Performance of high-efficiency UV-C LEDs in water disinfection: Experimental, life cycle assessment, and economic analysis of different operational scenarios.

The widespread use of low or medium pressure mercury lamps in UV-C water disinfection should consider recent advances in UV-C LED lamps that offer a more sustainable approach and avoid its main drawbacks. The type of water and the mode of operation are critical when deciding on the treatment technology to be used. Therefore, this study investigates the potential application of UV-C LED disinfection technology in terms of kinetics, environmental assessment, and economic analysis for two scenarios: the continuous disinfection of a wastewater treatment plant (WWTP), and disinfection of harvested rainwater (RWH) in a residential household that operates intermittently. Experiments are conducted using both the new UV-C LED system and the conventional mercury lamp to disinfect real wastewater. Removal of total coliforms and Escherichia coli bacteria, with concentrations of approximately 105 and 104 CFU per 100 mL has been followed to assess the performance of both types of UV-C lamps. The experimental study provides kinetic parameters that have been further used in the environmental assessment conducted from a life cycle perspective. Additionally, considering the significant role of electricity consumption, a preliminary economic analysis has been conducted. The results indicate that first-order kinetic constants of pathogens removal with UV-C LEDs achieve 1.4 times higher values than Hg lamp. Regarding the environmental and economic assessment, for disinfection systems operating continuously, LEDs result in environmental impacts 5 times higher than Hg lamp in most categories, indicating that Hg lamps offer a viable option both from economic and environmental point of view. However, for installations with intermittent operation, LEDs emerge as the most competitive alternative, due to their ability to be turned on and off without affecting their lifespan. This study shows that UV-C LED lamps hold promise to replace conventional mercury lamps in a near future.

Analysis of data from the PALOMA-3 trial confirms the efficacy of palbociclib and offers alternatives for novel assessment of clinical trials.

PURPOSE: There remains a need for novel therapies for patients with metastatic breast cancer (MBC). We explore the use of a novel biomarker of survival that could potentially expedite the testing of novel therapies. METHODS: We applied a tumor regression-growth model to radiographic measurement data from 393 women with MBC enrolled in PALOMA-3 examining efficacy of palbociclib in disease that had progressed on previous endocrine therapy. 261 and 132 women were randomized to fulvestrant plus palbociclib or placebo, respectively. We estimated rates of regression (d) and growth (g) of the sensitive and resistant fractions of tumors, respectively. We compared the median g of both arms. We examined the relationship between g and progression-free and overall survival (OS). RESULTS: As in other tumors, g is a biomarker of OS. In PALOMA-3, we found significant differences in g among patients with tumors sensitive to endocrine therapy but not amongst resistant tumors, emulating clinical trial results. Subgroup analysis found favorable g values in visceral metastases treated with palbociclib. Palbociclib efficacy demonstrated by slower g values was evident early in the trial, twelve weeks after the first 28 patients had been enrolled. CONCLUSION: Values of g, estimated using data collected while a patient is enrolled in a clinical trial is an excellent biomarker of OS. Our results correlate with the survival outcomes of PALOMA-3 and argue strongly for using g as a clinical trial endpoint to help inform go/no-go decisions, improve trial efficiency, and deliver novel therapies to patients sooner.

A Qualitative Exploration of COVID-19 Vaccine Hesitancy Among Hispanic/Latine and African American and Black Middle-Aged and Older Adults in South Florida.

Racial and ethnic health disparities are more conspicuous in the United States since the start of the coronavirus disease 2019 (COVID-19) pandemic. While the urgency of these disparities was already alarming, the pandemic has exacerbated longstanding issues in health equity, disproportionate impacts, and social determinants of health. Vaccine hesitancy was a crucial factor during the U.S. COVID-19 vaccination campaign. We conducted a qualitative exploration of vaccine hesitancy through thematic analysis of four focus groups with Hispanic/Latine and African American/Black adults and senior citizens (N=23). The focus groups were conducted between February and April of 2021, in both English and Spanish. All participants (mean age=66.2, female 78.3%) were recruited by community-based organizations in the South Florida area. We explored six categories: (1) barriers to prevention and preventive behaviors, (2) barriers to vaccination against COVID-19, (3) facilitators of prevention and preventative behaviors, (4) facilitators of vaccination against COVID-19, (5) trusted sources of information, and (6) suggested macrolevel measures. These categories are discussed vis-à-vis COVID-19 disparities among racial and ethnic minorities. Implications for public health policy and future vaccination campaigns are outlined and discussed.

Techno-economic evaluation of UV light technologies in water remediation.

Disinfection commonly follows conventional treatments in wastewater treatment and remediation plants aiming at reducing the presence of pathogens. However, the presence of the so called "micropollutants" has emerged as a serious concern, therefore developing tertiary treatments that are not only able to remove pathogens but also to degrade micropollutants is worth investigating. Nowadays, UV-C photo-degradation processes are widely used for disinfection due to their simplicity and easy operation; additionally, they have shown potential for the removal of contaminants of emerging concern. Conventional mercury lamps are being replaced by light-emitting diodes (LEDs) that avoid the use of toxic mercury and can be switched on and off with no effect on the lamp lifetime. This work aims to comparatively evaluate the performance of several photo-degradation technologies for the removal of two targeted micropollutants, the pharmaceutical dexamethasone (DXMT) and the herbicide S-metolachlor (MTLC), using UV irradiation doses typical of disinfection processes. To this end, the technical performance of UV-A/UV-C photolysis, UV-A/UV-C photocatalysis, UV-C/H2O2 and UV-C/NaOCl has been compared. The influence of operating conditions such as the initial concentration of the pollutants (3 mg L-1 - 30 mg L-1, concentrations found in membrane or adsorption remediation steps), pH (3-10), and water matrix (WWTP secondary effluent, and ultrapure water) on the degradation efficiency has been studied. The economic evaluation in terms of electricity and chemicals consumption and the carbon footprint has been evaluated. UV-C photolysis and UV-C photocatalysis appear as the most suitable technologies for the degradation of DXMT and MTLC, respectively, in terms of kinetics (1.53·10-1 min-1 for DXMT and 1.96·10-2 min-1 for MTLC), economic evaluation (1 € m-3 for DXMT and 32 € m-3 for MTLC) and environmental indicators (0.5 g-CO2 for DXMT and 223.1 g-CO2 for MTLC).

Substantial reduction in child stunting is differentially associated to geographical and socioeconomic disparities in Misiones Province, Argentina.

OBJECTIVE: To estimate trends in the prevalence of child stunting in the population of children under 5 years of age covered by public health programmes, between 2009 and 2014 in Misiones, Argentina. METHODS: Using Bayesian model-based geostatistics, we evaluated 724 872 anthropometric measurements corresponding to 110 633 children. In order to identify disparities at local scale, we evaluated the hypotheses of a differential reduction of stunting according to the geographical location (at two-level spatial resolution) and to the socioeconomic level in a rural or urban environment. RESULTS: The prevalence of stunting had fallen significantly in the province overall. Sex and age defined gender disparities at individual level, and there were regional disparities with higher prevalence values in the north and northeast regions. In these areas, stunting decreased to a greater degree during the studied period, although the spatial pattern remained smoother. Stunting increased in peripheral urban and dispersed rural areas that are socioeconomically vulnerable. CONCLUSIONS: The spatial multi-level geostatistical estimates of child undernutrition provide a precision public health tool to target public policies to those populations with the greatest need, in order to reduce health disparities.

OBJECTIF: Estimer les tendances dans la prévalence du retard de croissance dans la population des enfants de moins de 5 ans couverts par les programmes de santé publique, entre 2009 et 2014 à Misiones, en Argentine. MÉTHODES: En utilisant la géostatistique basée sur un modèle bayésien, nous avons évalué 724.872 mesures anthropométriques correspondant à 110.633 enfants. Afin d'identifier les disparités à l'échelle locale, nous avons évalué les hypothèses d'une réduction différentielle du retard de croissance en fonction de la situation géographique (à une résolution spatiale à deux niveaux) et du niveau socioéconomique en milieu rural ou urbain. RÉSULTATS: La prévalence du retard de croissance avait considérablement diminué dans l'ensemble de la province. Le sexe et l'âge définissaient des disparités entre les sexes au niveau individuel, et il y avait des disparités régionales avec des valeurs de prévalence plus élevées dans les régions du nord et du nord-est. Dans ces régions, le retard de croissance a diminué plus fortement au cours de la période étudiée, bien que le modèle spatial soit resté plus lisse. Le retard de croissance a augmenté dans les zones urbaines périphériques et les zones rurales dispersées qui sont socioéconomiquement vulnérables. CONCLUSIONS: Les estimations géostatistiques spatiales à plusieurs niveaux de la sous-nutrition infantile fournissent un outil de santé publique de précision pour cibler les politiques publiques sur les populations qui en ont le plus besoin, afin de réduire les disparités en matière de santé.

The economic burden of metastatic breast cancer in Spain.

Objectives: The study aimed to estimate the burden of metastatic breast cancer (mBC) in Spain over 5 years. Methods: An incidence-based cost-of-illness model was developed in which a cohort of patients with mBC was followed from the diagnosis of metastatic disease over 5 years or death. Resource use data were collected through a physician survey conducted with 10 clinical experts in Spain. The model distinguished patients according to HER2 and hormonal receptor (HR) status, and followed the patient cohort in monthly cycles. Results: The incident cohort was estimated to be 2,923 patients with mBC, consisting of 1,575 HER2-/HR+, 520 HER2+/HR+, 324 HER2+/HR-, and 503 triple negative patients. The estimated mean survival over the 5-year time period was 2.51 years, on average, with longer survival of 3.36 years for HER2+/HR+, 2.41 years for HER2-/HR+, 2.82 years for HER2+/HR- and shortest mean survival of 1.74 years for triple negative patients. The total costs were €469,92,731 for the overall population, €190,079,787 for the HER2-/HR+, €151,045,260 for the HER2+/HR+, €80,827,171 for the HER2+/HR- and €47,540,512 for the triple negative subgroups over 5 years. Per patient total costs were €160,642 on average, €120,664 for HER2-/HR+, €290,346 for HER2+/HR+, €249,152 for HER2+/HR-and €94,572 for triple negative patients over 5 years. Conclusions: The economic burden of mBC in Spain is significant, but differs by HER2 and HR status. HER2-/HR +patients account for the highest burden due to the prevalence of this category, but HER2+/HR +patients have the highest per patient costs.

LCA of greywater management within a water circular economy restorative thinking framework.

Greywater reuse is an attractive option for the sustainable management of water under water scarcity circumstances, within a water circular economy restorative thinking framework. Its successful deployment relies on the availability of low cost and environmentally friendly technologies. The life cycle assessment (LCA) approach provides the appropriate methodological tool for the evaluation of alternative treatments based on environmental decision criteria and, therefore, it is highly useful during the process conceptual design. This methodology should be employed in the early design phase to select those technologies with lower environmental impact. This work reports the comparative LCA of three scenarios for greywater reuse: photocatalysis, photovoltaic solar-driven photocatalysis and membrane biological reactor, in order to help the selection of the most environmentally friendly technology. The study has been focused on the removal of the surfactant sodium dodecylbenzenesulfonate, which is used in the formulation of detergents and personal care products and, thus, widely present in greywater. LCA was applied using the Environmental Sustainability Assessment methodology to obtain two main environmental indicators in order to simplify the decision making process: natural resources and environmental burdens. Energy consumption is the main contributor to both indicators owing to the high energy consumption of the light source for the photocatalytic greywater treatment. In order to reduce its environmental burdens, the most desirable scenario would be the use of solar light for the photocatalytic transformation. However, while the technological challenge of direct use of solar light is approached, the environmental suitability of the photovoltaic solar energy driven photocatalysis technology to greywater reuse has been demonstrated, as it involves the smallest environmental impact among the three studied alternatives.

Environmental and socio-demographic individual, family and neighborhood factors associated with children intestinal parasitoses at Iguazú, in the subtropical northern border of Argentina.

BACKGROUND: Intestinal parasitoses are a major concern for public health, especially in children from middle and low-income populations of tropical and subtropical areas. We examined the presence and co-infection of parasites in humans as well as parasitic environmental contamination in Puerto Iguazú, Argentina. We explored the environmental and socio-demographic characteristics of the persistence of parasites in children and their environment. METHODOLOGY/PRINCIPAL FINDINGS: This cross-section survey was conducted among children population comprised into the area of the public health care centers of Iguazú during June 2013 to May 2016. Copro-parasitological status of 483 asymptomatic children was assessed. Simultaneously, a design-based sampling of 744 soil samples and 530 dog feces was used for characterize the environmental contamination. The 71.5% of these sites were contaminated. Sixteen genera were detected in the environment being hookworms (62.0%) the main pathogens group detected followed by Toxocara spp (16.3%), Trichuris spp (15.2%) and Giardia (6.5%). Total children prevalence raised 58.8%, detecting twelve genera of parasite with Giardia intestinalis as the most prevalent pathogen (29.0%) followed by Enterobius vermicularis (23.0%), Hymenolepis nana (12.4%) and hookworms (4.4%). Through questionnaires and census data, we characterized the socio-demographics conditions at an individual, family and neighborhood levels. A multi-level analysis including environmental contamination data showed that the ´presence of parasites´ was mostly determined by individual (e.g. age, playing habits, previous treatment) and household level (e.g. UBN, WASH, mother's literacy) determinants. Remarkably, to define the level of 'parasite co-infection', besides individual and household characteristics, environmental factors at a neighborhood level were important. CONCLUSION/SIGNIFICANCE: Our work represents the major survey of intestinal parasites in human and environmental samples developed in the region. High prevalence was detected in the children population as well as in their environment. This work shows the importance of considering and promoting multi-level actions over the identified determinants to face this public health problem from integrative approaches.