Standard Unit Research Articles

Magic money: commodities and exchange in Bronze Age Europe

ABSTRACT Bronze Age Europe has been described as the first globalized economy: long-distance trade in bronze and other materials is seen as centrally implicated in the social and political transformations of the period. Recent research pointing to the existence of standardized units of weight (given material form in ‘proto-currencies’ such as the well-known bronze ösenringe of the Early Bronze Age, as well as in the appearance of weights and balance beams during the Late Bronze Age) has reignited longstanding discussions around the relative significance of commodity and gift exchange during the period. In this paper, we revisit anthropological discussions of trade and exchange on the one hand, and of ethnomathematics on the other, to consider the social implications of Bronze Age numeracy and metrology. In this way, it is possible to avoid imagining the Bronze Age as a proto-Capitalist economy and instead consider how economics, society and cosmology were inextricably intertwined.

Motor outcomes in individuals born small for gestational age at term: a systematic review.

Being born small for gestational age (SGA) is a risk factor for motor difficulties. Previous reviews exploring this topic are mostly focused on children born preterm. We aimed to review the literature to determine the association between being born SGA at term and motor outcomes. PubMed and Embase were searched for relevant articles without any restrictions on publication year or participants' age. Inclusion criteria were SGA exposure at term (≥ 37 weeks of gestation), cohort studies or randomized controlled trials with motor outcome assessed by standardized motor tests with results reported as continuous scores (mean/median) compared with a control group. Exclusion criteria were abstracts, editorials and commentaries, articles in non-English language or no full text available. Reviews were screened for relevant articles. Quality of included studies was assessed by the Newcastle-Ottawa Scale. In total, 674 records were identified by the literature search and screened by two independent authors. Thirteen original articles were eligible and included in a qualitative synthesis, and five (38%) of these were included in a meta-analysis. Nine (69%) studies were from high-income countries. Most studies were carried out in early childhood, and only one study in adulthood. Seven (54%) articles reported that individuals born SGA at term had poorer scores on standardized motor tests compared with controls, while no differences were reported in five (38%) articles. One article did not report p-values, although the differences were comparable to the other studies. Group differences were of small to moderate effect size (0.19 to 0.65 standard deviation units). The pooled effect size was -0.43 (95% confidence interval: -0.60 to -0.25). Adjustment for covariates were reported in seven (54%) articles and did not change the results. Proportions of motor difficulties, reported in five (38%) articles, ranged from 8.9 to 50% in individuals born SGA from infancy to adolescence. This systematic review shows that being born SGA, also at term, may be a risk factor for poorer motor outcomes throughout childhood, confirmed by a meta-analysis in early childhood. Further research is needed to establish the risk of adult motor difficulties in individuals born SGA at term.

Harmonizing measurements: establishing a common metric via shared items across instruments

BackgroundThe proliferation of instruments that define instrument-specific metrics impedes progress in comparative assessment across populations. This paper explores a method to extract a common metric from related but different instruments and transform the original measurements into scores with a standard unit of measurement.MethodsExisting data from four assessment instruments of child development, collected from three different samples of children, were used to create “equate clusters” of items that measure the same behaviour in (slightly) different ways. A probability model was formulated to identify best items and groups to serve as anchors linking the instruments, assuming that items in an anchoring or “active” equate cluster are psychometrically equivalent. Quantification and inspection of item characteristic curves were used to resolve which equate clusters should be active. We simulated the impact of various analytic choices.ResultsSimulation confirmed the feasibility of creating a common metric from data collected with different instruments from respondent samples with different abilities. The method performed as expected in an application in early childhood development.ConclusionsThe use of equate clusters is an intuitive and flexible way to establish a common metric across instruments and facilitates the transformation of measurements obtained to a standardized scale. Standardizing instrument scores to a common metric allows for population-level comparisons on a global scale.

Enhanced Efficiency of Latent Heat Energy Storage by Inclination

Latent heat storage (LHS) has emerged as a promising solution for addressing the challenges of large-scale and long-term energy storage, offering a clean and reusable system. Being in the developmental stage, and with only limited theoretical predictions being available, there is a need to enhance the efficiency of LHS systems. In this study, we use numerical simulations to study the melting process of a phase-change material (PCM) in a rectangular domain. A significant enhancement in the melt rate of the PCM is found by a simple inclination of the domain, with a 60% increase in melt rate compared to a standard square unit without inclination through enhanced heat transfer. We establish a theoretical relation for the optimal PCM melt rate, based on the inclination angle and the domain aspect ratio, outlining the optimal conditions for the PCM melt rate, which is solely dependent on the domain geometry. We further propose a heat-transfer model that predicts the optimal aspect ratio for achieving the maximum melt rate as a function of the Rayleigh and Prandtl numbers. Published by the American Physical Society 2024

Environmental Footprints of Yogurt Production: A Case Study of a Small-Scale Manufacturing Process in Sri Lanka

This study investigated the life cycle environmental impacts of yogurt production from cradle to gate at the Pulathisi milk factory in Polonnaruwa, Sri Lanka. The functional unit considered was one kilogram of yogurt produced in the factory using existing technology. The defined system boundary encompassed raw milk production and transportation, machinery fabrication, standardization of milk, and standard unit operations of yogurt production. Material and energy usage data were collected through a series of observations, literature and Ecoinvent 3.7.1 databases. The ReCiPe 2008 method was employed for impact analysis, considering eighteen impact categories with SimaPro software. The inventory analysis included material consumption for machinery fabrication, energy consumption, and emissions for each unit operation in yogurt production. Results were characterized using midpoint indicators, and normalized impacts were calculated. The characterized outcomes of the yogurt production process contributed 2.48 kgCO2eq to climate change, 0.0297 kgSO2eq to acidification, 0.0002 kgPeq to eutrophication, and 6.9199 kg 1,4-DBeq to human toxicity. The study identified hotspots, emphasizing the significant contributions of cow milk production and electricity usage to environmental impacts. Potential mitigations, such as improved waste management in dairy farming and switching to renewable energy sources, are proposed to address these impacts. The normalized impacts provided insights for decision-makers and stakeholders to compare environmental performances and guide sustainable practices in yogurt production. The total impact was recorded as 0.014-person equivalent per year per one kilogram of yogurt.

The effect of phenotyping, adult selection, and mating strategies on genetic gain and rate of inbreeding in black soldier fly breeding programs

BackgroundThe aim of this study was to compare genetic gain and rate of inbreeding for different mass selection breeding programs with the aim of increasing larval body weight (LBW) in black soldier flies. The breeding programs differed in: (1) sampling of individuals for phenotyping (either random over the whole population or a fixed number per full sib family), (2) selection of adult flies for breeding (based on an adult individual’s phenotype for LBW or random from larvae preselected based on LBW), and (3) mating strategy (mating in a group with unequal male contributions or controlled between two females and one male). In addition, the numbers of phenotyped and preselected larvae were varied. The sex of an individual was unknown during preselection and females had higher LBW, resulting in more females being preselected.ResultsSelecting adult flies based on their phenotype for LBW increased genetic gain by 0.06 genetic standard deviation units compared to randomly selecting from the preselected larvae. Fixing the number of phenotyped larvae per family increased the rate of inbreeding by 0.15 to 0.20% per generation. Controlled mating compared to group mating decreased the rate of inbreeding by 0.02 to 0.03% per generation. Phenotyping more than 4000 larvae resulted in a lack of preselected males due to the sexual dimorphism. Preselecting both too few and too many larvae could negatively impact genetic gain, depending on the breeding program.ConclusionsA mass selection breeding programs in which the adult fly is selected based on their larval phenotype, breeding animals mate in a group and sampling larvae for phenotyping at random over the whole population is recommended for black soldier flies, considering the positive effect on rates of genetic gain and inbreeding. The number of phenotyped and preselected larvae should be calculated based on the expected female weight deviation to ensure sufficient male and female candidates are selected.

Differences in Drug Shortages in the US and Canada

Drug shortages are a persistent public health issue that increased during the COVID-19 pandemic. Both the US and Canada follow similar regulatory standards and require reporting of drug-related supply chain issues that may result in shortages. However, it is unknown what proportion are associated with meaningful shortages (defined by a significant decrease in drug supply) and whether differences exist between Canada and the US. To compare how frequently reports of drug-related supply chain issues in the US vs Canada were associated with drug shortages. Longitudinal cross-sectional study conducted from January 2023 to March 2024 using drug-related reports of supply chain issues from 2017 to 2021 that were less than 180 days apart in Canada and the US. Shortages were assessed using data from the IQVIA Multinational Integrated Data Analysis database, comprising 89% of US and 100% of Canadian drug purchases. Country (Canada vs US), timing of report issuance (before vs after the COVID-19 pandemic), and characteristics of the supply chain prior to the reports of drug-related supply chain issues (including World Health Organization essential medicine status, Health Canada tier 3 medicine [moderate risk classification], whether there was sole-source manufacturing of the drug, the formulation, the price per unit, ≥20 years since drug approval, and the number of therapeutic alternatives). A drug shortage (a decrease of ≥33% in monthly purchased standardized drug units) within 12 months, relative to the average units purchased during the 6 months prior to the report of supply chain issues to a US or Canadian reporting system. Among the 104 drug-related reports of supply chain issues in both countries, 49.0% (95% CI, 39.3%-59.7%) were associated with drug shortages in the US vs 34.0% (95% CI, 25.0%-45.0%) in Canada (adjusted hazard ratio [HR], 0.53 [95% CI, 0.36-0.79]). The lower risk of drug shortages in Canada vs the US was consistent before the COVID-19 pandemic (adjusted HR, 0.47 [95% CI, 0.30-0.75]) and after the pandemic (adjusted HR, 0.31 [95% CI, 0.15-0.66]). After combining reports of supply chain issues in both countries, the shortage risk was double for sole-sourced drugs (adjusted HR, 2.58 [95% CI, 1.57-4.24]) and nearly half for Canadian tier 3 medicines (moderate risk) (adjusted HR, 0.56 [95% CI, 0.32-0.98]). Drug-related reports of supply chain issues were 40% less likely to result in meaningful drug shortages in Canada compared with the US. These findings highlight the need for international cooperation between countries to curb the effects of drug shortages and improve resiliency of the supply chain for drugs.

The Effects of a Single Vagus Nerve's Neurodynamics on Heart Rate Variability in Chronic Stress: A Randomized Controlled Trial.

The modulation of the autonomic nervous system's activity, particularly increasing its parasympathetic tone, is of significant interest in clinical physiotherapy due to its potential benefits for stress-related conditions and recovery processes. This study evaluated the effectiveness of the addition of neurodynamics in enhancing parasympathetic activation in subjects with chronic stress. A clinical trial randomly assigned participants to a group with neurodynamics (6 bpm breathing protocol + manual therapy + neurodynamic technique) or a group without neurodynamics (6 bpm breathing protocol + manual therapy only). Metrics of heart rate variability (HRV), including the Mean Heart Rate (Mean HR), standard deviation of intervals between consecutive heartbeats (SDNN), Heart Rate Difference (Diff. HR), Root Mean Square of Successive Differences (RMSSD), number of intervals differing by more than 50 ms (NN50), percentage of consecutive NN intervals that differed by more than 50 ms (pNN50), and the high-frequency component measured in standardized units (HF), were assessed before, during, and after the intervention. During the intervention, the group with neurodynamics showed significant changes in all variables except in the pNN50 and HF while the group without neurodynamics only showed improvements in the Mean HR, SDNN, and RMSSD. In the post-intervention phase, the group with neurodynamics maintained an increase in HRV while the group without neurodynamics experienced a decrease, suggesting an increase in sympathetic activity. Vagal nerve neurodynamics appear to represent an effective method for enhancing parasympathetic activation in patients with chronic stress. The results highlight the importance of a more comprehensive analysis of HRV variables in order to obtain a correct picture of the impact of interventions on the complex and multifaceted functioning of the autonomic nervous system.

Medication recommendation for Parkinson’s disease based on dynamics of symptom progression

Parkinson’s Disease (PD) is a chronic condition, with extensive research on initial medication selection for treatment, but limited guidance on long-term medication management. This study aims to identify optimal medication adjustment strategies based on patient clusters, focusing on either maximizing time spent in favorable health states or minimizing time spent in unfavorable ones while avoiding adverse effects. To guide treatment, we developed decision models using prescription dosages converted into standardized units for various medications. Using data from the Parkinson’s Progression Markers Initiative, we employed a multivariate time-series clustering approach to capture symptom progression dynamics. This analysis identified four distinct clusters: two representing desirable and undesirable states, and two highlighting motor-focused and non-motor-focused failures across multiple domains. We developed two separate Markov Decision Process (MDP) models to address these dual objectives, which were then integrated into a comprehensive framework that suggests optimal actions and cautions against risky ones for each patient state. This model provides valuable insights for clinical decision-making by offering flexible guidance on adjusting medication intensity rather than prescribing specific medication types, enhancing its applicability in clinical practice.

Prevalence and long-term change in alcohol consumption: results from a population-based cohort in Southern India

BackgroundAlcohol consumption in India is below the global average, with limited data on long-term effects. The current study aims to examine changes over time among alcohol consumers, the pattern of drinking and help-seeking for alcohol problems among South Indian men.MethodData on the intake of various alcohol types were collected through standard questionnaires in two adult follow-ups [Baseline: 1998–2002, Follow-up: 2016–2019] from male participants in the Vellore birth cohort (VBC). Alcohol intake was converted to weekly standard drink units for analysis. Data on drinking patterns using the Alcohol Use Disorder Identification Test (AUDIT) and information on help-seeking among problem drinkers were collected during follow-up. Socio-demographic associations with alcohol consumption were determined using logistic regression.ResultsThe prevalence of alcohol consumption was 54.5% and 47.7% at the baseline and follow-up, respectively. Over two decades, 12% of men reported to have newly started drinking and 18% quit drinking. Lower education and lower socio-economic status (SES) were the strongest predictors of alcohol consumption. The AUDIT assessment among drinkers reported hazardous drinking of 38.4%, harmful drinking of 4.7% and 3.7% probable alcohol dependence. Among the persons with high AUDIT scores, 25% were concerned about high consumption, and 9% sought help to stop their alcohol consumption.ConclusionOur results showed a decline in alcohol consumption in this cohort over two decades. Among drinkers, a high proportion report hazardous and harmful consumption. Low levels of education and SES are significant predictors of alcohol consumption. A low proportion of help-seeking reflects alcohol-related stigma in the community.

Association between physical activity and costs in very mild to moderately frail community-dwelling older adults: a cross-sectional study.

Physical activity (PA) plays a vital role in maintaining the functional ability that enables well-being in older age (healthy aging), potentially also saving costs for the healthcare system and society. The aim of this study was to examine the association between PA and healthcare and societal costs in a sample of very mild to moderately frail older adults. This cross-sectional study is a secondary analysis using baseline data from the PromeTheus randomized-controlled trial, which included 385 very mild to moderately frail community-dwelling older adults (70 + years) from Germany. Participants self-reported their health-related resource use in the previous 6 months (FIMA questionnaire), which was monetarily valued using standardized unit costs. PA was also self-reported using the German Physical Activity Questionnaire for middle-aged and older adults (German-PAQ-50+) and categorized as 'insufficient'/'sufficient' or 'insufficient'/'moderate'/'high' in accordance with the World Health Organization guidelines for PA. Mean and median healthcare costs (including outpatient, inpatient, rehabilitation, formal care, and medication costs) and societal costs (healthcare costs plus informal care costs) for different PA groups were estimated using generalized linear models and quantile regression, with sociodemographic variables and physical capacity (Short Physical Performance Battery) as covariates. Of the sample, 24% were classified as insufficiently, 23% as moderately, and 54% as highly active. Sufficient PA, especially high PA, was associated with lower costs in the 6 months prior to data collection compared to insufficient PA (-€6,237, 95% CI [-10,656; -1,817] and -€8,333, 95% CI [-12,183; -4,483], respectively). The cost difference between PA intensity groups was largely driven by differences in informal care costs and decreased substantially when physical capacity was accounted for in the analyses; e.g., the mean difference in societal costs between sufficient and insufficient PA decreased from -€7,615 (95% CI [-11,404; -3,825]) to -€4,532 (95% CI [-7,930; -1,133]). Promoting PA throughout the lifespan as a means of promoting healthy aging and reducing dependency in old age could potentially provide economic benefits and help to mitigate the economic consequences of an aging population with increasing health and long-term care needs. Future longitudinal studies should attempt to disentangle the mediating and confounding role of physical capacity and health status in the association between PA and costs.

Spatial inequality in sub-national human development index: A case study of West Bengal districts

Human Development and its regional disparity is an area of topical interest. In this paper, we consider space as an instrumental variable in understanding this disparity and explore spatial interdependence in human development across districts of West Bengal using alternate indicators of human development. This study uses both the standard United Nations Development Programme (UNDP) technique and an alternative methodology to construct a sub-national human development index. Spatial interdependence is measured using Moran's I coefficient and Local Indicators of Spatial Autocorrelation (LISA) cluster maps. Spatial regression is used to evaluate the spatial association between the Human Development Index as the dependent variable and a few independent variables. A high degree of clustering in all three dimensions of human development is observed among the southern districts of West Bengal. The pattern of cluster maps indicates the presence of both the growth pole process and the metropole-periphery process in the state. Spatial regression results indicate that the share of socially backward class population and urbanization rate are important variables affecting regional human development patterns. The findings of this study suggest policies targeted to promote social inclusion and urbanization linked with better access to economic opportunities in the lagging areas can help reduce regional imbalances.

Effectiveness of a Motivational Interviewing-Based Intervention in Decreasing Risky Alcohol Use in Primary Care Patients in Spain: A Controlled Clinical Trial

Objective: Our study aimed to evaluate the effectiveness of an intervention based on Motivational Interviewing (MI) performed by healthcare professionals in Primary Care (PC) patients with risky alcohol use through a multicenter, two-arm parallel, cluster-randomized, open-label controlled clinical trial. Methods: PC professionals were randomized into two groups: an Experimental Group (EG) and a Control Group (CG). The study was carried out in PC centers of the Andalusian Health Service, located in Cordoba, Spain. An MI-based approach was implemented with patients recruited in the EG, while health advice was provided to those included in the CG. The follow-up period was 12 months, with five visits scheduled. The consumption of standard drinking units per week was quantified, and risky alcohol use was estimated using the Alcohol Use Disorders Identification Test (AUDIT). An intention-to-treat statistical analysis was performed. Relative risk (RR), absolute risk reduction (ARR) and the number of subjects needed to treat (NNT) were used to estimate the intervention effect size. Results: A total of 268 patients were included, 148 in the EG and 120 in the CG. Considering the quantification of risky alcohol use, the ARR at 12 months after baseline visit was 16.46% (95% CI: 5.37–27.99), with an NNT of 6 (95% CI: 4–19). According to the AUDIT, the ARR at 12 months was 13.15% (95% CI: 2.73–24.24%), and the NNT was 8 (95% CI: 4–37). Conclusions: We concluded that MI is more effective than the usual health advice in decreasing risky alcohol use in patients treated in PC.

Cross-jurisdictional analysis and forecasting of North American nuclear fuel inventory using a standardized unit

This study fills the noted gap in comparative analyses of spent nuclear fuel (SNF) by assessing inventories from two key nuclear power regions, the USA and Canada, using a comprehensive analytical framework and standardized data from 2009 to 2021. In the USA, SNF inventory increased by 14.7 % in fuel assembly weight and 47 % in residual heavy metal content compared to Canada, in line with their use of light water reactors. Canada's SNF production is directly correlated to its nuclear power output, influenced by the lower burnup of natural uranium fuel used in CANDU reactors (R2 = 0.57; p-value < 0.05) while the USA shows insignificant correlation, likely due to a variety of reactor types and higher burnup rates (R2 = 0.008; p-value > 0.05). Further, the study identifies a strong negative correlation between uranium mine production and SNF inventory in the USA, indicating a reliance on imports amidst negligible domestic mining. In contrast, Canada also exhibits moderate negative dependency due to its position as a major uranium exporting jurisdiction. The obtained negative correlations with coal rents in both countries indicate a shift towards more nuclear energy use, impacting economic growth and energy patterns. The developed predictive models indicate a higher future SNF increase in Canada than in the USA. These findings are essential for planning the transition from temporary to permanent SNF disposal, ensuring safe long term management of radioactive waste.

Association of Psychological Safety with Burnout and Intent to Leave Among Physician Faculty in New York City.

Data on the potential protective effect of psychological safety (PS) on well-being and satisfaction among physicians are lacking. We sought to examine (1) prevalence of PS; (2) relationship between PS, burnout, and intent to leave one's job (ILJ); and (3) demographic and occupational factors associated with PS within our physician faculty. Participants: An institution-wide survey was sent to all faculty within our eight-hospital health system, between July and September 2022. PS was assessed using the seven-item Fearless Organization Questionnaire and burnout with the Maslach Burnout Inventory-2. Demographics and a measure of ILJ were assessed. Multivariable logistic regression analyses were conducted to determine associations between PS, burnout, ILJ, and demographic and occupational correlates of PS. A total of 867 out of 3086 total estimated clinical faculty members (28.1%) participated in the survey. The majority were 40 and older (67.4%), female (51.9%), white (60.0%), and married/partnered (80.4%); worked in ambulatory care departments (53.7%); and ranked assistant or associate professors (75.8%). On average, 57.6% of physicians evaluated their workplace as psychologically safe (range across items = 40.9-69.9%), with 35.2% screening positive for burnout and 13.4% reporting ILJ. After adjusting for demographic and occupational characteristics, each standard deviation unit increase in PS scores was associated with 27% lower odds of screening positive for burnout (odds ratio (OR) = 0.73, 95% confidence interval (CI) = 0.63-0.84) and 38% lower odds of ILJ (OR = 0.62, 95% CI = 0.52-0.74). Female gender was associated with lower scores of PS. A majority of faculty physicians reported working in a psychologically safe environment. Greater PS was associated with lower odds of burnout and ILJ. Investment in gender and diversity equity training may be one concrete step in advancing PS in the workplace.

Nanomechanical and bending properties of nickel-titanium orthodontics archwires by depth-sensing indentation

This study aimed to identify the link between alloy microstructures and the nanomechanical properties of different orthodontic archwires containing nickel-titanium (NiTi) by sensing sliced areas. Previous studies have focused on analyzing and contrasting physical properties such as microhardness, elasticity modulus, and resistance; therefore, the trend is to consider microstructural characteristics in detail. Thirty archwire samples from 3 different commercial brands, American Orthodontics (AO), 3M Unitek (3M), and Borgatta, were analyzed through scanning electron microscopy and energy-dispersive x-ray spectroscopy, transmission electron microscopy, atomic force microscopy, Berkovich nanoindentation, and microtensile microscopy to determine their chemical-crystallographic characteristics and nanomechanical and bending characteristics. The identified formulations of AO and 3M had averages of 20 wt%, for Ni and 15.4 wt% for Ti, with lower concentrations for Borgatta. Alloys of Ni and Ti were distributed in different concentrates in the matrix of the archwires. The nanomechanical properties showed high values of the elastic modulus (82.8 ± 3.6 GPa) and hardness (6.4 ± 1.2 GPa) and a minor deformation degree of 0.38% for the AO wires, although the bending strength exhibited the highest values for 3M. No corrosion was observed with a prolonged hydrolytic attack on the surface of any of the wires (0.0-0.5 National Bureau of Standards units). The highest nanomechanical properties and bending characteristics were observed for wires with higher NiTi precipitate contents, which were distributed differently in the alloy overall in the matrix. The nanoindentations sensed in different areas evidenced different mechanical properties for NiTi depending on its concentrations of Ti and enucleations.

Cost minimisation analyses of birth care in low-risk women in Norway: a comparison between planned home birth and birth in a standard obstetric unit

BackgroundEvidence exists that planned home births for low-risk women in settings in which they have access to hospital transfer if needed are safe. The costs of planned home births, compared to low-risk births in obstetric units, are not clear. The aim of this study was to compare costs associated with hospital births versus home births under different home birth organizations.MethodsWe performed a cost minimisation analysis (CMA) based on decision-analytic modelling while assuming that health outcomes were not affected by place of birth. Estimations of resource use were mainly based on three existing Norwegian datasets: (1) women with planned home births (n = 354), (2) women with planned home births (n = 482) of which 63 were transferred to a hospital, and (3) women with planned births in a hospital (n = 1550).ResultsPlanned home birth costs 45.9% (credibility interval [CrI] 39.1–54.2) of a low-risk birth at a hospital. For planned home birth, the birth was the costliest activity (32.1%). The costs for planned home birth were estimated to be €1872 (CrI 1694–2071) and included hospitalisations for some. Costs for only those with actual home birth was €1353 (CrI 1244–1469). Costs of a birth, including possible birth-related complications, in low-risk women in a hospital was €4077 (CrI 3575–4615).When including the costs of being on call for one woman at a time, a planned home birth costs €5,531 (CrI 5,171–5,906), which is 135.7% (CrI 117.7–156.8) of low-risk births at a hospital. When organizing midwives in the on call teams for multiple women at a time, a planned home birth costs € 2,842 (CrI 2,647–3,053), which is 69.7% (CrI 60.3–80.9) of a low-risk birth in a hospital.ConclusionsHome birth can be cost-effective if the midwives who facilitate home births are organised into larger groups, or they work for hospitals that also facilitate home births. A model in which midwives work separately or in pairs to assist with a home birth and are on call for one birth at a time may not be cost-effective.

Colourimetric changes experienced in three types of aligners according to the L'Eclairage Commission.

The objective was to compare the colourimetric increment (L*, a*, and b*) of three types of aligners after subjecting them to two stains and to evaluate the initial colourimetric characteristics. A total of 120 aligners (40 Invisalign®, 40 Spark®, and 40 QuickSmile®) were immersed in two different agents (distilled water and coffee). Measurements were taken using a spectrophotometer before immersion (T0), after 12 hours (T1), and after 7 days (T2). Colour changes (ΔE*) were evaluated based on the International Commission of L'Eclairage, and subsequently converted to National Bureau of Standards units. The measurement was repeated three times. The intraclass correlation coefficient, one-way ANOVA, Tukey's post hoc test, and the independent t test were used (P ≤ .05). At T0, significant differences were observed for a*: Invisalign® and Spark® tended towards redder tones, whereas Quicksmile® leaned towards greener shades. Regarding b*, all aligners tended towards yellow, with Invisalign® exhibiting the least tendency. No differences were found in water between T1 and T0. In the intervals, T2-T1 and T2-T0, Spark® showed more noticeable changes, whereas for Invisalign® and Quicksmile®, the change was only slight. In coffee, a shift to another colour was detected in T1-T0, T2-T1, and T2-T0 for Invisalign®, whereas for other brands, it was barely noticeable except for T2-T0 in Spark®, where the change was appreciable. In coffee, Invisalign® tended towards darker values (L*), turning redder (a*), and more yellow (b*) in T2-T1 and T2-T0. Invisalign® aligners initially presented a more reddish and less yellowish colour. In water, after 7 days, a noticeable colour change was found for Spark®. In coffee, a greater loss in brightness and a change to red and yellow were observed after 12 hours and 7 days for Invisalign®. This study highlights the importance of considering the impact of coffee on the colouring of aligners, especially with Invisalign®, which shows more noticeable changes.

THE RELATIVE CONTRIBUTION OF ACADEMIC PASSION TO ACADEMIC WELL-BEING AMONG NURSING STUDENTS

The current study aimed to reveal the relative contribution of academic passion to the academic well-being among nursing students. To achieve the study objectives, a sample of (143) male and female students from Palestinian students inside the Arabs (48) was selected by using the available sample method for the summer semester of the academic year 2023-2024. The academic passion scale and the academic well-being scale were applied to them. The results showed that the level of academic well-being was within the high level and that there were no statistically significant differences at (=0.05) in the responses of the sample members on the academic well-being scale attributed to the gender and academic level. The results also showed that whenever the obsessive academic passion increases by a standard unit, the academic well-being increases (0.489), and whenever the harmonious academic passion increases by a standard unit, the academic well-being increases (0.297).&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0725/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

Blood metabolites, neurocognition and psychiatric disorders: a Mendelian randomization analysis to investigate causal pathways

BackgroundNeurocognitive dysfunction is observationally associated with the risk of psychiatric disorders. Blood metabolites, which are readily accessible, may become highly promising biomarkers for brain disorders. However, the causal role of blood metabolites in neurocognitive function, and the biological pathways underlying their association with psychiatric disorders remain unclear.MethodsTo explore their putative causalities, we conducted bidirectional two-sample Mendelian randomization (MR) using genetic variants associated with 317 human blood metabolites (nmax = 215,551), g-Factor (an integrated index of multiple neurocognitive tests with nmax = 332,050), and 10 different psychiatric disorders (n = 9,725 to 807,553) from the large-scale genome-wide association studies of European ancestry. Mediation analysis was used to assess the potential causal pathway among the candidate metabolite, neurocognitive trait and corresponding psychiatric disorder.ResultsMR evidence indicated that genetically predicted acetylornithine was positively associated with g-Factor (0.035 standard deviation units increase in g-Factor per one standard deviation increase in acetylornithine level; 95% confidence interval, 0.021 to 0.049; P = 1.15 × 10−6). Genetically predicted butyrylcarnitine was negatively associated with g-Factor (0.028 standard deviation units decrease in g-Factor per one standard deviation increase in genetically proxied butyrylcarnitine; 95% confidence interval, −0.041 to −0.015; P = 1.31 × 10−5). There was no evidence of associations between genetically proxied g-Factor and metabolites. Furthermore, the mediation analysis via two-step MR revealed that the causal pathway from acetylornithine to bipolar disorder was partly mediated by g-Factor, with a mediated proportion of 37.1%. Besides, g-Factor mediated the causal pathway from butyrylcarnitine to schizophrenia, with a mediated proportion of 37.5%. Other neurocognitive traits from different sources provided consistent findings.ConclusionOur results provide genetic evidence that acetylornithine protects against bipolar disorder through neurocognitive abilities, while butyrylcarnitine has an adverse effect on schizophrenia through neurocognition. These findings may provide insight into interventions at the metabolic level for risk of neurocognitive and related disorders.