RATIONALE: Appropriate management of low-dose computed tomography (LDCT) screening detected lung nodules will have significant implications for health care resource utilization and minimizing harm ...from radiation exposure related to imaging studies, invasive procedures and clinically significant distress.
We aimed to: provide a practical, evidence-based best practice framework for healthcare professionals (HP) to manage screening LDCT detected lung nodules and identify areas that require future studies.
The Canadian Partnership Against Cancer and Pan-Canadian Lung Cancer Screening Network (PLCSN) undertook a scientific review of the assessment and management of screening LDCT detected lung nodules. Key messages were derived by consensus through a series of stakeholder meetings to obtain full consensus.
MAIN RESULTS: 1) A high standard of LDCT image quality is of importance to determine nodule type, size and growth; 2) Personalized approach to manage screen detected lung nodules based on malignancy probability is a promising approach to decrease resource utilization and minimize risk of screening; 3) Radiologist reports should provide specific guidance for expert and non-expert health care providers regarding the most appropriate next step with a separate lay-language report for screenees tailored to the general result category along with a recommended next step; 4) Diagnostic work-up in centers with multidisciplinary specialized expertise in minimally invasive sampling of pulmonary nodules is recommended to achieve the best possible yield and lowest complications rate; and 5) Common quality indicators in lung nodule management protocols across health jurisdictions provide the opportunity to evaluate and refine management protocols.
The long-chain acyl-CoA (LC-CoA) model of glucose-stimulated insulin secretion (GSIS) holds that secretion is linked to a glucose-induced increase in malonyl-CoA level and accumulation of LC-CoA in ...the cytosol. We have previously tested the validity of this proposal by overexpressing goose malonyl-CoA decarboxylase (MCD) in INS-1 cells, but these studies have been criticized due to: 1) the small insulin secretion response (2–4−fold) of the INS-1 cells used; 2) unknown contribution of the ATP-sensitive K+ (KATP) channel-independent pathway of GSIS in INS-1 cells, which has been implicated as the site at which lipids regulate insulin granule exocytosis; and 3) deletion of the N-terminal mitochondrial targeting sequence, but not the C-terminal peroxisomal targeting sequence in the goose MCD construct, raising the possibility that a significant fraction of the overexpressed enzyme was localized to peroxisomes. To address these outstanding concerns, INS-1-derived 832/13 cells, which exhibit robustKATP channel-dependent and -independent pathways of GSIS, were treated with a new adenovirus encoding human MCD lacking both its mitochondrial and peroxisomal targeting sequences (AdCMV-MCDΔ5), resulting in large increases in cytosolic MCD activity. Treatment of 832/13 cells with AdCMV-MCDΔ5 completely blocked the glucose-induced rise in malonyl-CoA and attenuated the inhibitory effect of glucose on fatty acid oxidation. However, MCD overexpression had no effect onKATP channel-dependent or -independent GSIS in 832/13 cells. Furthermore, combined treatment of 832/13 cells with AdCMV-MCDΔ5 and triacsin C, an inhibitor of long chain acyl-CoA synthetase that reduces LC-CoA levels, did not impair GSIS. These findings extend our previous observations and are not consistent with the LC-CoA hypothesis as originally set forth.
The preparation of side group modified polystyrene-based surface-active block copolymers (SABC) for use as marine fouling resistance/release applications is described. Modifying moieties such as ...poly(ethylene glycol) (PEG) and semifluorinated segments were used. A novel bilayer methodology has been employed that provides both suitable mechanical properties through the use of an elastomeric primer layer of styrene-ethylene/butylene-styrene (SEBS) and control of surface-chemistry through use of the SABCs. This approach has potential as a cost-effective technology for environmentally benign coatings that resist and release marine biofouling. Initial testing of these materials included determination of captive bubble contact angles and protein adsorption. Testing against marine fouling organisms was performed using settlement and adhesion bioassays with zoospores of the green alga Enteromorpha . The results showed that all surfaces had markedly reduced levels of zoospore settlement compared with glass controls and that adhesion strength was strongly affected by the semifluorinated SABC. The results are discussed in terms of surface properties.
This book chronicles the discovery and analysis of animal fossils found in one of the most important paleontological sites in the world—Porcupine Cave, located at an elevation of 9,500 feet in the ...Colorado Rocky Mountains. With tens of thousands of identified specimens, this site has become the key source of information on the fauna of North America's higher elevations between approximately 1 million and 600,000 years ago, a period that saw the advance and retreat of glaciers numerous times. Until now, little has been understood about how this dramatic climate change affected life during the middle Pleistocene. In addition to presenting state-of-the-art data from Porcupine Cave, this study also presents groundbreaking analysis on what the data from the site show about the evolutionary and ecological adjustments that occurred in this period, shedding light on how one of the world's most pressing environmental concerns—global climate change—can influence life on earth.
Ignition Jonathan Isham, Sissel Waage / Jonathan Isham, Sissel Waage
2012, 2007, 2007-07-30
eBook
The evidence is irrefutable: global warming is real. While the debate continues about just how much damage spiking temperatures will wreak, we know the threat to our homes, health, and even way of ...life is dire. So why isn't America doing anything? Where is the national campaign to stop this catastrophe? It may lie between the covers of this book. Ignition brings together some of the world's finest thinkers and advocates to jump start the ultimate green revolution. Including celebrated writers like Bill McKibben and renowned scholars like Gus Speth, as well as young activists, the authors draw on direct experience in grassroots organization, education, law, and social leadership. Their approaches are various, from building coalitions to win political battles to rallying shareholders to change corporate behavior. But they share a belief that private fears about deadly heat waves and disastrous hurricanes can translate into powerful public action. For anyone who feels compelled to do more than change their light bulbs or occasionally carpool, Ignition is an essential guide. Combining incisive essays with success stories and web resources, the book helps readers answer the most important question we all face: "What can I do?"
Abstract 45The industrialization of the United States throughout the 19th century resulted in the exploitation of millions of acres of timberland across the country. Logging during that era was ...described by critics as “cut out and get out” because the land was usually abandoned after the merchantable timber was exhausted. Concern about future timber supplies and the effect of logging on watersheds spurred the development of professional forestry after the Civil War. The first forestry leaders, including Bernhard Fernow and Gifford Pinchot, encouraged private non-industrial forest owners to sustainably manage their woodlands and specifically warned against destructive logging practices—including “cutting the best and leaving the rest”—aka high-grading. During the 1920s and 30s both the Forest Service and SAF spurred initiatives to encourage sustainable timber harvesting practices on private forestland. Although great progress has been made in forest management, logging on most private non-industrial forest land in the east has not changed significantly since the 19th century. Landowners usually sell timber without using the services of a forester, allowing the buyer to selectively cut the most valuable trees in the woodlot. Although this can reduce future value by 70-90%, it remains common practice because both the landowner and the timber buyer maximize short term income. The timber value and productivity of millions of acres of woodland throughout the United States have been significantly degraded as a result. This paper will trace the history of high-grading as described by forestry leaders from the 19th century through the 21st and will show that much work remains unfinished.
ABSTRACT
Objective:To examine the judicial outcomes for intoxicated drivers who were admitted to regional trauma centers as a result of motor vehicle collisions (MVCs).
Methods:A retrospective review ...of the trauma registry of a Level I trauma center was conducted for the period from January 1,1989, through December 31, 1990. Inclusion criteria for entry into the study were 1) identification of the patient as the driver involved in an MVC, 2) a blood alcohol content (BAC) above 0.10 g/dL, and 3) survival until discharge from the hospital. A total of 245 patients from the trauma registry met the inclusion criteria. The number of persons from the submitted list who were later convicted of driving under the influence of alcohol (DUI) was obtained from the Department of Motor Vehicles (DM V) of the Commonwealth of Virginia.
Results:Of the list submitted to the DMV, only nine individuals (3.7%; 95% confidence interval = 1.3–6.0%) were convicted of DUI during the MVCs that led to hospitalization during the study period. During the same time period, the statewide conviction rate for DUI‐cited drivers was 85%.
Conclusion:Admission to the trauma service at a Level I trauma center may provide a refuge from legal consequences for intoxicated drivers involved in MVCs.
PDF
