[Experimental] List of manuscripts available for review volunteers
Background. Sustainable purchasing can reduce greenhouse gas (GHG) emissions at healthcare facilities (HCF). A previous study found that converting from disposable to reusable sharps containers (DSC, RSC) reduced sharps waste stream GHG by 84% but, in finding transport distances impacted significantly on GHG outcomes, recommended further studies where transport distances are large. This case-study examines the impact on GHG of nation-wide transport distances when a large US health system converted from DSC to RSC.
Methods. The study examined the alternate use of DSC and RSC at a large US university hospital where: the source of polymer was distant from the RSC manufacturing plant; both manufacturing plants were over 3,000 km from the HCF; and the RSC disposal plant was considerably further from the HCF than was the DSC disposal plant. Using a “cradle to grave” life cycle assessment (LCA) tool we calculated annual GHG emissions (CO2, CH4, N2O) in metric tonnes of carbon dioxide equivalents (MTCO2eq) to assess the impact on global warming potential (GWP) of each container system. Primary energy input data was used wherever possible and region-specific impact conversions used to calculate GWP of each activity over a 12-month period. Unit process GHG were collated into Manufacture, Transport, Washing, and Treatment & disposal. Emission totals were workload-normalized and analysed using CHI2 test with P ≤0.05 and rate ratios at 95% CL.
Results. The hospital reduced its annual GWP by 168 MTCO2eq (-64.5%; p < 0.001), and annually eliminated 50.2 tonnes of plastic DSC and 8.1 tonnes of cardboard from the sharps waste stream. Of the plastic eliminated, 31.8 tonnes were diverted from landfill and 18.4 from incineration.
Discussion. Unlike GHG reduction strategies dependent on changes in staff behaviour (waste segregation, recycling, turning off lights, car-pooling, etc), purchasing strategies can enable immediate, sustainable and institution-wide GHG reductions to be achieved. Medical waste containers contribute significantly to the supply chain carbon footprint and, although non-sharp medical waste volumes have decreased significantly with avid segregation, sharps wastes have increased,and can account for 50% of total medical waste volume. Thus converting from DSC to RSC can assist reduce the GWP footprint of the medical waste stream. This study confirmed that large transport distances between polymer manufacturer and container manufacturer; container manufacturer and user; and/or between user and processing facilities, can significantly impact the GWP of sharps containment systems. However, even with large transport distances, we found that a large university health system significantly reduced the GWP of their sharps waste stream by converting from DSC to RSC.
Background and Objective: Clinical and experimental observations emphasize the role of inflammation as a direct risk factor for stroke. To better characterize the inflammation, we have conducted a detailed histological analysis of the inflammatory cell population after transient middle cerebral artery occlusion in a rat model.
Methods: Fifteen adult Wistar male rats were divided randomly into test (n=10) and sham (n=5) groups. In the ischemic group, transient focal cerebral ischemia was induced with an intraluminal filament technique. Histologic lesions of the ischemic core and the surrounding penumbra zone were evaluated, based on a complex algorithm. Representative morphological changes in the core and the penumbra zone were compared. Immunohistochemistry was performed for leukocytes markers (CD15, CD68, CD3), leukocyte-released effectors (MMP-9 and COX-2), and FXIII (possibly involved in microglia and macrophage activation)
Results: Neuronal vacuolation and degeneration were significantly more in the core lesion, whereas cellular edema and inflammatory infiltrate were increased in the penumbra. CD68, CD3, FXIII and Cox-2 expression were significantly higher in the penumbra than in the core (p=0.026; p=0.006; p=0.002; and p<0.001).
Discussion: In the rat model of middle cerebral artery occlusion, inflammatory mechanisms, microglia/macrophage cells, and T-lymphocytes likely play an important role in the penumbra. The deterioration of neurons is less in the penumbra than in the core. Appreciation of the role of the inflammatory cells and mechanisms involved in stroke might lead to measures to inhibit the injury and save brain volume.
Background. Experiencing an adequate amount of cold temperatures over winter is necessary for many temperate tree species to break dormancy and flower in spring. Thus, changes in winter and spring temperatures associated with climate change may influence when trees break dormancy and flower in the future. There have been several experimental studies that have quantified the effectiveness of cold temperatures for chilling requirements for vegetative budburst of temperate trees, however, there are few experimental studies addressing the chilling requirements for reproductive budburst of trees, as it is difficult to place reproductively mature trees in temperature-controlled environments.
Methods. To identify how changing temperatures associated with climate change may impact reproductive phenology, we completed a temperature-controlled growth chamber experiment using cuttings of reproductive branches of red alder (Alnus rubra), one of the most widespread hardwood tree species of the Pacific Northwest, USA. The purpose of this study was to examine how colder (4 °C) and warmer (9 °C) winter temperature regimes influenced the timing of reproductive budburst of red alder cuttings in spring.
Results. We found that cuttings flowered earlier after pretreatment with a 4 °C winter temperature regime than after a 9 °C winter temperature regime. We used our experimental data to estimate a “possibility-line” showing the accumulated chilling and forcing temperatures necessary prior to reproductive budburst of red alder.
Discussion. This study provides a preliminary indication that warmer winters with climate change may not be as effective for satisfying chilling temperature requirements of Northwest hardwood tree species.
Background. Woody plant encroachment into drylands is a geographically extensive land cover change that can have strong impacts on the structure and function of arid and semiarid ecosystems. This vegetation change often modifies soil organic carbon (SOC) storage and dynamics, and appears to be an important yet uncertain component of the carbon (C) cycle in global drylands. To reduce this uncertainty, sampling is needed at broader spatial scales, at greater depths in the soil profile, and within a chronological context.
Methods. We quantified spatial patterns of soil δ13C across a landscape to a depth of 1.2 m in a subtropical savanna undergoing woody encroachment. These data were then examined in a chronological context using prior soil radiocarbon (14C) measurements and historical aerial photography to provide an integrated assessment of the timing of this vegetation change and its impacts on SOC dynamics.
Results. We found that woody encroachment dramatically altered spatial patterns of soil δ13C through the entire soil profile, with soil δ13C being lowest in the centers of woody patches, increasing towards canopy edges, and reaching highest values within the grassland matrix. Soil δ13C and radiocarbon measurements on SOC throughout the soil profile indicated that this landscape was once primarily dominated by C4 grasses over timescales of hundreds to thousands of years ago. However, a rapid shift in vegetation dominance occurred during the past 100-200 years, characterized by (1) the increasing abundance of C3 forbs within the remnant grassland matrix, and (2) the active formation and expansion of woody patches across this landscape. This shift in vegetation dominance has substantially increased the proportion of new soil C derived from C3 plants into the SOC pool throughout the soil profile.
Discussion. These findings are consistent with other reports that vegetation in many dryland ecosystems is undergoing dramatic and rapid changes resulting in increased SOC storage, with implications for the C cycle at regional and global scales.
Background The spruce forests are dominant communities in northwest China, and play a key role in national carbon budgets. However, the patterns of carbon stock distribution and accumulation potential across stand ages are poorly documented.
Methods We investigated the carbon stocks in biomass and soil in the natural spruce forests in the region by surveys on 39 plots. Biomass of tree components were estimated using allometric equations previously established based on tree height and diameter at breast height, while biomass in understory (shrub and herb) and forest floor were determined by total harvesting method. Fine root biomass was estimated by soil coring technique. Carbon stocks in various biomass components and soil (0–100 cm) were estimated by analyzing the carbon content of each component.
Results The results showed that carbon stock in these forest ecosystems can be as high as 510.1 t ha-1, with an average of 449.4 t ha-1. Carbon stock ranged from 28.1 to 93.9 t ha-1 and from 0.6 to 8.7 t ha-1 with stand ages in trees and deadwoods, respectively. The proportion of shrubs, herbs, fine roots, litter, and deadwoods ranged from 0.1%–1% of the total ecosystem carbon, and was age-independent. Fine roots and deadwood which contribute to about 2% of the biomass carbon should be attached considerable weight in the investigation of natural forests. Soil carbon stock did not show a changing trend with stand age, ranging from 254.2 to 420.0 t ha-1 with an average of 358.7 t ha-1. The average value of carbon sequestration potential for these forests was estimated as 29.4 t ha-1, with the lower aged ones being the dominant contributor. The maximum carbon sequestration rate was 2.47 t ha-1 year-1 appearing in the growth stage of 37–56 years.
Conclusion The carbon stock in biomass was the major contributor to the increment of carbon stock in ecosystems. Stand age is not a good predictor of soil carbon stocks and accurate evaluation of the soil carbon dynamics thus requires long-term monitoring in situ. The results not only revealed carbon stock status and dynamics in these natural forests but were helpful to understand the role of Natural Forest Protection project in forest carbon sequestration as well.
Results. Additionally, they assessed how they experienced the previous day and the reported conflicts. Results showed that patients did not experience more goal conflicts than healthy controls, but that they did differ in the type of conflicts experienced. Compared to controls, patients reported more conflicts related to pain, and fewer conflicts involving work-related, social or pleasure-related goals. Moreover, patients experienced conflicts as more aversive and more difficult to resolve than control participants.
Discussion. This study provides more insight in the dynamics of goal conflict in daily life, and indicates that patients experience conflict as more aversive than controls, and that conflict between pain control (and avoidance) and other valued activities is part of the life of patients.
Background. Acitretin is a second-generation synthetic retinoid, and is widely used for treating the severe psoriasis vulgaris. However, it should be chosen with caution for its cardiovascular risk, and it is reported that acitretin may increase the serum lipids. The purpose of this study is to investigate the relationship between the SFRP4 rs1802073 polymorphism and the changes of serum lipids in Chinese psoriatic patients during the treatment with acitretin.
Methods. In our study, 100 psoriatic patients were recruited and systematically treated with acitretin (30 mg/day) for at least 8 weeks. Data of the patients’ demographic and clinical characteristics and the results of serum triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) were collected pre- and post-treatment.
Results. A total of 84 psoriatic patients were enrolled and divided into three groups by SFRP4 rs1802073 genotypes. The patients who carried with TT genotype had maintained levels of TG and LDL-C after acitretin treatment, while patients with GG/GT genotypes had significantly elevated levels of serum TG and LDL-C compared to the TT genotype (△TG%: 27.53±59.13 vs -1.47±37.79, p=0.026, △LDL-C%: 10.62±26.57 vs -1.29±17.07, p=0.042). The association of rs1802073 with TG and LDL-C profiles remained significant after adjusting for age, gender, and body mass index. Although without significance, the pre-post change in serum level of TC across rs1802073 GG/GT genotypes demonstrated a trend similar to TG and LDL.
Conclusions. Our results demonstrated that SFRP4 rs1802073 polymorphism was found to be associated with elevated serum lipid levels after acitretin treatment, and it may serve as a genetic marker of safe and precise treatment for individual psoriatic patients.
Background: Experts suggest we switch our focus from burnout to measuring positive organizational psychology. Concerns include burnout being a late sign of organizational decline. The Baldrige survey is promoted by the U.S. Department of Commerce to measure positive worksite conditions of industries including health care and education. For years, the survey has been completed by external examiners of organizations, but now the same survey is also promoted for completion by the organization’s workforce. We tested the structure of the Baldrige survey, when completed by the workforce, and also whether the results in an academic worksite correlate with an example metric of an organizational mission.
Methods: In 2015, our academic health center surveyed faculty and staff with the Baldrige. The validity of the Baldrige was tested with confirmatory factor analyses. Within the School of Medicine, responses for the Baldrige’s concepts were correlated against a measure of organizational outcome: graduates’ assessments of Departmental educational quality.
Results: The structure of the Baldrige did not validate from the workforce’s perspective (RMSEA=0.086; CFI=0.829; TLI=0.815). None of its concepts correlated with learner reported educational quality.
Conclusions: The Baldrige survey, when administered to a workforce, does not appear to measure workforce well-being within an academic health care center. We discourage use of the current survey for this purpose.
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