Examining plasma-generated ozone and nitric oxide's role in synthetic textile dye water remediation and ecotoxicological analysis.

Synthetic dyes produced by the textile dyeing industry and released into wastewater contribute significantly to water pollution. This study explores the efficacy and versatility of a novel multi-electrode dielectric barrier discharge (MEDBD) plasma system that mainly generates ozone (O3 generator) and nitric oxide (NO generator) selectively to degrade various synthetic textile dyes, namely Methylene Blue (MB), Congo Red (CR), Methyl Orange (MO), Crystal Violet (CV), and Evans Blue (EB). Plasma achieved selective enrichment of O3 and NO by utilizing optimized plasma generation duty cycles of 15% and 100%, respectively. The proposed O3 generator plasma involves plasma-generated aqua electron impact, excited species, and reactive oxygen species notably O3, which degrades synthetic textile dyes into simple forms such as CO2, H2O, and N2. This approach achieved over 95% degradation of the above synthetic textile dyes when employing the O3 enriched plasma with 2.44 ± 0.21 W of power. Ecotoxicological evaluation, including microbial, human cell, and phytotoxicity evaluations of the O3 generator plasma for MB and CR dye-contaminated water, underscored the potential of this plasma system for environmentally friendly dye degradation. Overall, this study promotes MEDBD plasma, particularly the O3 generator, as a sustainable and efficient solution for treating synthetic dye-contaminated water across industries.

A Scoping Review of Health Equity Interventions in Governmental Public Health.

CONTEXT: Despite major efforts in research, practice, and policy, racial and ethnic disparities in health and health care persist in the United States. Interventions in collaboration with governmental public health may provide ways to address these persistent racial and ethnic health and health care disparities and improve health outcomes. OBJECTIVE: To conduct a comprehensive review of health equity interventions performed in collaboration with public health agencies. DESIGN: This scoping review includes intervention studies from Ovid MEDLINE, PsycINFO, and Academic Search Premier, published between 2017 and 2023. The search strategy used terminology focused on 4 concepts: race/ethnicity, equity, health departments, and epidemiologic studies. ELIGIBILITY CRITERIA: The following inclusion criteria were determined a priori: (1) intervention tailored to reduce racial/ethnic health disparities, (2) public health department involvement, (3) health outcome measures, (4) use of epidemiologic study methods, (5) written in English, (6) implemented in the United States, (7) original data (not a commentary), and (8) published between January 2017 and January 2023. MAIN OUTCOME MEASURES: This review focused primarily on 4 dimensions of racial health equity interventions including intervention components, intervention settings, intervention delivery agents, and intervention outcomes. RESULTS: This review indicated that health equity interventions involving public health agencies focused on the following categories: (1) access to care, (2) health behavior, (3) infectious disease testing, (4) preventing transmission, and (5) cancer screening. Critical strategies included in interventions for reaching racial/ethnic minoritized people included using community settings, mobile clinics, social media/social networks, phone-based interventions, community-based workers, health education, active public health department involvement, and structural/policy change. CONCLUSIONS: This scoping review aims to provide an evidence map to inform public health agencies, researchers, and funding agencies on gaps in knowledge and priority areas for future research and to identify existing health equity interventions that could be considered for implementation by public health leaders.

1918 Influenza Pandemic: In Utero Exposure in the United States and Long-Term Impact on Hospitalizations.

OBJECTIVES: To explore associations between in utero exposure to the 1918 influenza pandemic and hospitalization rates in old age (≥ 70 years) in the United States. METHODS: We identified individuals exposed (mild and deadly waves) and unexposed in utero to the 1918 influenza pandemic (a natural experiment) by using birth dates from the Asset and Health Dynamics Among the Oldest Old survey. We analyzed differences in hospitalization rates by exposure status with multivariate linear regression. RESULTS: In utero exposure to the deadly wave of the 1918 influenza pandemic increased the number of hospital visits by 10.0 per 100 persons. For those exposed in utero to the deadliest wave of the influenza pandemic, high rates of functional limitations are shown to drive the higher rates of hospitalizations in old age. CONCLUSIONS: In utero exposure to the influenza pandemic increased functional limitations and hospitalization rates in old age. Public Health Implications. To determine investments in influenza pandemic prevention programs that protect fetal health, policymakers should include long-term reductions in hospitalizations in their cost-benefit evaluations.

A cluster randomized controlled trial comparing relative effectiveness of two licensed influenza vaccines in US nursing homes: Design and rationale.

BACKGROUND: Influenza, the most important viral infection affecting older adults, produces a substantial burden in health care costs, morbidity, and mortality. Influenza vaccination remains the mainstay in prevention and is associated with reduced rates of hospitalization, stroke, heart attack, and death in non-institutional older adult populations. Influenza vaccination produces considerably lower antibody response in the elderly compared to young adults. Four-fold higher vaccine antigen (high-dose) than in the standard adult vaccine (standard-dose) elicits higher serum antibody levels and antibody response in ambulatory elderly. PURPOSE: To describe the design considerations of a large clinical trial of high-dose compared to standard-dose influenza vaccine in nursing homes and baseline characteristics of participating nursing homes and long-stay (more than 90 days) residents over 65 years of age. METHODS: The high-dose influenza vaccine intervention trial is multifacility, cluster randomized controlled trial with a 2×2 factorial design that compares hospitalization rates, mortality, and functional decline among long-stay nursing home residents in facilities randomized to receive high-dose versus standard-dose influenza vaccine and also randomized with or without free staff vaccines provided by study organizers. Enrollment focused on nursing homes with a large long-stay resident population over 65 years of age. The primary outcome is the resident-level incidence of hospitalization with a primary diagnosis of pulmonary and influenza-like illness, based upon Medicare inpatient hospitalization claims. Secondary outcomes are all-cause mortality based upon the vital status indicator in the Medicare Vital Status file, all-cause hospitalization directly from the nursing home Minimum Data Set discharge records, and the probability of declining at least 4 points on the 28-point Activities of Daily Living Scale. RESULTS: Between February and September 2013, the high-dose influenza vaccine trial recruited and randomized 823 nursing homes. The analysis sample includes 53,035 long-stay nursing home residents over 65 years of age, representing 57.7% of the participating facilities' population. Residents are mainly women (72.2%), white (75.5%), with a mean age of 83 years. Common conditions include hypertension (79.2%), depression (55.1%), and diabetes mellitus (34.4%). The prevalence of circulatory and pulmonary disorders includes heart failure (20.5%), stroke (20.1%), and asthma/chronic obstructive pulmonary disease (20.2%). CONCLUSIONS: This high-dose influenza vaccine trial uniquely offers a paradigm for future studies of clinical and programmatic interventions within the framework of efforts designed to test the impact of changes in usual treatment practices adopted by health care systems. TRIAL REGISTRATION: NCT01815268.

Investigating the synergy of rapidly synthesized iron oxide predecessor and plasma-gaseous species for dye-removal to reuse water in irrigation.

This study explores a novel and sustainable approach to reusing textile wastewater for irrigation. This is investigated by degrading Evans blue dye, a model azo dye, in wastewater by combining iron oxide predecessor (IOP) catalyst with gaseous species generated by multi-electrode cylindrical plasma device (MCPD). Analysis of IOP-plasma gaseous species revealed the generation of different types of reactive oxygen species in solution which were responsible for degradation of model dye. Key factors influencing the degradation process were studied by performing optimization experiments that resulted in rates of up to 0.008 L mg-1 min-1, more than twice as fast as using plasma gas treatment alone. These studies included mechanistic response of MCPD generated gaseous species with the IOP. In particular, reusability testing of IOP affirmed the robustness and performance efficiency up to three cycles. Finally, toxicity analysis revealed not only reduced negative effects on plant growth by the treated wastewater, but also it can used as minerals to plants. These findings highlight the feasibility of the IOP-MCPD system as a sustainable and eco-friendly solution to reduce scarcity of water in irrigation by treating textile effluent.

Enhanced degradation of aqueous caffeine via cylindrical dielectric barrier discharge plasma: Efficacy and toxicity insights.

An environmentally friendly approach for caffeine degradation was explored in this study utilizing cylindrical dielectric barrier discharge (CDBD) plasma. The current-voltage characteristics and the plasma parameters of the CDBD, such as the electron temperature, electron density, density of nitrogen excited states, vibrational temperature, and rotational temperature, were assessed through electrical and optical characterization respectively. Fourier-transform infrared spectroscopy (FTIR) was employed to evaluate the reactive oxygen and nitrogen species (RONS) in the plasma-treated air. The physicochemical properties of deionized water (DW) were measured. To gain a deeper insight into the role of RONS in caffeine degradation, their concentrations in DW were analyzed. Furthermore, the effects of initial concentration, sample volume, and pH on caffeine degradation were investigated. The highest degradation of caffeine was 94% at initial concentration of 50 mg L-1, sample volume 50 mL and in neutral pH. Liquid chromatography-mass spectrometry (LC-MS) was then used to propose the degradation pathway for caffeine. The major reactive species involved in caffeine degradation was ozone. Finally, the phytotoxicity and cytotoxicity of caffeine were assessed before and after plasma treatment with plasma-treated caffeine (PTC) showing minimal toxicity to both plants and cells.

Enhanced dye degradation using plasma bubbles for the sustainable environmental remediation.

This study proposes a novel and eco-friendly approach for wastewater treatment using plasma jet technology under bubble condition. This method allows for the controlled production of highly reactive hydroxyl radicals (OH•) while minimizing unwanted interactions with nitrogen in the air. The presence of bubbles in liquid significantly boosts the diffusion of OH• within the wastewater, leading to a two-fold increase in degradation rate compared to normal condition. The effectiveness of the treatment was confirmed through ultraviolet-visible spectroscopy, which showed a significant decrease in rhodamine B and methyl orange absorbance peaks. Raman spectroscopy further revealed structural changes in both pollutants, indicating successful degradation. Additionally, plasma characteristics like power, electron temperature, and density were monitored to gain deeper insights into the underlying mechanism. Importantly, the process minimizes the formation of harmful secondary pollutants such as ozone and nitrogen oxides. These pollutants were found under concentration of 0.14 mg m-3 which is below established safety thresholds, adhering to World Health Organization guidelines. This research demonstrates that plasma jet treatment in bubble condition not only enhances the degradation efficiency of pollutants in wastewater but also minimizes the formation of harmful byproducts. This represents a significant breakthrough in developing sustainable wastewater treatment technologies.

Investigating plasma activated water as a sustainable treatment for improving growth and nutrient uptake in maize and pea plant.

In this study, an atmospheric pressure air plasma jet (APAPJ) was employed to generate plasma-activated water (PAW), which was applied to treat maize (monocot) and pea (dicot) seeds for evaluating its influence. This research explored APAPJ diagnostics by varying the air feed rate as 1, 2, and 3 liter per minute (Lpm) through current-voltage characterization, optical emission spectroscopy, electron temperature and density, nitrogen metastable state density, and rotational and vibrational temperature of the plasma. Additionally, various reactive oxygen and nitrogen species (RONS) formed and physicochemical properties of PAW were analyzed by varying plasma treatment time from 0 to 8 min. Furthermore, the water uptake of maize (Zea mays) and pea (Pisum sativum) seeds were examined by the measurement of the contact angle. Results indicated that APAPJ has the capacity of fostering germination, growth, chlorophyll, phosphorus, nitrite, nitrate, ammonium ion and leaf area in plants significantly with an optimized 6 min treated PAW for maize and 2 min treated PAW for peas. Among various categories, seeds soaked in PAW and irrigated with PAW exhibited the most outstanding result in germination and plant growth. Non-thermal plasma showed promising green methods for enhancing plant growth and boosting nutrient content.

Examining Satisfaction and Quality in Home- and Community-Based Service Programs in the United States: A Scoping Review.

BACKGROUND AND OBJECTIVES: Long-term services and supports in the United States are increasingly reliant on home- and community-based services (HCBS). Yet, little is known about the quality of HCBS. We conducted a scoping review of the peer-reviewed literature to summarize HCBS consumer, provider, and stakeholder satisfaction with services as a means of assessing quality. RESEARCH DESIGN AND METHODS: We searched PubMed, OVID-MEDLINE, and SCOPUS to identify articles published from 2000 to 2021 that reported on studies describing a U.S.-based study population. Articles were grouped into 3 categories: drivers of positive consumer satisfaction, drivers of negative consumer satisfaction, and provider and stakeholder perspectives on satisfaction. RESULTS: Our final sample included 27 articles. Positive perceptions of quality and reported satisfaction with services were driven by consistent, reliable, and respectful care providers, and adoption of person-centered models of service delivery. Mistreatment of consumers, staff turnover, training, service interruptions, and unmet functional needs were drivers of negative consumer perceptions of quality. Support for caregivers and emphasis on training were identified by providers and stakeholders as important for providing satisfactory services. DISCUSSION AND IMPLICATIONS: Multiple data challenges limit the ability to systematically evaluate HCBS program quality; however, studies examining single programs found that HCBS consumers are more satisfied and associate higher quality with easy-to-navigate programs and professional staff. Efforts to expand HCBS should also include requirements to systematically evaluate quality outcomes.

Feasibility of a cluster-randomized influenza vaccination trial in U.S. nursing homes: Lessons learned.

Influenza severity increases and vaccine effectiveness decreases with age. High-dose influenza vaccine (HD) with quadruple the antigen of standard-dose (SD) vaccine is more efficacious in community-dwelling persons 65 years and older. We evaluated the feasibility of recruiting and randomizing Medicare certified nursing homes (NHs) for a pragmatic cluster-randomized trial comparing HD vs. SD (NCT1720277). Residents were long-stay and at least 65 years old. NH leadership agreed to standard of care random assignment with HD (Fluzone® High-Dose) or SD (Fluzone®) influenza vaccine for their facility for the 2012-2013 influenza season. We used Minimum Data Set (MDS) 3.0 and Vital Status records for pre-specified clinical outcomes: 1) all-cause hospitalization, 2) NH mortality, and 3) functional decline. Intent-to-treat analyses were performed at the resident-level using Cox proportional hazards, multivariable Poisson, and logistic regression models accounting for clustering by facility. We randomized 39 NHs (19 SD and 20 HD), coordinated vaccine delivery, implemented web-based data collection, and accessed MDS data, demonstrating feasibility. There were 2,957 eligible residents (SD 1496; HD 1461); characteristics were similar between groups. A total of 301 (20.1%) of SD and 197 (13.5%) of HD allocated residents were ever hospitalized, (adjusted relative risk 0.680; 95% CI: 0.537, 0.862; p = 0.001). NH mortality was 274 (18.3%) SD vs. 249 (17.1%) HD, adjusted relative risk 0.834; 95% CI: 0.678, 1.027; p = 0.087). There were no differences in decline in functional status (13.4 vs. 13.8%, adjusted relative risk 0.994; 95% CI: 0.774,1.278; p = 0.965). We demonstrate that a pragmatic large-scale trial is feasible in a NH setting.

Palliative Care Consultations in Nursing Homes and End-of-Life Hospitalizations.

CONTEXT: Although specialty palliative care in hospital and outpatient settings is associated with lower acute care use, its impact in U.S. nursing homes (NHs) is unknown. OBJECTIVES: To understand how NH use of palliative care consults is associated with end-of-life hospitalizations. METHODS: Seven consult providers in four states and 24 counties shared data on the number of consult visits and residents served (per NH) in study years 2000-2010. All NHs in the 24 counties were studied (n = 286). An NH-level longitudinal file included consult data, aggregated Medicare resident assessment and claims data, and NH characteristics. Consult introduction was "yes" when 1% of residents received consults. Volume was the number of consult visits per 100 residents, annually. Panel multivariate regression with NH fixed effects examined whether rates of hospital deaths and hospitalizations in the last 30 days of life differentially changed for NHs introducing consults, or increasing consult volume. RESULTS: One hundred seventy (59%) of the 286 NHs introduced consults by 2010. NHs with consults, compared to others, had residents with higher acuity and functional impairment, and lower nurse but higher nursing assistant staffing. Controlling for covariate differences and compared to NHs without consults, NHs introducing consults had a 1% (95% CI -0.021, 0.002) greater reduction in hospital death rates and a 1.6% (95% CI -0.031, -0.002) greater reduction in hospitalizations in the last 30 days of life. No statistically significant associations between volume and study outcomes were observed. CONCLUSION: The introduction of specialty palliative care consults in NHs is associated with overall reductions in end-of-life hospitalizations.