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Purpose – The purpose of this study is to identify the most common characteristics that make Internet users at the Estonian Academy of Security Sciences (SKA) vulnerable to various threats. This includes password management habits, online banking, shopping and payment behaviours, time spent online, use of public Wi-Fi, gaming and watching movies online. Additionally, the study seeks to review the dangers users encounter and how cautious they are, such as which online activities they consider the most dangerous and which they perceive as safe. Design/methodology/approach – The data used in this paper is based on an overview of relevant literature, highlighting previous studies and methodologies and explaining why the human factor is considered the weakest link in cybersecurity. This research aims to help characterise the patrons of the SKA and make suggestions for future training and research. For this purpose, the students, administrative employees and academic staff of the SKA were investigated. A five-point scale questionnaire with 54 questions was used as the methodology of the study, considering the following four scales: risky behaviour, conservative behaviour, risk exposure behaviour and risk perception behaviour. The results are interpreted based on the literature, and data obtained from the completed questionnaires were analysed using Excel’s Data Analysis ToolPak. The results are presented mostly as tables and bar charts. Findings – The research results show that the cybersecurity behaviour of employees and students is generally at a good level. However, some aspects of conservative behaviour need increased attention, such as the use of USB and other external media, opening links in emails too readily, monitoring the authenticity of visited websites and deleting browsing history before logging out. Cyber training has a noticeable effect on behaviour, particularly in the context of password management. Originality/value – No previous research on cyber behaviour has been conducted in the context of Estonian higher education, despite the increasing number of cyber-attacks in this sector.

Open mires constitute a characteristic part of boreal natural landscapes, which is under various cumulative anthropogenic pressures. As a response, remaining mires are increasingly protected, and their degradation is addressed by ecological restoration (mostly drainage closure). To evaluate alternative environmental policies, there is a necessity for high-resolution landscape simulation models to assess future dynamics of mires under different management scenarios. We present such a model, SooSim, its R-script, and derivation and validation of its key parameters. SooSim iterates mire types and woody encroachment dynamics within 25 × 25 m grid at 1-year intervals. Management interventions (restoration; ditch renovation) are sequentially introduced based on priority rules in locations delineated prior to simulation. We applied SooSim to three management scenarios, compared with natural succession, until 2050 in Estonia. The ‘current’ (2022) database comprised >3.8 M mire pixels and > 7 M peatland-forest pixels (sparse-cover ones considered for mire restoration). The model parameterization, based on Lidar data, revealed rapid ongoing woody encroachment across all mire types, with significant positive feedback. The simulations revealed that, even in scenarios with intensive restoration (2500 ha annually), open mire conditions are reduced by >10 % until 2050, while few mire types lose >1 % in area. Ditch renovations mostly reduced restoration perspectives in currently forested peatlands. Thus, SooSim explicitly depicts a decision-making dilemma where mire restoration is time-sensitive but also uncertain. To address this and related land-use dilemmas in the environmental policy, landscape models such as SooSim have further importance as visualization tools to explain complex processes to a wide range of stakeholders.

Abstract Objectives In many countries, obesity treatments are not fully reimbursed by healthcare systems. People living with obesity (PwO) often pay out‐of‐pocket (OOP) for pharmacological and non‐pharmacological interventions, placing them in a position of financial risk to manage their condition. This study sought to understand the OOP expenditures and non‐financial costs incurred by PwO to manage weight. Methods A 25‐min cross‐sectional online survey was conducted with PwO between ages 18–60 in Italy, Japan, India, Brazil, Spain and South Korea. Respondents were recruited using proprietary vendor panels and non‐probability sampling. N = 600 participants completed the survey (n = 100 per country). Results The mean annual OOP expenditure related to weight loss/management was $7,351, accounting for nearly 17% of annual household income. Costs generally increased by BMI. Half or more of the respondents agreed that obesity affected multiple aspects of their lives (outside activities, running a household, social life, work, family life, traveling). 46% agreed that obesity limited their job prospects. Conclusion PwO spend a notable amount of their income paying OOP expenditures related to managing their weight. Quantifying the individual economic burden of living with obesity can inform the understanding of the resources required and policy changes needed to treat obesity as a disease.

Although patrons have considered the availability and quality of professional literature and library services to be very good, the current survey was conducted under special circumstances. During the Spring of 2020, the library was closed and access to remote services became more relevant. The current study, which was conducted at Tallinn Health Care College in Spring 2020, aims to provide a overview of the user satisfaction level with library services impacted by the lockdown. The questionnaire was conducted online. Libraries and their users suddenly had to confront the fact that access to printed materials was disrupted. We wanted to find out which services were used the most, and which services and resources would be most needed soon. The study revealed several bottlenecks that would not normally have emerged. The library should maintain and strengthen services that satisfy the needs of users, add new services, and work to improve users' awareness of counseling services. College members expect more specific instructions on how to independently find information, how to use databases, and how to find electronic theses. It is customary to have face-to-face consultations in the library, but not yet common to have consultations via online channels. Most respondents are ready to use the book delivery service via parcel machines and are willing to pay a reasonable price for it. The greatest asset of the library is its staff, who has the skills, experience and competencies to offer quick practical solutions to user inquiries both on-site and distance.

Background and Objectives: Data on characteristics of asthma in children with sickle cell disease (SCD) is conflicting. Recently, the L-arginine pathway has gained attention in the pathogenesis of asthma and SCD. This study aimed to determine the distinctive clinical and laboratory features and the role of arginine metabolism in asthmatic children with SCD. Materials and Methods: A total of 52 children and adolescents with SCD, including 24 with asthma (SCD-A) and 28 without asthma (SCD-NA), and 40 healthy controls were included. A questionnaire, atopy tests, fractional exhaled nitric oxide (FeNO), and lung function tests were employed. Serum metabolites of the arginine pathway were measured. The results of the three groups were compared. Results: The demographic characteristics and atopy markers of the three groups were similar. FEV1%, FEV1/FVC, MMEF%, and total lung capacity (TLC%) values of SCD-A patients were not significantly different from the SCD-NA group, but they were significantly lower than the values measured in the controls. FeNO values greater than 35 ppb were present only in the SCD-A group. In impulse oscillometry, median resistance values at 5 Hz (R5)% were higher in both SCD subgroups than in healthy controls (p = 0.001). The (R5-20/R5)% values were higher in the SCD-A group (p = 0.028). Serum arginine levels and arginine bioavailability indices were significantly lower in the SCD-A group than in the SCD-NA group and healthy controls (p = 0.003 and p < 0.001). Conclusions: Asthma in children with SCD was not associated with atopy or low FEV1/FVC levels. However, lower arginine bioavailability and higher FeNO levels differentiated asthma in patients with SCD. High R5% and (R5-20/R5)% values indicated increased airway resistance in SCD, with a predominance of small airway disease in asthmatics.

This study aims to reconstruct the changes in storminess during the past 7600 years in the northeastern Baltic Sea region. For storminess reconstructions, aeolian sand influx (ASI) in coastal peat bog deposits was applied as an indicator of the past storminess. We analyzed cores from four peat bogs in the western and northern coastal areas of Estonia: the cores from Hiiumaa N, Hiiumaa SW, Saaremaa and Juminda study sites covered the past 3700, 3750, 2400, and 8400 years, respectively. The sediment chronologies were established using 36 14C dates. Image-analysis method (ImageJ) was used to count and measure the grain size of all sand particles at every centimeter to gain high-resolution ASI records. Although minor site-to-site variations exist, all four ASI records were in general consistent, suggesting that stormier periods occurred around 7300, 6600, 5900, 4600, 3600, 2900, 2400, 2100, and 1600 cal yr BP and over the last 1200 years. The results and comparisons with other storminess and climate studies indicate a shift in climatic conditions around 2500 cal yr BP when stormy periods became more frequent. The ASI values were also high during the last millennium, suggesting either higher storminess or more suitable transport mechanisms for sand into the coastal bogs: the niveo-aeolian transport mode could have been favored in winters, especially during the Little Ice Age, and human impact on landscapes has probably increased over the past centuries. [ABSTRACT FROM AUTHOR]

Sandy beaches high in recreation value make up 16% of the over 4000 km long shoreline of Estonia. The shore processes associated with climate change have remarkably accelerated over recent decades. Many sandy shores have suffered from strong erosion, including an excellent former beach at Valgeranna. The jetties, which were built in the 1860s to protect the navigation channel of Port Pärnu from clogging, have prevented natural sediment transport along the coast from south to north. At the same time, the sandy beach in Pärnu is expanding, and part of the sand accumulates with strong storms also in between the jetties, reducing the width of the shipping channel. The channel needs regular dredging, but, so far, the dredged sediment has been taken far away to the open sea and accumulated on the seabed. The current paper addresses the possibilities of using that sand for beach restoration in destructed and eroded areas. An overview of the applied methods and measurements during field studies is given. The results of modelling the processes of wave activity and sediment transport are discussed. The recycling of shore sediments is an important measure in sustainable coastal zone management. Different options and scenarios are analysed in order to find the most reasonable ways to bring sand back onto beaches and stabilize natural processes. Support from the state by working out respective laws and regulations would be motivating as well.

Pediatric data on the clinical and etiologic features, treatment response, and use of omalizumab for chronic urticaria (CU) are quite limited. The aim of this study was to evaluate the clinical and demographic characteristics, laboratory findings, and response to treatment of CU in children. Children with a diagnosis of CU between 2019 and 2023 were included in the study. Information on demographic characteristics, clinical features, laboratory tests, provocation tests for inducible urticaria, urticaria activity scores (UAS7), and treatment responses were obtained from patients’ medical records. A total of 150 children (50.7% male) with CU were enrolled in the study. A total of 14 (9.3%) patients had autoimmune diseases of which 11 (7.3%) had autoimmune thyroiditis. Overall, 97 (64.7%) patients had chronic spontaneous urticaria (CSU) and 53 (35.3%) had chronic inducible urticaria. A total of 16 patients who remained symptomatic despite high-dose antihistamines were treated with omalizumab, with a good response in 13 (81.3%) and a partial response in 3 (18.7%) patients. CSU accounts for the majority of pediatric CU, with the etiology being in part related to an autoimmune background. This study provides an overview of CU in children and demonstrates the safety and efficacy of treatment with omalizumab.

For political and administrative governance of land-use decisions, high-resolution and reliable spatial models are required over large areas and for various time horizons. We present a process-centered simulation model 'NextStand' (a forest landscape model, FLM) and its R-script, which predicts regional forest characteristics at a forest stand resolution. The model uses whole area stand data and is optimized for realistic iterative timber harvesting decisions, based on stand compositions (developing over time) and locations. We used the model for simulating spatial predictions of the Estonian forests in North Europe (2.3 Mha, about 2 M stands); the decisions were parameterized by land ownership, protection regimes, and rules of clear-cut harvesting. We illustrate the model application as a potential broad-scale Decision Support Tool by predicting how the forest age composition, placement of clear-cut areas, and connectivity of old stands will develop until the year 2050 under future scenarios. The country-scale outputs had a generally low within-scenario variance, which enabled to estimate some main land-use effects and uncertainties at small computing efforts. In forestry terms, we show that a continuation of recent intensive forest management trends will produce a decline of the national timber supplies in Estonia, which greatly varies among ownership types. In a conservation perspective, the current level of 13% forest area strictly protected can maintain an overall area of old forests by 2050, but their isolation is a problem for biodiversity conservation. The behavior of low-intensity forest management units (owners) and strict governance of clear-cut harvesting rules emerged as key questions for regional forest sustainability. Our study confirms that high-resolution modeling of future spatial composition of forest land is feasible when one can (i) delineate predictable spatial units of transformation (including management) and (ii) capture their variability of temporal change with simple ecological and socioeconomic (including human decision-making) variables.

Abstract Background Hospitals in England have undergone considerable change to address the surge in demand imposed by the COVID-19 pandemic. The impact of this on emergency department (ED) attendances is unknown, especially for non-COVID-19 related emergencies. Methods This analysis is an observational study of ED attendances at the Imperial College Healthcare NHS Trust (ICHNT). We calibrated auto-regressive integrated moving average time-series models of ED attendances using historic (2015–2019) data. Forecasted trends were compared to present year ICHNT data for the period between March 12, 2020 (when England implemented the first COVID-19 public health measure) and May 31, 2020. We compared ICHTN trends with publicly available regional and national data. Lastly, we compared hospital admissions made via the ED and in-hospital mortality at ICHNT during the present year to the historic 5-year average. Results ED attendances at ICHNT decreased by 35% during the period after the first lockdown was imposed on March 12, 2020 and before May 31, 2020, reflecting broader trends seen for ED attendances across all England regions, which fell by approximately 50% for the same time frame. For ICHNT, the decrease in attendances was mainly amongst those aged

Abstract SARS-CoV-2 infections have been reported in all age groups including infants, children, and adolescents. However, the role of children in the COVID-19 pandemic is still uncertain. This systematic review of early studies synthesises evidence on the susceptibility of children to SARS-CoV-2 infection, the severity and clinical outcomes in children with SARS-CoV-2 infection, and the transmissibility of SARS-CoV-2 by children in the initial phases of the COVID-19 pandemic. A systematic literature review was conducted in PubMed. Reviewers extracted data from relevant, peer-reviewed studies published up to July 4th 2020 during the first wave of the SARS-CoV-2 outbreak using a standardised form and assessed quality using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. For studies included in the meta-analysis, we used a random effects model to calculate pooled estimates of the proportion of children considered asymptomatic or in a severe or critical state. We identified 2775 potential studies of which 128 studies met our inclusion criteria; data were extracted from 99, which were then quality assessed. Finally, 29 studies were considered for the meta-analysis that included information of symptoms and/or severity, these were further assessed based on patient recruitment. Our pooled estimate of the proportion of test positive children who were asymptomatic was 21.1% (95% CI: 14.0–28.1%), based on 13 included studies, and the proportion of children with severe or critical symptoms was 3.8% (95% CI: 1.5–6.0%), based on 14 included studies. We did not identify any studies designed to assess transmissibility in children and found that susceptibility to infection in children was highly variable across studies. Children’s susceptibility to infection and onward transmissibility relative to adults is still unclear and varied widely between studies. However, it is evident that most children experience clinically mild disease or remain asymptomatically infected. More comprehensive contact-tracing studies combined with serosurveys are needed to quantify children’s transmissibility relative to adults. With children back in schools, testing regimes and study protocols that will allow us to better understand the role of children in this pandemic are critical.

Abstract The ecology and evolution of reproductive timing and synchrony have been a topic of great interest in evolutionary ecology for decades. Originally motivated by questions related to behavioral and reproductive adaptation to environmental conditions, the topic has acquired new relevance in the face of climate change. However, there has been relatively little research on reproductive phenology in mammalian carnivores. The Eurasian lynx (Lynx lynx) occurs across the Eurasian continent, covering three of the four main climate regions of the world. Thus, their distribution includes a large variation in climatic conditions, making it an ideal species to explore reproductive phenology. Here, we used data on multiple reproductive events from 169 lynx females across Europe. Mean birth date was May 28 (April 23 to July 1), but was ~10 days later in northern Europe than in central and southern Europe. Birth dates were relatively synchronized across Europe, but more so in the north than in the south. Timing of birth was delayed by colder May temperatures. Severe and cold weather may affect neonatal survival via hypothermia and avoiding inclement weather early in the season may select against early births, especially at northern latitudes. Overall, only about half of the kittens born survived until onset of winter but whether kittens were born relatively late or early did not affect kitten survival. Lynx are strict seasonal breeders but still show a degree of flexibility to adapt the timing of birth to surrounding environmental conditions. We argue that lynx give birth later when exposed to colder spring temperatures and have more synchronized births when the window of favorable conditions for raising kittens is shorter. This suggests that lynx are well adapted to different environmental conditions, from dry and warm climates to alpine, boreal, and arctic climates. This variation in reproductive timing will be favorable in times of climate change, as organisms with high plasticity are more likely to adjust to new environmental conditions.