Advantages of the no-scalpel vasectomy technique

The no-scalpel vasectomy (NSV) technique should be used instead of the standard incisional method. (Strength of Recommendation: A, based on systematic reviews, mixed-quality randomized controlled trials [RCTs], cohort studies, and case-control series.) The NSV technique is associated with fewer complications, produces less perioperative and postoperative pain, results in quicker recovery, takes less time to perform, and is as effective as standard incisional vasectomy

Transitions in climate and energy discourse between Hurricanes Katrina and Sandy

Although climate change and energy are intricately linked, their explicit connection is not always prominent in public discourse and the media. Disruptive extreme weather events, including hurricanes, focus public attention in new and different ways offering a unique window of opportunity to analyze how a focusing event influences public discourse. Media coverage of extreme weather events simultaneously shapes and reflects public discourse on climate issues. Here, we analyze climate and energy newspaper coverage of Hurricanes Katrina (2005) and Sandy (2012) using topic models, mathematical techniques used to discover abstract topics within a set of documents. Our results demonstrate that post-Katrina media coverage does not contain a climate change topic, and the energy topic is limited to discussion of energy prices, markets, and the economy with almost no explicit linkages made between energy and climate change. In contrast, post-Sandy media coverage does contain a prominent climate change topic, a distinct energy topic, as well as integrated representation of climate change and energy, indicating a shift in climate and energy reporting between Hurricane Katrina and Hurricane Sandy

Operationalizing Energy Democracy: Challenges and Opportunities in Vermont's Renewable Energy Transformation

As the social movement promoting “energy democracy” expands, analysis of how the principles of energy democracy are being operationalized is increasingly valuable. The state of Vermont provides a unique case of a United States jurisdiction intentionally promoting multiple ideals of energy democracy as the state commits to transitioning toward renewable energy. This research explores how energy democracy principles are being operationalized in the state of Vermont. Collaboration among stakeholders state-wide has resulted in a variety of social innovations that advance energy democracy goals, yet there are limited examples of community ownership and strong community opposition to some renewable projects. A diverse set of stakeholders in this small state has developed and promoted the adoption of a comprehensive energy plan with a goal of achieving 90% renewables in all sectors (electricity, heating, and transportation) by 2050. These stakeholders are aligned toward achieving this goal, and a socially innovative, networked effort seeks to establish a creative and inclusive environment for individuals, communities and organizations to benefit in the renewable energy transformation. A collaborative culture has created a protected environment where social innovation and experimentation are supported and encouraged, yet tension and community opposition surrounds some wind and solar projects. Reviewing social innovations in Vermont highlights challenges and opportunities of operationalizing energy democracy and emphasizes the importance of local community and public ownership to distribute the economic and political power associated with renewable energy

A comparative state-level analysis of carbon capture and storage (CCS) discourse among U.S. energy stakeholders and the public

AbstractPerceptions of the potential of emerging technologies like carbon capture and storage (CCS) are constructed not just through technical and economic processes but also through discourse, i.e. through compelling narratives about what a technology is, what a technology might become and why it is needed and preferable to competing technologies. The influence of discourse is particularly important in the innovation phases prior to commercialization when innovation activities are focused on research, development and demonstration, and when feasibility and costs of alternatives systems cannot yet be tested by market dynamics. This paper provides a state-level comparative analysis of CCS discourse in the U.S. to provide insights about the socio-political context in which CCS technology is advancing and being considered in four different states: Massachusetts, Minnesota, Montana, and Texas. This research combines analysis of interviews of state-level energy stakeholders and media analysis of state-level newspapers. In semi-structured interviews, state-level energy policy stakeholders were asked to explain their perceptions of the potential opportunities and risks of CCS technology within their unique state context. Interview texts were coded to assess the frequency and extent of various different frames of CCS opportunities and risks including technical, political, economic, environmental, aesthetic, and health/safety. A similar coding scheme was applied to analysis of state-level newspaper coverage of CCS technology. Here, the frequency of these different framings of CCS opportunities and risks in state-level print media was assessed. This analysis demonstrates wide variation in state-level CCS discourse and perceptions of the potential opportunities and risks associated with CCS technology. This mixed-methods approach to characterizing the socio-political context for CCS advancement in these four states contributes to improved understanding of state-level variation in energy technology innovation, provides valuable information about energy technology development in these specific states, and also offers insight into the very different sub-national discourses associated with emerging low-carbon energy technologies in the U.S

Innovation and access to technologies for sustainable development: diagnosing weaknesses and identifying interventions in the Transnational Arena

Sustainable development – improving human well-being across present generations without compromising the ability of future generations to meet their own needs – is a central challenge for the 21st century. Technological innovation can play an important role in moving society toward sustainable development. However, poor, marginalized, and future populations often do not fully benefit from innovation due to their lack of market or political power to influence innovation processes. As a result, current innovation systems fail to contribute as much as they might to meeting sustainable development goals. This paper focuses on how actors and institutions operating in the transnational arena can mitigate such shortfalls. To identify the most important transnational functions required to meet sustainable development needs our analysis undertook three main steps. First, we developed a framework to diagnose blockages in the global innovation system for particular technologies. This framework was built on existing theory and new empirical analysis. On the theory side, we drew from the literatures of systems dynamics; technology and sectoral innovation systems, science and technology studies, the economics of innovation, and global governance. On the empirical front, we conducted eighteen detailed case studies of technology innovation in multiple sectors relevant to sustainable development: water, energy, health, food, and manufactured goods. We use the framework to analyze our case studies in the common language of (1) technology stocks, (2) non-linear flows between stocks substantiated by specific mechanisms, and (3) characteristics of actors and socio-technical conditions (STCs) which mediate the flows between stocks . We identify blockages in the innovation system for each of the cases, diagnosing where in the innovation system flows were hindered and which specific sets of STCs and actor characteristics were associated with these blockages. Figure E.1 displays the components of our framework and how they relate

Multiple Independent Loci at Chromosome 15q25.1 Affect Smoking Quantity: a Meta-Analysis and Comparison with Lung Cancer and COPD

Recently, genetic association findings for nicotine dependence, smoking behavior, and smoking-related diseases converged to implicate the chromosome 15q25.1 region, which includes the CHRNA5-CHRNA3-CHRNB4 cholinergic nicotinic receptor subunit genes. In particular, association with the nonsynonymous CHRNA5 SNP rs16969968 and correlates has been replicated in several independent studies. Extensive genotyping of this region has suggested additional statistically distinct signals for nicotine dependence, tagged by rs578776 and rs588765. One goal of the Consortium for the Genetic Analysis of Smoking Phenotypes (CGASP) is to elucidate the associations among these markers and dichotomous smoking quantity (heavy versus light smoking), lung cancer, and chronic obstructive pulmonary disease (COPD). We performed a meta-analysis across 34 datasets of European-ancestry subjects, including 38,617 smokers who were assessed for cigarettes-per-day, 7,700 lung cancer cases and 5,914 lung-cancer-free controls (all smokers), and 2,614 COPD cases and 3,568 COPD-free controls (all smokers). We demonstrate statistically independent associations of rs16969968 and rs588765 with smoking (mutually adjusted p-values<10$^{−35}$ and <10$^{−8}$ respectively). Because the risk alleles at these loci are negatively correlated, their association with smoking is stronger in the joint model than when each SNP is analyzed alone. Rs578776 also demonstrates association with smoking after adjustment for rs16969968 (p<10$^{−6}$). In models adjusting for cigarettes-per-day, we confirm the association between rs16969968 and lung cancer (p<10$^{−20}$) and observe a nominally significant association with COPD (p = 0.01); the other loci are not significantly associated with either lung cancer or COPD after adjusting for rs16969968. This study provides strong evidence that multiple statistically distinct loci in this region affect smoking behavior. This study is also the first report of association between rs588765 (and correlates) and smoking that achieves genome-wide significance; these SNPs have previously been associated with mRNA levels of CHRNA5 in brain and lung tissue

Using a Modified Intervention Mapping Approach to Develop and Refine a Single-Session Motivational Intervention for Methamphetamine-Using Men Who Have Sex With Men

There is an ongoing need for the development and adaptation of behavioral interventions to address behaviors related to acquisition and transmission of infectious diseases and for preventing the onset of chronic diseases. This paper describes the application of an established systematic approach to the development of a behavioral intervention to reduce sexual risk behaviors for HIV among men who have sex with men and who use methamphetamine. The approach includes six steps: (1) a needs assessment; (2) preparing matrices of proximal program objectives; (3) selecting theory-based methods and practical strategies; (4) producing program components and materials; (5) planning for program adoption, implementation, and sustainability; and (6) planning for evaluation. The focus of this article is on the intervention development process; therefore the article does not describe steps 5 and 6. Overall the process worked well, although it had to be adapted to fit the sequence of events associated with a funded research project. This project demonstrates that systematic approaches to intervention development can be applied even in research projects where some of the steps occur during the proposal writing process rather than during the actual project. However, intervention developers must remain flexible and be prepared to adapt the process to the situation. This includes being ready to make choices regarding intervention efficacy versus feasibility and being willing to select the best intervention that is likely to be delivered with available resources rather than an ideal intervention that may not be practical

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis

BioEarth: Envisioning and developing a new regional earth system model to inform natural and agricultural resource management

As managers of agricultural and natural resources are confronted with uncertainties in global change impacts, the complexities associated with the interconnected cycling of nitrogen, carbon, and water present daunting management challenges. Existing models provide detailed information on specific sub-systems (e.g., land, air, water, and economics). An increasing awareness of the unintended consequences of management decisions resulting from interconnectedness of these sub-systems, however, necessitates coupled regional earth system models (EaSMs). Decision makers’ needs and priorities can be integrated into the model design and development processes to enhance decision-making relevance and “usability” of EaSMs. BioEarth is a research initiative currently under development with a focus on the U.S. Pacific Northwest region that explores the coupling of multiple stand-alone EaSMs to generate usable information for resource decision-making. Direct engagement between model developers and non-academic stakeholders involved in resource and environmental management decisions throughout the model development process is a critical component of this effort. BioEarth utilizes a bottom-up approach for its land surface model that preserves fine spatial-scale sensitivities and lateral hydrologic connectivity, which makes it unique among many regional EaSMs. This paper describes the BioEarth initiative and highlights opportunities and challenges associated with coupling multiple stand-alone models to generate usable information for agricultural and natural resource decision-making

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead