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In the current era, the importance of proper hand hygiene to reduce the transmission of infectious diseases has become difficult to debate. Yet, compliance rates remain low and are affected by many factors, amongst which is user acceptability of hand hygiene products.The present study aimed at investigating drivers of preference towards different hand hygiene formulations.Three different formulations (liquid, foam and gel) of the same brand were randomly and blindly evaluated by 54 participants based on the WHO Protocol for Evaluation of Tolerability and Acceptability of Alcohol-based Handrubs.The majority (76%) of respondents indicated that the product formulation impacted their level of compliance with hand hygiene protocols. The preferred formulation was liquid, with 50% of participants ranking it as first choice. General product satisfaction, the product texture, the drying speed and the ease of application, were the statistically significant drivers for participants to rank a formulation as their first choice vs not ranking it as their first choice.When designing alcohol formulations and implementing hand hygiene protocols, understanding drivers of preference for formulations may enhance product user acceptability and therefore compliance with hand hygiene.

Objective and design:To assess the role of alcohol in drowning associated with recreational aquatic activity by reviewing the English language literature published up to October 2003.Results:Alcohol is widely used in association with recreational aquatic activity in the United States, but there is minimal information regarding the extent of use elsewhere. A priori and anecdotal evidence suggests that alcohol is an important risk factor for drowning associated with recreational aquatic activity. Specific studies provide good evidence supporting this, but the extent of increased risk associated with alcohol use, and the attributable risk due to alcohol use, is not well characterised. Drowning appears to be the overwhelming cause of death associated with recreational aquatic activity with alcohol detected in the blood in 30%–70% of persons who drown while involved in this activity. The few relevant studies on degree of increased risk suggest persons with a blood alcohol level of 0.10 g/100 ml have about 10 times the risk of death associated with recreational boating compared with persons who have not been drinking, but that even small amounts of alcohol can increase this risk. The population attributable risk seems to be in the range of about 10%–30%.Conclusions:Alcohol consumption significantly increases the likelihood of immersions resulting in drowning during aquatic activities. However, more information is required if appropriate prevention activities are to be planned, initiated, and evaluated. This includes better information on alcohol use, and attitudes to alcohol use, in association with recreational aquatic activity, and the nature and extent of increased risk associated with alcohol use. Evaluation of interventions is also needed.

Abstract Understanding the drivers of past and present energy consumption trends is important for a range of stakeholders, including governments, businesses and international development organizations, in order to prepare for impacts on global supply chains caused by changes in future energy price or availability shocks. In this paper we use environmentally-extended input–output tables to: (a) quantify the long-term drivers that have led to diversified energy footprint profiles of 186 countries around the world from 1990 to 2010; (b) identify which countries and sectors recorded an increase or decrease in energy footprints during this time period; (c) highlight the effect of international outsourcing of energy-intensive production processes by decomposing the structural and spatial change in energy footprints; and (d) discuss the implications for national economic policy for the identified drivers. To this end, we use a detailed Multi-Regional Input–Output database and three prevalent structural decomposition analysis methods. To reduce biases in the results due to time lapse and currency variations, we convert input–output tables to common US$ and 1990-constant prices. This study provides a broad overview of the magnitude and distribution of the drivers for energy footprints across countries. The results of this study demonstrate that for almost all countries affluence and population growth are driving energy footprints worldwide, which is in part counteracted by the retarding effect of industrial energy intensity. In particular, this study demonstrates that with increasing per-capita GDP, the total energy footprint of a country is increasingly concentrated on imports or consumption.

Metal use and modern society are intrinsically linked and it is no surprise that global processes of industrialization and urbanization have led to ever increasing amounts of metal use. In recent decades, global supply and demand networks for metals have become increasingly complex. Industrial Ecology research is well placed to unpack this complexity and to explore potential resource efficiencies for metals. This is especially important during the current period of rising ore prices. We examine patterns of supply and demand for iron ore and bauxite, and recent trends in resource productivity of these two important metal ores. We introduce a consumption perspective and compare the material footprint of metal ores to the GDP of countries to look at how much economic benefit countries achieve per unit of metal footprint. We find that for the past two decades global amounts of iron ore and bauxite extractions have risen faster than global GDP, that both supply and demand of iron ore and bauxite have been concentrated in a handful of countries and that resource productivity from a consumption perspective has fallen in developed nations, as well as globally. The research shows no saturation of metal ore consumption at any level of income. Policies will be required to enhance both the productivity of metal production and the economic productivity of consumption (GDP per metal footprint) through more efficient mining, product design, reuse and recycling.

As atmospheric greenhouse gas concentrations continue to rise, temperature and humidity will increase further, causing potentially dire increases in human heat stress. On physiological and biophysical grounds, exposure to higher levels of humidity should worsen heat stress by decreasing sweat evaporation. However, population-scale epidemiological studies of heat exposure and response often do not detect associations between high levels of humidity and heat-related mortality or morbidity. These divergent, disciplinary views regarding the role of humidity in heat-related health risks limit confidence in selecting which interventions are effective in reducing health impacts and in projecting future heat-related health risks.Via our multidisciplinary perspective we seek to a) reconcile the competing realities concerning the role of humidity in heat-related health impacts and b) help ensure robust projections of heat-related health risks with climate change. These objectives are critical pathways to identify and communicate effective approaches to cope with present and future heat challenges.We hypothesize six key reasons epidemiological studies have found little impact of humidity on heat-health outcomes: a) At high temperatures, there may be limited influence of humidity on the health conditions that cause most heat-related deaths (i.e., cardiovascular collapse); b) epidemiological data sets have limited spatial extent, a bias toward extratropical (i.e., cooler and less humid), high-income nations, and tend to exist in places where temporal variations in temperature and humidity are positively correlated; c) analyses focus on older, vulnerable populations with sweating, and thus evaporative, impairments that may be further aggravated by dehydration; d) extremely high levels of temperature and humidity (seldom seen in the historical record) are necessary for humidity to substantially impact heat strain of sedentary individuals; e) relationships between temperature and humidity are improperly considered when interpreting epidemiological model results; and f) sub-daily meteorological phenomena, such as rain, occur at high temperatures and humidity, and may bias epidemiological studies based on daily data. Future research must robustly test these hypotheses to advance methods for more accurate incorporation of humidity in estimating heat-related health outcomes under present and projected future climates. https://doi.org/10.1289/EHP11807.

This paper examines the sources of changes in energy use of the Brazilian economy of industries and households from 1970 to 1996, using structural decomposition analysis based on the logarithmic mean divisia index technique. Energy use can be decomposed into eight factors that explain changes in overall energy use over the entire time period, and within five sub-periods. The growth of energy use between 1970 and 1996 was mainly influenced by changes in affluence, population and intersectoral dependencies, while changes in direct energy intensity and per capita residential energy use had a retarding impact on energy use. The novel contributions of the paper are the alignment of a previously disparate data set, the use of supply-use tables for SDA, and the application of such an SDA to a developing country. Both contributions involve solving a range of methodological issues pertaining to handling of large data sets.

The primary objective of this review is to propose an approach for the biosynthesis of phylloquinone (vitamin K1) based upon its known sources, its role in photosynthesis and its biosynthetic pathway. The chemistry, health benefits, market, and industrial production of vitamin K are also summarized. Vitamin K compounds (K vitamers) are required for the normal function of at least 15 proteins involved in diverse physiological processes such as coagulation, tissue mineralization, inflammation, and neuroprotection. Vitamin K is essential for the prevention of Vitamin K Deficiency Bleeding (VKDB), especially in neonates. Increased vitamin K intake may also reduce the severity and/or risk of bone fracture, arterial calcification, inflammatory diseases, and cognitive decline. Consumers are increasingly favoring natural food and therapeutic products. However, the bulk of vitamin K products employed for both human and animal use are chemically synthesized. Biosynthesis of the menaquinones (vitamin K2) has been extensively researched. However, published research on the biotechnological production of phylloquinone is restricted to a handful of available articles and patents. We have found that microalgae are more suitable than plant cell cultures for the biosynthesis of phylloquinone. Many algae are richer in vitamin K1 than terrestrial plants, and algal cells are easier to manipulate. Vitamin K1 can be efficiently recovered from the biomass using supercritical carbon dioxide extraction.

Studies have shown that dengue virus transmission increases in association with ambient temperature. We performed a systematic review and meta-analysis to assess the effect of both high temperatures and heatwave events on dengue transmission in different climate zones globally.A systematic literature search was conducted in PubMed, Scopus, Embase, and Web of Science from January 1990 to September 20, 2022. We included peer reviewed original observational studies using ecological time series, case crossover, or case series study designs reporting the association of high temperatures and heatwave with dengue and comparing risks over different exposures or time periods. Studies classified as case reports, clinical trials, non-human studies, conference abstracts, editorials, reviews, books, posters, commentaries; and studies that examined only seasonal effects were excluded. Effect estimates were extracted from published literature. A random effects meta-analysis was performed to pool the relative risks (RRs) of dengue infection per 1 °C increase in temperature, and further subgroup analyses were also conducted. The quality and strength of evidence were evaluated following the Navigation Guide systematic review methodology framework. The review protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO).The study selection process yielded 6367 studies. A total of 106 studies covering more than four million dengue cases fulfilled the inclusion criteria; of these, 54 studies were eligible for meta-analysis. The overall pooled estimate showed a 13% increase in risk of dengue infection (RR = 1.13; 95% confidence interval (CI): 1.11-1.16, I2 = 98.0%) for each 1 °C increase in high temperatures. Subgroup analyses by climate zones suggested greater effects of temperature in tropical monsoon climate zone (RR = 1.29, 95% CI: 1.11-1.51) and humid subtropical climate zone (RR = 1.20, 95% CI: 1.15-1.25). Heatwave events showed association with an increased risk of dengue infection (RR = 1.08; 95% CI: 0.95-1.23, I2 = 88.9%), despite a wide confidence interval. The overall strength of evidence was found to be "sufficient" for high temperatures but "limited" for heatwaves. Our results showed that high temperatures increased the risk of dengue infection, albeit with varying risks across climate zones and different levels of national income.High temperatures increased the relative risk of dengue infection. Future studies on the association between temperature and dengue infection should consider local and regional climate, socio-demographic and environmental characteristics to explore vulnerability at local and regional levels for tailored prevention.Australian Research Council Discovery Program.