ergonomic hazards accounted for 82.44%, 74.76%, and 70.92%, respectively. The multilevel logistic regression shows that having social recognition (AOR: 0.37, 95% CI 0.14, 0.91), neutral attitude (AOR: 0.48, 95% CI 0.17, 1.41) as compared to negative attitude. The model also found that SWs those supervised could reduce the likelihood of occupational hazard exposures by 50% times (AOR: 0.50, 95% CI 0.18, 1.38) as compared to non-supervised SWs. The final model predicted the variation of occupational hazard exposures among sanitary workers from the hospitals to hospitals was 26.59%.
CONCLUSIONS: The concluded that hospital sanitary workers are facing biological, chemical, ergonomic, physical, psychological, mechanical, and electrical hazards. This study\'s findings predicted that dissatisfied with their environment, working more than 8 hr per a day,  a negative attitude towards workplace risks and inadequate supervision may serve as contributing factors for the likelihood of occupational hazard exposures among these groups. Thus, the study suggested that hospitals could reduce these hazard risks if they implement the Risk Assessment and Safety Management (RASM) model, which includes multi-modal strategies, indicators and tripartite philosophy.

With higher autonomy in maritime systems, tasks and responsibilities are moved from the human operator to software, increasing the complexity and the importance of safe and reliable functionality. Software failures, however, may be introduced from the early life cycle phases intentionally or unintentionally, and these must therefore be mitigated by safe and secure design approaches. A challenge is that existing methods are not particularly well-suited for analyzing software risks. Thus, the objective of this paper is to propose a systematic and efficient software failure identification approach by extending the Systems-Theoretic Process Analysis (STPA) with a software failure taxonomy and the System Modeling Language (SysML). This enables the control structure in STPA to cover both the dynamic and static aspects of the software functions. Combined with an implementation platform independent questionnaire, this gives a more systematic and guided search for potential software failures than existing approaches. To demonstrate the proposed approach, a case study on a ferry\'s navigation system that operates in manual control or semi-autonomous mode is performed. In the case study, the focus is on creating an avoidance map data structure, including both moving and static obstacles to be avoided by the ferry, and the subsequent process of collision risk warning calculation. Software failures are identified and evaluated in collision scenarios where the ferry operates under foggy conditions. The paper shows that the proposed systematic approach provides an improved process for identifying and analyzing critical software failures. This facilitates enhanced risk mitigation in the design and testing phases contributing to autonomous systems\' safety and security.

UNASSIGNED: Due to water scarcity, wastewater is used in agriculture in peri-urban areas.
UNASSIGNED: We aimed to assess the hazards associated with wastewater farming and develop an incremental improvement plan for the sanitation system of wastewater use for agriculture using Sanitation Safety Planning (SSP) in Bangalore urban district, India.
UNASSIGNED: Interviews and observations were conducted among 100 farmers in the Mugalur Gram Panchayat area.
UNASSIGNED: Direct ingestion and ingestion after contact with wastewater due to inadequate hand hygiene are the routes of contact with wastewater. The control measures followed in the community are the cultivation of crops, which do not have direct contact with wastewater, furrow and drip irrigation, and restricted irrigation. Methods to mitigate the hazards are the provision of interval between final irrigation and consumption,washing of produce with freshwater before transportation to market, and hygienic cooking.
UNASSIGNED: Occupational hazards and risks associated with wastewater farming can be mitigated through the adoption of locally acceptable preventive measures.

High levels of lipoprotein(a) [Lp(a)] are causal for atherosclerotic cardiovascular disease (ASCVD). Lp(a) is the most prevalent inherited dyslipidemia and strongest genetic ASCVD risk factor. This risk persists in the presence of at target, guideline-recommended, LDL-C levels and adherence to lifestyle modifications. Epidemiological and genetic evidence supporting its causal role in ASCVD and calcific aortic stenosis continues to accumulate, although various facets regarding Lp(a) biology (genetics, pathophysiology, and expression across race/ethnic groups) are not yet fully understood. The evolving nature of clinical guidelines and consensus statements recommending universal measurements of Lp(a) and the scientific data supporting its role in multiple disease states reinforce the clinical merit to start population screening for Lp(a) now. There is a current gap in the implementation of recommendations for primary and secondary cardiovascular disease (CVD) prevention in those with high Lp(a), in part due to a lack of protocols for management strategies. Importantly, targeted apolipoprotein(a) [apo(a)]-lowering therapies that reduce Lp(a) levels in patients with high Lp(a) are in phase 3 clinical development. This review focuses on the identification and clinical management of patients with high Lp(a). Specifically, we highlight the clinical value of measuring Lp(a) and its use in determining Lp(a)-associated CVD risk by providing actionable guidance, based on scientific knowledge, that can be utilized now to mitigate risk caused by high Lp(a).