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Abstract Ammonium (NH4+) removal from municipal wastewater poses challenges with the commonly used biological processes. Especially at low wastewater temperatures, the process is frequently ineffective and difficult to control. One alternative is to use ion-exchange. In the present study, a novel NH4+ ion-exchanger, metakaolin geopolymer (MK-GP), was prepared, characterised, and tested. Batch experiments with powdered MK-GP indicated that the maximum exchange capacities were 31.79, 28.77, and 17.75 mg/g in synthetic, screened, and pre-sedimented municipal wastewater, respectively, according to the Sips isotherm (R2 ≥ 0.91). Kinetics followed the pseudo-second-order rate equation in all cases (kp2 = 0.04–0.24 g mg−1 min−1, R2 ≥ 0.97) and the equilibrium was reached within 30–90 min. Granulated MK-GP proved to be suitable for a continuous column mode use. Granules were high-strength, porous at the surface and could be regenerated multiple times with NaCl/NaOH. A bench-scale pilot test further confirmed the feasibility of granulated MK-GP in practical conditions at a municipal wastewater treatment plant: consistently <4 mg/L NH4+ could be reached even though wastewater had low temperature (approx. 10°C). The results indicate that powdered or granulated MK-GP might have practical potential for removal and possible recovery of NH4+ from municipal wastewaters. The simple and low-energy preparation method for MK-GP further increases the significance of the results.
Objective One of the main goals of health examination surveys is to provide unbiased estimates of health indicators at the population level. We demonstrate how multiple imputation methods may help to reduce the selection bias if partial data on some nonparticipants are collected. Study Design and Setting In the FINRISK 2007 study, a population-based health study conducted in Finland, a random sample of 10,000 men and women aged 25–74 years were invited to participate. The study included a questionnaire data collection and a health examination. A total of 6,255 individuals participated in the study. Out of 3,745 nonparticipants, 473 returned a simplified questionnaire after a recontact. Both the participants and the nonparticipants were followed up for death and hospitalizations. The follow-up data allowed to check the assumptions on the missing data mechanism, and tailored multiple imputation methods were used to handle the missing data. Results Nonparticipation is a strong predictor for mortality in the five-year follow-up. However, the recontact response does not predict mortality or morbidity among the nonparticipants when adjusted for age and sex. The result suggests that the recontact respondents can be used as proxy for all nonparticipants. A comparison of raw estimates and estimates adjusted for selection bias reveals clear differences in the estimated population prevalences of smoking and heavy alcohol usage. Conclusion All efforts to collect data on nonparticipants are likely to be useful even if the response rate for the recontact remains low. Statistical analysis of the recontact respondents provides an indication of the extent of the selection bias, even in studies where follow-up data are not available to check the assumptions.
Abstract Geopolymers are functional materials that can be used in various environmental applications such as adsorbents in pollutant removal from wastewaters. Metakaolin geopolymer (MK-GP) has been proven to be especially suitable for ammonium (NH4+) removal. In this research, the optimal reagent and raw material ratios in the preparation of MK-GP in terms of NH4+ adsorption capacity were investigated. The response surface methodology based on the face-centered central composite design was used to optimize the levels of three factors: the amounts of hydroxide, silicate, and metakaolin. In addition, the effect of Na or K as the charge-balancing cation was studied. Empirical models were fitted to the experimental data using multiple linear regression. The significance of the models was confirmed by means of analysis of variance. Optimal NH4+ removal efficiency was achieved when the amounts of hydroxide and silicate were maximized, the amount of metakaolin was minimized, and Na-based reagents were used. These trends are most likely a result of optimized conversion of metakaolin into MK-GP.
Aims: A common objective of epidemiological surveys is to provide population-level estimates of health indicators. Survey results tend to be biased under selective non-participation. One approach to bias reduction is to collect information about non-participants by contacting them again and asking them to fill in a questionnaire. This information is called recontact data, and it allows to adjust the estimates for non-participation. Methods: We analyse data from the FINRISK 2012 survey, where re-contact data were collected. We assume that the respondents of the recontact survey are similar to the remaining non-participants with respect to the health given their available background information. Validity of this assumption is evaluated based on the hospitalization data obtained through record linkage of survey data to the administrative registers. Using this assumption and multiple imputation, we estimate the prevalences of daily smoking and heavy alcohol consumption and compare them to es1 timates obtained with a commonly used assumption that the participants represent the entire target group. Results: This approach produces higher prevalence estimates than what is estimated from participants only. Among men, smoking prevalence estimate was 28.5% (23.2% for participants), heavy alcohol consumption prevalence was 9.4% (6.8% for participants). Among women, smoking prevalence was 19.0% (16.5% for participants) and heavy alcohol consumption 4.8% (3.0% for participants). Conclusion: Utilization of re-contact data is a useful method to adjust for non-participation bias on population estimates in epidemiological surveys.
Background Declining participation rates in health examination surveys may impair the representativeness of surveys and introduce bias into the comparison of results between population groups if participation rates differ between them. Changes in the characteristics of non-participants over time may also limit comparability with earlier surveys. Methods We studied the association of socio-economic position with participation, and its changes over the past 25 years. Occupational class and educational level are used as indicators of socio-economic position. Data from six cross-sectional FINRISK surveys conducted between 1987 and 2012 in Finland were linked to national administrative registers, which allowed investigation of the differences between survey participants and non-participants. Results Our results show that individuals with low occupational class or low level of education were less likely to participate than individuals with high occupational class or high level of education. Participation rates decreased in all subgroups of the population but the decline was fastest among those with low level of education. Conclusions The differences in participation rates must be taken into account to avoid biased estimates because socio-economic position has also been shown to be strongly related to health, health behaviour and biological risk factors. Particular attention should be paid to the recruitment of the less-educated population groups.
Abstract Background: Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher. Methods: For this analysis, we pooled national, subnational, or community population-based studies that had measured blood pressure in adults aged 18 years and older. We used a Bayesian hierarchical model to estimate trends from 1975 to 2015 in mean systolic and mean diastolic blood pressure, and the prevalence of raised blood pressure for 200 countries. We calculated the contributions of changes in prevalence versus population growth and ageing to the increase in the number of adults with raised blood pressure. Findings: We pooled 1479 studies that had measured the blood pressures of 19.1 million adults. Global age-standardised mean systolic blood pressure in 2015 was 127.0 mm Hg (95% credible interval 125.7–128.3) in men and 122.3 mm Hg (121.0–123.6) in women; age-standardised mean diastolic blood pressure was 78.7 mm Hg (77.9–79.5) for men and 76.7 mm Hg (75.9–77.6) for women. Global age-standardised prevalence of raised blood pressure was 24.1% (21.4–27.1) in men and 20.1% (17.8–22.5) in women in 2015. Mean systolic and mean diastolic blood pressure decreased substantially from 1975 to 2015 in high-income western and Asia Pacific countries, moving these countries from having some of the highest worldwide blood pressure in 1975 to the lowest in 2015. Mean blood pressure also decreased in women in central and eastern Europe, Latin America and the Caribbean, and, more recently, central Asia, Middle East, and north Africa, but the estimated trends in these super-regions had larger uncertainty than in high-income super-regions. By contrast, mean blood pressure might have increased in east and southeast Asia, south Asia, Oceania, and sub-Saharan Africa. In 2015, central and eastern Europe, sub-Saharan Africa, and south Asia had the highest blood pressure levels. Prevalence of raised blood pressure decreased in high-income and some middle-income countries; it remained unchanged elsewhere. The number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries. The global increase in the number of adults with raised blood pressure is a net effect of increase due to population growth and ageing, and decrease due to declining age-specific prevalence. Interpretation: During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.
Abstract High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.
Blast-furnace slag and metakaolin were geopolymerised, modified with barium or treated with a combination of these methods in order to obtain an efficient SO42− sorbent for mine water treatment. Of prepared materials, barium-modified blast-furnace slag geopolymer (Ba-BFS-GP) exhibited the highest SO42− maximum sorption capacity (up to 119 mg g−1) and it compared also favourably to materials reported in the literature. Therefore, Ba-BFS-GP was selected for further studies and the factors affecting to the sorption efficiency were assessed. Several isotherms were applied to describe the experimental results of Ba-BFS-GP and the Sips model showed the best fit. Kinetic studies showed that the sorption process follows the pseudo-second-order kinetics. In the dynamic removal experiments with columns, total SO42− removal was observed initially when treating mine effluent. The novel modification method of geopolymer material proved to be technically suitable in achieving extremely low concentrations of SO42− (<2 mg L−1) in mine effluents.
Abstract Background: Although high-density lipoprotein (HDL) and non-HDL cholesterol have opposite associations with coronary heart disease, multi-country reports of lipid trends only use total cholesterol (TC). Our aim was to compare trends in total, HDL and non-HDL cholesterol and the total-to-HDL cholesterol ratio in Asian and Western countries. Methods: We pooled 458 population-based studies with 82.1 million participants in 23 Asian and Western countries. We estimated changes in mean total, HDL and non-HDL cholesterol and mean total-to-HDL cholesterol ratio by country, sex and age group. Results: Since ∼1980, mean TC increased in Asian countries. In Japan and South Korea, the TC rise was due to rising HDL cholesterol, which increased by up to 0.17 mmol/L per decade in Japanese women; in China, it was due to rising non-HDL cholesterol. TC declined in Western countries, except in Polish men. The decline was largest in Finland and Norway, at ∼0.4 mmol/L per decade. The decline in TC in most Western countries was the net effect of an increase in HDL cholesterol and a decline in non-HDL cholesterol, with the HDL cholesterol increase largest in New Zealand and Switzerland. Mean total-to-HDL cholesterol ratio declined in Japan, South Korea and most Western countries, by as much as ∼0.7 per decade in Swiss men (equivalent to ∼26% decline in coronary heart disease risk per decade). The ratio increased in China. Conclusions: HDL cholesterol has risen and the total-to-HDL cholesterol ratio has declined in many Western countries, Japan and South Korea, with only a weak correlation with changes in TC or non-HDL cholesterol.
Abstract From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions.
Abstract Background: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5–19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5–19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (−0·01 kg/m2 per decade; 95% credible interval −0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69–1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64–1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (−0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50–1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4–1·2) in 1975 to 5·6% (4·8–6·5) in 2016 in girls, and from 0·9% (0·5–1·3) in 1975 to 7·8% (6·7–9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0–12·9) in 1975 to 8·4% (6·8–10·1) in 2016 in girls and from 14·8% (10·4–19·5) in 1975 to 12·4% (10·3–14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7–29·6) among girls and 30·7% (23·5–38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44–117) million girls and 117 (70–178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24–89) million girls and 74 (39–125) million boys worldwide were obese. Interpretation: The rising trends in children’s and adolescents’ BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.
Kieli: | fin swe eng nor |
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Julkaisija: | Tampere : Informaatiotutkimuksen yhdistys 1996- |
ISSN: |
1797-9129 |
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Kieli: | eng fin |
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Julkaisija: | Helsinki : Family Federation of Finland 2006- |
ISSN: |
1796-6191 |
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Kieli: | mul fin eng |
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Julkaisija: | Helsinki : Suomen biologian seura Vanamo 1995- |
ISSN: |
0024-7383 |
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