Knowledge gaps in the construction of rural healthy homes: A research agenda for improved low-cost housing in hot-humid Africa

Lorenz von Seidlein and colleagues discuss improving house designs in rural Africa to benefit health

Ecosystem and Wildlife Implications of Brush: Management System Designed to Improve Water Runoff and Percolation

With the settlement of Texas and establishment of ranchers to produce cattle, there was an effort to maximize beef production. This caused serious overgrazing. In addition, there was a reduced incidence of fires across the landscape to clear out brush. These factors led to deterioration of the grazing lands and provided an opportunity for invasive intrusion by brush and other species onto the land and riparian zones. There has been a large-scale conversion from grasslands and savannahs to wildlands over the last 150 years (Scholes and Archer, 1997). The overall impacts are significantly impaired uplands and reduced percolation and surface flow of water from rainfall which caused changes and loss in basic aquatic and terrestrial habitat. The State of Texas adopted a program to study and implement brush management systems across the state to improve the water availability in streams, rivers, reservoirs and aquifers, as well as to improve the rangelands. The feasibility studies have shown great promise for improving ranchland and improving the water situation. However, there is less known about the aquatic and wildlife species response implications of brush management. Certainly, there are opportunities for improving the viability of an ecosystem through brush management strategies and continuing management practices. The purpose of this study was to evaluate the changes in hydrology and biological diversity associated with brush management in two watersheds where significant data was already available. This study focused on assessing the aquatic and terrestrial species implications related to specified brush management strategies over time. This involved an integrated analysis including modeling of the landscape, assessing biological diversity and developing economic implications for the two watersheds (Twin Buttes and Edwards regions). Thus, this study is comprised of three parts: modeling of brush management strategies temporally, assessing biological diversity (aquatic and terrestrial) and estimating economic implications. This represents a complex analysis involving variable units and multiple disciplines. Previous feasibility studies of brush removal have been targeted at maximizing water runoff. This analysis is an extension that is designed to examine the implications of brush management under a more restrictive set of brush removal criteria that were chosen based upon wildlife considerations. To achieve the integration of hydrologic modeling, range ecology, and economic implications, there were three team meetings bringing together all components to review status and set priorities for the remainder of the work. In addition, scientists in the three basic groups of specialization interacted daily along with representatives of the Corps of Engineers to assure that each decision was reflected in other parts of the analyses. The major addition of this analysis to brush management feasibility studies being conducted as part of the Texas brush management plan is the consideration of wildlife and aquatic biota and assessing changes in biological diversity likely to result from alternative brush management scenarios

The Safe Addition of Nitric Oxide into the Sweep Gas of the Extracorporeal Circuit during Cardiopulmonary Bypass and Extracorporeal Life Support

Low cardiac output syndrome and the systemic inflammatory response are consequences of the cardiac surgical perioperative course. The mechanisms responsible are multifactorial, but recent studies have shown that nitric oxide (NO) may be a key component in mitigating some of these processes. Following on from literature reports detailing the use of inhaled NO added to the gas phase of the extracorporeal circuit, we set about developing a technique to perform this addition safely and efficiently. In the setting of cardiopulmonary bypass, the technique was validated in a randomized prospective trial looking at 198 children. The benefits observed in this trial then stimulated the incorporation of NO into all extracorporeal life support (ECLS) circuits. This required additional hardware modifications all of which were able to be performed safely. Initial results from the first series of ECLS patients using NO also appear promising

Clinical Imaging and Dosimetry of a Pan-Cancer Targeting Alkylphosphocholine Analog, [¹²⁴I]I-NM404

The purpose of this study was to assess organ dosimetry and clinical use of [124I]I-NM404, a radiotheranostic alkylphosphocholine (APC) analog, for accurate detection and characterization of a wide variety of solid primary and metastatic malignancies anywhere in the body. Methods: Patterns of [124I]I-NM404 uptake were quantitatively analyzed and qualitatively compared with [18F]FDG PET/CT in 14 patients (median age, 61.5 years; 7 males, 7 females) with refractory metastatic cancer who were enrolled in one of two Phase I imaging studies. Primary cancer types included bronchogenic (n = 7), colorectal (n = 1), prostate (n = 1), triple-negative breast (n = 1), head and neck (n = 2), pancreatic (n = 1) carcinoma, and melanoma (n = 1). Patients were administered [124I]I-NM404 and imaged via PET/CT at 1–2, 4–6, 24, and 48 h and at 5–10 days post injection, from top of the skull to mid-thigh. Volumes of interest were drawn over lungs, heart, liver, kidneys, and whole body for dosimetry estimation using OLINDA 1.1 Representative metastatic index lesions were chosen when applicable for each case with active sites of disease to calculate maximum and mean tumor-to-background ratios (TBRmax, TBRmean), using the adjacent normal organ parenchyma as background when possible. Results: Administrations of [124I]-NM404 were safe and well-tolerated. The organs with the highest estimated absorbed dose (mean ± SD) were the lungs (1.74 ± 0.39 mSv/MBq), heart wall (1.52 ± 0.29 mSv/MBq), liver (1.28 ± 0.21 mSv/MBq) and kidneys (1.09 ± 0.20 mSv/MBq). The effective dose was 0.77 ± 0.05 mSv/MBq. Preferential uptake within metastatic foci was observed with all cancer subtypes, TBRmax ranged from 1.95 to 15.36 and TBRmean ranged from 1.63 to 6.63. Robust sensitive imaging of lesions was enhanced by delayed timing (2–6 days after single injection of [124I]I-NM404, respectively) due to persistent tumor retention coupled with progressive washout of background activity. NM404 uptake was evident in pulmonary, nodal, skeletal, CNS, and other metastatic sites of disease. Radiation related injury or necrosis were NM404 negative, whereas certain small number of metastatic brain lesions were false negative for NM404. Conclusions: In addition to being well tolerated, selective tumor uptake of NM404 with prolonged retention was demonstrated within a broad spectrum of highly treated metastatic cancers

Overview of the First NRG Oncology–National Cancer Institute Workshop on Dosimetry of Systemic Radiopharmaceutical Therapy

In 2018, the National Cancer Institute and NRG Oncology partnered for the first time to host a joint workshop on systemic radiopharmaceutical therapy (RPT) to specifically address dosimetry issues and strategies for future clinical trials. The workshop focused on current dosimetric approaches for clinical trials, strategies under development that would optimize dose reporting, and future desired or optimized approaches for novel emerging radionuclides and carriers in development. In this article, we review the main approaches that are applied clinically to calculate the absorbed dose. These include absorbed doses calculated over a variety of spatial scales, including whole body, organ, suborgan, and voxel, the last 3 of which are achievable within the MIRD schema (S value) and can be calculated with analytic methods or Monte Carlo methods, the latter in most circumstances. This article will also contrast currently available methods and tools with those used in the past, to propose a pathway whereby dosimetry helps the field by optimizing the biologic effect of the treatment and trial design in the drug approval process to reduce financial and logistical costs. We also briefly discuss the dosimetric equivalent of biomarkers to help bring a precision medicine approach to RPT implementation when merited by evidence collected during early-phase trial investigations. Advances in the methodology and related tools have made dosimetry the optimum biomarker for RPT