Health Disparities in the Aftermath of Flood Events: A Review of Physical and Mental Health Outcomes with Methodological Considerations in the USA.

PURPOSE OF REVIEW: This review applies an environmental justice perspective to synthesize knowledge of flood-related health disparities across demographic groups in the USA. The primary aim is to examine differential impacts on physical and mental health outcomes while also assessing methodological considerations such as flood exposure metrics, baseline health metrics, and community engagement. RECENT FINDINGS: In our review (n = 27), 65% and 72% of studies identified racial, ethnic, or socio-economic disparities in physical and mental health outcomes post-flooding, respectively. The majority of racial/ethnic disparities were based on Black race, while most socio-economic disparities were based on lower household income. Forty-two percent of studies lacked flood exposure metrics, but often identified disparities. Common flood exposure metrics included self-reported flooding, flood risk models, and satellite-based observations. Seventy percent of studies lacked baseline health measurements or suitable alternatives, and only 19% incorporated community engagement into their research design. The literature consistently finds that both physical and mental health burdens following flooding are unequally shared across racial, ethnic, and socio-economic groups. These findings emphasize the need for disaster risk reduction policies that address underlying vulnerabilities to flooding, unequal exposure to flooding, and progressive funding for recovery efforts. Findings also underscore the importance of methodological enhancements to facilitate precise assessments of flood exposure and health outcomes.

Sleep shapes the associative structure underlying pattern completion in multielement event memory.

Sleep supports the consolidation of episodic memory. It is, however, a matter of ongoing debate how this effect is established, because, so far, it has been demonstrated almost exclusively for simple associations, which lack the complex associative structure of real-life events, typically comprising multiple elements with different association strengths. Because of this associative structure interlinking the individual elements, a partial cue (e.g., a single element) can recover an entire multielement event. This process, referred to as pattern completion, is a fundamental property of episodic memory. Yet, it is currently unknown how sleep affects the associative structure within multielement events and subsequent processes of pattern completion. Here, we investigated the effects of post-encoding sleep, compared with a period of nocturnal wakefulness (followed by a recovery night), on multielement associative structures in healthy humans using a verbal associative learning task including strongly, weakly, and not directly encoded associations. We demonstrate that sleep selectively benefits memory for weakly associated elements as well as for associations that were not directly encoded but not for strongly associated elements within a multielement event structure. Crucially, these effects were accompanied by a beneficial effect of sleep on the ability to recall multiple elements of an event based on a single common cue. In addition, retrieval performance was predicted by sleep spindle activity during post-encoding sleep. Together, these results indicate that sleep plays a fundamental role in shaping associative structures, thereby supporting pattern completion in complex multielement events.

Comparative biomechanical study of a new transpedicular vertebral device and vertebroplasty for the treatment or prevention of vertebral compression fractures.

BACKGROUND: A comparative study was performed between a novel transpedicular implant (V-STRUT©, Hyprevention, France) and vertebroplasty. This study aims to assess the biomechanical efficacy of this implant in resurrecting and fortifying the osteoporotic vertebra following a vertebral body fracture. METHODS: A total of 17 vertebrae from 3 human osteoporotic spine segments (T9-L5) were selected. Vertebral compression fractures were generated by eccentric compressive loading until a height reduction of 25%. Then the vertebrae were either fixed using vertebroplasty technique (control group; n = 8) or implanted with V-STRUT© implant combined with bone cement (device group; n = 9). A new compressive loading was performed in the same conditions. Maximal load and stiffness, as well as total energy to fracture were measured. FINDINGS: Fracture force and energy to fracture were both increased either after V-STRUT© implantation or vertebroplasty compared to when the initial fracture was generated. Mean increase percentage between the initial value and the post-treatment value for each parameter were +77% vs +39% regarding fracture load and +126% vs +99% for energy to fracture, for the device group vs vertebroplasty group respectively. No pedicle fractures were observed in both groups, nor implant breaking or bending in the device group. INTERPRETATION: These results show the ability of V-STRUT© combined with bone cement to reinforce the vertebral body strength, with an at least equivalent biomechanical performance as vertebroplasty. Further clinical investigation needs to be undertaken to demonstrate any clinical superiority of V-STRUT© over vertebroplasty.