Case Studies from the Climate Technology Partnership: Landfill Gas Projects in South Korea and Lessons Learned

This paper examines landfill gas projects in South Korea. Two case studies provide concrete examples of lessons learned and offer practical guidance for future projects

Multifractal Analysis of Soil Surface Roughness

Soil surface roughness (SSR) is a parameter highly suited to the study of soil susceptibility to wind and water erosion. The development of a methodology for quantifying SSR is therefore instrumental to soil evaluation. We developed such a method, based on the multifractal analysis (MFA) of soil elevation measurements collected at the intersections on a 2- by 2-cm2 grid in a 200- by 200-cm2 plot. Samples were defined using the gliding box algorithm (GB), in which a box of a given size "glides" across the grid map in all possible directions. The advantage of the GB over the box counting algorithm is that it yields a greater number of large sample sizes, which usually leads to better statistical results. Standard deviation, semivariogram fractal dimension, and semivariogram crossover length were estimated for all scenarios to compare the results of SSR multifractal analysis to indices found with traditional techniques. For its high sensitivity to the spatial arrangement implicit in a data set, MFA appears to be better suited than classical indices to compare plots tilled under different management criteria. The results showed that MFA is able to effectively reflect the heterogeneity and complexity of agricultural SSR. Based on this type of analysis, two new indices have been defined to compare the multifractal spectrum characteristics of the raw data to the characteristics of a random field with the same average and SD

Modelling the intervention effect of opioid agonist treatment on multiple mortality outcomes in people who inject drugs:a three-setting analysis

BACKGROUND: Opioid agonist treatment (OAT) reduces many of the harms associated with opioid dependence. We use mathematical modelling to comprehensively evaluate the overall health benefits of OAT among people who inject drugs (PWID) in Kentucky (USA), Kyiv (Ukraine), and Tehran (Iran). METHODS: We developed a dynamic model of HIV and HCV transmission, incarceration, and mortality through overdose, injury, suicide, disease-related or other causes. The model was calibrated to site-specific data using Bayesian methods. We evaluated ‘preventable drug-related deaths’ (‘pDRD’: HIV/HCV/overdose/suicide/injury) averted over 2020-2040 for four scenarios, added incrementally, compared to a scenario without OAT: existing OAT coverage (setting dependent; community: 4-11%; prison: 0-40%); scaling-up community OAT to 40% coverage; increasing average OAT duration from 4-14 months to 2 years; and scaling-up prison-based OAT. OUTCOMES: Drug-related harms contribute differentially to mortality across settings: overdose contributes 27-47% (range of median projections) of pDRDs over 2020-2040, suicide 6-17%, injury 3-17%, HIV 0-59% and HCV 2-18%. Existing OAT coverage in Tehran (31%) could have substantial impact, averting 13% pDRDs, but will have negligible impact (<2%) in Kyiv and Kentucky due to low OAT coverage (<4%). Scaling-up community OAT to 40% could avert 12-24% pDRDs, including 13-19% of overdose deaths, with greater impact in settings with significant HIV mortality (Tehran and Kyiv). Improving OAT retention and providing prison-based OAT would have significant additional impact, averting 27-48% pDRDs. INTERPRETATION: OAT can substantially reduce drug-related harms, particularly in settings with HIV epidemics among PWID. Maximising these impacts requires research and investment into achieving higher coverage, longer retention and provision of OAT in prisons and the community. FUNDING: UK NIHR, NID

Results of a randomized, double blind, placebo controlled, crossover trial of melatonin for treatment of Nocturia in adults with multiple sclerosis (MeNiMS)

© 2018 The Author(s). Background: Nocturia is a common urinary symptom of multiple sclerosis (MS) which can affect quality of life (QoL) adversely. Melatonin is a hormone known to regulate circadian rhythm and reduce smooth muscle activity such as in the bladder. There is limited evidence supporting use of melatonin to alleviate urinary frequency at night in the treatment of nocturia. The aim of this study was to evaluate the effect of melatonin on the mean number of nocturia episodes per night in patients with MS. Methods: A randomized, double blind, placebo controlled crossover trial was conducted. 34 patients with nocturia secondary to multiple sclerosis underwent a 4-day pre-treatment monitoring phase. The patients were randomized to receive either 2 mg per night (taken at bedtime) of capsulated sustained-release melatonin (Circadin®) or 1 placebo capsule for 6 weeks followed by a crossover to the other regimen for an additional 6 weeks after a 1-month washout period. Results: From the 26 patients who completed the study, there was no significant difference observed in the signs or symptoms of nocturia when taking 2 mg melatonin compared to placebo. The primary outcome measure, mean number of nocturia episodes on bladder diaries, was 1.8/night at baseline, and 1.4/night on melatonin, compared with 1.6 for placebo (Medians 1.70, 1.50, and 1.30 respectively, p = 0.85). There was also no significant difference seen in LUTS, QoL and sleep quality when taking melatonin. No significant safety concerns arose. Conclusions: This small study suggests that a low dose of melatonin taken at bedtime may be ineffective therapy for nocturia in MS. Trial registration: (EudraCT reference) 2012-00418321 registered: 25/01/13. ISRCTN Registry: ISRCTN38687869

'Care and Prevent': rationale for investigating skin and soft tissue infections and AA amyloidosis among people who inject drugs in London.

BACKGROUND: Skin and soft tissue infections (SSTIs) are a leading cause of morbidity and mortality among people who inject drugs (PWID). International data indicate up to one third of PWID have experienced an SSTI within the past month. Complications include sepsis, endocarditis and amyloid A (AA) amyloidosis. AA amyloidosis is a serious sequela of chronic SSTI among PWID. Though there is a paucity of literature reporting on AA amyloidosis among PWID, what has been published suggests there is likely a causal relationship between AA amyloidosis and injecting-related SSTI. If left untreated, AA amyloidosis can lead to renal failure; premature mortality among diagnosed PWID is high. Early intervention may reverse disease. Despite the high societal and individual burden of SSTI among PWID, empirical evidence on the barriers and facilitators to injecting-related SSTI prevention and care or the feasibility and acceptability of AA amyloidosis screening and treatment referral are limited. This study aims to fill these gaps and assess the prevalence of AA amyloidosis among PWID. METHODS: Care and Prevent is a UK National Institute for Health Research-funded mixed-methods study. In five phases (P1-P5), we aim to assess the evidence for AA amyloidosis among PWID (P1); assess the feasibility of AA amyloidosis screening, diagnostic and treatment referral among PWID in London (P2); investigate the barriers and facilitators to AA amyloidosis care (P3); explore SSTI protection and risk (P4); and co-create harm reduction resources with the affected community (P5). This paper describes the conceptual framework, methodological design and proposed analysis for the mixed-methods multi-phase study. RESULTS: We are implementing the Care and Prevent protocol in London. The systematic review component of the study has been completed and published. Care and Prevent will generate an estimate of AA amyloidosis prevalence among community recruited PWID in London, with implications for the development of screening recommendations and intervention implementation. We aim to recruit 400 PWID from drug treatment services in London, UK. CONCLUSIONS: Care and Prevent is the first study to assess screening feasibility and the prevalence of positive proteinuria, as a marker for AA amyloidosis, among PWID accessing drug treatment services. AA amyloidosis is a serious, yet under-recognised condition for which early intervention is available but not employed

A cross-sectional survey of prevalence and correlates of suicidal ideation and suicide attempts among prisoners in New South Wales, Australia

<p>Abstract</p> <p>Background</p> <p>We aimed to estimate the prevalence of suicidal ideation and suicide attempt among prisoners in New South Wales, Australia; and, among prisoners reporting suicidal ideation, to identify factors associated with suicide attempt.</p> <p>Methods</p> <p>A cross-sectional design was used. Participants were a random, stratified sample of 996 inmates who completed a telephone survey. The estimated population prevalence of suicidal ideation and suicide attempt were calculated and differences by sex and Aboriginality were tested using <it>χ</it>2 tests. Correlates of suicidal ideation and suicide attempt were tested using logistic regression.</p> <p>Results</p> <p>One-third of inmates reported lifetime suicidal ideation and one-fifth had attempted suicide. Women and Aboriginal participants were significantly more likely than men and non-Aboriginal participants, respectively, to report attempting suicide. Correlates of suicidal ideation included violent offending, traumatic brain injury, depression, self-harm, and psychiatric hospitalisation. Univariate correlates of suicide attempt among ideators were childhood out-of-home care, parental incarceration and psychiatric hospitalization; however, none of these remained significant in a multivariate model.</p> <p>Conclusions</p> <p>Suicidal ideation and attempts are highly prevalent among prisoners compared to the general community. Assessment of suicide risk is a critical task for mental health clinicians in prisons. Attention should be given to ensuring assessments are gender- and culturally sensitive. Indicators of mental illness may not be accurate predictors of suicide attempt. Indicators of childhood trauma appear to be particularly relevant to risk of suicide attempt among prisoners and should be given attention as part of risk assessments.</p

Hepatitis C virus screening and treatment in Irish prisons from a governor and prison officer perspective - A qualitative exploration

Background: Prisons are a key location to access Hepatitis C Virus (HCV) infected people who inject drugs (PWID). Prison health care structures are complex and optimising health care delivery to this high need, marginalised and underserved population remains challenging. Despite international guidelines recommending that prisons are a priority location for HCV screening and treatment levels of prisoner engagement in HCV care remain low. Competing priorities between security and healthcare is a key feature of prison health care. A collaborative approach to health care delivery in prisons can maximise the benefits for prisoners, staff and the wider community. Aim: To identify the barriers and enablers to HCV screening and treatment in Irish prisons and inform the implementation of a HCV screening program within the Irish Prison Services (IPS). Methods: Qualitative study using focus group methodology underpinned by grounded theory. Results: The following themes emerged from the analysis: priority of safety and security, staffing and resources, concerns about personal risk, lack of knowledge, concerns around confidentiality, prisoners' fear of treatment and stigma, timing of screening, use of peer workers, in-reach hepatology and fibroscanning services. The primary role of prison security is to ensure the safety of staff and prisoners with a secondary but important supporting role in health care delivery. Maintaining adequate staffing levels and the provision of training and education were seen as priorities and impacted on prison officers' fear for personal safety and risk of HCV transmission. Opt-out screening and peer support workers had high levels of support among participants. Conclusion: Upscaling HCV management in prisons requires an in-depth understanding of all barriers and facilitators to HCV screening and treatment. Engaging prison officers in the planning and delivery of health care initiatives is a key strategy to optimising the public health opportunity that prisons provides. © 2018 The Author(s)

Linking soil microbial community structure to potential carbon mineralization: A continental scale assessment of reduced tillage

Potential carbon mineralization (Cmin) is a commonly used indicator of soil health, with greater Cmin values interpreted as healthier soil. While Cmin values are typically greater in agricultural soils managed with minimal physical disturbance, the mechanisms driving the increases remain poorly understood. This study assessed bacterial and archaeal community structure and potential microbial drivers of Cmin in soils maintained under various degrees of physical disturbance. Potential carbon mineralization, 16S rRNA sequences, and soil characterization data were collected as part of the North American Project to Evaluate Soil Health Measurements (NAPESHM). Results showed that type of cropping system, intensity of physical disturbance, and soil pH influenced microbial sensitivity to physical disturbance. Furthermore, 28% of amplicon sequence variants (ASVs), which were important in modeling Cmin, were enriched under soils managed with minimal physical disturbance. Sequences identified as enriched under minimal disturbance and important for modeling Cmin, were linked to organisms which could produce extracellular polymeric substances and contained metabolic strategies suited for tolerating environmental stressors. Understanding how physical disturbance shapes microbial communities across climates and inherent soil properties and drives changes in Cmin provides the context necessary to evaluate management impacts on standardized measures of soil microbial activity