Clay-based materials for passive control of ozone and reaction byproducts in buildings

Tropospheric ozone that infiltrates buildings reacts readily with many indoor materials and compounds that are commonly detected in indoor air. These reactions lead to lower indoor ozone concentrations. However, the products of ozone reactions may be irritating or harmful to building occupants. While active technologies exist (i.e., activated carbon filtration in HVAC systems) to suppress indoor ozone concentrations, they can be costly and/or infeasible for dwellings that do not have these systems. Passive methods of ozone removal are an interest of building environment researchers. This dissertation involves (1) a review of the state of the knowledge on building materials and coatings that are intended to passively remove indoor ozone, especially clay-based materials; (2) a compilation of current data on ozone removal and reaction byproduct formation for these materials; (3) a model for ozone removal effectiveness for a selected clay-based material that is implemented in a hypothetical home; (4) a survey of the effects of a clay-based coating with and without ozone and a reactant source on human perceptions of air quality; (5) an investigation of the long-term potential for passive control of indoor ozone by two different clay-based surface coatings that were exposed to real indoor environments; and (6) development of a location-specific model to estimate the monetary benefits versus costs of indoor ozone control using passive removal materials. The above tasks were completed through ongoing reviews of the literature, experimental studies conducted in small and large environmental chambers, and in the field. Results of these studies suggest that clay or materials made from clay are a viable material for passive reduction of indoor pollution, due in part to clay’s ability to catalyze ozone. Human sensory perceptions of indoor air quality were shown to significantly improve when a clay-based plaster was present in an ozonated environment. Based on modeling efforts, effective passive removal of indoor ozone is possible for realistic indoor scenarios when clay-based materials are implemented. There is a growing number of papers that are published on the subject of clay materials and indoor environmental quality, but few that investigate the longer term impacts and performance of clay materials, especially ones that have been exposed to real indoor environments.Civil, Architectural, and Environmental Engineerin

NICU admissions after a policy to discourage elective deliveries prior to 39 weeks

BACKGROUND: Early-term infants (37-38 weeks) are at increased risk of short- and long-term morbidities compared with full term infants (39-40 weeks). In 2009, the American College of Obstetricians and Gynecologists (ACOG) issued guidelines to discourage early elective deliveries prior to 39 weeks of gestation, and Beth Israel Deaconess Medical Center (BIDMC) in Boston, MA, adopted a policy to implement these guidelines. The impact of this policy on Neonatal Intensive Care Unit (NICU) utilization at BIDMC is unknown. Objectives: The objectives of this study were to (1) examine the gestational age distribution of infants at BIDMC from 2004 to 2015 and confirm a reduction in proportion of early-term births (37-38 weeks) after policy implementation in 2009, (2) compare the incidence of NICU admissions among infants ≥37 weeks of gestation before and after policy implementation, and (3) compare the length of NICU stays among infants ≥37 weeks of gestation before and after policy implementation. METHODS: We conducted a medical record review of infants ≥37 weeks of gestation born from January 1, 2004, through November 10, 2015. We used chi-square tests to compare the incidence of early-term deliveries and NICU admissions in two time periods: 2004-2008 (pre-period) and 2010-2015 (post-period). We excluded infants born in 2009 from the analysis. We used logistic regression to calculate the odds ratio of both short (>4 to <24 hours) and long (≥24 hours) NICU admissions in the two time periods. NICU stays ≤4 hours were excluded as they most often occur among asymptomatic infants for evaluation of sepsis in the setting of maternal fever during labor. We also excluded infants transferred to other hospitals. We considered potential confounding variables such as multiple births, maternal age, race and ethnicity, parity, insurance, and marital status. We compared median lengths of stay using a Wilcoxon test. RESULTS: A total of 50,373 infants were born ≥37 weeks of gestation during the study period, 46,254 of whom were included in the analysis excluding 4,119 infants born in 2009, the washout period. The incidence of early-term delivery was lower in the post-period (27.1%) versus the pre-period (34.2%) (P 4 hours, the median length of stay (LOS) increased from 21 hours (pre-period) to 39 hours (post-period) (P <0.0001). CONCLUSION: A local policy aligned with ACOG national guidelines to reduce early elective deliveries was associated with a reduction in early-term births. We observed a concurrent reduction of short but not long NICU stays. Our findings suggest that a reduction in early elective deliveries before 39 weeks of gestation may lead to more opportunities for infants to stay with their families in the first 24 hours but may not affect the incidence of significant morbidities requiring longer NICU stays.2017-06-16T00:00:00

Tetanic Stimulation Leads to Increased Accumulation of Ca^(2+)/Calmodulin-Dependent Protein Kinase II via Dendritic Protein Synthesis in Hippocampal Neurons

mRNA for the ɑ-subunit of CaMKII is abundant in dendrites of neurons in the forebrain (Steward, 1997). Here we show that tetanic stimulation of the Schaffer collateral pathway causes an increase in the concentration of ɑ-CaMKII in the dendrites of postsynaptic neurons. The increase is blocked by anisomycin and is detected by both quantitative immunoblot and semiquantitative immunocytochemistry. The increase in dendritic ɑ-CaMKII can be measured 100-200 µm away from the neuronal cell bodies as early as 5 min after a tetanus. Transport mechanisms for macromolecules from neuronal cell bodies are not fast enough to account for this rapid increase in distal portions of the dendrites. Therefore, we conclude that dendritic protein synthesis must produce a portion of the newly accumulated CaMKII. The increase in concentration of dendritic CaMKII after tetanus, together with the previously demonstrated increase in autophosphorylated CaMKII (Ouyang et al., 1997), will produce a prolonged increase in steady-state kinase activity in the dendrites, potentially influencing mechanisms of synaptic plasticity that are controlled through phosphorylation by CaMKII

Visualization of the distribution of autophosphorylated calcium/calmodulin-dependent protein kinase II after tetanic stimulation in the CA1 area of the hippocampus

Autophosphorylation of calcium/calmodulin-dependent protein kinase II (CaMKII) at threonine-286 produces Ca2+-independent kinase activity and has been proposed to be involved in induction of long-term potentiation by tetanic stimulation in the hippocampus. We have used an immunocytochemical method to visualize and quantify the pattern of autophosphorylation of CaMKII in hippocampal slices after tetanization of the Schaffer collateral pathway. Thirty minutes after tetanic stimulation, autophosphorylated CaM kinase II (P-CaMKII) is significantly increased in area CA1 both in apical dendrites and in pyramidal cell somas. In apical dendrites, this increase is accompanied by an equally significant increase in staining for nonphosphorylated CaM kinase II. Thus, the increase in P-CaMKII appears to be secondary to an increase in the total amount of CaMKII. In neuronal somas, however, the increase in P-CaMKII is not accompanied by an increase in the total amount of CaMKII. We suggest that tetanic stimulation of the Schaffer collateral pathway may induce new synthesis of CaMKII molecules in the apical dendrites, which contain mRNA encoding its alpha-subunit. In neuronal somas, however, tetanic stimulation appears to result in long-lasting increases in P-CaMKII independent of an increase in the total amount of CaMKII. Our findings are consistent with a role for autophosphorylation of CaMKII in the induction and/or maintenance of long-term potentiation, but they indicate that the effects of tetanus on the kinase and its activity are not confined to synapses and may involve induction of new synthesis of kinase in dendrites as well as increases in the level of autophosphorylated kinase

Call for Action: Provinces and Territories Must Protect our Genetic Information

The Genetic Non-Discrimination Act (GNDA), passed by Parliament in 2017, seeks to protect Canadians’ genetic information. The GNDA establishes certain criminal prohibitions to the use of genetic information and also amends federal employment and human rights legislation to protect against genetic discrimination. However, we argue that the GNDA alone is insufficient to protect Canadians given constitutional limitations on the powers of the federal government. Areas of profound importance relating to genetic discrimination are governed by the provinces and territories. We identify three key areas of provincial/territorial jurisdiction relevant to protection against genetic discrimination and outline the applicable legislative environments. We identify problems with the status quo and set out the gaps and limitations of relying solely on the GNDA. We conclude that provinces and territories need to amend their human rights, employment, and insurance legislation to ensure comprehensive protection of Canadians’ genetic information. La Loi sur la non-discrimination génétique (la Loi), adoptée par le Parlement en 2017, vise à protéger les informations génétiques des Canadiens. La Loi établit certaines règles pénales interdisant l’utilisation des informations génétiques et modifie également d’autres lois fédérales en matière d’emploi et de droits de la personne afin de protéger contre la discrimination génétique. Cependant, nous soutenons que la Loi seule est insuffisante pour protéger les Canadiens étant donné les limitations constitutionnelles des pouvoirs du gouvernement fédéral. Des domaines d’une grande importance relatifs à la discrimination génétique sont régis par les provinces et les territoires. Nous identifions trois domaines clés de compétence provinciale/territoriale pertinents pour la protection contre la discrimination génétique et décrivons les environnements législatifs applicables. Nous identifions les problèmes liés au statu quo et exposons les lacunes et les limites du recours à la seule Loi sur la non-discrimination génétique. Nous concluons que les provinces et les territoires doivent modifier leurs lois relatives aux droits de la personne, à l’emploi et aux assurances afin d’assurer une protection complète des renseignements génétiques des Canadiens

The Center on Civic Literacy

poster abstractThe Center for Civic Literacy at Indiana University–Purdue University Indianapolis was established to address the public deficit in constitutional and civic knowledge. It will be the nation’s first research center devoted to studying what our citizens do and do not know about their representative republic. Self-government in a democratic state requires a civically educated citizenry. There is ample evidence that Americans, on average, are civically illiterate. Only 36 percent of Americans can correctly name the three branches of government (Annenberg Public Policy Center, 2007). Fewer than half of 12th grade students can describe the meaning of federalism (NAEP, 2006). Newsweek recently asked 1,000 U.S. citizens to take the official citizenship test; seventy-three percent couldn’t say why we fought the Cold War, 44 percent were unable to define the Bill of Rights, and 94 percent were unable to list the correct number of Constitutional amendments (Romano, 2011). Surveys such as these, as well as the few formal studies that have been completed on civics, point to an alarming “civics recession” (Quigley, 2011). Annenberg Public Policy Center. 2007. “Annenberg Public Policy Center Judicial Survey.” http://www.annenbergpublicpolicy.org/Downloads/20071017_JudicialSurvey/Survey_Questions_10-17-2007.pdf (May 30, 2011). National Assessment of Educational Progress. 2006. “NAEP – Civics 2006: The Nation’s Report Card.” http://nationsreportcare.gov/civics_2006/ (May 30, 2011) Romano, Andrew. “How Dumb Are We?” The Daily Beast. Newsweek/Daily Beast, 20 Mar. 2011. Web. http://www.thedailybeast.com/newsweek/2011/03/20/how-dumb-are-we.html Quigley, Charles. “National Assessment Governing Board – Newsroom – Press Releases –2010 NAEP Civics Report – Charles N. Quigley’s Statement.” National Assessment Governing Board. Web. 27 Mar. 2012. http://www.nagb.org/civics/statement-quigley.htm The Center for Civic Literacy’s poster presentation highlights three things: 1. The current deficit in research and understanding of civic literacy 2. The intersection of civic literacy and civic engagement 3. The research agenda devised through our potential partnerships and National Advisory Committe

An Examination Of Clinical Decision Support For Discharge Planning: Systematic Review, Simulation, And Natural Language Processing To Elucidate Referral Decision Making

Statement of the Problem: As healthcare data becomes increasingly prolific and older adult patient needs become more complex, there is opportunity for evidence-based technology such as clinical decision support systems (CDSS) to improve decision making at the point of care. Although CDSS for discharge planning is available, few published tools have been translated to new settings. Existing studies have not explored discordance between recommended and actual discharge disposition. Understanding the reasons why patients do not receive optimal post-acute care referrals is critical to improving the discharge planning process for older adults and their families. Methods: Three-paper dissertation examining CDSS. Paper 1 is a systematic review of studies with prediction models for post-acute care (PAC) destination. Paper 2 is a retrospective simulation of a discharge planning CDSS on electronic health record (EHR) data from two hospitals to examine differences in patient characteristics and 30-day readmission rates based on a CDSS recommendation among patients discharged home to self-care. Paper 3 is a natural language processing (NLP) study including retrospective analysis of narrative clinical notes to identify barriers to PAC among hospitalized older adults and create an NLP system to identify sentences containing negative patient preferences. Results: Most prediction models in the literature were developed for specific surgical populations using retrospective structured EHR data. Most models demonstrated high risk of bias and few published follow-up studies. In the simulation study, surgical patients identified by the CDSS as needing PAC but discharged home to self-care experienced adjusted 51.8% higher odds of 30-day readmission compared to those not identified. In the NLP study, the top three barriers were patient has a caregiver, negative preferences, and case management clinical reasoning. Most patients experienced multiple barriers. The negative preferences NLP system achieved an F1-Score of 0.916 using a deep learning model after internal validation. Conclusions: Future prediction modeling studies should follow TRIPOD guidelines to ensure rigorous reporting. Findings from the simulation and NLP studies suggest transportability of the CDSS to large urban academic health systems, especially among surgical patients. Incorporating natural language processing variables into CDSS tools may aid the identification of barriers to PAC