Enforcement of Intellectual Property Rights

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Living conditions and respiratory health in Walmer Township and Wells Estate, Port Elizabeth, South Africa

Background. Many impoverished communities in South Africa (SA) simultaneously face multiple preventable socioenvironmental hazards associated with elevated burdens of ill health. One such hazard is failure to institute effective buffer zones between human settlements and point sources of pollution such as airports and industrial zones.Objectives. To gather information on living conditions, housing quality and health status in two poor communities in the SA coastal industrial city of Port Elizabeth.Methods. The study was undertaken in Walmer Township, situated in close proximity to Port Elizabeth International Airport, and Wells Estate, which borders two industrial sites. Approximately 120 households were randomly selected from each study site. Following written informed consent, information on the neighbourhood environment and housing conditions was collected through administration of a structured questionnaire.Results. The two study sites were similar in respect of household language, income, education, high levels of debt servicing and high reliance on social grants. Relative to Walmer Township, higher levels of indoor dust and bad odours in the neighbourhood were reported in Wells Estate, as were higher rates of selected respiratory ill-health symptoms. Upper respiratory tract symptoms were significantly associated with reports of high levels of indoor dust, while lower respiratory tract symptoms were significantly associated with low income, overcrowding, and having a young child in the household.Conclusions. The study highlights a scenario of a triple environmental hazard to health in the study communities: (i) poverty; (ii) poor-quality housing; and (iii) lack of an effective buffer zone between the study communities and local point sources of pollution. Respiratory ill-health conditions were significantly associated with poverty, household composition and living conditions

Effects of Soil Conservation Practices on Sediment Yield from Forest Road Ditches in Northern Iran

The fine-textured soil in forest road ditches is very susceptible to water erosion especially in rainy seasons in Hyrcanian forest. This study examined the yield of ditch segment-scale sediment after releasing two flow rates of 5 l s-1 and 10 l s-1 in segments treated by riprap (RR), grass cover by Festuca arundinacea L. (GC), compacted cotton geotextile (CG) and wooden wattle by local slash (WW). Sediment sampling from the runoff was carried out at the end of each segment every minute. Runoff flow velocity in different treatments was measured using an electromagnetic flow meter. Sediment concentration and runoff velocity in treatments of RR, GC, CG, WW was significantly lower than that of the control plot (Ctl). Increasing flow rate from 5 l s-1 to 10 l s-1 caused no significant change in sediment concentration (except for Ctl and RR) and runoff velocity (except for Ctl and CG), which means that some water might have penetrated into treated soil by RR, GC and WW and this is not acceptable in forest road maintenance practices. Sediment yield from RR (0.36 g l-1) and Ctl (0.50 g l-1) under the flow rate of 10 l s-1 was significantly higher than that of 5 l s-1 with values of 0.21 g l-1 and 0.38 g l-1, respectively. Minimum amount of sediment concentration was observed for CG (0.20 g l-1) with compacted ditch bed. Moreover, runoff velocity in CG and Ctl under the flow rate of 10 l s-1 was significantly higher than that of 5 l s-1. For a forest road with dimension 30×50 cm, slope of 5%, and clay soil with porosity of 57%, treatments of compacted CG can be used in ditch with low flow rates (5 l s-1) and high flow rate (10 l s-1) because of their high efficiency in reducing sediment yield

The Nature of SN 1961V

The nature of SN 1961V has been uncertain. Its peculiar optical light curve and slow expansion velocity are similar to those of super-outbursts of luminous blue variables (LBVs), but its nonthermal radio spectral index and declining radio luminosity are consistent with decades-old supernovae (SNe). We have obtained Hubble Space Telescope STIS images and spectra of the stars in the vicinity of SN 1961V, and find Object 7 identified by Filippenko et al. to be the closest to the optical and radio positions of SN 1961V. Object 7 is the only point source detected in our STIS spectra and only its H-alpha emission is detected; it cannot be the SN or its remnant because of the absence of forbidden lines. While the H-alpha line profile of Object 7 is remarkably similar to that of eta Car, the blue color (similar to an A2Ib supergiant) and lack of appreciable variability are unlike known post-outburst LBVs. We have also obtained Very Long Baseline Array (VLBA) observations of SN 1961V at 18 cm. The non-detection of SN 1961V places a lower limit on the size of the radio-emitting region, 7.6 mas or 0.34 pc, which implies an average expansion velocity in excess of 4,400 km/s, much higher than the optical expansion velocity measured in 1961. We conclude the following: (1) A SN occurred in the vicinity of SN 1961V a few decades ago. (2) If the SN 1961V light maximum originates from a giant eruption of a massive star, Object 7 is the most probable candidate for the survivor, but its blue color and lack of significant variability are different from a post-outburst eta Car. (3) The radio SN and Object 7 could be physically associated with each other through a binary system. (4) Object 7 needs to be monitored to determine its nature and relationship to SN 1961V.Comment: 16 pages, 3 figures, accepted by the Astronomical Journal for the 2004 May issu

A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife

Background: This pilot study assessed the diagnostic accuracy of rapid evaporative ionization mass spectrometry (REIMS) in colorectal cancer (CRC) and colonic adenomas. Methods: Patients undergoing elective surgical resection for CRC were recruited at St. Mary’s Hospital London and The Royal Marsden Hospital, UK. Ex vivo analysis was performed using a standard electrosurgery handpiece with aspiration of the electrosurgical aerosol to a Xevo G2-S iKnife QTof mass spectrometer (Waters Corporation). Histological examination was performed for validation purposes. Multivariate analysis was performed using principal component analysis and linear discriminant analysis in Matlab 2015a (Mathworks, Natick, MA). A modified REIMS endoscopic snare was developed (Medwork) and used prospectively in five patients to assess its feasibility during hot snare polypectomy. Results: Twenty-eight patients were recruited (12 males, median age 71, range 35–89). REIMS was able to reliably distinguish between cancer and normal adjacent mucosa (NAM) (AUC 0.96) and between NAM and adenoma (AUC 0.99). It had an overall accuracy of 94.4 % for the detection of cancer versus adenoma and an adenoma sensitivity of 78.6 % and specificity of 97.3 % (AUC 0.99) versus cancer. Long-chain phosphatidylserines (e.g., PS 22:0) and bacterial phosphatidylglycerols were over-expressed on cancer samples, while NAM was defined by raised plasmalogens and triacylglycerols expression and adenomas demonstrated an over-expression of ceramides. REIMS was able to classify samples according to tumor differentiation, tumor budding, lymphovascular invasion, extramural vascular invasion and lymph node micrometastases (AUC’s 0.88, 0.87, 0.83, 0.81 and 0.81, respectively). During endoscopic deployment, colonoscopic REIMS was able to detect target lipid species such as ceramides during hot snare polypectomy. Conclusion: REIMS demonstrates high diagnostic accuracy for tumor type and for established histological features of poor prognostic outcome in CRC based on a multivariate analysis of the mucosal lipidome. REIMS could augment endoscopic and imaging technologies for precision phenotyping of colorectal cancer

The recognition of stemi by paramedics and the effect of computer interpretation (respect): a cluster-randomised crossover pilot study.

BACKGROUND: Timely diagnosis and appropriate management of patients with ST-segment elevation myocardial infarction (STEMI) depends on accurate interpretation of the 12-lead ECG by paramedics. Computer interpretation messages on ECGs are often provided, but the effect they exert on paramedics' decision making is not known. The objective of this pilot study was to assess the feasibility of a trial using an online assessment tool, to determine the effect of computer interpretation messages on paramedics' diagnosis of STEMI. METHODS: The RESPECT pilot study is a cluster-randomised crossover trial using a bespoke, web-based assessment tool. Participants were randomly allocated 12 of 48 ECGs, with an equal mix of correct and incorrect computer interpretation messages, and STEMI and STEMI-mimics. These were viewed in two phases, with message visibility reversed between phases. RESULTS: 254 paramedics consented into the study, 205 completing the first phase and 150 completing phase two. The data were analysed in two subsets: computer message correct and computer message incorrect. In the subset of correct computer interpretations, accuracy was 84% (message hidden) and 87% (message visible). The subset of incorrect computer interpretations resulted in an accuracy of 77% (message hidden) and 71% (message visible). For the subset of correct computer interpretation, the unadjusted OR was 1.31 (95% CI 1.01-1.71), adjusted OR, 1.80 (95% CI 0.84-4.80), the ICC for participants was 0.36 and for ECGs, 0.18 Incorrect computer interpretations had an unadjusted OR of 0.76 (95% CI 0.61-0.93), adjusted OR, 0.58 (95% CI 0.41-0.80), the ICC for participants was 0.06 and for ECGs, 0.01. CONCLUSION: A randomised crossover trial to determine the effect of computer interpretation messages is feasible. Pilot data have provided an indication about expected rates of discordance and suggest that incorrect computer messages have a stronger influence across participants and ECGs

A Process and Outcome Evaluation of a Shelter for Homeless Young Women

To evaluate the processes and outcomes of a short-term shelter, both quantitative and qualitative data were gathered via participant observation, focus group interviews with shelter staff and residents, and individual interviews with a sample of 40 young women who had been homeless prior to using the shelter. The process evaluation showed that the shelter staff strived to utilize an empowerment philosophy in their relationships with residents, but that there were many challenges to implementing this philosophy. The outcome evaluation showed that, at a 3-month follow-up, the participants reported significant improvements in housing, income, independence, and life satisfaction, but most continued to experience poverty and a number of other difficulties. The results were discussed in terms of the implications for future research and the value and limitations of shelters for dealing with homeless youth. The need for more sustained and comprehensive program interventions and supportive social policies was underscored

Stakeholder Perspectives on Clinical Decision Support Tools to Inform Clinical Artificial Intelligence Implementation: Protocol for a Framework Synthesis for Qualitative Evidence

BACKGROUND: Quantitative systematic reviews have identified clinical artificial intelligence (AI)-enabled tools with adequate performance for real-world implementation. To our knowledge, no published report or protocol synthesizes the full breadth of stakeholder perspectives. The absence of such a rigorous foundation perpetuates the "AI chasm," which continues to delay patient benefit. OBJECTIVE: The aim of this research is to synthesize stakeholder perspectives of computerized clinical decision support tools in any health care setting. Synthesized findings will inform future research and the implementation of AI into health care services. METHODS: The search strategy will use MEDLINE (Ovid), Scopus, CINAHL (EBSCO), ACM Digital Library, and Science Citation Index (Web of Science). Following deduplication, title, abstract, and full text screening will be performed by 2 independent reviewers with a third topic expert arbitrating. The quality of included studies will be appraised to support interpretation. Best-fit framework synthesis will be performed, with line-by-line coding completed by 2 independent reviewers. Where appropriate, these findings will be assigned to 1 of 22 a priori themes defined by the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability framework. New domains will be inductively generated for outlying findings. The placement of findings within themes will be reviewed iteratively by a study advisory group including patient and lay representatives. RESULTS: Study registration was obtained from PROSPERO (CRD42021256005) in May 2021. Final searches were executed in April, and screening is ongoing at the time of writing. Full text data analysis is due to be completed in October 2021. We anticipate that the study will be submitted for open-access publication in late 2021. CONCLUSIONS: This paper describes the protocol for a qualitative evidence synthesis aiming to define barriers and facilitators to the implementation of computerized clinical decision support tools from all relevant stakeholders. The results of this study are intended to expedite the delivery of patient benefit from AI-enabled clinical tools. TRIAL REGISTRATION: PROSPERO CRD42021256005; https://tinyurl.com/r4x3thvp. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33145