In the first broad-scale estimate of air pollution removal by trees nationwide, U.S. Forest Service scientists and collaborators calculated that trees are saving more than 850 human lives a year and preventing 670,000 incidents of acute respiratory symptoms.While trees’ pollution removal equated to an average air quality improvement of less than 1 percent, the impacts of that improvement are substantial. Researchers valued the human health effects of the reduced air pollution at nearly $7 billion every year in a study published recently in the journal Environmental Pollution.The study by Dave Nowak and Eric Greenfield of the U.S. Forest Service’s Northern Research Station and Satoshi Hirabayashi and Allison Bodine of the Davey Institute is unique in that it directly links the removal of air pollution with improved human health effects and associated health values. The scientists found that pollution removal is substantially higher in rural areas than urban areas, however the effects on human health are substantially greater in urban areas than rural areas.”With more than 80 percent of Americans living in urban area, this research underscores how truly essential urban forests are to people across the nation,” said Michael T. Rains, Director of the Forest Service’s Northern Research Station and the Forest Products Laboratory. “Information and tools developed by Forest Service research are contributing to communities valuing and managing the 138 million acres of trees and forests that grace the nation’s cities, towns and communities.”The study considered four pollutants for which the U.S. EPA has established air quality standards: nitrogen dioxide, ozone, sulfur dioxide, and particulate matter less than 2.5 microns (PM2.5) in aerodynamic diameter. Health effects related to air pollution include impacts on pulmonary, cardiac, vascular, and neurological systems. In the United States, approximately 130,000 PM2.5-related deaths and 4,700 ozone-related deaths in 2005 were attributed to air pollution.Trees’ benefits vary with tree cover across the nation. …Read more
Many of your favorite products at the grocery store are going to cost more, according to Glynn Tonsor, associate professor of agricultural economics at Kansas State University.”When consumers walk in the grocery store, they are going to have to continue to juggle what they put in those baskets,” Tonsor said.Several items will cost more this year, including beef, pork, vegetables and nuts. Most of the increase in price is because of extreme drought facing several states.”Most people recognize weather has a big hand in food production,” Tonsor said. “What they might not recognize is the actual location of food production around the country and therefore how weather across the country impacts the food prices they see.”California, described as the salad bowl of the United States, produces more than 90 percent of select vegetables and nut products. However, the state is facing extreme drought conditions. That means fewer of these products are available. Tonsor says the limited supply will increase the price of the products anywhere from 5 to 20 percent.Drought is also taking a toll on beef. The drought in Oklahoma, coupled with the already historically low amount of cattle in the United States, will hike up the price for beef.”It’s not just a weather story,” Tonsor said. “The other thing that’s getting talked a lot about that will show up at the meat counter is animal health issues, particularly in the pork industry.These animal health issues do not affect human health, but they do decrease the amount of pork available. That could affect the prices at the grocery store by summer, Tonsor said.Story Source:The above story is based on materials provided by Kansas State University. The original article was written by Lindsey Elliott. …Read more
Beer drinkers know that hops are what gives the drink its bitterness and aroma. Recently, scientists reported that the part of hops that isn’t used for making beer contains healthful antioxidants and could be used to battle cavities and gum disease. In a new study in ACS’ Journal of Agricultural and Food Chemistry, they say that they’ve identified some of the substances that could be responsible for these healthful effects.Yoshihisa Tanaka and colleagues note that their earlier research found that antioxidant polyphenols, contained in the hop leaves (called bracts) could help fight cavities and gum disease. Extracts from bracts stopped the bacteria responsible for these dental conditions from being able to stick to surfaces and prevented the release of some bacterial toxins. Every year, farmers harvest about 2,300 tons of hops in the United States, but the bracts are not used for making beer and are discarded. Thus, there is potentially a large amount of bracts that could be repurposed for dental applications. But very few of the potentially hundreds of compounds in the bracts have been reported. Tanaka’s group decided to investigate what substances in these leaves might cause those healthful effects.Using a laboratory technique called chromatography, they found three new compounds, one already-known compound that was identified for the first time in plants and 20 already-known compounds that were found for the first time in hops. The bracts also contained substantial amounts of proanthocyanidins, which are healthful antioxidants.Story Source:The above story is based on materials provided by American Chemical Society. Note: Materials may be edited for content and length.Read more
To look at Henry Fiorentini’s artificial right ear, you could never tell he lost his real ear to cancer.Loyola University Medical Center ear surgeon Sam Marzo, MD, fitted Fiorentini with a prosthetic ear that looks just like the real thing. Marzo implanted three small metal posts in the side of Fiorentini’s head. Each post is fitted with a magnet. The silicone prosthetic ear also is magnetized, so it sticks to the metal posts.But even more remarkable to Fiorentini is the delicate surgery Marzo performed to successfully remove the cancer, without harming the facial nerve. Other doctors had told Fiorentini it couldn’t be done.”Dr. Marzo saved my life,” said Fiorentini, 56. “I now have a long life ahead of me, free of significant disfiguration and recurrent cancer.”Fiorentini had basal cell skin cancer, the most common type of cancer in the United States. It’s slow-growing and usually easily treated. But in Fiorentini’s case, the cancer would become life-threatening.The cancer started behind his right ear. And despite multiple surgeries at other centers, the cancer persisted. …Read more
Water supply is the most pressing environmental issue facing the United States according to a survey of policy makers and scientists revealed in a new publication in BioScience by researchers at the University of York and the University of California, Davis.A question on the water supply necessary to sustain human populations and ecosystem resilience was ranked as having the greatest potential, if it was answered, to increase the effectiveness of policies related to natural resource management in the United States. The publication comes as California suffers its worst drought in nearly half a century.The question emerged from a previous collaboration among decision makers and scientists that yielded 40 research questions that most reflected the needs of those with jurisdiction over natural resources. That research also was published in BioScience.The survey, by Dr Murray Rudd of the Environment Department at York and Dr Erica Fleishman, of the John Muir Institute of the Environment at UC Davis, asked managers, policymakers and their advisers, and scientists to rank the questions on the basis of their applicability to policy.The 602 respondents included 194 policymakers, 70 government scientists, and 228 academic scientists.Other questions that were ranked as of high importance to policy included those on methods for measuring the benefits humans receive from ecosystems; the effects of sea-level rise, storm surge, erosion and variable precipitation on coastal ecosystems and human communities; and the effect on carbon storage and ecosystem resilience of different management strategies for forests, grasslands, and agricultural systems .Dr Rudd said, “We found a significant difference in research priorities between respondents. Importantly, there was no evidence of a simple science-policy divide. Priorities did not differ between academics and government employees or between scientists (academic and government) and policymakers.”Our results suggest that participatory exercises such as this are a robust way of establishing priorities to guide funders of research and researchers who aim to inform policy.”Dr Fleishman added, “The consensus in priorities is even more striking as California’s current drought leads to unprecedented reductions in water supply and delivery.”Story Source:The above story is based on materials provided by University of York. Note: Materials may be edited for content and length.Read more
About 2000 to 3000 new cases of mesothelioma are diagnosed each year in the United States. Once a patient receives a diagnosis of this cancer, his or her physician will most likely discuss the prognosis or probable course and outcome of the disease with the patient.Factors That Determine PrognosisMost times a diagnosis of mesothelioma is made when the cancer has reached an advanced stage as it usually takes a very long amount of time after the contact with asbestos before most victims start displaying the symptoms associated with the disease.In addition to this fact, even when the symptoms of this cancer do eventually surface, they often resemble the symptoms of more general diseases like pneumonia, influenza and some other lung diseases. This fact coupled with the long …Read more
United States veterans have sacrificed a great deal so that the citizens of our country could continue to have the quality of life we often take for granted. The collective heroism, bravery, risk and sacrifice of this group are extraordinary. Sadly, it is this group that are also most affected by mesothelioma. That’s because for many years, the U.S. Military used asbestos widely in many applications. Likely as a result of this high level of exposure, veterans make up roughly 30% of all mesothelioma patients.From the 1930′s to the 1970′s, the U. S. Military used over 300 products containing asbestos, some of them mandated for use because of their fire-retardant properties. In the Air Force, these mesothelioma-linked materials were used with brakes, heat shields, …Read more
Oct. 17, 2013 — Skin-related laser procedures such as hair removal remain one of the most popular elective types of laser surgery performed in the United States today. To meet demand, more non-physicians are performing these procedures than ever before.A study published online Oct. 16 in JAMA Dermatology found that lawsuits related to procedures when non-physicians are operating the laser are increasing, particularly outside of a traditional medical setting.”Procedures performed by untrained individuals, particularly in non-medical settings, are more likely to result in litigation,” said Dr. H. Ray Jalian, clinical instructor of medicine, division of dermatology, David Geffen School of Medicine at UCLA. “Consumers should be aware that laser treatments are medical procedures and should verify the training, certification, and experience of the person performing the procedure.Researchers identified the frequency of medical professional liability claims stemming from skin laser surgery performed by non-physicians by using an online national database of public legal documents.In 175 cases related to injury from skin laser surgery from 1999 to 2012, researchers found 75 (42.9 percent) cases involving a non-physician. The percentage of cases involving non-physicians increased from 36.3 percent in 2008 to 77.8 percent in 2011.Laser hair removal was the most commonly performed procedure. While one-third of laser hair removal procedures were performed by non-physicians, 75.5 percent of hair removal lawsuits from 2004 to 2012 involved non-physicians, and 85.7 percent involved non-physicians between 2008 and 2012.Non-physicians performing skin laser surgery in the study included a diversity of operators, including nurse practitioners, registered nurses, medical assistants, electrologists and aestheticians, among others.To meet the demand for these procedures, physician delegation of laser surgery has grown significantly in the past decade and non-supervised laser surgery is performed legally in many states at nonmedical facilities such as medical spas that offer aesthetic and cosmetic procedures.According to Jalian, physician and other laser operators should know their state laws regarding physician supervision of non-physicians operating the lasers. He notes that in the correct setting with close on-site supervision and appropriate training, the use of non-physician operators can prove to be a productive and safe environment for patients.Read more
Sep. 3, 2013 — Medicaid paid for nearly half of the 3.8 million births in the United States in 2010—an amount that has been rising over time, according to a report out today. The study, published in the September 2013 issue of the peer-reviewed journal Women’s Health Issues, offers the most comprehensive information to date on Medicaid financing of births in each of the 50 states and nationally.The new data will help researchers gauge the impact of health reform on maternal and child health, the authors say. Under the Affordable Care Act (ACA), some states are expanding Medicaid and the expansion may lead to improved coverage of well-woman and maternity care—and perhaps result in better health outcomes, said lead author of the study Anne Markus, JD, PhD, MHS, an associate professor of health policy at the George Washington University School of Public Health and Health Services (SPHHS).“As states expand coverage, low-income women of childbearing age will be able to obtain more continuous coverage before and between pregnancies,” said Markus. “Now, for the first time, researchers will have a comprehensive baseline that will help them determine how increased access to services might change pregnancies and ultimately birth outcomes.”Previously, data on Medicaid funding of births either did not exist in a comprehensive form or were not reliable. Markus and a team that included researchers from the March of Dimes set out to change that by collecting all such data on Medicaid births from individual states from 2008 to 2010.They discovered that in 2010 Medicaid paid for 48 percent of all births in the United States, up from 40 percent of Medicaid covered births in 2008. That represents a 19 percent increase in the proportion of all births financed by Medicaid and a 5 percent increase in the total number of Medicaid-financed births in just two years. The authors found that the number of Medicaid-financed births increased by 90,000 over the course of the study.The hope is that researchers will be able to use such data to determine whether rates of Medicaid financing of births change in the coming years and whether there is a connection between Medicaid coverage and health outcomes. For example, future studies would be able to examine whether expanding Medicaid coverage before and between pregnancies leads to fewer complicated pregnancies and more healthy, full-term babies.“About half a million babies are born prematurely in the United States every year,” said March of Dimes President Dr. Jennifer L. …Read more
Aug. 28, 2013 — Investigators working to stem the spread of antibiotic-resistant bacteria have taken a major step in their efforts to develop new treatments.In mBio, researchers at The University of Texas Health Science Center at Houston (UTHealth) report they have identified a novel mechanism that a particular superbug uses to fend off a key front-line antibiotic called daptomycin. The superbug often affects critically ill patients.This information is helping investigators identify compounds to knock out a mechanism of resistance in order to “disarm” the superbug.Prior to the mass production of antibiotics, a cut or strep throat could lead to serious illness or even death. Antibiotics gave doctors the ability to treat bacterial infections. But, bacteria have developed mechanisms of resistance that can make antibiotics ineffective against the most aggressive superbugs.Thousands of people succumb to superbug-related infections worldwide annually and superbugs account for $20 billion in excess health care costs in the United States each year.”Antibiotic resistance is one of the major public health threats of the 21st Century,” said Cesar Arias, M.D., Ph.D., the study’s senior author and associate professor in the Division of Infectious Diseases at the UTHealth Medical School. “These superbugs can make antibiotics useless, which makes certain bacterial infections virtually untreatable.”While there are several types of antibiotic-resistant bacteria, the study focused on a hard-to-treat superbug called vancomycin-resistant enterococci or VRE. VRE usually affect patients who have a compromised immune system or who are critically ill.The frequency of VRE recovered from hospitalized patients in the United States has increased eightfold in the last 15 years, becoming the second most common hospital-associated bacterium in the United States, Arias said.The superbug appears to be building resistance to one of the few antibiotics that works against it — daptomycin.To see how VRE developed the ability to ward off daptomycin during the course of treatment, Arias’ team used fluorescent labeled daptomycin and observed the interaction between the superbug and the antibiotic with the aid of advanced microscopy techniques.Contrary to the prevailing belief that tiny electrical charges on the surface of VRE cells repel the antibiotic, the researchers report that the VRE cells actually divert the antibiotic and “trap” it to an area where it is rendered ineffective. The mechanism of resistance is completed by changing the composition of the bacterial cell membrane. The study also provides the genetic and biochemical basis for the resistance pathway.”The importance of this work is that an understanding of ‘how’ bacteria become resistant can then lead to a search for new antibiotics that target the resistance pathway itself, thus overcoming and preventing resistance,” said Barbara E. Murray, M.D., study co-author as well as director of the Division of Infectious Diseases and holder of the J. …Read more
July 30, 2013 — In an epidemic or a bioterrorist attack, the response of government officials could range from a drastic restriction of mobility — imposed isolation or total lockdown of a city — to moderate travel restrictions in some areas or simple suggestions that people remain at home. Deciding to institute any measure would require officials to weigh the costs and benefits of action, but at present there’s little data to guide them on the question of how disease spreads through transportation networks.However, a new MIT study comparing contagion rates in two scenarios — with and without travel restrictions — shows that even moderate measures of mobility restriction would be effective in controlling contagion in densely populated areas with highly interconnected road and transit networks. The researchers called the difference between infection rates in the two scenarios the “price of anarchy,” a concept from game theory that’s frequently used as a metric in studies of the controlled use of transportation networks.The study, published online July 31 in the Journal of the Royal Society Interface, is the first to link the concept of price of anarchy to the spread of contagion. It assumes that transmission of the news of the epidemic (which influences how people select travel routes) and the epidemic itself follow the same mobility network, and uses standard epidemiological models to simulate the flow of contagion.The researchers — Ruben Juanes, the ARCO Associate Professor in Energy Studies in MIT’s Department of Civil and Environmental Engineering, graduate student Christos Nicolaides and research associate Luis Cueto-Felgueroso — used data from the 2000 U.S. census to establish the aggregate daily flux of people commuting between counties.Previous research had shown that when individuals become aware of an epidemic, they travel not by taking the shortest route, but by taking the shortest route that avoids infected areas — even if they’re already infected — a strategy that exposes people in uninfected areas to disease. Such “selfish behavior,” as it’s called in game theory, is in direct opposition to the strategy of policymakers, who presumably would act in the benefit of the greater social good by routing infected individuals through areas where infection rates were already high.The MIT study shows that the price of anarchy in some regions of the United States, such as along Interstate 95 in the Northeast, would be considerable. For a moderately contagious disease — one in which every infected person infects, on average, two others — restricting individuals to specific travel routes would decrease infection rates by as much as 50 percent.”In an area with high connectivity, the outcome of action coordinated by officials is going to be better than selfish action, but the economic and social costs of disruption could sometimes be too high,” Juanes says. “In other cases, there would be an enormous benefit to having authorities impose travel restrictions. The price of anarchy is a quantitative measure that identifies areas where intervention might pay off.””Although the study is an idealized scenario, it does give insight to authorities about when and where it would be important to impose route restrictions on human mobility in the case of an emergent outbreak or in the extreme case of bioterrorism,” says Nicolaides, the paper’s first author, who was funded by a Vergottis Fellowship from the MIT School of Engineering. “But you have to take into account the structure of the underlying mobility network and its traffic properties. …Read more
July 30, 2013 — Taxing sugary beverages may help reduce calories from these beverages in the United States, but the health benefits may be partially offset as consumers substitute with other unhealthy foods, according to a joint study by researchers at RTI International, Duke University, and the U.S. Department of Agriculture.The study, published online in the American Journal of Agricultural Economics, found that a half-cent per ounce increase in sugar-sweetened beverage prices, which adds up to about ten cents on a typical 20-ounce bottle of soda, could reduce total calories from the 23 foods and beverages examined under the study.However, researchers found the reduction in sugary beverages due to a soda tax would likely lead consumers to substitute for those beverage calories by increasing their calorie, salt and fat intake from untaxed foods and beverages.”Instituting a sugary beverage tax may be an appealing public policy option to curb obesity, but it’s not as easy to use taxes to curb obesity as it is with smoking,” said Chen Zhen, Ph.D., a research economist at RTI, and the paper’s lead author. “Consumers can simply substitute an untaxed high calorie food for a taxed one. And as we know, reducing calories is just one of many ways to promoting healthy eating and reducing nutrition-related chronic disease.”The study also examined differences in purchase behavior between lower and higher income households. Compared to higher income families’ purchases, foods and beverages purchased by lower income families tend to be higher in calories, fat and sodium content on average.”Because lower-income families tend to buy more sugary soft drinks than higher income families, they would more readily reap the health benefits of reduced sugary beverage intake,” Zhen said. “However, they would also pay more in beverage taxes, making it a regressive tax.”To conduct the study, researchers used data on household food purchases from the 2006 Nielsen Homescan panel, a large national consumer panel maintained by the Nielsen Company. Families in the panel are provided with a handheld scanner and instructed to scan the Universal Product Code (UPC) of products they purchased at retail outlets, record purchase quantities and coupons used and identify the retailer that the product was purchased from.Obesity rates in the United States are about 36 percent for adults and 17 percent for children and adolescents. A previous RTI study found that medical costs associated with obesity are estimated at $147 billion or more per year.The study was funded by the Robert Wood Johnson Foundation and the National Institutes of Health.Read more
July 29, 2013 — A team led by researchers at the National Institutes of Health has overcome a major biological hurdle in an effort to find improved treatments for patients with a rare disease called methylmalonic acidemia (MMA). Using genetically engineered mice created for their studies, the team identified a set of biomarkers of kidney damage — a hallmark of the disorder — and demonstrated that antioxidant therapy protected kidney function in the mice.Researchers at the National Human Genome Research Institute (NHGRI), part of NIH, validated the same biomarkers in 46 patients with MMA seen at the NIH Clinical Center. The biomarkers offer new tools for monitoring disease progression and the effects of therapies, both of which will be valuable in the researchers’ design of clinical trials for this disease.The discovery, reported in the July 29, 2013, advance online issue of the Proceedings of the National Academy of Sciences, paves the way for use of antioxidant therapy in a clinical trial for patients with MMA. It also illustrates the mechanisms by which dysfunction of mitochondria — the power generators of the cell — affects kidney disease. Mitochondrial dysfunction is a factor not only in rare disorders, such as MMA, but also in a wide variety of common conditions, such as obesity, diabetes and cancer.MMA affects as many as one in 67,000 children born in the United States. It can have several different causes, all involving loss of function of a metabolic pathway that moderates levels of an organic compound called methylmalonic acid. Affected children are unable to properly metabolize certain amino acids consumed in their diet, which damages a number of organs, most notably the kidneys.”Metabolic disorders like MMA are extremely difficult to manage because they perturb the delicate balance of chemicals that our bodies need to sustain health,” said Daniel Kastner, M.D., Ph.D., NHGRI scientific director. “Given that every newborn in the United States is screened for a number of inherited metabolic disorders, including MMA, there is a critical need for better understanding of the disease mechanisms and therapies to treat them.”MMA is the most common organic acid disorder and invariably impairs kidney function, which can lead to kidney failure. The most common therapy is a restrictive diet, but doctors must resort to dialysis or kidney transplantation when the disease progresses. MMA patients also suffer from severe metabolic instability, failure to thrive, intellectual and physical disabilities, pancreatitis, anemia, seizures, vision loss and strokes.”There are no definitive treatments for the management of patients with MMA,” said Charles Venditti, M.D., Ph.D., senior author and investigator in the Organic Acid Research Section of NHGRI’s Genetics and Molecular Biology Branch. …Read more
June 27, 2013 — Today, on National HIV Testing Day, the Rollins School of Public Health at Emory University launched its annual update of AIDSVu, including new interactive online maps that show the latest HIV prevalence data for 20 U.S. cities by ZIP code or census tract. AIDSVu also includes new city snapshots displaying HIV prevalence alongside various social determinants of health — such as poverty, lack of health insurance and educational attainment.Share This:AIDSVu — the most detailed publicly available view of HIV prevalence in the United States — is a compilation of interactive online maps that display HIV prevalence data at the national, state and local levels and by different demographics, including age, race and sex. The maps pinpoint areas of the country where the rates of people living with an HIV diagnosis are the highest. These areas include urban centers in the Northeast and the South, and visualize where the needs for prevention, testing, and treatment services are the most urgent.”Our National HIV/AIDS Strategy calls for reducing new HIV infections by intensifying our efforts in HIV prevention where the epidemic is most concentrated. AIDSVu provides a roadmap to identifying those high-prevalence areas of the HIV epidemic and showing where the local testing resources are located,” says Patrick S. Sullivan, PhD, DVM, professor of epidemiology at Emory University’s Rollins School of Public Health, and the principal researcher for AIDSVu. “The addition of new city data means that AIDSVu now displays data from 20 U.S. cities. This expanded city information is critical because most HIV diagnoses in the United States occur in cities.”The free, interactive online tool’s new data and features include:National maps displaying 2010 data at the state-and county-level, the most recent national HIV prevalence data available from the U.S. …Read more
June 27, 2013 — Contact lenses correct many people’s eyesight but do nothing to improve the blurry vision of those suffering from age-related macular degeneration (AMD), the leading cause of blindness among older adults in the western world. That’s because simply correcting the eye’s focus cannot restore the central vision lost from a retina damaged by AMD. Now a team of researchers from the United States and Switzerland led by University of California San Diego Professor Joseph Ford has created a slim, telescopic contact lens that can switch between normal and magnified vision. With refinements, the system could offer AMD patients a relatively unobtrusive way to enhance their vision.The team reports its work in the Optical Society’s (OSA) open-access journal Optics Express.Visual aids that magnify incoming light help AMD patients see by spreading light around to undamaged parts of the retina. These optical magnifiers can assist patients with a variety of important everyday tasks such as reading, identification of faces, and self-care. But these aids have not gained widespread acceptance because they either use bulky spectacle-mounted telescopes that interfere with social interactions, or micro-telescopes that require surgery to implant into the patient’s eye.”For a visual aid to be accepted it needs to be highly convenient and unobtrusive,” says co-author Eric Tremblay of the École Polytechnique Fédérale de Lausanne (EPFL) in Switzerland. A contact lens is an “attractive compromise” between the head-mounted telescopes and surgically implanted micro-telescopes, Tremblay says.The new lens system developed by Ford’s team uses tightly fitting mirror surfaces to make a telescope that has been integrated into a contact lens just over a millimeter thick. The lens has a dual modality: the center of the lens provides unmagnified vision, while the ring-shaped telescope located at the periphery of the regular contact lens magnifies the view 2.8 times.To switch back and forth between the magnified view and normal vision, users would wear a pair of liquid crystal glasses originally made for viewing 3-D televisions. These glasses selectively block either the magnifying portion of the contact lens or its unmagnified center. The liquid crystals in the glasses electrically change the orientation of polarized light, allowing light with one orientation or the other to pass through the glasses to the contact lens.The team tested their design both with computer modeling and by fabricating the lens. …Read more
June 21, 2013 — The brain-preserving cooling treatment known as therapeutic hypothermia is rarely being used in patients who suffer cardiac arrest while in the hospital, despite its proven potential to improve survival and neurological function, researchers from the Perelman School of Medicine at the University of Pennsylvania report in the June issue of Critical Care Medicine. The authors suggest that scarce data about in-hospital cardiac arrest patients and guidelines that only call for health care providers to consider use of therapeutic hypothermia, rather than explicitly recommending it, may explain the study’s results.In a prospective study between 2003 and 2009 of over 530 hospitals in the United States, the Penn team found that 98 percent of over 67,000 patients who went into cardiac arrest in the hospital received only conventional post-resuscitation care–leaving just 2 percent who received therapeutic hypothermia, which has been credited with saving the lives of a growing number of patients who arrest outside hospitals.”We know it’s being used in patients who went into cardiac arrest in their homes, at work, or anywhere else outside of a hospital, but little was known about how often it’s used in patients who arrest in the hospital,” said Mark E. Mikkelsen, MD, MSCE, assistant professor in the division of Pulmonology, Critical Care and Allergy at Penn Medicine. “We found that even though most hospitals have the capability to treat these patients with therapeutic hypothermia, it’s not being used. And even when it was used, in nearly half the cases, the correct target temperature was not being achieved.”Several factors could explain this: there is little data, which is often conflicting, to support its use for patients in the hospital, and we have national guidelines that only have clinicians considering its use, which may lead to hesitation and lack of institutional protocol.”Cooling the body down to about 89.6 degrees after cardiac arrest protects it against neurological damage initiated by the lack of blood flow and oxygenation, several studies of out-of-hospital cardiac arrest patients have shown. It has also been shown to improve survival–a welcome development, since cardiac arrest survival statistics remain grim, with less than 10 percent of patients surviving in most cities across the U.S.More than 300,000 people who go into cardiac arrest out of the hospital die each people each year in the United States; thousands of others are left neurologically devastated.About 210,000 patients a year go into cardiac arrest while in the hospital–many of those patients may have other conditions that point to a poor prognosis, and a substantial portion may be terminally ill patients who are not candidates for hypothermia.National recommendations established in 2005 call for out-of-hospital cardiac arrest patients to be treated with hypothermia when they remain comatose after resuscitation. In-hospital recommendations, however, are less direct. The International Liaison Committee on Resuscitation guidelines recommend providers to “consider its use,” while the American Heart Association recommends that therapeutic hypothermia “may be considered” for a patient who goes into cardiac arrest caused by non-shockable rhythms.For the study, the team analyzed treatments of 67,498 patients at 538 hospitals participating in the American Heart Association’s Get With the Guidelines-Resuscitation database from 2003 to 2009. Of those patients, 1,367 patients were given therapeutic hypothermia. The use of therapeutic hypothermia increased slightly, from 0.7 percent in 2003 to 3.3 percent in 2009.Younger patients and patients who were treated in a non-ICU location and a teaching hospital were more likely to get therapeutic hypothermia. …Read more
June 11, 2013 — Skin cancer is the most common form of cancer diagnosed in the United States, with one in five Americans expected to develop a form of skin cancer in their lifetime. Fortunately, there are simple steps people can take to reduce their skin cancer risk.”The easiest way to prevent skin cancer is to protect your skin with clothing,” said board-certified dermatologist Zoe D. Draelos, MD, FAAD, consulting professor at Duke University School of Medicine, Durham, N.C. “Keep a wide-brimmed hat and sunglasses near your door so you can put them on before you go outside. Wearing a long-sleeved shirt and pants also can help protect from the damaging rays of the sun.”In addition, Dr. Draelos shares these additional tips for preventing skin cancer:1. Apply sunscreen every day. When you are going to be outside, even on cloudy days, apply sunscreen to all skin that will not be covered by clothing. Reapply approximately every two hours, or after swimming or sweating. Use a broad- spectrum, water-resistant sunscreen that protects the skin against both UVA and UVB rays and that has an SPF of at least 30.2. …Read more
May 8, 2013 — Bioenergy crops, such as Miscanthus and switchgrass, appear to be promising resources for renewable energy, but these new crops did not come with a manual on how to measure details on their sustainability impacts. Jody Endres, University of Illinois professor of energy and environmental law and chair of the Council on Sustainable Biomass Production (CSBP) says standards are needed so farmers, ethanol producers, and others in the biofuels industry will all be on the same page here in the United States as well as in Europe and Brazil.
Endres believes that three conditions must be met before the benefits of standards can be fully realized.
“First, to achieve public acceptance, standards must be built upon foundations of good governance,” Endres said. “Environmental and social advocacy groups should be included at some level in the process. For example, we’re discussing what standards the aviation sector should recognize to meet their sustainability expectations. Instead of the substantive innerworkings of standards’ principles, such as protections for air, water, soil, biodiversity, and community values, debate has centered on the level of participation and transparency standards development observes, and particularly whether a standard meets environmental groups’ governance demands.”
The second precondition Endres defines is to fortify the producer’s sustainability toolbox, including a determination as to whether or not existing tools are effective. “If they’re not, how can we build these socio-technical systems to help farmers rethink their actions in the landscape and how it relates to the environment?” Endres asked. “For example, environmentalists would like to see improvements at the watershed scale. If only isolated farmers need to be certified, and they have to figure out what their contributions to that watershed are, it can be very difficult, particularly when states have not fully assessed baseline water quality and all parties responsible for its degradation.”
The third precondition for successful standard implementation is international harmonization. “Even if the biomass goes to the biorefinery with the right lignin-to-sugar content and the right amount of water, if you had to add nitrogen to produce it, or lost habitat or soil when harvesting it, it may not comply with European regulations.
“Environmental groups don’t want to see a race to the bottom — adopting requirements that are bare minimum,” Endres said. “But the European standards contain requirements that are difficult to achieve, particularly for small growers. A biomass farmer doesn’t know where to begin to apply it to their farming practices.”
The European Renewable Energy Directive provides a baseline framework for sustainability reporting and requirements. “They’re primarily concerned with land conversion — high carbon stock land or lands that are high in biodiversity values,” Endres said. “They also require a cross-compliance with agro- environmental laws, which is something required in return for receipt of agricultural payments under the Common Agricultural Program. In large part, we don’t have a similar system in the United States. We have requirements for highly erodible land and protection of endangered species, but in Europe there’s a broader program specifically designed for agricultural contexts to comply with environmental law and to improve the environment.”
Adopting European standards is not a simple task for U.S. growers, Endres said. “For the past three years, the Council for Sustainable Biomass Production has been developing a standard that the European Commission will recognize, but one that is at the same time one designed for American growers to implement practically on the ground and that deploys tools such as those developed by USDA and Extension. Until we have a standard uniquely developed for the American market, producers’ access to European markets could be inhibited. Harmonization questions between Europe, the U.S. and Brazil likely will arise, particularly when stakeholders disagree on substantive and governance questions associated with the many standards emerging in the international marketplace.”
Endres said that other than certification for organic food, the United States does not have widespread experience with certifying commodities. “European calls for biofuels certification are pushing efforts in the U.S. to figure out how to certify an agricultural supply chain. It’s something we’ve never done here at a large scale,” she said.
She stressed that international harmonization is vital for the aviation industry because of looming compliance mandates for carbon reductions in Europe. “To land a plane in Europe, U.S. carriers will have to prove that they have reduced their carbon footprint below a certain level. If not, they will have to buy credits within the European Emissions Trading System. Although the requirement has been postponed until January 2014, the aviation sector is actively seeking ways to reduce greenhouse gas emissions through biofuels. The challenge is not only how to convert cellulosics into jet fuel, but also how to certify that they are grown, refined, and distributed in a sustainable manner,” Endres said.
Endres said that there are still a lot of questions about how to implement standards for biomass. “It’s important to match the goal of regulation with what actually can and does occur on the ground. We can put any requirement into writing, but will it really work on the ground or is it just ‘green washing?’
“In the war of words and in the public media, biofuels have had to face more accusations than any other renewable energy source, such as solar power and wind,” Endres said. “So, even though we think we’re achieving rural development, receiving carbon reductions or climate mitigation benefits, or that we’re having increased energy security, people may still be suspicious of biomass fuels unless there is a certification that we can operationalize.”
Funding was provided by the Energy Biosciences Institute.Read more