Domestic and international risk shocks have greatly increased the demand for systemic risk management in China. This paper estimates China\'s multi-layer financial network based on multiple financial relationships among banks, assets, and firms, using China\'s banking system data in 2021. An improved PageRank algorithm is proposed to identify systemically important banks and other economic sectors, and a stress test is conducted. This study finds that China\'s multi-layer financial network is sparse, and the distribution of transactions across financial markets is uneven. Regulatory authorities should support economic recovery and adjust the money supply, while banks should differentiate competition and manage risks better. Based on the PageRank index, this paper assesses the systemic importance of large commercial banks from the perspective of network structure, emphasizing the role of banks\' transaction behavior and market participation. Different industries and asset classes are also assessed, suggesting that increased attention should be paid to industry risks and regulatory oversight of bank investments. Finally, stress tests confirm that the improved PageRank algorithm is applicable within the multi-layer financial network, reinforcing the need for prudential supervision of the banking system and revealing that the degree of transaction concentration will affect the systemic importance of financial institutions.

Poor management of fecal sludge (FSM) presents significant risks to public health and the environment. This study employed qualitative and quantitative data collection methods, along with the Shit Flow Diagram (SFD) data analyzing tool to investigate FSM patterns in Kombolcha town, Ethiopia. The findings indicate that 75.7% of housing unites in the town are shared toilets, with multiple households sharing a single facility. The primary toilet technologies used include cistern flush toilets (2.1%), pour/manual flush toilets (19.8%), ventilated improved pit latrines (11.1%), pit latrines with slabs (56.4%), and pit latrines without slabs (10.6%). However, 98.5% of these toilet types had either unlined or only partially lined containments. Furthermore, only 37% of households practice safe pit or sludge tank emptying. As a result, only 17% of fecal sludge goes through the sanitation value chain and is effectively treated, while 39% remains onsite and unemptied, and the remaining 44% is disposed of in a manner that poses risks to the environment and public health. The study highlights the significant public health and environmental risks associated with the high reliance on shared toilets, the prevalence of inadequately lined toilet types, and the low adoption of proper fecal sludge management practices. Addressing these challenges requires the implementation of sanitation bylaws and building code regulations that prioritize hygienic standards and promote improved toilet technologies.

Exposure to endocrine-disrupting chemicals (EDCs) has been linked to various immune deficiency disorders, including autoimmune diseases like Sjögren Syndrome (SjS). However, the detrimental effects of exposure to EDCs, including bisphenols, parabens, and triclosan (TCS), on SjS have been inadequately documented. Thus, we conducted a cross-sectional study that included both healthy individuals (controls) and patients with SjS (cases). We assessed serum concentrations of bisphenol A (BPA), bisphenol S (BPS), methyl parabens (MeP), ethyl parabens (EtP), and TCS. The relationship between the five EDCs levels and the risk of SjS was also explored. Additionally, we conducted an in-depth analysis of the collective influence of these EDCs mixtures on SjS, employing a weighted quantile sum regression model. Out of the five EDCs analyzed, EtP displayed the highest mean concentration (2.80 ng/mL), followed by BPA (2.66 ng/mL) and MeP (1.99 ng/mL), with TCS registering the lowest level (0.36 ng/mL). Notably, BPS exposure was significantly positively associated with the risk of being diagnosed with SjS (with an odds ratio [OR] of 1.17, p = 0.042). No statistically significant associations with SjS were observed for BPA, MeP, EtP, and TCS (p > 0.05). And we did not observe any significant effects of the EDCs mixture on SjS. To the best of our knowledge, this study is the first to suggest that BPS may potentially increase the risk of SjS. Although no significant effects were observed between other EDCs and SjS risk, we cannot disregard the potential harm of EDCs due to their non-monotonic dose response.

Polyphosphates (PPs) constitute a class of food additives widely used due to their ability to exercise different useful activities. The food safety concern about the use of PPs in food is both the possible non-declared addition and some health effects, such as bile duct stones, decrease in oligo-element absorption, and allergic reactions in susceptible people. In this study, an analytical method based on ion chromatography with conductivity detection was applied for the detection and quantification of PPs in 238 samples of animal-derived products such as meat, dairy, and fish products. A contribution to risk assessment was also included. The monitoring confirmed the absence of non-compliant results. All concentrations of PPs were indeed lower than the legal limits set in European Regulation No. 1333/2008. Moreover, no residue of PPs was detected (> limit of quantification: 0.09 g kg-1) in samples where it was not reported on the product label. No PPs were detected in mollusks, meat-based preparations, semi-ripened, unripened, and spun paste cheese, while they are widely used in surimi, with concentrations in the range of 0.1-0.5 g kg-1. The highest concentrations were quantified in a würstel sample (4.7±0.3 g kg-1) and a spreadable cheese sample (8.9±0.7 g kg-1). Considering that the high exposure scenario together with a very susceptible population group (toddlers) were taken into account for this risk exposure study and that the highest admissible daily intake obtained was equal to 10.4%, the assessment demonstrated that the actual use of PPs in food does not pose a risk for food safety.

Cutting boards can serve as potential carriers for the cross-contamination of pathogens from chicken to other surfaces. This study aimed to assess chefs\' handling practices of cutting boards across five provinces in China and identify the key factors contributing to unsafe cutting board usage, including cleaning methods and handling practices. Handling practices associated with cutting boards were examined through a web-based survey (N = 154), while kitchen environment tests were conducted to investigate the splashing or survival of Campylobacter, inoculated in chicken or on cutting boards, to mimic the practices of chefs. Among chefs in the five provinces of China, wood and plastic cutting boards were the most commonly used for preparing chicken meat. Approximately 33.7% of chefs washed boards with running tap water, 31.17% of chefs washed boards with detergent, and 24.03% of chefs cleaned boards by scraping them with a knife after preparing other meats or chicken. The study tested 23 cutting boards from commercial kitchens for Campylobacter presence before and after chicken preparation and cleaning. Among these, 17 were cleaned with a knife, 5 with running tap water, and only 1 with disinfectant. Results showed that cleaning with a knife significantly reduced Campylobacter presence on cutting boards (p < 0.05), while the three main cleaning methods were inadequate in eliminating contamination to a safe level. In kitchen environment tests, contaminated chicken was chopped on cutting boards, with a maximum distance of 60 cm for low contamination, and 120 cm for medium and high contamination levels. This suggested a contamination risk exposure area ranging from 60 cm to 120 cm. Campylobacter survival on surfaces of wood, plastic, and stainless steel was also tested, with plastic surfaces showing the longest survival time (4.5 h at 15 °C and 3.5 h at 25 °C) In comparison, survival time on stainless steel or wood surfaces was only 3 h, implying a cross-contamination risk exposure period of 3 to 4.5 h after chicken preparation. In conclusion, based on the current study data, the practices employed by chefs play an important role in Campylobacter transfer in the kitchen environment. The presence of Campylobacter on cutting boards even after wiping or droplet splashing highlights its potential as a source of cross-contamination in the kitchen environment. So, chefs in China should reinforce their hygiene culture and adopt effective cutting board cleaning practices to prevent pathogen contamination.

BACKGROUND: The increasing use of minimally invasive orthopedic procedures has led to a greater reliance on fluoroscopy, resulting in elevated radiation exposure for surgeons. This study aimed to evaluate the knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in an academic hospital. Understanding radiation safety is crucial to minimize patient exposure and prevent adverse effects on surgeons.
METHODS: This cross-sectional study was conducted at the Department of Orthopedics of different tertiary care hospitals in Rawalpindi, Pakistan. Data were collected prospectively for two years, and a total of 505 participants, including residents, consultants, and operation theatre assistants, completed a questionnaire. The questionnaire was validated by experts and covered information on fluoroscopy usage, frequency of surgeries, awareness of radiation safety, and protective measures. Ethical approval was obtained, and data were analyzed using SPSS version 26.0.
RESULTS: The majority of participants were male (74.1%), and the sample included various ranks of orthopedic surgeons. Only 56.2% of participants were aware of the usage of fluoroscopy, and 40.2% had read some research on the topic. While 44.6% used lead aprons for radiation protection, the usage of other protective measures and dosimeters was limited. The mediation analysis showed an insignificant indirect association between the rank of orthopedic surgeons, number of surgeries performed, and fluoroscopy usage as a mediator. Awareness and reading research on fluoroscopy were significantly associated with radiation protection.
CONCLUSIONS: The knowledge, awareness, and daily practices of orthopedic surgeons regarding radiation safety in fluoroscopy use need improvement. The findings emphasize the importance of implementing training programs, providing radiation protection devices, and ensuring compliance with safety guidelines.

BACKGROUND: Childhood malnutrition is a major public health issue in Sub-Saharan Africa (SSA) and 61.4 million children under the age of five years in the region are stunted. Although insight from existing studies suggests plausible pathways between ambient air pollution exposure and stunting, there are limited studies on the effect of different ambient air pollutants on stunting among children.
OBJECTIVE: Explore the effect of early-life environmental exposures on stunting among children under the age of five years.
METHODS: In this study, we used pooled health and population data from 33 countries in SSA between 2006 and 2019 and environmental data from the Atmospheric Composition Analysis Group and NASA\'s GIOVANNI platform. We estimated the association between early-life environmental exposures and stunting in three exposure periods - in-utero (during pregnancy), post-utero (after pregnancy to current age) and cumulative (from pregnancy to current age), using Bayesian hierarchical modelling. We also visualise the likelihood of stunting among children based on their region of residence using Bayesian hierarchical modelling.
RESULTS: The findings show that 33.6% of sampled children were stunted. In-utero PM2.5 was associated with a higher likelihood of stunting (OR = 1.038, CrI = 1.002-1.075). Early-life exposures to nitrogen dioxide and sulphate were robustly associated with stunting among children. The findings also show spatial variation in a high and low likelihood of stunting based on a region of residence.
UNASSIGNED: This study explores the effect of early-life environmental exposures on child growth or stunting among sub-Saharan African children. The study focuses on three exposure windows - pregnancy, after birth and cumulative exposure during pregnancy and after birth. The study also employs spatial analysis to assess the spatial burden of stunted growth in relation to environmental exposures and socioeconomic factors. The findings suggest major air pollutants are associated with stunted growth among children in sub-Saharan Africa.

UNASSIGNED: COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress.
UNASSIGNED: This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak.
UNASSIGNED: This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress.
UNASSIGNED: This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress (B = 0.551, 95% CI: -0.019, 1.121; B = 2.161, 95% CI: 1.067, 3.255; B = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress (B = 0.217, 95% CI: 0.036, 0.398; B = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress (B = -0.180, 95% CI: -0.362, 0.002; B = -0.187, 95% CI: -0.404, 0.030).
UNASSIGNED: These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public\'s perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.

Nitrite and nitrate are well-known food additives used in cured meats and linked to different food safety concerns. However, no study about the possible effect of cooking treatment on the residual level of these compounds before consumption is available. In this work, 60 samples of meat products were analyzed in order to evaluate the variation in residual nitrite and nitrate level after baking, grilling and boiling. The analyses by ion chromatography demonstrated that meat cooking leads to a decrease in nitrite and an increase in nitrate residual levels in the final products. Meat boiling caused an overall decrease in two additives\' concentration, while baking and particularly grilling caused an increase in nitrate and, in some cases, nitrite as well. Some regulatory aspects were also considered, such as the possibility of revising the legal limit of nitrate from the actual 150 mg kg-1 to a more cautious 100 mg kg-1. Indeed, several meat samples (bacon and swine fresh sausage) resulted in a higher nitrate concentration than the legal limit after cooking by grilling (eleven samples) or baking (five samples). Finally, the Margin of Safety evaluation demonstrated a good level of food safety, all values being higher than the protective threshold of 100.

Pesticides are widely used in Ghana, especially in cocoa farming. However, the practice is suboptimal and unsupervised. Incorrect use of these chemicals can seriously harm human health, the environment, and economies that rely on these farmers\' output. The study assessed cocoa farmers\' pesticide knowledge, practices, and risk perception. Four hundred and four cocoa farmers were chosen randomly from 26 communities in four cocoa-growing regions of Ghana to answer questions about their risk knowledge, awareness, and practices, including personal protective equipment, storage and disposal of leftover pesticides, and used containers. The study revealed that 87% of the respondents belonged to cooperatives and certification groups. There was a significant positive relationship between group membership and benefits derived from inputs and training in pesticide use. About 70% of insecticides used were approved by the Ghana Cocoa Board, with neonicotinoids and pyrethroids being the most highly used insecticide classes in cocoa farms. Although farmers claimed adequate pesticide knowledge, this did not translate into practice, with the majority exhibiting improper pesticide storage, application, and disposal practices. Farmers appeared to know a lot but lacked the skills and attitude to put their knowledge to use. The improper practices appear to manifest in a variety of health symptoms experienced by farmers as a result of chemical exposure. The findings from this study suggest that cocoa farmers in Ghana require adequate practical training and support on pesticide use to reduce their associated health risks, protect the environment and ensure sustainable cocoa production in the world\'s second-largest cocoa bean exporter.