Recycling Rates of Aluminum in the United States

Recycling rates of aluminum are defined in different (sometimes inconsistent) ways and poorly quantified. To address this situation, the definitions and calculation methods of four groups of indicators are specified for the United States: (1) indicators used to measure recycling efficiencies of old aluminum scrap at the end‐of‐life (EOL) stage, including EOL collection rate (CR), EOL processing rate, EOL recycling rate, and EOL domestic recycling rate; (2) indicators used to compare generation or use of new with old scrap, including new to old scrap ratio, new scrap ratio (NSR), and old scrap ratio; (3) indicators used to compare production or use of primary aluminum with secondary aluminum, including four recycling input rates (RIRs); and (4) indicators used to track the sinks of aluminum metal in the U.S. anthroposphere. I find that the central estimate of EOL CR varies between 38% and 65% in the United States from 1980 to 2009 and shares a relatively similar historical trend with the primary aluminum price. The RIR is shown to be significantly reduced if excluding secondary aluminum produced from new scrap resulting from the relatively high NSR. In 2003, a time when approximately 73% of all of the aluminum produced globally since 1950 was considered to still be “in service,” approximately 68% to 69% of all metallic aluminum that had entered the U.S. anthroposphere since 1900 was still in use: 67% in domestic in‐use stock and 1% to 2% exported as scrap. Only 6% to 7% was definitely lost to the environment, although the destination of 25% of the aluminum was unknown. It was either exported as EOL products, was currently hibernating, or was lost during collection.     

Overview of Fish Consumption Rates in the United States

Contaminants that accumulate in fish may pose health risks and have raised concerns among consumers. Contaminated finfish and shellfish are possible routes of human exposure to toxic chemicals. Fish advisories are established to protect local populations from the consumption of contaminated commercial and non-commercially caught fish. Children, women of childbearing age, and subsistence fishermen or other highly exposed individuals who for socioeconomic or cultural reasons consume more fish than the general population are among the populations of concern from the ingestion of contaminated fish. Estimating exposure to a toxic chemical among fish-consuming populations requires knowledge about intake rates of fish and shellfish. Data on fish consumption rates come from various sources, including national, state, and local government studies. Although these data have their limitations, they serve as a source for deriving fish consumption rates that may be used by exposure assessors. Data on specific populations of concern are critical. Studies presented here show that ethnicity, age, and geographical region play an important role in fishing behavior and consumption. Results from studies on Native American populations show that this ethnic group eats fish at a higher rate than recreational anglers. This article summarizes data on fish consumption for various populations and provides a framework for evaluating data from these studies for exposure assessment applications.     

BMI and Risk Factors for Suicide: Why Is BMI Inversely Related to Suicide?

Higher BMI has been associated with a lower risk of suicide in large prospective studies, but the mechanisms for this link require elucidation. In the 2002 and 2004 iterations of the Behavioral Risk Factor Surveillance System (BRFSS), a large, population‐based telephone survey of US adults conducted by the Centers for Disease Control and Prevention, participants reported their height, weight, and several potential risk factors for suicide, including alcohol use, mental health, marital status, firearm ownership, and risk‐taking behaviors. We assessed whether BMI was associated with these risk factors among 224,247 eligible respondents in 2002 and 275,194 in 2004 after sample‐weighted adjustment for age, race, region, smoking, and education. Alcohol‐related risk factors tended to be lower with heavier BMI among women, while firearm‐related risk factors tended to be higher with heavier BMI among men. Heavier BMI also tended to be associated with unmarried status and poor mental health, especially among women, and with infrequent seat belt use in men and women. No potential risk factors were consistently inversely associated with BMI in both sexes and years. In summary, in these samples of the US population, conventional risk factors for suicide were inconsistently associated with BMI, making them unlikely mediators for the observed relationship of BMI with lower risk of suicide. In some cases, risk factors were actually greater with heavier BMI. Further study of the relationship of BMI and suicide may yield novel modifiable risk factors that could cause or prevent this important cause of death.     

Antidepressant Utilization and Suicide in Europe: An Ecological Multi-National Study

Background

Research concerning the association between use of antidepressants and incidence of suicide has yielded inconsistent results and is the subject of considerable controversy. The first aim is to describe trends in the use of antidepressants and rates of suicide in Europe, adjusted for gross domestic product, alcohol consumption, unemployment, and divorce. The second aim is to explore if any observed reduction in the rate of suicide in different European countries preceded the trend for increased use of antidepressants.

Methods

Data were obtained for 29 European countries between 1980 and 2009. Pearson correlations were used to explore the direction and magnitude of associations. Generalized linear mixed models and Poisson regression distribution were used to clarify the effects of antidepressants on suicide rates, while an autoregressive adjusted model was used to test the interaction between antidepressant utilization and suicide over two time periods: 1980–1994 and 1995–2009.

Findings

An inverse correlation was observed in all countries between recorded Standardised Death Rate (SDR) for suicide and antidepressant Defined Daily Dosage (DDD), with the exception of Portugal. Variability was marked in the association between suicide and alcohol, unemployment and divorce, with countries depicting either a positive or a negative correlation with the SDR for suicide. Every unit increase in DDD of an antidepressant per 1000 people per day, adjusted for these confounding factors, reduces the SDR by 0.088. The correlation between DDD and suicide related SDR was negative in both time periods considered, albeit more pronounced between 1980 and 1994.

Conclusions

Suicide rates have tended to decrease more in European countries where there has been a greater increase in the use of antidepressants. These findings underline the importance of the appropriate use of antidepressants as part of routine care for people diagnosed with depression, therefore reducing the risk of suicide.     

Ecological and epidemiological studies of histoplasmosis in the United States of America

Histoplasmosis is a disease that is transmitted from nature to man. The causative agent,Histoplasma capsulatum, grows freely in the soil and the infection is spread by inhalation of the infectious spores. The infection is highly endemic in the central United States. Soil contaminated with fecal droppings of chickens, starlings, blackbirds, and other avian species is a principal source of infection.Paper read at the Eighth International Congresses for Tropical Medicine and Malaria, September 1968, Teheran (Iran).     

Raptor Electrocution Rates for a Utility in the Intermountain Western United States

ABSTRACT We estimated electrocution rates for raptors and common ravens (Corvus corax) for the Moon Lake Electrical Association in northeastern Utah and northwestern Colorado, USA. From July 2001 to May 2003, we conducted mortality searches at randomly selected distribution line segments and poles within 3 regions, but rate estimates (0.0036–0.0112 deaths/pole/yr) may have been biased by the effects of scavengers and by long sampling intervals (≥ 3 months), which prevented us from determining the cause of death for most birds because of advanced decay. In 2002–2003, we conducted carcass removal experiments in the Rangely Oil Field (ROF) in northwestern Colorado to estimate scavenging effects, and in 2003–2004, we reduced sampling intervals to 1 month and searched for dead birds at all distribution poles in the ROF. The shorter sampling interval nearly tripled the number of birds suitable for necropsy, but we were still unable to establish cause of death for >40% of our sample. Instead of eliminating the unknowns from rate estimates, we estimated minimum annual electrocution rates using only confirmed electrocutions and maximum annual electrocution rates based on all available mortalities, including mortalities without known causes. Golden eagles (Aquila chrysaetos) accounted for 63% of dead birds found in 2003–2004, but they were removed by scavengers at rates well below hawks and owls (6.8% vs. 55.6%). We compared maximum rates for the ROF in 2003–2004 with the rates estimated from a survey conducted at the same poles in 1999 to assess the effects of retrofitting conducted by Moon Lake from 1999 to 2003. Electrocution rates in 2003–2004 were 47% lower than those in 1999. Raptor densities in the ROF did not change during our study, suggesting the reduction was not the result of changes in raptor populations. However, estimates of raptor densities in 1999 were not available, and we cannot be sure that numbers of birds using the oil field in 1999 were similar to those in 2003–2004. Our research emphasizes the difficulties of estimating electrocution rates precisely but suggests that utilities will have the greatest effect on mortality by monitoring power lines at large scales and focusing subsequent mitigation efforts in areas that pose the greatest risk to the greatest number of birds.     

美国煤矿废弃地的生态修复

在对美国煤矿废弃地生态修复项目实地考察的基础上,结合相关文献资料,介绍了其煤矿废弃地生态修复的管理体系、资金来源及使用\\技术路线及保障措施。结合实例介绍了美国煤矿废弃地生态修复的工程措施,并重点介绍了"师法自然生态修复法"的新理念及其指导下的生态修复设计和生态修复工程建设。"师法自然生态修复法"是基于地形、地貌、水文、气象、气候等条件,模拟自然的生态修复过程。"师法自然生态修复法"将会对我国的生态修复产生积极而深远的影响。     

Association between the Density of Physicians and Suicide Rates in Japan: Nationwide Ecological Study Using a Spatial Bayesian Model

Background

Regional disparity in suicide rates is a serious problem worldwide. One possible cause is unequal distribution of the health workforce, especially psychiatrists. Research about the association between regional physician numbers and suicide rates is therefore important but studies are rare. The objective of this study was to evaluate the association between physician numbers and suicide rates in Japan, by municipality.

Methods

The study included all the municipalities in Japan (n = 1,896). We estimated smoothed standardized mortality ratios of suicide rates for each municipality and evaluated the association between health workforce and suicide rates using a hierarchical Bayesian model accounting for spatially correlated random effects, a conditional autoregressive model. We assumed a Poisson distribution for the observed number of suicides and set the expected number of suicides as the offset variable. The explanatory variables were numbers of physicians, a binary variable for the presence of psychiatrists, and social covariates.

Results

After adjustment for socioeconomic factors, suicide rates in municipalities that had at least one psychiatrist were lower than those in the other municipalities. There was, however, a positive and statistically significant association between the number of physicians and suicide rates.

Conclusions

Suicide rates in municipalities that had at least one psychiatrist were lower than those in other municipalities, but the number of physicians was positively and significantly related with suicide rates. To improve the regional disparity in suicide rates, the government should encourage psychiatrists to participate in community-based suicide prevention programs and to settle in municipalities that currently have no psychiatrists. The government and other stakeholders should also construct better networks between psychiatrists and non-psychiatrists to support sharing of information for suicide prevention.     

Encephalitis Hospitalization Rates and Inpatient Mortality in the United States, 2000-2010

Background

Encephalitis rates by etiology and acute-phase outcomes for encephalitis in the 21^st century are largely unknown. We sought to evaluate cause-specific rates of encephalitis hospitalizations and predictors of inpatient mortality in the United States.

Methods

Using the Nationwide Inpatient Sample (NIS) from 2000 to 2010, a retrospective observational study of 238,567 patients (mean [SD] age, 44.8 [24.0] years) hospitalized within non-federal, acute care hospitals in the U.S. with a diagnosis of encephalitis was conducted. Hospitalization rates were calculated using population-level estimates of disease from the NIS and population estimates from the United States Census Bureau. Adjusted odds of mortality were calculated for patients included in the study.

Results

In the U.S. from 2000–2010, there were 7.3±0.2 encephalitis hospitalizations per 100,000 population (95% CI: 7.1–7.6). Encephalitis hospitalization rates were highest among females (7.6±0.2 per 100,000) and those <1 year and >65 years of age with rates of 13.5±0.9 and 14.1±0.4 per 100,000, respectively. Etiology was unknown for approximately 50% of cases. Among patients with identified etiology, viral causes were most common (48.2%), followed by Other Specified causes (32.5%), which included predominantly autoimmune conditions. The most common infectious agents were herpes simplex virus, toxoplasma, and West Nile virus. Comorbid HIV infection was present in 7.7% of hospitalizations. Average length of stay was 11.2 days with mortality of 5.6%. In regression analysis, patients with comorbid HIV/AIDS or cancer had increased odds of mortality (odds ratio [OR]  = 1.70; 95% CI: 1.30–2.22 and OR = 2.26; 95% CI: 1.88–2.71, respectively). Enteroviral, postinfectious, toxic, and Other Specified causes were associated with lower odds vs. herpes simplex encephalitis.

Conclusions

While encephalitis and encephalitis-related mortality impose a considerable burden in the U.S. in the 21^st Century, the reported demographics of hospitalized encephalitis patients may be changing.     

Utilization Trends and Positive Biopsy Rates for Prostate Biopsies in the United States: 2005 to 2011

This article assesses the positive biopsy rate and core sampling pattern in patients undergoing needle biopsy of the prostate in the United States at a national reference laboratory (NRL) and anatomic pathology laboratories integrated into urology group practices, and analyzes the relationship between positive biopsy rates and the number of specimen vials per biopsy. For the years 2005 to 2011 we collected pathology data from an NRL, including number of urologists and urology practices referring samples, total specimen vials submitted for prostate biopsies, and final pathologic diagnosis for each case. The diagnoses were categorized as benign, malignant, prostatic intraepithelial neoplasia, or atypical small acinar proliferation. Over the same period, similar data were gathered from urology practices with in-house laboratories performing global pathology services (urology practice laboratories; UPLs) as identified by a survey of members of the Large Urology Group Practice Association. For each year studied, positive biopsy rate and number of specimen vials per biopsy were calculated in aggregate and separately for each site of service. From 2005 to 2011, 437,937 biopsies were submitted in > 4.23 million vials (9.4 specimen vials/biopsy); overall positive biopsy rate was 40.3%-this was identical at both the NRL and UPL (P = .97). Nationally, the number of specimen vials per biopsy increased sharply from a mean of 8.8 during 2005 to 2008 to a mean of 10.3 from 2009 to 2011 (difference, 1.5 specimen vials/biopsy; P = .03). For the most recent 3-year period (2009–2011), the difference of 0.6 specimen vials per biopsy between the NRL (10.0) and UPL (10.6) was not significant (P = 0.08). Positive biopsy rate correlated strongly (P < .01) with number of specimen vials per biopsy. The positive prostate biopsy rate is 40.3% and is identical across sites of service. Although there was a national trend toward increased specimen vials per biopsy from 2005 to 2011, from 2009 to 2011 there was no significant difference in specimen vials per biopsy across sites of service. Increased cancer detection rate correlated significantly with increased number of specimens examined. Segregation of prostate biopsy cores into 10 to 12 unique specimen vials has been widely adopted by urologists across sites of service.Key Words: Prostate cancer, Prostate biopsy, Utilization trends, National reference laboratory, Urology practice laboratoriesPublished data over the past decade suggesting that prostate cancer detection rates are enhanced with additional sampling of the prostate have resulted in modifications to the traditional 6-core (sextant) biopsy regimen^1,2 such that recent clinical guidelines recommend that extended biopsy schemes with 10 to 12 specimens be obtained.^3–5 There are also data that suggest that segregation of prostate biopsy tissue specimens into individual vials improves specimen handling, enhances tissue representation, and improves diagnostic accuracy.^6–8 Furthermore, focal prostate cancer treatment strategies gaining recent popularity are dependent on more precise tumor mapping, requiring even greater tissue sampling.⁹Over approximately the same time frame, there has been an increase in consolidation of medical practices into larger single- or multispecialty group practices. By incorporating efficiencies of scale, these groups afford physicians the opportunity to retain the characteristics of traditional medical practices while improving their ability to adapt to changing health care circumstances.¹⁰ These groups often integrate additional capabilities beyond professional services, including anatomic and clinical pathology, diagnostic imaging, and radiation therapy. Proponents of these arrangements argue that integration of medical services facilitates the development of coordinated clinical pathways, improves communication between specialists, offers better quality control of ancillary services, and enhances data collection—all of which can improve patient care and lead to lower costs.^11–13 Specifically with regard to anatomic pathology, recent data suggest that certain specimen handling errors are significantly lower (P = .018) at urology practices with integrated in-house pathology laboratories (urology practice laboratories [UPLs]) than at other sites of service¹⁴; however, some contend that group practice integration creates conflicts of interest and self-referral issues, which ultimately leads to increased utilization of services.^15–19 A recent study based on analysis of Medicare claims data purported that positive prostate biopsy rates and the number of samples submitted per biopsy are significantly different across sites of service²⁰; however, this study has been criticized as both methodologically flawed and scientifically inaccurate.²¹ Also problematic is the fact that calculation of prostate cancer incidence has been identified as particularly susceptible to error when determined by analysis of outpatient claims data alone.²²We sought to determine positive biopsy rates and utilization trends in the United States via direct analysis of laboratory records from both a national reference laboratory (NRL) and UPLs, and to determine if there was a correlation between positive biopsy rates and number of specimen vials submitted.     

Ecological engineering: A rationale for standardized curriculum and professional certification in the United States

The demand for engineering solutions to ecosystem–level problems has increased as the impact of human activities has expanded to global proportions. While the science of restoration ecology has been developed to address many critical ecosystem management issues, the high degree of complexity and uncertainty associated with these issues demands a more quantitative approach. Ecological engineering uses science-based quantification of ecological processes to develop and apply engineering-based design criteria for sustainable systems. We suggest that in the United States ecological engineering curricula should be offered at the graduate level and should require rigorous Accreditation Board of Engineering and Technology-accredited (or equivalent) undergraduate preparation in engineering fundamentals. In addition to strengthening students’ mastery of engineering theory and application, the graduate curriculum should provide core courses in ecosystem theory including quantitative ecology, systems ecology, restoration ecology, ecological engineering, ecological modeling, and ecological engineering economics. Advanced courses in limnology, environmental plant physiology, ecological economics, and specific ecosystem design should be provided to address students’ specific professional objectives. Finally, professional engineering certification must be developed to insure the credibility of this new engineering specialization.     

Ecological immunity of human milk: Life history perspectives from the United States and Kenya

Objectives

Previous research has established population variation in anti‐inflammatory immunological biomarkers in human milk. This immunity is potentially ecology‐dependent and may alter the life history trade‐off between growth and maintenance in infants. The current study has two aims: (1) to assess the ecological differences in milk immunity in two populations, one from the urban U.S. and one from rural Kenya; and (2) to test the hypothesis that milk immunity can affect infant growth indicators.

Materials and Methods

Kenyan Ariaal (n = 233) and U.S. (n = 75) breastfeeding mother‐infant pairs participated in a cross‐sectional study at two separate field sites. Laboratory analysis was performed on milk for the anti‐inflammatory biomarkers TGF‐β2, sTNF‐αRI, sTNF‐αRII, and IL‐1ra using ELISA. Multiple imputation was used to extrapolate data below the limit of detection before multivariate analysis.

Results

There were significant differences between U.S. and Kenyan mothers on all four milk biomarkers, with Kenyan mothers having significantly higher sTNF‐αRI and sTNF‐αRII and lower TGF‐β2 and IL‐1ra than U.S. mothers. U.S. mothers with higher milk TGF‐β2 and IL‐1ra have infants that are significantly longer and heavier for their age, while Kenyan mothers with higher sTNF‐αRI have significantly longer and heavier infants for their age, and those with higher TGF‐β2 have marginally significantly longer infants.

Discussion

There were significant differences in ecological milk immunity between U.S. and Kenyan mothers. These differences potentially play a role in the growth of their infants. Further research in milk immunity should consider the possibility of shared maternal–infant life histories.

     

Ecological correlates of risk and incidence of West Nile virus in the United States

West Nile virus, which was recently introduced to North America, is a mosquito-borne pathogen that infects a wide range of vertebrate hosts, including humans. Several species of birds appear to be the primary reservoir hosts, whereas other bird species, as well as other vertebrate species, can be infected but are less competent reservoirs. One hypothesis regarding the transmission dynamics of West Nile virus suggests that high bird diversity reduces West Nile virus transmission because mosquito blood-meals are distributed across a wide range of bird species, many of which have low reservoir competence. One mechanism by which this hypothesis can operate is that high-diversity bird communities might have lower community-competence, defined as the sum of the product of each species’ abundance and its reservoir competence index value. Additional hypotheses posit that West Nile virus transmission will be reduced when either: (1) abundance of mosquito vectors is low; or (2) human population density is low. We assessed these hypotheses at two spatial scales: a regional scale near Saint Louis, MO, and a national scale (continental USA). We found that prevalence of West Nile virus infection in mosquito vectors and in humans increased with decreasing bird diversity and with increasing reservoir competence of the bird community. Our results suggest that conservation of avian diversity might help ameliorate the current West Nile virus epidemic in the USA