Search Results (22,406)

The sustainability of rural areas depends on effective wastewater management to reduce human impact on the environment, including the risk of pollution to surface water, groundwater, and soil from human waste. However, organized sanitation systems, which include pipeline networks and wastewater treatment plants in rural communities with low population densities, often have very low profitability and cost-efficiency, which greatly reduces their acceptance and residents’ willingness to pay. This study examines the economic profitability and cost-efficiency of selected on-site household sewage collection and treatment systems operating under real economic conditions in Poland. An evaluation was conducted on seven contemporary models of individual bioreactors, as well as a standard anaerobic septic tank equipped with drainage filters. Additionally, all options were tested on permeable and poorly permeable soils. For each variant, investment costs, as well as operation and maintenance expenses, were calculated. Financial evaluation utilized indicators of economic profitability and cost-efficiency, including the Payback Period, Net Present Value, Benefits–Cost Ratio, and Dynamic Generation Costs. The potential financial benefits included savings from avoiding the use of holding septic tanks and sewage transport by slurry wagons. All the studied designs of on-site sanitary sewage management showed significant economic feasibility and cost-efficiency. Full article

Background: Emotional disturbances such as anxiety and depression are common in breast cancer patients and may intensify during systemic therapy. This study aimed to assess changes in the severity of anxiety and depression among women undergoing neoadjuvant chemotherapy and to identify factors influencing emotional outcomes. Methods: A total of 211 women with stage I–III breast cancer treated at the Podkarpackie Oncology Center in Brzozów, Poland, were included. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) one week before and three weeks after chemotherapy. Statistical analyses were performed using the Wilcoxon signed-rank test and descriptive statistics (STATISTICA v.13). Results: After chemotherapy, anxiety and depression levels increased significantly. Nearly half of the patients experienced clinically relevant anxiety, and over one-third showed symptoms of depression. The emotional burden appeared particularly high among women reporting financial difficulties. In contrast, no clear associations were found with marital status, place of residence, or cancer stage. Conclusions: Chemotherapy in breast cancer patients is associated with a significant increase in anxiety and depression severity. Routine psychological assessment and psycho-oncological support should be implemented as integral components of oncological care, with particular attention to patients in disadvantaged socioeconomic conditions. Full article

Yukon residents often must travel long distances to access specialized cancer care, which may impact cancer treatment patterns. We conducted a retrospective study to characterize all adult breast, prostate, colorectal, and lung cancer cases from the Yukon, diagnosed from 2009 to 2021 and seen in consultation at BC Cancer. We collected data on demographics, tumour characteristics and treatment, including timepoints for cancer care. A secondary analysis of non-referred cases was conducted. There were a total of 336 breast, 270 prostate, 279 colorectal and 266 lung cancer cases diagnosed in the Yukon from 2009 to 2021, of which 298 (88.7%), 120 (44.4%), 206 (73.8%) and 204 (76.7%) cases were referred to BC Cancer, and 266 (79.2%), 118 (43.7%), 204 (73.1%) and 183 (68.8%) were included in this study, respectively. Most cases were diagnosed at an early stage (breast: 92.9%, prostate: 82.2%, colorectal: 72.1%, lung: 45.9%). Nearly 70% of cases resided in Whitehorse (Yukon’s capital), where most Yukon residents live. Compared to available published Canadian timepoints, Yukon patients had similar or shorter wait times in 13 of 22 timepoints along the pathway to diagnosis and treatment. However, time from biopsy to surgery had the longest relative wait times across all tumour groups (range: 26–60% longer). Our study provides baseline data that can help inform cancer care provision for Yukon residents. Full article

The ability to precisely prepare microfluids with targeted concentrations is critical for numerous applications, including protein crystallization and drug efficacy evaluation. This study presents an efficient microfluidic method for the continuous preparation of fluids at desired concentrations utilizing AC electroosmosis (ACEO). Two miscible fluids of different initial concentrations are introduced through separate inlets. Target concentrations are achieved through ACEO-driven mixing, where fluid manipulation via electric signal and flow velocity control enables precise concentration adjustment at the outlet. To elucidate the concentration control mechanism via ACEO, we develop a three-dimensional numerical model coupling electric, flow, and concentration fields. Our results demonstrate that concentration modulation is significantly influenced by intrinsic fluid properties and external control parameters, including fluid viscosity, conductivity, axial fluid velocity, driving voltage, and signal frequency. Specifically, higher fluid viscosity and conductivity dampen electroosmotic flow, necessitating increased voltage to achieve target concentration. Axial fluid velocity determines the residence time in the mixing zone, directly affecting mixing efficiency and concentration control effect. The intensity of ACEO flow increases with applied voltage, enabling tunable mixing performance and outlet concentration. Overall, the simplicity of device design combined with precise concentration manipulation makes this method particularly attractive for applications requiring accurate fluid preparation. Full article

Over 292 million tons of municipal solid waste (MSW) are generated annually in the United States, with more than half disposed of in landfills. Municipal solid waste landfills (MSWLFs) are stationary sources of air pollution and potential health risks for nearby communities. The Agency for Toxic Substances and Disease Registry (ATSDR) has completed over 300 public health assessments (PHAs) and related investigations at MSWLFs and open dumps since the 1980s. This paper reviews the ATSDR’s evaluations of air pathway concerns at 125 MSWLF sites assessed between 1988 and early 2025, with many being evaluated during the 1990s. Most sites were located in the Midwest and Northeast, and only 25% remained active. The ATSDR found no air-related public health hazard at 86% of sites. At sites where hazards were identified, common issues included elevated outdoor or indoor toxicants (e.g., hydrogen sulfide, benzene, trichloroethylene, and mercury) and unsafe methane accumulations. Contributing factors included older site designs, inadequate gas-collection, subsurface fires, and distance from nearby residences. Corrective actions effectively reduced exposures at the affected sites. Results suggest that well-located and maintained landfills minimize public health hazards, while aging or poorly managed sites pose risks. Continued monitoring and research are warranted as waste management shifts toward reducing, reusing, recycling, composting, and energy-recovery technologies to improve efficiency, advance technologies, and address systemic public health challenges. Full article

Background/Objectives: Infective endocarditis (IE) remains a rare but increasingly complex condition, posing significant challenges for cardiologists and cardiac surgeons. Blood groups from the ABO/Rh system have been associated with susceptibility to various diseases, including infections and bacterial colonization tendencies. However, data on the distribution of ABO/Rh blood types among IE patients are lacking. We hypothesized that the prevalence of ABO/Rh blood types among IE patients differs from their frequency in the general population. This study aimed to assess the distribution of ABO/Rh blood types in the LODZ-ENDO database in comparison to general populations. Methods: LODZ-ENDO is a single-center retrospective study conducted in a tertiary cardiology and cardiac surgery facility serving 2.35 million residents. All consecutive patients with confirmed IE hospitalized between 1 January 2015 and 1 October 2025 were included. Clinical data and ABO/Rh blood types were collected and compared with national population data using Fisher’s exact and chi-square tests. Results: A total of 329 patients with IE were analyzed (median age 61 [41–68] years; 69% men), of whom 227 underwent cardiac surgery. Overall ABO/Rh distribution differed significantly from the general population (p = 0.033), driven by a tendency to an overrepresentation of B− (LODZ-ENDO 5.2% vs. Poland 2%; OR 2.88; 95% CI 1.17–7.29; p = 0.03; power 0.89; p(adj) = 0.23). Considering regional demographics and blood use (≈3 units per surgery), this represents an excess annual use of 1.9 B− units, equal to 0.23% of regional B− reserves, with additional indirect depletion of O− blood. Based on WHO data, if this overrepresentation exists elsewhere, IE-related surgeries could consume 0.2–1.3% of national B− stocks in smaller European countries such as Malta, Iceland, Luxembourg, Cyprus, Estonia, Lithuania, Latvia, and Slovenia. Conclusions: This, probably the first report of B− blood type overrepresentation in IE indicates disproportionate use of a rare blood group, highlighting the need for targeted blood management strategies, especially near specialized cardiac surgery centers. Full article

Objective: Historically, television has been regarded as the mass medium that is most closely associated with audiences’ needs and expectations. In the context of rapid population ageing, older adults now inhabit a progressively important place in society, and they remain the most frequent consumers of broadcast television. This study investigates the formative role of television among Portuguese older adults—combining informal learning, cognitive engagement, and social connection. It explores how TV contributes to well-being and participation in later life. Methods: An anonymous survey was conducted with 203 participants aged 65 to 94. Results: Television continues to play a fundamental role in older adults’ everyday lives, mitigating loneliness and promoting happiness, information, and life satisfaction. We also saw that higher TV consumption is related with superior income and residence in urban areas. Conclusions: The findings highlight television’s enduring formative and compensatory functions and contribute to ongoing debates on active ageing, media literacy, and digital inclusion among older adults. Full article

Ground-borne vibrations caused by railway traffic represent a significant environmental concern, particularly in densely populated or vibration-sensitive urban areas. These phenomena can lead to discomfort and annoyance among residents, interfere with the operation of sensitive equipment, and even threaten the integrity of heritage sites or structurally vulnerable buildings and infrastructures. Building on these concerns, this paper presents a comprehensive review of the current state of knowledge on the subject. It begins by examining the impacts of ground-borne vibrations on both people and structures, followed by an overview of the regulatory frameworks implemented in different countries to manage these effects, with a focus on four examples from Europe and North America. The review then systematically explores the key factors associated with the generation and propagation of ground-borne noise and vibrations. Furthermore, prediction methodologies are categorised into four groups—analytical and semi-analytical, numerical, empirical and AI-based models—and critically assessed. Finally, the paper reviews mitigation strategies applied at the source, along the propagation path, and at the receiver, assessing their effectiveness in reducing the identified impacts. Full article

This study evaluates resident satisfaction with small-town infrastructure and generates a policy-ready ranking of improvement priorities using a modified importance–performance analysis (IPA) that infers indicator importance statistically rather than from self-reported scores. We surveyed small towns in the new districts of Wuhan, China, and developed a resident satisfaction-based evaluation framework spanning road and transport, basic living facilities, public services, public activity space, and townscape and character. We assessed reliability in SPSS, estimated implicit importance via partial correlations with overall satisfaction, and mapped indicators into quadrants to set priorities. Results indicate that overall performance is perceived as generally good, yet road and transport and townscape and character consistently emerge as high importance/low satisfaction domains, and there was notable variation across towns. The framework offers a replicable, user-centered diagnostic that turns resident feedback into a ranked set of priority indicators to guide targeted investment and operations, with transferability to comparable regions. Full article

Ultrafine particles, as raw materials for various industries such as construction and environmental protection, are currently obtained through repeated ball milling and multiple classifications, but classification efficiency remains at a low level. Based on the principle of hydrocyclone classification, this paper designs a hydrocyclone with a triple-vortex finder structure that can achieve finer particle size distributions without altering the main structure of the hydrocyclone. The classification performance of the triple-vortex finder hydrocyclone is investigated through numerical analysis and experimental methods, with numerical comparisons made to single-vortex finder and double-vortex finder structures. The results indicate that with an increase in the number of vortex finders, the static pressure and tangential velocity gradually decrease, reducing the likelihood of tangential vortex formation while meeting classification requirements. The axial velocity in the triple-vortex finder structure is significantly reduced, which extends the residence time within the hydrocyclone and facilitates sufficient particle classification. As the number of vortex finders increases, the zero-velocity envelope surface (LZVV) gradually migrates inward, enlarging the external swirling classification space. Through numerical and experimental analyses, it is found that the triple-vortex finder hydrocyclone exhibits the highest classification efficiency, the strongest cutting ability, and the best classification accuracy. Compared to the single-vortex finder structure, the cutting particle size of the triple-vortex finder hydrocyclone decreases by 2.5 µm, and the content of fine particles in the underflow is reduced by 4.36 percentage points, effectively decreasing the fine particle content in the underflow. The quality efficiency improves by 18.85 percentage points compared to the single-vortex finder, while the quantity efficiency shows no significant decline. The obtained data provide a theoretical foundation and data support for the structural design of the new hydrocyclone. Full article

Globally, the rise in car ownership and usage has intensified parking challenges, particularly within central business districts (CBDs) of many developed cities. Scarce parking infrastructure and escalating land values have further exacerbated these issues, leading to heightened competition among business owners, residents, shoppers, and clients for the limited available paid and free on-street parking spaces. Against this backdrop, the present study sought to model the determinants of motorists’ parking challenges using a recursive structural equation model (RSEM), drawing on empirical evidence from Greater Kumasi, Ghana. Primary data were collected through a structured survey involving 1000 drivers within the designated catchment area, employing cluster and systematic sampling techniques to ensure representativeness. The findings reveal that four out of five structural paths of the constructs exerted significant influences on the structural model components. Both time-related indices and parking costs demonstrated direct and indirect effects on parking challenges, with vehicle type serving as a mediating variable. Furthermore, most of the measurement models significantly impacted the latent factors, either positively or negatively, highlighting the complex interrelationships between parking behavior and underlying determinants. Overall, this study makes several contributions: it provides localized empirical evidence from a developing-country context, offers theoretical refinements to existing models, demonstrates methodological rigor through the application of RSEM, and proposes practical policy insights to address urban parking challenges in rapidly growing African cities such as Kumasi. Full article

The 15 min city concept seeks to promote health, well-being, and quality of life by ensuring that essential services are located within a 15 min walking or cycling distance from housing and are accessible through sustainable modes of transportation. This study aims to evaluate the compliance of this concept in a developing country context and provide supporting evidence by examining if residing within the 15 min reach to basic services affects perceived health, perceived accessibility, and life satisfaction. To assess pedestrian accessibility in Lahore, Pakistan, we adapted the NEXT proximity index—originally developed as part of the Landscape Metropolis Project in Italy—which scores 15 min access using open data sources. A network analysis was conducted to determine the shortest travel times to various points of interest, including education, transportation, healthcare, shops, restaurants, leisure spaces, places of worship, and financial services. Each hexagonal unit in the study area was assigned an access score proportional to its proximity to these facilities. These access scores were then analyzed using multiple regression models, based on survey data collected from 519 university students regarding their perceived health, perceived accessibility, and life satisfaction. According to the network analysis conducted using WorldPop estimates of Lahore’s population, only up to 30% of the population resides in areas that qualify as a 15 min city for each facility type. Moreover, access to bus stops significantly enhances both perceived accessibility and life satisfaction, while proximity to healthcare services shows the strongest positive association with life satisfaction. Full article

Background/Objectives: Motion sickness is a prevalent neuro-vestibular syndrome that affects individuals across various modes of transport and can significantly impact quality of life and travel safety. This study aimed to assess the prevalence, severity, and associated risk factors of severe dizziness related to motion sickness among adult residents in the Kingdom of Saudi Arabia (KSA), with particular focus on socio-demographic and behavioral determinants. Methods: A cross-sectional survey was conducted among 349 participants recruited primarily from the Riyadh region. A structured questionnaire captured demographic variables, personal health history, and experiences of dizziness and related symptoms during air or metro travel. Chi-square tests and multivariable logistic regression were applied to examine associations between dizziness and potential predictors, with p ≤ 0.05 considered significant. Results: Overall, (23.5%) of respondents reported experiencing severe dizziness during metro travel (82/349). Females were more affected than males (32.1% vs. 15.8%; χ²(1) = 12.06, p = 0.0005, Cramer’s V = 0.186), although this association lost significance in the adjusted model. Height showed a borderline association (p = 0.053). In multivariable analysis, previous similar episodes were the strongest independent predictor of dizziness (aOR 15.63, 95% CI 6.40–38.16, p < 0.001). ANOVA revealed no difference in severity by sex or height (p > 0.7). Conclusions: Motion sickness affects nearly one-quarter of Saudi metro travelers (23.5%) and is predominantly influenced by a history of previous similar episodes rather than demographic factors. These findings underscore the need for targeted preventive strategies, ergonomic vehicle design, and public health education to mitigate the burden of motion sickness in the KSA’s expanding transportation systems. Full article

Background/Objectives: Falls are a leading cause of hospitalization, injury, and healthcare spending among older adults. Surveillance data on local falls, especially for those associated with Alzheimer’s disease and related dementias (ADRD), are limited. We conducted a surveillance analysis to describe fall-related hospitalizations and their associations with ADRD in Los Angeles County (LAC). Methods: We analyzed countywide hospital discharge data for LAC residents aged 50+ from 2016–2022 (n = 3,520,927) to assess differences in fall-related hospitalizations by ADRD status and demographic characteristics. We used multivariable logistic regression to identify predictors of fall status and multinomial regression to examine associations between ADRD status and discharge disposition. Results: Of all hospitalizations, 6.8% were fall-related. Individuals hospitalized for falls had longer stays, higher charges, and were more frequently female, older, and White. Fall frequency peaks consistently occurred during winter months, with higher seasonal variation among those without ADRD. After adjustment, ADRD diagnosis was associated with increased odds of fall-related hospitalization (AOR = 1.14) and non-routine discharge, including transfer to a short-term hospital (AOR = 1.35), skilled nursing or other care facilities (AOR = 1.88), and home health care (AOR = 1.23). Conclusions: This study provides one of the most comprehensive local assessments of fall-related hospitalization among older adults in the United States. The findings highlight the increased risk and care complexity among patients with ADRD. As results are descriptive and reflect cross-sectional surveillance, temporality and causality cannot be inferred. Nevertheless, the findings underscore the need for better surveillance and integrated fall prevention, discharge planning, and post-hospital support strategies tailored to individuals with ADRD. Full article

There remains a persistent lack of patient-centered evidence on insurance reform and real-world experiences of patients with chronic disease. This study gathered insights around insurance design from chronic disease beneficiaries. This mixed-methods analysis comprised an online survey and virtual focus group sessions (August to December 2023) involving US residents with chronic disease and health insurance. Patients’ perspectives on insurance design were explored. Survey data were analyzed descriptively. Key themes were identified from focus group transcripts and direct observations. In total, 146 patients across 15 chronic diseases completed the survey; 29 then participated in focus groups. Although most beneficiaries were satisfied with their health plan, concerns centered on prescription medication affordability due to high deductibles and cost exposure, the disproportionate effects of cost exposure based on income, and the unpredictability of out-of-pocket costs. For some, the financial burden led to financial debt, therapy abandonment, mental health issues, and/or worsening of their condition. Overall, there was broad support for policy solutions to redesign insurance and adjust cost exposure for patients with chronic disease. This research offers valuable patient insights into health insurance design in the US to ensure patients’ needs are addressed. Full article