Advancing Disaster Resistant University Planning Beyond the Basic Requirements

This presentation provides an overview of the activities involved in the development of the LSU System Disaster Resistant University plan with a particular focus on non-traditional efforts. Developing an effective plan for a college campus is challenging: a campus’ footprint is fairly limited, which presents obstacles in regard to data availability and vulnerability modeling; student populations are often unfamiliar with local hazard conditions; hazardous research and materials are frequently present on campus; and so forth. Thus, generating meaningful and realistic hazard, vulnerability and risk assessments for a university by means of traditional input data and modeling approaches is difficult. New and creative ways of leveraging the institution’s strengths are needed to overcome these obstacles. In an attempt to develop a comprehensive and effective planning tool, the LSU System Plan went beyond the basic DRU requirements. Unique to this Plan are: (a) an extensive building assessment and the integration of the assessment data into HAZUS-MH, (b) the use of a user-generated population and building inventory for more realistic impact modeling in HAZUS-MH, (c) the utilization of day-time population estimates instead of census data, (d) the implementation of a user-defined analysis level at the building level – instead of census blocks, (e) comprehensive archival work to supplement generic hazards information, (f) incorporation of a hazardous material inventory, (g) direct involvement of students through service learning courses, and (h) the utilization of social media, web-based mapping and feedback tools

Advancing Disaster Resistant University Planning Beyond the Basic Requirements

This presentation provides an overview of the activities involved in the development of the LSU System Disaster Resistant University plan with a particular focus on non-traditional efforts. Developing an effective plan for a college campus is challenging: a campus’ footprint is fairly limited, which presents obstacles in regard to data availability and vulnerability modeling; student populations are often unfamiliar with local hazard conditions; hazardous research and materials are frequently present on campus; and so forth. Thus, generating meaningful and realistic hazard, vulnerability and risk assessments for a university by means of traditional input data and modeling approaches is difficult. New and creative ways of leveraging the institution’s strengths are needed to overcome these obstacles. In an attempt to develop a comprehensive and effective planning tool, the LSU System Plan went beyond the basic DRU requirements. Unique to this Plan are: (a) an extensive building assessment and the integration of the assessment data into HAZUS-MH, (b) the use of a user-generated population and building inventory for more realistic impact modeling in HAZUS-MH, (c) the utilization of day-time population estimates instead of census data, (d) the implementation of a user-defined analysis level at the building level – instead of census blocks, (e) comprehensive archival work to supplement generic hazards information, (f) incorporation of a hazardous material inventory, (g) direct involvement of students through service learning courses, and (h) the utilization of social media, web-based mapping and feedback tools

Teaching Hazard Mitigation Planning through Learning Service

This presentation will showcase the work of two service-learning classes at Louisiana State University during the plan application and capability assessment phase for the DRU plan of Louisiana State University. More often than not, a consulting firm develops the Disaster Resistant University plan. There are many reasons why this might be a good choice for universities with limited personnel, computing resources, skills, experience, and so forth. Whenever universities produce their Plan in-house, they commonly tend to assign responsibilities to university administrators as well as faculty and staff members from public safety, risk management, geography, sociology, and engineering to name a few. For the majority of out-sourced as well as in-house developed plans though, students tend to show limited engagement. The most common opportunities for interaction are public meetings, presentations, or the presence of student delegates at Plan committee meetings. Undoubtedly, students are an invaluable resource and asset to a plan. Not only do students have a different hazard awareness and preparedness behavior than most other university groups but they can also actively support the creation of the plan outside of the usual meetings and presentations. The most common route is obviously by working on the plan as research assistants. However, students can also contribute through course work particularly in the form of service-learning classes, which is presented here. In this case, students collected a multitude of data, designed and conducted surveys, and analyzed as well as presented their findings. These service-learning classes required students to directly apply their knowledge on hazard mitigation planning to a real-world problem, which facilitated their learning but at the same time also enhanced the quality of the plan

Genetic counselling and testing in pulmonary arterial hypertension:a consensus statement on behalf of the International Consortium for Genetic Studies in PAH

Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene, BMPR2 (bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.</p

Developing a programme theory for a transdisciplinary research collaboration: Complex Urban Systems for Sustainability and Health

Background: Environmental improvement is a priority for urban sustainability and health and achieving it requires transformative change in cities. An approach to achieving such change is to bring together researchers, decision-makers, and public groups in the creation of research and use of scientific evidence. Methods: This article describes the development of a programme theory for Complex Urban Systems for Sustainability and Health (CUSSH), a four-year Wellcome-funded research collaboration which aims to improve capacity to guide transformational health and environmental changes in cities. Results: Drawing on ideas about complex systems, programme evaluation, and transdisciplinary learning, we describe how the programme is understood to “work” in terms of its anticipated processes and resulting changes. The programme theory describes a chain of outputs that ultimately leads to improvement in city sustainability and health (described in an ‘action model’), and the kinds of changes that we expect CUSSH should lead to in people, processes, policies, practices, and research (described in a ‘change model’). Conclusions: Our paper adds to a growing body of research on the process of developing a comprehensive understanding of a transdisciplinary, multiagency, multi-context programme. The programme theory was developed collaboratively over two years. It involved a participatory process to ensure that a broad range of perspectives were included, to contribute to shared understanding across a multidisciplinary team. Examining our approach allowed an appreciation of the benefits and challenges of developing a programme theory for a complex, transdisciplinary research collaboration. Benefits included the development of teamworking and shared understanding and the use of programme theory in guiding evaluation. Challenges included changing membership within a large group, reaching agreement on what the theory would be ‘about’, and the inherent unpredictability of complex initiatives

Antibiotic-induced disturbances of the gut microbiota result in accelerated breast tumor growth

The gut microbiota's function in regulating health has seen it linked to disease progression in several cancers. However, there is limited research detailing its influence in breast cancer (BrCa). This study found that antibiotic-induced perturbation of the gut microbiota significantly increases tumor progression in multiple BrCa mouse models. Metagenomics highlights the common loss of several bacterial species following antibiotic administration. One such bacteria, Faecalibaculum rodentium, rescued this increased tumor growth. Single-cell transcriptomics identified an increased number of cells with a stromal signature in tumors, and subsequent histology revealed an increased abundance of mast cells in the tumor stromal regions. We show that administration of a mast cell stabilizer, cromolyn, rescues increased tumor growth in antibiotic treated animals but has no influence on tumors from control cohorts. These findings highlight that BrCa-microbiota interactions are different from other cancers studied to date and suggest new research avenues for therapy development

The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis

Background A growing body of research identifies the harmful effects that adverse childhood experiences (ACEs; occurring during childhood or adolescence; eg, child maltreatment or exposure to domestic violence) have on health throughout life. Studies have quantified such effects for individual ACEs. However, ACEs frequently co-occur and no synthesis of findings from studies measuring the effect of multiple ACE types has been done. Methods In this systematic review and meta-analysis, we searched five electronic databases for cross-sectional, case-control, or cohort studies published up to May 6, 2016, reporting risks of health outcomes, consisting of substance use, sexual health, mental health, weight and physical exercise, violence, and physical health status and conditions, associated with multiple ACEs. We selected articles that presented risk estimates for individuals with at least four ACEs compared with those with none for outcomes with sufficient data for meta-analysis (at least four populations). Included studies also focused on adults aged at least 18 years with a sample size of at least 100. We excluded studies based on high-risk or clinical populations. We extracted data from published reports. We calculated pooled odds ratios (ORs) using a random-effects model. Findings Of 11 621 references identified by the search, 37 included studies provided risk estimates for 23 outcomes, with a total of 253 719 participants. Individuals with at least four ACEs were at increased risk of all health outcomes compared with individuals with no ACEs. Associations were weak or modest for physical inactivity, overweight or obesity, and diabetes (ORs of less than two); moderate for smoking, heavy alcohol use, poor self-rated health, cancer, heart disease, and respiratory disease (ORs of two to three), strong for sexual risk taking, mental ill health, and problematic alcohol use (ORs of more than three to six), and strongest for problematic drug use and interpersonal and self-directed violence (ORs of more than seven). We identified considerable heterogeneity (I 2 of > 75%) between estimates for almost half of the outcomes. Interpretation To have multiple ACEs is a major risk factor for many health conditions. The outcomes most strongly associated with multiple ACEs represent ACE risks for the next generation (eg, violence, mental illness, and substance use). To sustain improvements in public health requires a shift in focus to include prevention of ACEs, resilience building, and ACE-informed service provision. The Sustainable Development Goals provide a global platform to reduce ACEs and their life-course effect on health. Funding Public Health Wales. © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licens

Publisher Correction: Telomerecat: A ploidy-agnostic method for estimating telomere length from whole genome sequencing data.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper

GWAS meta-analysis of intrahepatic cholestasis of pregnancy implicates multiple hepatic genes and regulatory elements

Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder affecting 0.5–2% of pregnancies. The majority of cases present in the third trimester with pruritus, elevated serum bile acids and abnormal serum liver tests. ICP is associated with an increased risk of adverse outcomes, including spontaneous preterm birth and stillbirth. Whilst rare mutations affecting hepatobiliary transporters contribute to the aetiology of ICP, the role of common genetic variation in ICP has not been systematically characterised to date. Here, we perform genome-wide association studies (GWAS) and meta-analyses for ICP across three studies including 1138 cases and 153,642 controls. Eleven loci achieve genome-wide significance and have been further investigated and fine-mapped using functional genomics approaches. Our results pinpoint common sequence variation in liver-enriched genes and liver-specific cis-regulatory elements as contributing mechanisms to ICP susceptibility

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase