Small Decrease Research Articles

Elastické tahy v Ortodoncii

Aim: The work assesses force characteristics of one type and size of elastics, specifically 3/16“ medium elastics, of five different manufacturers. We compared initial forces, and particularly the relationship between their force degradation over aɸperiod of time. Material and method: 500 latex elastics 3/16“ medium from Dentaurum, American Orthodontics, 3M, Ortho Organizers and G & H Orthodontics (100 of each) were tested. Force was measured with dynamometer at time 0, 2, 8, 24 and 48 hours. Elastics were stretched to triple of their original diameter and they were placed onto the plate manufactured by us. The plate was produced with 3D printer. Then everything was put into an incubator at the temperature of 37 °C and constant humidity. Shapiro-Wilk normality tests, ANOVA and Bonferroni’sɸpost-hoc tests were used for statistical evaluation. Individual manufacturers were asked whether they know in which plants exactly the elastic tractions are produced. Unfortunately, they did not answer the question. Results: The average initial force was between 1.109 N and 1.550 N; elastics made by Dentaurum were closest to the declared force of 1.255 N. The force decreased most during the first two hours. Between the individual producers the decrease of elastic tractions during 24 hours oscillated between 20 and 33%. The greatest drop in force was recorded for American Orthodontics products. The smallest decrease was recorded between 2nd and 8th hour for 3M, and between 24th and 48th hour for OrthoOrganizers products. Conclusion: Intermaxillary elastics of 3/16“ medium measured in vitro differ both in the amount of their initial force and in force degradation. Orthodontists should know the basic parameters of elastic tractions. To secure maximum care aɸdoctor should measure initial force of elastic tractions with dynamometer intraorally.

Youth Are the Experts! Youth Participatory Action Research to Address the Adolescent Mental Health Crisis.

Adolescent mental health is an urgent global public health issue. Youth participatory action research is an effective strategy to amplify youth voices and can serve as a catalyst for evidence-based action addressing the mental health crisis. To illustrate the benefits of youth participatory action research for informing community health, we describe an ongoing collaboration with a youth council located in the central coast of California, USA. Research methods included an anonymous online self-report survey to gather information about the mental health of high school students in 2020 (n = 176) and 2022 (n = 234), 93% Latinx/Mexican American. Both surveys included a four-item patient health questionnaire to screen for depression and anxiety risk, in addition to scaled and open-ended survey questions selected by the youth leaders based on their research questions. Quantitative and qualitative results indicated a significant but small decrease in mental health risk, and a continued need for resources to access mental health support. Results led to community-based action aimed at improving local youth mental health. The interdisciplinary research team (psychology and public health) and youth leaders share reflections highlighting the innovative, empowering, and transformative impact of youth participatory action research as a tool for improving community health.

Comparison of sexual function after robot-assisted radical prostatectomy and carbon-ion radiotherapy for Japanese prostate cancer patients using propensity score matching

BackgroundThe quality of life of patients is an important consideration when selecting treatments for localized prostate cancer (PCa). We retrospectively compared sexual function after robot-assisted radical prostatectomy (RARP) and carbon-ion radiotherapy (CIRT) using propensity score matching.MethodsIn total, 127 Japanese PCa patients treated with RARP and 190 treated with CIRT monotherapy were evaluated. We evaluated the Expanded Prostate Cancer Index Composite (EPIC) score before treatment and 12 and 24 months after treatment. After propensity score matching, data from 101 patients from each group were analyzed. The study protocol was approved by the Institutional Review Board of Gunma University Hospital (no. IRB2020-050, 1839).ResultsAfter propensity score matching, the mean EPIC sexual function summary scores in the RARP and CIRT groups were 46.4 and 48.2, respectively. At 12 and 24 months after treatment, these scores were 27.9 (39.9% decrease) and 28.2 (39.2% decrease) in the RARP group and 41.4 (14.1% decrease) and 41.6 (13.7% decrease) in the CIRT group, respectively. Both groups demonstrated significantly decreased scores after 12 and 24 months of treatment compared to before treatment (all p < 0.05). At 12 and 24 months, the sexual function summary score was significantly higher in the CIRT group than in the RARP group (p < 0.001).ConclusionsThere was a smaller decrease in the EPIC sexual function score in the CIRT group than in the RARP group. These results provide useful information for treatment decision-making of Japanese PCa patients.

Application of Multilayered Blend Films as Soft, Stretchable, Self‐Adhesive, and Self‐Healing Absorption‐Dominant EMI Shielding and Microwave Absorber

AbstractSolution‐processable organic conductor–supramolecular elastomer blends are emerging materials for intrinsically stretchable and autonomously self‐healing organic electronics. Herein, the feasibility of a heterogenous multiphase polymer blend is demonstrated for soft, ultraflexible, self‐adhesive, and self‐healing multilayered film structures for electromagnetic interference (EMI) shielding and microwave absorber (MWA) purposes. The developed soft multilayered films achieve a 5–40 fold improvement in the thickness of the MWA compared to the current state‐of‐the‐art. The thickness normalized reflection loss (RL) is up to 65.26 dB mm−1 with 8.5 GHz bandwidth at 18–26.5 GHz. The maximum thickness normalized EMI shielding effectiveness peaks at up to 175 dB mm−1. The EMI shielding and MWA properties are maintainable up to 150% tensile strain with only a small decrease in the overall attenuation and RL. Furthermore, the developed films are capable of fully autonomously self‐healing and achieve a tough adhesion in temperatures of −30–145 °C, and underwater with maximum single‐lap shear adhesion strength of ≈481.5 kPa to soft thermoplastic polyurethane films. Thus, the developed multilayered films can be utilized for absorption‐dominant EMI shielding or MWA purposes as stretchable coatings. The developed materials also show considerable potential for emerging damage and puncture‐resistant organic soft electronics with autonomous material‐level self‐healing.

The spatiotemporal changes and trade-off synergistic effects of ecosystem services in the Jianghan Plain of China under different scenarios

Disturbance from human activities has intensified the evolution of ecosystem structure in the Jianghan Plain of China, leading to intensified conflicts between ecosystem services. It is essential to clarify the trade-off synergies between ecosystem services in the Jianghan Plain of China to better coordinate the economic and social development and ecological protection of the region. Based on historical data and scenario predictions using the GeoSOS-FLUS model, the InVEST model was applied to five key ecosystem services: Carbon storage, crop production, habitat quality, soil conservation and water yield from 2000 to 2020. Spearman correlation analysis was used to explore the trade-off synergies between different ecosystem services in space and time. The results showed that arable land and water land areas are the most important land types in the Jianghan Plain of China. From 2000 to 2020, the increase in build-up land and water land areas was accompanied by a decrease in arable land, forest land and unused land, and an increase in forest land. The natural development scenario in 2035 continues this trend except forest land reduction, while the ecological protection scenario reverses this trend. From 2000 to 2020, crop production, water yield, and soil conservation increased in the Jianghan Plain of China, while carbon storage and habitat quality declined significantly, showing a spatial distribution pattern of higher in the northwest and lower in the southeast. The comprehensive ecosystem services simulated in 2035 showed a downward trend compared with 2020, and the ecological protection scenario has the smallest decrease. There is an overall synergistic relationship between the five ecosystem services in the Jianghan Plain of China, and the strongest synergistic relationship is between soil conservation and water yield. The spatiotemporal relationship between the ecosystems in the Jianghan Plain of China is dynamic and requires sustainable management. Thus, it is necessary to rationally utilize land resources and enhance the ecological functions of the area to minimize trade-offs based on scientific land and spatial planning to maximize synergy.

Synthesis of historical reservoir operations from 1980 to 2020 for the evaluation of reservoir representation in large-scale hydrologic models

Abstract. All the major river systems in the contiguous United States (CONUS) (and many in the world) are impacted by dams, yet reservoir operations remain difficult to quantify and model due to a lack of data. Reservoir operation data are often inaccessible or distributed across many local operating agencies, making the acquisition and processing of data records quite time-consuming. As a result, large-scale models often rely on simple parameterizations for assumed reservoir operations and have a very limited ability to evaluate how well these approaches match actual historical operations. Here, we use the first national dataset of historical reservoir operations in the CONUS domain, ResOpsUS, to analyze reservoir storage trends and operations in more than 600 major reservoirs across the US. Our results show clear regional differences in reservoir operations. In the eastern US, which is dominated by flood control storage, we see storage peaks in the winter months with sharper decreases in the operational range (i.e., the difference between monthly maximum and minimum storage) in the summer. In the more arid western US where storage is predominantly for irrigation, we find that storage peaks during the spring and summer with increases in the operational range during the summer months. The Lower Colorado region is an outlier because its seasonal storage dynamics more closely mirrored those of flood control basins, yet the region is classified as arid, and most reservoirs have irrigation uses. Consistent with previous studies, we show that average annual reservoir storage has decreased over the past 40 years, although our analyses show a much smaller decrease than previous work. The reservoir operation characterizations presented here can be used directly for development or evaluation of reservoir operations and their derived parameters in large-scale models. We also evaluate how well historical operations match common assumptions that are often applied in large-scale reservoir parameterizations. For example, we find that 100 dams have maximum storage values greater than the reported reservoir capacity from the Global Reservoirs and Dams database (GRanD). Finally, we show that operational ranges have been increasing over time in more arid regions and decreasing in more humid regions, pointing to the need for operating policies which are not solely based on static values.

Mental and Physical Health-Related Quality of Life Following Military Polytrauma.

The long-term impact of deployment-related trauma on mental and physical health-related quality of life (HRQoL) among military personnel is not well understood. We describe the mental and physical HRQoL among military personnel following deployment-related polytrauma after their discharge from the hospital and examine factors associated with HRQoL and longitudinal trends. The U.S. military personnel with battlefield-related trauma enrolled in the Trauma Infectious Diseases Outcomes Study were surveyed using SF-8 Health Surveys at 1 month post-discharge (baseline) and at follow-up intervals over 2 years. Inclusion in the longitudinal analysis required baseline SF-8 plus responses during early (3 and/or 6 months) and later follow-up periods (12, 18, and/or 24 months). Associations of demographics, injury characteristics, and hospitalization with baseline SF-8 scores and longitudinal changes in SF-8 scores during follow-up were examined. Survey responses were used to calculate the Mental Component Summary score (MCS) and the Physical Component Summary score (PCS). The MCS focuses on vitality, mental health, social functioning, and daily activity limitations, whereas PCS is related to general health, bodily pain, physical functioning, and physical activity limitations. Longitudinal trends in SF-8 scores were assessed using chi-square tests by comparing the median score at each timepoint to the median 1-month (baseline) score, as well as comparing follow-up scores to the immediately prior timepoint (e.g., 6 months vs. 3 months). Associations with the 1-month baseline SF-8 scores were assessed using generalized linear regression modeling and associations with longitudinal changes in SF-8 were examined using generalized linear regression modeling with repeated measures. Among 781 enrollees, lower baseline SF-8 total scores and PCS were associated with spinal and lower extremity injuries (P < .001) in the multivariate analyses, whereas lower baseline MCS was associated with head/face/neck injuries (P < .001). Higher baseline SF-8 total was associated with having an amputation (P = .009), and lower baseline SF-8 total was also associated with sustaining a traumatic brain injury (TBI; P = .042). Among 524 enrollees with longitudinal follow-up, SF-8 scores increased, driven by increased PCS and offset by small MCS decreases. Upward SF-8 total score and PCS trends were associated with time post-hospital discharge and limb amputation (any) in the multivariate analyses (P < .05), whereas downward trends were independently associated with spinal injury and developing any post-discharge infection (P ≤ .001). Patients with lower extremity injuries had lower-magnitude improvements in PCS over time compared to those without lower extremity injuries (P < .001). Upward MCS trend was associated with higher injury severity (P = .003) in the multivariate analyses, whereas downward trends were independently associated with having a TBI (P < .001), time post-hospital discharge (P < .001), and occurrence of post-discharge infections (P = .002). Overall, HRQoL increased during the 2-year follow-up period, driven by PCS improvement. Increasing HRQoL was associated with time since hospital discharge and limb amputation, whereas a downward trend in HRQoL was associated with spinal injury and post-discharge infection. The longitudinal decline in MCS, driven by TBI occurrence, time since hospital discharge, and developing post-discharge infections, emphasizes the importance of longitudinal mental health care in this population.

How Does the Elimination of Group Mean-Differences Affect Factor Score Determinacy?

The present study investigates to what degree the common variance of the factor score predictor with the original factor, i.e., the determinacy coefficient or the validity of the factor score predictor, depends on the mean-difference between groups. When mean-differences between groups in the factor score predictor are eliminated by means of covariance analysis, regression, or group specific norms, this may reduce the covariance of the factor score predictor with the common factor. It is shown that in a one-factor model with the same group mean-difference on all observed variables, the common factor cannot be distinguished from a common factor representing the group mean-difference. It is also shown that for common factor loadings equal or larger than .60, the elimination of a d = .50 mean-difference between two groups in the factor score predictor leads to only small decreases of the determinacy coefficient. A compensation-factor k is proposed allowing for the estimation of the number of additional observed variables necessary to recover the size of the determinacy coefficient before elimination of a group mean-difference. It turns out that for factor loadings equal or larger than .60 only a few additional items are needed in order to recover the initial determinacy coefficient after the elimination of moderate or large group mean-differences.

Efficacy of the “Start to move” protocol on functionality, ICU-acquired weakness and delirium: A randomized clinical trial

ObjectiveTo evaluate the efficacy of the Start to move protocol compared to conventional treatment in subjects over 15 years of age hospitalized in the ICU on an improvement in functionality, decrease in ICU-acquired weakness (DAUCI), incidence of delirium, days of mechanical ventilation (MV), length of stay in ICU and mortality at 28 days. Designrandomized controlled clinical trial. SettingIntensive Care Unit. ParticipantsIncludes adults older than 15 years with invasive mechanical ventilation more than 48h, randomized allocation. InterventionsStart to move protocol and conventional treatment. Main variables of interestFunctionality, incidence of ICU-acquired weakness, incidence of delirium, days on mechanical ventilation, ICU stay and mortality-28 days, ClinicalTrials.gov number, NCT05053724. Results69 subjects were admitted to the study, 33 to the Start to move group and 36 to conventional treatment, clinically and sociodemographic comparable. In the “Start to move” group, the incidence of IUCD at ICU discharge was 35.7% vs. 80.7% in the “conventional treatment” group (p=0.001). Functionality (FSS-ICU) at ICU discharge corresponds to 26 vs. 17 points in favor of the “Start to move” group (p=0.001). The difference in Barthel at ICU discharge was 20% in favor of the “Start to move” group (p=0.006). There were no significant differences in the incidence of delirium, days of mechanical ventilation, ICU stay and 28-day mortality. The study did not report adverse events or protocol suspension. ConclusionsThe application of the “Start to move” protocol in ICU showed a reduction in the incidence of IUAD, an increase in functionality and a smaller decrease in Barthel score at discharge.

Mitral Valve Surgery for Mitral Regurgitation Results in Reduced Left Ventricular Ejection Fraction in Barlow's Disease as Compared with Fibro-Elastic Deficiency.

Surgical correction of severe mitral regurgitation (MR) can reverse left ventricular (LV) remodeling in patients with mitral valve prolapse (MVP). However, whether this process is similar to the case in Barlow's Disease (BD) and Fibro-elastic Deficiency (FED) is currently unknown. The aim of this study is to evaluate post-operative LV reverse remodeling and function in patients with BD versus FED. In this study, 100 MVP patients (BD = 37 and FED = 63) with severe MR who underwent mitral valve surgery at three Belgian centers were retrospectively included. Transthoracic echocardiography was used to assess MR severity, LV volumes and function before surgery and 6 months thereafter. Baseline MR severity, LV ejection fraction (LVEF), indexed LV end-diastolic (LVEDVi) and end-systolic volumes (LVESVi) were not different between the groups. After a median follow-up of 278 days, there was a similar decrease in LVEDVi, but a trend towards a smaller decrease in LVESVi in BD compared to FED (-3.0 ± 11.2 mL/m2 vs. -5.3 ± 9.0 mL/m2; p = 0.154). This resulted in a significantly larger decrease in LVEF in BD (-8.3 ± 9.6%) versus FED (-3.9 ± 6.9%) after adjusting for baseline LVEF (p < 0.001) and type of surgical intervention (p = 0.01). These findings suggest that LV (reverse) remodeling in BD could be affected by other mechanisms beyond volume overload, potentially involving concomitant cardiomyopathy.

Water quality trends of streams in Puerto Rico: Evaluating 50 years of the Clean Water Act.

Water quality regulations entail a substantial commitment of resources from governments and private entities. It is important to continually evaluate the effectiveness of these regulations to ensure they are having the intended impact. In this paper, we evaluated nutrient data as indicators of primary productivity and dissolved oxygen (DO) concentrations and pH as response variables to assess historical water quality trends from 55 stations of Puerto Rico. The stations were divided into impaired versus non-impaired categories based on their historical total phosphorus (TP) mean concentration. Mean TP and total nitrogen (TN) concentrations were significantly higher in the impaired stations relative to the non-impaired stations. In contrast, DO mean concentrations and mean pH values were significantly lower in the impaired stations. A generalized additive mixed model was used to demonstrate temporal trends. A significant decrease in TP and TN concentrations was observed with time at the impaired stations. This was accompanied by significant increases in DO concentrations and pH. The non-impaired stations showed a marginal (statistically nonsignificant) decreasing trend with time. The large reductions in nutrient concentrations observed at the impaired stations seem to be related to the closure of several primary wastewater treatment plants (WWTPs) across the island. The conversion of abandoned crop agricultural lands into secondary forest in recent decades has resulted in small but significant decreases in TN (not TP) in receiving streams. We conclude that the Clean Water Act has promoted improvements in water quality in Puerto Rico by advancing upgrades in sanitary infrastructure and the regulation of point sources of pollution.

Graphene quantum dots incorporated ZIF‐67 for stabilization of Au nanoparticles: Efficient catalyst for A3‐coupling and nitroarenes reduction reactions

Zeolitic imidazolate framework‐67 (ZIF‐67) functionalized with graphene quantum dots was prepared and utilized for the reduction of Au (III) and stabilization of Au nanoparticles. This newly prepared ZIF‐67/GQD@Au was characterized with different techniques and employed as a capable heterogeneous catalyst for reduction of aromatic nitro compounds and A1‐coupling reaction of alkynes, amines, and aldehydes in water solvent. Experiments indicate that this catalyst is able to reduce nitroarenes in short reaction times (10–20 min) in water at room temperature and corresponding amines were obtained in excellent yields (90–100%). Also, reactions of structurally different alkynes, amines, and aldehydes in the presence of this catalyst proceed effectively at 60°C and desired propargylic amine achieved in good to very good yields (76–88%) in water during 1 day. This catalyst displayed excellent stability and recyclability in both reactions and recycled for six runs with a small decrease in the activity.

Investigation of the renewed methane growth post-2007 with high-resolution 3-D variational inverse modeling and isotopic constraints

Abstract. We investigate the causes of the renewed growth of atmospheric methane (CH4) amount fractions after 2007 by using variational inverse modeling with a three-dimensional chemistry-transport model. Together with CH4 amount fraction data, we use the additional information provided by observations of CH4 isotopic compositions (13C : 12C and D : H) to better differentiate between the emission categories compared to the differentiation achieved by assimilating CH4 amount fractions alone. Our system allows us to optimize either the CH4 emissions only or both the emissions and the source isotopic signatures (δsource(13C,CH4) and δsource(D,CH4)) of five emission categories. Consequently, we also assess, for the first time, the influence of applying random errors to both emissions and source signatures in an inversion framework. As the computational cost of a single inversion is high at present, the methodology applied to prescribe source signature uncertainties is simple, so it can serve as a basis for future work. Here, we investigate the post-2007 increase in atmospheric CH4 using the differences between 2002–2007 and 2007–2014. When random uncertainties in source isotopic signatures are accounted for, our results suggest that the post-2007 increase (here defined using the two periods 2002–2007 and 2007–2014) in atmospheric CH4 was caused by increases in emissions from (1) fossil sources (51 % of the net increase in emissions) and (2) agriculture and waste sources (49 %), which were slightly compensated for by a small decrease in biofuel- and biomass-burning emissions. The conclusions are very similar when assimilating CH4 amount fractions alone, suggesting either that random uncertainties in source signatures are too large at present to impose any additional constraint on the inversion problem or that we overestimate these uncertainties in our setups. On the other hand, if the source isotopic signatures are considered to be perfectly known (i.e., ignoring their uncertainties), the relative contributions of the different emission categories are significantly changed. Compared to the inversion where random uncertainties are accounted for, fossil emissions and biofuel- and biomass-burning emissions are increased by 24 % and 41 %, respectively, on average over 2002–2014. Wetland emissions and agricultural and waste emissions are decreased by 14 % and 7 %, respectively. Also, in this case, our results suggest that the increase in CH4 amount fractions after 2007 (despite a large decrease in biofuel- and biomass-burning emissions) was caused by increases in emissions from (1) fossil fuels (46 %), (2) agriculture and waste (37 %), and (3) wetlands (17 %). Additionally, some other sensitivity tests have been performed. While the prescribed interannual variability in OH can have a large impact on the results, assimilating δ(D,CH4) observations in addition to the other constraints has only a minor influence. Using all the information derived from these tests, the net increase in emissions is still primarily attributed to fossil sources (50 ± 3 %) and agriculture and waste sources (47 ± 5 %). Although our methods have room for improvement, these results illustrate the full capacity of our inversion framework, which can be used to consistently account for random uncertainties in both emissions and source signatures.

Study on extreme sulfuration behavior of brush-electroplated silver-graphene composite coatings as the electrical contact materials for the outdoor high-voltage isolating switch

The silver-graphene (Ag-G) composite coating was successfully prepared on the copper substrate via the method of cyanide-free brush plating. When the sulfuration temperature is increased from −70 °C to 45 °C, the sulfuration degree of the Ag-G composite coating fabricated in the composite solution with the optimal graphene content of 2 g L−1 gradually increase to a maximum. With increasing the sulfuration temperature to 90 °C, the sulfuration degree of the Ag-G composite coating has a small decrease in comparison with that of 45 °C. The Ag-G composite coating achieves excellent sulfuration, abrasion and corrosive resistance under extreme sulfuration temperatures, which is superior to pure Ag coating owing to the incorporation of graphene in the bulk. The sulfuration temperature and O2 content in the Na2S solution interactively determine the sulfuration resistance. The work provides novel high-performance Ag-based coating by employing a cyanide-free composite electrolyte for the possible practical application under different extreme environments.

Political protection: The case of large‐scale oil spills and the stock prices of energy firms

AbstractIn this study, we utilize a sample of publicly traded US energy firms to investigate the stock market responses to 40 large‐scale oil spills. Our findings reveal that the stock prices of extraction and refining firms experience significant declines during the periods surrounding these oil spill incidents, and energy pipeline firms exhibit a relatively smaller decrease. These results underscore the risk exposure shared by all energy firms, irrespective of their direct involvement in the oil spill incident. Furthermore, our study uncovers an intriguing dynamic—the influence of political connections established through lobbying activities. We observe that these political ties serve to significantly mitigate the negative market reactions to oil spills. Our results suggest that, from the market's perspective, firms with political connections are less vulnerable to the impending costs associated with oil spills when compared to their non‐politically connected counterparts.

Effects of Students’ Autonomy Support on their Self-Regulated Learning Strategies: Three Field Experiments in Secondary Education

Providing students with autonomy over their learning process can support the development of their self-regulation skills. This study aimed to examine the effects of autonomy-support interventions on students’ self-regulated learning strategies. The participants were 432 students from three secondary schools in the Netherlands. In each school, a one-year field experiment was performed, in which teachers and students shared control over learning processes. At the start and end of the school year, students from both the experimental and control conditions completed a questionnaire on perceived autonomy support and self-regulation strategies used. Univariate analyses of covariance were performed to examine the effects of the interventions on perceived autonomy support and the use of self-regulated learning strategies. The intervention with the highest amount of student control showed positive effects on self-regulated learning strategies ‘task orientation’, ‘planning’, and ‘process evaluation’, although it did show a small decrease in perceived autonomy support. The other two interventions showed an increase in perceived autonomy support and a positive trend in ‘monitoring’. The field experiments suggest that different ways of supporting student autonomy can yield different effects on students’ self-regulated learning strategies. The tentative conclusion is that a focus on student control is the most effective.

Demonstrating scale-up of a novel water treatment process using super-bridging agents

Fiber-based materials have emerged as a promising option to increase the efficiency of water treatment plants while reducing their environmental impacts, notably by reducing the use of unsustainable chemicals and the size of the settling tank. Cellulose fiber-based super-bridging agents are sustainable, reusable, and versatile materials that considerably improve floc separation in conventional settling tanks or via alternative screening separation methods. In this study, the effectiveness of fiber-based materials for wastewater treatment was evaluated at lab-scale (0.25 L) and at pilot-scale (20 L) for two separation methods, namely settling and screening. For the fiber-based method, the performance of floc separation during settling was slightly affected by an 80x upscaling factor. A small decrease in turbidity removal from 93 and 86 % was observed for the jar and pilot tests, respectively. By contrast, the turbidity removal of the conventional treatment, i.e., no fibers with a settling separation, was largely affected by the upscaling with turbidity removals of 84 and 49 % for jar and pilot tests, respectively. Therefore, results are suggesting that fiber-based super-bridging agents could be implemented in full-scale water treatment plants. Moreover, the tested fibers increase the robustness of treatment by providing better floc removal than conventional treatment under several challenging conditions such as low settling time and screening with coarse screen mesh size. Furthermore, at both lab-scale and pilot-scale, the use of fiber-based materials reduced the demand for coagulant and flocculant, potentially lowering the operational costs of water treatment plants and reducing the accumulation of metal-based coagulants and synthetic polymers in sludge. Acute toxicity tests using the model organism Daphnia magna show that the cellulose fibers introduce insignificant toxicity at the optimized fiber concentration. Although dedicated mechanistic studies are required at various scales to understand in detail the influence of fibers on water treatment (coagulation/flocculation time, floc formation, floc size distribution velocity gradient, etc.), the efficacy and scalability of the fiber-based approach, along with its minimal environmental impact, position it as a viable and sustainable option for existing and future wastewater treatment plants.

Randomized trial of an integrated care intervention among Latino adults: Sustained effects on diabetes management

Abstract We examined the 12-month maintenance effects of a previously successful integrated model of diabetes care at improving glycemic management and psychological well-being among Latino adults with type 2 diabetes (T2D). A randomized controlled trial (2015–19) compared an integrated care intervention (ICI) with usual care among 456 adults with T2D. The ICI included integrated medical and behavioral care and health education over 6 months. Assessments were completed at baseline, 3, 6, 9, and 12 months. Most participants were female (63.7%) with a mean age of 55.7 years. In multilevel models, significant Group × Time (quadratic) interaction effects were found for HbA1c [Bint = 0.10, 95% confidence interval (CI) 0.02, 0.17, P &amp;lt; .01] and anxiety symptoms (Bint = 0.20, 95% CI 0.05, 0.35, P &amp;lt; .009), but not depression symptoms (Bint = 0.15, 95% CI −0.01, 0.31, P &amp;lt; .07). Analyses of instantaneous rate of change in the ICI group showed significant decreases at 3 and 6 months for both HbAc1 (B = −0.31 at 3 months; B = −0.12 at 6 months) and anxiety symptoms (B = −0.92 at 3 months; B = −0.46 at 6 months), and no significant instantaneous changes at 9 or 12 months, suggesting that initial improvements were largely maintained. The usual care group showed a small decrease in anxiety symptoms at 6 months (B = −0.17), but no other significant changes at any time-point for anxiety or HbA1c (all Ps &amp;gt; .05). This culturally tailored integrated care model shows potential in producing and sustaining positive effects on clinical and psychological outcomes above standard care.

The impact of COVID-19 on life expectancy across socioeconomic groups in Denmark

BackgroundDenmark was one of the few countries that experienced an increase in life expectancy in 2020, and one of the few to see a decrease in 2021. Because COVID-19 mortality is associated with socioeconomic status (SES), we hypothesize that certain subgroups of the Danish population experienced changes in life expectancy in 2020 and 2021 that differed from the country overall. We aim to quantify life expectancy in Denmark in 2020 and 2021 by SES and compare this to recent trends in life expectancy (2014–2019).MethodsWe used Danish registry data from 2014 to 2021 for all individuals aged 30+. We classified the study population into SES groups using income quartiles and calculated life expectancy at age 30 by year, sex, and SES, and the differences in life expectancy from 2019 to 2020 and 2020 to 2021. We compared these changes to the average 1-year changes from 2014 to 2019 with 95% confidence intervals. Lastly, we decomposed these changes by age and cause of death distinguishing seven causes, including COVID-19, and a residual category.ResultsWe observed a mortality gradient in life expectancy changes across SES groups in both pandemic years. Among women, those of higher SES experienced a larger increase in life expectancy in 2020 and a smaller decrease in 2021 compared to those of lower SES. Among men, those of higher SES experienced an increase in life expectancy in both 2020 and 2021, while those of lower SES experienced a decrease in 2021. The impact of COVID-19 mortality on changes in life expectancy in 2020 was counterbalanced by improvements in non-COVID-19 mortality, especially driven by cancer and cardiovascular mortality. However, in 2021, non-COVID-19 mortality contributed negatively even for causes as cardiovascular mortality that has generally a positive impact on life expectancy changes, resulting in declines for most SES groups.ConclusionsCOVID-19 mortality disproportionally affected those of lower SES and exacerbated existing social inequalities in Denmark. We conclude that in health emergencies, particular attention should be paid to those who are least socially advantaged to avoid widening the already existing mortality gap with those of higher SES. This research contributes to the discussion on social inequalities in mortality in high-income countries.

The Appropriateness of Medical Devices Is Strongly Influenced by Sex and Gender.

Until now, research has been performed mainly in men, with a low recruitment of women; consequentially, biological, physiological, and physio-pathological mechanisms are less understood in women. Obviously, without data obtained on women, it is impossible to apply the results of research appropriately to women. This issue also applies to medical devices (MDs), and numerous problems linked to scarce pre-market research and clinical trials on MDs were evidenced after their introduction to the market. Globally, some MDs are less efficient in women than in men and sometimes MDs are less safe for women than men, although recently there has been a small but significant decrease in the sex and gender gap. As an example, cardiac resynchronization defibrillators seem to produce more beneficial effects in women than in men. It is also important to remember that MDs can impact the health of healthcare providers and this could occur in a sex- and gender-dependent manner. Recently, MDs' complexity is rising, and to ensure their appropriate use they must have a sex-gender-sensitive approach. Unfortunately, the majority of physicians, healthcare providers, and developers of MDs still believe that the human population is only constituted by men. Therefore, to overcome the gender gap, a real collaboration between the inventors of MDs, health researchers, and health providers should be established to test MDs in female and male tissues, animals, and women.