Mean Consumption Research Articles

Healthcare expenditure trends among adult stroke patients in the United States, 2011-2020

BackgroundIn the US, between 2018 and 2019, approximately $57 billion were expended on stroke and related conditions. The aim of this study was to understand trends in direct healthcare expenditures among stroke patients using novel cost estimation methods and a nationally representative database. MethodsThis study was a retrospective analysis of 193,003 adults, ≥18 years of age, using the Medical Expenditure Panel Survey during 2009-2016. Manning and Mullahy's two-part model were used to calculate adjusted mean and incremental medical expenditures after adjusting for covariates. ResultsThe mean (Standard Deviation) direct annual healthcare expenditure among stroke patients was $16,979.0 ($16,222.0- $17,736.0) and was nearly 3 times greater than non-stroke participants which were $5,039.7 ($4,951.0-$5,128.5) and were mainly spent on inpatient services, prescription medications, and office-based visits. Stroke patients had an additional healthcare expenditure of $4096.0 (3543.9, 4648.1) per person per year, compared to participants without stroke after adjusting for covariates (P<0.001). The total mean annual direct healthcare expenditure for stroke survivors increased from $16,142.0 (15,017.0-17,267.0) in 2007-2008 to $16,979.0 (16,222.0-17,736.0) in 2015-2016. ConclusionOur study showed that stroke survivors had significantly greater healthcare expenses, compared to non-stroke individuals, mainly due to higher expenditures on inpatient services, prescription drugs, and office visits. These findings are concerning because the prevalence of stroke is projected to increase due to aging population and increased survival rates.

Acceptance and utilization efficiency of a purple durum wheat genotype by Sitophilus granarius (L.)

The granary weevil (Sitophilus granarius L.) is a major primary pest of stored cereals throughout the world. Among the major classes of plant secondary metabolites, flavonoids can affect insect feeding behaviour and their growth rate. In this study, the susceptibility of an anthocyanin-rich purple durum wheat genotype (T1303) to the granary weevil was evaluated in comparison with two yellow durum (Ofanto) and bread (Mec) wheat varieties. The feeding response and food utilisation efficiency by adult insects was also investigated by calculating nutritional indices in whole flour disk bioassays. Different levels of susceptibility to granary weevil emerged among genotypes tested. The mean food consumption by an insect, F1 progeny, and female parental offspring calculated for the T1303 genotype were significantly lower than those of yellow kernel wheat varieties. Moreover, T1303 genotype induced deterrence in the adult insects as demonstrated by the positive values of the food deterrence index. Besides, relative grow rate and efficiency conversion of ingested food indices were negative for T1303 and positive for both yellow wheat varieties indicating respectively a decrease and an increase of insect body weight during the bioassays. Finally, a higher mortality rate was recorded for insects fed on T1303 flour disks compared to disks obtained from yellow wheat varieties. These results provide evidence for the antifeedant and toxic effects of anthocyanins present in the T1303 pericarp against the granary weevil. Overall, this study contributes new insights into the mechanisms of host acceptance and food utilization by S. granarius and would be useful to identify antifeedant flavonoids as well as to develop varietal resistance-based strategies against this pest.

Association between alcohol consumption and risk of stroke among adults: results from a prospective cohort study in Chongqing, China

BackgroundThe incidence of stroke in China is increasing, along with a clear trend in the prevalence of risk factors. Alcohol consumption is also a risk factor for stroke. Many cohort studies have explored the relationship between alcohol consumption and stroke risk. However, findings have been inconsistent.MethodsWe used cluster sampling to select 13 districts and counties (at the same level) in Chongqing, China. Then, we used stratified random sampling to distribute the number of people in each district and county. 23,308 adults aged 30–79 were recruited between October 2018 and February 2019. Follow-up was conducted through a monitoring system and questionnaires until September 2022. Information on alcohol consumption and other covariates was collected using a standardized questionnaire. Participants were asked to report their weekly frequency of drinking over the past year and weekly intake of various alcoholic beverages in general. The frequency of drinking was divided into three categories: 1–2 d/week, 3–5 d/week, and 6–7 d/week. The average daily alcohol consumption is calculated based on the amount of alcohol contained in different alcoholic beverages. It is classified as nondrinker (0 g/day), light (0 to 12 g/day), moderate (13 to 36 g/day), and high (> 36 g/day). Cox proportional hazard regression models were used to estimate the association between alcohol consumption and stroke risk. Results are shown as multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs).ResultsWith an average follow-up of 3.80 years, there were 310 new stroke events. The incidence of total stroke was 368.69 per 100,000 person-years. Overall, after adjusting for covariates, moderate alcohol consumption (average daily alcohol consumption 13–36 g/d) was associated with a lower risk of total stroke (HR: 0.48; 95% CI: 0.25–0.92) compared with nondrinkers. The adjusted HR and 95% CI for total stroke and ischemic stroke for those who drank alcohol 6–7 days per week were 0.60(0.37, 0.96) and 0.53(0.30, 0.94), respectively. The risk of total stroke (HR: 0.39; 95% CI: 0.17–0.89) was reduced in a pattern of drinking 6–7 days per week but with a mean alcohol consumption of less than 36 g/d. There was no significant association between alcohol consumption and hemorrhagic stroke.ConclusionThis study suggests moderate alcohol consumption is associated with a lower risk of total stroke. And healthy drinking patterns should be of more significant concern.

Alcohol consumption and cancer incidence in women: interaction with smoking, body mass index and menopausal hormone therapy

BackgroundAlcohol consumption has been associated with increased risks of certain site-specific cancers and decreased risks of some other cancers. There is, however, little reliable evidence as to whether the alcohol-associated risks for specific cancers are modified by smoking, body mass index (BMI) and menopausal hormone therapy (MHT) use.MethodsIn the prospective UK Million Women Study, 1,233,177 postmenopausal women without prior cancer, mean age 56 (SD 5) years, reported their alcohol consumption in median year 1998 (IQR 1998–1999), and were followed by record-linkage for incident cancer. 438,056 women who drank no alcohol or < 1 drink/week were excluded. Cox regression yielded adjusted relative risks (RRs) and 95% confidence intervals (CIs) for 21 cancers by alcohol amount; statistical significance of interactions with smoking, BMI and MHT use was assessed after allowing for multiple testing.ResultsIn 795,121 participants, mean consumption was 6.7 (SD 6.4) alcoholic drinks/week. During 17 (SD 5) years of follow-up, 140,203 incident cancers were recorded. There was strong evidence for a substantial association between alcohol intake and risk of upper aero-digestive cancers (oesophageal squamous cell carcinoma, oral cavity, pharynx and larynx; RR per 1 drink/day = 1.38 [95% CI 1.31–1.46]). There was also strong evidence for more moderate positive associations with breast, colorectal and pancreatic cancer (RRs per 1 drink/day = 1.12 [1.10–1.14], 1.10 [1.07–1.13], 1.08 [1.02–1.13] respectively), and moderate negative associations with thyroid cancer, non-Hodgkin’s lymphoma, renal cell carcinoma and multiple myeloma (RRs per 1 drink/day = 0.79 [0.70–0.89], 0.91 [0.86–0.95], 0.88 [0.83–0.94], 0.90 [0.84–0.97] respectively). Significant interactions between alcohol and smoking were seen for upper aero-digestive cancers (RRs per 1 drink/day = 1.66 [1.54–1.79], 1.23 [1.11–1.36], 1.12 [1.01–1.25] in current, past, and never smokers respectively). BMI and MHT did not significantly modify any alcohol-associated risks.ConclusionsThese findings provide robust evidence that greater alcohol intake, even within relatively moderate ranges, increases the risk of cancers of the aerodigestive tract, breast, colorectal and pancreatic cancer, and probably decreases the risk of thyroid cancer, non-Hodgkin’s lymphoma, renal cell carcinoma and multiple myeloma. Associations of alcohol intake with cancer risk were not modified by MHT use, adiposity or smoking, except in the case of upper aero-digestive cancers, where the alcohol-associated risk was largely confined to smokers.

Ultra-processed food consumption is associated with variations in daily routines in elementary schoolchildren during the COVID-19 pandemic in Chile.

To assess the association between child ultra-processed food (UPF) consumption and home-school learning environment characteristics during school closures due to the COVID-19 pandemic in schoolchildren with low- and middle income in Chile. Cross-sectional. UPF consumption was collected using the Nova screener. We apply the structured days hypothesis (SDH) to assess home-school learning environment characteristics with three constructs that summarised school preparedness for online teaching and learning, school closure difficulties for caregivers and child routine. We explored associations between child UPF consumption and home-school environment characteristics using multivariate linear regression analyses after controlling for child demographic and school characteristics. Low- and middle-income neighbourhoods in southeastern Santiago, Chile. Children from the Food Environment Chilean Cohort (n 428, 8-10 years old). Based on the Nova score, child mean consumption of UPF was 4·3 (sd 1·9) groups. We found a statistically significant negative association between child routine for eating, play and study and child UPF consumption when we adjusted for child sociodemographic (model 1: β = -0·19, (95 % CI -0·40, 0·02)) and school characteristics (model 2: β = -0·20, (95 % CI -0·41, 0·00)). Associations between school preparedness for online teaching or school closure difficulties and UPF were not statistically significant. Variations in child routines during the COVID-19 pandemic were negatively associated with UPF intake in schoolchildren with low- and middle income. Our findings are consistent with the SDH, suggesting the school environment helps regulate eating behaviours. Future research should evaluate what happens when children return to in-person classes at school.

Efficacy of Oral Toradol (Ketorolac) Compared to Oral Tramadol as a Preemptive Analgesic in Impacted Third Molar Surgery.

To compare ketorolac with Tramadol as a preemptive analgesic in impacted third molar surgery in terms of mean pain score, mean time of first analgesic and mean total analgesic consumption postoperatively. Experimental study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Islamic International Dental Hospital, (IIDH) Riphah International University, Islamabad, from March 2018 to March 2020. Ninety-four patients, aged 18-45 years with impacted third molars were divided into two groups. Preoperatively oral tramadol 50 mg was given in group A and oral ketorolac 10 mg was given in group B. Pain score was measured 3 hours postoperatively, using the visual analogue scale (VAS), the time was noted for first analgesic consumption in hours and total consumption of analgesics. The mean postoperative pain was measured for both groups. Pain was significantly less in Group B. The mean pain score was 4.02+1.20 in group A and 3.42+1.08 in group B measured at 3 hours postoperatively (p=0.02). The mean time interval for 1st postoperative analgesic was 2.90+1.24 hours in group A and 3.61+1.02 in group B (p=0.007). The mean total analgesic consumption was 3.75+1.27 grams in Group A and 2.27+1.74 grams min Group B (p=0.006). Preemptive Ketorolac has a more prolonged analgesic effect as compared to tramadol. Preemptive analgesia, Tramadol, Ketorolac, Pain score, Third molar surgery.

Single-Shot Regional Anesthesia for Bariatric Surgery: a Systematic Review and Network Meta-Analysis.

Laparoscopic bariatric surgeries can cause intense postoperative pain. Opioid medication can alleviate the pain but can have harmful side effects especially in patients with obstructive sleep apnea. To promote early recovery, enhanced recovery after surgery guideline advises minimizing opioid use and opting for alternative analgesics. This paper aims to investigate the effect of regional anesthesia techniques through a systematic review and network meta-analysis. Primary outcome is postoperative morphine equivalent consumption at 24h. Search was conducted in the following databases: PubMed, CENTRAL, Scopus, and EMBASE, from the inception until 10 January 2023. The eligibility criteria were determined by PICOS, including postoperative opioid consumption, pain scores, time to ambulate, use of additional analgesics, and adverse events. The quality assessment was performed using the Risk of Bias 2 Tool, and the certainty of evidence was assessed using the GRADE approach. Funnel plots were used to evaluate publication bias. We included 22 studies in quantitative synthesis. A review of 12 studies found that all techniques had a lower mean consumption of opioids compared to placebo or no intervention, with TAP block having the greatest reduction. The quality of evidence for postoperative pain, PONV, time to deambulate, and use of rescue analgesics, was rated as moderate, with TAP block being the most effective intervention. There was no publication bias in any outcome. TAP block is superior to other regional anesthesia techniques in reducing opioid consumption, pain, PONV, and use of rescue analgesics in bariatric surgery. However, further research is needed.

Effect of tip path overlap on ring debarker performance of frozen and unfrozen black spruce logs

ABSTRACT The effect of the tip path overlap on debarking quality of unfrozen and frozen black spruce logs was studied. The power, energy consumption, and torque were also measured for both temperature conditions. The experiment consisted of debarking logs using three overlaps (8, 27, and 43%) at two temperatures (−12°C and +20°C). Debarking quality was evaluated by the proportion of bark remaining on log surfaces and by the amount of wood in bark residues. Log characteristics (dimensions, eccentricity, and knot features), bark/wood shear strength (BWSS), moisture content, and basic densities of sapwood, inner, and outer barks were measured and treated as covariates. Experiments revealed that tip path overlap affects debarking quality for both temperature conditions: the amount of bark remaining on log surfaces decreased, and the proportion of wood in bark residues increased as tip path overlap increased. In addition, the effects of bark/wood shear strength, the proportion of knot area and sapwood, inner and outer barks densities, and moisture content on debarking quality criteria were analyzed. The mean power, energy consumption, and torque increased as the tip path overlap increased. These parameters were also positively affected by the log diameter and BWSS for frozen logs. The results give helpful information to improve debarking quality within the studied range of overlaps, log characteristics, and debarking parameters with efficient energy use.

Enhancing Household Food Security and Dietary Diversity through Homegardens: A Case Study in Selected Districts of Sri Lanka

Homegardens are resourceful ecosystems that provide essential services to the environment and mankind. Their contribution to secure household food requirement is among the provisional services of contemporary relevance. A study was conducted in 429 homegardens in Jaffna, Matale, Ratnapura, and Hambantota districts to assess the scope of utilizing homegarden resources on household food security. A questionnaire survey was conducted to gather information on the consumption frequency and the number of food categories that were purchased, produced, and shared. The mean food consumption score (FCS) was 60±23, where 89% of the study population had an acceptable level of FCS (FCS&gt;35). As per the dietary diversity score (HDDS), an average household consumed at least eight food categories per day. Coconut was the most common food commodity produced in homegardens, followed by jackfruit and other fruits (mango, guava, soursop and pomegranate). Households rely on the market-available foods as their primary food source. The study revealed that utilizing at least one food category as a homestead-resource produced, could improve FCS and assist to fulfil the household food demand significantly. However, the majority of the homestead-resources were identified as plant-based, except in Jaffna where the presence of livestock and poultry in homegarden was common. Many of the plant-based resources were from perennial fruit-bearing trees. Therefore, modifying and utilizing the tree composition and viable crops can be considered a timely option to avert household food insecurity. Further, incorporating livestock components (dairy, poultry) as a part of homegardens is beneficial in fulfilling the animal protein demand of the household.

Unilateral Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy for Pain Control Comparison with Conventional Port Site and Peritoneal Infiltration

Objective: To compare image-guided unilateral subcostal transversus abdominis plane (STA) block with infiltration of local anaesthetic both port site and peritoneal for post-operative analgesia for laparoscopic gall bladder surgery.&#x0D; Study Design: Quasi-experimental study&#x0D; Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Quetta Pakistan, from Nov 2018 to Apr 2019.&#x0D; Methodology: The study sample (n=80) was divided into two Groups, one for image-guided subcostal transversus abdominis plane block and the other for peritoneal and port site infiltration of local anaesthetic. Anaesthesia was induced with intravenously administered propofol, atracurium, nalbuphine, and intraoperative non-opioid analgesia with ketorolac following which endotracheal intubation was done. The level of abdominal pain was assessed.&#x0D; Results: The mean opioid consumption at the 24th post-operative hour was 22.75±8.55 in Group-A and 43.20±11.80 in GroupB. Mean total opioid consumption was 111.40±35.99 and 218.90±63.91 in Group-A and B, respectively. The mean VAS score at the 24th post-operative hour was 1.20±0.96 in Group- A and 3.12±1.63 in Group-B. The results showed a significant mean difference between opioid consumption and VAS pain score at the 24th hour (p&lt;0.05).&#x0D; Conclusion: The unilateral Subcostal transversus abdominis plane block proved a superior alternative to port site and peritoneal infiltration combined for laparoscopic cholecystectomy.

263-LB: Food Intake Impacts on Insulin Secretion, Resistance, and Glucose Variability in Free-Living Individuals with Type 2 Diabetes Mellitus

Changes in eating habits and physical activity are the cornerstone of treatment of type 2 diabetes mellitus (T2D). Dietary composition has important effects on the postprandial glucose and insulin response, but little is known about its impact in a real-life context. We analyzed the self-reported daily food composition of 13 individuals with obesity and T2D not on insulin (7F/6M, age 48±9, BMI 33±2, A1C 7±1) with ASA24 (NIH), while wearing continuous glucose monitor (Dexcom G4) for 3±1 days. They also underwent an oral glucose tolerance test to explore correlations with standard indices of insulin secretion and sensitivity. The mean consumption per meal of total calorie was: 534±110Kcal, carbohydrate: 51±19g, total grains: 1.78±0.66g (refined 1.61±0.59g, whole 0.17±0.18g), total fat: 25±6g (10±3.17g monounsaturated fat), and protein: 24±7g. We observed a positive correlation between average intake of total and monounsaturated fat with the insulin secretion index (ρ= 0.630, p=0.02,) and Disposition Index (DI) (p=0.001, ρ=0.821). An inverse relationship between the consumption of total and refined grains was noted with the insulin sensitivity indexes (p=0.01, ρ= -0.663); as well as with whole grains and DI (p=0.03, ρ= -0.601). We documented glycemic variability (GV) related to meal nutrient intake through macro program: CGM peak and nadir analysis, Microsoft Excel. Total and monounsaturated fats correlated with lower GV (p=0.02), while total and refined grains were associated with greater GV (p&amp;lt;0.03). Glucose nadir after a meal and glucose at the time of the meal inversely correlated with insulin secretion indexes and with DI (p&amp;lt;0.05). These data suggest, in a real-life context, the impact of food composition on modulation of GV, with fats being associated with greater insulin secretion and refined grains with decreased insulin sensitivity, reinforcing the importance of the effect of diet on management of diabetes. Disclosure A. Comarella: None. R. Belfort-DeAguiar: Research Support; Fractyl Health, Inc., Silver Palate Kitchens. Funding National Institutes of Health (DK098286-02)

Analysis of multiple sleeps and N-policy on a M/G/1/K user request queue in 5g networks base station

The primary purpose of green communication is to reduce energy use. The base station (BS) is a radio receiver/transmitter that acts as the wireless network’s hub. It serves as a link between a wired and wireless network. To receive and transmit messages, BS uses a lot of energy. The use of effective sleep and wake-up/setup activities with an acceptable delay helps reduce base station power consumption. In this paper, the BS’s service process is modelled as a finite buffer queue with close down, sleep, and setup. After a certain number of user requests (URs) have accumulated in the system, to awaken the BS from multiple sleeps (MS) the -Policy is implemented. To produce probability generating functions, the supplementary variable approach is applied. The UR’s mean delay and the BS’s mean power consumption are calculated using simulation. According to computational studies, multiple sleeps with -policy consume less power than multiple sleeps without -policy.

Reducing Leakage: Subsidies and Tariff Reform in Water and Sanitation Services in Metropolitan Lima, Peru

Water utility companies around the globe are seeking to improve their financial sustainability and expand services in growing urban areas, while guaranteeing low-income families access to water. In Lima and Callao, the biggest metropolitan area in Peru, an important tariff reform for their water and sanitation services was implemented in 2017. The new policy differentiated tariffs between customers residing in poor and non-poor blocks, and revised the subsistence level (lifeline block) used in its tariff structure from 25 to 20[Formula: see text]m3. This study uses utility historical billing records of the population to evaluate three outcomes: (i) the effect on the subsidy amount received by poor and non-poor households at different consumption levels, (ii) the subsidy distributive incidence, and (iii) the effects on the utility’s financial situation. Results show that after the reform, the subsidy for the poor was 45% higher than that of non-poor households at 14[Formula: see text]m3, the mean consumption of subsidy-eligible households. Subsidy targeting changed from being regressive to progressive, with the poor receiving 22% more than they would have under a random subsidy scheme. In turn, by reducing subsidies to non-poor households, the utility’s monthly income from customer payments has increased by 7%.

Hygiene behaviors and nutritional status of children living in orphanages in Bangladesh

Background: Malnutrition is considered a complicated public health issue and depends on multiple factors. Hygienic behavior is related to orphan children’s growth, nutritional outcomes, and sound health. The study’s aim was to assess the hygiene behaviors and nutritional status of orphan students in Bangladesh. Methods: A descriptive cross-sectional quantitative study was conducted in three orphanage centers. A total of 120 respondents were interviewed. A descriptive analysis of the collected data was performed. Results: The monthly mean and median expenditure of orphans was 2000±475 BDT (20$). The number of toilets and waiting time for the orphan to use them are closely associated (χ2= 33.38; Cramer’s V=0.44, df=13; Sig; p&lt;0.001). On average, an orphan waits 32.20 minutes to use the toilet facility when they need it. Orphan family income and disposal of waste in the toilet of the orphan center are strongly associated (χ2=99.19; Cramer’s V=0.49, df=39; Sig; p&lt;0.001). There was a significant association between attending toilet-related hygiene and types of diseases. Hair fall, muscle wasting, fever, and xerosis of the skin were common diseases among orphans. Types of diseases orphans and schedule for the dietary chart are strongly associated (χ2=23.35; Cramer’s V=0.37, df=24; Sig; p&lt;0.001). Conclusions: Integrated approach is required to counter the extent of malnutrition among orphans. Teachers of orphanages should receive proper training so that they are able to take care of the physical and mental health of the orphan children.

Analysis of cyclic frosting and defrosting of a vehicle heat pump

Heat pumps are used for energy-efficient heating in electric vehicles. If ambient air is used as a heat source, frost may form on the surface of the exterior heat exchanger at low ambient temperatures. If significant amounts of frost accumulate, the heat exchanger performance degrades and it must be defrosted. The aim of this work is the energy analysis of a heat-release-controlled vehicle heat pump with a direct flat tube evaporator in cyclic frosting and defrosting operation. The effects of fan speed and number of refrosting phases on the heat quantity released per frosting phase are analyzed on a laboratory test rig. The experiments show that the heat quantity released decreases with lower fan speed and increasing number of frosting phases. Defrosting operation parameters are also examined using the test rig and it is found that shorter defrosting times can be achieved at higher compressor speeds and larger expansion valve openings. A numerical model of the heat pump in cyclic frosting and defrosting operation is developed and validated using test rig data. An average relative deviation of less than 7% is determined between the model and experimental data. The heat pump is then integrated in a prototypical vehicle and the model is calibrated with experimental data from test drives. A numerical study of the validated vehicle heat pump model in cyclic frosting and defrosting operation shows a maximum increase of the mean total electric power consumption of 33% between dry air and saturated moist air at an ambient temperature of 0 °C. At an ambient temperature of -10 °C the mean total electric power consumption increases by 17% from dry air to saturated moist air conditions.

Sizing of community centralized battery energy storage system and aggregated residential solar PV system as virtual power plant to support electrical distribution network reliability improvement

Virtual Power Plants (VPP) have been seen as one of the techniques to integrate more decentralized and distributed variable renewable energy systems into the grid. They will thus facilitate the greater democratization of the energy systems. VPP is an aggregation of renewable energy technologies, such as solar PV. It is usually operated with battery energy storage system (BESS) facilities to solve the variability issue of solar PV. However, BESS used as part of VPP has to be appropriately sized to work in the electrical network. While VPP operated with BESS may provide significant technical and financial advantage, most of the BESS sized to be used as VPP in the literature are large scale, operated with large scale VRE’s in the grid. Some of the literatures also provide the use of BESS sizing with Solar PV but for shared residential community use only. The context of BESS sizing for VPP from a residential community is not prevalent in the literature. In this paper, the context of a sizing BESS for VPP from a residential neighbourhood is studied. It is aimed that by optimally sizing BESS for a residential community with rooftop solar PV can supply power to the community and any excess energy may be used for VPP application for the grid. This paper provides a practical process for evaluating the proper size of a centralized BESS in a community with rooftop Solar PV by considering the energy consumption and peak demand profiles of the residential units in three types of communities with rooftop Solar PV, namely low-cost, medium-cost, and high-end community, by considering the mean and maximum energy consumption and peak demand profiles of each residential unit. Such values are used to allocate for the Solar PV system per residential unit and the centralized BESS at mean, 75% of maximum, maximum, and 125% of maximum energy consumption, to be used for the community and for any excess energy to support the electrical networks reliability improvement. The result shows that using the maximum and 125% of maximum energy consumption can provide more than enough energy capacity for VPP application, particularly electrical networks reliability improvement by supplying for the Energy not Supplied (EnS), EN. The result provides that for a High-end community, the stored energy in the BESS can reach up to 24.578 MW h using 125% of maximum sizing at either mean or maximum energy consumption. While for Medium-cost and Low-cost communities, the stored energy can reach up to 17.549 MW h and 14.527 MW h using 125% of maximum sizing at either mean or maximum energy consumption, respectively. Moreover, the result also shows that to alleviate Energy not Supplied (EnS) and contribute to reliability improvement, more residential units are needed if sizing is based on maximum energy consumption, while a lesser number of residential units if the size is based on 125% of the maximum energy consumption.

A More Supportive Social Environment May Protect Against Nutritional Risk: A Cross-Sectional Analysis Using Data From the Canadian Longitudinal Study on Aging

BackgroundNutritional risk has been linked to individual social factors, but the relationship with the overall social environment has not been assessed. ObjectivesTo evaluate associations between different support profiles of the social environment and nutritional risk using cross-sectional data from the Canadian Longitudinal Study on Aging (n = 20,206). Subgroup analyses were performed among middle-aged (range, 45–64 y; n = 12,726) and older-aged (≥65 y, n = 7480) adults. Consumption of major food groups [whole grains, proteins, dairy products, and fruits and vegetables (FV)] by social environment profile was a secondary outcome. MethodsLatent structure analysis (LSA) classified participants into social environment profiles according to data on network size, social participation, social support, social cohesion, and social isolation. Nutritional risk and food group consumption were assessed with the SCREEN-II-AB and Short Dietary questionnaires, respectively. ANCOVA was conducted to compare SCREEN-II-AB mean scores by social environment profile, adjusted for sociodemographic and lifestyle factors. Models were repeated to compare mean food group consumption (times/day) by social environment profile. ResultsLSA identified 3 social environment profiles classified as low, medium, and high support (17%, 40%, and 42% of the sample, respectively). Adjusted mean SCREEN-II-AB scores significantly increased with increasing social environment support, with the low support score indicating high nutritional risk status [low, medium, high support, respectively: 37.1 (99% CI: 36.9, 37.4), 39.3 (39.2, 39.5), 40.3 (40.2, 40.5), all comparisons P < 0.0001]. Results were consistent among age subgroups. The low support social environment profile had lower consumption of protein [low, medium, high support, respectively (mean ± SD): 2.17 ± 0.09, 2.21 ± 0.07, 2.23 ± 0.08, P = 0.004], dairy (2.32 ± 0.23, 2.40 ± 0.20, 2.38 ± 0.21, P = 0.009), and FV (3.65 ± 0.23, 3.94 ± 0.20, 4.08 ± 0.21, P < 0.0001), with some variation among age subgroups. ConclusionsThe low support social environment profile had the poorest nutritional outcomes. Therefore, a more supportive social environment may protect against nutritional risk among middle- and older-aged adults.

Optimising targeted dietary intervention strategies based on regional disparities of the related burden of cardiovascular disease in China

Optimising targeted dietary intervention strategies based on regional disparities of the related burden of cardiovascular disease in China

Health-care expenditures are less for minimally invasive than open colectomy for colon cancer: A US commercial claims database analysis

BackgroundMost studies comparing surgical platforms focus on short-term outcomes. In this study, we compare the expanding societal penetration of minimally invasive surgery (MIS) with open colectomy by assessing payer and patient expenditures up to one year for patients undergoing surgery for colon cancer.MethodsWe analyzed the IBM MarketScan Database for patients who underwent left or right colectomy for colon cancer between 2013 and 2020. Outcomes included perioperative complications and total health-care expenditures up to 1 year following colectomy. We compared results for patients who had open colectomy (OS) to those with MIS operations. Subgroup analyses were performed for adjuvant chemotherapy (AC+) versus no adjuvant chemotherapy (AC-) groups and for laparoscopic (LS) versus robotic (RS) approaches.ResultsOf 7,063 patients, 4,417 cases did not receive adjuvant chemotherapy (OS: 20.1%, LS: 67.1%, RS: 12.7%) and 2646 cases had adjuvant chemotherapy (OS: 28.4%, LS: 58.7%, RS: 12.9%) after discharge. MIS colectomy was associated with lower mean expenditure at index surgery and post-discharge periods for AC- patients (index surgery: $34,588 vs $36,975; 365-day post-discharge $20,051 vs $24,309) and for AC+ patients (index surgery: $37,884 vs $42,160; 365-day post-discharge $103,341vs $135,113; p < 0.001 for all comparisons). LS had similar index surgery expenditures but significantly higher expenditures at post-discharge 30 days (AC-: $2,834 vs $2276, p = 0.005; AC+: $9100 vs $7698, p = 0.020) than RS. The overall complication rate was significantly lower in the MIS group than the open group for AC- patients (20.5% vs 31.2%) and AC+ patients (22.6% vs 39.1%, both p < 0.001).ConclusionMIS colectomy is associated with better value at lower expenditure than open colectomy for colon cancer at the index operation and up to one year after surgery. RS expenditure is less than LS in the first 30 postoperative days regardless of chemotherapy status and may extend to 1 year for AC- patients.

Knowledge Regarding Hypertension and Amount of Diet Consumption Among Adults From Uttarakhand: A Comparative Survey.

Hypertension is becoming more common worldwide, and by 2025, its incidence is predicted to rise by 32.4%. The present study aims to assess the knowledge related to hypertension and the amount of diet consumption among adults at risk of developing hypertension in both rural and urban areas of Uttarakhand. A cross-sectional survey was conducted on 667 adults at risk of hypertension. The study sample included adults selected from the rural and urban communities of Uttarakhand. A semi-structured questionnaire on knowledge regarding hypertension and self-reported amount of diet consumption was used as a tool for data collection. The mean age of participants in this study was 51.46 ± 1.44 years, and the majority of the participants had poor knowledge regarding hypertension as a disease and its consequences as well as preventive measures. The mean days for consumption offruits were three days, four days for green vegetables, two days for eggs, and two days for a well-balanced diet, and the mean± SD of a non-vegetarian diet consumption was 128 ± 182 gm. Another highlighted significant mean difference was found between knowledge of raised blood pressure with the amount of consumption of fruits, green leafy vegetables, a non-vegetarian diet, and a well-balanced diet. In the present study, knowledge of blood pressure and raised blood pressure with its related factors was poor among all participants. The average consumption of all types of diet was two to three days a week, which was borderline, based on recommended dietary allowances. The knowledge related to raised blood pressure and its associated factors had significant mean differences for the mean consumption of fruits, non-vegetarian diet, and well-balanced diet.