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INTRODUCTION: Severe obesity presents significant challenges in imaging and delivery of therapy, including pacemaker implant. METHODS AND RESULT: We present our experience implanting a leadless pacemaker (LP) in a severely obese man presenting with heart block. We describe our multidisciplinary approach using right internal jugular venous access and transesophageal imaging in lieu of fluoroscopy which failed to provide workable images in this instance. CONCLUSION: Ultrasound guided LP placement may have wider application in the midst of an ongoing obesity epidemic where fluoroscopy imaging is both limited and unsafe.
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Vitamin deficiencies, especially after Bariatric surgery, are common and, when not properly addressed, can lead to debilitating complications. Bariatric procedures, to variable degrees, alter the anatomy and physiology of the gastrointestinal; this alteration makes these patients more susceptible to developing nutritional deficiencies. Peripheral neuropathy is one of the complications that can arise from nutritional deficiencies, and it can cause severe functional impairment. Vision loss is a relatively uncommon complication after weight loss procedure. Changes in the retinal nerve fiber layer, choroidal thickness, and visual fields due to hypovitaminosis result in nutritional optic neuropathy and retinopathy. The main retinal complication is nyctalopia (night blindness), which is caused by vitamin A deficiency. We present a case of concomitant peripheral neuropathy and vision loss secondary to reduced levels of multiple vitamins following gastric bypass surgery. This case highlights the need for regular vitamin level monitoring and appropriate replenishment in patients after bariatric surgery to prevent significant morbidities.
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PURPOSE OF REVIEW: The present investigation evaluates clinical uses and roles of platelet rich plasma in the management of vetrebrogenic and discogenic mediated pain states. RECENT FINDINGS: Back pain is a common and significant condition that affects millions of people around the world. The cause of back pain is often complex and multifactorial, with discogenic and vertebrogenic pain being two subtypes of back pain. Currently, there are numerous methods and modalities in which back pain is managed and treated such as physical therapy, electrical nerve stimulation, pharmacotherapies, and platelet-rich plasma. To conduct this systematic review, the authors used the keywords "platelet-rich plasma", "vertebrogenic pain", and "discogenic pain", on PubMed, EuroPMC, Who ICTRP, and clinicaltrials.gov to better elucidate the role of this treatment method for combating vertebrogenic and discogenic back pain. In recent decades, there has been a rise in popularity of the use of platelet-rich plasma for the treatment of numerous musculoskeletal conditions. Related to high concentration of platelets, growth factors, cytokines, and chemokines, platelet-rich plasma is effective in reducing pain related symptoms and in the treatment of back pain. Platelet-rich plasma use has evolved and gained popularity for pain related conditions, including vertebrogenic and discogenic back pain. Additional well-designed studies are warranted in the future to better determine best practice strategies to provide future clinicians with a solid foundation of evidence to make advancements with regenerative medical therapies such as platelet-rich plasma.
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Plasma Rico en Plaquetas , Humanos , Dolor de Espalda/terapia , Dolor de Espalda/sangreRESUMEN
Introduction: Uterine fibroids are the commonest benign tumors of the reproductive tract in women of childbearing age. They are usually asymptomatic but can cause menorrhagia. Treatments include myomectomy and uterine artery embolization (UAE). The latter is a relatively new procedure, therefore of special interest. Objectives: We conducted a systematic review and meta-analysis of all published studies to provide a comprehensive outlook on the effectiveness of UAE by comparing its outcomes to those of myomectomy. Electronic databases (PubMed and Cochrane Central) were systematically searched from January 2000 to March 2022 for published randomized control trials, observational studies, and meta-analyses that compared UAE to myomectomy for at least one of the pre-specified outcomes, namely re-intervention rates, length of hospital stay, and complications. Methods: We shortlisted nine studies for the final analysis. For continuous outcomes, results from random-effects meta-analysis were presented as mean differences (MDs) and corresponding 95% confidence intervals (CIs). Risk ratios (RRs) for dichotomous outcomes were pooled using a random-effects model. Results: The final analysis consisted of nine studies. Factors like re-intervention, hospitalization, and complications, each with its unique follow-up duration were assessed. Pooled analysis demonstrated significant results for greater re-intervention rates with UAE as compared to myomectomy (RR: 2.16, 95% CI: (1.27-3.66), p-value 0.004, heterogeneity I2 = 85%). UAE holds a greater but statistically insignificant risk for major complications (RR: 0.62, 95% CI: (0.29-1.33), p-value 0.22, heterogeneity I2 = 0%) and myomectomy shows a statistically insignificant greater risk for minor complications (RR: 1.72, 95% CI: (0.92-3.22), p-value 0.09, heterogeneity I2 = 0%). UAE had a shorter but statistically insignificant duration of hospital stay (MD: -1.12, 95% CI: (-2.50 to 0.27), p-value 0.11, heterogeneity I2 = 96%) (p-value for subgroup differences = 0.005). Conclusion: Our meta-analysis of approximately 196,595 patients demonstrates that myomectomy results in a significant reduction in re-intervention rate compared to UAE.
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BACKGROUND: Immune checkpoint inhibitors (ICIs) have uncommon associations with cardiotoxicity, yet these cardiotoxic effects are associated with high mortality. An accurate assessment of risk for cardiotoxicity is essential for clinical decision-making, but data from randomized controlled trials often differ from real-world observational studies. METHODS AND RESULTS: A systematic search of PubMed, Embase, Cochrane Library, and Scopus was performed, including phase II and III randomized controlled trials (RCTs) and observational studies (OSs) reporting myocarditis or pericardial disease, myocardial infarction, or stroke with an immunotherapy. Odds ratios (ORs) were used to pool results between ICIs and other cancer therapy in RCTs and OSs. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. In total, 54 RCTs (N=38 264) and 24 OSs (N=12 561 455) were included. In RCTs, ICI use resulted in higher risk of myocarditis (OR, 3.55 [95% CI, 2.10-5.98]), pericardial disease (OR, 2.73 [95% CI, 1.57-4.77]), and myocardial infarction (OR, 1.83 [95% CI, 1.03-3.25]), compared with non-ICI (placebo or chemotherapy). In OSs, ICI use was not associated with myocarditis, pericardial disease, or myocardial infarction compared with controls; however, combination ICIs demonstrated higher risk of myocarditis compared with single ICI use (OR, 3.07 [95% CI, 1.28-7.39]). Stroke risk was not increased with use of ICIs in RCTs. CONCLUSIONS: We demonstrated increased risk of ICI myocarditis, pericardial disease, and myocardial infarction in RCTs but not OSs. Results of this study suggest there are differences between ICI cardiotoxicity risk, possibly suggesting differences in diagnoses and management, in clinical trials versus the OSs.
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Cardiotoxicidad , Inhibidores de Puntos de Control Inmunológico , Neoplasias , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Inhibidores de Puntos de Control Inmunológico/efectos adversos , Neoplasias/tratamiento farmacológico , Medición de Riesgo/métodos , Factores de RiesgoRESUMEN
With its high rate of consanguineous marriages and diverse ethnic population, little is currently understood about the genetic architecture of autism spectrum disorder (ASD) in Pakistan. Pakistan has a highly ethnically diverse population, yet with a high proportion of endogamous marriages, and is therefore anticipated to be enriched for biallelic disease-relate variants. Here, we attempt to determine the underlying genetic abnormalities causing ASD in thirty-six small simplex or multiplex families from Pakistan. Microarray genotyping followed by homozygosity mapping, copy number variation analysis, and whole exome sequencing were used to identify candidate. Given the high levels of consanguineous marriages among these families, autosomal recessively inherited variants were prioritized, however de novo/dominant and X-linked variants were also identified. The selected variants were validated using Sanger sequencing. Here we report the identification of sixteen rare or novel coding variants in fifteen genes (ARAP1, CDKL5, CSMD2, EFCAB12, EIF3H, GML, NEDD4, PDZD4, POLR3G, SLC35A2, TMEM214, TMEM232, TRANK1, TTC19, and ZNF292) in affected members in eight of the families, including ten homozygous variants in four families (nine missense, one loss of function). Three heterozygous de novo mutations were also identified (in ARAP1, CSMD2, and NEDD4), and variants in known X-linked neurodevelopmental disorder genes CDKL5 and SLC35A2. The current study offers information on the genetic variability associated with ASD in Pakistan, and demonstrates a marked enrichment for biallelic variants over that reported in outbreeding populations. This information will be useful for improving approaches for studying ASD in populations where endogamy is commonly practiced.
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Trastorno del Espectro Autista , Secuenciación del Exoma , Linaje , Humanos , Trastorno del Espectro Autista/genética , Pakistán , Masculino , Femenino , Variaciones en el Número de Copia de ADN/genética , Predisposición Genética a la Enfermedad , Niño , Alelos , Consanguinidad , Preescolar , Mutación , HomocigotoRESUMEN
The cerebellum, through its connectivity with the cerebral cortex, plays an integral role in regulating cognitive and affective processes, and its dysregulation can result in neurodevelopmental disorder (NDD)-related behavioural deficits. Identifying cerebellar-cerebral functional connectivity (FC) profiles in children with NDDs can provide insight into common connectivity profiles and their correlation to NDD-related behaviours. 479 participants from the Province of Ontario Neurodevelopmental Disorders (POND) network (typically developing = 93, Autism Spectrum Disorder = 172, Attention Deficit/Hyperactivity Disorder = 161, Obsessive-Compulsive Disorder = 53, mean age = 12.2) underwent resting-state functional magnetic resonance imaging and behaviour testing (Social Communication Questionnaire, Toronto Obsessive-Compulsive Scale, and Child Behaviour Checklist - Attentional Problems Subscale). FC components maximally correlated to behaviour were identified using canonical correlation analysis. Results were then validated by repeating the investigation in 556 participants from an independent NDD cohort provided from a separate consortium (Healthy Brain Network (HBN)). Replication of canonical components was quantified by correlating the feature vectors between the two cohorts. The two cerebellar-cerebral FC components that replicated to the greatest extent were correlated to, respectively, obsessive-compulsive behaviour (behaviour feature vectors, rPOND-HBN = -0.97; FC feature vectors, rPOND-HBN = -0.68) and social communication deficit contrasted against attention deficit behaviour (behaviour feature vectors, rPOND-HBN = -0.99; FC feature vectors, rPOND-HBN = -0.78). The statistically stable (|z| > 1.96) features of the FC feature vectors, measured via bootstrap re-sampling, predominantly comprised of correlations between cerebellar attentional and control network regions and cerebral attentional, default mode, and control network regions. In both cohorts, spectral clustering on FC loading values resulted in subject clusters mixed across diagnostic categories, but no cluster was significantly enriched for any given diagnosis as measured via chi-squared test (p > 0.05). Overall, two behaviour-correlated components of cerebellar-cerebral functional connectivity were observed in two independent cohorts. This suggests the existence of generalizable cerebellar network differences that span across NDD diagnostic boundaries.
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Trastorno del Espectro Autista , Niño , Humanos , Mapeo Encefálico , Imagen por Resonancia Magnética/métodos , Cerebelo , Encéfalo/diagnóstico por imagenRESUMEN
BACKGROUND AND HYPOTHESIS: People with first-episode psychosis (FEP) in low- and lower-middle-income countries (LMIC) experience delays in receiving treatment, resulting in poorer outcomes and higher mortality. There is robust evidence for effective and cost-effective early intervention in psychosis (EIP) services for FEP, but the evidence for EIP in LMIC has not been reviewed. We aim to review the evidence on early intervention for the management of FEP in LMIC. STUDY DESIGN: We searched 4 electronic databases (Medline, Embase, PsycINFO, and CINAHL) to identify studies describing EIP services and interventions to treat FEP in LMIC published from 1980 onward. The bibliography of relevant articles was hand-searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. STUDY RESULTS: The search strategy produced 5074 records; we included 18 studies with 2294 participants from 6 LMIC countries. Thirteen studies (1553 participants) described different approaches for EIP. Pharmacological intervention studies (nâ =â 4; 433 participants) found a high prevalence of metabolic syndrome among FEP receiving antipsychotics (Pâ ≤â .005). One study found a better quality of life in patients using injectables compared to oral antipsychotics (Pâ =â .023). Among the non-pharmacological interventions (nâ =â 3; 308 participants), SMS reminders improved treatment engagement (ORâ =â 1.80, CIâ =â 1.02-3.19). The methodological quality of studies evidence was relatively low. CONCLUSIONS: The limited evidence showed that EIP can be provided in LMIC with adaptations for cultural factors and limited resources. Adaptations included collaboration with traditional healers, involving nonspecialist healthcare professionals, using mobile technology, considering the optimum use of long-acting antipsychotics, and monitoring antipsychotic side effects.
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Países en Desarrollo , Intervención Médica Temprana , Trastornos Psicóticos , Humanos , Trastornos Psicóticos/terapia , Antipsicóticos/administración & dosificaciónRESUMEN
Chronic exposure to high fluoride (F-) levels in groundwater causes community fluorosis and non-carcinogenic health concerns in local people. This study described occurrence, dental fluorosis, and origin of high F-groundwater using δ2H and δ18O isotopes at semiarid Gilgit, Pakistan. Therefore, groundwater (n = 85) was collected and analyzed for F- concentrations using ion-chromatography. The lowest F- concentration was 0.4 mg/L and the highest 6.8 mg/L. F- enrichment is linked with higher pH, NaHCO3, NaCl, δ18O, Na+, HCO3-, and depleted Ca+2 aquifers. The depleted δ2H and δ18O values indicated precipitation and higher values represented the evaporation effect. Thermodynamic considerations of fluorite minerals showed undersaturation, revealing that other F-bearing minerals viz. biotite and muscovite were essential in F- enrichment in groundwater. Positive matrix factorization (PMF) and principal component analysis multilinear regression (PCAMLR) models were used to determine four-factor solutions for groundwater contamination. The PMF model results were accurate and reliable compared with those of the PCAMLR model, which compiled the overlapping results. Therefore, 28.3% exceeded the WHO permissible limit of 1.5 mg/L F-. Photomicrographs of granite rocks showed enriched F-bearing minerals that trigger F- in groundwater. The community fluorosis index values were recorded at > 0.6, revealing community fluorosis and unsuitability of groundwater for drinking.
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Agua Subterránea , Contaminantes Químicos del Agua , Humanos , Fluoruros/análisis , Monitoreo del Ambiente/métodos , Contaminantes Químicos del Agua/análisis , Minerales/análisis , Agua Subterránea/química , Isótopos/análisisRESUMEN
BACKGROUND: Gender clinic and single-item questionnaire-based data report increased co-occurrence of gender diversity and neurodevelopmental conditions. The nuances of these associations are under-studied. We used a transdiagnostic approach, combining categorical and dimensional characterization of neurodiversity, to further the understanding of its associations with gender diversity in identity and expression in children. METHODS: Data from 291 children (Autism N = 104, ADHD N = 104, Autism + ADHD N = 17, neurotypical N = 66) aged 4-12 years enrolled in the Province of Ontario Neurodevelopmental Network were analyzed. Gender diversity was measured multi-dimensionally using a well-validated parent-report instrument, the Gender Identity Questionnaire for Children (GIQC). We used gamma regression models to determine the significant correlates of gender diversity among age, puberty, sex-assigned-at-birth, categorical neurodevelopmental diagnoses, and dimensional neurodivergent traits (using the Social Communication Questionnaire and the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior Rating Scales). Internalizing and externalizing problems were included as covariates. RESULTS: Neither a categorical diagnosis of autism nor ADHD significantly correlated with current GIQC-derived scores. Instead, higher early-childhood dimensional autistic social-communication traits correlated with higher current overall gender incongruence (as defined by GIQC-14 score). This correlation was potentially moderated by sex-assigned-at-birth: greater early-childhood autistic social-communication traits were associated with higher current overall gender incongruence in assigned-males-at-birth, but not assigned-females-at-birth. For fine-grained gender diversity domains, greater autistic restricted-repetitive behavior traits were associated with greater diversity in gender identity across sexes-assigned-at-birth; greater autistic social-communication traits were associated with lower stereotypical male expression across sexes-assigned-at-birth. CONCLUSIONS: Dimensional autistic traits, rather than ADHD traits or categorical neurodevelopmental diagnoses, were associated with gender diversity domains across neurodivergent and neurotypical children. The association between early-childhood autistic social-communication traits and overall current gender diversity was most evident in assigned-males-at-birth. Nuanced interrelationships between neurodivergence and gender diversity should be better understood to clarify developmental links and to offer tailored support for neurodivergent and gender-diverse populations.
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Motor proteins, encoded by Kinesin superfamily (KIF) genes, are critical for brain development and plasticity. Increasing studies reported KIF's roles in neurodevelopmental disorders. Here, a 6 years and 3 months-old Chinese boy with markedly symptomatic epilepsy, intellectual disability, brain atrophy, and psychomotor retardation was investigated. His parents and younger sister were phenotypically normal and had no disease-related family history. Whole exome sequencing identified a novel heterozygous in-frame deletion (c.265_267delTCA) in exon 3 of the KIF5C in the proband, resulting in the removal of evolutionarily highly conserved p.Ser90, located in its ATP-binding domain. Sanger sequencing excluded the proband's parents and family members from harboring this variant. The activity of ATP hydrolysis in vitro was significantly reduced as predicted. Immunofluorescence studies showed wild-type KIF5C was widely distributed throughout the cytoplasm, while mutant KIF5C was colocalized with microtubules. The live-cell imaging of the cargo-trafficking assay revealed that mutant KIF5C lost the peroxisome-transporting ability. Drosophila models also confirmed p.Ser90del's essential role in nervous system development. This study emphasized the importance of the KIF5C gene in intracellular cargo-transport as well as germline variants that lead to neurodevelopmental disorders and might enable clinicians for timely and accurate diagnosis and disease management in the future.
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Neurodevelopmental conditions can be associated with decreased health-related quality of life; however, the predictors of these outcomes remain largely unknown. We characterized the predictors of health-related quality of life (HRQoL) in a sample of neurodiverse children and youth. We used a cross-sectional subsample from the Province of Ontario Neurodevelopmental Disorders Network (POND) consisting of those children and young people in the POND dataset with complete study data (total n = 615; 31% female; age: 11.28 years ± 2.84 years). Using a structural equation model, we investigated the effects of demographics (age, sex, socioeconomic status), core features (Social Communication Questionnaire, Toronto Obsessive Compulsive Scale, Strengths and Weaknesses of attention deficit/hyperactivity disorder (ADHD)-symptoms and Normal Behavior), co-occurring symptoms (Child Behaviour Checklist), and adaptive functioning (Adaptive Behaviour Assessment System) on HRQoL (KINDL). A total of 615 participants had complete data for this study (autism = 135, ADHD = 273, subthreshold ADHD = 7, obsessive-compulsive disorder (OCD) = 38, sub-threshold OCD = 1, neurotypical = 161). Of these participants, 190 (31%) identified as female, and 425 (69%) identified as male. The mean age was 11.28 years ± 2.84 years. Health-related quality of life was negatively associated with co-occurring symptoms (B = - 0.6, SE = 0.20, CI (- 0.95, - 0.19), p = 0.004)) and age (B = - 0.1, SE = 0.04, CI (- 0.19, - 0.01), p = 0.037). Fewer co-occurring symptoms were associated with higher socioeconomic status (B = - 0.5, SE = - 0.05, CI (- 0.58, - 0.37), p < 0.001). This study used a cross-sectional design. Given that one's experiences, needs, supports, and environment and thus HrQoL may change significantly over the lifespan and a longitudinal analysis of predictors is needed to capture these changes. Future studies with more diverse participant groups are needed. These results demonstrate the importance of behavioural and sociodemographic characteristics on health-related quality of life across neurodevelopmental conditions.
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Trastorno por Déficit de Atención con Hiperactividad , Trastorno Obsesivo Compulsivo , Niño , Adolescente , Humanos , Masculino , Femenino , Calidad de Vida , Estudios Transversales , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno Obsesivo Compulsivo/epidemiología , Trastorno Obsesivo Compulsivo/diagnóstico , Adaptación PsicológicaRESUMEN
The contamination of farm soils with heavy metals (HMs) has raised significant concerns due to the increased bioavailability and accumulation of HMs in agricultural food crops. To address this issue, a survey experiment was conducted in the suburbs of Multan and Faisalabad to investigate the spatial distribution, bioaccumulation, translocation, and health risks of cadmium (Cd) and lead (Pb) in agricultural crops. The results show a considerable concentration of Cd and Pb in soils irrigated with wastewater, even though these levels were below the permissible limits in water and soil matrices. The pollution index for Cd was mostly greater than 1 at the selected sites, indicating its accumulation in soil over time due to wastewater irrigation. Conversely, the pollution index for Pb was below 1 at all sites. Among the plants, Zea mays accumulated the highest concentration of Cd and Pb. The translocation factor from soil to root was highest for Brassica olearecea (7.037 for Cd) and Zea mays (6.383 for Pb). The target hazard quotient (THQ) value of Cd exceeded the non-carcinogenic limit for most vegetables. The highest value was found in Allium cepa (5.256) and the lowest in Allium sativum (0.040). In contrast, the THQ level of Pb was below the non-carcinogenic limit for most vegetables, except for Allium cepa (1.479), Solanum lycopersicum (1.367), and Solanum tuberosum (1.326). The study highlights that Allium cepa poses the highest health risk for humans, while Medicago sativa poses the highest risk for animals due to Cd and Pb contamination. These results underscore the urgent need for effective measures to mitigate the health risks associated with HM contamination in crops and soils.
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The aorta is particularly damaged by Takayasu's arteritis (TA), a rare form of vasculitis. Chest discomfort, exhaustion, fever, elevated blood pressure, heart failure, and stroke can all result from this. Major intimal fibrosis with vascular constriction is the disease's hallmark; although anybody can have it, Asian females in their 20s or 30s seem to be most typically affected. The treatment of a 23-year-old Asian female with Takayasu's arteritis (TA) is discussed in this case study, along with her presentation. Before developing seizures, the patient first showed signs of left-sided weakness and facial droop. Ischemic infarcts and vasculopathy were detected by imaging. The patient fulfilled several American College of Rheumatology (ACR) criteria for TA with a positive erythrocyte sedimentation rate (ESR). During treatment, high-dose prednisolone, cyclophosphamide, and neuroprotective measures were used. The patient's attentiveness and mobility improved despite early complications, such as vascular friability. This case illustrates the difficulties and effective treatment of neurovascular problems connected to TA.
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A primary dataset capturing five distinct types of sheep activities in realistic settings was constructed at various resolutions and viewing angles, targeting the expansion of the domain knowledge for non-contact virtual fencing approaches. The present dataset can be used to develop non-invasive approaches for sheep activity detection, which can be proven useful for farming activities including, but not limited to, sheep counting, virtual fencing, behavior detection for health status, and effective sheep breeding. Sheep activity classes include grazing, running, sitting, standing, and walking. The activities of individuals, as well as herds of sheep, were recorded at different resolutions and angles to provide a dataset of diverse characteristics, as summarized in Table 1. Overall, a total of 149,327 frames from 417 videos (the equivalent of 59 minutes of footage) are presented with a balanced set for each activity class, which can be utilized for robust non-invasive detection models based on computer vision techniques. Despite a decent existence of noise within the original data (e.g., segments with no sheep present, multiple sheep in single frames, multiple activities by one or more sheep in single as well as multiple frames, segments with sheep alongside other non-sheep objects), we provide original videos and the original videos' frames (with videos and frames containing humans omitted for privacy reasons). The present dataset includes diverse sheep activity characteristics and can be useful for robust detection and recognition models, as well as advanced activity detection models as a function of time for the applications.
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Currently, there is a surge in the adoption of green construction practices (GCP) to address and attempt to alleviate the adverse effects of construction activities on the natural environment. The current research surrounding sustainability in the industry has witnessed a notable surge in efforts, primarily driven by a growing consciousness of environmental concerns. In this context, it is worth noting that the focus of assessment schemes in developed countries has predominantly gravitated toward economic and environmental factors, with relatively less emphasis placed on social performance (SP). Many researchers have underscored this disparity, highlighting the need for a more comprehensive approach encompassing all three sustainability dimensions. Hence, the present research examines the effects of green construction practices on economic performance (ECP) while considering the mediating role of environmental performance (EP) and SP. The results showed no direct impact of GCP on ECP. However, the mediating role of SP and EP in the association between GCP and ECP was found to be statistically significant. The present study provides several implications. This study presents empirical evidence that implementing GCP yields several benefits for contractors, including cost reduction in waste management, legal expenses, and energy consumption. These cost savings effectively offset the initial investment required to implement GCP, enabling construction projects to attain ECP thresholds. This study provides a significant contribution to the expanding corpus of knowledge concerning green building site practices and construction management. It offers novel insights into the influence of a project's EP and SP on its economic feasibility. Furthermore, this research study has effectively showcased the positive impact of GCP on construction projects' environmental construction performance, particularly concerning environmental and social considerations. Integr Environ Assess Manag 2024;20:1396-1406. © 2024 SETAC.
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Conservación de los Recursos Naturales , Industria de la Construcción , Conservación de los Recursos Naturales/métodos , Administración de Residuos/métodos , Administración de Residuos/economía , Desarrollo Sostenible , AmbienteRESUMEN
Background and Objectives: Patterns of electrical activity in the brain (EEG) during sleep are sensitive to various health conditions even at subclinical stages. The objective of this study was to estimate sleep EEG-predicted incidence of future neurologic, cardiovascular, psychiatric, and mortality outcomes. Methods: This is a retrospective cohort study with 2 data sets. The Massachusetts General Hospital (MGH) sleep data set is a clinic-based cohort, used for model development. The Sleep Heart Health Study (SHHS) is a community-based cohort, used as the external validation cohort. Exposure is good, average, or poor sleep defined by quartiles of sleep EEG-predicted risk. The outcomes include ischemic stroke, intracranial hemorrhage, mild cognitive impairment, dementia, atrial fibrillation, myocardial infarction, type 2 diabetes, hypertension, bipolar disorder, depression, and mortality. Diagnoses were based on diagnosis codes, brain imaging reports, medications, cognitive scores, and hospital records. We used the Cox survival model with death as the competing risk. Results: There were 8673 participants from MGH and 5650 from SHHS. For all outcomes, the model-predicted 10-year risk was within the 95% confidence interval of the ground truth, indicating good prediction performance. When comparing participants with poor, average, and good sleep, except for atrial fibrillation, all other 10-year risk ratios were significant. The model-predicted 10-year risk ratio closely matched the observed event rate in the external validation cohort. Discussion: The incidence of health outcomes can be predicted by brain activity during sleep. The findings strengthen the concept of sleep as an accessible biological window into unfavorable brain and general health outcomes.
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Overuse of chemical fertilizers in agroecosystems leads to the increased economic burden, low crop production in terms of input and environmental pollution. Due to its improved nutrient management and degrading properties, synthetic slow release fertilizers have become a significant advancement in the fertilizer sector. In this study we evaluated the effect of slow release urea on nitrous oxide (N2O) emission, crop growth and crop nutrient contents. Measurements were carried out in two different texture soils (sandy loam and silty clay) under two different conditions (bare soil and planted). The N2O emission was measured for 15 days from bare soils and 48 days from planted soil. Plant fresh weight, dry weight, chlorophyll contents, N and Zn were measured in the end of the experiment. The results showed that N2O emission was reduced 33-39 % from coated urea as compared to conventional urea in bare soil. In planted soil, the coated urea reduced the N2O emission 29-33 %. The deep placement of urea in silty clay soil reduced the N2O emission up to 22.8 % as compared to surface placement. Plant fresh matter, dry matter, N and Zn contents were significantly (p ≤ 0.05) higher with coated urea as compared to conventional urea. It is concluded that the coating of urea with hydrophobic materials like stearic acid, along with Zn sources i.e. Zn fortified nano-bentonite or the ZnO nanoparticles (NPs) presents opportunities to overcome the environmental pollution and increasing the crop production and quality.
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The datasets included in this paper provide periodically measured physico-chemical and rheological properties of mesophilic batch anaerobic digesters' content for 30 days biochemical methane potential tests (BMP). Waste activated sludge (WAS) and primary sludge (PS) were the main substrates and digested sludge from a large scale mesophilic anaerobic digester was the inoculum. The substrates (F) and inoculum (I) were fed into the BMP rectors at different ratios of feed to inoculum (F/Iâ¯=â¯1:1, 1:2, and 1:3). Experimental data on co-digestion of WAS with inorganic and organic additives were also reported. The reported characteristics such as total solids, volatile solids, total and soluble biochemical oxygen demand, ammonia, pH, as well as rheological properties over the duration of the BMP test could be used for analysing the changes in digestate properties as the anaerobic digestion process proceeds. The discussion and interpretation of the data have been provided in previous publications [[1], [2], [3]].