Mapping consumptions and market size of cocaine, amphetamine and MDMA through wastewater analysis: A Dutch case study.

BACKGROUND AND AIMS: Illicit drug consumption is associated with public health effects and criminal activities. This study aimed to estimate Illicit drug consumption and annual market in the Netherlands from wastewater analysis of drug residues. METHODS: Residues of cocaine, amphetamine and 3,4-methylene dioxymethamphetamine (MDMA) were measured between 2015 and 2022 in 30 Dutch wastewater treatment plants serving both rural and urban populations. These wastewater treatment plants covered 20% of the total Dutch population. The Dutch annual retail market was estimated by extrapolating consumption to the total Dutch population, back-calculating consumption volume, correcting for drug purity and street price collected in voluntary checking services, and accounting for the correlation of consumption and urbanity. RESULTS: The per capita MDMA and cocaine consumption correlated positively with the urbanity of the wastewater treatment plant catchments with r2 of 31% and 64%, respectively. Amphetamine did not show a significant correlation with urbanity. The three studied drugs were conservatively estimated to cover an average annual market value of 903 (95% prediction interval 829 to 987) million Euro for the studied period. Market estimations from prevalence figures and interceptions of international trade were similar. CONCLUSIONS: Illicit drug consumption in the Netherlands appears to correlate positively with urban (in contrast to rural) areas. Wastewater analysis can be used to estimate the volume and monetary value of illicit drug markets as a proof of concept.

Socioeconomic and Demographic Determinants of Readmission Rates in Congestive Heart Failure Patients: Insights From the Nationwide Readmissions Database.

Background Congestive heart failure (CHF) is a leading cause of hospitalizations and readmissions, placing a significant burden on the healthcare system. Identifying factors associated with readmission risk is crucial for developing targeted interventions and improving patient outcomes. This study aimed to investigate the impact of socioeconomic and demographic factors on 30-day and 90-day readmission rates in patients primarily admitted for CHF. Methods The study was carried out using a cross-sectional study design, and the data were obtained from the Nationwide Readmissions Database (NRD) from 2016 to 2020. Adult patients with a primary diagnosis of CHF were included. The primary outcomes were 30-day and 90-day all-cause readmission rates. Multivariable logistic regression was used to identify factors independently associated with readmissions, including race, ethnicity, insurance status, income level, and living arrangements. Results A total of 219,904 patients with a primary diagnosis of CHF were used in the study. The overall 30-day and 90-day readmission rates were 17.3% and 23.1%, respectively. In multivariable analysis, factors independently associated with higher 30-day readmission risk included Hispanic ethnicity (OR 1.18, 95% CI 1.03-1.35), African American race (OR 1.15, 95% CI 1.04-1.28), Medicare insurance (OR 1.24, 95% CI 1.12-1.38), and urban residence (OR 1.11, 95% CI 1.02-1.21). Higher income was associated with lower readmission risk (OR 0.87, 95% CI 0.79-0.96 for highest vs. lowest quartile). Similar patterns were observed for 90-day readmissions. Conclusion Socioeconomic and demographic factors, including race, ethnicity, insurance status, income level, and living arrangements, significantly impact 30-day and 90-day readmission rates in patients with CHF. These findings highlight the need for targeted interventions and policies that address social determinants of health and promote health equity in the management of CHF. Future research should focus on developing and evaluating culturally sensitive, community-based strategies to reduce readmissions and improve outcomes for high-risk CHF patients.

Ectomycorrhizal fungal communities in natural and urban ecosystems: Quercus humboldtii as a study case in the tropical Andes.

Worldwide urban landscapes are expanding because of the growing human population. Urban ecosystems serve as habitats to highly diverse communities. However, studies focusing on the diversity and structure of ectomycorrhizal communities are uncommon in this habitat. In Colombia, Quercus humboldtii Bonpl. is an ectomycorrhizal tree thriving in tropical montane forests hosting a high diversity of ectomycorrhizal fungi. Q. humboldtii is planted as an urban tree in Bogotá (Colombia). We studied how root-associated fungal communities of this tree change between natural and urban areas. Using Illumina sequencing, we amplified the ITS1 region and analyzed the resulting data using both OTUs and Amplicon Sequence Variants (ASVs) bioinformatics pipelines. The results obtained using both pipelines showed no substantial differences between OTUs and ASVs for the community patterns of root-associated fungi, and only differences in species richness were observed. We found no significant differences in the species richness between urban and rural sites based on Fisher's alpha or species-accumulation curves. However, we found significant differences in the community composition of fungi present in the roots of rural and urban trees with rural communities being dominated by Russula and Lactarius and urban communities by Scleroderma, Hydnangium, and Trechispora, suggesting a high impact of urban disturbances on ectomycorrhizal fungal communities. Our results highlight the importance of urban trees as reservoirs of fungal diversity and the potential impact of urban conditions on favoring fungal species adapted to more disturbed ecosystems.

Role of Patient's Ethnicity in Seeking Preventive Dental Services at the Community Health Centers of South-Central Texas: A Cross-Sectional Study.

BACKGROUND: This study was conducted to determine the impact of a patient's ethnicity on seeking preventive dental services at the Community Health Centers (CHCs) in South-Central Texas. METHODS: Primary electronic health records (EHR) data were collected regarding each patient's medical and dental history, and comprehensive treatment planning. The researchers retrieved EHR from January 2016 to 2022. Bivariate analysis was completed to test the outcome with the predictor variable and covariates using the appropriate statistical tests. A multiple linear regression model was used to understand the association between the predictor and outcome variable while controlling for confounders. RESULTS: The study findings revealed significantly higher dental visits (2.26 ± 2.88) for Hispanic patients. The results from the multiple regression model indicated that non-Hispanic patients had a smaller chance of visiting CHC for preventive dental services, by eight percent, compared to the Hispanic population (p-value < 0.001) when all other variables were held constant. However, the study results were not significant, as the effect size was too small to conclude the effect of ethnicity on the patients visiting the dental clinic at the CHC for preventive services. CONCLUSION: The study concluded that there is no difference in the preventive dental services completed by Hispanics and non-Hispanics when all other variables are controlled.

Shared Species Analysis, Augmented by Stochasticity Analysis, Is More Effective Than Diversity Analysis in Detecting Variations in the Gut Microbiomes.

Diversity analysis is a de facto standard procedure for most existing microbiome studies. Nevertheless, diversity metrics can be insensitive to changes in community composition (identities). For example, if species A (e.g., a beneficial microbe) is replaced by equal number of species B (e.g., an opportunistic pathogen), the diversity metric may not change, but the community composition has changed. The shared species analysis (SSA) is a computational technique that can discern changes of community composition by detecting the increase/decrease of shared species between two sets of microbiome samples, and it should be more sensitive than standard diversity analysis in discerning changes in microbiome structures. Here, we investigated the effects of ethnicity and lifestyles in China on the structure of Chinese gut microbiomes by reanalyzing the datasets of a large Chinese cohort with 300+ individuals covering 7 biggest Chinese ethnic groups (>95% Chinese population). We found: (i) Regarding lifestyles, SSA revealed significant differences between 100% of pair-wise comparisons in community compositions across all but phylum taxon levels (phylum level = 29%), but diversity analysis only revealed 14-29% pair-wise differences in community diversity across all four taxon levels. (ii) Regarding ethnicities, SSA revealed 100% pair-wise differences in community compositions across all but phylum (phylum level = 48-62%) levels, but diversity analysis only revealed 5-57% differences in community diversity across all four taxon levels. (iii) Ethnicity seems to have more prevalent effects on community structures than lifestyle does (iv) Community structures of the gut microbiomes are more stable at the phylum level than at the other three levels. (v) SSA is more powerful than diversity analysis in detecting the changes of community structures; furthermore, SSA can produce lists of unique and shared OTUs. (vi) Finally, we performed stochasticity analysis to mechanistically interpret the observed differences revealed by the SSA and diversity analyses.

Place Attachment and Views on Tree Management.

Few studies have investigated relational environmental views of different stakeholder groups. In this study, we investigated how residents of rural and urban municipalities view the management of trees (who should decide about trees' removal - the landowner, or the municipality), which provides a various range of ecosystem services and the extent that place attachment as a relational variable affects these views. The analysis was based on 231 questionnaires conducted in two Polish municipalities: one rural (Nysa) and one urban (Racibórz). Data were analyzed using statistical methods including logistic regression models for analyzing factors impacting the main research question. Our investigation showed that both place attachment involving public good sentiments and the perception of ecosystem services provided by trees, that are related to private interests significantly impacted views on tree management. In rural areas the opinion, that the municipality should decide to remove trees was positively associated with a place attachment. For residents of urban areas (Racibórz), the strength of place attachment was not related to the perception of tree removal, but it was related to the perception of trees' cultural benefits. We argue that considering psychological variables related to the tree management issues could help avoid conflicts.

What are the probable predictors of urinary incontinence during pregnancy?

Objectives. The frequency, predisposing factors and impact of urinary incontinence (UI) on quality of life (QoL) during pregnancy were investigated. Materials and Method. A preliminary cross-sectional survey was studied among pregnant women between January and July of 2014. A total of 132 pregnant women were recruited using a questionnaire form for sociodemographic features, the Turkish version of the International Consultation on Incontinence-Short Form (ICIQ-SF), for the characteristics of UI and Wagner's Quality of Life scale to assess impact on QoL. p < 0.05 was set significant. Results.Urinary incontinence was present in 56 out of 132 pregnant women (42.4%, UI-present group): mean age, 26.7 ± 5.4y(p = 0.780); median height, 160 cm (min-max: 153-176, p = 0.037); median BMI, 28.7 kg/m(2)(min-max: 22.4-50.0, p = 0.881); urine leakage occurred per week once (n = 18, 32.1%), twice or thrice (n = 8, 14.3%); per day few times (n = 14, 25%), once (n = 5, 8.9%) and always (n = 8, 14.3%) with mainly a small amount of urine leakage (n = 33, 58.9%) or a moderate (n = 4, 7.1%). There were statistically significant relationships between QoL scores and frequency of UI (p = 0.002) or amount of leakage (p = 0.002). Impact on QoL scores ranged from mild (n = 33, 58.9%), moderate (n = 4, 7.1%) to severe (n = 4, 7.1%) levels in daily life. UI impacted the daily life activities of women by making them less likely to undertake activities outside their homes (23.2%), by affecting their working performance and friendships (8.9%), their daily home activities (7.1%), their general health status (12.5%), their sexual relations (12.5%), by making them more nervous or anxious (10.7%) and by the need to wear pads or protectors (25%). ANOVA, Tukey, and Tamhane tests as the minimal important difference model yielded significant relevance between statistical analyses and clinical outcomes by using standard deviations (p = 0.001, 0.001 and 0.005 respectively). The following features favored the occurence of UI: Age (OR = 0.845, 95% CI [0.268-2.669]), being a housewife (OR = 1.800, 95% CI [0.850-3.810]), anemia (OR = 0.939, 95% CI [0.464-1.901]), parity (OR = 0.519, 95% CI [0.325-0.829]), miscarriage (OR = 1.219, 95% CI [0.588-2.825]) and living in rural areas (OR = 1.800, 95% CI [0.887-3.653]). Height (p = 0, 037), educational status (0.016), miscarriage (0.002), parity (0.006) and place of living (0.020) were significant factors. Conclusions.Many pregnant women are suffering from UI, which warrants a significant public health consideration in the region. Age, height, being a housewife or graduation level higher than primary school, living in rural, parity, miscarriage, and anemia were the factors in favor of the onset of UI. The authors plan a health promotion program in the region according to the results in order to provide information to health caregivers, especially family physicians, and to educate women about the predictors of UI and pelvic floor exercises for primary prevention and secondary relief of UI during and after pregnancy and provide some hygienic supplies to the poor in this aspect.