Environmental Management for Malaria Control in the East Asia and Pacific (EAP) Region

Pursuant to Rule 24 (j), R. Utah S. Ct., defendant LDS Social Services hereby submits the following supplemental authority for Point III of its Respondents\u27 Brief, pertaining specifically to the validity of the presumption of abandonment in U.C.A. § 78-30- 4(3)(c)

Environmental Management for Malaria Control

This series is produced by the Health, Nutrition, and Population Family (HNP) of the World Bank's Human Development Network (HNP Discussion Paper). The papers in this series aim to provide a vehicle for publishing preliminary and unpolished results on HNP topics to encourage discussion and debate. The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations or to members of its Board of Executive Directors or the countries they represent. Citation and the use of material presented in this series should take into account this provisional character. For free copies of papers in this series please contact the individual authors whose name appears on the paper. Enquiries about the series and submissions should be made directly to the Editor in Chief. Submissions should have been previously reviewed and cleared by the sponsoring department, which will bear the cost of publication. No additional reviews will be undertaken after submission. The sponsoring department and authors bear full responsibility for the quality of the technical contents and presentation of material in the series. Since the material will be published as presented, authors should submit an electronic copy in a predefined format as well as three camera-ready hard copies (copied front to back exactly as the author would like the final publication to appear). Rough drafts that do not meet minimum presentational standards may be returned to authors for more work before being accepted

Doppler Study of the Fetal Renal Artery in Oligohydramnios with Post-term Pregnancy

The aim of the study was to investigate the fetal renal artery impedance and hemodynamics in the context of post-term pregnancy with oligohydramnios, using Doppler indices. Methods: This is a prospective study which took place between December 2011 and March 2013. Fetal renal artery Doppler was performed in women at gestational age between 40.1 weeks and 41.3 weeks with singleton pregnancies. The fetal renal artery Doppler resistance index (RI), pulsatility index (PI), systolic/diastolic ratio (S/D), acceleration time (AT), blood flow (BF), fetal renal volume, APGAR, and cesarean ratio were measured. Stepwise logistic regression and the two-tailed t test were used to determine whether the Doppler indices correlated with oligohydramnios (amniotic fluid index < 5 cm). Results: We studied 84 well-dated, singleton, post-term pregnancies, referenced from the high post-term pregnancy obstetric service. Forty-one patients (48.1%) had oligohydramnios. Patients with oligohydramnios had higher S/D, RI, and AT. The fetal renal artery BF (FRABF) was lower in patients with oligohydramnios than those without oligohydramnios (p = 0.037). Stepwise logistic regression using renal artery Doppler indices found FRABF to be the only significant predictor of oligohydramnios: p = 0.012, p < 0.005 [odds ratio = 0.821, 95% confidence interval (CI) = 0.769–0.912]. Conclusion: In oligohydramnios in the context of post-term pregnancies, there is an increased resistance in the fetal renal vascular bed. The reduced FRABF suggests that increased arterial impedance is an important factor in the development of oligohydramnios. This study supports the idea of increased vascular resistance in the fetal renal bed in patients in post-term pregnancies. We think that fetal renal artery Doppler measurement should be part of a routine daily clinical obstetric practice in post-term pregnancies with oligohydramnios

Current Status of Biparametric MRI in Prostate Cancer Diagnosis: Literature Analysis

The role of multiparametric MRI (mpMRI) in the detection of prostate cancer is well-established. Based on the limited role of dynamic contrast enhancement (DCE) in PI-RADS v2.1, the risk of potential side effects, and the increased cost and time, there has been an increase in studies advocating for the omission of DCE from MRI assessments. Per PI-RADS v2.1, DCE is indicated in the assessment of PI-RADS 3 lesions in the peripheral zone, with its most pronounced effect when T2WI and DWI are of insufficient quality. The aim of this study was to evaluate the methodology and reporting in the literature from the past 5 years regarding the use of DCE in prostate MRI, especially with respect to the indications for DCE as stated in PI-RADS v2.1, and to describe the different approaches used across the studies. We searched for studies investigating the use of bpMRI and/or mpMRI in the detection of clinically significant prostate cancer between January 2017 and April 2022 in the PubMed, Web of Science, and Google Scholar databases. Through the search process, a total of 269 studies were gathered and 41 remained after abstract and full-text screening. The following information was extracted from the eligible studies: general clinical and technical characteristics of the studies, the number of PI-RADS 3 lesions, different definitions of clinically significant prostate cancer (csPCa), biopsy thresholds, reference standard methods, and number and experience of readers. Forty-one studies were included in the study. Only 51% (21/41) of studies reported the prevalence of csPCa in their equivocal lesion (PI-RADS category 3 lesions) subgroups. Of the included studies, none (0/41) performed a stratified sub-analysis of the DCE benefit versus MRI quality and 46% (19/41) made explicit statements about removing MRI scans based on a range of factors including motion, noise, and image artifacts. Furthermore, the number of studies investigating the role of DCE using readers with varying experience was relatively low. This review demonstrates that a high proportion of the studies investigating whether bpMRI can replace mpMRI did not transparently report information inherent to their study design concerning the key indications of DCE, such as the number of clinically insignificant/significant PI-RADS 3 lesions, nor did they provide any sub-analyses to test image quality, with some removing bad quality MRI scans altogether, or reader-experience-dependency indications for DCE. For the studies that reported on most of the DCE indications, their conclusions about the utility of DCE were heavily definition-dependent (with varying definitions of csPCa and of the PI-RADS category biopsy significance threshold). Reporting the information inherent to the study design and related to the specific indications for DCE as stated in PI-RADS v2.1 is needed to determine whether DCE is helpful or not. With most of the recent literature being retrospective and not including the data related to DCE indications in particular, the ongoing dispute between bpMRI and mpMRI is likely to linger

Exposure to indoor air pollution from household energy use in rural China: The interactions of technology, behavior, and knowledge in health risk management

Indoor air pollution (IAP) from household use of biomass and coal is a leading environmental health risk in many developing nations. Much of the initial research on household energy technology overlooked the complex interactions of technological, behavioral, economic, and infrastructural factors that determine the success of environmental health interventions. Consequently, despite enormous interest in reducing the large and inequitable risks associated with household energy use in international development and global health, there is limited empirical research to form the basis for design and delivery of effective interventions. We used data from four poor provinces in China (Gansu, Guizhou, Inner Mongolia, and Shaanxi) to examine the linkages among technology, user knowledge and behavior, and access and infrastructure in exposure to IAP from household energy use. We conclude that broad health risk education is insufficient for successful risk mitigation when exposure behaviors are closely linked to day-to-day activities of households such as cooking and heating, or have other welfare implications, and hence cannot be simply stopped. Rather, there should be emphasis on the economic and infrastructure determinants of access to technology, as well as the details of behaviors that affect exposure. Better understanding of technology-behavior interface would also allow designing technological interventions that account for, and are robust to, behavioral factors or to provide individuals and households with alternative behaviors. Based on the analysis, we present technological and behavioral interventions for these four Chinese provinces.Household energy Indoor air pollution Global health Sustainable development Health behavior Risk Technology diffusion Environment and development China

The ongoing debate in thyroid surgery: Should frozen section analysis be omitted?

WOS: 000253083200006PubMed ID: 17429155Controversies concerning the role of frozen section (FS) have been a matter of debate. The aim of this study was to identify the role of FS analysis in intraoperative decision making and analyze the effect of the cost in detecting thyroid malignancies in Turkey. Out of 214 consecutive patients who had been operated on for thyroid cancer between January 1996 and August 2004, 178 patients were evaluated retrospectively. All 178 patients were subjected to FS. Intraoperative FS correctly identified the pathology as malignant in 58.4% of patients. A true-positive FS result changed the surgical strategy in 30 (27.6%) cases False negative FS lesions were defined histologically as papillary microcarcinoma in 54%, follicular variant of papillary cancer in 18% and follicular cancer in 8% of cases. The sensitivities of FNAB and intraoperative FS in thyroid cancer patients were 22.5% and 58.4%, respectively. False negative FS results increased the cost for each informative FS from (sic)25 to (sic)42.7. Despite limitations, results of this Study reject the idea that the role of FS is becoming limited. We recommend routine frozen section in the operative assessment of thyroid nodules. Omitting FS may be suggested only in cases with a FNAB revealing malignancy