Life cycle inventory and life cycle impact assessment datasets of an industrial-scale milk fractionation process generating 5 co-products: Cream, casein, lactose and two whey-protein ingredients enriched in α-lactalbumin or ß-lactoglobulin.

Food plays a significant role in the environmental impacts of human activities. However, many agro-industrial processes are multi-product systems and their impacts need to be distributed between the different co-products in order to properly address two major issues: (1) prevention of food spoilage and food losses and (2) the eco-design of food systems, from processing up to recommendations for changes in Western diets. As a culturally and nutritionally central component of most human diets, milk is critical because processing is a preservation issue and most dairy products follow from separations, thereby generating co-products. Life Cycle Assessment (LCA) is a reference and standard method that allows quantification of the potential environmental impacts of a manufactured product throughout its life cycle. Application of the method requires foreground information on the system considered, as well as input and output flows that feed and exit the system. This data paper provides data related to the fractionation of milk into cream, casein, lactose and two whey protein ingredients at industrial scale, using up-to-date technologies used in French dairy factories in years 2000-2010s. Cleaning is included. Transcription of these input and output flows into a selection of processes in the Agribalyse 3.0.1 and Ecoinvent 3.8 databases is also provided. Application of the LCA method in its attributional approach leaves methodological choices up to the practitioner, such as subdivision of the system, allocation of the environmental burden where subdivision is not applied or not possible, and aggregation of the impacts. Therefore, this data paper also provides the allocation factors that are necessary to apply mass, dry matter, protein or economic allocation at every separation operation throughout the processing itinerary. Using the characterization method EF 3.0, this data paper provides the potential environmental impacts of the 5 co-products obtained with an initial input of 600 tons of raw milk, i.e., 63 tons of cream, 183 tons of wet casein, 90 tons of lactose, 1.7 ton of dried ß-lactoglobulin and 0.3 ton of dried α-lactalbumin. The respective shares of the 5 co-products are calculated for each allocation rule. Finally, this data paper provides the potential environmental impacts for the manufacture of 1 kg of α-lactalbumin enriched ingredient, as the co-product with the longest process itinerary, with details of all intermediate input contributions as well as two possible aggregation rules: by step or by input type. The dataset participates in providing often confidential industrial-scale LCI data to the public. It will be helpful for the eco-design of future itineraries. In particular, it contributes to taking the fate of the co-products into account when using LCA for such eco-design.

Nicorandil attenuates lithocholic acid-induced hepatotoxicity in mice through impeding oxidative stress, inflammation and apoptosis.

This study was performed to explore the beneficial protective impact of nicorandil (Nico) against lithocholic acid (LCA)-induced hepatotoxicity. MATERIALS AND METHODS: Mice received Nico (50 and 100 mg/kg. orally) for 7 days and LCA (125 mg/kg, i.p.) was injected for the last 4 days two times daily. RESULTS: Nico improved both structural and functional abnormalities induced by LCA. Nico significantly decreased serum levels of transaminases, ALP, GGT and markedly elevated albumin levels. Additionally, Nico mitigated oxidative stress; it decreased contents of MDA and NO and increased GSH level and SOD activity. Moreover, Nico markedly decreased the elevated levels of TNF-α, JNK, Bax, Caspase-3 and iNOS, and increased the levels of eNOS in hepatic tissues. Furthermore, Nico substantially decreased the expression of NFκBp65 in hepatic tissues. Histopathological and transmission electron microscopy findings further supported these biomarkers. CONCLUSION: Nico might be used as an adjuvant medication to prevent LCA-induced hepatotoxicity, pending further clinical research, through impeding oxidative stress, inflammation and apoptosis.

Metabolomic profiling of dengue infection: unraveling molecular signatures by LC-MS/MS and machine learning models.

BACKGROUND & OBJECTIVE: The progression of dengue fever to severe dengue (SD) is a major public health concern that impairs the capacity of the medical system to predict and treat dengue patients. Hence, the present study used a metabolomic approach integrated with machine models to identify differentially expressed metabolites in patients with SD compared to nonsevere patients and healthy controls. METHODS: Comprehensively, the plasma was collected at different clinical phases during dengue without warning signs (DWOW, N = 10), dengue with warning signs (DWW, N = 10), and SD (N = 10) at different stages [i.e., day of admission (DOA), day of defervescence (DOD), and day of convalescent (DOC)] in comparison to healthy control (HC). The samples were subjected to LC‒ESI‒MS/MS to identify metabolites. Statistical and machine learning analyses were performed using R and Python language. Further, biomarker, pathway and correlation analysis was performed to identify potential predictors of dengue. RESULTS & CONCLUSION: A total of 423 metabolites were identified in all the study groups. Paired and unpaired t-tests revealed 14 highly differentially expressed metabolites between and across the dengue groups, with four metabolites (shikimic acid, ureidosuccinic acid, propionyl carnitine, and alpha-tocopherol) showing significant differences compared to HC. Furthermore, biomarker (ROC) analysis revealed 11 potential molecules with a significant AUC value of 1 that could serve as potential biomarkers for identifying different dengue clinical stages that are beneficial for predicting dengue disease outcomes. The logistic regression model revealed that S-adenosylhomocysteine, hypotaurine, and shikimic acid metabolites could be beneficial indicators for predicting severe dengue, with an accuracy and AUC of 0.75. The data showed that dengue infection is related to lipid metabolism, oxidative stress, inflammation, metabolomic adaptation, and virus manipulation. Moreover, the biomarkers had a significant correlation with biochemical parameters like platelet count, and hematocrit. These results shed some light on host-derived small-molecule biomarkers that are associated with dengue severity and novel insights into metabolomics mechanisms interlinked with disease severity.

Supporting the investigation of health outcomes due to airborne emission by different approaches: current evidence for the waste incineration sector.

Life cycle assessment (LCA) along with a survey on epidemiologic and oxidative potential studies was used for analysing the current evidence of the impact of airborne emissions from municipal solid waste incineration (MSWI) on human health. The correspondence among investigated health outcomes and pollutants was discussed based on the Chemical Abstract Service (CAS) and the International Agency for Research on Cancer (IARC). LCA indicated the ability of MSWI in avoiding human health impact, about - 2 × 10-4 DALY/tonne together with avoided emissions of particulate matter (PM) and resource depletion, about - 2.5 × 10-3 kg Sbeq/tonne and about - 0.11 kg PM2.5 eq/tonne, respectively. Positive emissions were detected for greenhouses (about 900 kg CO2eq/tonne) and ecotoxicity (about 15,000 CTUe/tonne). Epidemiologic studies performed on population exposed to MSWI reported quite contrasting results. In some of these, hazard ratio (HR) ranging from about 0.7 to 2.2 was reported concerning the incidence of stomach, liver, breast and bladder cancer. Larger agreement was detected concerning the incidence of larynx and lung cancer with HR ranging from about 1 to about 2.6. Direct causal nexuses were not definitively identified. Oxidative potential of PM was characterized by a high Pearson correlation > 0.8 to the presence of CrVI, Cu and Zn. These heavy metals were also identified by both CAS and IARC as toxic (i.e. Cu and Zn) and cancerous (i.e. CrVI) substances affecting the organs of both respiratory and digestive apparatus. In general, even if more research is necessary, LCA, oxidative potential and the epidemiologic survey results showed a high level of accordance. This suggests their integrated exploitation for supporting the investigation of both direct and indirect consequences on environment and health related to waste incineration for both retrospective and predictive studies.

Feeling discriminated means poor self-perceived health: a gender analysis using SHARE.

Most part of the literature has highlighted the detrimental effects of discrimination on health. However, the influence of past and perceived discrimination on older workers' self-assessed health has been understudied. Firstly, we aim at studying whether reported discrimination is associated with self-assessed health among adults of working ages (50-65 years of age). Secondly, we analyze the existence of differences by gender. Data was retrieved from the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) to obtain the regular panel of questions, and the third and seventh waves of the SHARELIFE questionnaire, that includes information about discrimination (n = 30,019). We develop logistic regression models to determine the relationship of discrimination on male and female workers' self-assessed health separately. Our results show that 49.0% of our sample was composed of highly discriminated women, while the remaining percentage covered men and women (42.3% males and 8.7% females) that reported lower levels of discrimination. Our estimations reveal a significant association between discrimination and poor health status, especially in the case of men ranging from OR = 1.802 (95% CI 1.502-2.163) to OR = 1.565 (95% CI 1.282-1.910). In the case of women our results range from OR = 1.728 (95% CI 1.463-2.040) to OR = 1.196 (95% CI 0.992-1.442). These findings are essential to highlight the importance of tackling discrimination as a determinant of health that negatively affects both sexes, men and women.

Qualitative analysis of Fasciola gigantica excretory and secretory products coimmunoprecipitated with buffalo secondary infection sera shows dissimilar components from primary infection sera.

Buffaloes cannot mount a robust adaptive immune response to secondary infection by Fasciola gigantica. Even if excretory and secretory products (ESPs) exhibit potent immunoregulatory effects during primary infection, research on ESPs in secondary infection is lacking, even though the ESP components that are excreted/secreted during secondary infection are unknown. Therefore, qualitative analysis of ESP during secondary infection was performed and compared with that of primary infection to deepen the recognition of secondary infection and facilitate immunoregulatory molecules screening. Buffaloes were divided into three groups: A (n = 3, noninfected), B (n = 3, primary infection) and C (n = 3, secondary infection). Buffaloes in the primary (0 weeks post infection; wpi) and secondary (-4 and 0 wpi) infection groups were infected with 250 metacercariae by oral administration. Then, sera were collected from groups at different wpi, and interacting proteins were precipitated by coimmunoprecipitation (Co-IP), qualitatively analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), and annotated by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses to infer their potential functions. In group C, 324 proteins were identified, of which 76 proteins were consistently identified across 7 time points (1, 3, 6, 8, 10, 13, and 16 wpi). Compared with 87 proteins consistently identified in group B, 22 proteins were identified in group C. Meanwhile, 34 proteins were only identified in group C compared to 200 proteins identified in group B. Protein pathway analysis indicated that these proteins were mainly involved in the cellular processes and metabolism of F. gigantica. Among them, 14-3-3θ was consistently identified in group C and may be involved in various cellular processes and innate immune signalling pathways. Members of the HSP family were identified in both groups B and C and may function in both primary and secondary infection processes. The proteins discovered in the present study will help to deepen the understanding of the molecular interactions between F. gigantica and buffalo during secondary infection and facilitate the identification of new potential immunoregulatory molecules.

A critical review of consumer responsibility in promoting sustainable cocoa production.

Consumer buying behavior can be defined as all the different steps that consumers follow before purchasing a good or service. Web browser research, involvement in online networking discussions, and a range of other activities might be a part of this process. Despite the negative effects of its production chain on the environment, and on the socio-economical condition of local farmers, chocolate products are among the most distributed food and beverage items in the world. In this review, the consumer responsibility for sustainable cocoa production is described. This study determines the consumer opinions and attitudes on the different operations pursued in the production chain of chocolate, from the collection of cocoa beans to their processing into different final products. For this, data on life cycle assessment from some studies was gathered to identify and investigate links between the production chain of different types of chocolate (dark, white, milk) and its impact on natural resources so that the sensitivity of consumers to purchase more sustainable products can be evaluated. This approach revealed that consumers will not only purchase chocolate because of its good quality or health benefits, but they also consider it the most sustainable product.

Toward More Realistic Estimates of Product Displacement in Life Cycle Assessment.

Life-cycle assessment (LCA) is one of the most widely applied methods for sustainability assessment. A main application of LCA is to compare alternative products to identify and promote those that are more environmentally friendly. Such comparative LCA studies often rest on, explicitly or implicitly, an idealized assumption, namely, 1:1 displacement between functionally equivalent products. However, product displacement in the real world is much more complicated, affected by various factors such as the rebound effect and policy schemes. Here, we quantitatively review studies that have considered these aspects to evaluate the magnitude and distribution of realistic displacement estimates across several major product categories (biofuels, electricity, electric vehicles, and recycled products). Results show that displacement ratios concentrate around 40-60%, suggesting considerable overestimation of the benefits of alternative products if the 1:1 displacement assumption was used. Overall, there have been a small number of modeling studies on realistic product displacement and their scopes were limited. Additional research is needed to cover more product categories and geographies and improve the modeling of market and policy complexities. As such research accumulates, their displacement estimates can form a database that can be drawn upon by comparative LCA studies to more accurately determine the environmental impacts of alternative products.

Hematite tailings to high-purity silica: Mechanistic studies and life cycle assessment analysis.

This study aimed to recover high-purity silica from hematite tailings (HTs) using superconducting high-gradient magnetic separation (S-HGMS) technology. This process involved converting silica into a silicone-rich concentrate and subsequently employing a fluorine-free mixed acid to leach the silicon-rich concentrate to remove impurities and achieve refinement and purification. The optimization of the S-HGMS process was conducted using the "Box-Behnken Design" method, resulting in the following optimal conditions: a pulp concentration of 50 g/L, a magnetic velocity ratio of 0.076 T s/m, and a pulp velocity of 500 mL/min. These conditions yielded a silica grade range of 61.905% in the HTs to 91.818% in the silicon-rich concentrate, with corresponding recovery rates of 53.031%. Under the optimized leaching process, this resulted in an increase in the silica content from 91.818% in the silicon-rich concentrate to 99.938% in high-purity silica. Additionally, by analyzing the production process of 1 kg of high-purity silica from HTs using the process LCA method, environmental hotspots were identified, and corresponding solutions were proposed. This approach is vital for efficient utilization of HTs as a resource. This process has low energy consumption and is environmentally friendly, enabling the reduction of hematite tailings. It has a wide range of applications and offers substantial economic benefits, rendering it a promising candidate for industrial applications.

Cradle to gate life-cycle assessment of battery grade nickel sulphate production through high-pressure acid leaching.

The rising global demand for high-purity nickel (Ni) sulphate, primarily used in lithium-ion batteries, is largely met by processing Indonesian laterite ores via hydrometallurgy. However, this supply chain is associated with significant environmental challenges and lack of transparent industrial data. This study uses a cradle-to-gate life cycle assessment (LCA) approach to quantify the greenhouse gas (GHG) emissions and energy use associated with the production of mixed hydroxide precipitate (MHP) from low-grade Indonesian laterites via high-pressure acid leaching (HPAL), which is then refined in China for the production of battery-grade nickel sulphate hexahydrate (NiSO4·6H2O, NSH). Fifteen impact categories are analyzed using established impact assessment and allocation (mass and economic) methods. The analysis reveals that feed preparation/HPAL and purification are the stages that contribute most to environmental impacts and in particular to global warming potential (GWP). Mass allocation results in higher environmental impacts, with 36.8 kg CO2-eq per 1 kg of Ni in NSH for GWP, compared to 33.8 kg CO2-eq per 1 kg of Ni in NSH when economic allocation is used. Sensitivity analysis shows a potential reduction (up to 13 %) in key impact categories if production of NSH is fully integrated in Indonesia or a greener electricity mix is used. Overall, our results indicate that the production of MHP in Indonesia and its refinement to NSH in China has a GWP about two times higher than the global average. Given the limited number of LCA studies for the production of battery-grade nickel, this study highlights major environmental concerns for the NSH production process from Indonesian laterites and identifies opportunities for improvement, towards a more sustainable global battery supply chain.

On the Nature of the Last Common Ancestor: A Story from its Translation Machinery.

The Last Common Ancestor (LCA) is understood as a hypothetical population of organisms from which all extant living creatures are thought to have descended. Its biology and environment have been and continue to be the subject of discussions within the scientific community. Since the first bacterial genomes were obtained, multiple attempts to reconstruct the genetic content of the LCA have been made. In this review, we compare 10 of the most extensive reconstructions of the gene content possessed by the LCA as they relate to aspects of the translation machinery. Although each reconstruction has its own methodological biases and many disagree in the metabolic nature of the LCA all, to some extent, indicate that several components of the translation machinery are among the most conserved genetic elements. The datasets from each reconstruction clearly show that the LCA already had a largely complete translational system with a genetic code already in place and therefore was not a progenote. Among these features several ribosomal proteins, transcription factors like IF2, EF-G, and EF-Tu and both class I and class II aminoacyl tRNA synthetases were found in essentially all reconstructions. Due to the limitations of the various methodologies, some features such as the occurrence of rRNA posttranscriptional modified bases are not fully addressed. However, conserved as it is, non-universal ribosomal features found in various reconstructions indicate that LCA's translation machinery was still evolving, thereby acquiring the domain specific features in the process. Although progenotes from the pre-LCA likely no longer exist recent results obtained by unraveling the early history of the ribosome and other genetic processes can provide insight to the nature of the pre-LCA world.

Advancements in sustainable production of biofuel by microalgae: Recent insights and future directions.

Microalgae is considered as sustainable and viable feedstock for biofuel production due to its significant advantages over terrestrial plants. Algal biofuels have received significant attention among researchers and energy experts owing to an upsurge in global energy issues emanating from depletion in fossil fuel reserves increasing greenhouse gases emission conflict among agricultural crops, traditional biomass feedstock, and potential futuristic energy security. Further, the exploration of value-added microalgae as sustainable and viable feedstock for the production of variety of biofuels such as biogas, bio-hydrogen, bioethanol, and biodiesel are addressed. Moreover, the assessment of life-cycle, energy balance, and environmental impacts of biofuel production from microalgae are briefly discussed. The present study focused on recent advancements in synthetic biology, metabolic engineering tools, algal bio refinery, and the optimization of algae growth conditions. This paper also elucidates the function of microalgae as bio refineries, the conditions of algae-based cultures, and other operational factors that must be adjusted to produce biofuels that are price-competitive with fossil fuels.

Lateral extra-articular tenodesis in association to All-inside anterior cruciate ligament reconstruction does not modify return to play in basketball players: A comparative cohort study. / La aumentación con tenodesis extraarticular de la reconstrucción del ligamento cruzado anterior asociado a la técnica «all-inside¼ no modifica la vuelta al deporte en jugadores de baloncesto federados: estudio de cohortes comparativo.

INTRODUCTION: Return to play rates after anterior cruciate ligament (ACL) reconstruction range between 50-98% depending on sport professionality, without being modified by the addition of an extra-articular augmentation (EA). The objective of the study is to describe the rate of return to play in our cohort. The hypothesis is that the addition of EA increases that rate. MATERIAL AND METHODS: A retrospective, descriptive and analytical study of a 130 basketball players cohort between 18 and 45 years old, whom underwent ACL reconstruction between the years 2018 and 2022, with a minimum follow-up of 18 months. Data was collected by reviewing medical records. IKDC score was registered after one year from surgery. All patients operated from 2020 received an extra-articular tenodesis. RESULTS: Of all patients, 72.31% returned to training, 70.77% returned to competition and 46.15% returned to the same level of performance prior to injury. The EA group (46.15%) did not increase the rate of return to competition (P=.552) nor to the same level of performance (P=.664). The mean IKDC. score was 86.83 (SD 14.85), and was not higher in the EA group (P=.418). However, its value was higher in the players who returned to training, competition and level of performance (P<.05). EA did not delay the return to play in any group (P=.282). CONCLUSION: To sum up, the EA does not modify the return to sport rate. Higher IKDC values predict a greater return to sport rate. in all groups. Prospective studies with larger sample size and longer follow-up time are required.

GHG emission quantification and reduction pathway of subway shield tunnel engineering: a case study on Guangzhou Metro, China.

The shield method is a commonly used construction technique in subway tunnel engineering. However, studies on greenhouse gas (GHG) emissions specifically in subway shield tunnel engineering are lacking. This study aims to investigate the GHG emission characteristics and GHG reduction pathways during the construction period of subway shield tunnels. Firstly, based on the life cycle assessment (LCA) method, a greenhouse gas (GHG) emission quantification model for the shield tunnel construction period was developed using a multi-level decomposition of construction. Then, the GHG emission level and intensity during the construction period of a case project are quantified, and its emission characteristics and GHG reduction potential points are assessed. Finally, a comprehensive path for GHG reduction in subway shield tunnel engineering is proposed. The research results indicate that constructing 1 km of subway shield tunnel can generate 19,294.28 t CO2eq. Among these, material production element dominates the emissions with a percentage of 89.05%, while transportation and mechanical construction elements contribute 1.81% and 9.14%, respectively. From the structure perspective, the main structure contributes 88.73% of total emissions, while the ancillary structure contributes 11.27%. Among them, the working shaft and tunnel segments are the main sources of emissions for the main structure, accounting for 23.65% and 65.08%, respectively. Connecting channel and end reinforcement are the main emission sources of the ancillary structures, accounting for 43.63% and 31.30%, respectively. These findings provide a scientific foundation for the environmentally friendly transformation of urban railway development regarding pursuing "carbon peaking and carbon neutrality" strategic goals.

A Life Cycle Assessment Study of the Impacts of Pig Breeding on the Environmental Sustainability of Pig Production.

Lifecycle assessment (LCA) quantified changes in environmental impact categories (global warming, eutrophication, etc.) from 2021 to 2030 due to genetic trends in (re)production traits in pig lines of the breeding company Genus-PIC. The 2030 levels were projected with selection index theory based on weightings of traits in the breeding goals and genetic covariances among them. The projected improvement was 0.9% annually for most impact categories. Another LCA compared the impacts of 2021 North American pig production based on PIC genetics versus the industry average. Software openLCA converted material and energy flows to impact categories of frameworks ReCiPe-2016, PEF-3.1, and IPCC-2021. Flows came from data recorded by customers (1.1/4.7 million sows/finishing pigs) and by subscribers to a third-party data aggregator (1.3/9.1 million). PIC genetics have a 7-8% better impact than industry average for 13/18 categories of ReCiPe-2016, 19/25 of PEF-3.1, and all categories of IPCC-2001. Pig breeding delivers positive environmental outcomes as correlated responses to selection for profitability-oriented breeding goals. This trend is additive; technology development will increase it. Different investment levels in breeding population structure and technology and different operational efficiencies of breeding companies cause substantial differences in the environmental impact of pig production.

Comparative life cycle assessment of excreta management systems through composting and biomethanization: Case of a low-income tropical country.

Low-income tropical regions, such as Haiti, grapple with environmental issues stemming from inadequate sanitation infrastructure for fecal sludge management. This study scrutinizes on-site sanitation systems in these regions, evaluating their environmental impacts and pinpointing improvement opportunities. The focus is specifically on systems integrating excreta valorization through composting and/or anaerobic digestion. Each system encompasses toilet access, evacuation, and sludge treatment. A comparative life cycle assessment was undertaken, with the functional unit managing one ton of excreta in Haiti over a year. Six scenarios representing autonomous sanitation systems were devised by combining three toilet types (container-based toilets (CBTs), ventilated improved pit (VIP) latrines, and flush toilets (WC)) with two sludge treatment processes (composting and biomethanization). Biodigester-based systems exhibited 1.05 times higher sanitary impacts and 1.03 times higher ecosystem impacts than those with composters. Among toilet types, CBTs had the lowest impacts, followed by VIP latrines, with WCs having the highest impacts. On average, WC scenarios were 3.85 times more impactful than VIP latrines and 4.04 times more impactful than those with CBTs regarding human health impact. Critical variables identified include the use of toilet paper, wood shavings, greenhouse gas emissions, and construction materials.

Spatial heterogeneity in the properties of hydroponic wheat fodder and its sustainability.

This study was conducted to determine the heterogeneity of the quantitative and qualitative properties of fodder growth in cultivated hydroponic wheat fodder (HWF) in the growth tray area and to evaluate the impact on the environment. HWF was grown using nutrient film technique. Yield productivity (YP) of HWF in the growth tray area was divided into four characteristic zones (A, B, C, and D). The most fertile zone A accounted for only 22.3 ± 4.2% of the entire growth tray area, while zone B accounted for 44.7 ± 4.0%. Zones C and D, which accounted for 28.0 ± 1.3% and 5.0 ± 0.3% area, respectively, pose various problems for forage production, i.e., they negatively impact the quantity and quality of HWF, as well as the environment. If all areas in the growth tray support the highest fodder YP (zones A and B), then one kg of dry wheat grains will yield about 6-7 kg of HWF (consisting of 10.7-12.4% dry matter, 17.3-17.5% crude protein, 1.8-2.3% starch, 13.1-14.4% crude fiber, and 4.5-4.6% ether extract). Results of life cycle assessment show that HWF with YPs of 3-5 kg from one kg of dry grains (zones C and D) has the most adverse impact on the environment (150 and 220 kg CO2eq t-1). Under optimum conditions (zone A), CO2eq varied from 94 to 115 kg CO2eq t-1 of feed. Environmentally, HWF production had the most impact on marine aquatic ecotoxicity, abiotic depletion, global warming potential, and freshwater aquatic ecotoxicity.

Changes in patterns of multimorbidity and associated with medical costs among Chinese middle-aged and older adults from 2013 to 2023: an analysis of repeated cross-sectional surveys in Xiangyang, China.

Background: Multimorbidity has become a major public health problem among Chinese middle-aged and older adults, and the most costly to the health care system. However, most previous population-based studies of multimorbidity have focused on a limited number of chronic diseases, and diagnosis was based on participants' self-report, which may oversimplify the problem. At the same time, there were few reports on the relationship between multimorbidity patterns and health care costs. This study analyzed the multimorbidity patterns and changes among middle-aged and older people in China over the past decade, and their association with medical costs, based on representative hospital electronic medical record data. Methods: Two cross-sectional surveys based on representative hospital data were used to obtain adults aged 45 years and older in Xiangyang in 2013 (n = 20,218) and 2023 (n = 63,517). Latent Class Analysis was used to analyze changes in the patterns of multimorbidity, gray correlation analysis and ordered logistics model were used to assess the association of multimorbidity patterns with medical expenses. The diagnosis and classification of chronic diseases were based on the International Classification of Diseases, Tenth Revision codes (ICD-10). Results: The detection rate of chronic disease multimorbidity has increased (70.74 vs. 76.63%, p < 0.001), and multimorbidity patterns have increased from 6 to 9 (2013: Malignant tumors pattern, non-specific multimorbidity pattern, ischemic heart disease + hypertension pattern, cerebral infarction + hypertension pattern, kidney disease + hypertension pattern, lens disease + hypertension pattern; new in 2023: Nutritional metabolism disorders + hypertension pattern, chronic lower respiratory diseases + malignant tumors pattern, and gastrointestinal diseases pattern) in China. The medical cost of all multimorbidity patients have been reduced between 2013 and 2023 (RMB: 8216.74 vs. 7247.96, IQR: 5802.28-15,737 vs. 5014.63-15434.06). The top three specific multimorbidity patterns in both surveys were malignancy tumor pattern, ischemic heart disease + hypertension pattern, and cerebral infarction + hypertension pattern. Hypertension and type 2 diabetes are important components of multimorbidity patterns. Compared with patients with a single disease, only lens disorders + hypertension pattern were at risk of higher medical costs in 2013 (aOR:1.23, 95% CI: 1.03, 1.47), whereas all multimorbidity patterns were significantly associated with increased medical costs in 2023, except for lens disorders + hypertension (aOR:0.35, 95% CI: 0.32, 0.39). Moreover, the odds of higher medical costs were not consistent across multimorbidity patterns. Among them, ischemic heart disease + hypertension pattern [adjusted odds ratio (aOR):4.66, 95%CI: 4.31, 5.05] and cerebral infarction + hypertension pattern (aOR: 3.63, 95% CI: 3.35, 3.92) were the two patterns with the highest risk. Meanwhile, men (aOR:1.12, 95CI:1.09, 1.16), no spouse (aOR:1.09, 95CI: 1.03, 1.16) had a positive effect on medical costs, while patients with total self-pay (aOR: 0.45, 95CI: 0.29, 0.70), no surgery (aOR: 0.05, 95CI: 0.05, 0.05), rural residence (aOR: 0.92, 95CI: 0.89, 0.95), hospitalization days 1-5 (aOR: 0.04, 95CI: 0.04, 0.04), and hospitalization days 6-9 (aOR: 0.15, 95CI: 0.15, 0.16) had a negative impact on medical costs. Conclusion: Multimorbidity patterns among middle-aged and older adults in China have diversified over the past decade and are associated with rising health care costs in China. Smart, decisive and comprehensive policy and care interventions are needed to effectively manage NCDS and their risk factors and to reduce the economic burden of multimorbidity on patients and the country.

Heterogeneity in public health service utilization and its relationship with social integration among older adult migrants in China: a latent class analysis.

Background: The older adult migrant population in China is on the rise, which presents challenges for the national public health service system. However, the heterogeneity of public health service utilization and its relationship with social integration among the older adult migrant population remains unclear. This study aims to explore the heterogeneity the public health service utilization and how it relates to their social integration. Methods: A total of 6,178 older adult migrants from the China Migrants Dynamic Survey (CMDS) in 2017 were included in this study. Exploratory factor analysis was used to categorize social integration into four dimensions. Latent class analysis (LCA) was used to identify different sub-groups of public health service utilization. ANOVA and multivariate logistic regression were used to determine the characteristics of different sub-groups. Results: Three potential classes of public health service utilization were identified: low utilization of basic public health services class (N = 3,264,52.756%), medium utilization of basic public health services class (N = 1,743,28.172%), and high utilization of basic public health services class (N = 1,180,19.072%). Gender, education, extent of mobility, and move alone or not, flow time were all predictors of the class of public health service utilization. There were significant differences in social integration across potential categories (p<0.0001). Conclusion: The utilization of public health services of the older adult migrants is affected by many aspects. Social integration deserves attention as a significant influencing factor in the utilization of public health services. The government should pay attention to the characteristics of the older adult migrants and formulate relevant policies in a targeted manner in order to improve the utilization of public health services of the older adult migrants.

Materials and Products Development Based on a Novelty Approach to Quality and Life Cycle Assessment (QLCA).

The development of materials and the products made from them should respond to new challenges posed by market changes and also by climate change. Therefore, the objective of this investigation was to develop a method that supports the sustainable development of materials and the products made from them based on an aggregated indicator of quality and environmental load in the life cycle (QLCA). The testing and illustration of the QLCA method included a passenger car tyre and nine prototypes. These prototypes were described using eight quality criteria: season, class, size of the load index, speed index, rolling, adhesion, and external noise. Then, customer expectations regarding the importance of the criteria and satisfaction with the indicators in the current and modified states were obtained. Based on the customer assessment, the quality indicators of the prototypes were assessed. This assessment was supported by the weighted sum model (WSM) and the entropy method. Then, life cycle assessment for the reference tyre was performed using the Ecoinvent database in the OpenLCA program. LCA indicators were modelled for other prototypes, taking into account quality changes. As a result of the verification of the method, an aggregated QLCA indicator was estimated, based on which it was possible to select the most favourable (qualitatively and environmentally) prototype out of nine. This was the P4 prototype (QLCA = 0.57). The next position in the ranking was taken by P7 (QLCA = 0.43). The QLCA method can be used to determine the direction of development of materials and products in terms of their sustainable development.