ALBERT

Description: Background: In 2012, a pilot health policy of contractual service relations between general practitioners and patients was implemented in China. Due to the decline in body and cognitive function, as well as the lack of family care and narrow social support networks, the demand of health services among the elderly is much higher than that among the general population. This study aims to probe into the empty nesters’ willingness-to-pay for general practitioners using a contractual service policy, investigating empty nesters’ payment levels for the service, and analyze the main factors affecting the willingness of empty-nesters’ general practitioners using contractual service supply cost. Methods: This cross-sectional study adopted a multistage stratified sampling method to survey 865, city empty nesters (six communities in three districts of one city) aged 60–85 years. A condition value method was used to infer the distribution of the willingness-to-pay; Cox’s proportional hazards regression model was used to analyze the influencing factors of willingness-to-pay. Results: More than seventy percent (76.6%) of the empty nesters in this city were willing to pay general practitioners using contract service in Chongqing. The level of willingness-to-pay for the surveyed empty nesters was 34.1 yuan per year. The median value was 22.1 yuan per year, which was below the Chongqing urban and rural cooperative medical insurance individual funding level (60 yuan per year) in 2013. Cox’s proportional hazards regression model analysis showed that the higher the education level was, the worse the self-reported health status would be, accompanied by higher family per capita income, higher satisfaction of community health service, and higher willingness-to-pay empty nesters using a contract service. Women had a higher willingness-to-pay than men. Conclusions: The willingness-to-pay for general practitioners by contractual service is high among city empty nesters in Chongqing, thus, individual financing is feasible. However, people are willing to pay less than half of the current personal financing of cooperative medical insurance of urban and rural residents. Education level, family per capita income, and self-reported health status are the main factors affecting the cost sharing intention for general practitioners using contract service supply. According to the existing situation of different empty nesters, it is important to perfect the design of general practitioners using a contractual service policy system, according to differentiated personal financing levels.

Description: Lightweighting in the transportation industry is today recognized as one of the most important strategies to improve fuel efficiency and reduce anthropogenic climate-changing, environment-damaging, and human death-causing emissions. However, the structural applications of lightweight alloys are often limited by some inherent deficiencies such as low stiffness, high wear rate and inferior strength. These properties could be effectively enhanced by the addition of stronger and stiffer reinforcements, especially nano-sized particles, into metal matrix to form composites. In most cases three common strengthening mechanisms (load-bearing effect, mismatch of coefficients of thermal expansion, and Orowan strengthening) have been considered to predict the yield strength of metal matrix nanocomposites (MMNCs). This study was aimed at developing a unified model by taking into account the matrix grain size and porosity (which is unavoidable in the materials processing such as casting and powder metallurgy) in the prediction of the yield strength of MMNCs. The Zener pinning effect of grain boundaries by the nano-sized particles has also been integrated. The model was validated using the experimental data of magnesium- and titanium-based nanocomposites containing different types of nano-sized particles (namely, Al2O3, Y2O3, and carbon nanotubes). The predicted results were observed to be in good agreement with the experimental data reported in the literature.

Description: In order to achieve process intensification for adsorption chillers and heat pumps, a new composite material was developed based on sintered aluminum fibers from a melt-extraction process and a dense layer of silico-aluminophosphate (SAPO-34) on the fiber surfaces. The SAPO-34 layer was obtained through a partial support transformation (PST) process. Preparation of a composite sample is described and its characteristic pore size distribution and heat conductivity are presented. Water adsorption data obtained under conditions of a large pressure jump are given. In the next step, preparation of the composite was scaled up to larger samples which were fixed on a small adsorption heat exchanger. Adsorption measurements on this heat exchanger element that confirm the achieved process intensification are presented. The specific cooling power for the adsorption step per volume of composite is found to exceed 500 kW/m3 under specified conditions.

Description: The relationship between soil fauna and different fertilizer management practices is of growing concern. The aim of this research was to investigate the response of soil fauna to fertilization regimes, to explore the relationships among the community of soil animals, soil moisture and crop yields. The application of organic fertilizers (i.e., sheep manure or crop residues) increased crop yields and promoted the number of individuals and species of soil fauna owing to the exogenous organic matter that fertilizers provided for the survival and development of soil fauna. Furthermore, the treatments that applied sheep manure (i.e., sheep manure only or nitrogen, phosphorus, potassium and sheep manure plus) were significantly beneficial for increasing crop yields and diversity of soil fauna compared to treatments with crop residues returned (i.e., crop residues returned only or nitrogen, phosphorus, potassium and crop residues returned to the field) (p 〈 0.05) due to the response of soil fauna to diverse exogenous nutrients and the effect of soil fertility. Therefore, the finding that soil fauna abundance is significantly positively correlated with soil moisture and crop yield may mean the effects of fertilizer applications on soil animals were partly masked by the soil moisture and crop yield.

Description: A fast and effective wound healing process would substantially decrease medical costs, wound care supplies, and hospitalization significantly improving the patients’ quality of life. The search for effective therapeutic approaches seems to be imperative in order to avoid the aggravation of chronic wounds. In spite of all the efforts that have been made during the recent years towards the development of artificial wound dressings, none of the currently available options combine all the requirements necessary for quick and optimal cutaneous regeneration. Therefore, technological advances in the area of temporary and permanent smart dressings for wound care are required. The development of nanoscience and nanotechnology can improve the materials and designs used in topical wound care in order to efficiently release antimicrobial, anti-inflammatory and regenerative compounds speeding up the endogenous healing process. Nanostructured dressings can overcome the limitations of the current coverings and, separately, natural origin components can also overcome the drawbacks of current antibiotics and antiseptics (mainly cytotoxicity, antibiotic resistance, and allergies). The combination of natural origin components with demonstrated antibiotic, regenerative, or anti-inflammatory properties together with nanostructured materials is a promising approach to fulfil all the requirements needed for the next generation of bioactive wound dressings. Microbially compromised wounds have been treated with different essential oils, honey, cationic peptides, aloe vera, plant extracts, and other natural origin occurring antimicrobial, anti-inflammatory, and regenerative components but the available evidence is limited and insufficient to be able to draw reliable conclusions and to extrapolate those findings to the clinical practice. The evidence and some promising preliminary results indicate that future comparative studies are justified but instead of talking about the beneficial or inert effects of those natural origin occurring materials, the scientific community leads towards the identification of the main active components involved and their mechanism of action during the corresponding healing, antimicrobial, or regenerative processes and in carrying out systematic and comparative controlled tests. Once those natural origin components have been identified and their efficacy validated through solid clinical trials, their combination within nanostructured dressings can open up new avenues in the fabrication of bioactive dressings with outstanding characteristics for wound care. The motivation of this work is to analyze the state of the art in the use of different essential oils, honey, cationic peptides, aloe vera, plant extracts, and other natural origin occurring materials as antimicrobial, anti-inflammatory and regenerative components with the aim of clarifying their potential clinical use in bioactive dressings. We conclude that, for those natural occurring materials, more clinical trials are needed to reach a sufficient level of evidence as therapeutic agents for wound healing management.

Description: This paper provides an overview of the main manufacturing technologies of displays, focusing on those with low and ultra-low levels of power consumption, which make them suitable for current societal needs. Considering the typified value obtained from the manufacturer’s specifications, four technologies—Liquid Crystal Displays, electronic paper, Organic Light-Emitting Display and Electroluminescent Displays—were selected in a first iteration. For each of them, several features, including size and brightness, were assessed in order to ascertain possible proportional relationships with the rate of consumption. To normalize the comparison between different display types, relative units such as the surface power density and the display frontal intensity efficiency were proposed. Organic light-emitting display had the best results in terms of power density for small display sizes. For larger sizes, it performs less satisfactorily than Liquid Crystal Displays in terms of energy efficiency.

Description: Model selection is an integral, yet contentious, component of epidemiologic research. Unfortunately, there remains no consensus on how to identify a single, best model among multiple candidate models. Researchers may be prone to selecting the model that best supports their a priori, preferred result; a phenomenon referred to as “wish bias”. Directed acyclic graphs (DAGs), based on background causal and substantive knowledge, are a useful tool for specifying a subset of adjustment variables to obtain a causal effect estimate. In many cases, however, a DAG will support multiple, sufficient or minimally-sufficient adjustment sets. Even though all of these may theoretically produce unbiased effect estimates they may, in practice, yield somewhat distinct values, and the need to select between these models once again makes the research enterprise vulnerable to wish bias. In this work, we suggest combining adjustment sets with model averaging techniques to obtain causal estimates based on multiple, theoretically-unbiased models. We use three techniques for averaging the results among multiple candidate models: information criteria weighting, inverse variance weighting, and bootstrapping. We illustrate these approaches with an example from the Pregnancy, Infection, and Nutrition (PIN) study. We show that each averaging technique returns similar, model averaged causal estimates. An a priori strategy of model averaging provides a means of integrating uncertainty in selection among candidate, causal models, while also avoiding the temptation to report the most attractive estimate from a suite of equally valid alternatives.

Description: The widespread, intentional and increasingly frequent chemical emplacement in the troposphere has gone unidentified and unremarked in the scientific literature for years. The author presents evidence that toxic coal combustion fly ash is the most likely aerosolized particulate sprayed by tanker-jets for geoengineering, weather-modification and climate-modification purposes and describes some of the multifold consequences on public health. Two methods are employed: (1) Comparison of 8 elements analyzed in rainwater, leached from aerosolized particulates, with corresponding elements leached into water from coal fly ash in published laboratory experiments, and (2) Comparison of 14 elements analyzed in dust collected outdoors on a high-efficiency particulate air (HEPA) filter with corresponding elements analyzed in un-leached coal fly ash material. The results show: (1) the assemblage of elements in rainwater and in the corresponding experimental leachate are essentially identical. At a 99% confidence interval, they have identical means (T-test) and identical variances (F-test); and (2) the assemblage of elements in the HEPA dust and in the corresponding average un-leached coal fly ash are likewise essentially identical. The consequences on public health are profound, including exposure to a variety of toxic heavy metals, radioactive elements, and neurologically-implicated chemically mobile aluminum released by body moisture in situ after inhalation or through transdermal induction.

Description: The impacts of climate change on human health have been documented globally and in the United States. Numerous studies project greater morbidity and mortality as a result of extreme weather events and other climate-sensitive hazards. Public health impacts on the U.S. Gulf Coast may be severe as the region is expected to experience increases in extreme temperatures, sea level rise, and possibly fewer but more intense hurricanes. Through myriad pathways, climate change is likely to make the Gulf Coast less hospitable and more dangerous for its residents, and may prompt substantial migration from and into the region. Public health impacts may be further exacerbated by the concentration of people and infrastructure, as well as the region’s coastal geography. Vulnerable populations, including the very young, elderly, and socioeconomically disadvantaged may face particularly high threats to their health and well-being. This paper provides an overview of potential public health impacts of climate variability and change on the Gulf Coast, with a focus on the region’s unique vulnerabilities, and outlines recommendations for improving the region’s ability to minimize the impacts of climate-sensitive hazards. Public health adaptation aimed at improving individual, public health system, and infrastructure resilience is urgently needed to meet the challenges climate change may pose to the Gulf Coast in the coming decades.

Description: This study forecasts the liquidity gap in China’s pension scheme for urban workers in the context of an ageing population and the possible effects of recent governmental policies by constructing a basic pension model, including “old people”, “middle people” and “new people” and a simulation method. We find, firstly, that China’s liquidity gap of pension will reach its peak of approximately 13.11 trillion yuan in 2038. Subsequently, this gap will gradually decrease with growth in the mortality rate. Secondly, reasonable intervals for the replacement and contribution rates should be set at [0.417, 0.604] and [0.189, 0.262], respectively, to sustain China’s pension system. Thirdly, compared to increasing fiscal subsidies, an income doubling plan, raising the contribution rate, lowering the replacement rate and delaying the retirement age can significantly reduce the liquidity gap, although the policy costs are relatively high. A policy permitting families to have two children will increase the rate of reduction of the liquidity gap, but it cannot effectively narrow the gap at the peak moment.