A Decellularization Methodology for the Production of a Natural Acellular Intestinal Matrix

Successful tissue engineering involves the combination of scaffolds with appropriate cells in vitro or in vivo. Scaffolds may be synthetic, naturally-derived or derived from tissues/organs. The latter are obtained using a technique called decellularization. Decellularization may involve a combination of physical, chemical, and enzymatic methods. The goal of this technique is to remove all cellular traces whilst maintaining the macro- and micro-architecture of the original tissue.Intestinal tissue engineering has thus far used relatively simple scaffolds that do not replicate the complex architecture of the native organ. The focus of this paper is to describe an efficient decellularization technique for rat small intestine. The isolation of the small intestine so as to ensure the maintenance of a vascular connection is described. The combination of chemical and enzymatic solutions to remove the cells whilst preserving the villus-crypt axis in the luminal aspect of the scaffold is also set out. Finally, assessment of produced scaffolds for appropriate characteristics is discussed.     

Data-Driven Decisions for Reducing Readmissions for Heart Failure: General Methodology and Case Study

Background

Several studies have focused on stratifying patients according to their level of readmission risk, fueled in part by incentive programs in the U.S. that link readmission rates to the annual payment update by Medicare. Patient-specific predictions about readmission have not seen widespread use because of their limited accuracy and questions about the efficacy of using measures of risk to guide clinical decisions. We construct a predictive model for readmissions for congestive heart failure (CHF) and study how its predictions can be used to perform patient-specific interventions. We assess the cost-effectiveness of a methodology that combines prediction and decision making to allocate interventions. The results highlight the importance of combining predictions with decision analysis.

Methods

We construct a statistical classifier from a retrospective database of 793 hospital visits for heart failure that predicts the likelihood that patients will be rehospitalized within 30 days of discharge. We introduce a decision analysis that uses the predictions to guide decisions about post-discharge interventions. We perform a cost-effectiveness analysis of 379 additional hospital visits that were not included in either the formulation of the classifiers or the decision analysis. We report the performance of the methodology and show the overall expected value of employing a real-time decision system.

Findings

For the cohort studied, readmissions are associated with a mean cost of $13,679 with a standard error of $1,214. Given a post-discharge plan that costs $1,300 and that reduces 30-day rehospitalizations by 35%, use of the proposed methods would provide an 18.2% reduction in rehospitalizations and save 3.8% of costs.

Conclusions

Classifiers learned automatically from patient data can be joined with decision analysis to guide the allocation of post-discharge support to CHF patients. Such analyses are especially valuable in the common situation where it is not economically feasible to provide programs to all patients.     

Interdisciplinary Methodology: The Case of Kitcher's Freud

The guiding idea of Patricia Kitcher's Freud's Dream is that the use of interdisciplinary methodology accounts at the same time for the most central features of Freud's theory of the mind and for its most serious shortcomings. Kitcher proposes to provide an account of Freud's theory that illuminates its interdisciplinary underpinnings. While she indisputably succeeds in providing a subtle and rich reconstruction of Freud's work, her attempt to show up the limitations of interdisciplinary studies does not work. The value of her account is attributable not to the idea that Freud's was a flawed interdisciplinary endeavour but to a contextually and historically sensitive approach that makes explicit and elucidates the norms of explanation at work in his method of theory construction and that takes into account the multifaceted nature of his scientific practice.     

Application of a Multi-Criteria Decision-Making Approach for Ranking Environmental Risks Caused by Petrochemical Industries: A Case Study of a Sodium Carbonate Production Unit

The occurrence of accidents in petrochemical industries that cause environmental catastrophes has persuaded experts to use risk-oriented approaches. The approach is to rank the key elements of risk assessment by which the priority of each risk is specified compared to the other ones. The present study was performed to test the applicability of a multi-criteria decision-making approach for prioritizing environmental risks of a petrochemical complex in southwestern Iran. Accordingly, all risky activities of the Sodium Carbonate Production Unit (SCPU) were identified initially. Afterward, the relevant environmental components affected by the risky activities were specified. According to the specification, the most significant risks were shortlisted using experts’ judgment based on three criteria: “impact intensity,” “occurrence probability,” and the “extent of contamination dispersion in the environment.” The shortlisted environmental risks were then prioritized by the Method “Elimination et Choice Translating Reality (Elimination and Choice Expressing Reality)” abbreviated as ELECTRE. Based on the obtained results, “decreased air quality” and “manpower health threatening” are the top-priority risks while “poor quality of groundwater” was identified as the least priority risk. In a general conclusion, a multi-criteria decision-making approach is quite useful for assessing environmental risks of petrochemical industries.     

Technological Change and the Environmental Impacts of Food Production and Consumption: The Case of the UK Yogurt Industry

This article examines the changing food production and consumption system of yogurt in the United Kingdom, focusing on the environmental impact of the yogurt processing stage from a technological perspective. Based on interviews with key industry stakeholders, we describe the evolution of the yogurt industry since the 1950s, characterized by a shift toward industrialized mass production and increased product diversity. We explain how new technologies, sociopolitical trends, and industrial strategies have shaped the evolution of the industry over this period. Moreover, we argue that the environmental impact of the current yogurt production and consumption system has been determined to a large extent by technological change. The article explores the future of the yogurt production and consumption system, considering the environmental implications of increased production of more differentiated yogurt products and how technological change may mitigate some of those impacts. The analysis reveals that to appreciate the environmental impact of the yogurt industry, policy makers should not focus simply on the primary stage of production but on all stages of the yogurt production and consumption system. Minimizing waste and improving resource efficiency at the yogurt processing stage are found to be particularly important. Transformation to an alternative yogurt production and consumption system with substantially lower environmental impacts requires significant commitment to change across the industry and the wider sociotechnical landscape.     

The Relative Impacts of Disease on Health Status and Capability Wellbeing: A Multi-Country Study

Background

Evaluations of the impact of interventions for resource allocation purposes commonly focus on health status. There is, however, also concern about broader impacts on wellbeing and, increasingly, on a person''s capability. This study aims to compare the impact on health status and capability of seven major health conditions, and highlight differences in treatment priorities when outcomes are measured by capability as opposed to health status.

Methods

The study was a cross-sectional four country survey (n = 6650) of eight population groups: seven disease groups with: arthritis, asthma, cancer, depression, diabetes, hearing loss, and heart disease and one health population ‘comparator’ group. Two simple self-complete questionnaires were used to measure health status (EQ-5D-5L) and capability (ICECAP-A). Individuals were classified by illness severity using condition-specific questionnaires. Effect sizes were used to estimate: (i) the difference in health status and capability for those with conditions, relative to a healthy population; and (ii) the impact of the severity of the condition on health status and capability within each disease group.

Findings

5248 individuals were included in the analysis. Individuals with depression have the greatest mean reduction in both health (effect size, 1.26) and capability (1.22) compared to the healthy population. The effect sizes for capability for depression are much greater than for all other conditions, which is not the case for health. For example, the arthritis group effect size for health (1.24) is also high and similar to that of depression, whereas for the same arthritis group, the effect size for capability is much lower than that for depression (0.55). In terms of severity within disease groups, individuals categorised as ''mild'' have similar capability levels to the healthy population (effect sizes <0.2, excluding depression) but lower health status than the healthy population (≥0.4).

Conclusion

Significant differences exist in the relative effect sizes across diseases when measured by health status and capability. In terms of treating morbidity, a shift in focus from health gain to capability gain would increase funding priorities for patients with depression specifically and severe illnesses more generally.     

Assessing Impacts of Wind-Energy Development on Nocturnally Active Birds and Bats: A Guidance Document

ABSTRACT Our purpose is to provide researchers, consultants, decision-makers, and other stakeholders with guidance to methods and metrics for investigating nocturnally active birds and bats in relation to utility-scale wind-energy development. The primary objectives of such studies are to 1) assess potential impacts on resident and migratory species, 2) quantify fatality rates on resident and migratory populations, 3) determine the causes of bird and bat fatalities, and 4) develop, assess, and implement methods for reducing risks to bird and bat populations and their habitats. We describe methods and tools and their uses, discuss limitations, assumptions, and data interpretation, present case studies and examples, and offer suggestions for improving studies on nocturnally active birds and bats in relation to wind-energy development. We suggest best practices for research and monitoring studies using selected methods and metrics, but this is not intended as cookbook. We caution that each proposed and executed study will be different, and that decisions about which methods and metrics to use will depend upon several considerations, including study objectives, expected and realized risks to bird and bat populations, as well as budgetary and logistical considerations. Developed to complement and extend the existing National Wind Coordinating Committee document “Methods and Metrics for Assessing Impacts of Wind Energy Facilities on Wildlife” (Anderson et al. 1999), we provide information that stakeholders can use to aid in evaluating potential and actual impacts of wind power development on nocturnally active birds and bats. We hope that decision-makers will find these guidelines helpful as they assemble information needed to support the permitting process, and that the public will use this guidance document as they participate in the permitting processes. We further hope that the wind industry will find valuable guidance from this document when 1) complying with data requirements as a part of the permitting process, 2) evaluating sites for potential development, 3) assessing impacts of operational wind-energy facilities, and 4) mitigating local and cumulative impacts on nocturnally active birds and bats.     

Conservation Planning for Offsetting the Impacts of Development: A Case Study of Biodiversity and Renewable Energy in the Mojave Desert

Balancing society’s competing needs of development and conservation requires careful consideration of tradeoffs. Renewable energy development and biodiversity conservation are often considered beneficial environmental goals. The direct footprint and disturbance of renewable energy, however, can displace species’ habitat and negatively impact populations and natural communities if sited without ecological consideration. Offsets have emerged as a potentially useful tool to mitigate residual impacts after trying to avoid, minimize, or restore affected sites. Yet the problem of efficiently designing a set of offset sites becomes increasingly complex where many species or many sites are involved. Spatial conservation prioritization tools are designed to handle this problem, but have seen little application to offset siting and analysis. To address this need we designed an offset siting support tool for the Desert Renewable Energy Conservation Plan (DRECP) of California, and present a case study of hypothetical impacts from solar development in the Western Mojave subsection. We compare two offset scenarios designed to mitigate a hypothetical 15,331 ha derived from proposed utility-scale solar energy development (USSED) projects. The first scenario prioritizes offsets based precisely on impacted features, while the second scenario offsets impacts to maximize biodiversity conservation gains in the region. The two methods only agree on 28% of their prioritized sites and differ in meeting species-specific offset goals. Differences between the two scenarios highlight the importance of clearly specifying choices and priorities for offset siting and mitigation in general. Similarly, the effects of background climate and land use change may lessen the durability or effectiveness of offsets if not considered. Our offset siting support tool was designed specifically for the DRECP area, but with minor code modification could work well in other offset analyses, and could provide continuing support for a potentially innovative mitigation solution to environmental impacts.     

Environmental Footprints and Scenario Analysis for Assessing the Impacts of the Agri‐Food Industry on a Regional Economy: A Case Study in Spain

The study of the environmental footprints of various sectors and industries is increasingly demanded by institutions and by society. In this context, the regional perspective is becoming particularly important, and even more so in countries such as Spain, where the autonomous communities have the primary responsibility for implementing measures to combat environmental degradation and promote sustainable development, in coordination with national strategies. Taking as a case study a Spanish region, Aragon, and significant economic sectors, including agriculture and the food industry, the aim of this work is twofold. First, we calculate the associated environmental footprints (of emissions and water) from the dual perspectives of production (local impacts) and consumption (final destination of the goods produced by the agri‐food industry). Second, through a scenarios analysis, based on a general equilibrium model designed and calibrated specifically for the region, we evaluate the environmental implications of changes in the agri‐food industry (changes in the export and import pattern, as well as in consumer behavior). This model provides a flexible approximation to the environmental impacts, controlling for a wider range of behavioral and economic interactions. Our results indicate that the agri‐food industry has a significant impact on the environment, especially on water resources, which must be responsibly managed in order to maintain the differential advantage that a regional economy can have, compared to other territories.     

Complexity and Human Health: The Case for a Transdisciplinary Paradigm

Transdisciplinary thinking is an emerging philosophy underpinning health social science. We advance a definition of transdisciplinary thinking and link it with complexity theory. Complexity theory's concern with non-linear relationships, interactive causality and emergent properties of systems compels researchers to adopt a transdisciplinary perspective. We construct a generic framework for analyzing health processes from diverse disciplines and apply it to coronary heart disease in the Australian Coalfields. Insights from this analysis support our argument that transdisciplinary thinking maximizes understanding of the complexity of human health.     

Addressing Potential Cumulative Impacts of Development on Threatened Species: The Case of the Endangered Black-Throated Finch

Where threatened biodiversity is adversely affected by development, policies often state that "no net loss" should be the goal and biodiversity offsetting is one mechanism available to achieve this. However, developments are often approved on an ad hoc basis and cumulative impacts are not sufficiently examined. We demonstrate the potential for serious threat to an endangered subspecies when multiple developments are planned. We modelled the distribution of the black-throated finch (Poephila cincta cincta) using bioclimatic data and Queensland''s Regional Ecosystem classification. We overlaid granted, extant extractive and exploratory mining tenures within the known and modelled ranges of black-throated finches to examine the level of incipient threat to this subspecies in central Queensland, Australia. Our models indicate that more than half of the remaining P. cincta cincta habitat is currently under extractive or exploratory tenure. Therefore, insufficient habitat exists to offset all potential development so "no net loss" is not possible. This has implications for future conservation of this and similarly distributed species and for resource development planning, especially the use of legislated offsets for biodiversity protection.     

Beyond the Hazard: The Role of Beliefs in Health Risk Perception

This article addresses how beliefs about health risks cluster and how these relate to perceptions of risk among Canadians. A principal components analysis conducted on items reflecting various beliefs from the Canadian National Health Risk Perception Survey extracted four underlying dimensions: Cancer Dread, Trust in Regulators, Environmental Concern, and Personal Agency. Factor scores were then used to investigate relationships between belief factors and the perceived health risk of various hazards with gender, education, income, and province of residence as covariates. Environmental and Therapeutic health risk perceptions were significantly higher in respondents with high Cancer Dread and high Environmental Concern, but lower in respondents with high Trust in Regulators. Environmental health risk perceptions were lower in respondents with high Personal Agency, whereas Social health risk perceptions were higher in respondents with high Cancer Dread and Personal Agency. Results suggest that information about health risk–related beliefs can be useful in improving our understanding of the public's perceived risk of health hazards.     

The Health Risk Assessment Performed in California for the Herbicide Simazine: A Case Study

Simazine, a member of the triazine group, is registered in California for weed control in soils where a wide range of crops will be (or are) planted. The health risks from simazine use in California were recently assessed by the California Department of Pesticide Regulation (CDPR) for all potential (acute and long-term) exposure scenarios relevant to Californian residents and workers. The results of the CDPR risk assessment indicate that current exposure levels in many of the scenarios under consideration are not health protective for the people in California. The main objective of the present summary report (i.e., case study) was two-fold, both for offering a forum to advance further scientific discussion: (1) to highlight the toxicity and exposure data as well as the assumptions used in the CDPR simazine risk assessment and then (2) to systematically requalify the uncertainties and complexities involved in terms of the toxicity and exposure appraisals given in that risk assessment. In both attempts, the focus was more on residential exposures for young children and women of child-bearing age in that simazine was reportedly seen to exhibit neuroendocrine effects across a variety of species.     

Safety,Health, and Environmental Risk Assessment of a Gas Power Plant: A Case Study from Southern Iran

This research was conducted to assess health, safety, and environmental risks of a gas power plant in southern Iran. In order to identify the subject risks of the power plant at operational phase a questionnaire was designed using the Delphi method. The questionnaires were put at the disposal of 99 electricity industry experts. Risk assessment was done using multicriteria decision-making methods such as technique for order of preference by similarity to ideal solution (TOPSIS), entropy, and Eigenvector technique. Following prioritization of risks at each power plant unit, top-priority risks were determined by one-way ANOVA. The obtained results indicated that the risk of working with medium voltage boards with a weight of 0.879 at the power plant's Electricity Unit is the most important safety and health risk in the studied power plant while risk of servicing the unit with fuel of gas weighting 0.807 and delivery of gas fuel with weight of 0.630 in the Exploiting Unit and work on liquid fuel clutch with weight of 0.603 in the Mechanical Unit are the most important environmental risks in the gas power plant. In conclusion, this study concludes that health, safety, and environmental risk assessment can be a structured and used as a systematic approach to plan for environmental protection and personnel health.     

Local Modelling Techniques for Assessing Micro-Level Impacts of Risk Factors in Complex Data: Understanding Health and Socioeconomic Inequalities in Childhood Educational Attainments

Although inequalities in health and socioeconomic status have an important influence on childhood educational performance, the interactions between these multiple factors relating to variation in educational outcomes at micro-level is unknown, and how to evaluate the many possible interactions of these factors is not well established. This paper aims to examine multi-dimensional deprivation factors and their impact on childhood educational outcomes at micro-level, focusing on geographic areas having widely different disparity patterns, in which each area is characterised by six deprivation domains (Income, Health, Geographical Access to Services, Housing, Physical Environment, and Community Safety). Traditional health statistical studies tend to use one global model to describe the whole population for macro-analysis. In this paper, we combine linked educational and deprivation data across small areas (median population of 1500), then use a local modelling technique, the Takagi-Sugeno fuzzy system, to predict area educational outcomes at ages 7 and 11. We define two new metrics, “Micro-impact of Domain” and “Contribution of Domain”, to quantify the variations of local impacts of multidimensional factors on educational outcomes across small areas. The two metrics highlight differing priorities. Our study reveals complex multi-way interactions between the deprivation domains, which could not be provided by traditional health statistical methods based on single global model. We demonstrate that although Income has an expected central role, all domains contribute, and in some areas Health, Environment, Access to Services, Housing and Community Safety each could be the dominant factor. Thus the relative importance of health and socioeconomic factors varies considerably for different areas, depending on the levels of each of the other factors, and therefore each component of deprivation must be considered as part of a wider system. Childhood educational achievement could benefit from policies and intervention strategies that are tailored to the local geographic areas'' profiles.     

Life Cycle Assessment of Greenhouse Gas Emissions from Marine Fuels: A Case Study of Saudi Crude Oil versus Natural Gas in Different Global Regions

The understanding of the greenhouse gas (GHG) emissions dimension in discussing the future of marine fuels makes it important to advance the current life cycle assessment (LCA) practice in this context. Previous LCA studies of marine fuels rely on general LCA models such as GREET and JEC well‐to‐wheels study. These models do not fully capture the various methane losses in the fuel supply chain. The primary goal of this LCA study is to compare the GHG emissions of heavy fuel oil and marine gas oil produced from Saudi crude oil to liquefied natural gas (LNG) in different global regions. A sensitivity analysis was performed to show how results may vary with non‐Saudi crudes. A secondary goal was to advance LCA of marine fuels by utilizing, for the first time, a set of bottom‐up engineering models that enable detailed analysis of specific oil and gas projects worldwide. The results show particular cases where LNG use in marine applications has a significant countereffect in terms of climate change compared to conventional marine fuels produced from a low‐carbon‐intensity crude oil. When the results are calculated based on a 20‐ versus 100‐year methane global warming potential, LNG appears noncompetitive for climate impact in marine applications.     

The Impacts of Dietary Change on Greenhouse Gas Emissions,Land Use,Water Use,and Health: A Systematic Review

Food production is a major driver of greenhouse gas (GHG) emissions, water and land use, and dietary risk factors are contributors to non-communicable diseases. Shifts in dietary patterns can therefore potentially provide benefits for both the environment and health. However, there is uncertainty about the magnitude of these impacts, and the dietary changes necessary to achieve them. We systematically review the evidence on changes in GHG emissions, land use, and water use, from shifting current dietary intakes to environmentally sustainable dietary patterns. We find 14 common sustainable dietary patterns across reviewed studies, with reductions as high as 70–80% of GHG emissions and land use, and 50% of water use (with medians of about 20–30% for these indicators across all studies) possible by adopting sustainable dietary patterns. Reductions in environmental footprints were generally proportional to the magnitude of animal-based food restriction. Dietary shifts also yielded modest benefits in all-cause mortality risk. Our review reveals that environmental and health benefits are possible by shifting current Western diets to a variety of more sustainable dietary patterns.