Charging NO x Emitters for Health Damages: An Exploratory Analysis

We present a proof-of-concept analysis of the measurement of the health damage of ozone (O 3) produced from nitrogen oxides (NO x = NO + NO 2) emitted by individual large point sources in the eastern United States. We use a regional atmospheric model of the eastern United States, the Comprehensive Air Quality Model with eXtensions (CAMx), to quantify the variable impact that a fixed quantity of NO x emitted from individual sources can have on the downwind concentration of surface O 3, depending on temperature and local biogenic hydrocarbon emissions. We also examine the dependence of resulting ozone-related health damages on the size of the exposed population. The investigation is relevant to the increasingly widely used "cap and trade" approach to NO x regulation, which presumes that shifts of emissions over time and space, holding the total fixed over the course of the summer O 3 season, will have minimal effect on the environmental outcome. By contrast, we show that a shift of a unit of NO x emissions from one place or time to another could result in large changes in resulting health effects due to ozone formation and exposure. We indicate how the type of modeling carried out here might be used to attach externality-correcting prices to emissions. Charging emitters fees that are commensurate with the damage caused by their NO x emissions would create an incentive for emitters to reduce emissions at times and in locations where they cause the largest damage.surface ozone, NO x emissions, point sources, health impacts, mortality, morbidity, cap-and-trade

Charging NOx Emitters for Health Damages: An Exploratory Analysis

We present a proof-of-concept analysis of the measurement of the health damage of ozone (O3) produced from nitrogen oxides (NOx = NO NO2) emitted by individual large point sources in the eastern United States. We use a regional atmospheric model of the eastern United States, the Comprehensive Air Quality Model with Extensions (CAMx), to quantify the variable impact that a fixed quantity of NOx emitted from individual sources can have on the downwind concentration of surface O3, depending on temperature and local biogenic hydrocarbon emissions. We also examine the dependence of resulting ozone-related health damages on the size of the exposed population. The investigation is relevant to the increasingly widely used "cap and trade" approach to NOx regulation, which presumes that shifts of emissions over time and space, holding the total fixed over the course of the summer O3 season, will have minimal effect on the environmental outcome. By contrast, we show that a shift of a unit of NOx emissions from one place or time to another could result in large changes in the health effects due to ozone formation and exposure. We indicate how the type of modeling carried out here might be used to attach externality-correcting prices to emissions. Charging emitters fees that are commensurate with the damage caused by their NOx emissions would create an incentive for emitters to reduce emissions at times and in locations where they cause the largest damage.

Charging NOx Emitters for Health Damages: An Exploratory Analysis

We present a proof-of-concept analysis of the measurement of the health damage of ozone (O3) produced from nitrogen oxides (NOx = NO + NO2) emitted by individual large point sources in the eastern United States. We use a regional atmospheric model of the eastern United States, the Comprehensive Air Quality Model with Extensions (CAMx), to quantify the variable impact that a fixed quantity of NOx emitted from individual sources can have on the downwind concentration of surface O3, depending on temperature and local biogenic hydrocarbon emissions. We also examine the dependence of resulting ozone-related health damages on the size of the exposed population. The investigation is relevant to the increasingly widely used “cap and trade” approach to NOx regulation, which presumes that shifts of emissions over time and space, holding the total fixed over the course of the summer O3 season, will have minimal effect on the environmental outcome. By contrast, we show that a shift of a unit of NOx emissions from one place or time to another could result in large changes in the health effects due to ozone formation and exposure. We indicate how the type of modeling carried out here might be used to attach externality-correcting prices to emissions. Charging emitters fees that are commensurate with the damage caused by their NOx emissions would create an incentive for emitters to reduce emissions at times and in locations where they cause the largest damage.surface ozone, NOx emissions, point sources, health impacts, mortality, morbidity, cap-and-trade

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Importance Transcutaneous lower eyelid blepharoplasty is a commonly performed procedure with a postoperative risk of eyelid malposition. Objective To quantify the change in lower eyelid position after transcutaneous lower eyelid blepharoplasty. Design, Setting, and Participants This retrospective medical record review describes patients who underwent transcutaneous blepharoplasty at a private facial plastic surgery practice. Patients with less than 3 months of follow-up, a history of periocular trauma, and concurrent midface lift were excluded. Interventions Bilateral skin-muscle flap lower eyelid blepharoplasties with possible tarsorrhaphy, canthopexy, or canthoplasty as indicated. Main Outcomes and Measures Lower eyelid position determined by measurement of preoperative and postoperative pupil to eyelid and lateral limbus to eyelid distances. Results Data from 100 consecutive patients (mean age, 56.7 years; 92 female [92.0%]) undergoing bilateral skin-muscle flap lower eyelid blepharoplasty were analyzed. The mean increase in distance was 0.33 mm (95% CI, 0.24-0.42 mm) from the pupil to the lower eyelid margin and 0.32 mm (95% CI, 0.23-0.41 mm) from the lateral limbus to the lower eyelid margin at final follow-up. For both measurements, patients undergoing concurrent canthopexy had a significantly greater change in eyelid position (P < .001). Men had a greater change in the distance of pupil to lower eyelid compared with women (0.76 mm; 95% CI, 0.44-1.08 mm, vs 0.30 mm; 95% CI, 0.20-0.39 mm, respectively; P = .008) at final follow-up. Two patients required revision procedures secondary to eyelid malposition, and 25 patients had new onset of dry eye symptoms. Conclusions and Relevance Transcutaneous skin-muscle lower eyelid blepharoplasty with selective performance of canthoplasty or canthopexy causes a small, predictable eyelid position change in this population with a low rate of revision procedures. Level of Evidence 3

Boundedness of an intrinsic square function on grand p-adic Herz-Morrey spaces

This research paper focuses on establishing a framework for grand Herz-Morrey spaces defined over the $p$-adic numbers and their associated $p$-adic intrinsic square function. We will define the ideas of grand $p$-adic Herz-Morrey spaces with variable exponent ${M\dot{K} ^{\alpha, u), \theta}_{ s(\cdot)}(\mathbb{Q}^n_p)}$ and $p$-adic intrinsic square function. Moreover, the corresponding operator norms are estimated. Grand $p$-adic Herz-Morrey spaces with variable exponent is the generalization of $p$-adic Herz spaces. Our main goal is to obtain the boundedeness of $p$-adic intrinsic square function in grand $p$-adic Herz-Morrey spaces with variable exponent ${M\dot{K} ^{\alpha, u), \theta}_{ s(\cdot)}(\mathbb{Q}^n_p)}$. The boundedness is proven by exploiting the properties of variable exponents in these function spaces

Boundedness of Marcinkiewicz integral operator of variable order in grand Herz-Morrey spaces

Let $\mathbb{S}^{n-1}$ denotes the unit sphere in $\mathbb{R}^n$ equipped with the normalized Lebesgue measure. Let $\Phi \in L^r(\mathbb{S}^{n-1})$ be a homogeneous function of degree zero. The variable Marcinkiewicz fractional integral operator is defined as $\mu _{\Phi} (f)(z_1) = \left( \int \limits _0 ^ \infty \left|\int \limits _{|z_1-z_2| \leq s} \frac{\Phi(z_1-z_2)}{|z_1-z_2|^{n-1-\zeta(z_1)}}f(z_2)dz_2\right|^2 \frac{ds}{s^3}\right)^{\frac{1}{2}}.$ The Marcinkiewicz fractional operator of variable order $\zeta(z_1)$ is shown to be bounded from the grand Herz-Morrey spaces ${M\dot{K} ^{\alpha(\cdot), u), \theta}_{\beta, p(\cdot)}(\mathbb{R}^n)}$ with variable exponent into the weighted space ${M\dot{K} ^{\alpha(\cdot), u), \theta}_{\beta, \rho, q(\cdot)}(\mathbb{R}^n)}$ where $\rho = (1+|z_1|)^{-\lambda}$ and ${1 \over q(z_1)} = {1 \over p(z_1)}-{\zeta(z_1) \over n}$ when $p(z_1)$ is not necessarily constant at infinity

Boundedness of some operators on grand Herz spaces with variable exponent

Our aim in this paper is to prove boundedness of an intrinsic square function and higher order commutators of fractional integrals on grand Herz spaces with variable exponent ${\dot{K} ^{a(\cdot), u), \theta}_{ s(\cdot)}(\mathbb{R}^n)}$ by applying some properties of variable exponent

A derivative-type operator and its application to the solvability of a nonlinear three point boundary value problem

In this paper we introduce an operator that can be thought as a derivative of variable order, i.e. the order of the derivative is a function. We prove several properties of this operator, for instance, we obtain a generalized Leibniz‘s formula, Rolle and Cauchy‘s mean theorems and a Taylor type polynomial. Moreover, we obtain its inverse operator. Also, with this derivative we analyze the existence of solutions of a nonlinear three-point boundary value problem of “variable order”

Boundedness of Hardy operators on grand variable weighted Herz spaces

In this paper, we will introduce the idea of grand variable weighted Herz spaces ${{\dot{K} ^{\alpha(\cdot), \epsilon), \theta}_{ q(\cdot)}(\tau)}}$ in which $\alpha$ is also a variable. Our main purpose in this paper is to prove the boundedness of Hardy operators on grand variable weighted Herz spaces

Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care

Background: Evidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited.Objective: The objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses\u27 experience and thus enhancing patient experience in a tertiary care hospital in Pakistan.Methods: Designed as an intervention development study, it was completed between January 2018-December 2019. The programme was developed by a team composed of service and nursing leadership, director patient experience of care and a compassion specialist using a theory of change model. The package followed a series of steps, a) identification of a framework, b) creation of working group c) needs assessment and d) multiple meetings to frame the model followed by implementing the preconditions for roll-out of the programme with the frontline staff.Results: The eventual outcome was improving the patient\u27s experience of compassion while the intermediate outcome was to have nurses demonstrate compassionate care. The pre-conditions were identified as: recruitment of staff with appropriate skills for pediatric care, provision of compassionate experience to the frontline nurses by addressing their specific pain points, development of competent head nurses as supervisors and creation of a compassionate culture. To ensure the pre-conditions, various interventions were planned with some implemented through the course of the study while others are in the process of being rolled out. These involved, inclusion of pediatric compassion specific module during orientation of new hires, creation of space to talk about compassionate skills with staff, provision of trainings and mentorship to create competent head nurses, and creating a culture that promoted and recognized compassionate care values.Conclusion: The approach helped to delineate feasible pathways for an on-job compassionate mentorship programme enhancing routine supervisors\u27 role as facilitators of compassionate care