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Managing uncertainty

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https://www.readbyqxmd.com/read/28325591/global-scanning-of-antihistamines-in-the-environment-analysis-of-occurrence-and-hazards-in-aquatic-systems
#1
Lauren A Kristofco, Bryan W Brooks
Concentration of the global population is increasingly occurring in megacities and other developing regions, where access to medicines is increasing more rapidly than waste management systems are implemented. Because freshwater and coastal systems are influenced by wastewater effluent discharges of differential quality, exposures in aquatic systems must be considered. Here, we performed a global scanning assessment of antihistamines (AHs), a common class of medicines, in surface waters and effluents. Antihistamines were identified, literature occurrence and ecotoxicology data on AHs collated, therapeutic hazard values (THVs) calculated, and environmental exposure distributions (EEDs) of AHs compared to ecotoxicity thresholds and drug specific THVs to estimate hazards in surface waters and effluents...
March 18, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28321877/pharmacological-interventions-for-acute-hepatitis-b-infection-an-attempted-network-meta-analysis
#2
REVIEW
Konstantinos Mantzoukis, Manuel Rodríguez-Perálvarez, Elena Buzzetti, Douglas Thorburn, Brian R Davidson, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Infection with hepatitis B virus (HBV) can be symptomatic or asymptomatic. Apart from chronic HBV infection, the complications related to acute HBV infection are severe acute viral hepatitis and fulminant hepatitis characterised by liver failure. The optimal pharmacological treatment of acute HBV infection remains controversial. OBJECTIVES: To assess the benefits and harms of pharmacological interventions in the treatment of acute HBV infection through a network meta-analysis and to generate rankings of the available treatments according to their safety and efficacy...
March 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28320621/global-reverse-supply-chain-design-for-solid-waste-recycling-under-uncertainties-and-carbon-emission-constraint
#3
Zhitao Xu, Adel Elomri, Shaligram Pokharel, Qin Zhang, X G Ming, Wenjie Liu
The emergence of concerns over environmental protection, resource conservation as well as the development of logistics operations and manufacturing technology has led several countries to implement formal collection and recycling systems of solid waste. Such recycling system has the benefits of reducing environmental pollution, boosting the economy by creating new jobs, and generating income from trading the recyclable materials. This leads to the formation of a global reverse supply chain (GRSC) of solid waste...
March 17, 2017: Waste Management
https://www.readbyqxmd.com/read/28319706/fire-spread-predictions-sweeping-uncertainty-under-the-rug
#4
Akli Benali, Ana C L Sá, Ana R Ervilha, Ricardo M Trigo, Paulo M Fernandes, José M C Pereira
Predicting fire spread and behavior correctly is crucial to minimize the dramatic consequences of wildfires. However, our capability of accurately predicting fire spread is still very limited, undermining the utility of such simulations to support decision-making. Improving fire spread predictions for fire management purposes, by using higher quality input data or enhanced models, can be expensive, unfeasible or even impossible. Fire managers would benefit from fast and inexpensive ways of improving their decision-making...
March 15, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28318880/highly-conformal-craniospinal-radiotherapy-techniques-can-underdose-the-cranial-clinical-target-volume-if-leptomeningeal-extension-through-skull-base-exit-foramina-is-not-contoured
#5
D J Noble, T Ajithkumar, J Lambert, I Gleeson, M V Williams, S J Jefferies
AIMS: Craniospinal irradiation (CSI) remains a crucial treatment for patients with medulloblastoma. There is uncertainty about how to manage meningeal surfaces and cerebrospinal fluid (CSF) that follows cranial nerves exiting skull base foramina. The purpose of this study was to assess plan quality and dose coverage of posterior cranial fossa foramina with both photon and proton therapy. MATERIALS AND METHODS: We analysed the radiotherapy plans of seven patients treated with CSI for medulloblastoma and primitive neuro-ectodermal tumours and three with ependymoma (total n = 10)...
March 15, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28318825/riparian-erosion-vulnerability-model-based-on-environmental-features
#6
Alejandra Botero-Acosta, Maria L Chu, Jorge A Guzman, Patrick J Starks, Daniel N Moriasi
Riparian erosion is one of the major causes of sediment and contaminant load to streams, degradation of riparian wildlife habitats, and land loss hazards. Land and soil management practices are implemented as conservation and restoration measures to mitigate the environmental problems brought about by riparian erosion. This, however, requires the identification of vulnerable areas to soil erosion. Because of the complex interactions between the different mechanisms that govern soil erosion and the inherent uncertainties involved in quantifying these processes, assessing erosion vulnerability at the watershed scale is challenging...
March 16, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28318698/stochastic-modeling-of-phosphorus-transport-in-the-three-gorges-reservoir-by-incorporating-variability-associated-with-the-phosphorus-partition-coefficient
#7
Lei Huang, Hongwei Fang, Xingya Xu, Guojian He, Xuesong Zhang, Danny Reible
Phosphorus (P) fate and transport plays a crucial role in the ecology of rivers and reservoirs in which eutrophication is limited by P. A key uncertainty in models used to help manage P in such systems is the partitioning of P to suspended and bed sediments. By analyzing data from field and laboratory experiments, we stochastically characterize the variability of the partition coefficient (Kd) and derive spatio-temporal solutions for P transport in the Three Gorges Reservoir (TGR). We formulate a set of stochastic partial different equations (SPDEs) to simulate P transport by randomly sampling Kd from the measured distributions, to obtain statistical descriptions of the P concentration and retention in the TGR...
March 16, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28314630/experiences-of-being-parents-of-young-adults-living-with-recessive-limb-girdle-muscular-dystrophy-from-a-salutogenic-perspective
#8
Anna Carin Aho, Sally Hultsjö, Katarina Hjelm
Recessive limb-girdle muscular dystrophies (LGMD2) involve progressive muscle weakness. Parental support is important for young adults living with LGMD2, but no study has been identified focusing on the parents' experiences. The salutogenic perspective concentrates on how daily life is comprehended, managed and found meaningful, i.e. the person's sense of coherence. The aim of this study was to describe, from a salutogenic perspective, experiences of being parents of young adults living with LGMD2. Nineteen participants were included...
February 3, 2017: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/28306566/anemia-management-in-chronic-kidney-disease-and-dialysis-a-narrative-review
#9
David Collister, Claudio Rigatto, Navdeep Tangri
PURPOSE OF REVIEW: This review describes the current state of anemia management with erythropoietin (EPO)-stimulating agents and iron supplementation in both chronic kidney disease and dialysis patients, with a focus on novel therapies. RECENT FINDINGS: We review the benefits and risks of EPO-stimulating agents, focusing on health-related quality of life and the uncertainties regarding optimal iron utilization in patients with kidney disease. We discuss novel therapies for iron supplementation including iron-based phosphate binders and dialysate iron delivery as well as alternatives to EPO-stimulating agents including hypoxia-inducible factor prolyl hydroxylase inhibitors...
March 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28303014/a-young-child-with-a-history-of-wheeze
#10
James Paton, Patrick Bindels, Ann McMurray, Jodie Biggins, Rebecca Nantanda, Marianne Stubbe Østergaard
The parents of a 3-year old boy are anxious about their son who has recurring episodes of wheezing. They are frustrated that no one seems to be able to give them answers to their questions and would like a referral to a specialist. Does their son have asthma and what is the prognosis; how can the recurrent wheezing be managed and can the risk of asthma be reduced; are there lifestyle changes that could improve the environment and avoid triggers? Communication and support from the family practice team were essential...
March 16, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28302056/antibiotic-overuse-for-acute-respiratory-tract-infections-in-sri-lanka-a-qualitative-study-of-outpatients-and-their-physicians
#11
L Gayani Tillekeratne, Champica K Bodinayake, Thushani Dabrera, Ajith Nagahawatte, Wasantha Kodikara Arachchi, Anoji Sooriyaarachchi, Kearsley Stewart, Melissa Watt, Truls Østbye, Christopher W Woods
BACKGROUND: Acute respiratory tract infections (ARTIs) are a common reason for antibiotic overuse worldwide. We previously showed that over 80% of outpatients presenting to a tertiary care hospital in Sri Lanka with influenza-like illness received antibiotic prescriptions, although almost half were later confirmed to have influenza. The purpose of this qualitative study was to assess Sri Lankan patients' and physicians' attitudes towards ARTI diagnosis and treatment. METHODS: Semi-structured interviews were conducted with 50 outpatients with ARTIs and five physicians in the Outpatient Department (OPD) at a large, public tertiary care hospital in southern Sri Lanka...
March 16, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28301387/antibody-mediated-rejection-in-heart-transplantation-new-developments-and-old-uncertainties
#12
Valentina Manfredini, Ornella Leone, Valentina Agostini, Luciano Potena
PURPOSE OF REVIEW: Antibody-mediated rejection (AMR) currently represents one of the main problems for clinical management of heart transplant because of its diagnostic complexity and poor evidences supporting treatments. RECENT FINDINGS: Disorder-based diagnosis is a cornerstone in defining AMR. The limitations of the current classification have been partially overcome by novel studies improving the description of the immune-pathological graft abnormalities, and by new molecular approaches allowing a better understanding of the mechanisms behind AMR and of its relationship with cellular rejection and chronic vasculopathy...
March 15, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28300276/reassessing-the-clinical-spectrum-associated-with-hereditary-leiomyomatosis-and-renal-cell-carcinoma-syndrome-in-french-fh-mutation-carriers
#13
Marie Muller, Sophie Ferlicot, Marine Guillaud-Bataille, Gwénaël Le Teuff, Catherine Genestie, Sophie Deveaux, Abdelhamid Slama, Nicolas Poulalhon, Bernard Escudier, Laurence Albiges, Nadem Soufir, Marie-Françoise Avril, Betty Gardie, Carolina Saldana, Yves Allory, Anne-Paule Gimenez-Roqueplo, Brigitte Bressac-de Paillerets, Stéphane Richard, Patrick R Benusiglio
We addressed uncertainties regarding Hereditary Leiomyomatosis and Renal Cell Carcinoma (HLRCC) by exploring all French cases, representing the largest series to date. Fumarate Hydratase (FH) germline testing was performed with Sanger sequencing and qPCR/MLPA. Enzyme activity was measured when necessary. We carried out whenever possible a pathology review of RCC and S-(2-succino)-cysteine (2SC)/fumarate hydratase immunohistochemistry. We estimated survival using non-parametric Kaplan-Meier. There were 182 cases from 114 families...
March 16, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/28298899/decision-making-in-multiple-sclerosis-the-role-of-aversion-to-ambiguity-for-therapeutic-inertia-among-neurologists-discutir-ms
#14
Gustavo Saposnik, Angel P Sempere, Daniel Prefasi, Daniel Selchen, Christian C Ruff, Jorge Maurino, Philippe N Tobler
OBJECTIVES: Limited information is available on physician-related factors influencing therapeutic inertia (TI) in multiple sclerosis (MS). Our aim was to evaluate whether physicians' risk preferences are associated with TI in MS care, by applying concepts from behavioral economics. DESIGN: In this cross-sectional study, participants answered questions regarding the management of 20 MS case scenarios, completed 3 surveys, and 4 experimental paradigms based on behavioral economics...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28297994/method-to-manage-integration-error-in-the-green-kubo-method
#15
Laura de Sousa Oliveira, P Alex Greaney
The Green-Kubo method is a commonly used approach for predicting transport properties in a system from equilibrium molecular dynamics simulations. The approach is founded on the fluctuation dissipation theorem and relates the property of interest to the lifetime of fluctuations in its thermodynamic driving potential. For heat transport, the lattice thermal conductivity is related to the integral of the autocorrelation of the instantaneous heat flux. A principal source of error in these calculations is that the autocorrelation function requires a long averaging time to reduce remnant noise...
February 2017: Physical Review. E
https://www.readbyqxmd.com/read/28297602/use-storage-and-disposal-of-electronic-equipment-in-switzerland
#16
Esther Thiébaud, Lorenz M Hilty, Mathias Schluep, Martin Faulstich
Electronic devices contain important resources, including precious and critical raw materials. For an efficient management of these resources, it is important to know where the devices are located, how long they are used and when and how they are disposed of. In this article, we explore the past and current quantities of electronic devices in the in-use stock and storage stock in Switzerland and quantify the flows between the use, storage and disposal phase with dynamic material flow analysis (MFA). Devices included are mobile phones, desktop and laptop computers, monitors, cathode ray tube and flat panel display televisions, DVD players, and headphones...
March 15, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28295178/granulocyte-transfusions-in-the-management-of-invasive-fungal-infections
#17
REVIEW
Kamille A West, Juan Gea-Banacloche, David Stroncek, Sameer S Kadri
Granulocyte transfusions have a long history of being used in patients with neutropenia or neutrophil dysfunction to prevent and treat invasive fungal infections. However, there are limited and conflicting data concerning its clinical effectiveness, considerable variations in current granulocyte transfusion practices, and uncertainties about its benefit as an adjunct to modern antifungal therapy. In this review, we provide an overview on granulocyte transfusions and summarize the evidence on their role in the prevention and treatment of invasive fungal infections...
March 14, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28292489/the-3-year-cost-effectiveness-of-a-nurse-based-case-management-versus-usual-care-for-elderly-patients-with-myocardial-infarction-results-from-the-korinna-follow-up-study
#18
Hildegard Seidl, Matthias Hunger, Christa Meisinger, Inge Kirchberger, Bernhard Kuch, Reiner Leidl, Rolf Holle
OBJECTIVES: To assess the 3-year cost-effectiveness of a nurse-based case management intervention in elderly patients with myocardial infarction from a societal perspective. METHODS: The intervention consisted of one home visit and quarterly telephone calls in the first year, and semi-annual calls in the following 2 years. The primary effect measures were quality-adjusted life-years (QALYs), on the basis of the EuroQol five-dimensional questionnaire (EQ-5D-3L) and adjusted life-years from patients' self-rated health states according to the visual analogue scale (VAS-ALs)...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28289961/the-time-has-come-for-new-models-in-febrile-neutropenia-a-practical-demonstration-of-the-inadequacy-of-the-mascc-score
#19
A Carmona-Bayonas, P Jiménez-Fonseca, J Virizuela Echaburu, M Sánchez Cánovas, F Ayala de la Peña
Since its publication more than 15 years ago, the MASCC score has been internationally validated any number of times and recommended by most clinical practice guidelines for the management of febrile neutropenia (FN) around the world. We have used an empirical data-supported simulated scenario to demonstrate that, despite everything, the MASCC score is impractical as a basis for decision-making. A detailed analysis of reasons supporting the clinical irrelevance of this model is performed. First, seven of its eight variables are "innocent bystanders" that contribute little to selecting low-risk candidates for ambulatory management...
March 13, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28288182/modelling-optimal-allocation-of-resources-in-the-context-of-an-incurable-disease
#20
Betty Nannyonga, David J T Sumpter
Nodding syndrome has affected and led to the deaths of children between the ages of 5 and 15 in Northern Uganda since 2009. There is no reliable explanation of the disease, and currently the only treatment is through a nutritional programme of vitamins, combined with medication to prevent symptoms. In the absence of a proper medical treatment, we develop a dynamic compartmental model to plan the management of the syndrome and to curb its effects. We use incidence data from 2012 and 2013 from Pader, Lamwo and Kitgum regions of Uganda to parameterize the model...
2017: PloS One
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