Developing and Implementing a 100% Renewable Electricity Resolution: A Research-Based Framework

While it may seem that the efforts of local governments have only a marginal impact on the global issue of climate change, local action can spread to generate large-scale change. Local action can inspire other communities to adopt policies, creating the potential to expand and form regional action on climate change. Furthermore, local policies can influence state and federal policies. This guide will walk you through a five-step framework that was developed from the results of a qualitative research study that explored how three Utah cities, Salt Lake City, Park City, and Moab, successfully adopted 100% renewable electricity resolutions

Imaging characterization of non-hypersecreting adrenal masses. Comparison between MR and radionuclide techniques.

AIM: In patients with non-hypersecreting adrenal masses, tumor characterization is clinically relevant to establish the appropriate treatment planning. The aim of this study was to comparatively characterize such adrenal lesions using MR and radionuclide techniques. METHODS: Thirty patients with non-hypersecreting unilateral adrenal tumors underwent both MR and adrenal scintigraphy. MR was performed using SE T1- (pre- and post-gadolinium DTPA) and T2-weighted images as well as in- and out-phase chemical-shift imaging (CSI). MR qualitative and quantitative (signal intensity ratios) evaluation was performed. Radionuclide studies consisted of iodine-131 nor-cholesterol (n=20), iodine-131 MIBG (n=15) and fluorine-18 FDG PET (n=11) scans. Histology (n=16), biopsy (n=3) or clinical-imaging follow-up (n=11) demomstrated 13 adenomas, 3 cysts, 2 myelolipomas, 4 pheochromocytomas (pheos), 4 carcinomas, 1 sarcoma and 3 metastases. Comparative imaging analysis was focused on adenomas, pheos and malignant tumors. RESULTS: Qualitative MR evaluation showed: signal T2-hyperintensity in 46% of adenomas and in 100% of pheos and malignant tumors, no gadolinium enhancement in 92% of adenomas and definite signal intensity loss on CSI in 100% of such tumor lesions, gadolinium enhancement in 100% of pheos and in 63% of malignancies and no absolute change of signal intensity on CSI in 100% of both pheos and malignancies. Quantitative MR analysis demonstrated: significantly higher signal T2-hyperintensity of pheos compared to adenomas and malignancies as well as significantly higher enhancement after gadolinium in pheos compared to adenomas and malignancies (p<0.03). Radionuclide studies showed significantly increased nor-cholesterol uptake only in adenomas (n=13), significant MIBG accumulation only in pheos (n=4) and FDG activity only in malignant adrenal lesions (n=8). CONCLUSION: MR techniques may provide some presumptive criteria to characterize non-hypersecreting adrenal masses, such as no gadolinium enhancement and definite signal intensity loss on CSI in adenomas or quantitatively measured T2-hyperintensity and gadolinium enhancement in pheos. On the other hand, radionuclide modalities offer more specific findings in this setting since nor-cholesterol and MIBG scans are respectively able to reveal benign tumors such as adenoma and pheochromocytoma, while FDG imaging allows identification of malignant adrenal lesions. Adrenal scintigraphy is recommended in those patients, when MR images are uncertain or inconclusive

Covid-19 and spirometry in this age

In the last year, many countries adopted a plan to contain hospital infections by Sars-Cov-2 also limiting pulmonary function tests (PFTs), exclusively to indispensable cases. All the recommendations of the major scientific societies regarding the use of PFTs, in particular spirometry, in the Covid era were formulated in the initial period of the pandemic. Currently, the new scientific knowledge about Sars-Cov-2 and the vaccination among healthcare workers, shown new insight to start doing PFTs again to help the investigation and monitoring of patients with respiratory pathology. In this article, we sum up the recommendations of major International Respiratory Societies, and we shared our experience about PFTs in a Pediatric Respiratory Disease Unit during the pandemic

Exercise-Induced Bronchoconstriction in Children

Exercise-induced bronchoconstriction (EIB) is a transient airflow obstruction, typically 5–15 min after physical activity. The pathophysiology of EIB is related to the thermal and osmotic changes of the bronchial mucosa, which cause the release of mediators and the development of bronchoconstriction in the airways. EIB in children often causes an important limitation to physical activities and sports. However, by taking appropriate precautions and through adequate pharmacological control of the condition, routine exercise is extremely safe in children. This review aims to raise awareness of EIB by proposing an update, based on the latest studies, on pathological mechanisms, diagnosis, and therapeutic approaches in children

Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine

Patients with masticatory muscle pain and migraine typically report that the intensity of pain fluctuates over time and is affected by weather changes. Weather variables, such as ambient temperature and humidity, may vary significantly depending on whether the individual is outdoor or indoor. It is, therefore, important to assess these variables at the individual level using portable monitors, during everyday life. This study aimed to determine and compare the temporal patterns of pain in individuals affected with facial and head pain and to investigate its relation with weather changes. Eleven patients (27·3 ± 7·4 years) with chronic masticatory muscle pain (MP) and twenty (33·1 ± 8·7 years) with migraine headache (MH) were asked to report their current pain level on a visual analogue scale (VAS) every hour over fourteen consecutive days. The VAS scores were collected using portable data-loggers, which were also used to record temperature, atmospheric pressure and relative humidity. VAS scores varied markedly over time in both groups. Pain VAS scores fluctuate less in the MP group than in the MH group, but their mean, minimum and maximum values were higher than those of migraine patients (all P < 0·05). Pain scores <2 cm were more common in the MH than in the MP group (P < 0·001). Perceived intensity of pain was negatively associated with atmospheric pressure in the MP group and positively associated with temperature and atmospheric in the MH group. Our results reveal that patients with masticatory muscle pain and patients with migraine present typical temporal pain patterns that are influenced in a different way by weather changes

A protocol for eliciting nonmaterial values through a cultural ecosystem services frame

Conservation Biology published by Wiley Periodicals, Inc. on behalf of Society for Conservation Biology. Stakeholders\u27 nonmaterial desires, needs, and values often critically influence the success of conservation projects. These considerations are challenging to articulate and characterize, resulting in their limited uptake in management and policy. We devised an interview protocol designed to enhance understanding of cultural ecosystem services (CES). The protocol begins with discussion of ecosystem-related activities (e.g., recreation, hunting) and management and then addresses CES, prompting for values encompassing concepts identified in the Millennium Ecosystem Assessment (2005) and explored in other CES research. We piloted the protocol in Hawaii and British Columbia. In each location, we interviewed 30 individuals from diverse backgrounds. We analyzed results from the 2 locations to determine the effectiveness of the interview protocol in elucidating nonmaterial values. The qualitative and spatial components of the protocol helped characterize cultural, social, and ethical values associated with ecosystems in multiple ways. Maps and situational, or vignette-like, questions helped respondents articulate difficult-to-discuss values. Open-ended prompts allowed respondents to express a diversity of ecosystem-related values and proved sufficiently flexible for interviewees to communicate values for which the protocol did not explicitly probe. Finally, the results suggest that certain values, those mentioned frequently throughout the interview, are particularly salient for particular populations. The protocol can provide efficient, contextual, and place-based data on the importance of particular ecosystem attributes for human well-being. Qualitative data are complementary to quantitative and spatial assessments in the comprehensive representation of people\u27s values pertaining to ecosystems, and this protocol may assist in incorporating values frequently overlooked in decision making processes

Minimally invasive percutaneous treatment for osteoid osteoma of the Spine. A case report

Osteoid osteomas are benign but painful bone-forming tumors usually involving long bones, with localization at the spine in 10-20% of the cases. The most common symptom is back pain responding to nonsteroidal anti-inflammatory drugs, but in some cases, also radicular pain can be present. For years, surgical excision has been considered the best choice of treatment for cases with unresponsive pain and has been practiced with a high percentage of success but also a high rate of fusion with instrumentation. In the last years, percutaneous radiofrequency ablation has been proposed as a new mini-invasive technique for the treatment of osteoid osteomas

A social-ecological approach to conservation planning: embedding social considerations

Many conservation plans remain unimplemented, in part because of insufficient consideration of the social processes that influence conservation decisions. Complementing social considerations with an integrated understanding of the ecology of a region can result in a more complete conservation approach. We suggest that linking conservation planning to a social-ecological systems (SES) framework can lead to a more thorough understanding of human-environment interactions and more effective integration of social considerations. By characterizing SES as a set of subsystems, and their interactions with each other and with external factors, the SES framework can improve our understanding of the linkages between social and ecological influences on the environment. Using this framework can help to identify socially and ecologically focused conservation actions that will benefit ecosystems and human communities, and assist in the development of more consistent evidence for evaluating conservation actions by comparing conservation case studies

An overview on the primary factors that contribute to non-allergic asthma in children

The prevalence of non-allergic asthma in childhood is low, peaking in late adulthood. It is triggered by factors other than allergens, like cold and dry air, respiratory infections, hormonal changes, smoke and air pollution. In the literature, there are few studies that describe non-allergic asthma in pediatric age. Even though it is a less common disorder in kids, it is crucial to identify the causes in order to keep asthma under control, particularly in patients not responding to conventional treatments. In this review, we discuss non-IgE-mediated forms of asthma, collecting the latest research on etiopathogenesis and treatment