Evaluation of Continuous Monitoring as a Tool for Municipal Stormwater Management Programs

The purpose of this study is to evaluate the uncertainty attributable to inadequate temporal sampling of stormwater discharge and water quality, and understand its implications for meeting monitoring objectives relevant to municipal separate storm sewer systems (MS4s). A methodology is presented to evaluate uncertainty attributable to inadequate temporal sampling of continuous stormflow and water quality, and a case study demonstrates the application of the methodology to six small urban watersheds (0.8-6.8 km2) and six large rural watersheds (30-16,192 km2) in Virginia. Results indicate the necessity of high-frequency continuous monitoring for accurately capturing multiple monitoring objectives, including illicit discharges, acute toxicity events, and stormflow pollutant concentrations and loads, as compared to traditional methods of sampling. For example, 1-h sampling in small urban watersheds and daily sampling in large rural watersheds would introduce uncertainty in capturing pollutant loads of 3–46% and 10–28%, respectively. Overall, the outcomes from this study highlight how MS4s can leverage continuous monitoring to meet multiple objectives under current and future regulatory environments

Neonatal abstinence syndrome: Pharmacologic strategies for the mother and infant.

Opioid use in pregnancy has increased dramatically over the past decade. Since prenatal opioid use is associated with numerous obstetrical and neonatal complications, this now has become a major public health problem. In particular, in utero opioid exposure can result in neonatal abstinence syndrome (NAS) which is a serious condition characterized by central nervous system hyperirritability and autonomic nervous system dysfunction. The present review seeks to define current practices regarding the approach to the pregnant mother and neonate with prenatal opiate exposure. Although the cornerstone of prenatal management of opioid dependence is opioid maintenance therapy, the ideal agent has yet to be definitively established. Pharmacologic management of NAS is also highly variable and may include an opioid, barbiturate, and/or α-agonist. Genetic factors appear to be associated with the incidence and severity of NAS. Establishing pharmacogenetic risk factors for the development of NAS has the potential for creating opportunities for personalized genomic medicine and novel, individualized therapeutic interventions

Attraction of Culex mosquitoes to aldehydes from human emanations.

Anecdotes related to preferential mosquito bites are very common, but to date there is no complete explanation as to why one out of two people systematically receives more mosquito bites than the other when both are equally accessible. Here we tested the hypothesis that two constituents of skin emanations, 6-methyl-5-heptan-2-one (6-MHO) and geranylacetone (GA), are natural repellents and may account for differential attraction in different ratios. We studied skin emanations from two human subjects, confirmed in behavioral assays that female southern house mosquitoes are significantly more attracted to subject A (attractant) than to subject N (non-attractant), and tested their 6-MHO/GA ratios in a dual-choice olfactometer. Although repelling at high doses, 6-MHO/GA mixtures were not active at the levels emitted by human skin. We found, however, differential attraction elicited by the aldehydes in the ratios produced by subjects A and N. When tested in a dose commensurate with the level released from human skin and in the ratio produced by subject A, the aldehyde mixture significantly attracted mosquitoes. By contrast, an aldehyde mixture at the same ratio released by subject N did not attract mosquitoes. We, therefore, hypothesized that aldehydes may play a role in the commonly observed differential attraction

Factors influencing nurses' engagement with CPD activities: a systematic review.

Continuing professional development (CPD) is necessary for nurse registration and development. Understanding the factors influencing engagement may enhance CPD uptake. What factors influence hospital-based nurses' engagement with CPD activities in the UK? This was a systematic review incorporating narrative synthesis. Database searches for published and grey literature from January 1995 to November 2018 were conducted via EBSCO Discovery Service, the British Nursing Index and the British Library. An approved systematic review protocol was followed with studies then assessed against strict inclusion and exclusion criteria. Included studies were critically appraised, data extracted and a narrative synthesis conducted. Five studies were reviewed. Four themes emerged: nurses' individual resources, their professional motivation, organisational commitment to learning and development, and managerial support. Factors influencing nurses' engagement with activities are multifaceted and inter-woven. A question-based checklist to facilitate discussions between nurses and educators, managers or appraisers is presented

Hidden Caldeira-Leggett dissipation in a Bose-Fermi Kondo model

We show that the Bose-Fermi Kondo model (BFKM), which may find applicability both to certain dissipative mesoscopic qubit devices and to heavy fermion systems described by the Kondo lattice model, can be mapped exactly onto the Caldeira-Leggett model. This mapping requires an ohmic bosonic bath and an Ising-type coupling between the latter and the impurity spin. This allows us to conclude unambiguously that there is an emergent Kosterlitz-Thouless quantum phase transition in the BFKM with an ohmic bosonic bath. By applying a bosonic numerical renormalization group approach, we thoroughly probe physical quantities close to the quantum phase transition.Comment: Final version appearing in Physical Review Letter