A Total-System View of Environmental Management

Man, vastly increasing in number and continuing to exploit his natural resources, has altered the quality of his environment until it is in danger of becoming unfit for human life. The reversal of this trend must begin with the formulation of a management system that encompasses the total cycle of man\u27s environmental manipulation — from the extraction of raw materials and the production of goods to the eventual disposal of those goods. This paper describes how environmental quality can be managed on a large scale and outlines the methods for implementing this management through the total-system approach

Herbicide Movement and Dissipation at Four Midwestern Sites

This study was conducted to evaluate atrazine (2‐chloro‐4‐ethylamino‐6‐isopropyl‐1, 3, 5‐triazine) and alachlor (2‐chIoro‐N‐(methoxymethyl)acetamide) dissipation and movement to shallow aquifers across the Northern Sand Plains region of the United States. Sites were located at Minnesota on a Zimmerman fine sand, North Dakota on Hecla sandy loam, South Dakota on a Brandt silty clay loam, and Wisconsin on a Sparta sand. Herbicide concentrations were determined in soil samples taken to 90 cm four times during the growing season and water samples taken from the top one m of aquifer at least once every three months. Herbicides were detected to a depth of 30 cm in Sparta sand and 90 cm in all other soils. Some aquifer samples from each site contained atrazine with the highest concentration in the aquifer beneath the Sparta sand (1.28 μg L‐1). Alachlor was detected only once in the aquifer at the SD site. The time to 50% atrazine dissipation (DT50) in the top 15 cm of soil averaged about 21 d in Sparta and Zimmerman sands and more than 45 d for Brandt and Hecla soils. Atrazine DT50 was correlated positively with % clay and organic carbon (OC), and negatively with % fine sand. Alachlor DT50 ranged from 12 to 32 d for Zimmerman and Brandt soils, respectively, and was correlated negatively with % clay and OC and positively with % sand

Advanced Air Bag Technology Assessment

As a result of the concern for the growing number of air-bag-induced injuries and fatalities, the administrators of the National Highway Traffic Safety Administration (NHTSA) and the National Aeronautics and Space Administration (NASA) agreed to a cooperative effort that "leverages NHTSA's expertise in motor vehicle safety restraint systems and biomechanics with NASAs position as one of the leaders in advanced technology development... to enable the state of air bag safety technology to advance at a faster pace..." They signed a NASA/NHTSA memorandum of understanding for NASA to "evaluate air bag to assess advanced air bag performance, establish the technological potential for improved technology (smart) air bag systems, and identify key expertise and technology within the agency (i.e., NASA) that can potentially contribute significantly to the improved effectiveness of air bags." NASA is committed to contributing to NHTSAs effort to: (1) understand and define critical parameters affecting air bag performance; (2) systematically assess air bag technology state of the art and its future potential; and (3) identify new concepts for air bag systems. The Jet Propulsion Laboratory (JPL) was selected by NASA to respond to the memorandum of understanding by conducting an advanced air bag technology assessment. JPL analyzed the nature of the need for occupant restraint, how air bags operate alone and with safety belts to provide restraint, and the potential hazards introduced by the technology. This analysis yielded a set of critical parameters for restraint systems. The researchers examined data on the performance of current air bag technology, and searched for and assessed how new technologies could reduce the hazards introduced by air bags while providing the restraint protection that is their primary purpose. The critical parameters which were derived are: (1) the crash severity; (2) the use of seat belts; (3) the physical characteristics of the occupants; (4) the proximity of the occupants to the airbag module; (5) the deployment time, which includes the time to sense the need for deployment, the inflator response parameters, the air bag response, and the reliability of the air bag. The requirements for an advanced air bag technology is discussed. These requirements includes that the system use information related to: (1) the crash severity; (2) the status of belt usage; (3) the occupant category; and (4) the proximity to the air bag to adjust air bag deployment. The parameters for the response of the air bag are: (1) deployment time; (2) inflator parameters; and (3) air bag response and reliability. The state of occupant protection advanced technology is reviewed. This review includes: the current safety restraint systems, and advanced technology characteristics. These characteristics are summarized in a table, which has information regarding the technology item, the potential, and an date of expected utilization. The use of technology and expertise at NASA centers is discussed. NASA expertise relating to sensors, computing, simulation, propellants, propulsion, inflatable systems, systems analysis and engineering is considered most useful. Specific NASA technology developments, which were included in the study are: (1) a capacitive detector; (2) stereoscopic vision system; (3) improved crash sensors; (4) the use of the acoustic signature of the crash to determine crash severity; and (5) the use of radar antenna for pre-crash sensing. Information relating to injury risk assessment is included, as is a summary of the areas of the technology which requires further development

Serological Testing Versus Other Strategies for Diagnosis of Active Tuberculosis in India: A Cost-Effectiveness Analysis

This cost-effectiveness study shows that sputum smear microscopy is the most cost-effective test for active tuberculosis (TB) in India, and liquid culture plus microscopy is more cost-effective for TB diagnosis than serological tests

Modelling the impact of social protection on tuberculosis: the S-PROTECT project.

BACKGROUND: Tackling the social determinants of Tuberculosis (TB) through social protection is a key element of the post-2015 End TB Strategy. However, evidence informing policies are still scarce. Mathematical modelling has the potential to contribute to fill this knowledge gap, but existing models are inadequate. The S-PROTECT consortium aimed to develop an innovative mathematical modelling approach to better understand the role of social protection to improve TB care, prevention and control. METHODS: S-PROTECT used a three-steps approach: 1) the development of a conceptual framework; 2) the extraction from this framework of three high-priority mechanistic pathways amenable for modelling; 3) the development of a revised version of a standard TB transmission model able to capture the structure of these pathways. As a test case we used the Bolsa Familia Programme (BFP), the Brazilian conditional cash transfer scheme. RESULTS: Assessing one of these pathways, we estimated that BFP can reduce TB prevalence by 4% by improving households income and thus their nutritional status. When looking at the direct impact via malnutrition (not income mediated) the impact was 33%. This variation was due to limited data availability, uncertainties on data transformation and the pathway approach taken. These results are preliminary and only aim to serve as illustrative example of the methodological challenges encountered in this first modelling attempt, nonetheless they suggest the potential added value of integrating TB standard of care with social protection strategies. CONCLUSIONS: Results are to be confirmed with further analysis. However, by developing a generalizable modelling framework, S-PROTECT proved that the modelling of social protection is complex, but doable and allowed to draw the research road map for the future in this field

Effectiveness of low-dose theophylline for the management of biomass-associated COPD (LODOT-BCOPD): study protocol for a randomized controlled trial

BACKGROUND: COPD is a leading cause of death globally, with the majority of morbidity and mortality occurring in low- and middle-income country (LMIC) settings. While tobacco-smoke exposure is the most important risk factor for COPD in high-income settings, household air pollution from biomass smoke combustion is a leading risk factor for COPD in LMICs. Despite the high burden of biomass smoke-related COPD, few studies have evaluated the efficacy of pharmacotherapy in this context. Currently recommended inhaler-based therapy for COPD is neither available nor affordable in most resource-limited settings. Low-dose theophylline is an oral, once-a-day therapy, long used in high-income countries (HICs), which has been proposed for the management of COPD in LMICs in the absence of inhaled steroids and/or bronchodilators. The Low-dose Theophylline for the Management of Biomass-Associated COPD (LODOT-BCOPD) trial investigates the clinical efficacy and cost-effectiveness of low-dose theophylline for the management of biomass-related COPD in a low-income setting. METHODS: LODOT-BCOPD is a randomized, double-blind, placebo-controlled trial to test the efficacy of low-dose theophylline in improving respiratory symptoms in 110 participants with moderate to severe COPD in Central Uganda. The inclusion criteria are as follows: (1) age 40 to 80 years, (2) full-time resident of the study area, (3) daily biomass exposure, (4) post-bronchodilator FEV1/FVC below the 5th percentile of the Global Lung Initiative mixed ethnic reference population, and (5) GOLD Grade B-D COPD. Participants will be randomly assigned to receive once daily low-dose theophylline (200 mg ER, Unicontin-E) or placebo for 52 weeks. All participants will receive education about self-management of COPD and rescue salbutamol inhalers. We will measure health status using the St. George's Respiratory Questionnaire (SGRQ) and quality of life using the EuroQol-5D (EQ-5D) at baseline and every 6 months. In addition, we will assess household air pollution levels, serum inflammatory biomarkers (fibrinogen, hs-CRP), and theophylline levels at baseline, 1 month, and 6 months. The primary outcome is change in SGRQ score at 12 months. Lastly, we will assess the cost-effectiveness of the intervention by calculating quality-adjusted life years (QALYs) from the EQ-5D. TRIAL REGISTRATION: ClinicalTrials.gov  NCT03984188 . Registered on June 12, 2019 TRIAL ACRONYM: Low-dose Theophylline for the Management of Biomass-Associated COPD (LODOT-BCOPD)

Ozone exposure is associated with acute changes in inflammation, fibrinolysis, and endothelial cell function in coronary artery disease patients

Air pollution is a major risk factor for cardiovascular disease, of which ozone is a major contributor. Several studies have found associations between ozone and cardiovascular morbidity, but the results have been inconclusive. We investigated associations between ozone and changes across biological pathways associated with cardiovascular disease

Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: A population-based survey in Shaanxi province, China

© 2013 Tan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: The aim of this study was to examine health-related quality of life (HRQoL) as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. Methods: A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. Results: The most frequently reported problems involved pain/discomfort (8.8%) and anxiety/depression (7.6%). Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. Conclusion: The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs. © 2013 Tan et al.National Nature Science Foundation (No. 8107239

Communication in Diagnostic Radiology

Communication in the diagnostic radiology department in regard to the current work load has been discussed with certain recommendations being made to increase efficiency. The need for improvement in communication equipment and techniques is necessitated by problems facing diagnostic radiology today.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73519/1/j.1440-1673.1972.tb01316.x.pd