In the United States chronic illnesses have become a way of life for multiple generations – they are the number one cause of death and disability (accounting for more than 70% of deaths), 60% of American adults have at least one chronic disease, and 40% have multiple chronic conditions. Although multiple factors contribute to the growth in chronic disease prevalence, a major factor has been overreliance on health care systems for promoting health and preventing disease. Large health care systems are ill equipped for this role since they are designed to detect, treat, and manage disease, not to promote health or address the underlying causes of disease. Improving health outcomes in the U.S. will require implementing broad-based prevention strategies combining biological, behavioral, and societal variables that move beyond clinical care. According to community medicine, clinical care alone cannot create, support, or maintain health. Rather, health can only ensue from combining clinical care with epidemiology and community organization, because health is a social outcome resulting from a combination of clinical science, collective responsibility, and informed social action. During the past 20 years, our team has developed an operational community medicine approach known as community health science. Our model provides a simple framework for integrating clinical care, population health, and community organization, using community-based participatory research (CBPR) practices for developing place-based initiatives. In the present paper, we present a brief overview of the model and describe its evolution, applications, and outcomes in two major urban environments. The paper demonstrates means for integrating the social determinants of health into collaborative place-based approaches, for aligning community assets and reducing health disparities. We conclude by discussing how asset-based community development can promote social connectivity and improve health, and discuss how our approach reflects the emerging national consensus on the importance of place-based population system change.
The FAO Water Productivity Open Access Portal (WaPOR) offers continuous actual evapotranspiration and interception (ETIa-WPR) data at a 10-day basis across Africa and the Middle East from 2009 onwards at three spatial resolutions. The continental level (250m) covers Africa and the Middle East (L1). The national level (100m) covers 21 countries and four river basins (L2). The third level (30m) covers eight irrigation areas (L3). To quantify the uncertainty of WaPOR version 2 (V2.0) ETIa-WPR in Africa, we used a number of validation methods. We checked the physical consistency against water availability and the long term water balance and then verify the continental spatial and temporal trends for the major climates in Africa. We directly validated ETIa-WPR against in-situ data of 14 eddy covariance stations (EC). Finally, we checked the level consistency between the different spatial resolutions. Our findings indicate that ETIa-WPR is performing well, but with some noticeable overestimation. The ETIa-WPR is showing expected spatial and temporal consistency with respect to climate classes. ETIa-WPR shows mixed results at point scale as compared to EC flux towers with an overall R2 of 0.61, and a root mean square error of 1.04 mm/day. The level consistency is very high between L1 and L2. However, the consistency between L1 and L3 varies significantly between irrigation areas. In rainfed areas, the ETIa-WPR is overestimating at low ETIa-WPR and underestimating when ETIa is high. In irrigated areas, ETIa-WPR values appear to be consistently overestimating ETa. The soil moisture content, the input of quality layers and local advection effects were some of the identified causes. The quality assessment of ETIa-WPR product is enhanced by combining multiple evaluation methods. Based on the results, the ETIa-WaPOR dataset is of enough quality to contribute to the understanding and monitoring of local and continental water processes and water management.
Numerous socio-economic activities depend on the seasonal rainfall and groundwater recharge cycle across the Central American Isthmus. Population growth and unregulated land use changes resulted in extensive surface water pollution and a large dependency on groundwater resources. This work combines stable isotope variations in rainfall, surface water, and groundwater of Costa Rica, Nicaragua, El Salvador, and Honduras to develop a regionalized rainfall isoscape, isotopic lapse rates, spatial-temporal isotopic variations, and air mass back trajectories determining potential mean recharge elevations, moisture circulation patterns, and surface water-groundwater interactions. Intra-seasonal rainfall modes resulted in two isotopically depleted incursions (W-shaped isotopic pattern) during the wet season and two enriched pulses during the Mid-Summer Drought and the months of the strongest trade winds. Notable isotopic sub-cloud fractionation and near-surface secondary evaporation were identified as common denominators within the Central American Dry Corridor. Groundwater and surface water isotope ratios depicted the strong orographic separation into the Caribbean and Pacific domains, mainly induced by the governing moisture transport from the Caribbean Sea, complex rainfall producing systems across the N-S mountain range, and the subsequent mixing with local evapotranspiration, and, to a lesser degree, the eastern Pacific Ocean fluxes. Groundwater recharge was characterized by a) depleted recharge in highland areas (72.3%), b) rapid recharge via preferential flow paths (13.1%), and enriched recharge due to near-surface secondary fractionation (14.6%). Median recharge elevation ranged from 1,104 to 1,979 m asl. These results are intended to enhance forest conservation practices, inform water protection regulations, and facilitate water security and sustainability planning in the Central American Isthmus.
Endotoxins are considered as the major contributors to the pyrogenic response observed with contaminated pharmaceutical products. Recombinant biopharmaceutical products are manufactured using living organisms, including gram-negative bacteria. Upon the death of a gram-negative bacteria, endotoxins (also known as lipopolysaccharides; LPS) in the outer cell membrane are released into the lysate where it can interact with and form bonds with biomolecules, including target therapeutic compounds. Endotoxin contamination of biologic products may also occur through water, raw materials such as excipients, media, additives, sera, equipment, containers closure systems, and expression systems used in manufacturing. The manufacturing process is therefore in critical need to reduce and remove endotoxins by monitoring raw materials and in-process intermediates at critical steps, in addition to final drug product release testing. In this review, a discussion regarding the progression of endotoxin detection techniques, from crude to refined are presented. We provide a brief overview of the upstream processed used to manufacture therapeutic products and then discuss various downstream purification techniques widely used to purify the products off endotoxins. Finally, we investigate the effectiveness of endotoxin purification processes, both from a perspective of precision as well as cost-effectiveness.
Rationale, aims and objectives The main purpose of this paper is to measure the efficiency and ranking of medical diagnostic laboratories by applying a Network Data Envelopment Analysis. Methods In this study, each medical diagnostic laboratory is considered as a decision making unit (DMU) and a network data envelopment analysis (NDEA) model is utilized to calculate the efficiency of each medical diagnostic laboratory. Therefore, we design a series four-stage system composed of three main laboratory processes (the pre-test process, the test process and the post-test process). We also consider sustainability criteria in order to cover social, economic, and environmental problems of health care organizations. Results The results show that three of the 22 considered laboratories are efficient. Therefore, the network DEA approach can lead to performance scores and ultimately real ranking. Also, the average efficiency scores show that the decrease of the reception unit’s efficiency results in a decrease of the efficiency of each laboratory. Therefore, the laboratories can increase the number of patients. Along with the intermediate values of the reception unit and the sampling unit, the efficiency of the reception unit increases, which results in an increase for the overall efficiency of each laboratory. Conclusion The proposed model can appropriately help the administrators and managers to identify inefficient units in their laboratory and ultimately improve the laboratory performance.
Rationale, aims and objectives Creating networked business models is one of the innovative approaches that have the ability and potential for meeting market needs. The purpose of this study is to provide a decision making model for a fair profit sharing among the members of a diagnostic laboratory network while providing a distinctive value for the patients. Methods To identify the members of the network of laboratories, a suitable approach to calculate members’ efficiency scores is proposed. Then, the network members are classified into three groups based on their performance scores. The three groups help administrators identify eligible members, members who need to improve their performance in order to meet the minimum requirements, and members who do not qualify for admission to the network. Since the performance of the members should play a significant role in the fair profit sharing mechanism, the fair allocation of profits among network members is done by the use of Shapely’s value based on the efficiency scores of members. Results The results show that for such a fair mechanism, the efficiency and sample size (the number of samples (blood, urine) taken from the patients by the laboratories), as the two effective factors, have a decisive role in the share of profit of laboratory units of the network. In the Laboratory Services Network, members receive a number of samples according to their performance. As a result, the sample size received has a direct impact on the net income of each member. Conclusion In conclusion, it is evident that the use of Shapely value may help managers in the process of sharing profits among network members in a fair way, thereby improving network performance. In this way, incentive strategies may be created for the members of the network and long-term survival of the network may be achieved.
Building on a previous work, pseudopotential sets are developed and tested for a variety of \(sp^2\) and \(sp^3\) carbon fragments. These fragments contain only one or two explicit protons and electrons, and make use of non-atom-centred potentials. They are tested with Density Functional Theory calculations in a selection of chemical environments in which several physical characteristics, including orbital and first ionisation energies, are found to be well-reproduced. They are then employed in the reproduction of molecular absorption spectra for large organic molecules and carbon allotropes, and are found to recreate both absorption and ECD spectra to a high accuracy. They are also found significantly to increase the computational efficiency of TDDFT calculations in which they are used.
Underpinnings of the distribution of allopolyploid species (hybrids with duplicated genome) along spatial and ecological gradients are elusive. As allopolyploid speciation combines the range of genetic and ecological characteristics of divergent diploids, allopolyploids initially show their additivity and are predicted to evolve differentiated ecological niches to establish in face of their competition. Here, we use four diploid wild wheats that differentially combined into four independent allopolyploid species to test for such additivity and assess the impact of ecological constraints on species ranges. Divergent genetic variation from diploids being fixed in heterozygote allopolyploids supports their genetic additivity. Spatial integration of comparative phylogeography and modeling of climatic niches supports ecological additivity of locally adapted diploid progenitors into allopolyploid species which subsequently colonized wide ranges. Allopolyploids fill suitable range to a larger extent than diploids and conservative evolution following the combination of divergent species appears to support their expansion under environmental changes.
Ecological processes in food webs depend on species interactions. By identifying broad-scaled interaction patterns, important information on species ecological roles may be revealed. Here, we use the group model to examine how spatial resolution and proximity influence the group structure. We examine a dataset from the Barents Sea, with species occurrences for both the whole region and 25 subregions. Specifically, we test how the group structure in the networks differ comparing i) the regional metaweb to subregions and ii) subregion to subregion. We find that more than half the species in the metaweb change groups when compared to subregions. Between subregions, networks with similar group structure are usually spatially related. Interestingly, although species overlap is important for similarity in group structure, there are notable exceptions. Our results highlight that species ecological roles differ depending on fine-scaled differences in patterns of interactions, and that local network characteristics are important to consider.
We have developed a new database of structures and bond energies of 45 noble-gas containing molecules. The structures were calculated by CCSD(T)/aug-cc-pVTZ methods and the bond energies were obtained using CCSD(T)/CBS (complete basis set) method. Many wavefunction-based and density functional theory methods have been benchmarked against the 45 accurate bond energies. Our result showed that the MPW1B95, B2GP-PLYP, and DSD-BLYP functionals with the aug-cc-pVTZ basis set excel on predicting the bond energies of the noble-gas molecules with MUEs (mean unsigned errors) of 1.5-1.9 kcal/mol. When combinations of Dunning’s basis sets are used, the MPW1B95, MPW1PW91, and B2GP-PLYP functional give significantly lower MUEs of 1.1-1.3 kcal/mol. Doubly hybrid methods using B2GP-PLYP and DSD-BLYP functionals and MP2 calculation also provide satisfactory accuracy with MUEs of 1.3-1.4 kcal/mol. If the noble-gas bond energies and the total atomization energies of a group of 109 main-group molecules are considered at the same time, the MPW1B95/aug-cc-pVTZ single-level method (MUE = 2.7 kcal/mol) and the B2GP-PLYP functional with combinations of basis sets (MUEs = 1.8 kcal/mol) give the overall best result.
In Belgium, IWVA uses Managed Aquifer Recharge (MAR) to recharge the aquifer with treated wastewater generated from the communities to sustain the potable water supply on the Belgian coast. This MAR facility is faced with a challenge of reduced infiltration rates during the winter season when pond water temperatures near 4 °C. This study involves the identification of the predominant factor influencing the rate of infiltration through the pond bed. Several factors including pumping rates, natural recharge, tidal influences of the North Sea and pond-water temperature were identified as potential causes for variation of the recharge rate. Correlation statistics and linear regression analysis were used to determine the sensitivity of the infiltration rate to the aforementioned factors. Two groundwater flow models were developed in visual MODFLOW to simulate the water movement under the pond bed and to obtain the differences in flux to track the effects of variation of hydraulic conductivity during the two seasons. A 32 % reduction in vertical hydraulic gradient in the top portion of the aquifer was observed in winter causing the recharge rates to fluctuate. Results showed that water temperature caused a 30 % increase in hydraulic conductivity in summer as compared to winter and has the maximum impact on infiltration rate. Cyclic variations in water viscosity, occurring because of seasonal temperature changes, influence the saturated hydraulic conductivity of the pond bed. Results from the models confirm the impact on infiltration rate by temperature influenced hydraulic conductivity.
Skin sensitization occurs when an exogenous chemical substance forms a covalent adduct with a dermal protein electrophile or nucleophile. This instigates an immune response which leads to inflammation. The local lymph node assay (LLNA) is an in-vivo model used in the assessment of relative skin sensitizing potency of chemicals. The method is time consuming and expensive, as well as poses ethical questions given that a number of mice must be sacrificed for each compound assessed. In this work we investigate the use of an inexpensive, rapid and ethical method to predict the skin sensitization potential of Schiff base chemicals. We employ quantum chemical methods to rationalize the sensitization potential of 22 compounds with a diverse range of activities. To this end we have evaluated the mechanistic profile associated with this type of reaction using gas-phase models. We subsequently use the predicted rate determining barriers and key physico-chemical parameters (such as logP) to establish SAR guidelines to predict the skin sensitization potential for new chemicals. We find that the predicted rate determining barriers for aldehydes, ketone and 1,2 and 1,3 diones generally decrease in the given order, which concurs with the overall trends in sensitization. We find that lipophilicity also plays a role, with those chemicals displaying both low barriers to reaction, and lower lipophilicity (i.e. diones), being more likely to display undesirable skin sensitization effects. These findings are in line with experimental based observations in the literature and point to the value 3D quantum chemical simulations can play in the combination of approaches used to estimate skin sensitization potential of chemicals.
Long-distance migrations by marine fish have long fascinated scientists, but are difficult to track by visual surveys. Here, we propose a new method to easily and precisely track such migrations using stable nitrogen isotopic composition at the base of the food web (δ15NBase), which can be estimated by using compound-specific isotope analysis. δ15NBase exclusively reflects the δ15N of nitrate in the ocean at a regional scale and is not affected by the trophic position of sampled organisms. We initially constructed a δ15NBase isoscape in the northern North Pacific, and determined retrospective δ15NBase values of chum salmon (Oncorhynchus keta) from their vertebral centra. Then, we estimated the migration routes of chum salmon during their skeletal growth by using a state-space model. Our isotope tracking method successfully reproduced a known chum salmon migration route between the Okhotsk and Bering seas, and indicates the presence of a novel migration route to the eastern Bering Sea Shelf during a later growth stage.
Lactic acid producing bacteria are important in many fermentations, such as the production of biobased plastics. Insight in the competitive advantage of lactic acid bacteria over other fermentative bacteria in a mixed culture enables ecology-based process design and can aid the development of sustainable and energy-efficient bioprocesses. Here we demonstrate the enrichment of lactic acid bacteria in a controlled sequencing batch bioreactor environment using a glucose based medium supplemented with peptides and B vitamins. A mineral medium enrichment operated in parallel was dominated by Ethanoligenens species and fermented glucose to acetate, butyrate and hydrogen. The complex medium enrichment was populated by Lactococcus, Lactobacillus and Megasphaera species and showed a product spectrum of acetate, ethanol, propionate, butyrate and valerate. An intermediate peak of lactate was observed, showing the simultaneous production and consumption of lactate, which is of concern for lactic acid production purposes. This study underlines that the competitive advantage for lactic acid producing bacteria primarily lies in their ability to attain a high biomass specific uptake rate of glucose, which was two times higher for the complex medium enrichment when compared to the mineral medium enrichment. The competitive advantage of lactic acid production in rich media can be explained using a resource allocation theory for microbial growth processes.
3D cell culture has developed rapidly over the past 5-10 years with the goal of better replicating human physiology and tissue complexity in the laboratory. Quantifying cellular responses is fundamental in understanding how cells and tissues respond during their growth cycle and in response to external stimuli. There is a need to develop and validate tools that can give insight into cell number, viability and distribution in real-time, non-destructively and without the use of stains or other labelling processes. Impedance spectroscopy can address all of these challenges and is currently used both commercially and in academic laboratories to measure cellular processes in 2D cell culture systems. However, its use in 3D cultures is not straight forward due to the complexity of the electrical circuit model of 3D tissues. In addition, there are challenges in the design and integration of electrodes within 3D cell culture systems. Researchers have used a range of strategies to implement impedance spectroscopy in 3D systems. This review examines electrode design, integration and outcomes of a range of impedance spectroscopy studies and multi-parametric systems relevant to 3D cell cultures. While these systems provide whole culture data, impedance tomography approaches have shown how this technique can be used to achieve spatial resolution. This review demonstrates how impedance spectroscopy and tomography can be used to provide real-time sensing in 3D cell cultures, but challenges remain in integrating electrodes without affecting cell culture functionality. If these challenges can be addressed and more realistic electrical models for 3D tissues developed, the implementation of impedance-based systems will be able to provide real-time, quantitative tracking of 3D cell culture systems.
Tropical montane cloud forests (TMCF) are recognized for their capacity to maintain high dry-season baseflow, and a host of other, ecosystem services. Despite their importance, they are endangered with a multidirectional array of land use changes, including conversion to pasture and crops such as coffee, while there are places where forest is being recovered. However, little is known about the effects of this complex dynamic on catchment hydrology. We investigated the effect of land use on rainfall-runoff response in five neighboring headwater micro-catchments in central Veracruz, Mexico, by comparing primary TMCF (PF), young (20 yr-old) and intermediate (40 yr-old) naturally regenerating TMCF (YF and IF, respectively), shaded coffee (SC), and an intensively grazed pasture (IP). We used a 4-year record of high-resolution rainfall and streamflow (10 min) data, collected from 2015 to 2019. These data were analyzed via hydrologic metrics and statistical tests. Results showed no statistical difference in the regulation capacity of high flows after 20 years of natural regeneration, compared to the PF. In terms of baseflow sustenance, our results suggested that PF and IF better promote this hydrological service than the other land uses, although all the catchments showed high mean annual low flows. SC exhibited a high capacity to modulate peak flows comparable to that of PF, and an intermediate capacity to sustain baseflow, suggesting that the integrated functioning of this catchment was largely preserved. Finally, we found that 40 years of pasture management can decrease the soil hydraulic properties in the area, causing a fivefold increase in the peak discharge response, and a much lower baseflow maintenance compared to PF.