The "unintended pedestrian" on expressways

OBJECTIVE: To explore the epidemiology of pedestrian deaths in Dallas County, Texas, and to compare factors associated with pedestrian deaths on expressways versus those that occurred on other roadways. METHODS: We studied all pedestrian deaths among persons 15 years of age or older in Dallas County, Texas, from 1997 to 2004 by linking data from Medical Examiner's office, the Fatality Analysis Reporting System, and local police records. Univariate and multivariate analysis compared various factors associated with death on an expressway. RESULTS: Among 437 pedestrian deaths who were 15 years of age or older, 197 (45%) occurred on expressways; the proportion that occurred on expressways was highest among 15- to 29-year-olds (65%) and was lower with advancing age group (p < 0.01, chi square for trend). At least 36% of these expressway-related pedestrian deaths were known to have been "unintended pedestrians," who had exited a vehicle after being on the roadway, compared with 11% of pedestrian deaths on surface streets (OR 4.6, 95% CI, 2.7-8.1), and this was also highest among younger age groups. Pedestrian deaths on an expressway, compared with deaths on surface streets, remained strongly associated with having been an "unintended pedestrian" (OR 6.2, 95% CI, 3.1-14.0), after controlling for several other variables, including age, sex, race, nighttime of crash, and alcohol involvement. CONCLUSIONS: Expressways are the predominant site of fatal pedestrian crashes among young adults in this urban area. Since many of these deaths were "unintended pedestrians," procedures for management of occupants of disabled vehicles on expressways could have a large impact on pedestrian deaths in young adults.     

Fetal cells in the uterine cervix: a source for early non-invasive prenatal diagnosis

Various non-invasive techniques for prenatal diagnosis have been under investigation. We evaluated the success of fetal sexing using a non-invasive technique for obtaining fetal cells, uterine cervix brushing, in combination with FISH. Thirty pregnant women who completed between 6 and 10 weeks of gestation and who were scheduled to undergo pregnancy termination were included in the study. A Pap smear cytobrush was inserted through the external os to a maximum depth of 2 cm and removed while rotating it a full turn. The material that was caught on the brush was spread on four microscope slides. Two-color FISH was used for fetal sexing. Following pregnancy termination, a placental sample was used for full karyotyping. In 29/30 cases FISH diagnosis was confirmed by chromosomal analysis. The only male case in which a Y chromosome was not seen was from a pregnancy of 6 weeks 6 days gestational age. One case was mosaic of 46,XY/47,XXY (25%). In most cases (7/13) the Y chromosome was already identified in the first analyzed slide. With the use of a cytobrush fetal cells can be easily obtained for the purpose of prenatal diagnosis of chromosomal disorders. Copyright © 2001 John Wiley & Sons, Ltd.     

Nitrogen fertilizer management for nitrous oxide (N<Subscript>2</Subscript>O) mitigation in intensive corn (Maize) production: an emissions reduction protocol for US Midwest agriculture

Nitrous oxide (N₂O) is a major greenhouse gas (GHG) product of intensive agriculture. Fertilizer nitrogen (N) rate is the best single predictor of N₂O emissions in row-crop agriculture in the US Midwest. We use this relationship to propose a transparent, scientifically robust protocol that can be utilized by developers of agricultural offset projects for generating fungible GHG emission reduction credits for the emerging US carbon cap and trade market. By coupling predicted N₂O flux with the recently developed maximum return to N (MRTN) approach for determining economically profitable N input rates for optimized crop yield, we provide the basis for incentivizing N₂O reductions without affecting yields. The protocol, if widely adopted, could reduce N₂O from fertilized row-crop agriculture by more than 50%. Although other management and environmental factors can influence N₂O emissions, fertilizer N rate can be viewed as a single unambiguous proxy—a transparent, tangible, and readily manageable commodity. Our protocol addresses baseline establishment, additionality, permanence, variability, and leakage, and provides for producers and other stakeholders the economic and environmental incentives necessary for adoption of agricultural N₂O reduction offset projects.     

A new method for assessing CO2-emissions from container terminals: a promising approach applied in Rotterdam

At present, the notion is generally accepted that societies have to combat climate change. The reduction of CO₂-emissions, an important cause for global warming, has become a priority, and consequently there is increasing pressure on governments and industries to come forward with initiatives to reduce CO₂-emissions. This is highly relevant for the transport sector, as the share of transportation is still increasing, while other sectors are reducing their CO₂-footprint. The main purpose of this paper is to present a methodology to analyse the CO₂-emissions from container terminals, illustrated by the Port of Rotterdam.The objective of this paper is twofold. Firstly, the development of a methodology to analyse and gain a better understanding of the CO₂-emissions by container terminals in port areas is described. Secondly, the most effective solutions to reduce CO₂-emissions by container terminals in port areas are identified. The study provides insight into the processes of container transshipment at the terminals and the contribution of these processes to the CO₂-emissions of the container terminals. Using these insights, potential solutions to reduce the CO₂ at the terminals are identified and policy proposals are made for the operators of existing terminals and for governments.The most effective measure for CO₂ reduction is undoubtedly the adaptation of the terminal layout as in the example of the Rotterdam Shortsea Terminal. This makes it possible to reduce the CO₂-emissions of the current terminals by nearly 70 per cent. The other perspective is the incorporation of mixing 30 per cent biofuels with the presently used diesel. This results in a reduction of CO₂-emissions by between 13 and 26 per cent per terminal and a reduction of the emissions of the total container sector by 21 per cent. On the basis of these findings, concrete recommendations are made to reducing CO₂-emissions at container terminals.     

Campylobacter coli infection causing second trimester intrauterine growth restriction (IUGR): a case report and review of the literature

Campylobacter is a gram-negative, microaerophilic, curved rod and a normal resident of the gastrointestinal flora and may be the cause of disease in animals. Transmission to humans occurs by ingestion of contaminated food or by direct contact with infected animals. In the past few decades, an increasing number of reports have implicated the presence of this organism in human abortions as well. An infectious mechanism due to primary placental inflammatory damage followed by secondary damage to the fetus following placental insufficiency and ischemia was suggested. The most common species of Campylobacter are Campylobacter jejuni and Campylobacter coli, which are classically associated with enteritis in humans. We present a rare case of mid-gestation intrauterine growth restriction (IUGR) associated with maternal bacteremia caused by C. coli infection. Our literature review focuses on Campylobacter infections occurring in the second and third trimesters of pregnancy. In all cases, mild maternal symptoms consisting of fever and weakness were presented. However, associated adverse fetal outcome, including abortions, IUGR or preterm labor may occur more frequently than anticipated. Our report strengthens the importance of awareness to this finding and focuses the need to consume properly cooked meat during pregnancy. © 2015 John Wiley & Sons, Ltd.     

Sonographic diagnosis of fetal congenital cataracts

Five fetuses with congenital cataracts diagnosed in utero by ultrasound are reported. The fetuses, who were between 14 and 27 weeks' gestation, also had other severe malformations. The sonographic features of the cataracts are presented.