Response of Illinois municipal water systems to a prolonged period of drought

This research evaluates the impact of the 1976-1977 extended periods of shortage of rainfall on Illinois municipal systems. The analysis determines how municipalities responded to the drought and to what extent the experience of the drought has left a lasting impact on the way in which municipal water systems operate. Excluded from the analysis were water systems in the suburban areas of the large metropolitan cities. Data were obtained from 66 municipalities which had not been affected by the drought and 25 municipalities which had to deal explicitly and publicly with the shortage of water caused by the period of drought. The research is a continuation of an earlier study on municipal water systems in small and medium-sized Illinois municipalities. The data were obtained through questionnaires sent to the mayors, and additional data were obtained from the water systems operator in each municipality. Follow-up on the mailed questionnaires was done both by phone and through extensive personal studies of a number of smaller municipalities. When comparing municipalities affected by the drought and those not affected by the drought we find that prior to the drought those municipalities affected by it were more likely to have smaller water systems, show a smaller margin between daily rated capacity and maximum daily usage, and rely more heavily on surface water sources. There is no evidence that the municipalities which subsequently experienced the drought were significantly and systematically less well managed than the municipalities which did not experience the drought. Municipalities affected by the drought made efforts to both increase the supply of available water and decrease demands for available water. Few municipalities succeeded in obtaining water from other sources; it was either too expensive or not available to them. Municipalities made widespread attempts to conserve the usage of water. Those municipalities which were not directly affected by the drought made very few changes in the way their water systems operate or in the way they handle the demand for service on their water system. Municipalities affected by the drought, however, frequently made changes in the water system operations which continued in effect beyond the end of the drought and which, in some cases, were not instituted until after the drought had subsided.U.S. Department of the InteriorU.S. Geological SurveyOpe

Comparison of decision making and administrative organization for municipal water supplies in medium-sized and small Illinois municipalities

The study was designed to provide information on the decision making and organizational characteristics of municipally owned water systems in small and medium-sized Illinois municipalities, and to relate these characteristics to municipal as well as other water system characteristics. Data on the municipal water systems of 228 Illinois incorporated municipalities were gathered through mail and telephone surveys, as well as from secondary sources. The municipalities were chosen as part of a 50-percent sample, stratified by size, of all incorporated municipalities in Illinois with populations between 1,000 and 50,000. In addition to selected descriptive information on the water systems, the data are reported under water system decision making; planning and financial management; and technical management. Attempts to determine the relationships between the dependent variables and municipal and water system characteristics indicated a general weakness or absence of such relationships. While the quality of the data cannot be ruled out with certainty as the reason for the absence of the relationships, it is suggested that the relative lack of active interest on the part of municipalities in their water systems may account for the findings. The historical absence of the necessity to actively manage the water system other than in a routine fashion may have left these water systems quite unprepared to meet future sudden challenges.U.S. Department of the InteriorU.S. Geological SurveyOpe

Global burden of 87 risk factors in 204 countries and territories, 1990�2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: Rigorous analysis of levels and trends in exposure to leading risk factors and quantification of their effect on human health are important to identify where public health is making progress and in which cases current efforts are inadequate. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 provides a standardised and comprehensive assessment of the magnitude of risk factor exposure, relative risk, and attributable burden of disease. Methods: GBD 2019 estimated attributable mortality, years of life lost (YLLs), years of life lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 87 risk factors and combinations of risk factors, at the global level, regionally, and for 204 countries and territories. GBD uses a hierarchical list of risk factors so that specific risk factors (eg, sodium intake), and related aggregates (eg, diet quality), are both evaluated. This method has six analytical steps. (1) We included 560 risk�outcome pairs that met criteria for convincing or probable evidence on the basis of research studies. 12 risk�outcome pairs included in GBD 2017 no longer met inclusion criteria and 47 risk�outcome pairs for risks already included in GBD 2017 were added based on new evidence. (2) Relative risks were estimated as a function of exposure based on published systematic reviews, 81 systematic reviews done for GBD 2019, and meta-regression. (3) Levels of exposure in each age-sex-location-year included in the study were estimated based on all available data sources using spatiotemporal Gaussian process regression, DisMod-MR 2.1, a Bayesian meta-regression method, or alternative methods. (4) We determined, from published trials or cohort studies, the level of exposure associated with minimum risk, called the theoretical minimum risk exposure level. (5) Attributable deaths, YLLs, YLDs, and DALYs were computed by multiplying population attributable fractions (PAFs) by the relevant outcome quantity for each age-sex-location-year. (6) PAFs and attributable burden for combinations of risk factors were estimated taking into account mediation of different risk factors through other risk factors. Across all six analytical steps, 30 652 distinct data sources were used in the analysis. Uncertainty in each step of the analysis was propagated into the final estimates of attributable burden. Exposure levels for dichotomous, polytomous, and continuous risk factors were summarised with use of the summary exposure value to facilitate comparisons over time, across location, and across risks. Because the entire time series from 1990 to 2019 has been re-estimated with use of consistent data and methods, these results supersede previously published GBD estimates of attributable burden. Findings: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure. Global declines also occurred for tobacco smoking and lead exposure. The largest increases in risk exposure were for ambient particulate matter pollution, drug use, high fasting plasma glucose, and high body-mass index. In 2019, the leading Level 2 risk factor globally for attributable deaths was high systolic blood pressure, which accounted for 10·8 million (95 uncertainty interval UI 9·51�12·1) deaths (19·2% 16·9�21·3 of all deaths in 2019), followed by tobacco (smoked, second-hand, and chewing), which accounted for 8·71 million (8·12�9·31) deaths (15·4% 14·6�16·2 of all deaths in 2019). The leading Level 2 risk factor for attributable DALYs globally in 2019 was child and maternal malnutrition, which largely affects health in the youngest age groups and accounted for 295 million (253�350) DALYs (11·6% 10·3�13·1 of all global DALYs that year). The risk factor burden varied considerably in 2019 between age groups and locations. Among children aged 0�9 years, the three leading detailed risk factors for attributable DALYs were all related to malnutrition. Iron deficiency was the leading risk factor for those aged 10�24 years, alcohol use for those aged 25�49 years, and high systolic blood pressure for those aged 50�74 years and 75 years and older. Interpretation: Overall, the record for reducing exposure to harmful risks over the past three decades is poor. Success with reducing smoking and lead exposure through regulatory policy might point the way for a stronger role for public policy on other risks in addition to continued efforts to provide information on risk factor harm to the general public. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Notch and Wnt inhibitors as potential new drugs for intestinal neoplastic disease.

Colorectal cancer is a major cause of death in the western world. Recent advances in treatment comprise variations on the classical themes of surgical resection combined with chemotherapy using cytotoxic drugs and radiation therapy. Because this therapy is only moderately successful, novel approaches to the treatment of colorectal cancer are required. Our rapidly increasing knowledge of molecular signalling pathways that are deregulated in colorectal cancer might provide a platform from which to develop new rational cancer therapies. Here, we give an update on the roles of the Wnt and Notch signalling pathways in the self renewal of the intestinal epithelium and the consequences of Wnt deregulation in colorectal cancer. We focus on the potential of recently identified small-molecule inhibitors of the Wnt pathway and gamma-secretase inhibitors of the Notch pathway as novel colon cancer therapeutics.

Farm ownership, political participation, and other social participation in Central Brazil

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