Mother-Song

https://digitalcommons.library.umaine.edu/mmb-vp/5788/thumbnail.jp

State-Led Approaches to Electronic Waste Management in the U.S.: A Study of Stakeholder Involvement in Take-Back Legislation Efficiency

Information technology has proliferated over the past two decades, and waste from electronics represents the fastest growing waste stream in the world. The production and disposal of electronics, from cradle to grave, pose critical threats to human health and the environment. The management of electronic, or e-waste, streams poses a particular set of challenges for solid waste management, hazardous waste management, and economic development in the United States. As e-waste accumulates, state governments, municipalities and private landfills are refusing to accept the responsibility for its disposal. To address this problem, the federal and state governments must find a safe and economically feasible way to process e-waste. This thesis analyzes the lessons learned from both the European Union’s e-waste programs and from a set of US e-waste cases. These range from state-led e-waste programs to manufacturer-led and voluntary e-waste programs. Based on this comparative case method, a set of key barriers emerge in the US cases that undermine e-waste management policies: the perception that US manufacturers will recycle electronic products properly, the power of the electronics industry to block policies, the lack of public consumer education about the environmental consequences of e-waste disposal, and the fact that recycling e-waste is more expensive than extracting raw materials. These factors reflect political and socio-economic realities within the US, including the power of the electronics industry, the perceived capacity of municipal solid waste systems, and the salience and the perception of consumers that US federal laws appropriately manage e-waste disposal. Part of the issue is that e-waste falls into regulatory gaps across major waste management federal laws. This thesis argues that state-led e-waste management policies are not adequate because of the lack of cooperation from all e-waste stakeholders from the federal government, state government, electronics industry, third party processors, and consumers

Impact of Motor Therapy with Dynamic Body-Weight Support on Functional Independence Measures in Traumatic Brain Injury: An Exploratory Study

BACKGROUND: Contemporary goals of rehabilitation after traumatic brain injury (TBI) aim to improve cognitive and motor function by applying concepts of neuroplasticity. This can be challenging to carry out in TBI patients with motor, balance, and cognitive impairments. OBJECTIVE: To determine whether use of dynamic body-weight support (DBWS) would allow safe administration of intensive motor therapy during inpatient rehabilitation and whether its use would yield greater improvement in functional recovery than standard-of-care (SOC) therapy in adults with TBI. METHODS: Data in this retrospective cohort study was collected from patients with TBI who receive inpatient rehabilitation incorporating DBWS (n = 6) and who received inpatient rehabilitation without DBWS (SOC, n = 6). The primary outcome measure was the change in Functional Independence Measures (FIM) scores from admission to discharge. RESULTS: There was significant improvement in total FIM scores at discharge compared to admission for both the DBWS (p = 0.001) and SOC (p = 0.005) groups. Overall, the DBWS group had greater improvement in total FIM score and FIM subscales compared to the SOC group. CONCLUSIONS: Our results suggest DBWS has the potential to allow a greater intensity of therapy during inpatient rehabilitation and yield better outcomes compared to SOC in patients with TBI

Safety and Improvement of Movement Function After Stroke with Atomoxetine: A Pilot Randomized Trial

Background: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention. Objective: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke. Methods: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, Wolf Motor Function Test, and Action Research Arm Test at baseline, post-intervention, and 1-month follow-up. Results: No significant between-groups differences were found in mean heart rate (95% CI, –12.4–22.6; p = 0.23), mean systolic blood pressure (95% CI, –1.7–29.6; p = 0.21), or mean diastolic blood pressure (95% CI, –10.4–13.3; p = 0.08). A statistically significant between-groups difference on Fugl-Meyer at post-intervention favored the atomoxetine group (95% CI, 1.6–12.7; p = 0.016). Conclusion: Atomoxetine combined with motor training appears safe and may optimize motor training outcomes after stroke

Safety and Improvement of Movement Function After Stroke with Atomoxetine: A Pilot Randomized Trial

BACKGROUND: Intensive, task-oriented motor training has been associated with neuroplastic reorganization and improved upper extremity movement function after stroke. However, to optimize such training for people with moderate-to-severe movement impairment, pharmacological modulation of neuroplasticity may be needed as an adjuvant intervention. OBJECTIVE: Evaluate safety, as well as improvement in movement function, associated with motor training paired with a drug to upregulate neuroplasticity after stroke. METHODS: In this double-blind, randomized, placebo-controlled study, 12 subjects with chronic stroke received either atomoxetine or placebo paired with motor training. Safety was assessed using vital signs. Upper extremity movement function was assessed using Fugl-Meyer Assessment, Wolf Motor Function Test, and Action Research Arm Test at baseline, post-intervention, and 1-month follow-up. RESULTS: No significant between-groups differences were found in mean heart rate (95% CI, -12.4-22.6; p = 0.23), mean systolic blood pressure (95% CI, -1.7-29.6; p = 0.21), or mean diastolic blood pressure (95% CI, -10.4-13.3; p = 0.08). A statistically significant between-groups difference on Fugl-Meyer at post-intervention favored the atomoxetine group (95% CI, 1.6-12.7; p = 0.016). CONCLUSION: Atomoxetine combined with motor training appears safe and may optimize motor training outcomes after stroke

Pulmonary Embolism in a Woman Taking Oral Contraceptives and Valdecoxib

A 25-y-old woman, who had been on an oral contraceptive pill for 3 years, presented with pulmonary embolism. One month prior to presentation she had been started on valdecoxib for neck pain

A Randomized Controlled Trial to Determine Whether Beta-Hydroxy-Beta-Methylbutyrate and/or Eicosapentaenoic Acid Improves Diaphragm and Quadriceps Strength in Critically Ill Mechanically Ventilated Patients

BACKGROUND: Intensive care unit acquired weakness is a serious problem, contributing to respiratory failure and reductions in ambulation. Currently, there is no pharmacological therapy for this condition. Studies indicate, however, that both beta-hydroxy-beta-methylbutyrate (HMB) and eicosapentaenoic acid (EPA) increase muscle function in patients with cancer and in older adults. The purpose of this study was to determine whether HMB and/or EPA administration would increase diaphragm and quadriceps strength in mechanically ventilated patients. METHODS: Studies were performed on 83 mechanically ventilated patients who were recruited from the Medical Intensive Care Units at the University of Kentucky. Diaphragm strength was assessed as the trans-diaphragmatic pressure generated by supramaximal magnetic phrenic nerve stimulation (PdiTw). Quadriceps strength was assessed as leg force generated by supramaximal magnetic femoral nerve stimulation (QuadTw). Diaphragm and quadriceps thickness were assessed by ultrasound. Baseline measurements of muscle strength and size were performed, and patients were then randomized to one of four treatment groups (placebo, HMB 3 gm/day, EPA 2 gm/day and HMB plus EPA). Strength and size measurements were repeated 11 days after study entry. ANCOVA statistical testing was used to compare variables across the four experimental groups. RESULTS: Treatments failed to increase the strength and thickness of either the diaphragm or quadriceps when compared to placebo. In addition, treatments also failed to decrease the duration of mechanical ventilation after study entry. CONCLUSIONS: These results indicate that a 10-day course of HMB and/or EPA does not improve skeletal muscle strength in critically ill mechanically ventilated patients. These findings also confirm previous reports that diaphragm and leg strength in these patients are profoundly low. Additional studies will be needed to examine the effects of other anabolic agents and innovative forms of physical therapy. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01270516. Registered 5 January 2011, https://clinicaltrials.gov/ct2/show/NCT01270516?term=Supinski&draw=2&rank=4

Temperature as a Circadian Marker in Older Human Subjects: Relationship to Metabolic Syndrome and Diabetes

Background: Circadian rhythms are characterized by approximate 24-hour oscillations in physiological and behavioral processes. Disruptions in these endogenous rhythms, most commonly associated with shift work and/or lifestyle, are recognized to be detrimental to health. Several studies have demonstrated a high correlation between disrupted circadian rhythms and metabolic disease. The aim of this study was to determine which metabolic parameters correlate with physiological measures of circadian temperature amplitude (TempAmp) and stability (TempStab). Methods: Wrist skin temperature was measured in 34 subjects (ages 50 to 70, including lean, obese, and diabetic subjects) every 10 minutes for 7 consecutive days. Anthropometric measures and fasting blood draws were conducted to obtain data on metabolic parameters: body mass index, hemoglobin A1C, triglycerides, cholesterol, high-density lipoprotein, and low-density lipoprotein. A history of hypertension and current blood pressure was noted. Results: Analysis of the data indicated a substantial reduction in TempAmp and TempStab in subjects with metabolic syndrome (three or more risk factors). To determine the impact of individual interdependent metabolic factors on temperature rhythms, stepwise multilinear regression analysis was conducted using metabolic syndrome measurements. Interestingly, only triglyceride level was consistently correlated by the analysis. Triglyceride level was shown to contribute to 33% of the variability in TempAmp and 23% of the variability in TempStab. Conclusion: Our results demonstrate that elevated triglycerides are associated with diminished TempAmp and TempStab in human subjects, and triglycerides may serve as a primary metabolic predictor of circadian parameters

A global database for metacommunity ecology, integrating species, traits, environment and space

The use of functional information in the form of species traits plays an important role in explaining biodiversity patterns and responses to environmental changes. Although relationships between species composition, their traits, and the environment have been extensively studied on a case-by-case basis, results are variable, and it remains unclear how generalizable these relationships are across ecosystems, taxa and spatial scales. To address this gap, we collated 80 datasets from trait-based studies into a global database for metaCommunity Ecology: Species, Traits, Environment and Space; “CESTES”. Each dataset includes four matrices: species community abundances or presences/absences across multiple sites, species trait information, environmental variables and spatial coordinates of the sampling sites. The CESTES database is a live database: it will be maintained and expanded in the future as new datasets become available. By its harmonized structure, and the diversity of ecosystem types, taxonomic groups, and spatial scales it covers, the CESTES database provides an important opportunity for synthetic trait-based research in community ecology

Cardiovascular rhythms and the molecular clock

Cardiovascular physiology, as well as path ophysiology, undergoes marked diurnal variation, which may be influenced by the master circadian clock located in the suprachiasmatic nucleus. Peripheral clocks have recently been discovered in several tissues including heart, aorta, and aortic smooth muscle, and a mechanism by which the latter clock may be phase shifted by circulating hormones elucidated. However, no study to date has characterized a clock in isolated vascular endothelium or examined the ability of hormones to phase shift an endothelial clock. We examined the expression of core clock proteins in vascular endothelium by Western blot. The ability of serum shock or humoral treatment to induce clock gene expression in these cells was also examined. Although endothelial cells expressed the necessary components for a functional oscillator, these cells did not respond to the serum shock model via rhythmic expression of molecular clock components. Humoral factors failed to alter acutely the expression of clock genes in these cells. The expression of clock- or endothelial-specific genes in aortas harvested from Bmal1-ECKO (endothelial cell knock-out) mice was analyzed, providing some of the first in vivo evidence for endothelial clock regulation by BMAL1. Microarray analysis of mouse aorta harvested across circadian time had previously revealed oscillations in transcripts relevant to vascular injury and integrity. We explored the influence of circadian clocks in conditioning the response to vascular injury using an in vivo photochemical injury model. A diurnal variation in the time to vessel occlusion was observed in WT mice and this pattern was disrupted with clock dysfunction. Clock-mutant and Npas2 knock-out mice displayed significantly longer occlusion times compared to WT, while loss of endothelial Bmal1 had the opposite impact. Platelet activation or aggregation does not appear to impact the diurnal regulation of thrombogenesis. The fibrinolytic system may play a role, although diurnal variations in fibrinolysis alone do not fully explain the observed phenomena. Future studies will likely shed light on the multiple mechanisms and complex interplay involved