A Quantitative Chemicals' Mixture Risk Assessment Approach For Contaminants Of Emerging Concern Management In Drinking Water

Uncertainties on occurrence and hazard of mixtures of Contaminants of Emerging Concern (CECs) in drinking water (DW) challenge water utilities and decision makers in prioritizing these compounds in, respectively, interventions for the optimization of DW treatment and DW regulations. Continuous development of quantitative risk assessment procedures addressing adverse effects of CECs supports decision-making regarding mitigation actions in minimizing health risks. We propose a novel, quantitative chemical risk assessment (QCRA) approach for mixtures of CECs in DW. The risks are evaluated with the aid of the benchmark quotient probabilistic distribution and including uncertainties in both (i) exposure assessment using occurrence data of different DW sources and simulating DW treatment by granular activated carbon and (ii) hazard assessment steps. The QCRA was applied to compare risks deriving from the presence of alkylphenols mixtures in tap or bottled DW, and to evaluate how actual DW consumption habits affect health risks

Evaluation of on-farm veal calves' responses to unfamiliar humans and potential influencing factors

The human–animal relationship is an important component of the welfare of farm animals and for this reason animal responsiveness tests to humans are included in on-farm welfare assessment schemes that provide indicators for this. However, apart from the behaviour of stockpersons towards their animals, other factors may also influence animals’ reactivity to humans as observed through behavioural tests, which can add a further layer of complexity to the interpretation of test results. Knowledge of these factors may help a better interpretation of differences from one farm to another in the outcome of human–animal relationship tests, and may provide clues for improving the relationship between animals and humans. The main objective of this study was to identify whether management or environmental factors could influence the outcome of human–animal relationship tests in veal calves. Two tests were performed when calves were aged 14.9 ± 1.6 (SD) weeks in 148 veal farms: the voluntary approach of an unfamiliar human standing at the feeding fence and the reaction towards an unfamiliar human who entered the home pen and tried to touch each calf in a standardised way (Calf Escape Test (CET) – score 0 to 4). Questionnaires were filled in and interviews with the stockpersons were performed in order to obtain information on stockpersons, management, animal and building characteristics. The latency to touch an unfamiliar human at the feeding fence was significantly correlated with the CET scores. Total number of calves on the farm, space allowance, breed, environmental enrichment, stockperson's experience and season of observation influenced the percentage of calves that scored 0 in CET (i.e. calves that could not be approached). Type of milk distribution, type of breed and number of calves per stockperson influenced the percentage of calves that scored 4 in CET (i.e. calves could be touched). For both CET0 and CET4, the level of self-reported contacts by the stockperson (analysed only on the French subset of 36 farms) did not influence the results. This paper concludes that according to the tests conducted on veal calves on commercial farms, factors such as milk distribution method, breed of the calves or the level of experience of stockpersons with veal farming can have an impact on the results of tests focusing on human–animal relationships

Association of thrombus density and endovascular treatment outcomes in patients with acute ischemic stroke due to M1 occlusions

PURPOSE: We aimed to study the association of non-contrast CT (NCCT) thrombus density with procedural and clinical outcomes in patients with acute ischemic stroke who underwent endovascular treatment (EVT). Since thrombus density is associated with thrombus location, we focused on M1 occlusions only.METHODS: Patients with available thin-slice (&lt; 2.5 mm) NCCT were included from a nationwide registry. Regression models were used to assess the relation between thrombus density (per Hounsfield unit [HU]) and the following outcomes. For reperfusion grade, adjusted common odds ratios (acOR) indicated a 1-step shift towards improved outcome per HU increase in thrombus density. For the binary outcomes of first-pass reperfusion (first-pass extended thrombolysis in cerebral infarction [eTICI] 2C-3, FPR), functional independence [90-day modified Rankin Scale (mRS) score of 0-2] and mortality), aORs were reported. Adjusted β coefficients (aβ) were reported for 24-h NIHSS and procedure duration in minutes. Outcome differences between first-line treatment devices (stent retriever versus aspiration) were assessed with interaction terms.RESULTS: In 566 patients with M1 occlusions, thrombus density was not associated with reperfusion (acOR 1.01, 95% CI 0.99-1.02), FPR (aOR 1.01, 95% CI 0.99-1.03), mortality (aOR 0.98, 95% CI 0.95-1.00), 24-h NIHSS (aβ - 0.7%, 95% CI - 1.4-0.2), or procedure duration (aβ 0.27, 95% CI - 0.05-0.58). In multivariable analysis, thrombus density was associated with functional independence (aOR 1.02, 95% CI 1.00-1.05). No interaction was found between thrombus density and first-line treatment device for any outcome.CONCLUSION: In patients with M1 occlusions, thrombus density was not clearly associated with procedural and clinical outcomes after EVT.</p

Woodrow Wilson’s diplomatic agenda and strategic military interventions: how they affected the Russian Civil War 1918-1920

This thesis aims to understand the factors that affected Woodrow Wilson’s foreign and military policy actions, which subsequently led to decisions that dictated United States’ intervention into the Russian Civil War, 1918-1920. The background information discussed demonstrates the importance of the Russian Civil War. This chaotic time in history surrounding World War I caused much of Woodrow Wilson’s dilemma and consequentially changed future of Soviet-American relations. It details how it would take numerous foreign policy shifts to convince Mr. Wilson to send U.S. troops to intervene into North Russia and Siberia. Lenin’s opposing perspective will encompass what is contained in much of the supporting information surrounding this thesis. In conjunction with military operations there, the allies attempted to broker peace with Lenin and the Bolsheviks in the form of the Prinkipo Proposal, the Bullitt Mission, and the Hoover-Nansen Proposal. The concluding question that frames the argument of this research will answer what happened because Wilson intervened on Russian soil and how it affected the Communist world revolution. What positive results, if any, can be discovered? (Author abstract)Rinehart, R.A. (2017) Woodrow Wilson’s diplomatic agenda and strategic military interventions: how they affected the Russian Civil War 1918-1920. Retrieved from http://academicarchive.snhu.eduMaster ArtsHistoryCollege of Online and Continuing Educatio

The burden of carotid-related strokes

International audienceNo abstract availabl

A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke

The value of administering intravenous alteplase before endovascular treatment (EVT) for acute ischemic stroke has not been studied extensively, particularly in non-Asian populations. METHODS We performed an open-label, multicenter, randomized trial in Europe involving patients with stroke who presented directly to a hospital that was capable of providing EVT and who were eligible for intravenous alteplase and EVT. Patients were randomly assigned in a 1:1 ratio to receive EVT alone or intravenous alteplase followed by EVT (the standard of care). The primary end point was functional outcome on the modified Rankin scale (range, 0 [no disability] to 6 [death]) at 90 days. We assessed the superiority of EVT alone over alteplase plus EVT, as well as noninferiority by a margin of 0.8 for the lower boundary of the 95% confidence interval for the odds ratio of the two trial groups. Death from any cause and symptomatic intracerebral hemorrhage were the main safety end points. RESULTS The analysis included 539 patients. The median score on the modified Rankin scale at 90 days was 3 (interquartile range, 2 to 5) with EVT alone and 2 (interquartile range, 2 to 5) with alteplase plus EVT. The adjusted common odds ratio was 0.84 (95% confidence interval [CI], 0.62 to 1.15; P=0.28), which showed neither superiority nor noninferiority of EVT alone. Mortality was 20.5% with EVT alone and 15.8% with alteplase plus EVT (adjusted odds ratio, 1.39; 95% CI, 0.84 to 2.30). Symptomatic intracerebral hemorrhage occurred in 5.9% and 5.3% of the patients in the respective groups (adjusted odds ratio, 1.30; 95% CI, 0.60 to 2.81). CONCLUSIONS In a randomized trial involving European patients, EVT alone was neither superior nor noninferior to intravenous alteplase followed by EVT with regard to disability outcome at 90 days after stroke. The incidence of symptomatic intracerebral hemorrhage was similar in the two groups

Probabilistic derivation of the interspecies assessment factor for skin sensitization.

An interspecies sensitization assessment factor (SAF) is used in the quantitative risk assessment (QRA) for skin sensitization when a murine-based NESIL (No Expected Sensitization Induction Level) is taken as point of departure. Several studies showed that, on average, the murine sensitization threshold is in good correspondence with that determined in humans. However, on an individual level, the murine and human sensitization thresholds may differ considerably. In this study, the interspecies SAF was quantified by using a probabilistic approach, to be able to take these cases into account. As expected, the geometric means of the probability distributions of murine and human sensitization threshold ratios were close to one, but taking the 95 th percentile of these distributions resulted in an interspecies SAF of 15. By using this value, one is sure that with 95% probability, the sensitization threshold determined in mice does not underestimate the human threshold. It can be concluded that a murine-based NESIL requires the use of an interspecies SAF (of 15) in the QRA for skin sensitization, to correct for the differences between mice and humans. This empirically derived interspecies SAF contributes to refinement of the risk assessment methodology

Health impact assessment of a skin sensitizer: Analysis of potential policy measures aimed at reducing geraniol concentrations in personal care products and household cleaning products.

A methodology to assess the health impact of skin sensitizers is introduced, which consists of the comparison of the probabilistic aggregated exposure with a probabilistic (individual) human sensitization or elicitation induction dose. The health impact of potential policy measures aimed at reducing the concentration of a fragrance allergen, geraniol, in consumer products is analysed in a simulated population derived from multiple product use surveys. Our analysis shows that current dermal exposure to geraniol from personal care and household cleaning products lead to new cases of contact allergy and induce clinical symptoms for those already sensitized. We estimate that this exposure results yearly in 34 new cases of geraniol contact allergy per million consumers in Western and Northern Europe, mainly due to exposure to household cleaning products. About twice as many consumers (60 per million) are projected to suffer from clinical symptoms due to re-exposure to geraniol. Policy measures restricting geraniol concentrations to <0.01% will noticeably reduce new cases of sensitization and decrease the number of people with clinical symptoms as well as the frequency of occurrence of these clinical symptoms. The estimated numbers should be interpreted with caution and provide only a rough indication of the health impact