A new multipollutant, no-threshold air quality health index based on short-term associations observed in daily time-series analyses

Air quality indices currently in use have been criticized because they do not capture additive effects of multiple pollutants, or reflect the apparent no-threshold concentration-response relationship between air pollution and health. We propose a new air quality health index (AQHI), constructed as the sum of excess mortality risk associated with individual pollutants from a time-series analysis of air pollution and mortality in Canadian cities, adjusted to a 0-10 scale, and calculated hourly on the basis of trailing 3-hr average pollutant concentrations. Extensive sensitivity analyses were conducted using alternative combinations of pollutants from single and multipollutant models. All formulations considered produced frequency distributions of the daily maximum AQHI that were right-skewed, with modal values of 3 or 4, and less than 10% of values at 7 or above on the 10-point scale. In the absence of a gold standard and given the uncertainty in how to best reflect the mix of pollutants, we recommend a formulation based on associations of nitrogen dioxide, ozone, and particulate matter of median aerodynamic diameter less than 2.5 microm with mortality from single-pollutant models. Further sensitivity analyses revealed good agreement of this formulation with others based on alternative sources of coefficients drawn from published studies of mortality and morbidity. These analyses provide evidence that the AQHI represents a valid approach to formulating an index with the objective of allowing people to judge the relative probability of experiencing adverse health effects from day to day. Together with health messages and a graphic display, the AQHI scale appears promising as an air quality risk communication tool.     

The influence of top management team attention patterns on global strategic posture of firms

Drawing upon the managerial cognition and the upper echelons perspectives, this study proposes that the cognitive capabilities of top executives significantly affect globalization efforts. Specifically, the study suggests that managerial attention patterns or the cognitive processes of [noticing and constructing meaning] about the environment influence strategic posture of firms. Based on a longitudinal sample of U.S. firms operating in technologically intensive industries, the results indicate that firms were more likely to develop an expansive global strategic posture when their top management paid attention to the external environment and considered a diverse set of elements in this environment. On the other hand, firms led by top management that paid more attention to the internal environment were less likely to be global. Copyright © 2005 John Wiley & Sons, Ltd.     

Mitochondrial DNA depletion presenting prenatally with skin edema and multisystem disease immediately after birth

We describe two newborn sisters who presented in the third trimester with diminished fetal movements and skin edema, but with no other signs of hydrops fetalis. Within hours of birth, both developed profound lactic acidemia, followed by multi-organ failure. In muscle mitochondria, the activity of all enzymatic complexes that contain mitochondrial DNA (mtDNA)-encoded subunits was markedly decreased. Southern blot analysis revealed a profound reduction in the mtDNA/nuclear DNA ratio, implying mtDNA depletion. The prenatal identification of skin edema in two patients with mtDNA depletion, and its absence in a healthy sibling, suggest that skin edema should be regarded as a novel manifestation of mtDNA depletion. This finding shows that mtDNA depletion can present prenatally and, consequently, may aid the clinician in making a diagnosis, prenatally, of this genetic defect. Copyright © 2002 John Wiley & Sons, Ltd.