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AIM To better understand the healthcare burden of people with type 2 diabetes (T2D) and estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 in Ontario, Canada. MATERIALS AND METHODS We used administrative data to evaluate the prevalence of T2D, eGFR < 90 mL/min/1.73 m2 and adverse cardiovascular co-morbidities in individuals aged ≥ 30 years living in Ontario, Canada. We also examined incremental healthcare costs and healthcare resource utilization (HCRU) for these patients with specific incident cardiovascular and renal outcomes, in comparison with controls without these outcomes. RESULTS While the prevalence of T2D in the general population aged ≥ 30 years in Ontario increased by 1.8% over a 5-year period (2011-2012 to 2015-2016), the prevalence of eGFR < 90 mL/min/1.73 m2 among people with T2D increased by 35%. In comparison with corresponding controls without these outcomes, the per patient average total costs (Canadian dollars) over a 2-year analysis period were higher for patients with cardiovascular disease/chronic kidney disease related death ($69 827; n = 32 407), doubling of serum creatinine ($52 260; n = 22 825), those who started dialysis ($150 627; n = 3499) or received a kidney transplant ($50 664; n = 651). Similarly, HCRU was significantly greater for patients with these incident outcomes. CONCLUSIONS This real-world retrospective study highlights an increasing prevalence of T2D, eGFR < 90 mL/min/1.73 m2 , and the substantially higher healthcare costs and HCRU when these patients have adverse cardiovascular and renal outcomes. The existence of such a large economic burden underpins the importance of preventing these diabetes-related complications.

Publisher Copyright: © 2022 The Royal Society of Chemistry. Driven by the need for delivering sustainable water purification solutions for the removal of heavy metals from water, electrospun PVC membranes were functionalised with triethylenetetramine (TETA) and were used to remove lead(ii) ions selectively from water. The membranes were characterised and their adsorption behavior towards the removal of lead from water was investigated. The incorporation of TETA on the membrane's surface significantly improved the removal efficiency of lead(ii) up to 99.8% in 30 minutes and under ambient conditions, with the lowest concentration of 50 ppm. The adsorption mechanism was investigated and kinetic data showed a better correlation with the pseudo-second-order model. Similarly, the equilibrium data best fitted with the Langmuir adsorption isotherm model with a relatively high maximum adsorption capacity of 1250 mg g−1 for lead(ii) ions, larger than recently reported adsorption capacities for similar membranes. The functionalised membrane also showed high selectivity to lead(ii) in a mixed solution containing lead(ii), mercury(ii), cadmium(ii), arsenic(iii), copper(ii), and zinc(ii). The functionalised membrane was regenerated, where desorption of lead(ii) was achieved, under mildly acidic conditions. The removal efficiency of the regenerated membrane after six cycles of adsorption/desorption was maintained at a high level of 98%. The proposed design offers a simple yet effective, sustainable, and environmentally friendly solution for water treatment.

Objective: Few studies have longitudinally followed trends in antidepressant prescribing for Canadian children following the Black Box warning issued in 2004. Using a national data source, we aim t...

Graphene-based polymer composites exhibit a microstructure formed by aggregates within a matrix with enhanced thermal conductivity. We develop a percolation-based computational method, based on the multiple runnings of the shortest path iteratively for ellipsoidal particles to predict the thermal conductivity of such composites across stochastically-developed channels. We analyze the role of the shape and the aspect ratio of the flakes and we predict the onset of percolation based on the density and particle dimensions. Consequently, we complement and verify the conductivity trends via our experiments by inclusion of graphene aggregates and fabrication of graphene-polymer composites. The analytical development and the numerical simulations are successfully verified with the experiments, where the prediction could explain the role of larger set of particle geometry and density. Such percolation-based quantification is very useful for the effective utilization and optimization of the equivalent shape of the graphene flakes and their distribution across the composite during the preparation process and application.

Graphene-based polymers exhibit a conductive microstructure formed by aggregates in a matrix which drastically enhances their transmitting properties. We develop a new numerical framework for predicting the electrical conductivity based on continuum percolation theory in a two dimensional stochastically-generated medium. We analyze the role of the flake shape and its aspect ratio and consequently predict the onset of percolation based on the particle density and the domain scale. Simultaneously, we have performed experiments and have achieved very high electrical conductivity for such composites compared to other film fabrication techniques, which have verified the results of computing the homogenized electrical conductivity. As well, the proximity to and a comparison with other analytical models and other experimental techniques are presented. The numerical model can predict the composite transmitting conductivity in a larger range of particle geometry. Such quantification is exceedingly useful for effective utilization and optimization of graphene filler densities and their spatial distribution during manufacturing.

Publisher Copyright: © 2022 The Authors. Macromolecular Rapid Communications published by Wiley-VCH GmbH. The search for materials with better performance, longer service life, lower environmental impact, and lower overall cost is at the forefront of polymer science and material engineering. This has led to the development of self-healing polymers with a range of healing mechanisms including capsular-based, vascular, and intrinsic self-healing polymers. The development of self-healable systems has been inspired by the healing of biological systems such as skin wound healing and broken bone reconstruction. The goal of using self-healing polymers in various applications is to extend the service life of polymers without the need for replacement or human intervention especially in restricted access areas such as underwater/underground piping where inspection, intervention, and maintenance are very difficult. Through an industrial and scholarly lens, this paper provides: a) an overview of self-healing polymers; b) classification of different self-healing polymers and polymer-based composites; c) mechanical, thermal, and electrical analysis characterization; d) applications in coating, composites, and electronics; e) modeling and simulation; and f) recent development in the past 20 years. This review highlights the importance of healable polymers for an economically and environmentally sustainable future, the most recent advances in the field, and current limitations in fabrication, manufacturing, and performance.

Publisher Copyright: © 2022 The production and consumption of textiles is continuously increasing due to the growth of population and fast fashion. Fiber fragments (1 µm–5 mm) released from garments and home textiles during washing, drying, and wearing are considered a new source of environmental pollution and health hazard. Fiber fragments can be ingested by aquatic animals and substantially threaten their metabolic activities. Small fiber fragments can also enter our food chain by the consumption of sea creatures, sea table salt, and drinking water. In this paper, we overview various important parameters on the release of fiber fragments from garments, and home textiles including the type of fabric, weaving/knitting structure, detergent type and concentration, temperature, pH, spin-speed, and duration of the washing and drying processes. The influence of various mechanical and chemical textile finishes on the release of fiber fragments is explained. Any process that reduces the strength of fibers and their interactions including sanding, brushing, bleaching can potentially increase the release of fiber fragments in consecutive wet processes. We highlight some of the most important environmental regulations on the release of microplastics and fiber fragments to the environment and provide a series of recommendations to reduce the impact.

Aim To better understand the healthcare burden of people with type 2 diabetes (T2D) and estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 in Ontario, Canada. Materials and Methods We used administrative data to evaluate the prevalence of T2D, eGFR < 90 mL/min/1.73 m2 and adverse cardiovascular co‐morbidities in individuals aged ≥ 30 years living in Ontario, Canada. We also examined incremental healthcare costs and healthcare resource utilization (HCRU) for these patients with specific incident cardiovascular and renal outcomes, in comparison with controls without these outcomes. Results While the prevalence of T2D in the general population aged ≥ 30 years in Ontario increased by 1.8% over a 5‐year period (2011‐2012 to 2015‐2016), the prevalence of eGFR < 90 mL/min/1.73 m2 among people with T2D increased by 35%. In comparison with corresponding controls without these outcomes, the per patient average total costs (Canadian dollars) over a 2‐year analysis period were higher for patients with cardiovascular disease/chronic kidney disease related death ($69 827; n = 32 407), doubling of serum creatinine ($52 260; n = 22 825), those who started dialysis ($150 627; n = 3499) or received a kidney transplant ($50 664; n = 651). Similarly, HCRU was significantly greater for patients with these incident outcomes. Conclusions This real‐world retrospective study highlights an increasing prevalence of T2D, eGFR < 90 mL/min/1.73 m2, and the substantially higher healthcare costs and HCRU when these patients have adverse cardiovascular and renal outcomes. The existence of such a large economic burden underpins the importance of preventing these diabetes‐related complications.

Background and Aims The CREDENCE trial with canagliflozin demonstrated definitive evidence of renal benefits to slow the progression of end stage renal disease (ESRD) in type 2 diabetes (T2D) patients with chronic kidney disease (CKD). This real-world study was undertaken to better understand the prevalence of CKD among T2D patients in Ontario using the CREDENCE trial criteria. Ontario is the largest province, accounting for 38.8% of Canada’s population in 20191. Patients were identified in the following cohorts: T2D-CKD, T2D-CKD+cardiovascular disease (CVD), T2D-CKD+stroke, and T2D-CKD+CVD or stroke. Method This population-based retrospective cohort study was conducted in partnership with IQVIA and the Institute for Clinical Evaluative Sciences (ICES). The ICES data repository contains publicly funded administrative health service records for the Ontario population eligible for universal health coverage since 1986. Patients’ eligibility for this study was aligned with enrolment criteria in the CREDENCE trial. Patients were ≥30 years of age at index and were identified as having both T2D and CKD. Diabetes patients were identified using the validated Ontario Diabetes Database (ODD), patients Results The prevalence of T2D patients ≥30 years of age in Ontario has increased from 959,850 in FY2011/12 to 1,169,759 in FY2015/16 (Figure 2). The prevalence of CKD among T2D patients ≥30 years of age in Ontario has increased across all methods from FY2011/12 to FY2015/16: from 21% to 28% based on diagnosis/billing codes, 47% to 63% based on eGFR, 55% to 70% based on diagnosis/billing codes or eGFR, and 76% to 84% based on capture-recapture. Similarly, prevalence of T2D-CKD+CVD, T2D-CKD+stroke, and T2D-CKD+CVD or stroke has increased in most cases (Figure 3). Conclusion CKD is a common comorbidity amongst T2D patients ≥30 years of age. The study provides estimates of the prevalence of CKD in four cohorts of T2D patients with defined co-morbidities and shows that the use of diagnosis/billing codes alone may underestimate the prevalence of CKD in T2D patients. Furthermore, this real-world analysis highlights a significant, increasing prevalence of CKD among T2D patients ≥30 years of age in Ontario with all methods. On-going research aims to assess the burden of illness of patients with both T2D and CKD who are incident to T2D-related outcomes (CKD or CVD related death, kidney transplant, kidney dialysis, doubling of serum creatinine).

Inspired by the effects of a switching surface on the stability of passive dynamic walking (Safa and Naraghi in Robotica 33(01):195–207, 2015; Safa et al. in Nonlinear Dyn. 81(4):2127–2140, 2015), this paper suggests a new control strategy for stabilization of dynamic bipedal locomotion. It verifies that the stability improvement of a dynamic walking system is feasible while preserving the speed, step-length, period, natural dynamics, and the energy effectiveness of the gait. The proposed control policy goes behind the three primary principles: (i) The system’s switching surface has to be replaced by a new one if an external disturbance is induced. (ii) The new switching surface has to be reshaped back into its old style, together with the disturbance rejection. (iii) The stabilization procedure has to be performed with as small energy consumption as possible. Because of the reversibility effects of the switching surfaces in the above rules, the terminology of “Reversible Switching Surfaces” (RSS) is employed to address the control scheme; so the control objective would be the implementation of RSS for a bipedal robotic system. In this paper, this aim is achieved by a kinematically controlled foot scheme that is implemented on a simple structured biped. The presented idea is validated by a commercial version of MSC Adams software.

While cognitive theory has advanced several candidate frameworks to explain attentional entrainment, the neural basis for the temporal allocation of attention is unknown. Here we present a new model of attentional entrainment that is guided by empirical evidence obtained using a cohort of 50 artificial brains. These brains were evolvedin silicoto perform a duration judgement task similar to one where human subjects perform duration judgements in auditory oddball paradigms1. We found that the artificial brains display psychometric characteristics remarkably similar to those of human listeners, and also exhibit similar patterns of distortions of perception when presented with out-of-rhythm oddballs. A detailed analysis of mechanisms behind the duration distortion in the artificial brains suggests that their attention peaks at the end of the tone, which is inconsistent with previous attentional entrainment models. Instead, our extended model of entrainment emphasises increased attention to those aspects of the stimulus that the brain expects to be highly informative.

By employing the concept of “Reversible Switching Surfaces” (RSS), we demonstrate that it is possible to stabilize unstable periodic orbits of a push-off based dynamic walker. The concept is implemented by a simple event-based control which kinematically controls the foot during the swing phase to adjust the heel-strike. The feedback controller is designed based on the theory of Virtual Holonomic Constraints (VHC). Simulation results demonstrate, there exists a broad range of VHC which satisfies stable dynamic walking.

Objective: The goal of this study was to characterize the frequency and trends of psychotropic drug prescribing in Canadian children from 2010 to 2016 and to compare these results with a previous study conducted between 2005 and 2009. Methods: Using a national physician panel survey database from IQVIA Canada, aggregated frequencies of written prescriptions and therapeutic indications for antipsychotics, attention-deficit/hyperactivity disorder (ADHD) medications (psychostimulants and nonstimulants), and antidepressants were analyzed in children. Changes in frequency of written prescriptions and therapeutic indications are presented using descriptive statistics. Results: Written prescriptions for antipsychotics decreased by 10% from 2010 to 2016, in contrast to a 114% increase in written prescriptions for antipsychotics observed between 2005 and 2009. Written prescriptions for psychostimulants and antidepressants rose by 35% and 27%, respectively, between 2012 and 2016, comparable with previous results. The most common reasons for recommending an antipsychotic were ADHD and conduct disorder, although there appears to be a downward trend for ADHD compared with other conditions. In contrast, the share of written prescriptions for antipsychotics for autism increased 34% over the study period. Within the second-generation antipsychotics, written prescriptions for aripiprazole increased. An increase in the use of guanfacine extended release for ADHD was also observed. Conclusion: Several factors may be involved in stabilization and small decrease in antipsychotic use in recent years, including physician and patient awareness of adverse effects related to antipsychotic use, knowledge implementation strategies advocating short-term and judicious use of antipsychotics in children, and the approval of guanfacine extended release for use in Canada for ADHD in 2013.

Inverted pendulum (IP) has been broadly used to model locomotor systems. In this paper, we demonstrate that an IP-like model could simulate stable periodic handspring maneuvers with passive flight phases. The model is a 2-D symmetric rigid body which is merely controlled during the contact phase. To benefit from an open-loop sensorless strategy, the control policy is implemented only by an unvaried torque input. The system’s dynamics is an example of nonlinear impulsive systems studied and analyzed by the Poincare section method. The numerical results reveal that the stable periodic solutions are sufficiently robust for a broad range of the parameter space.

In this study, a cationic gemini surfactant with cleavable spacer and two monomeric single chain counterparts were synthesized and used. The critical micelle concentration (CMC) was measured by tensiometry for these surfactants. The emulsion stability of (Toluene 30:70 Water) emulsions in the presence of these surfactants and at various concentrations was determined by two dispersion testers (i.e. Turbiscan ® under gravity force and Lumisizer ® analytical centrifuge). The surfactant critical concentration for the emulsion stability was found to be at 2 × CMC. The emulsion stability in the presence of these surfactants followed the same trend and remained almost constant at surfactant concentration (2–6 × CMC). The gemini surfactant with lower CMC value is far better an emulsion stabilizer on concentration basis than the monomeric surfactants. The phase separation velocities of the emulsions as a function of the relative centrifugal force were fitted with linear and power correlations. The results showed that the estimated separation velocities at earth’s gravity (1 × g ) are larger than the measured values by Turbiscan for all of the surfactants. While the accelerated phase separation by Lumisizer is a fast and easy method for testing the emulsion stability and comparing the predicted shelf lives, the extrapolation and estimation of the real emulsion stability should be considered cautiously.

By employing a few simple models of passive dynamic walking mechanism, we have shown the possibility of extending the boundaries of the maximum stable speed of these autonomous robots merely by changing their terrain. The replaced terrain consists of a series of parallel local slopes and is recognized as a general form of a ramp–stair surface. Although here, the mechanism of stabilization of the unstable locomotion patterns is not clearly known, the technique is quite simple and works effectively. The merit to the method over other strategies, could be described in two separate aspects: First, it is still completely passive; so we do not need any external energy to control the robot. Second, the existing passive trajectory is preserved; thus except for the robot's stability, other walking characteristics like speed, step length, period and efficiency, either do not change (if the machine is a point-foot walker) or ultimately minimally vary (if the model possesses other kinds of foot). This theory is validated using MSC Adams commercial software. There is hope that the presented passive strategy contributes to the development of efficient control algorithms, i.e. control methods boosting the gait stability without going against the gait efficiency.