Physical pain among urban Native American emerging adults: Socio-cultural risk and protective factors.

OBJECTIVE: American Indian/Alaska Native (AI/AN) people have high rates of physical pain. Pain is understudied in urban-dwelling, AI/AN emerging adults, a group with unique socio-cultural risk and protective factors. We explore associations between socioeconomic disadvantage, additional socio-cultural factors, and pain among urban AI/AN emerging adults. METHODS: AI/AN participants aged 18-25 (N = 417) were recruited via social media. Regression models tested associations between socioeconomic disadvantage (income and ability to afford healthcare) and pain as well as additional socio-cultural factors (discrimination, historical loss, cultural pride and belonging, visiting tribal lands) and pain. Multi-group regression models tested whether associations between socio-cultural factors and pain differed between participants who were socioeconomically disadvantaged and those who were less disadvantaged. RESULTS: In the full sample, lower income (b = 1.00 - 1.48, p < .05), inability to afford healthcare (b = 1.00, p = .011), discrimination (b = 0.12, p = .001), and historical loss (b = 0.24, p = .006) were positively associated with pain, whereas visiting tribal lands was negatively associated with pain (b = -0.86 - -0.42, p < .05). In the multi-group model, visiting tribal lands 31+ days was negatively associated with pain only among the less socioeconomically disadvantaged group (b = -1.48, p < .001). CONCLUSIONS: Socioeconomic disadvantage may, in part, drive pain disparities among AI/AN emerging adults and act as a barrier to benefitting from visiting tribal lands. Results support a biopsychosocial approach to targeting pain in this population, including addressing socioeconomic challenges and developing culturally informed, strengths-based interventions.

The Impact of Social and Material Resources on Resilience Communication at the Intersection of Race and Gender.

In the communicative theory of resilience (CTR), communication constructs resilience processes that can promote change or continuity during hardship. The enactment of resilience is theorized to depend on available resources. The current study tests this theoretical link in the context of the COVID-19 pandemic, examining differences at the intersection of race and gender (N = 588). Job security, education quality, and friend support positively predicted continuity and change resilience. Four differences based on race/gender emerged: necessities negatively predicted continuity resilience for Black men and White women, healthcare and government representation positively predicted continuity resilience for Black women only, and family support positively predicted change resilience for Black women and White men. Findings support CTR's claim that resource access influences resilience enactment and indicate that theoretical associations differ based on race/gender. The current research emphasizes the importance of considering intersectionality in relation to CTR processes and structural barriers to enacting resilience.

Sustainability reports as a tool for measuring and monitoring the transition towards the circular economy of organisations: Proposal of indicators and metrics.

Sustainability reports may play an important role as a supporting tool in the transition of organisations towards more circular economy models, since their content can help to measure, monitor and communicate the organisations' transition and to establish goals in the short/medium term. The aim of this study is to determine whether it is possible to calculate indicators capable of measuring the transition of organisations towards circularity from the information that they are currently communicating in their Corporate Sustainability Reports (CSRs), and what information would need to be incorporated in these reports to successfully carry out this procedure. To this end, by applying a three-step methodology, 34 indicators grouped into 10 categories were proposed to measure the level of circularity of organisations. This was completed with a detailed proposal of units/metrics to measure the indicators, based on those that organisations commonly use in their CSRs. For this purpose, information from 8 international programmes/frameworks that measure circularity at the territorial level was combined with circularity information that organisations are currently communicating in their CSRs. Finally, the proposed set of indicators and metrics were applied to a Spanish organisation dedicated to the forestry and paper sector with a CSR based on GRI-Standards. The results demonstrated that 25 of the 34 proposed indicators (74%) can be measured directly using the information included in the CSRs.

Food Additives as Inhibitors of Intestinal Drug Transporter OATP2B1.

Food additives are compounds that are added to food and beverage to improve the taste, color, preservation, or composition. Generally, food additives are considered safe for human use due to safety evaluations conducted by food safety authorities and high safety margins applied to permitted usage levels. However, the interaction potential of food additives with simultaneously administered medication has not received much attention. Even though many food additives are poorly absorbed into systemic circulation, high concentrations could exist in the intestinal lumen, making intestinal drug transporters, such as the uptake transporter organic anion transporting polypeptide 2B1 (OATP2B1), a possible site of food additive-drug interactions. In the present work, we aimed to characterize the interaction of a selection of 25 food additives including colorants, preservatives, and sweeteners with OATP2B1 in vitro. In human embryonic kidney 293 (HEK293) cells transiently overexpressing OATP2B1 or control, uptake of dibromofluorescein was studied with and without 50 µM food additive at pH 7.4. As OATP2B1 displays substrate- and pH-dependent transport functions and the intraluminal pH varies along the gastrointestinal tract, we performed the studies also at pH 5.5 using estrone sulfate as an OATP2B1 substrate. Food additives that inhibited OATP2B1-mediated substrate transport by ≥50% were subjected to dose-response studies. Six colorants were identified and validated as OATP2B1 inhibitors at pH 5.5, but only three of these were categorized as inhibitors at pH 7.4. One sweetener was validated as an inhibitor under both assay conditions, whereas none of the preservatives exhibited ≥50% inhibition of OATP2B1-mediated transport. Extrapolation of computed inhibitory constants (Ki values) to estimations of intestinal food additive concentrations implies that selected colorants could inhibit intestinal OATP2B1 also in vivo. These results suggest that food additives, especially colorants, could alter the pharmacokinetics of orally administered OATP2B1 substrate drugs, although further in vivo studies are warranted to understand the overall clinical consequences of the findings.

Management of obstructive sleep apnoea in a primary care vs sleep unit setting: a randomised controlled trial.

OBJECTIVE: To assess the effectiveness and cost-effectiveness of primary care (PC) and sleep unit (SU) models for the management of subjects with suspected obstructive sleep apnoea (OSA). METHODS: Multicentre, open-label, two-arm, parallel-group, non-inferiority randomised controlled trial. A total of 302 subjects with suspected OSA and/or resistant hypertension were consecutively enrolled, 149 were treated at 11 PC units and 153 patients at a SU. The primary outcomes were a 6-month change in the Epworth Sleepiness Scale (ESS) score and Health Utilities Index (HUI). The non-inferiority margin for the ESS score was -2.0. RESULTS: A total of 80.2% and 70.6% of the PC and SU patients were diagnosed with OSA, respectively, and 59.3% and 60.4% of those were treated with CPAP in PC and SU units, respectively. The Apnoea-Hypopnoea Index was similar between the groups (PC vs SU (median (IQR); 23.1 (26.8) events/h vs 21.8 (35.2) events/h), and the baseline ESS score was higher in the PC than in the SU group (10.3 (6.6) vs 9 (7.2)). After 6 months, the ESS score of the PC group decreased from a mean of 10.1 to 7.6 (-2.49; 95% CI -3.3 to -1.69), and that of the SU group decreased from 8.85 to 5.73 (-3.11; 95% CI -3.94 to 2.28). The adjusted difference between groups for the mean change in the ESS score was -1.25 (one-sided 95% CI -1.88; p=0.025), supporting the non-inferiority of PC management. We did not observe differences in the HUI between groups. The cost analysis showed a median savings of €558.14/patient for the PC setting compared with the SU setting. CONCLUSIONS: Among patients with suspected OSA, the PC model did not result in a worse ESS score or HUI than the specialist model and generated savings in terms of management cost. Therefore, the PC model was more cost-efficient than the SU model. TRIAL REGISTRATION: Results; >>NCT02234765, Clinical Trials.gov.

Breast Cancer Tissue Marked Selectively by Magnetic Nanoparticles in an Experimental Animal Model.

The use of magnetic nanoparticles have been proposed as alternative techniques to assist breast cancer diagnosis and treatment. Peritumoral and intratumoral biodistribution of magnetic nanoparticles have been the main practical approaches, and the evaluation of breast tumor tissue marked selectively by magnetic nanoparticles has been not widely studied so far. The aim of this study was to evaluate the c-erbB-2 antigen in tissue of a breast cancer animal model as specific target for the use of magnetic nanoparticles coupled to specific Monoclonal Antibody (Mab). A breast cancer animal model was adapted and standardized in female rats. Tumor tissue was characterized histopathological and inmunohistochemical for cancer type and c-erbB-2 expression respectively. A bioconjugate was developed by the covalent union of fluorescent magnetic nanoparticles and anti c-erbB-2 Mab, and was used for incubation in two consecutive slides of breast cancer tissue acoordingly following conditions: (a) the c-erbB-2 receptor previously blocked by a primary antibody, and (b) the c-erbB-2 receptor non-blocked. Microscopy fluorescence was used to determine the selective marked of tumor tissue by the bioconjugate. Healthy breast tissue was used as negative control of selective labeling of the bioconjugate. The results show a well-differentiated fluorescent mark by magnetic nanoparticles in the non-blocked c-erbB-2 receptor breast cancer tissue condition, the observation suggests the use of the c-erbB-2 antigen as specific target to mark selectively breast tumor tissue by magnetic nanoparticles.

Organ and tissue-dependent effect of resveratrol and exercise on antioxidant defenses of old mice.

BACKGROUND: Oxidative stress has been considered one of the causes of aging. For this reason, treatments based on antioxidants or those capable of increasing endogenous antioxidant activity have been taken into consideration to delay aging or age-related disease progression. AIM: In this paper, we determine if resveratrol and exercise have similar effect on the antioxidant capacity of different organs in old mice. METHODS: Resveratrol (6 months) and/or exercise (1.5 months) was administered to old mice. Markers of oxidative stress (lipid peroxidation and glutathione) and activities and levels of antioxidant enzymes (SOD, catalase, glutathione peroxidase, glutathione reductase and transferase and thioredoxin reductases, NADH cytochrome B5-reductase and NAD(P)H-quinone acceptor oxidoreductase) were determined by spectrophotometry and Western blotting in different organs: liver, kidney, skeletal muscle, heart and brain. RESULTS: Both interventions improved antioxidant activity in the major organs of the mice. This induction was accompanied by a decrease in the level of lipid peroxidation in the liver, heart and muscle of mice. Both resveratrol and exercise modulated several antioxidant activities and protein levels. However, the effect of resveratrol, exercise or their combination was organ dependent, indicating that different organs respond in different ways to the same stimulus. CONCLUSIONS: Our data suggest that physical activity and resveratrol may be of great importance for the prevention of age-related diseases, but that their organ-dependent effect must be taken into consideration to design a better intervention.

Effects of digital transformation on firm performance: The role of IT capabilities and digital orientation.

Organisations undertake profound changes to fit in a rapidly evolving digital setting. However, although the IT capabilities of the organisational members play a critical role in this, the mechanism driving IT capabilities towards enhanced firm performance is not fully understood. A theoretical model to analyse the role of digital orientation and digital transformation in this relationship is introduced and tested on a set of 246 firms through the Partial Least Squares-Structural Equation Modeling method (PLS-SEM). This research contributes to the literature by introducing the social aspect to the study of technology management, delving also into the antecedents of digital transformation. Results confirm a positive effect of IT capabilities on firm performance through the development of a digital orientation and the digital transformation of the organisation.

Voices of Identity: Exploring Identity Development and Transformation among Urban American Indian/Alaska Native Emerging Adults.

Emerging adulthood shapes personal, professional, and overall well-being through identity exploration. This study addresses a gap in the minority identity literature by investigating how urban AI/AN emerging adults think about their identity and discussing challenges and protective factors associated with exploring their identity holistically. This mixed-methods study created a sampling framework based on discrimination experiences, cultural identity, social network support, mental health, and problematic substance use. We recruited 20 urban AI/AN emerging adults for interviews. We sought to gain deeper insights into their experiences and discussions surrounding identity formation and exploration. We provide descriptives for demographic characteristics and conducted a thematic analysis of the qualitative data from the interviews. Four themes emerged: a) being an urban AI/AN emerging adult means recognizing that one's identity is multifaceted; b) a multifaceted identity comes with tension of living in multiple worlds; c) the trajectory of one's identity grows over time to a deeper desire to connect with Native American culture; and d) understanding one's Native American background affects one's professional trajectory. Findings underscore the importance of developing programs to support well-being and identity development through cultural connection for urban AI/AN emerging adults.

The Role of Social Networks on Depression and Anxiety Among a Sample of Urban American Indian/Alaska Native Emerging Adults.

PURPOSE: Mental health inequalities continue to persist among American Indian/Alaska Native (AI/AN) people. However, few studies have examined the association of social networks and depression and anxiety among urban emerging AI/AN adults. METHODS: This study analyzes the association of social network characteristics with depression and anxiety among a sample of urban AI/AN emerging adults. A second set of regression models tested the same associations but controlling for respondent sexual and gender minority (SGM) status. Data were from a sample of 150 AI/AN emerging adults residing in urban areas from 20 different states (86% female; mean age 21.8; 48.0% SGM) who participated in a randomized controlled trial analyzing the effects of culturally grounded interventions on alcohol and other drug use and cultural connectedness. RESULTS: Participants with a higher proportion of network members who were around the same age reported significantly less anxiety. Those who had a higher proportion of network members who they sometimes/often argue/fight with were more likely to report greater depression and anxiety. Participants with higher proportions of social network members who have ever lived on a reservation/Rancheria/tribal land/tribal village reported significantly less depression. However, participants with higher proportions of social network members who lived 50 miles away or more reported significantly more depression. Controlling for SGM status, results were largely similar. DISCUSSION: Results highlight the role of social connections on the mental well-being of urban AI/AN emerging adults.

[Evaluation of the efficacy and safety of tigecycline for treatment of respiratory tract infections: systematic review of literature]. / Evaluación de la eficacia y seguridad de tigeciclina en el tratamiento de infecciones del tracto respiratorio: Revisión sistemática de la literatura científica.

BACKGROUND: Tigecycline is indicated for the treatment of complicated skin infections, soft tissue and intraabdominal infections. Its use could be extended to community-acquired pneumonia (CAP) and hospital pneumonia (HN). The objective was to evaluate the efficacy and safety of tigecycline in the treatment of respiratory infections. METHODS: systematic review (2012). Databases used were MEDLINE, EMBASE, Cochrane Library, CRD and WOK. We identified clinical trials of adults with respiratory infection, treated with tigecycline. The quality of the studies was assessed using CASPe checklist. RESULTS: We selected four clinical trials of high-moderate quality. Three studies with patients with CAP and a trial with HN patients. In patients with CAP, efficacy of tigecycline (88.6 to 90.6%) was higher than levofloxacin (85.3 to 87.2%). The non inferiority testing was statistically significant (p < 0.001). In the study of patients with HN tigecycline showed an efficiency of 67.9% versus 78.2% for imipenem/cilastatin. Main adverse effects were gastrointestinal. CONCLUSIONS: The efficacy of tigecycline is non inferior than levofloxacin in patients with CAP, but less than imipenem in patients with HN. Tigecycline demonstrates noninferiority versus others tested antibiotics, and it shows a good safety profile.

The Objective Structured Clinical Examination (OSCE) in Periodontology with Simulated Patient: The Most Realistic Approach to Clinical Practice in Dentistry.

The objective structured clinical examination (OSCE) is becoming an increasingly established assessment test in dental schools. The use of simulated patients in the OSCE makes the stations more similar to clinical practice. Therefore, the student can show their technical and clinical knowledge, and certainly, their ability to manage the patient. These sorts of tests, in which simulated patients can be included, would be used before the student started clinical practice with patients and/or at the end of the degree. The objective of this work was to describe how the periodontology station was developed using a simulated patient for students of a fifth year dentistry degree taking an OSCE test. Furthermore, a questionnaire was created to learn the perception of the students about this station and its characteristics. The fifth year students at the European University of Madrid positively evaluated this station in their examination. In addition, it was recorded that they preferred a simulated patient in their tests, rather than stations with clinical cases, images, X-rays, and presentations. It is essential that once the OSCE has been completed, the student receives a feedback to learn where they have failed and, therefore, be able to improve any of the aspects evaluated in the station.

Risk and Resilience Among Families in Urban AI/AN Communities: the Role of Young Adults.

Urban American Indian/Alaska Native (AI/AN) young adults and their families are often geographically or socially distant from tribal networks and traditional social support. Young adults can be especially vulnerable to cultural and social disconnection, so understanding how AI/AN family functioning can augment resilience and protect against risk is important. This research precedes a preventive substance use intervention study and explores urban Native family functioning, emphasizing the role of young adults by analyzing data from 13 focus groups with urban AI/AN young adults (n = 32), parents (n = 25), and health providers (n = 33). We found that young adults can and want to become agents of family resilience, playing active roles in minimizing risks and strengthening family functioning in both practical and traditional ways. Also, extended family and community networks played a vital role in shaping family dynamics to support resilience. These resilience pathways suggest potential targets for intervention.

Social Networks, Cultural Pride, and Historical Loss Among Non-Reservation American Indian / Alaska Native Emerging Adults.

Health disparities among American Indian/Alaska Native (AI/AN) populations in the United States are the result of historical traumas, such as colonization, forced relocation, and federal policies focused on cultural assimilation. Culturally-tailored health interventions aim to address intergenerational trauma by emphasizing cultural strengths and building positive social connections. In this article, we explore the social network characteristics of participants of the first culturally-tailored health intervention for AI/AN emerging adults (18-25) living outside of tribal lands. Participants (N = 150; 86% female) were recruited across the United States via social media and completed online egocentric network interviews prior to the start of intervention workshops. Participants' networks were diverse in composition and structure. They were primarily composed of family and friends, were people they had regular contact with, were similar age, and provided participants with support. We tested for significant associations between network characteristics, individual characteristics (age, gender, travel to reservations, speaking tribal languages, etc.) and two dependent measures: 1) cultural pride and belongingness and 2) thoughts of historical loss. Multiple regression results show that higher proportions of network members who discussed AI/AN identity with participants and having more network members who engage in traditional practices was associated with stronger cultural pride and belongingness. Higher proportions of network members having discussion of AI/AN identity with participants was also associated with more frequent thoughts of historical loss. Controlling for network factors, no individual characteristics were associated with either dependent variable. We discuss implications for the development of culturally-tailored health interventions.

Risk and protective factors of social networks on alcohol, cannabis, and opioid use among urban American Indian/Alaska Native emerging adults.

OBJECTIVES: Assess associations between social networks and urban American Indian/Alaska Native emerging adults' alcohol, cannabis, and opioid use and intentions. METHOD: American Indian/Alaska Native participants ages 18-25 (N = 150; 86% female) were recruited across the United States from 12/20 to 10/21 via social media. Participants named up to 15 people whom they talked with most over the past 3 months and reported who (a) used alcohol and cannabis heavily or used other drugs (e.g., opioid use), (b) engaged in traditional practices, and (c) provided support. They also reported past 3-month alcohol, cannabis, and opioid use and intentions to use. RESULTS: Having a higher proportion of network members engaging in regular cannabis and heavy alcohol use (but not other drugs) was associated with more frequent cannabis use and stronger cannabis use intentions. Participants with higher proportions of members engaging in heavy alcohol use, regular cannabis use, or other drug use and who did not engage in traditional practices were more likely to report cannabis use and greater intentions to use cannabis and drink alcohol. In contrast, participants with higher proportions of network members engaging in traditional practices and who did not report heavy alcohol use, regular cannabis use, or other drug use were less likely to report intentions to use cannabis or drink alcohol. CONCLUSIONS: Findings emphasize what many studies have shown among various racial/ethnic groups-having network members who use substances increases the chance of use. Findings also highlight that traditional practices may be an important part of the prevention approach for this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Colonic Microbiota Profile Characterization of the Responsiveness to Dietary Fibre Treatment in Hypercholesterolemia.

This study aimed to determine how the microbiota profile might be predisposed to a better response in blood lipid profiles due to dietary fibre supplementation. A three-arm intervention study that included three different fibre types (mainly insoluble, soluble, and antioxidant fibre) supplemented (19.2 g/day) during 2 months in individuals with hypercholesterolemia was developed. Changes in faecal microbiota and blood lipid profile after fibre supplementation were determined. In all volunteers, regardless of fibre type, an increase in the abundance of Bifidobacterium was observed, and similarly, an inverse relationship between faecal propionic acid and blood LDL-cholesterol, LDL particle size, and LDL/HDL particle ratio (p-values 0.0067, 0.0002, and 0.0067, respectively) was observed. However, not all volunteers presented an improvement in lipid profile. The non-responders to fibre treatment showed a decrease in microbiota diversity (Shannon and Simpson diversity index p-values of 0.0110 and 0.0255, respectively) after the intervention; where the reduction in short-chain fatty acids (SCFAs) producing bacterial genera such as Clostridium XIVa and Ruminococcus after dietary fibre treatment was the main difference. It was concluded that the non-responsiveness to dietary fibre treatment might be mediated by the lack of ability to maintain a stable SCFA producing bacteria diversity and composition after extra fibre intake.

Storage stability of anthocyanins in freeze-dried elderberry pulp using low proportions of encapsulating agents.

Berry fruits are well recognized for health-promoting constituents due to their properties of free radical scavengers which confer antioxidant activity against cellular oxidation reactions. Elderberry fruit contains one of the highest levels of anthocyanins. The objective of this work was to evaluate the storage stability of total monomeric anthocyanins, cyanidin-3-glucoside (one of two major anthocyanins in elderberry), and color parameters in freeze-dried elderberry encapsulated with a low proportion of different carriers (Maltodextrin, Capsul™, Promitor ™, and κ-carrageenan). Encapsulated samples were stored at two different water activities (aw) 0.10-0.20 and 0.43 at 38 ℃ for 90 days and evaluated for the content of monomeric anthocyanins, cyanidin-3-glucoside, color parameters, and physical characteristics. Freeze-dried powders remained free-flowing during storage at 38 ℃ with aw 0.12-0.20, but agglomeration occurred at aw = 0.43. Total anthocyanins and color parameter a* (redness) remained unchanged during storage at the lower aw. Glass transition temperatures (Tg) were determined and mostly correlated with observed physical phenomena. The powders had a very high total monomeric anthocyanin contents as high as 13 mg/g (cyanidin-3-glucoside). The addition of encapsulants in low proportions allowed the researchers to obtain elderberry powders with a very high concentration of total monomeric anthocyanins. aw plays a key role in all stability parameters studied.

Contribution of Entrepreneurship to the Social Integration of People Intellectual Disabilities: A Case Study Based on the Analysis of Social Networks.

In an environment characterized by high unemployment rates among people with disabilities, the objective of the present work is to analyze entrepreneurship as a labor option which fully inserts people with intellectual disabilities (PwID) into their societies. In order to carry out this research, a case study methodology based on social network analysis has been adopted, given the nature of the variables analyzed. The results indicate that the fact of having managed to start up the company has been an important source of self-confidence and inspiration, as well as increasing and intensifying the social networks of PwID involved in the entrepreneurial project.

On the Impact of Information Technologies Secondary-School Capacity in Business Development: Evidence From Smart Cities Around the World.

Smart City initiatives across the globe have spurred increasing demand for high-skilled workers. The digital transformation, one of the main building blocks of the Smart City movement, is calling for a workforce prepared to develop novel business processes. Problem-solving, critical and analytical thinking are now the essential skills being looked at by employees. The development of the so-called STEM curriculum, Science, Technology, Engineering, and Mathematics is being given a lot of attention by educational boards in response to preparing young generations for the Smart City work market. Based on the IMD Smart City Index, PISA, and World Bank reports, we develop a model for assessing the impact of the IT secondary school capacities on Smart-City business developments. The model reveals the relationship between the technological capacity of the secondary-school, and the business activity of a Smart City. Moreover, the study shows the existence of a positive relationship between the IT capacity of secondary schools and the resulting entrepreneurial activity of the city. Our results are of interest to decision-makers and stakeholders responsible for designing educational policies and agents involved in the digital transformation and development of Smart Cities initiatives.

Geolocation of premises subject to radon risk: Methodological proposal and case study in Madrid.

Useful information on the potential radon risk in existing buildings can be obtained by combining data from sources such as potential risk maps, the 'Sistema de Información sobre Ocupación del Suelo de España' (SIOSE) [information system on land occupancy in Spain], cadastral data on built property and population surveys. The present study proposes a method for identifying urban land, premises and individuals potentially subject to radon risk. The procedure draws from geographic information systems (GIS) pooled at the municipal scale and data on buildings possibly affected. The method quantifies the magnitude of the problem in the form of indicators on the buildings, number of premises and gross floor area that may be affected in each risk category. The findings are classified by type of use: residential, educational or office. That information may guide health/prevention policies by targeting areas to be measured based on risk category, or protection policies geared to the construction industry by estimating the number of buildings in need of treatment or remediation. Application of the methodology to Greater Madrid showed that 47% of the municipalities have houses located in high radon risk areas. Using cadastral data to zoom in on those at highest risk yielded information on the floor area of the vulnerable (basement, ground and first storey) premises, which could then be compared to the total. In small towns, the area affected differed only scantly from the total, given the substantial proportion of low-rise buildings in such municipalities.