Cumulative Impact Research Articles

Association between Mixed Heavy Metal Exposure and Arterial Stiffness, with Alkaline Phosphatase Identified as a Mediator.

Elevated arterial stiffness has been associated with exposure to heavy metals such as lead (Pb) and cadmium (Cd). However, the collective impact of multiple metals and the underlying mechanisms are not fully elucidated. The purpose of this study was to assess the combined effects of exposure to nine heavy metals on arterial stiffness and explore whether serum alkaline phosphatase (ALP) acts as a mediator in this relationship. In the retrospective analysis, data from 8,700 participants were retrieved from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. Arterial stiffness was measured by estimated pulse wave velocity (ePWV). The cumulative impact of exposure to multiple metals was examined using adaptive elastic-net, environmental risk score, weighted quantile sum regression, and quantile g-computation. Additionally, mediation analysis was conducted to explore the potential mediating role of serum ALP. We found that combined exposure to multiple metals was consistently associated with elevated ePWV, with Ba, Pb, and Sb exhibiting the greatest contributions. Notably, serum ALP partially mediated the associations between individual (Pb, Sb) and mixed metal exposure with ePWV, with mediation proportions at 10.76% for Pb, 18.22% for Sb, and 11.07% for mixed metal exposure. In conclusion, this study demonstrates a clear association between exposure to heavy metals, either individually or in combination, and heightened arterial stiffness. Furthermore, the findings suggest that serum ALP activity may act as a mediator in these relationships.

Metabolic syndrome traits differentially and cumulatively influence micro- and macrovascular disease risk in patients with MASLD.

The cumulative impact of metabolic syndrome (MetS) components on micro- and macrovascular disease in metabolic dysfunction-associated steatotic liver disease (MASLD) is unclear. We aimed to determine whether the number of the MetS components increases the risk of micro- and macrovascular disease in patients with MASLD. We performed a retrospective cohort study of electronic medical records using the TriNetX network, a global federated database. The exposure arm was patients with hepatic steatosis (defined via International Classification of Diseases, 10th Revision coding, or modified hepatic steatosis index), and ≥1 MetS components (obesity/central adiposity, insulin resistance, hypertension, or dyslipidaemia), compared with a reference arm of adults without any MetS components or hepatic steatosis. Our propensity score matched (1:1) for confounders with 5 years of follow-up. Primary outcomes included microvascular (peripheral neuropathy, retinopathy, and nephropathy) and macrovascular (cardiovascular events, cerebrovascular accidents, and peripheral vascular disease) disease. Secondary analyses assessed the impact of additional MetS components on these outcomes, as well as the impact of sex. MASLD, defined by hepatic steatosis and insulin resistance (n = 15 937), carried the highest risk of microvascular disease (HR 13.93 (95% CI 8.55-22.68)), whilst MASLD, defined by hepatic steatosis and hypertension (n = 53 028), carried the highest risk of macrovascular disease (7.23 (6.45-8.13)). MASLD with all MetS components carried greatest risk of both micro- (31.20 (28.88-33.70) (n = 462 789)) and macrovascular (8.04 (7.33-8.82) (n = 336 010)) disease. We demonstrate a differential effect of MetS components on micro- and macrovascular disease risk in patients with MASLD, with a cumulative impact of multiple MetS on overall risk. The impact of MetS components was most pronounced in women. Aggressive metabolic risk factor management is critical for prevention of micro- and macrovascular complications.

From land to deep sea: A continuum of cumulative human impacts on marine habitats in Atlantic Canada

AbstractEffective management and mitigation of multiple human impacts on marine ecosystems require accurate knowledge of the spatial patterns of human activities and their overlap with vulnerable habitats. Cumulative impact (CI) mapping combines spatial information and the intensity of human activities with the spatial extent of habitats and their vulnerabilities to those stressors into an intuitive relative CI score that can inform marine spatial planning processes and ecosystem‐based management. Here, we mapped potential CIs of 45 human activities from five sectors (climate change, land‐based, marine‐based, coastal, commercial fishing) on 21 habitats in Atlantic Canada's Scotian Shelf bioregion. We applied an uncertainty and sensitivity analysis to assess the robustness of results and identify hot and cold spots of CIs. Nearly the entire Scotian Shelf bioregion experiences the CIs of human activities, and high CIs were frequently associated with multiple stressors. CIs varied widely across habitats: CI scores in habitats >30 m deep were dominated by climate change and commercial fishing, while nearshore habitats were influenced by a much wider range of activities across all five sectors. When standardized by area, coastal habitats had among the highest CI scores, highlighting the intensity of multiple stressors in these habitats despite their relatively small spatial extent and emphasizing the importance of a multisector approach when managing coastal ecosystems. Robust hot spots of CIs (i.e., areas with high CI scores that were insensitive to alternative modeling assumptions and simulated data quality issues) occurred mostly in coastal areas where multiple high‐intensity activities overlapped with highly vulnerable biogenic habitats. In contrast, robust cold spots of CI mostly occurred offshore. Overall, our results emphasize the need to consider CIs in management and protection and demonstrates that, in many areas, targeting only one activity will be insufficient to reduce overall human impact. The CI map will be useful to highlight areas in need of protection from multiple human impacts, provide information for ecological indicator development, and establish a baseline of the current state of human use in the bioregion.

Are Our Climate Data Fit for Your Purpose?

Abstract This paper describes the vision and objectives for evaluation and quality control of datasets available on the Climate Data Store (CDS) of the Copernicus Climate Change Service (C3S). The CDS is a cloud service providing reliable, open, and free access to climate datasets from many different sources, including observations and derived climate data records, global and regional reanalysis products, and output from global and regional climate models. CDS data and information are widely used to monitor climate change, for policy development, environmental impact studies, business plans, public awareness, and many other purposes. CDS users include policymakers, technical consultants, and data scientists who are climate literate but not necessarily specialized in climate science. A key objective for C3S is to simplify data discovery and access and to ensure that all information provided is fit for purpose. The role of evaluation and quality control is to generate useful statements about the technical and scientific quality of the datasets available on the CDS, presented in a form that can be mapped directly to user requirements associated with specific application contexts. The ambition is to enable users to select, locate, access, and process climate data that are fit for purpose, simply by expressing their requirements in their own words.

Characteristics of positive feedback provided by UK health service users: content analysis of examples from two databases

BackgroundMost feedback received by health services is positive. Our systematic scoping review mapped all available empirical evidence for how positive patient feedback creates healthcare change. Most included papers did not...

Current species protection does not serve its porpoise-Knowledge gaps on the impact of pressures on the Critically Endangered Baltic Proper harbour porpoise population, and future recommendations for its protection.

Successful management requires information on pressures that threaten a species and areas where conservation actions are needed. The Baltic Proper harbour porpoise population was first listed as Critically Endangered by the International Union for the Conservation of Nature in 2008. Now, 16 years later, there is no change in conservation status despite ample conservation policy calling for its protection and an urgent need for management action to protect this population. Here, we provide an overview of the current status of the population, highlight knowledge gaps on the impact of pressures, and make recommendations for management of anthropogenic activities. Based on an exceeded limit for anthropogenic mortality, the high concentrations of contaminants in the Baltic Sea, combined with reductions in prey availability and increases in underwater noise, it is inferred that this population is likely still decreasing in size and conservation action becomes more urgent. As bycatch and unprotected underwater explosions result in direct mortality, they must be reduced to zero. Inputs of contaminants, waste, and existing and emerging noise sources should be minimised and regulated. Additionally, ecosystem-based sustainable management of fisheries is paramount in order to ensure prey availability, and maintain a healthy Baltic Sea. Stranding networks to routinely assess individuals for genetic population assignment and health need to be expanded, to identify rare samples from this population. Knowledge is still scarce on the population-level impact of each threat, along with the cumulative impact of multiple pressures on the population. However, the current knowledge and management instruments are sufficient to apply effective protection for the population now. While bycatch is the main pressure impacting this population, urgent conservation action is needed across all anthropogenic activities. Extinction of the Baltic Proper harbour porpoise population is a choice: decision-makers have the fate of this genetically and biologically distinct marine mammal population in their hands.

254. QUANTIFYING PERIOPERATIVE RISKS FOR ANTIREFLUX AND HIATUS HERNIA SURGERY: A MULTICENTER COHORT STUDY OF 4301 PATIENTS

Abstract Background Predicting perioperative risks for fundoplication and hiatus hernia repair will inform treatment decision-making, hospital resource allocation, and benchmarking. However, available risk calculators do not account for hernia anatomy or technical aspects of surgery in estimating perioperative risk. Using a comprehensive Australian cohort, we quantified the incidence and determined the independent predictors of intraoperative and postoperative complications associated with antireflux and hiatus hernia surgeries. Additionally, we performed an in-depth analysis to understand the complication profiles associated with each independent risk factor. Methods Retrospective analysis of all elective antireflux and hiatus hernia surgeries in 36 Australian hospitals over 10 years. Hierarchical multivariate logistic regression analyses were performed to determine the independent predictors of intraoperative and postoperative complications accounting for patient, surgical, anatomical, and perioperative factors. Results A total of 4301 surgeries were analyzed. Of these, 1569 (36.5%) were large/giant hernias and 292 (6.8%) were revisional procedures. The incidence rates of intra- and postoperative complications were 12.6% and 13.3%, respectively. The Charlson Comorbidity Index, hernia size, revisional surgery, and baseline anticoagulant usage independently predicted both intraoperative and postoperative complications. These risk factors were associated with their own complication profiles. Finally, using risk matrices, we visualized the cumulative impact of these four risk factors have on the development of intraoperative, overall postoperative, and major postoperative complications. Conclusions This study has improved our understanding of perioperative morbidity associated with antireflux and hiatus hernia surgery. Our findings group patients along a spectrum of perioperative risks that informs care at an individual and institutional level.

Barriers in providing quality end-of-life care as perceived by nurses working in critical care units: an integrative review

BackgroundDespite increasing interest in quality end-of-life care (EOLC), critically ill patients often receive suboptimal care. Critical care nurses play a crucial role in EOLC, but face numerous barriers that hinder their ability to provide compassionate and effective care.MethodsAn integrative literature review was conducted to investigate barriers impacting the quality of end-of-life care. This review process involved searching database like MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL, EBSCO, and ScienceDirect up to November 2023. Search strategies focused on keywords related to barriers in end-of-life care and critical care nurses from October 30th to November 10th, 2023. The inclusion criteria specified full-text English articles published between 2010 and 2023 that addressed barriers perceived by critical care nurses. This integrative review employs an integrated thematic analysis approach, which combines elements of deductive and inductive analysis, to explore the identified barriers, with coding and theme development overseen by the primary and secondary authors.ResultsOut of 103 articles published, 11 articles were included in the review. There were eight cross-sectional descriptive studies and three qualitative studies, which demonstrated barriers affecting end-of-life care quality. Quality appraisal using the Mixed Method Appraisal Tool was completed by two authors confirmed the high credibility of the selected studies, indicating the presence of high-quality evidence across the reviewed articles. Thematic analysis led to the three main themes (1) barriers related to patients and their families, (2) barriers related to nurses and their demographic characteristics, and (3) barriers related to health care environment and institutions.ConclusionThis review highlights barriers influencing the quality of end of life care perceived by critical care nurses and the gaps that need attention to improve the quality of care provided for patients in their final stages and their fsmilies within the context of critical care. This review also notes the need for additional research to investigate the uncover patterns and insights that have not been fully explored in the existing literature to enhance understanding of these barriers. This can help to inform future research, care provision, and policy-making. Specifically, this review examines how these barriers interact, their cumulative impact on care quality, and potential strategies to overcome.

Suitability and Structural Optimization of Vegetation Restoration on the Loess Plateau: A MaxEnt Model-Based Study of Environmental and Anthropogenic Impacts

Suitability and Structural Optimization of Vegetation Restoration on the Loess Plateau: A MaxEnt Model-Based Study of Environmental and Anthropogenic Impacts

Using cumulative human impact assessment to support adaptive management of the threatened species’ habitats in the Yangtze River Estuary

The conflict between multiple functions of human use and habitat conservation represents an intractable challenge for environmental management. While numerous studies on marine conservation prioritize cumulative impact assessments (CIA) to tackle this issue, estuaries — despite their immense conservation significance amidst intense human activities — remain overlooked. Taking the Yangtze River Estuary (YRE) as the case study area, it is one of the most intensely human-utilized estuaries globally, yet it serves as a critical habitat and migratory corridor for the endangered Chinese sturgeon (Acipenser sinensis).We employed ecological indicators and quantitative modeling to assess habitat suitability and cumulative anthropogenic impacts on this endangered species in the YRE. The results demonstrated that suitable habitat distribution and human impact varied for juvenile Chinese sturgeon in the YRE. The suitable habitat distribution for juvenile Chinese sturgeon was concentrated in Chongming Dongtan and the North Channel. Ship density, submarine optical cables, and smooth cord grass invasion were the main anthropogenic factors impacting the Chinese sturgeon's migrating habitat in the YRE. Moreover, existing Chinese sturgeon habitats remain at risk, with 36.24 % of potential habitats and 56.60 % of high human impact areas requiring enhanced protection. Adaptive management strategies were proposed, tailored to the spatial and environmental protection needs across the dynamic habitat demands of aquatic species. Our spatially explicit and indicator-based findings provide key scientific support for enlarging protected areas and implementing adaptive management of human activities to balance conservation and sustainable use in this highly utilized ecosystem.

Use of Engineering-Educational-Empowerment Model to Improve the Integrated Traffic Impact Analysis and Environment Impact Analysis Results

In order to control road carriage way capacity and/or road environment degradation due to transport activities, the Traffic Impact Analysis TIA document has been directed to be integrated within the Environment Impact Analysis EIA document. However, only medium and high trip attractiveness was considered. Consequently, cumulative impact due to dense small scale concentrated in a certain corridor not only decrease road capacity but also increase road environment degradation. These unintended situations, especially at fast growth corridors, was recorded, including the parking index, on-street parking impacts due to inadequacy in existing parking space capacity. This activity aims to socialized and discussed the technical and environmental impacts due to on-street parking in order to improve better knowledge and transport policy decision. Therefore, an integrated approaches - using a Focus Group Discussion - based on engineering, educational and empowerment method was undertaken to identify a change in stake holder’s perception towards the correlation between transport and land use. It was found that, although within low trip attractiveness level category, but a dense small scale of activities produces great roadside friction and contribute negative impact on roadway capacity and air pollutant essence. This strongly indicate that a micro zoning regulation is required to control the type, number, scale and dense of social-economic activities, particularly in fast growth corridors.

Insights into different marine aquaculture infrastructures from a life cycle perspective

Aquaculture facilities represent an often-neglected process in environmental impact studies. This study focus on the environmental impact assessment of alternative net materials in Mediterranean marine aquaculture. A Life Cycle Assessment was conducted using primary and secondary data from specific databases and literature. Three baseline scenarios were compared: copper alloy net cages with 100 % of recycled material (CAN100), 75 % of recycled material (CAN75), and polyethylene net (PEN) System boundaries include manufacturing and disposal of cages, nets, and mooring system. The use and emissions of antifouling paints and CAN were considered. Sensitivity analysis of the most impacting sub-processes and Uncertainty analysis were also conducted. The use of CAN is advantageous in terms of environmental impact, but only considering a complete recyclability of the net at the end of its service life. Moreover, when considering a reduced service life of the PEN due to the detrimental effect of biofouling, the advantage of the CAN is even more evident. To counteract the negative effect of biofouling, copper-based antifouling paints are generally used in marine aquaculture. These products are a main environmental hotspot in PEN systems. Therefore, a higher consumption of such products could determine an environmental burden shifting from CAN to PEN ones. So far, CAN are not widespread in the aquaculture industry, mainly due to the high cost of initial investment compared to traditional PEN. Considering operational and environmental advantages, CAN cages could represent an affordable and resilient solution for aquaculture enhancing environmental, economic, and social performances of this industry.

The Cumulative Impacts of Fatigue during Overload Training Can Be Tracked Using Field-Based Monitoring of Running Stride Interval Correlations.

Integrating running gait coordination assessment into athlete monitoring systems could provide unique insight into training tolerance and fatigue-related gait alterations. This study investigated the impact of an overload training intervention and recovery on running gait coordination assessed by field-based self-testing. Fifteen trained distance runners were recruited to perform 1-week of light training (baseline), 2 weeks of heavy training (high intensity, duration, and frequency) designed to overload participants, and a 10-day light taper to allow recovery and adaptation. Field-based running assessments using ankle accelerometry and online short recovery and stress scale (SRSS) surveys were completed daily. Running performance was assessed after each training phase using a maximal effort multi-stage running test-to-exhaustion (RTE). Gait coordination was assessed using detrended fluctuation analysis (DFA) of a stride interval time series. Two participants withdrew during baseline training due to changed personal circumstances. Four participants withdrew during heavy training due to injury. The remaining nine participants completed heavy training and were included in the final analysis. Heavy training reduced DFA values (standardised mean difference (SMD) = -1.44 ± 0.90; p = 0.004), recovery (SMD = -1.83 ± 0.82; p less than 0.001), performance (SMD = -0.36 ± 0.32; p = 0.03), and increased stress (SMD = 1.78 ± 0.94; p = 0.001) compared to baseline. DFA values (p = 0.73), recovery (p = 0.77), and stress (p = 0.73) returned to baseline levels after tapering while performance trended towards improvement from baseline (SMD = 0.28 ± 0.37; p = 0.13). Reduced DFA values were associated with reduced performance (r2 = 0.55) and recovery (r2 = 0.55) and increased stress (r2 = 0.62). Field-based testing of running gait coordination is a promising method of monitoring training tolerance in running athletes during overload training.

Is previous prostatectomy a risk factor for postoperative complications following minimally invasive inguinal hernia repair? A systematic review and meta-analysis.

The literature indicates that patients with prior pelvic surgery, particularly radical prostatectomy, pose challenges in minimally invasive inguinal hernia repair (IHR). However, there is no conclusive evidence regarding the impact of pelvic surgery on postoperative complications. To address this gap, we conducted a systematic review and meta-analysis to evaluate the influence of previous prostatectomy in men undergoing MIS IHR. We searched Cochrane Central, Scopus, SciELO, Lilacs, and PubMed/MEDLINE for studies comparing men undergoing MIS IHR after prostatectomy with men without previous pelvic surgery. Key outcomes evaluated included recurrence, overall postoperative complications, seroma, hematoma, surgical site infection (SSI), conversion rates, and operative time. Out of 402 screened studies, 9 met the inclusion criteria. Among the included studies, three analyzed totally extraperitoneal (TEP) technique, while four analyzed transabdominal preperitoneal (TAPP) and two presented both techniques together. The analysis comprised 189,183 patients, of which 4551 (2.4%) had a history of prostatectomy. The analysis revealed that post-prostatectomy patients presented higher postoperative complications (3.7% vs. 1.9%; RR 1.9; 95% CI [1.23; 2.94]; P = 0.004) and seroma (1.6% vs. 0.9%; RR 1.58; 95% CI [1.23; 2.04]; P < 0.001) following MIS IHR. Additionally, patients with a previous prostatectomy presented an increased operative time (MD 21.25min; 95% CI [19.1; 23.4]; P < 0.001). No significant differences were observed in recurrence (0.98% vs. 0.92%; RR 1.1; 95% CI [0.8; 1.53]; P = 0.54), SSI (0.07% VS. 0.07%; RR 0.99; 95% CI [0.34; 2.9]; P = 0.98), hematoma (3.6% vs. 1.2%; RR 3.18; 95% CI [0.84; 12.1]; P = 0.09), and conversion rates (1.1% vs. 0.9%; RR 1.26; 95% CI [0.91; 1.72]; P = 0.16). However, subgroup analysis of TEP technique in patients with previous prostatectomy showed higher conversion rates (2.4% vs. 0%; RR 20; 95% CI [2.9; 138.2]; P < 0.01). Analysis using funnel plots showed the absence of publication bias in the study outcomes. This comprehensive analysis indicates that patients with a history of prostatectomy undergoing MIS IHR may present higher postoperative complications and an increased operative time. Further comparative studies are needed to evaluate the cumulative impact of MIS IHR in patients with previous prostatectomy.

Repetitive Head Impacts and Perivascular Space Volume in Former American Football Players

Exposure to repetitive head impacts (RHI) is associated with increased risk for neurodegeneration. Accumulation of toxic proteins due to impaired brain clearance is suspected to play a role. To investigate whether perivascular space (PVS) volume is associated with lifetime exposure to RHI in individuals at risk for RHI-associated neurodegeneration. This cross-sectional study was part of the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project, a 7-year multicenter study consisting of 4 US study sites. Data were collected from September 2016 to February 2020 and analyses were performed between May 2021 and October 2023. After controlling for magnetic resonance image (MRI) and processing quality, former American football players and unexposed asymptomatic control participants were included in analyses. Prior exposure to RHI while participating in American football was estimated using the 3 cumulative head impact indices (CHII-G, linear acceleration; CHII-R, rotational acceleration; and CHII, number of head impacts). Individual PVS volume was calculated in the white matter of structural MRI. Cognitive impairment was based on neuropsychological assessment. Linear regression models were used to assess associations of PVS volume with neuropsychological assessments in former American football players. All analyses were adjusted for confounders associated with PVS volume. Analyses included 224 participants (median [IQR] age, 57 [51-65] years), with 170 male former football players (114 former professional athletes, 56 former collegiate athletes) and 54 male unexposed control participants. Former football players had larger PVS volume compared with the unexposed group (mean difference, 0.28 [95% CI, 0.00-0.56]; P = .05). Within the football group, PVS volume was associated with higher CHII-R (β = 2.71 × 10-8 [95% CI, 0.50 × 10-8 to 4.93 × 10-8]; P = .03) and CHII-G (β = 2.24 × 10-6 [95% CI, 0.35 × 10-6 to 4.13 × 10-6]; P = .03). Larger PVS volume was also associated with worse performance on cognitive functioning in former American football players (β = -0.74 [95% CI, -1.35 to -0.13]; P = .04). These findings suggest that impaired perivascular brain clearance, as indicated by larger PVS volume, may contribute to the association observed between RHI exposure and neurodegeneration.

Impact of sediment mobilization on trace elements release in Galician Rías (NW Iberian Peninsula): insights into aquaculture

In the latest years, the concentration levels of certain metals and metalloids in the sediments of the Galician Rías have shown an increasing trend (e.g., As, Zn, Cu, Pb, Hg). These areas are also characterized by their richness in nutrients and their great aquaculture or mariculture activity, with the presence of more than 3500 mussel rafts in the Rías Baixas. The inner areas of the Galician Rías are subjected to activities that resuspend the sediment such as high levels of maritime traffic and dredging or cleaning operations. It is likely that a transfer of these elements to the water column happens during the resuspension of sediments caused by natural events or anthropogenic activities. In this study, selected samples of surface sediments of the Ría de Pontevedra (NW Spain) were subjected to a procedure of aerobic oxidation to determine the concentration of some elements (Fe, Mn, Cu, Cr, Pb, Hg, and Zn) released from the sediment to the aqueous phase. The experiment was carried out within 5 days. Measurements of pH and total concentration were taken both in water and sediment samples. Furthermore, speciation of trace elements was carried out in the sediment samples. Trace element concentrations were lower in the sediments during aerobic oxidation, being released to the aqueous phase. From an environmental point of view, Cu was the only trace element released in quantities that may be toxic for the organisms in the area. This problem of sediment oxidation related to dredging activities or natural storm conditions should be considered in environmental impact studies and transferred to stakeholders.

Exploring cumulative identity-based discrimination, distress, and traumatic exposure among Muslims living in the United States.

Muslims living in the United States (MLUS), a highly heterogeneous group, experience high rates of discrimination that may cumulatively contribute to traumatic stress. This study explored whether identity-based discrimination (i.e., due to religion, gender, race) was individually and cumulatively associated with psychological distress and exposure to trauma among MLUS. Fifty-nine MLUS completed the survey at two time points (~1 year apart). We administered measures of discrimination (at Time 1), distress (at Times 1 and 2), and trauma exposure (at Time 2). Multiple linear regressions determined whether discrimination at Time 1 was associated with traumatic exposure or distress at Time 2, after controlling for covariates. Mediation analyses determined whether the relationship between cumulative discrimination and distress at Time 2 occurred via distress at Time 1. MLUS who reported experiencing both religious and racial discrimination also reported greater exposure to traumatic events, after controlling for covariates. All three forms of identity-based discrimination (religion, race, gender) were individually and cumulatively (i.e., experiencing all three) associated with distress at Time 1, but not Time 2. However, the relationships between cumulative discrimination at Time 1 and distress at Time 2 were mediated by distress at Time 1. U.S.-born Muslims were particularly at risk for experiencing discrimination, distress, and traumatic exposure. Experiences of discrimination may have a cumulative impact on trauma and psychological distress among MLUS. This study underscores the need for targeted interventions that assess MLUS clients' discriminatory experiences to develop a more holistic conceptualization, better support systems, and the most effective approaches. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Response surface methodology based investigations of total organic carbon removal using cerium oxide nanoparticle

This study aimed to optimize the removal of total organic carbon (TOC) from drinking water using cerium oxide nanoparticle (CONP) through response surface methodology (RSM) based approach. The CONP was synthesized using an efficient microwave combustion (EMC) technique. It was further characterised by High-resolution transmission electron microscopy (HR-TEM), X-Ray diffraction (XRD), energy dispersive X-ray (EDX), Brunauer-Emmett-Teller (BET) surface area analysis, and zeta potential. CONP was found highly efficient in removing up to 94 % TOC at the optimum condition i.e., pH = 7, dosage = 0.5 g/L, and contact time = 30 min. Pareto analysis revealed that amongst all the selected variables, the CONP dose had the greatest cumulative impact on TOC removal. The second-order polynomial model developed using the RSM technique was found highly accurate in predicting the removal of TOC from drinking water (R2 = 0.98). The study offers a unique approach for reducing the number of experimental trials and arriving at an optimal experimental conditions to achieve higher TOC adsorption efficiency.

Strong synergistic and antagonistic effects of quinones and metal ions in oxidative potential (OP) determination by ascorbic acid (AA) assays

A key challenge in oxidative potential (OP) assays is to accurately assess the cumulative impact of redox-active aerosol species rather than only their individual effects. This study investigates the OP of single and combined mixtures of 1,2-naphthoquinone (1,2-NQ), 1,4-naphthoquinone (1,4-NQ), 9,10-phenanthrenequinone (9,10-PQ), 1,4-benzoquinone (1,4-BQ), Cu, Fe, Mn, and Zn in standard ascorbic acid (OPAA) and the synthetic respiratory tract lining fluid (OPRTLF) assays. In both OPAA and OPRTLF, binary mixtures showed additive and synergistic effects in the presence of 1,2-NQ. The mixture of Cu and Zn showed substantial synergisms in both assays, while the mixtures in the absence of 1,2-NQ primarily induced antagonistic effects. For the first time, we propose linear equations to improve the prediction of OP values by considering the impacts of synergistic and antagonistic effects. Under this approach, we observed that the potential effects caused by binary mixtures in ambient particulate matter (PM) samples could account for up to 68 % of the PM-OP values in Fez, Morocco (OPmAA: 0.34 nmol min−1 µg−1 and OPmRTLF: 0.18 nmol min−1 µg−1). The present study improves the understanding of effects of chemical interaction of potentially toxic substances that are important in the understanding of PM-induced oxidative stress in the human body.

Correlation Between the Number of Pathological Risk Factors and Postoperative Prognosis in Patients with Stage I Lung Adenocarcinoma.

Although visceral pleural invasion, lymphovascular invasion, tumor spread through air spaces, and poor differentiation are pathological risk factors associated with unfavorable prognosis in patients with lung adenocarcinoma, the cumulative impact of these factors on prognosis remains unclear. We enrolled 1532 patients with stage I lung adenocarcinoma. Patients were divided according to the number of risk factors as follows: Group A (without risk factors), Group B (one risk factor), and Group C (multiple risk factors). Moreover, we stratified patients into two subgroups based on tumor size (≤ 3cm, 3-4cm). Kaplan-Meier analysis was used to evaluate 5-year disease-free survival (DFS) and overall survival (OS). Overall, 949, 404, and 179 patients were included in Groups A, B, and C, respectively. Group C had a larger tumor size and more cases of extrathoracic recurrence than the other groups. The 5-year DFS and OS gradually decreased across Groups A to C (DFS: 94.3%, 80.6%, and 64.3%, respectively, p < 0.001; OS: 97.2%, 92.7%, and 77%, respectively, p < 0.001). A similar trend was observed for tumors ≤ 3cm in size (DFS: 95.2%, 83.2%, and 68.5%, respectively, p < 0.001; OS: 97.6%, 94.1%, and 79.6%, respectively, p < 0.001), but a less pronounced trend was observed for tumors between 3 and 4 cm in size (DFS: 72.1, 60.8, and 43.3%, respectively, p = 0.054; OS: 85.7, 82.1, and 64.7%, respectively, p = 0.16). Postoperative survival worsened with increasing pathological risk factors in patients with stage I lung adenocarcinoma, especially those with tumor size ≤ 3cm.