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Background: The Kingdom of Saudi Arabia has developed rigorous strategies to control and prevent the spread of COVID-19. However, the effectiveness of these measures in containing and mitigating the epidemic has yet to be studied. This paper aims to assess the efficiency of preventive policy initiatives that Saudi Arabia has taken to reduce the spread of COVID-19, which was rapid and progressive in nature. Information on the effectiveness of measures applies to help the Saudi government adjust policy responses when considering which measures to relax once the epidemic is controlled. Methods: Data for this study were retrieved via publicly available data sources such as the Saudi Arabia Ministry of Health and the government's official news agency—Saudi Press Agency (SPA) websites. Other datasets, such as prevention measures, were gathered from the Country Policy Tracker website. Our dataset's time component extends over 590 consecutive days from 20 January 2020–31 August 2021. Moreover, a mixed-method approach combining COVID-19 data and prevention measures was adopted to assess preventative measures practice. We compiled the dataset used in this study in a Microsoft Excel database. The significance of observed differences among implementing effective strategies was determined using ANOVA and Mixed methods approach. Noticeably, the statistical analysis was performed using the open-source statistical system R version 4.2 (available at http://cran.r-project.org). Results: Our analysis showed that only three out of the 32 (9.4%) measures significantly reduced the spread of COVID-19. Our results also show substantial variations in the spread of COVID-19 associated with preventive measures in Saudi Arabia. There was a significant positive correlation between activating and massive testing in communities and cases of COVID-19 (measure effect = 923.086 and p

The fractional-order design for conceptualizing corruption offers several advantages on the corruption spreading over the integer-order corruption models such as acknowledgement of the intricate dynamics of corruption, including corruption super-spreading aspects, variable corruption transmission rates, it capture the persistence of memory effects, accounting for the past trajectory of corruption epidemic, and also providing a more accurate explanation of corruption dynamics. The author of the study has formulated the fractional order model on corruption dynamics by dividing the total population into five sub-groups namely the susceptible group, the exposed group, the moderately corrupted group, the highly corrupted group, and the corruption repented group. In the qualitative analyses section the author of this study has: shown the model solutions existence and uniqueness by applying the well-known Picard–Lindelöf criteria, computed the model basic reproduction number using the next generation approach, computed the model equilibrium points and investigated their stabilities, re-formulated the corresponding fractional order optimal control problem using the proposed three time-dependent controlling variables (prevention measure, moderate corruption treatment measure and high corruption treatment measure). The necessary optimality conditions for the fractional order optimal control problem and the existence of optimal control strategies are derived and presented by applying Pontryagin's Maximum Principle. Eventually, the study demonstrated the effectiveness of the combinations of the three controlling strategies through numerical methods (simulations) and the analysis results shows that the implementation of the three time-dependent controlling strategies significantly minimizes the number of corrupted individuals in the community.

The world’s climate, particularly in Africa, has changed substantially during the past few decades, contributed by several human activities. Africa is one of the continents that is most vulnerable to climate change globally. Since the beginning of 2022, extreme weather events in Africa have affected about 19 million people and killed at least 4,000 individuals. Cyclones, floods, heatwaves, wildfires, droughts, and famine were among the severe weather occurrences. Natural disasters and extreme weather events brought on by climate change may compromise access to clean water, sanitation systems, and healthcare facilities, making people more vulnerable to a number of illnesses. Floods and drought can lead to both communicable and non-communicable diseases. The African population is more likely to experience more mental health disorders than before because of natural disasters, which result in the loss of property and sometimes loss of lives more frequently. We, therefore, call for an improved implementation of strategies to prevent the health effects of climate change so that the health of the people in Africa can be maintained.

Background: Variable control measures for vancomycin-resistant Enterococcus (VRE) infections were adopted among different hospitals and areas. We investigated the burden and patient characteristics of healthcare-associated VRE infections in 2018–2019 and 2020, when multiple preventive measures for COVID-19 were taken. Methods: During the COVID-19 pandemic, mask waring and hand hygiene were enforced in the study hospital. The incidence densities of healthcare-associated infections (HAIs), including overall HAIs, methicillin-resistant Staphylococcus aureus (MRSA) HAIs, VRE HAIs, and VRE healthcare-associated bloodstream infections (HABSIs), consumption of broad-spectrum antibiotics and hygiene products, demographic characteristics and medical conditions of affected patients, were compared before and after the pandemic. Results: The incidence density of both VRE HAIs and VRE HABSIs did not change statistically significantly, however, the highest in 2020 than that in 2018 and 2019. This was in spite of universal mask waring and increased consumption of 75% alcohol in 2020 and consistent implementation of an antibiotic stewardship program in three observed years. The increased prescriptions of broad-spectrum cephalosporins might partially explain the increase of VRE infection. Conclusion: Increased mask wearing and hand hygiene may not result in the decline in the development of VRE HAIs in the hospital during the COVID-19 pandemic, and continued monitoring of the dynamics of HAIs remains indispensable.

Summary: Background: To propose infection prevention measures it is essential to understand the dynamics of SARS-CoV-2 shedding, particularly in asymptomatic patients. This report compares the viral load progression in exhaled breath (EB) with the symptom severity. We aim to evaluate the adequacy of symptom assessment regarding the infectivity level of individuals. Methods: We observed infected patients since their first positive test during hospitalization. EB samples were collected on days 1, 3, 5, 7, 10, 12 and 14 of hospitalization using a filter-based device. After extraction, viral loads were quantified with qRT-PCR. The infection trajectory was documented after symptom onset. Case Presentation and Discussion: A 34-year old patient showed mild symptoms, e.g. fever, cough, headache, muscle pain and loss of taste and smell across trajectory of infection (Case 1). The viral loads emitted via exhaling were nearly constant and ranged from 8.6 x 103 and 4.1 x 104 RNA copies per hour. After the infection, the patient developed a pneumonia. The second case of a 65-year old patient depicted an asymptomatic infection trajectory for 14 days after the first diagnosis (Case 2). Nevertheless, the patient exhaled up to 2 x 105 SARS-CoV-2 virus copies hourly, approximately 10 fold higher than measured for Case 1. Conclusion: Symptomatic and asymptomatic COVID-19 patients exhale distinctive amounts of SARS-CoV-2 not necessarily correlating with symptom severity. Particularly, asymptomatic patients might show higher EB viral shedding. Therefore, EB testing should be included in infection prevention measures as it has high potential to reveal the most infectious individuals regardless of their symptoms during infection.

Countries in sub-Saharan Africa (SSA) are expected to experience more public health emergencies (PHEs) in the near future. The fragile health systems emanating from poor health governance, inadequate health infrastructure, shortage of healthcare workers (HCWs), inadequate essential medicines and technology, and limited funding will make responses to these outbreaks slow and ineffective as seen with the COVID-19 pandemic. The workload for HCWs will grow due to these PHEs, which will increase the likelihood that they may experience burnout. This narrative review loosely followed the guidelines provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) statement. Google Scholar, PubMed, and ScienceDirect databases were used to retrieve relevant articles. Two reviewers assessed the titles and abstracts of all identified articles and extracted the data independently and compared their results thereafter. The causes of burnout among HCWs, its impact on patients, HCWs, and healthcare institutions, as well as preventive steps that should be taken to safeguard HCWs from burnout, are all covered in this article.

Tinea Capitis is a common worldwide fungal infectious disease. This paper investigates the transmission dynamics of tinea captis infection using Caputo fractional derivative approach. The qualitative analysis part of the proposed fractional order model investigates: the model solutions existence and uniqueness by using the well-known Picard–Lindelöf criteria, the basic reproduction number using the next generation matrix approach, the model equilibrium points and their stabilities. The study re-formulates the fractional order optimal control problem with the three time-dependent controlling variables such as prevention measure, acute infection treatment measure and chronic infection treatment measure and also investigates the necessary optimality conditions and the existence of optimal control strategies by applying Pontryagin's Maximum Principle. Finally, the paper examines the effectiveness of the combinations of the three controlling strategies through numerical simulations and the results indicate that the simultaneous implementation of the three time-dependent controlling strategies significantly minimizes the number of tinea capitis infected individuals in the community.

Ski touring is an emerging trend in the Alps, defined as ascending and descending a slope/backcountry with ski-touring equipment. The aim of this research is to understand risk-taking behavior, risk-avoidance behavior and assessed expertise (ascending/descending) of backcountry ski tourers. A cross-sectional survey design was chosen (N ​= ​300). Results show that e.g. genderwise, the difference is statistically significant in terms of ‘I consciously expose myself to danger’ t(158) ​= ​2.94, and e.g. skillwise, for ‘I check every piece of equipment before use’ t(152) ​= ​−2.98 – providing insights into the risk behavior of BCSTers in terms of gender and skills.

Background: The 2019 novel coronavirus disease pandemic (COVID-19) is one of the most serious health risks facing the global population. Teachers’ responses are important in the management of the outbreak in schools. The purpose of this study is to examine teachers’ risk perception, self-efficacy, response efficacy, and approach to disease prevention during the COVID-19 outbreak in Taiwan. Methods: A descriptive, cross-sectional online survey was completed by 344 teachers across four levels of education. Pearson correlations between major variables were calculated. General linear model with a posthoc test was used to estimate the least squares means for each level of the independent variables and test the mean differences between the response scores. Results: The teachers with a higher risk perception showed a stronger adoption of disease prevention measures, but they also showed lower self-efficacy. In addition, teachers with higher self-efficacy had higher response efficiency. Female teachers had relatively stronger adoption of disease prevention measures than their male colleagues, and age was associated with a 0.040 point increase in adoption scores. Elementary school teachers were significantly stronger in this regard than teachers at junior high schools, high schools and universities in terms of behavior scores. Conclusions: High implementation rate of Taiwanese teachers’ disease prevention measures came from their higher risk perceptions. Among them, older female teachers, especially those who teach at elementary schools, are key to implementing disease prevention measures.

Background and aims: Leishmaniasis is a neglected tropical disease which causes significant morbidity and mortality, particularly in developing countries. Cutaneous leishmaniasis (CL) is the main form of leishmaniasis that affects the skin. Knowledge and perception of people about leishmaniasis has a great impact to prevent the disease in endemic areas. Hence, the aim of this study was to assess the knowledge, attitude and preventive measures of Wegeltena secondary school students towards CL in Delanta district, one of the endemic areas in Northeast Ethiopia. Methods: A facility-based cross-sectional study was conducted from January 4 to 20, 2021 at Wegeltena secondary school in Delanta district, Northeast Ethiopia. A pre-tested, interviewer administered structured questionnaire was used to collect the data. Multivariable logistic regression analysis was utilized to measure the degree of association between outcome and independent variables. Statistically significant association with the outcome variables was declared at a p-value of

Large-scale utilization of high-alkali fuels is considered an effective solution for alleviating energy shortages and reducing CO 2 emissions. However, combustion of high-alkali fuels in boilers releases alkali metals into the flue gas, which leads to severe ash deposition and corrosion on the heating surface. Consequently, research into the efficient use of highly alkaline fuels has been conducted in recent years. In this review, ash issues and measures for their prevention during high-alkali fuel combustion are summarized. First, the characteristics of fly ash produced from high-alkali fuel combustion are reviewed, and the form, migration, and deposition characteristics of alkali metals are summarized. Subsequently, research progress of high alkali fuel ash is introduced in detail. Mechanisms of slagging, fouling, corrosion on the heating surface and the selective catalytic reduction (SCR) unit deactivation are summarized. Prevention and control methods for the high-alkali fuel ash problem are then introduced. Finally, based on current research, existing problems and future development directions for high-alkali fuel research are proposed. Through this review, we hope to provide insights into the effective utilization of high-alkali fuels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Objective: The Omicron variant of SARS-COV-2 is replacing previously circulating variants around the world in 2022. Sporadic outbreaks of the Omicron variant into China have posed a concern how to properly response to battle against evolving coronavirus disease 2019 (COVID-19)., Methods: Based on the epidemic data from website announced by Beijing Center for Disease Control and Prevention for the recent outbreak in Beijing from April 22nd to June 8th in 2022, we developed a modified SEPIR model to mathematically simulate the customized dynamic COVID-zero strategy and project transmissions of the Omicron epidemic. To demonstrate the effectiveness of dynamic-changing policies deployment during this outbreak control, we modified the transmission rate into four parts according to policy-changing dates as April 22nd to May 2nd, May 3rd to 11st, May 12th to 21st, May 22nd to June 8th, and we adopted Markov chain Monte Carlo (MCMC) to estimate different transmission rate. Then we altered the timing and scaling of these measures used to understand the effectiveness of these policies on the Omicron variant., Results: The estimated effective reproduction number of four parts were 1.75 (95% CI 1.66-1.85), 0.89 (95% CI 0.79-0.99), 1.15 (95% CI 1.05-1.26) and 0.53 (95% CI 0.48 -0.60), respectively.  In the experiment, we found that till June 8th the cumulative cases would rise to 132,609 (95% CI 59,667-250,639), 73.39 times of observed cumulative cases number 1,807 if no policy were implemented on May 3rd, and would be 3,235 (95% CI 1,909 - 4,954), increased by 79.03% if no policy were implemented on May 22nd. A 3-day delay of the implementation of policies would led to increase of cumulative cases by 58.28% and a 7-day delay would led to increase of cumulative cases by 187.00%. On the other hand, taking control measures 3 or 7 days in advance would result in merely 38.63% or 68.62% reduction of real cumulative cases. And if lockdown implemented 3 days before May 3rd, the cumulative cases would be 289 (95% CI 211-378), reduced by 84%, and the cumulative cases would be 853 (95% CI 578-1,183), reduced by 52.79% if lockdown implemented 3 days after May 3rd., Conclusion: The dynamic COVID-zero strategy might be able to effectively minimize the scale of the transmission, shorten the epidemic period and reduce the total number of infections., Competing Interests: The authors declare no competing interest., (© 2023 The Authors. Published by Elsevier B.V. on behalf of Chinese Medical Association.)

Objectives: As the world responds to the coronavirus outbreak, the role of public health in ensuring equitable health care that considers the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) dynamics in rural communities is still a challenge. The same suppression and mitigation measures have been implemented homogeneously, ignoring the differences between urban and rural areas. We propose an epidemiological model and simulate the dynamics of SARS-CoV-2 in urban and rural areas considering the interaction between these regions., Study Design: This was a population modeling study., Methods: A compartmental epidemiological model was formulated to simulate the transmission of SARS-CoV-2 in urban and rural areas. We use the model to investigate the impact of control strategies focused on the urban-rural interface to contain the epidemic size of SARS-CoV-2 in rural areas., Results: Considering five different levels for the exposition rate in urban areas and keeping intrarural and urban-rural exposition rates fixed, the preventive measures reduce the size and delay the peak for the urban infectives. The response of infected individuals and cumulative deaths in rural areas upon changes in the urban dynamics was small but not negligible. On the other hand, preventive measures focused on the urban-rural interface impact the number of infected individuals and deaths in rural areas., Conclusions: The maintenance of SARS-CoV-2 in rural areas depends on the interaction of individuals at the urban-rural interface. Thus, restrictive measures established by the governments would not be required within rural areas. We highlight the importance of focused preventive measures on the urban-rural interface to reduce the exposure and avoid the transmission of SARS-CoV-2 to rural communities., (Copyright © 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)