Health Risk Assessment of Employees Exposed to Chlorination By-products of Recreational Water in Large Amusement Parks in Shanghai

Objective Chlorination is often used to disinfect recreational water in large amusement parks;however,the health hazards of chlorination disinfection by-products(DBPs)to occupational populations are unknown.This study aimed to assess the exposure status of chlorinated DBPs in recreational water and the health risks to employees of large amusement parks.Methods Exposure parameters of employees of three large amusement parks in Shanghai were investigated using a questionnaire.Seven typical chlorinated DBPs in recreational water and spray samples were quantified by gas chromatography,and the health risks to amusement park employees exposed to chlorinated DBPs were evaluated according to the WHO's risk assessment framework.Results Trichloroacetic acid,dibromochloromethane,bromodichloromethane,and dichloroacetic acid were detected predominantly in recreational water.The carcinogenic and non-carcinogenic risks of the five DBPs did not exceed the risk thresholds.In addition,the carcinogenic and non-carcinogenic risks of mixed exposure to DBPs were within the acceptable risk limits.Conclusion Typical DBPs were widely detected in recreational water collected from three large amusement parks in Shanghai;however,the health risks of DBPs and their mixtures were within acceptable limits.

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

Health risk assessment of trace metal(loid)s in agricultural soils based on Monte Carlo simulation coupled with positive matrix factorization model in Chongqing, southwest China

This study aimed to investigate the pollution characteristics, source apportionment, and health risks associated with trace metal(loid)s(TMs) in the major agricultural producing areas in Chongqing, China. We analyzed the source apportionment and assessed the health risk of TMs in agricultural soils by using positive matrix factorization(PMF) model and health risk assessment(HRA) model based on Monte Carlo simulation. Meanwhile, we combined PMF and HRA models to explore the health risks of TMs in agricultural soils by different pollution sources to determine the priority control factors. Results showed that the average contents of cadmium(Cd), arsenic (As), lead(Pb), chromium(Cr), copper(Cu), nickel(Ni), and zinc(Zn) in the soil were found to be 0.26, 5.93, 27.14, 61.32, 23.81, 32.45, and 78.65 mg/kg, respectively. Spatial analysis and source apportionment analysis revealed that urban and industrial sources, agricultural sources, and natural sources accounted for 33.0%, 27.7%, and 39.3% of TM accumulation in the soil, respectively. In the HRA model based on Monte Carlo simulation, noncarcinogenic risks were deemed negligible(hazard index <1), the carcinogenic risks were at acceptable level(10^(-6)<total carcinogenic risk ≤ 10^(-4)), with higher risks observed for children compared to adults. The relationship between TMs, their sources, and health risks indicated that urban and industrial sources were primarily associated with As, contributing to 75.1% of carcinogenic risks and 55.7% of non-carcinogenic risks, making them the primary control factors. Meanwhile, agricultural sources were primarily linked to Cd and Pb, contributing to 13.1% of carcinogenic risks and 21.8% of non-carcinogenic risks, designating them as secondary control factors.

Assessment of Satisfaction in the Reception and Emergency Department of a Health Center

Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.

Health Assessment of Typical Reservoirs in Eastern Jilin: A Case Study of Niligou Reservoir

Niligou Reservoir,a typical reservoir in the eastern region of Jilin Province,is subordinate to Niligou River,which is located in the Changbai Mountains in eastern Jilin,with abundant plant and animal resources and well protected biodiversity in the basin,but there are also some related problems such as fragile ecosystem of forest wetland.This paper carried out a health assessment of Niligou River,including water quality monitoring,aquatic organism monitoring,and riparian zone investigation.According to the requirements of the Technical Guidelines for River and Lake Health Assessment,13 assessment indexes were selected to build a river and lake health assessment index system.By sorting and analyzing the monitoring and investigation data,we got a clear picture of the ecological environment status and existing problems of Niligou Res-ervoir.Based on the actual situation of Niligou River,we evaluated the hydrologic integrity,chemical integrity,morphological and structural integrity,biological integrity and sustainability of social service function,and put forward corresponding countermeasures according to the re-sults,in order to provide a technical support for the health treatment of rivers and lakes in Jilin Province.

Distribution, health and ecological risk assessments of trace elements in Nigerian oil sands

The Nigerian oil sands represent the largest oil sand deposit in Africa, yet there is little published information on the distribution and potential health and ecological risks of trace elements in the oil resource. In the present study, we investigated the distribution pattern of 18trace elements(including biophile and chalcophile elements) as well as the estimated risks associated with exposure to these elements. The results of the study indicated that Fe was the most abundant element, with a mean concentration of 22,131 mg/kg while Br had the lowest mean concentration of 48 mg/kg. The high occurrence of Fe and Ti suggested a possible occurrence of ilmenite(Fe TiO_(3)) in the oil sands. Source apportionment using positive matrix factorization showed that the possible sources of detected elements in the oil sands were geogenic, metal production, and crustal. The contamination factor, geo-accumulation index, modified degree of contamination, pollution load index, and Nemerow pollution index indicated that the oil sands are heavily polluted by the elements. Health risk assessment showed that children were relatively more susceptible to the potentially toxic elements in the oil sands principally via ingestion exposure route(HQ > 1E-04). Cancer risks from inhalation are unlikely due to CR < 1E-06 but ingestion and dermal contact pose severe risks(CR > 1E-04). The high concentrations of the elements pose serious threats due to the potential for atmospheric transport, bioaccessibility, and bioavailability.

Assessment of public perspectives and barriers towards dengue preventive practices using the Health Belief Model in Puducherry,India:A cross-sectional study

Objective:To assess the perspectives and barriers towards dengue preventive practices among the residents of Puducherry,India.Methods:A cross-sectional survey was conducted in 300 households in Puducherry,using a population-proportionate(7:3)distribution from urban and rural areas by grid sampling.One adult interview per household was conducted and the participants were selected using a KISH grid.A semi-structured questionnaire based on the Health Belief Model(HBM)with additional questions on knowledge assessment was used.Knowledge was assessed based on the correctness of answers and the HBM scores were calculated on a 5-point Likert scale.Participants were categorized based on the median score under each domain.Logistic regression was used for adjusted analysis and models were built to predict the performances in each domain.Results:Four percent of the participants lacked basic knowledge regarding dengue transmission.While 208(69.3%)participants did not consider themselves at risk of contracting dengue within the next year,majority perceived dengue as a disease with low severity.Around 49.3%(148)were skeptical about the benefit of time and money spent on dengue prevention.Inadequate government efforts were stated as the major barrier(47.0%)and frequent reminders(142,47.3%)as the major cue to action.Age above 50 years(aOR 1.78,95%CI 1.04-3.06,P=0.037)and rural locality(aOR 2.68,95%CI 1.52-4.71,P=0.001)were found to be significantly associated with poor knowledge scores.Urban participants had a significantly higher chance to perceive low susceptibility as compared to the rural counterparts(aOR 1.74,95%CI 1.05-2.9,P=0.03).Participants with less than a high school education had low perceived benefits(aOR 2.46,95%CI 1.52-3.96,P<0.001)and low self-efficacy scores(aOR 2.66,95%CI 1.61-4.39,P<0.001).Conclusions:This study identifies key gaps in dengue prevention,including low perceived susceptibility,mild disease perception,limited knowledge of breeding sites,and overreliance on government efforts.Tailoring interventions to community needs,stratified to factors influencing the community perspectives can significantly improve dengue prevention efforts.

Assessment of groundwater quantity, quality, and associated health risk of the Tano river basin, Ghana

In the Tano River Basin,groundwater serves as a crucial resource;however,its quantity and quality with regard to trace elements and microbiological loadings remain poorly understood due to the lack of groundwater logs and limited water research.This study presents a comprehensive analysis of the Tano River Basin,focusing on three key objectives.First,it investigated the aquifer hydraulic parameters and the results showed significant spatial variations in borehole depths,yields,transmissivity,hydraulic conductivity,and specific capacity.Deeper boreholes were concentrated in the northeastern and southeastern zones,while geological formations,particu-larly the Apollonian Formation,exhibit a strong influence on borehole yields.The study identified areas with high transmissivity and hydraulic conductivity in the southern and eastern regions,suggesting good groundwater avail-ability and suitability for sustainable water supply.Sec-ondly,the research investigated the groundwater quality and observed that the majority of borehole samples fall within WHO(Guidelines for Drinking-water Quality,Environmental Health Criteria,Geneva,2011,2017.http://www.who.int)limit.However,some samples have pH levels below the standards,although the groundwater generally qualifies as freshwater.The study further explores hydrochemical facies and health risk assessment,highlighting the dominance of Ca–HCO3 water type.Trace element analysis reveals minimal health risks from most elements,with chromium(Cr)as the primary contributor to chronic health risk.Overall,this study has provided a key insights into the Tano River Basin’s hydrogeology and associated health risks.The outcome of this research has contributed to the broader understanding of hydrogeologi-cal dynamics and the importance of managing groundwater resources sustainably in complex geological environments.

Eco-toxicity and health risk assessment of polycyclic aromatic hydrocarbons in surface sediments of Burullus Lake in Egypt

Polycyclic aromatic hydrocarbons(PAHs)are ubiquitous environmental contaminants of growing concern due to their potential ecological and human health risks.This study presents a comprehensive assessment of PAHs contamination in the surface sediments of Burullus Lake,a vital and second largest delta lake in Egypt.The aim was to evaluate the eco-toxicity and potential health risks associated with the presence of these compounds.Surface seven sediment samples were collected from various drains in the southern part of Burullus Lake.Soxhlet extraction method was employed to extract PAHs(16PAHs)from the sediment sample.Analytically,target compounds were located using HPLC.The results showed that samples contained PAHs levels ranging from 0.038×10^(-6)to 0.459×10^(-6),which is considered heavily polluted by the European standard for PAHs pollution.Additionally,there was no apparent source of PAHs in the ElKhashah drain or the Brinbal Canal,as HPLC found none of the compounds.The most prevalent compound in sediment samples along the study area was fluoranthene.The diagnostic indices in the present study indicated that the hydrocarbons in the region originated from pyrolytic and man-made sources along the drains of Burullus Lake.The principal component analysis(PCA)and diagnostic ratios revealed that coal combustion and pyrolytic sources were responsible for the PAHs contamination in the surface sediments.The non-carcinogenic risk(HI),which is the product of the HQs for the adult and child populations,respectively,was calculated.HI values under 1,therefore,demonstrated that they had no carcinogenic effects on human health.TEQs and MEQs in the sediments of Burullus Lake do not have a cancer-causing impact on people.For the safety of nearby wildlife,aquatic life,and people,all activities that raise petroleum hydrocarbon levels in Burullus Lake must be adequately regulated and controlled.According to the ecological risk assessment,there is little chance that PAHs will be found in the sediments of Burullus Lake.This study underscores the urgent need for effective pollution control measures and regular monitoring of PAHs levels in Burullus Lake sediments to protect the aquatic ecosystem and public health.It also highlights the importance of considering eco-toxicity and human health risks in integrated risk assessments of PAHs-contaminated environments.

Community Needs Assessment for a Professional University Health Counselling Course in Cambodia

Developing health and counselling professionals remains an important part of supporting mental health services in Cambodia.This paper aims to identify how the key stakeholders and mental health experts in Cambodia consider how a university level health counselling course could contribute to addressing the needs/treatment gap for mental health services in Cambodia.In order to do this,the study consists of semi-structured interviews with stakeholders,community needs assessment,and community resource mapping.The data were drawn from 15 NGOs,various profit and not-for-profit organizations as well as two key government stakeholders.The participants were invited to take part in a stakeholders/expert semi-structured interview that lasted between 30-60 minutes at the participants’organizations.The findings revealed that all participants believe that a university level health counseling course was crucial in Cambodia to address pressing mental health issues in the country.Most participants believed that a graduate or post-graduate level program such as a B.A.or M.A.was necessary to train qualified counsellors.The program should be internationally benchmarked,with a Cambodian context.Topics should include psychopathology,professional ethics and competencies,counselling theories and interventions,trauma treatment,as well as emotional intelligence and addiction.Other topics might need to include parenting,support system for suicidal patients,self-care,staff wellbeing programs,and school counselor programs.

Distribution, Mobility, and Health Risks Assessment of Trace Metals in River Sediments from Intense Agricultural Activity Areas in West Africa

The economy of West African countries is mainly based on agriculture. However, the trace metal(loid)s contamination status in rivers is relatively unknown in the region. In this work, 45 surface sediments collected from the Bandama, Comoé, and Bia Rivers in south and south eastern Côte d’Ivoire (West Africa), were analyzed for total metal concentrations and chemical speciation. The results showed that the river sediments were considerably contaminated by Cd and moderately contaminated by As, Cu, Pb, and Zn. Significant spatial variations were observed among the stations but not between the rivers. Metals Cd and Cu were likely to cause more ecological risks. The speciation analysis unravelled that the metal(loid)s partitioned mainly in the residual fraction, with the potential mobile fraction varying from 14% to 28%. The study calls for establishment of strict policies relative to the application of fertilizers and agrochemicals and mining activities to protect the environment and human health risks.

Contamination assessment,source apportionment and associated health risks of PTEs in agricultural soil under five land-use patterns in Sanya,China

To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.

Health risk assessment of heavy metals in soils and crops in a mining area(Au-Ag-Cutrona-oil et al.) of the Nanyang Basin, Henan Province, China

Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the study area, ensure the safety of local crops and the health of local residents, and provide a basis for the subsequent environmental restoration and the prevention and control of environmental pollution. Based on the analysis of the heavy metal concentrations in local soils and crops, the study investigated the spatial distribution, pollution degrees, and potential ecological risks of heavy metals in the farmland of a mining area in the southeastern Nanyang Basin, Henan province, China explored the sources of heavy metals and assessed the health risks caused by crop intake. The results of this study are as follows. The root soils of crops in the study area suffered heavy metal pollution to varying degrees. The degree of heavy metal pollution in maize fields is higher than that in wheat fields, and both types of fields suffer the most severe Cd pollution. Moreover, the root soils of different crops suffer compound pollution.The root soils in the maize fields suffer severe compound pollution at some sampling positions, whose distribution is similar to that of the mining area. Cd poses the highest potential ecological risks among all heavy metals, and the study area mainly suffers low and moderate comprehensive potential ecological risks. The principal component analysis(PCA) shows that the distribution of Zn, Cd, Pb, and As in soils of the study area is mainly affected by anthropogenic factors such as local mining activities;the distribution of Cr and Ni is primarily controlled by the local geological background;the distribution of Hg is mainly affected by local vehicle exhaust emissions, and the distribution of Cu is influenced by both human activities and the geological background. Different cereal crops in the study area are polluted with heavy metals dominated by Cd and Ni to varying degrees, especially wheat. As indicated by the health risk assessment results, the intake of maize in the study area does not pose significant human health risks;however, Cu has high risks to human health, and the compound heavy metal pollution caused by the intake of wheat in the study area poses risks to the health of both adults and children. Overall, the soils and crops in the study area suffer a high degree of heavy metal pollution, for which mining activities may be the main reason.

Shaoma Zhijing granule for children with tic disorders: A rapid health technology assessment

Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.

全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Scoping review on health-related physical fitness in patients with inflammatory bowel disease:Assessment,interventions,and future directions

BACKGROUND Reaching the Selecting Therapeutic Targets in Inflammatory Bowel Disease-II(STRIDE-II)therapeutic targets for inflammatory bowel disease(IBD)requires an interdisciplinary approach.Lifestyle interventions focusing on enhancing and preserving health-related physical fitness(HRPF)may aid in improving subjective health,decreasing disability,or even controlling inflammation.However,ambiguity remains about the status and impact of HRPF(i.e.body composition,cardiorespiratory fitness,muscular strength,muscular endurance,and flexibility)in IBD patients,hindering the development of physical activity and physical exercise training guidelines.AIM To review HRPF components in IBD patients and the impact of physical activity and physical exercise training interventions on HRPF.METHODS A systematic search in multiple databases was conducted for original studies that included patients with IBD,assessed one or more HRPF components,and/or evaluated physical activity or physical exercise training interventions.RESULTS Sixty-eight articles were included.No study examined the complete concept of HRPF,and considerable heterogeneity existed in assessment methods,with frequent use of non-validated tests.According to studies that used gold standard tests,cardiorespiratory fitness seemed to be reduced,but findings on muscular strength and endurance were inconsistent.A limited number of studies that evaluated physical activity or physical exercise training interventions reported effects on HRPF,overall showing a positive impact.CONCLUSION We performed a scoping review using a systematic and iterative approach to identify and synthesize an emerging body of literature on health-related physical fitness in patients with IBD,highlighting several research gaps and opportunities for future research.Findings of this review revealed a gap in the literature regarding the accurate assessment of HRPF in patients with IBD and highlighted important methodological limitations of studies that evaluated physical activity or physical exercise training interventions.This scoping review is a step towards performing studies and systematic reviews in the future,which was not possible at present given the heterogeneity in endpoints and designs of the available studies on this topic.Future well-designed studies are required to determine the optimal training paradigm for improving HRPF in patients with IBD before guidelines can be developed and integrated into the therapeutic strategy.

Seasonal variations and health risk assessment of trace elements in the Badigad River,lesser Himalayas,Nepal

The consumption of contaminated river water can have severe effects on human health.This study aims to investigate the trace elements(TEs)content and their health risk assessment in the Badigad River Basin in the lesser Himalayas of Nepal.In total,44 water samples were collected from 22 different sites during the pre-monsoon and monsoon seasons,and 25 TEs were analyzed.Correlation matrix and principal component analysis(PCA)were used to analyze the potential relationship between the measured TEs and their source tracking.Furthermore,the water quality index(WQI),metal index(MI),and cancer index(CI)were evaluated.The TEs content in all samples were found to be within the WHO recommended guideline for drinking and domestic purposes.The dominancy order of the TEs was observed as Sr>Ba>Li>Rb>Zn>Cr>Sc>Mn>Ti>Cu>As>Ni>Co>U>V>Pb>Cs>Ga>Y>Tl>Th>Zr>Bi>Cd>Nb.The PCA analysis suggested that TEs could have natural,anthropogenic,and mixed origins.The WQI indicated that the river water is safe from a human health perspective.The MI suggested that Badigad River can be considered safer for drinking purposes,and the cancer index(CI)showed that all the reported TEs are at low-risk levels.The findings of this study could be useful for government agencies in developing more sustainable water management policies in the region.However,it is suggested that further investigations should be conducted in terms of other hydrogeochemical variables,including major ions,at spatiotemporal levels for the sustainability of the river basin.

Intelligent Student Mental Health Assessment Model on Learning Management System

A learning management system(LMS)is a software or web based application,commonly utilized for planning,designing,and assessing a particular learning procedure.Generally,the LMS offers a method of creating and delivering content to the instructor,monitoring students’involvement,and validating their outcomes.Since mental health issues become common among studies in higher education globally,it is needed to properly determine it to improve mental stabi-lity.This article develops a new seven spot lady bird feature selection with opti-mal sparse autoencoder(SSLBFS-OSAE)model to assess students’mental health on LMS.The major aim of the SSLBFS-OSAE model is to determine the proper health status of the students with respect to depression,anxiety,and stress(DAS).The SSLBFS-OSAE model involves a new SSLBFS model to elect a useful set of features.In addition,OSAE model is applied for the classification of mental health conditions and the performance can be improved by the use of cuckoo search optimization(CSO)based parameter tuning process.The design of CSO algorithm for optimally tuning the SAE parameters results in enhanced classifica-tion outcomes.For examining the improved classifier results of the SSLBFS-OSAE model,a comprehensive results analysis is done and the obtained values highlighted the supremacy of the SSLBFS model over its recent methods interms of different measures.

Assessment of reproductive health service utilization in urban slums: Evidence from Western Rajasthan

Objective:To assess the utilization of reproductive health services in urban slum of Jodhpur city,India.Methods:A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021.Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care(ANC)services,delivery and post-partum services.Results:The majority of females were aged less than 25 years(n=195;65.0%),married after 18 years(n=240;80%),living in extended families(n=265;88.3%)and with monthly family income less than 10000 rupees(n=182;60.7%).Statistically significant associations were found between≥4 ANC visits and educational level of secondary and above(OR 2.47,95%CI 1.03–6.28;P=0.04),older age(OR 15.70,95%CI 14.87–16.54 for women aged 26-35 years,OR 16.14,95%CI 12.12–20.01 for women aged≥36 years;P<0.01),and backward and general castes(OR 15.91,95%CI 13.57–17.85 for backward caste and OR 8.11,95%CI 8.07–8.26 for general category of caste;P<0.01).Seven percent of females had undergone parturition.Older age was associated with higher risks of postpartum complications(OR 1.06,95%CI 1.01–1.57 for women aged 26-35 years,OR 3.56,95%CI 1.29–4.69 for women aged≥36 years;P<0.01).In addition,risks of postpartum complications were associated with backward and general castes(OR 1.69,95%CI 1.34–2.13 for backward classes and OR 5.01,95%CI 4.29–5.31 for general category castes;P<0.01),and more than 4 ANC visits(OR 0.20,95%CI 0.09–0.34;P<0.01).Conclusions:More frequent ANC visits are associated with a lower risk of postpartum complications.Furthermore,a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

A Blockchain and CP-ABE Based Access Control Scheme with Fine-Grained Revocation of Attributes in Cloud Health

The Access control scheme is an effective method to protect user data privacy.The access control scheme based on blockchain and ciphertext policy attribute encryption(CP–ABE)can solve the problems of single—point of failure and lack of trust in the centralized system.However,it also brings new problems to the health information in the cloud storage environment,such as attribute leakage,low consensus efficiency,complex permission updates,and so on.This paper proposes an access control scheme with fine-grained attribute revocation,keyword search,and traceability of the attribute private key distribution process.Blockchain technology tracks the authorization of attribute private keys.The credit scoring method improves the Raft protocol in consensus efficiency.Besides,the interplanetary file system(IPFS)addresses the capacity deficit of blockchain.Under the premise of hiding policy,the research proposes a fine-grained access control method based on users,user attributes,and file structure.It optimizes the data-sharing mode.At the same time,Proxy Re-Encryption(PRE)technology is used to update the access rights.The proposed scheme proved to be secure.Comparative analysis and experimental results show that the proposed scheme has higher efficiency and more functions.It can meet the needs of medical institutions.