The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

Road traffic injuries to foreigners in the People's Republic of China, 2000-2008

Introduction: China's rapid motorization has resulted in significant challenges in road safety. Method: Using official national statistics, this study examines road traffic injuries (RTIs) experienced by foreigners in China. The number of foreigners entering China has increased 2.4 times over the study period, from 10.16 million in 2000 to 24.33 million in 2008. Results: From 2000- 2008, the number of road traffic fatalities among foreigners similarly increased 2.5 fold, including 49 fatalities reported in 2008. Nonfatal RTIs during this same time frame increased by a magnitude of 1.8 (126 nonfatal injuries in 2000 to 223 in 2008). Conclusions: This study suggests that the total number of foreigners working or visiting China each year who suffer fatal and nonfatal road traffic injuries is relatively low. Impact on Industry: This study provided evidence suggesting that foreigners visiting or working in China face a relatively low risk of road traffic injuries.     

Can Forest-protection carbon projects improve rural livelihoods? Analysis of the Noel Kempff Mercado climate action project,Bolivia

We studied the Noel KempffMercado Climate Action Project (NKMCAP),Bolivia, to assess whether forestprotection carbon (C) projects cansignificantly benefit local people. Wehypothesized that forest protection canonly securely deliver C if significantstakeholders are meaningfully andtransparently involved, traditional orcustomary rights are recognized and theirloss compensated for, and there are directlinkages between conservation anddevelopment objective. Our researchfocused on 53 members of the communities ofFlorida, Porvenir and Piso Firme and 36secondary stakeholders. In each of thevillages we held half-day meetings withcommunity leaders, complemented bysemi-structured one-hour interviews with 5,10, and 7 families, representing 20%, 10%and 8% of each community. The long-termimpact of the NKMCAP on the localcommunities may well be positive. However,in the short run, certain sections of thelocal communities are financially poorer. Forest protection projects clearly have thepotential to sequester C, protectbiodiversity and simultaneously contributeto sustainable rural development, but ifthey really are to improve rurallivelihoods, they must be designed andimplemented carefully and participatively.     

Chorionic villus sampling—short-term versus long-term culture in a subtle 2; 18 translocation

Prenatal diagnosis on chorionic villous tissue was performed for a woman with the karyotype 46,XX,t(2;18)(q32;q12)—a subtle ‘difficult’ translocation. The case illustrates the necessity of good quality cytogenetics for accurate prenatal diagnosis. For chorionic villi this can be obtained only with long-term culture.     

Response of “Alamo” switchgrass tissue chemistry and biomass to nitrogen fertilization in West Tennessee,USA

Switchgrass (Panicum virgatum) is a perennial, warm-season grass that has been identified as a potential biofuel feedstock over a large part of North America. We examined above- and belowground responses to nitrogen fertilization in “Alamo” switchgrass grown in West Tennessee, USA. The fertilizer study included a spring and fall sampling of 5-year old switchgrass grown under annual applications of 0, 67, and 202 kg N ha^?1 (as ammonium nitrate). Fertilization changed switchgrass biomass allocation as indicated by root:shoot ratios. End-of-growing season root:shoot ratios (mean ± SE) declined significantly (P ≤ 0.05) at the highest fertilizer nitrogen treatment (2.16 ± 0.08, 2.02 ± 0.18, and 0.88 ± 0.14, respectively, at 0, 67, and 202 kg N ha^?1). Fertilization also significantly increased above- and belowground nitrogen concentrations and decreased plant C:N ratios. Data are presented for coarse live roots, fine live roots, coarse dead roots, fine dead roots, and rhizomes. At the end of the growing season, there was more carbon and nitrogen stored in belowground biomass than aboveground biomass. Fertilization impacted switchgrass tissue chemistry and biomass allocation in ways that potentially impact soil carbon cycle processes and soil carbon storage.     

An investigation of methods for enriching trophoblast from maternal blood

Trophoblast deportation is known to occur in normal human pregnancy, but it is not yet clear whether these cells routinely enter the maternal peripheral circulation and are available as a source of fetal DNA for non-invasive prenatal diagnosis of genetic disorders. To resolve this issue requires an efficient method of enriching trophoblast from maternal blood combined with a means to confirm its identity. Five different techniques were tested on ten retroplacental blood samples to determine the most sensitive and operator-efficient method. Lysis of red cells alone gave the best recovery of trophoblast but had to be discounted, together with Ficoll density gradient centrifugation, due to the very low purity and the excessive time required. Fluorescence-activated cell sorting (FACS) of pre-enriched trophoblast resulted in the lowest recovery rate (8 per cent) despite a 3250-fold enrichment and a very high purity. Immunomagnetic beads (Dynabeads) coated with anti-CD 16 antibody proved to be the best method for the subsequent immunocytochemical characterization of deported trophoblast. However, IO beads coated with anti-CD45 antibody may be more useful for isolating trophoblast for prenatal diagnosis due to the high purity, enrichment (32-fold), and recovery rate (78 per cent) obtained with this method.     

Prenatal diagnosis of herlitz junctional epidermolysis bullosa by amniocentesis

Herlitz junctional epidermolysis bullosa (HJEB) is a severe blistering disorder which usually results in death during infancy. We have previously shown that the anchoring filament protein laminin-5 (kalinin/nicein), which mediates keratinocyte attachment and dermal–epidermal cohesion, is abnormally expressed in individuals with HJEB. Laminin-5 was detected by Western blot analysis in amniotic fluid from 44 consecutive normal secondtrimester control pregnancies, but was undetectable in second-trimester amniotic fluid from four pregnancies with fetuses affected by HJEB. In one case of severe non-Herlitz JEB, laminin-5 was detected in both amniotic fluid and skin. In human amniotic fluid, the laminin-5 a3 subunit was processed to a major 165 kD species and a minor 145 kD species and the β2 subunit was partially processed to 105 kD. Although laminin-5 was covalently associated with laminin-6 (K-laminin) in amniotic membrane, no covalent interaction was detected in amniotic fluid. Laminin-5 from amniotic fluid strongly supported keratinocyte attachment. These results suggest that Western blot analysis of second-trimester amniotic fluid is useful in determining the prenatal diagnosis of HJEB and that laminin-5 may serve a physiologically important function in amniotic fluid.     

“We cannot let this happen again”: reversing UK flood policy in response to the Somerset Levels floods, 2014

The Multiple Streams Framework offers a theoretical account of how policy proposals move from latent possibilities to becoming favored for implementation. We apply this framework in the context of the policy response to the 2013–2014 flooding of the Somerset Levels and Moors. Stakeholder interviews and analysis of news media coverage evidence the way in which a specific policy option that had fallen out of favor with the national Environment Agency – dredging – came to the fore and was eventually adopted during the period in which the conjunction of problem, policy, and political pressures came to a head. Local political activists mobilized a wider campaign with the help of social media and capitalized on national political sensitivities to successfully promote dredging. What is less clear is the longevity of the policy reversal, given funding constraints.     

Flooding in Texas: Examination of Temporal Changes and Impacts of Tropical Cyclones

Annual maximum peak discharge measurements from 62 stations with a record of at least 70 years are used to assess extreme flooding in Texas at the regional scale. This work focuses on examination of the validity of the stationarity assumption and on the impact of tropical cyclones (TCs) on the upper tail of the flood peak distribution. We assess the validity of the stationarity assumption by testing the records for abrupt and gradual changes. The presence of abrupt changes in the first two moments of the flood peak distribution is assessed using the Lombard test. We use the Mann‐Kendall test to examine the presence of monotonic trends. Results indicate that violations of the stationarity assumption are most commonly caused by abrupt changes, which are often associated with river regulation. We fit the time series of stationary flood records with the generalized extreme value distribution to investigate whether TCs control the upper tail of the flood peak distribution. Our results indicate that TCs play a diminished role in shaping the upper tail of the flood peak distribution compared with areas of the eastern United States subject to frequent TCs.