Seven-year Study Research Articles

Seven-year study of monsoonal rainwater chemistry over the mid-Brahmaputra plain, India: assessment of trends and source regions of soluble ions.

This work is a 7-year study of monsoonal rainwater chemistry (n = 302), over mid-Brahmaputra plain during 2012 to 2018. The samples were analyzed for major chemical parameters viz. pH, electrical conductivity (EC), and ions (SO42-, NO3-, Br-, Cl-, F-, Mg2+, Ca2+, K+, NH4+, Na+, and Li+) to assess the chemistry. The mean pH of rainwater varied among the years, which was maximum in 2018 (6.18 ± 0.72) and minimum in the year 2014 (5.39 ± 0.54), and the variations were significant at p < 0.0001. Ridgeline plots were drawn to visualize interannual variations, which revealed that Ca2+ was the dominant cation in the early years, whereas NH4+ prevailed in the latter years. Mann-Kendall analysis and Sen's slope statistical tests were employed, and it was found that all the ions showed positive S values indicating increasing trends. Enrichment factors (EF) of K+, SO42-, and NO3- were found to be high with respect to both soil and seawater suggesting the influence of emissions from fossil fuel and biomass burning in the chemistry of rainwater. Principal component analysis (PCA) was applied to identify the sources of rain constituents, and five factors were obtained explaining crustal dust, biomass burning, fossil fuel combustion, agricultural emissions, and coal burning as possible sources. Airmass back trajectory clusters and Potential Source Contribution Function (PSCF) were computed by application of HYbrid Single-Particle Lagrangian Integrated Trajectory model to appreciate the terrestrial influence on the chemistry. The results indicated inputs from both local and regional dust and anthropogenic constituents that influenced the monsoonal rainwater chemistry over Brahmaputra Valley.

Oral Antibiotics Bowel Preparation Without Mechanical Preparation for Minimally Invasive Colorectal Surgeries: Current Practice and Future Prospects.

BACKGROUND: The efficacy of preoperative oral antibiotics alone compared to mechanical bowel preparation and oral antibiotics in minimally invasive surgery is still a matter of ongoing debate. OBJECTIVE: This study aimed to assess the trend of surgical site infection rates in parallel to the utilization of bowel preparation modality over time for minimally invasive surgery colorectal surgeries in the United States. DESIGN: Retrospective analysis. SETTINGS: The American College of Surgeons National Surgical Quality Improvement Program database. PATIENTS: Adult patients who underwent elective colorectal surgery and reported bowel preparation modality. MAIN OUTCOME MEASURES: The trends and compare surgical site infection rates for mutually exclusive groups according to the underlying disease (colorectal cancer, inflammatory bowel disease, and diverticular disease) who underwent bowel preparation using oral antibiotics or combined mechanical bowel preparation and oral antibiotics. Patients who had rectal surgery were analyzed separately. RESULTS: A total of 30,939 patients were included. Of them, 12,417 (40%) had rectal resections. Over the seven-year study period, mechanical bowel preparation and oral antibiotics utilization has increased from 29.3% in 2012 to 64.0% in 2018; p<0.0001 at the expense of no preparation and mechanical bowel preparation alone. Similarly, oral antibiotics utilization has increased from 2.3% in 2012 to 5.5% in 2018; p<0.0001. For colon cancer patients, patients who had oral antibiotics alone had higher superficial surgical site infection rates compared to patients who had combined mechanical bowel preparation and oral antibiotics (1.9% vs. 1.1%; p=0.043). Superficial, deep and organ space surgical site infection rates were similar for all other comparative colon surgery groups (cancer, inflammatory bowel disease, and diverticular disease). Patients with rectal cancer who had oral antibiotics had higher rates of deep surgical site infection (0.9% vs. 0.1%; p=0.004). However, superficial, deep and organ space surgical site infection rates were similar for all other comparative rectal surgery groups. LIMITATIONS: Retrospective nature of the analysis. CONCLUSION: This study revealed widespread adoption of mechanical bowel preparation and oral antibiotics mechanical bowel preparation and oral antibiotics and increased adoption of oral antibiotics over the study period. Surgical site infection rates appear to be similar from a clinical relevance standpoint among most comparative groups, questioning systematic preoperative addition of mechanical bowel preparation to oral antibiotics alone in all patients for minimally invasive colorectal surgery. See Video Abstract at https://links.lww.com/DCR/B828 .

Unplanned admission to pediatric intensive care after general anesthesia: A seven-year retrospective cohort study in a tertiary children's hospital.

Thorough preoperative risk assessment and planning is key to improving patient safety in the perioperative period. Analysis of unplanned ICU admissions after general anesthesia has been validated as a measure of patient safety and its use as a quality initiative is recommended in many countries. The aims of this study were to determine the reasons for unplanned ICU admission, required interventions, and outcomes after general anesthesia in our hospital, as well as predictability and preventability of the events that led to admission with a view to improving anesthetic management. A single-center, retrospective cohort study in a tertiary children's hospital was performed. All patients under the age of 18years admitted to our PICU between June 2014 and May 2021 were included. Unplanned ICU admission after general anesthesia was defined as an admission to the ICU either immediately postoperatively or after recovery room stay, which was not planned preoperatively. The reasons for ICU admission were classified as anesthesia-related, surgical, medical, or mixed. Required intervention, length of ICU stay, and patient outcome of each group, as well as preventability and predictability of the events were investigated. There were 75 admissions, representing 0.23% of all general anesthesia procedures during the study period. "Anesthesia-related" was the major reason for admission of which the majority required observation only or transient respiratory support with a median ICU stay of two days. Most of the admissions for medical reasons required disease-specific interventions resulting in the longest ICU stays with a median of six days. A total of 19% of the admissions were preventable, where most of them were for anesthesia-related reasons, and 33% were predictable. Seven patients required cardiopulmonary resuscitation, of which one patient died, giving an observed mortality rate of 1.3% overall. All but one patient who died demonstrated no changes in the Pediatric Cerebral Performance Category (PCPC) scale. "Anesthesia-related" was the leading reason for unplanned ICU admissions, of which the majority required only observation or transient respiratory support. All but one patient who died demonstrated no changes in the PCPC scale, presenting favorable outcome overall.

Subjective-objective sleepiness discrepancy in adult-onset myotonic dystrophy type 1.

Subjective-objective sleepiness discrepancy in adult-onset myotonic dystrophy type 1.

Assessment of Environmental Pollution and Human Exposure to Pesticides by Wastewater Analysis in a Seven-Year Study in Athens, Greece.

Pesticides have been used in large amounts around the world for decades and are responsible for environmental pollution and various adverse effects on human health. Analysis of untreated wastewater can deliver useful information on pesticides’ use in a particular area and allow the assessment of human exposure to certain substances. A wide-scope screening method, based on liquid chromatography coupled to quadrupole-time-of-flight mass spectrometry, was applied, using both target and suspect screening methodologies. Daily composite influent wastewater samples were collected for seven or eight consecutive days in Athens between 2014 and 2020 and analyzed for 756 pesticides, their environmental transformation products and their human metabolites. Forty pesticides were quantified at mean concentrations up to 4.9 µg/L (tralkoxydim). The most abundant class was fungicides followed by herbicides, insect repellents, insecticides and plant growth regulators. In addition, pesticide transformation products and/or metabolites were detected with high frequency, indicating that research should be focused on them. Human exposure was evaluated using the wastewater-based epidemiology (WBE) approach and 3-ethyl-carbamoyl benzoic acid and cis-1,2,3,6-tetrahydrophthalimide were proposed as potential WBE biomarkers. Wastewater analysis revealed the presence of unapproved pesticides and indicated that there is an urgent need to include more transformation products in target databases.

Assessment of Environmental Pollution and Human Exposure to Pesticides by Wastewater Analysis in a Seven-Year Study in Athens, Greece

Assessment of Environmental Pollution and Human Exposure to Pesticides by Wastewater Analysis in a Seven-Year Study in Athens, Greece

National Trends and Perioperative Outcomes of Robotic-assisted Hepatectomy in the USA: A Propensity-score Matched Analysis from the National Cancer Database.

A paucity of data exists on the national use of robotic hepatectomy. We assessed national trends and perioperative outcomes of robotic hepatectomy in the USA. In addition, factors associated with use of the robotic approach were analyzed. The National Cancer Database (NCDB) was queried for patients undergoing hepatectomy from 2010 to 2016. Patients undergoing total hepatectomy for transplant were excluded. Factors associated with the use of the robotic approach were assessed using logistic regression multivariable analysis. Propensity-score analysis was performed (robotic vs. laparoscopic and robotic vs. open approaches), and perioperative outcomes were compared between the matched groups. The robotic approach was used in 287 patients (110 hospitals). Utilization of the robotic approach increased significantly on the national level from 0.8% in 2010 to 4.1% in 2016 (P<0.001). The number of hospitals performing a minimum of one robotic hepatectomy per year increased from 8 in 2010 to 35 in 2016. The median hospital length of stay was 4days (IQR 3-6), 30-day readmission rate was 5%, and 30-day/90-day mortality rates were 3%/4%. Factors associated with using robotic approach were African-American race (95% CI 1.02-2.11), recent year of surgery (95% CI 1.11-1.32), HCC histology (95% CI 1.01-52.03), tumor size (95% CI 0.87-0.96), and early-stage tumor (Stage I-II, 95% CI 1.27-3.99). On propensity-matched analysis, there were no differences between robotic and open approaches (n=184 each group) in 30-day readmission (5% vs. 7%, P=0.651), 30-day mortality (2% vs. 4%, P=0.106), 90-day mortality (3% vs. 7%, P=0.080), or 5-year overall survival (58% vs. 43%, P=0.211). However, the robotic approach was associated with a significantly shorter hospital stay (median: 4 vs. 6days, P<0.001). There were no differences between matched groups of patients undergoing robotic and laparoscopic approaches (n=182 in each group) in perioperative outcomes or length of hospital stay. National use of robotic-assisted hepatectomy has increased by fivefold over the seven-year study period. It was associated with a shorter hospital length of stay compared to the open approach without compromising perioperative outcomes or survival.

Characteristics and Service Utilization by Complex Chronic and Advanced Chronic Patients in Catalonia: A Retrospective Seven-Year Cohort-Based Study of an Implemented Chronic Care Program.

The Chronic Care Program introduced in Catalonia in 2011 focuses on improving the identification and management of complex chronic (CCPs) and advanced chronic patients (ACPs) by implementing an individualized care model. Its first stage is their identification based on chronicity, difficult clinical management (i.e., complexity), and, in ACPs, limited life prognosis. Subsequent stages are individual evaluation and implementation of a shared personalized care plan. This retrospective study, including all CCPs and ACPs identified in Catalonia between 2013 and 2019, was aimed at describing the characteristics and healthcare service utilization among these patients. Data were obtained from an administrative database and included sociodemographic, clinical, and service utilization variables and morbidity-associated risk according to the Adjusted Morbidity Groups (GMA) stratification. During the study period, CCPs’ and ACPs’ prevalence increased and was higher in lower-income populations; most cases were women. CCPs and ACPs had all comorbidities at higher frequencies, higher utilization of healthcare services, and were more frequently at high risk (63% and 71%, respectively) than age-, sex-, and income level-adjusted non-CCP (23%) and non-ACP populations (30%). These results show effective identification of the program’s target population and demonstrate that CCPs and ACPs have a higher burden of multimorbidity and healthcare needs.

Post-tonsillectomy Hemorrhage: A Seven-year Retrospective Study.

Introduction:Post-tonsillectomy hemorrhage (PTH) is a serious complication that sometimes requires immediate surgical interventions. The present study aimed to assess the association between patients’ age, the time of onset of PTH, and the need for surgery to control bleeding.Materials and Methods:All patients with PTH were retrospectively admitted to two tertiary hospitals in Mashhad, during 2012-2019. Hospital records were investigated to select eligible cases and retrieve their characteristics such as demographics, source and time of bleeding, and type of intervention. Chi-square, independent samples T-test, and binary logistic regression were used as research tools.Results:A total of 227 patients with PTH and a mean age of 14.99±10.34 years were studied, of whom 128 (56.4%) were male and 63 (27.8%) required surgery to control PTH. The mean onset of PTH was 8.14±3.47 days after the surgery and in 59 cases (26.5%) was the seventh day. Those patients aged 6 years or older in whom PTH occurred during the first postoperative week were significantly more likely to need surgery to control it (P= 0.034). Adult (OR= 4.032, 95%CI= 1.932-8.414, P<0.001), bleeding from both tonsils (OR= 2.380, 95%CI= 1.032-5.487, P= 0.042), and receiving blood transfusion (OR= 7.934, 95%CI= 2.003-31.422, P= 0.002) were independent predictors of the need for surgical treatment to control PTH.Conclusion:PTH within the first postoperative week in patients older than 6 years, adults, bleeding from both tonsils, and receiving a blood transfusion is recommended to be considered as a potential predictor of the need for surgery.

The Clinical Profile, Wound Dressings, and Clinical Outcomes of In-patients with Pressure Ulcers at a Tertiary Hospital in the Philippines: A Seven-year Retrospective Study

Objectives. Currently, there are no local studies examining wound dressing usage among pressure ulcers in Filipino patients. The study aims to provide preliminary Philippine data among in-patients with pressure ulcers: their demographic characteristics, wound characteristics, wound dressing usage, and associated outcomes per wound dressing.&#x0D; Methods. A retrospective chart review of patients admitted at the Philippine General Hospital from 2011 to 2017 with a diagnosis of pressure ulcer was conducted.&#x0D; Results. Eighty-five records were retrieved; 56% were female and 44% male, with a mean age of 47.67 ± 23.03 years. The mean number of ulcers per patient was 1.65 ± 1.37, mostly in Stages 2 and 3, and 90.6% were in the sacral area. Seventy-three (85.9%) had utilized at least one form of the wound dressing, mostly plain gauze (83.5%), usually with silver sulfadiazine or Dakin’s solution. Only a smaller subset used silver-impregnated dressings (10.55%) and hydrocolloid dressings (5.9%). Comparing advanced versus basic dressings for improved wound outcomes, the crude odds ratio was 3.81 (1.62 - 8.99; p-value 0.003), which on stratification accounting for bed turning, became 8.92 (1.66 - 47.97; p-value 0.009) for those bed turned and 3.05 (1.01-9.20; p-value 0.075) for those not bed turned.&#x0D; Conclusion. Filipino in-patients with pressure ulcers were similar to those in the literature in terms of the mean number of ulcers and site of involvement. Basic gauze dressings, combined with topical agents, constitute the majority of wound dressing practice. Use of an advanced wound dressing showed a trend favoring improved outcomes, enhanced by pressure redistribution through bed repositioning.

Comparative Evaluation of Health Care-Related Infections in Pediatric and Newborn Intensive Care Units in A University Hospital: The Seven-Year Retrospective Study

Comparative Evaluation of Health Care-Related Infections in Pediatric and Newborn Intensive Care Units in A University Hospital: The Seven-Year Retrospective Study

Longitudinal Effects of Excessive Weight and Obesity on Academic Performance of Primary School Boys in Different Socio-Economic Statuses: The NW-CHILD Study.

Obesity affects millions of children worldwide and can often impact their academic performance. This longitudinal study, conducted over seven years, determines the effects of excessive weight and obesity on the academic performance of primary school boys, taking into account their socio-economic status (SES). The study forms part of a seven-year (2010–2016) longitudinal study, the North-West Child-Health-Integrated-Learning and Development (NW-CHILD) study, which includes a baseline measurement and two follow-up measurements of the 181 participants from varying areas in the North West Province. Two-way frequency tables, repeated measure ANOVA’s and Spearman rank order correlations were used to analyze the data. The Body Mass Index (BMI) of the participants reported an increase from 2010–2016. Nearly all of the school subjects reported small to large correlations between BMI and academic performance (r ≥ 0.1 and r ≥ 0.3), except for Afrikaans in 2013 (r = −0.06). Only two subjects (English and Language as tested with the ANA test) reported medium effects (r ≥ 0.3), whereas the other subjects only reported small effects (r ≥ 0.1). No statistically significant relationships (p ≥ 0.05) were observed between the BMI values and academic subjects, however SES and school subject scores reported several statistically significant relationships, especially regarding Language (English and First Additional Language) and Mathematics (p = 0.02). Overweight and obese primary school boys in the North West Province of South Africa reported a higher academic performance in comparison to boys of a normal weight, even when SES was taken into consideration. Further studies are recommended to verify current findings regarding weight, obesity and academic performance.

Associations of Dietary Pattern and Sleep Duration with Cognitive Decline in Community-Dwelling Older Adults: A Seven-Year Follow-Up Cohort Study.

A few studies have linked dietary patterns and sleep to cognitive decline. To examine the independent and joint associations of dietary patterns and sleep with cognitive decline. Our analysis included 2,307 participants aged 55- 89 years at baseline from the China Health and Nutrition Survey. Dietary intake was assessed using weighing methods in combination with 24 h dietary recalls for three consecutive days. Exploratory factor analysis was applied to identify major dietary factors. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Five dietary patterns were identified: dairy-fruits-fast foods, grains-vegetables-pork, plant-based food, beans-mushroom, and beverages-nuts patterns. Beans-mushroom pattern and sleep duration of 8 h/day were defined as healthy habits. There was a positive association between the beans-mushroom pattern and change in the global cognitive Z-score over seven years (β (95% CI) for quintile 5 versus quintile 1:0.17 (0.05, 0.30)). Compared to individuals with sleep duration of 8 h/day, those with sleep duration of≤5 h/day (β (95% CI): - 0.23 (- 0.45, - 0.00)) or > 10 h/day (- 0.52 (- 0.73, - 0.32)) had a greater decrease in global cognitive Z-score. Compared to individuals with no healthy patterns, those with a healthy dietary pattern only (β (95% CI): 0.18 (0.08, 0.28)), healthy sleep pattern only (0.13 (0.04, 0.23), and both healthy dietary and sleep patterns (0.19 (0.08, 0.31)) had a relative increase in global cognitive Z-score. Our findings highlight the importance of involving both diet and sleep as intervention priorities for the potential prevention of cognitive decline.

Pain in rheumatoid arthritis: a seven-year follow-up study of pain distribution and factors associated with transition from and to chronic widespread pain

Objective: To study transitions from and to chronic widespread pain (CWP) over 7 years in patients with rheumatoid arthritis (RA). Method: Two postal questionnaires were sent to patients included in the BARFOT (Better Anti-Rheumatic Pharmacotherapy) study, the first in 2010 and the second in 2017. The questionnaires assessed pain, number of tender and swollen joints, functional disability, health-related quality of life (HRQoL), pharmacological treatment, lifestyle factors, and patient-reported body mass index (BMI). The responders to both questionnaires were divided into three groups according to the reported pain duration and distribution: patients having no chronic pain (NCP), chronic regional pain (CRP), and CWP. Results: In all, 953 patients answered the questionnaires at both time-points. One-third (324) of the patients reported CWP in 2010, and 140 (43%) of the patients had transition to NCP or CRP in 2017. In multivariate logistic regression models, adjusting for age, gender, and disease duration, transition from CWP was associated with normal BMI, fewer tender joints, less pain, less fatigue, fewer pain regions, less disability, better HRQoL, and biologic treatment. In 2010, 628 patients reported NCP or CRP, whereas 114 of them reported CWP in 2017. Transition to CWP was associated with female gender, obesity, more tender and swollen joints, higher pain-related variables, worse disability, and worse HRQoL. Conclusion: There are modifiable factors associated with transitions from and to CWP that could be identified. Paying attention to these factors could improve pain treatment in the management of RA.

Foundations of Climate Investing: How Equity Markets Have Priced Climate-Transition Risks

Countries have set varying targets to reduce greenhouse gas emissions in line with the Paris Agreement’s goal of keeping the increase in global average temperatures to well below 2°C. In this article, the authors examine to what extent climate risk has been priced into equity markets and whether climate change can be modeled using a typical risk model structure. They develop the fundamental economic transmission channels to explain the potential impact of climate change on equity prices, including empirical evidence for climate policies and green technology as financial risk drivers. They also study the impact of climate-transition risk on valuation levels and trends. They conclude with a discussion of how to measure and categorize companies’ climate-risk exposures and how to integrate climate-transition risks into risk models. <b>TOPICS:</b>ESG investing, security analysis and valuation, tail risks <b>Key Findings</b> ▪ The authors identified economic transmission channels showing how regulatory policies and green technology influence financial markets. In developed markets outside the United States, more carbon-efficient companies experienced stronger performance over a seven-year study period. They found companies’ green revenue share was clearly associated with higher earnings growth and relatively better stock performance within a given sector. ▪ Next, they looked at the relationship between companies’ climate-transition risk profiles and their valuation levels, finding that carbon-intensive companies experienced declining valuation in terms of price-to-book ratios than their less carbon-intensive sector peers—suggesting that markets have discounted the book value of carbon-intensive companies during the study period. In contrast, companies with significant green revenues saw their price-to-earnings ratios increase relative to their sector peers. ▪ Companies’ earnings growth and stock performance was directly related to their greenhouse gas emissions. Using five MSCI low carbon transition categories, the authors found that the riskiest category (stranded assets) had the weakest performance and the solutions category the strongest during the study period. Although most performance differences were explained by the industry factor, there was a significant stock-specific return that showed a strong correlation to companies’ climate transition-risk profile.

Exploring the importance of diversified physical activities in early childhood for later motor competence and physical activity level: a seven-year longitudinal study

BackgroundResearch indicates that childhood motor competence (MC) can predict physical activity (PA) levels later in life and it has been argued that frequently engaging in a wide diversity of physical activities will eventually improve children’s MC. However, no longitudinal or experimental studies have confirmed this theoretical rationale. The aims of this study are to explore the longitudinal associations between diversified physical activities at age six and later MC and PA (time spent in moderate-to-vigorous PA) (age nine and 13). Furthermore, we explore to what extent the longitudinal association between diversified physical activity and PA is mediated by MC.MethodsLongitudinal data from the Copenhagen School Intervention Study were used for this analysis, where 704 participated (69% response rate). Diversified physical activity (self-reported), MC (The Körperkoordinationstest für Kinder battery of postural stability and locomotor skills) and PA (accelerometer) were assessed in the children at age six, age nine and age 13. A total of 654 participated in at least two of the measures and, therefore, were included in the analysis. Two structural equation models were constructed, with diversified physical activity at age six and MC and PA at age nine as predictors of PA and MC at age 13.ResultsThe data from both models demonstrated good model fit. Diversified physical activity at 6 years of age was significantly associated with physical activity and MC at age 13, when adjusting for sex, age, intervention, weight, height, and previous levels of PA and MC. Diversified physical activity at age six was also positively associated with PA and MC at age nine, which were, in turn, positively related to PA at age 13 but to a lesser degree than diversified PA at age six. The association between diversified physical activity at age six and PA at age 13 was not mediated by MC at age nine.ConclusionsThe results of this study indicate that diversified physical activity at age six is important for the development of MC and PA in adolescence. Increasing the diversity of children’s daily physical activities, not only the amount and intensity, seems important for future PA behavior and thereby health promotion in a life course perspective.

Reflections from the field (mountain, cityscape and park): walking for management development and links to being-in-the world, belonging and “Ba”

PurposeThe purpose of this paper, based on reflections from practice, is to shed light on the realities of using walking as a tool for learning and development. This is done through an initial analysis of longitudinal reflective data spanning seven years and connecting these reflections to the concepts: being-in-the-world, belonging and Ba.Design/methodology/approachThis research takes a practice based phenomenological and reflective approach. The value of this approach is to seek a new understanding, through three distinct conceptual frames, of the effective use of walking within management development.FindingsThe findings connect three conceptual approaches of being-in-the-world, belonging and “Ba” to the practicalities of delivery, thus encouraging practitioners and designers to deeply reflect on the role of walking in management development.Research limitations/implicationsA limitation is that this is largely a personal story exploring the impact of an intuitively developed set of interventions. Despite this, the paper represents a unique and deep interpretation of walking as a mechanism for management development.Practical implicationsThe paper concludes with three recommendations to practitioners wanting to use walking in management development programmes. These are: facilitators need to be familiar with their surroundings; they should look for spaces and places where participants can connect and build relationships; and organisers and sponsors need to recognise how walking not only consolidates knowledge but can help create knowledge too.Originality/valueThis is a unique, seven-year longitudinal study that broadens the theoretical focus of walking as a mechanism for management and leadership development that combines the theoretical lenses of being-in-the-world, belonging and “Ba”, the authors believe, for the first time in research on management development.

Life Table Analysis for Evaluating Curative-effect of One-stage Non-submerged Dental Implant in Taiwan

According to the available literature, long-term survival and success rates of one-stage, non-submerged dental implant (A dental implant is not totally buried beneath the gum.) are predictable. However, until now there is no similar study in Taiwan regarding to the efficacy of one-stage, non-submerged dental implant. This prospective study from August 1997 to the end of 2005 includes 316 patients who received the dental implants and prosthesis and were followed up at least 6 months. The total implants are 717. Life table analysis is used to analyze the effectiveness of the one stage, non-submerged dental implant. Our result indicates the survival rate and success rate are 99.58% and 96.13%, respectively, from this seven-year follow-up study. This study strongly demonstrates that the efficacy of one stage, non-submerged dental implant is also predictable in Taiwan if the patients are under regular follow-up after active treatments.

Mindful tourism: nothing left behind–creating a circular economy society for the tourism industry of Krabi, Thailand

PurposeThis research aims to demonstrate how the circular economy is employed to drive the sustainability of the tourism industry in Krabi, Thailand, through the concept of mindful consumption and service-dominant logic (hereafter S-D logic).Design/methodology/approachA seven-year longitudinal study (2013–2020) was conducted through four studies from different perspectives, including macro, meso and micro levels of development in Krabi province.FindingsKrabi tourism stakeholders have collaborated to co-create green culture and behavior whereby the value network among stakeholders plays an important role in driving the circular economy in practice.Research limitations/implicationsThis study provides an understanding of how the circular economy society has been co-created. However, further research should be conducted in other tourism cities by focusing on the key success factors that drive the circular economy.Originality/valueThe longitudinal study with multi-perspective micro, macro and meso levels of development in this study has shed the light on how the circular economy (CE) policy can be turned into practice.

Hydrologic evaluation of a poplar phytoextraction system

This paper reports the results of a seven-year study of a phytoremediation system consisting of 349 hybrid poplars (Populous deltoids x Populus nigra ‘DN-21’) that were emplaced to reduce the migration of impacted groundwater toward a nearby stream. For the relatively small tree stand, the achievement of hydraulic containment was challenged by several factors, including topographic constraints on tree placement, spatial heterogeneity in depth-to-groundwater, and lack of controls on surface runoff. However, the interpretation of measured diurnal water table fluctuations indicated substantial and increasing levels of groundwater extraction, consistent with poplar sap flow measurements collected during two growing seasons. The project also provided unique educational experiences for undergraduate and graduate students from multiple academic disciplines who participated in monitoring, site maintenance, and data interpretation. Novelty statement The paper adds to the limited literature on poplar-based phytoextraction of contaminated groundwater by describing a seven-year case study with detailed hydrologic measurements. Novel elements include (1) a very large data set of poplar sap flow measurements that provides insight into potential spatial and temporal variability, and (2) a detailed application of an under-utilized analytical tool (water table fluctuations) to evaluate hydraulic capture.