To compare the effects of blue light-filtering and non-blue light-filtering senofilcon A daily disposable contact lenses on color discrimination and contrast sensitivity in healthy young adults with myopia. This comparative study included 68 eyes of 34 myopic adults with best-corrected visual acuity of 0.0 logMAR. All participants were evaluated while wearing blue light-filtering and non-blue light-filtering senofilcon A daily disposable contact lenses. Color discrimination was assessed binocularly using the Farnsworth-Munsell 100 Hue test, with blue-yellow axis local error score (LES), red-green axis LES, and total error score (TES) recorded. Contrast sensitivity was evaluated monocularly using the Spaeth-Richman Contrast Sensitivity (SPARCS) test, and central, peripheral, and total SPARCS scores were compared between the two lens types. No statistically significant differences were observed between blue light-filtering and non-blue light-filtering contact lenses in blue-yellow axis LES (p = 0.130), red-green axis LES (p = 0.275), or TES (p = 0.090). Contrast sensitivity scores were significantly higher with blue light-filtering lenses than with non-blue light-filtering lenses in the central area (p = 0.009), superotemporal area (p = 0.024), inferotemporal area (p = 0.013), and in the total SPARCS score (p = 0.016). No significant differences were found in the superonasal or inferonasal areas. Blue light-filtering senofilcon A daily disposable contact lenses were associated with higher contrast sensitivity in central and selected peripheral visual field regions, without a measurable effect on color discrimination.
The widespread use of disposable polypropylene-based personal protective equipment (PPE) in dentistry contributes significantly to healthcare waste. Sustainable approaches that promote responsible material use within educational clinical settings are increasingly needed to mitigate the environmental footprint of dental training. To evaluate the feasibility of a controlled, sustainability-oriented repurposing strategy for disposable SMS polypropylene surgical gowns in a university dental clinic, focusing on functional performance, user perception, and educational implications. A mixed-methods, quasi-experimental applied study was conducted between August and November 2025. Used SMS gowns underwent standardized inspection, cleaning, disinfection (0.1% sodium hypochlorite), terminal dry heat treatment (70-75 °C), and subsequent transformation into repurposed dental chair covers for use as non-critical barriers during non-aerosol-generating procedures. Functional performance was assessed via structured checklists. User perception and instrument reliability (α = 0.82) were evaluated through validated 5-point Likert-scale questionnaires administered to dental students (n = 148) and professionals (n = 25). This study does not aim to validate microbiological sterility or clinical repurposing of personal protective equipment, but rather to assess sustainability-oriented repurposing into non-critical barriers within an educational dental setting. Of 286 gowns collected, 205 (71.7%) met eligibility criteria and were successfully repurposed. The transformed materials demonstrated adequate stability, resistance to displacement, and tolerance to routine surface disinfection. High acceptance was reported across both groups (Global Index: 3.89/5), with significantly stronger institutional adoption support among professionals (80%) compared to students (66.2%). Preliminary environmental estimation further indicated that the intervention diverted approximately 12.9 kg of SMS polypropylene from disposal, corresponding to an estimated reduction of 20.5 kg CO₂-equivalent emissions. Controlled repurposing of disposable SMS gowns into non-critical barriers is feasible and represents a practical strategy to reduce clinical waste while fostering sustainability competencies in dental education. By integrating functional assessment, stakeholder acceptance, and preliminary environmental impact estimation within a real-world academic workflow, this study provides a replicable systems-integration model that supports the implementation of circular economy principles in dental education.
Electrical stimulation accelerates wound repair by modulating endogenous bioelectric signals that regulate inflammation, angiogenesis, extracellular matrix remodeling, and cellular responses within the wound microenvironment. However, clinical translation has been hindered by cumbersome devices with procedures that disrupt standard wound-care workflows, direct electrode contact with the wound bed, and/or limited stimulation output. Wearable Disposable Electrotherapy (WDE) integrates an electronics-free printed electrochemical architecture into an mm-thick patch that looks and is applied like a conventional bandage. The device is self-powered and delivers a single electrotherapy dose simply by application to the skin. Device dose-control (electrochemical performance) and efficacy were evaluated in a full-thickness excisional wound model in rats, compared with a sham device and a conventional Constant Current (CC) stimulator. WDE or control treatments were applied daily from day 1 through day 13, with endpoint evaluation on day 14. WDE delivered electrical stimulation comparable to CC while reducing the time required to achieve 50% wound closure by 2.08 days (~29%) relative to sham treatment. Histological and immunofluorescence analyses at day 14 demonstrated enhanced tissue remodeling, including increased collagen deposition (~25%), tissue cellularity (~73%), myofibroblast-associated αSMA expression (~2.6-fold), angiogenesis-associated CD31 expression (~2.0-fold), and increased expression of both M2- (CD206, ~2.0-fold) and M1-associated (iNOS, ~1.7-fold) markers compared with sham. A novel cellular-resolution dosimetry model, leveraging charge-based boundary element method accelerated with the fast multipole method (BEM-FMM), provides a biophysical framework linking electrical stimulation with wound microenvironment and tissue repair mechanisms. Together, these findings establish WDE as a practical bioelectric wound dressing that accelerates wound healing and tissue remodeling, with the simplicity and scalability of disposable bandages.
As robotic platform adoption expands, differences in procedural cost for inguinal hernia repair are frequently attributed to surgical technology. However, the relative contribution of surgical approach versus surgeon-specific practice patterns to cost variation remains incompletely defined. We conducted a retrospective cohort study of adults undergoing inguinal hernia repair within a multi-hospital healthcare system from 2017 to 2025. Mixed-effects regression models evaluated direct disposable supply cost and operating room time, adjusting for patient characteristics, case complexity, surgeon experience, calendar year, and clustering at both surgeon and hospital levels. The cohort included 14,313 repairs performed by 137 surgeons across 29 hospitals (open 43.8%, robotic 46.7%, laparoscopic 9.5%). Robotic utilization increased from 8.7 to 66.0% by 2024, largely replacing laparoscopy; 62% of surgeons performed only one approach. After adjustment, mean direct disposable supply cost was $567 for open, $1,527 for robotic, and $1,741 for laparoscopic repair (robot vs. laparoscopic: - $213, 95% CI - $274 to - $153, p < 0.001). Adjusted mean operating room time was 119 min for open, 142 for robotic, and 120 for laparoscopic repair (robotic vs. open: + 23.1 min, p < 0.001). Robotic repair was associated with lower odds of overnight admission (OR 0.73, 95% CI 0.55-0.96, p = 0.022). Within each platform, surgeon-level cost deviations ranged up to $777 (open) and $196 (robotic) above the platform mean, often exceeding between-platform differences. Standardized per 1,000 cases, combined potentially avoidable cost (supplies plus operating room time at $75/min) was $638,000 for robotic repairs. Surgeon-level practice variation is a major contributor to procedural cost variation in inguinal hernia repair and may provide an important target for value-improvement efforts. Because most surgeons in this cohort performed only one approach, such efforts are likely to have the greatest practical impact when directed at preference-card standardization and peer benchmarking within the platforms where surgeons already practice.
The decentralization of biosensing to point-of-need (PON) settings necessitates single-use devices that combine laboratory-level sensitivity with field-deployable simplicity. Existing fluorescent optofluidic chips achieve high sensitivity but rely on bench-top optics, pumps, and trained personnel. Here, we present a smart, disposable evanescent wave fluorescent optofluidic bio-nanochip (DEFOB) that bridges this performance gap. The DEFOB integrates a gravity-driven, 3D-printed microfluidic chip with a functionalized tapered fiber nanosensor, a compact alignment-free all-fiber optical reader, and a smartphone application. This synergistic design enables ultrasensitive, quantitative detection in both homogeneous and heterogeneous assay formats without the need for external pumps or complex peripherals. We demonstrate the platform's versatility through the laboratory-comparable quantification of sulfamerazine antibiotics via immunoassay and of SARS-CoV-2 via an integrated RAA-CRISPR/Cas12b assay, achieving detection limits of 0.06 µg/L and 0.70 copies/µL, respectively. By combining dual-mode operation, high sensitivity, quantitative accuracy, intelligence, plug-and-play functionality, and a low-cost workflow, the DEFOB platform represents a paradigm shift in PON testing, with broad applications in clinical diagnostics, environmental monitoring, and global health security.
The Alisklamp® Nero M is a novel metallic disposable circumcision device allowing thermocautery-assisted excision, immediate device removal, and standardized mucosal cuff length. This study evaluated its real-world safety profile and complication rates in a large pediatric cohort. This retrospective study included 6000 boys aged 1 month to 12 years circumcised using the Alisklamp® Nero M between November 2020 and November 2025. Procedures were performed by a single experienced surgeon using a standardized local anesthesia technique. Postoperative follow-up was conducted through a structured smartphone-based telemedicine protocol until complete wound healing. Primary and secondary outcomes were overall complication and revision surgery rates, respectively. The mean patient age was 3.14 ± 3.13 years. No patients were lost to follow-up. A total of 130 complications (2.16%) occurred, predominantly wound dehiscence (0.95%) and postoperative bleeding (0.58%). Revision surgery was required in only 10 patients (0.16%) due to persistent bleeding (n = 5) or secondary phimosis (n = 5). Remaining complications were managed conservatively, yielding complete mucocutaneous healing in all patients. Circumcision with the Alisklamp® Nero M demonstrated low overall complication and exceptionally low revision surgery rates. Standardized excision, immediate device removal, and structured telemedicine follow-up support its safety, feasibility, and practicality in routine pediatric care.
A disposable glove-derived flexible biosensor employs vertex-selective Pd-Pt nanodendrites catalyzing dissolved oxygen-mediated electrochemiluminescence, quenched by organophosphorus poisoning for on-site detection.
Prolonged digital device use can result in digital eye strain which may be exacerbated by uncorrected astigmatism. This study explored how sustained smartphone reading impacts on visual function and symptoms when astigmatism is corrected with disposable soft toric contact lenses. 30 adult contact lens wearers (mean age 23 ± 4 years, mean astigmatism 1.12 ± 0.35 D) habitually using digital devices for ≥10 h/day were fitted with Delefilcon A daily disposable toric contact lenses for 14-days. High and low contrast near visual acuity (VA) were assessed before and after a prolonged smartphone reading task on day 1 and day 14 of lens wear. The severity of digital eye strain symptoms were reported using a 0-100 visual analogue scale following the reading task. Contact lens dry eye symptoms were assessed using the 8-item Contact Lens Dry Eye Questionnaire (CLDEQ-8). At baseline, the mean high and low contrast near VAs were - 0.08 ± 0.05 and + 0.04 ± 0.08 logMAR, respectively, which did not decline significantly following the prolonged reading task, or after 14 days of lens wear. The average reading speed was not significantly different between day 1 and day 14 of lens wear (251 ± 85 words-per-minute vs 252 ± 80 words-per-minute, p = 0.47). Digital eyestrain symptoms following the reading task (mean of all symptom scores: 13 ± 21) remained stable over the 14-days of lens wear (all p > 0.05), and > 75% of the reported symptoms were ranked as <15/100 in severity. The mean CLDEQ-8 score was 15.2 ± 8.8. The correction of astigmatism with disposable toric contact lenses provided stable functional visual performance, with minimal digital eye strain during a prolonged smartphone reading task. However, over half of participants, reported significant dryness/discomfort (CLDEQ-8, ≥12) during 2-weeks of wear, highlighting a disconnect between short-term digital task symptoms and overall daily lens comfort in participants habitually using digital devices for ≥10 h/day.
Flavor is a key driver of e-cigarette appeal, particularly among youth. This study examines concept flavors in U.S. online e-cigarette marketing, which are ambiguous descriptors used by the industry to evoke sensory experiences while circumventing flavor restrictions. We scraped product-level data of e-liquids and disposables in 2021 and 2024, respectively, from six popular online retailers. Flavor information was extracted from source code, product descriptions, and images. Using an expanded e-cigarette flavor wheel, we linked concept descriptors on packages to 12 explicit flavor categories. We also identified concept flavors suggesting cooling agents (e.g., "ice"). Among 5368 e-liquid images from 2021, 1091 (20 %) featured concept flavors; among 3917 disposable images from 2024, 1256 (32 %) featured concept flavors. Across both years, we identified 754 unique concept flavor terms without ice mentions and 136 with ice mentions. Fruity and sweet flavors had the highest number of concept descriptors without ice mentions, whereas fruity, sweet, and menthol flavors had the highest numbers of concept descriptors with ice mentions. Concept flavor labeling is common in U.S. e-cigarette products. Our database facilitates rapid surveillance of e-cigarette products by the Food and Drug Administration and enables timely policy actions to regulate non-characterizing flavor labeling.
Waste management in hospitals is an important factor with respect to environmental sustainability. Surgical waste disposal causes substantial CO2 emissions. In addition to recycling, waste reduction is an essential strategy for reducing emissions. Reusable textiles offer a promising approach to decrease waste in operating rooms. Assessment of reusable textiles in terms of waste generation, operational processes and staff acceptance. This prospective observational study compared waste generation when using disposable or reusable drapes in 272 orthopedic and trauma operations over periods of 2 weeks each. Waste volume and weight as well as preparation, clean-up and surgery times were recorded and statistically analyzed. Surgical staff were then asked about their experiences with reusable textiles. The use of disposable drapes resulted in 93.59l (± 75.16l) and 5.32kg (± 2.04kg) of hospital-specific waste per operation. The introduction of reusable drapes reduced waste volume by 40% and weight by 34% (p < 0.001) without affecting preparation, clean-up or surgical time. Of the staff 96% considered the use of reusable textiles to be unproblematic. The use of reusable textiles significantly reduces waste in operating rooms without affecting workflows and is supported by operating room staff. The implementation represents a practical and effective measure towards greater sustainability in operating rooms. HINTERGRUND: Das Abfallmanagement im Krankenhaus stellt einen wesentlichen Faktor in Bezug auf ökologische Nachhaltigkeit dar. Abfälle aus Operationen müssen häufig unter hoher CO2-Emission vernichtet werden. Neben Recycling ist Abfallvermeidung eine wichtige Maßnahme zur Reduktion der CO2-Emissionen. Mehrwegtextilien stellen eine vielversprechende Möglichkeit zur Abfallreduktion in Operationssälen dar. Evaluation von Mehrwegabdeckungen in Bezug auf anfallende Abfälle sowie auf Abläufe und Akzeptanz des Personals. In dieser prospektiven Beobachtungsstudie wurde der anfallende Abfall 272 orthopädisch-unfallchirurgischer Operationen gemessen. Je zwei Wochen erfolgte die Nutzung von Einwegabdeckungen sowie nachfolgend von Mehrwegabdeckungen. Es wurden Volumen sowie Gewicht des Abfalls sowie Vor‑, Nachbereitungs- und Operationszeit erfasst und statistisch ausgewertet. Im Anschluss erfolgte die Befragung des Personals zur Nutzung von Mehrwegtextilien. Während unter Nutzung von Einwegabdeckungen 93,59 (± 75,16) l bzw. 5,32 (± 2,04) kg krankenhausspezifischer Abfall pro Operation anfiel, konnte diese unter Nutzung von Mehrwegabdeckungen signifikant um 40 % des Volumens bzw. 34 % des Gewichtes gesenkt werden (p < 0,001). Es zeigte sich keine Differenz der Dauer der Vor- und Nachbereitung oder der Operation. Die dauerhafte Nutzung von Mehrwegtextilien im Operationssaal wurde von 96 % des befragten Personals als unproblematisch eingeschätzt. Durch Nutzung von Mehrwegtextilien im Operationssaal kann der Abfall signifikant reduziert werden, ohne die Abläufe der Operationen zu beeinflussen; dies wird vom Personal befürwortet.
Contaminated environmental surfaces contribute to the transmission of pathogens that cause healthcare-associated infections. The present study aimed to assess the efficacy and cost implications of a chlorine-based combined detergent-disinfectant used for environmental decontamination around methicillin-resistant Staphylococcus aureus (MRSA) patients. The study was conducted over a six-month period in the inpatient wards (medical, surgical, and orthopedic) of Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, People's Republic of China. The surrounding areas of newly diagnosed MRSA patients were divided into two equal halves and decontaminated using either the conventional two-step process (cleaning with detergent followed by disinfection with a 1000 ppm hypochlorite solution) or a new one-step method using a combined detergent-disinfectant. High-touch surfaces in the patients' immediate environment were sampled before and after decontamination to detect MRSA by culture and to measure adenosine triphosphate (ATP) levels. The number of disposable wipes used and the duration of the decontamination process were recorded for the cost analysis. Both the conventional and the new methods significantly reduced the MRSA detection rate from 68.7% to 12.7% and to 15.3%, respectively (p < 0.001), and significantly reduced the ATP failure rate from 78.2% to 2.7% and to 4.5%, respectively (p < 0.001). Compared with the conventional method, the new method saved an average of 5.9 minutes of decontamination time and 10.2 disposable wipes per patient, resulting in a substantial cost saving of over 6 million Hong Kong dollars per year according to current infection control recommendations for MRSA patients in public hospitals in Hong Kong. The one-step method using a combined detergent-disinfectant effectively decontaminated high-touch hospital surfaces in the patient environment while reducing both time and costs. Its broader implementation in local inpatient settings may enhance environmental hygiene while reducing costs.
To evaluate the effect of a low-molecular weight hyaluronic acid derivative (HAD), incorporated into a multipurpose disinfecting solution (MPS), on symptoms and signs of comfort during contact lens wear. Contact lens wearers with dry eye symptoms (CLDEQ-8 ≥ 12) were enrolled across three clinical trials. Participants wore comfilcon A contact lenses and used cleadew MPS with or without HAD for eight weeks, with monthly lens replacement. The first trial compared HAD-containing MPS with habitual lens care, the second compared non-HAD MPS (containing identical excipients) with habitual care, and the third directly compared HAD and non-HAD MPS. Follow-up assessments included CLDEQ-8, tear meniscus height, non-invasive tear break-up time (NITBUT), meibomian gland morphology, lipid layer thickness (LLT), tear volume (phenol red thread test), and ocular surface health assessed by slit-lamp examination and fluorescein staining. Twenty-three participants used HAD MPS and eighteen used non-HAD MPS. In all trials using HAD-containing MPS, CLDEQ-8 scores improved significantly after eight weeks (P ≤ 0.003; mean reduction ≥7.7). No significant comfort improvement was observed with non-HAD MPS (P ≤ 0.13; mean reduction ≤3.3). These symptom improvements were generally not accompanied by significant changes in tear stability, tear volume, LLT, or ocular staining. Notably, participants previously wearing daily disposable lenses and reporting discomfort demonstrated significant improvement in CLDEQ-8 scores with HAD MPS (P < 0.008), with a trend toward normalization of symptoms. HAD-containing MPS improves contact lens comfort, including in previously symptomatic daily disposable lens wearers. This benefit may relate to improved lens surface wettability and reduced friction, warranting further investigation.
Health Technology Assessment (HTA) supports evidence-based decision-making, but integrating economic evaluation within Multi-Criteria Decision Analysis (MCDA) remains challenging in hospital-level HTA. This study developed and preliminarily applied an integrated decision-support framework combining MCDA, economic evaluation, and contextualized evidence assessment to support adoption recommendations. A pragmatic digital framework integrated MCDA with Budget Impact Analysis (BIA) and Cost-Consequence Analysis (CCA) within a rule-based decision matrix. The economic module estimated cost per patient, incremental cost, budget impact, cost-consequence outputs, and, when appropriate, a supportive soft ICER. Evidence was assessed through structured critical appraisal, Summary of Findings tables, and outcome relevance, using a GRADE-informed approach mapped onto the predefined 0-1-3-5-7-9 MCDA evidence scale. Operational robustness was assessed through Failure Mode and Effects Analysis (FMEA) and self-audit controls. In a case study comparing disposable and reusable continence care systems, the disposable option showed a lower MCDA score than the current standard (2.60 vs 4.80; ΔMCDA = -2.20) and a higher cost per patient (€1.00 vs €0.65; incremental cost €0.35). Although the 3-year budget impact was €2,634 and remained within the institutional affordability threshold, the technology was classified as dominated because it generated lower value at a higher cost. The final recommendation was not favorable for routine adoption. The framework supports transparent integration of MCDA and economic evaluation in hospital-level HTA and helps distinguish affordability from overall value. The case study suggests that technologies should not be adopted solely because their budget impact is acceptable when the value-risk profile is unfavorable. Further validation across technologies and settings is required.
Infrared thermography allows non-invasive, real-time assessment of ocular surface temperature and represents a promising tool in contact lens (CL) research. Information regarding the short-term thermal changes before, during and after soft CL wear remains limited. This study investigated the short-term thermal response associated with daily disposable soft CL wear, the influence of CL material, and the repeatability of a portable thermographic camera. A prospective study was conducted in 29 healthy young adults (mean age 23.5 ± 4.0 years, and 65.5% women) wearing two types of daily disposable soft CLs (stenfilcon A and omafilcon B). Ocular surface temperature was recorded at baseline, 1-min, 10-min and post-CL removal using a portable thermographic camera. Measurements were repeated one week later. Statistical analyses evaluated temperature changes following CL wear, thermal changes during the first 10 min of wear, and differences between CL materials. Repeatability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman analyses. Baseline and post-CL temperatures differed significantly in both sessions (both p < 0.005). Significant thermal changes were also observed between the 1-min and 10-min time points after CL insertion (both sessions p < 0.05). No material-dependent differences were found (both sessions p ≥ 0.456). Baseline temperature showed poor repeatability (ICC = 0.043), whereas the temperature change between baseline and post-CL removal showed improved agreement (ICC = 0.438). Bland-Altman analyses confirmed wider limits of agreement for baseline measurements than for temperature change. Soft CL insertion induces significant short-term thermal changes before, during and after CL wear, independent of CL material. Although absolute baseline temperature measurements showed poor repeatability, the portable infrared thermographic camera demonstrated improved agreement for the temperature change between baseline and post-CL removal and may be a useful tool for evaluating thermal changes associated with CL wear.
To disentangle the contribution of the Covid-19 pandemic and the abolition of the Seguro Popular (SP) health protection system to changes in out-of-pocket health expenditures (OPE) in Mexico during 2020. We used national representative surveys between 2014 and 2020. We described OPE in absolute and relative terms and per disposable income. Changes in OPE were estimated using adjusted two-part models. Results were reported nationally, by health insurance and income quintile. OPE increased for all in 2020 with the largest increases for the high- and very high-income households and those with social security (30.4, 23.4 and 22.2 USD, respectively). Households with no health insurance and those with Seguro Popular/Instituto de Salud para el Bienestar had the lowest increase in OPE. However, for the lowest income households and those with no social security, OPE represented the highest proportion per disposable income as their income decreased during the Covid-19. Social safety nets, including access to health care services for the uninsured and lower income households, are crucial.
Oral Cavity Squamous Cell Carcinoma (OCSCC) is a common and deadly form of head and neck cancer which disproportionately afflicts low- and middle-income communities. Since the majority of OCSCC lesions are visible within the oral cavity, visual exam-guided biopsy remains the standard method for detection. However, visual examination can be subjective, biopsy can be painful, and pathological evaluation can be time consuming. With the goal of developing an accessible and noninvasive platform for OCSCC detection, we adapted the MSPen technology as a modular system for direct molecular analysis of OCSCC in vivo. The modular MSPen (Mod-MSPen) system consists of a controller unit and a disposable handheld device that directly contacts tissues, performs gentle liquid extraction of molecules, and collects the sample in a vial for subsequent mass spectrometric analysis. We have used the Mod-MSPen to analyze OCSCC and normal oral tissues spanning various anatomical areas: tongue, buccal mucosa, gingiva, and floor of mouth. The molecular data obtained presented distinct trends in the abundances of metabolites such as glutamate, which was consistently observed in higher relative abundances in OCSCC tissues when compared to normal oral tissues. These trends were corroborated using mass spectrometry imaging, which revealed clear spatio-molecular differences in OCSCC and adjacent normal oral mucosa tissues. Statistical classifiers built from the data provided high performance for disease detection, with >95% agreement with standard histopathology. To evaluate clinical suitability, we also deployed the Mod-MSPen for in vivo analysis of OCSCC and normal oral tissues alongside clinical procedures.
Graduate student well-being is an emerging public health priority, yet the role of pre-university structural background, particularly rural versus urban origin, remains poorly understood. This study examined whether rural-urban disparities in life satisfaction persist among students at an elite Chinese university, and to what extent health behaviors account for any observed gap. In a cross-sectional survey, 497 master's and doctoral students at a Double First-Class university in eastern China completed the Satisfaction with Life Scale (SWLS), the IPAQ short-form physical activity questionnaire, and items on insomnia, sleep duration, and sociodemographic characteristics, including monthly disposable income. Two hierarchical linear regression models were constructed: Model 1 (sociodemographic variables only) and Model 2 (adding sleep, physical activity, and insomnia). Because Model 1 is a proper subset of Model 2, the attenuation of the rural-origin coefficient between model estimates the share of the gap associated with health behaviors. After adjustment for sociodemographic covariates, rural-origin students scored 1.95 points lower on the SWLS than urban-origin peers (Model 1, p = 0.003). Adding health behaviors to the model reduced this gap by roughly half (p = 0.088). Insomnia showed a pronounced graded association with life satisfaction (p < 0.001). Physical activity and sleep duration (p < 0.001) were independently associated with higher SWLS. Being in a relationship or married was also associated with greater well-being. Health behaviors accounted for approximately half of the rural-urban gap in life satisfaction. The other half persisted independently, suggesting that structural disadvantage exerts effects on well-being that are not reducible to individual health practices. Campus interventions targeting sleep and physical activity are warranted, but closing the remainder of the gap will likely require strategies that address the cultural and institutional dimensions of rural-to-urban educational mobility.
Comparisons between transfemoral transcatheter aortic valve implantation (TF-TAVI) and surgical aortic valve replacement (SAVR) in severe aortic stenosis have demonstrated a consistent mortality benefit, lower 1 year costs and greater quality-adjusted life years in favour of TF-TAVI. However, the differences in the environmental impact of these two interventions have not yet been sufficiently investigated. The aim of the present study was to compare the intraprocedural environmental impact of these two procedures and to identify emission hotspots in order to mitigate their environmental impact. In this prospective, observational, single-centre study, usage data were collected from 15 TF-TAVI and 15 SAVR procedures. All products, energy and water consumed during the procedures were identified and were used in a comprehensive comparative environmental life cycle assessment to quantify the intraprocedural environmental impact of these two interventions. Material use in SAVR amounted to 17.7 kg compared with 8.7 kg in TF-TAVI, consisting of 84% and 69% plastics, respectively. Electricity use in TF-TAVI was 52% less than in SAVR; in both interventions, energy consumption was dominated by the use of electronic devices. In SAVR, water consumption was 30 times higher than in TF-TAVI (5800 vs 194 L), mainly due to the heating cooling system of the cardiopulmonary bypass in SAVR. In all 10 calculated environmental impact categories, SAVR had a greater life-cycle impact. Its carbon footprint was 181.2 kg CO2-eq, compared with 68.6 kg CO2-eq per TF-TAVI. TF-TAVI outperformed SAVR in all environmental impact categories and had a carbon footprint of 38% that of SAVR. In TF-TAVI, 51% less material, 52% less energy and 97% less water were used. Despite these impressive results, there is still room for improvement in the environmental impact of TF-TAVI by using fewer disposable items, powering down idle imaging systems and introducing reusable/remanufactured valve delivery systems.
Mosquito control programs rely on larvicides such as S-methoprene to suppress vector populations and prevent mosquito-borne diseases including West Nile virus (WNV). Resistance surveillance is essential for maintaining the long-term effectiveness of larvicide active ingredients and is typically conducted using cup bioassays to evaluate larval susceptibility. Disposable Styrofoam cups are commonly used for these assays because they minimize adsorption of S-methoprene under standard testing conditions. However, recent restrictions on expanded polystyrene products in California necessitated the identification and evaluation of suitable replacement cup materials for larval resistance bioassays. Four alternative cup materials, high-density polyethylene (HDPE), polyethylene terephthalate (PET), polypropylene (PP), and paper cups, were compared to Styrofoam cups. Cup bioassays were conducted using a laboratory colony of Culex quinquefasciatus exposed to S-methoprene concentrations of 1-40 ppb. Emergence inhibition data were analyzed using probit regression to estimate the concentrations causing 50% and 90% emergence inhibition (LC50 and LC90, respectively) for each cup type. Cup material significantly affected concentration-response relationships. HDPE and paper cups produced significantly higher LC50 and LC90 estimates than Styrofoam, whereas PET and PP produced responses more comparable to the Styrofoam reference. Concentration-response slopes were similar among cup materials, indicating that cup material primarily shifted the concentration required to achieve a given level of emergence inhibition. These findings demonstrate that cup material can significantly influence estimated S-methoprene LC values. Replacement assay cups should therefore be validated before implementation in larval resistance monitoring programs.