The anuric preterm newborn infant with a normal renal ultrasound: a diagnostic and ethical challenge

Diagnosis and treatment of an anuric premature infant with severe respiratory compromise and a normal renal ultrasound (US), is a difficult task that requires a multidisciplinary approach. A 29-week gestation premature male infant, born after 5 weeks of worsening oligohydramnios, was ventilated for respiratory distress and remained anuric. Intensive clinical investigations and pediatric nephrology consultation that predicted very poor prognosis were followed by progressive renal failure, electrolyte imbalance, respiratory failure, ventricular arrhythmia, and finally cardiac arrest and death on day 5. In view of the predicted poor outcome, and after discussion with the parents, a decision was made not to start peritoneal dialysis (PD), and to offer only palliative therapy, with comfort care alone. Pre and postnatal diagnosis lead, in this case, to an ethical challenge that focuses on the question of futility. Copyright © 2006 John Wiley & Sons, Ltd.     

Demotivating factors affecting the implementation of ISO 14001:2015 in Malaysia

Industrialization has brought with it environmental problems and the consequences of pollution, which has been affecting the world for decades. Immediate action is required to raise industry's awareness of its social responsibilities toward the environment. However, experience shows that companies that have obtained International Organization of Standardization (ISO) 14001:2015 certifications in Malaysia occupy but a small niche among the country's businesses. The purpose of this study is to assess the list of barriers and challenges to implementing and obtaining certifications under the ISO 14001:2015 Environmental Management System (EMS) by Malaysian firms. In addition, this study will rank these factors relative to their importance. This study is aimed at EMS experts at the Scientific and Industrial Research Institute of Malaysia (SIRIM QAS International Sdn. Bhd.). The study uses mathematical pairwise comparisons to generate the list of critical challenges and barriers. Therefore, the study is expected to raise environmental awareness among Malaysia's industries regarding the adoption of ISO 14001:2015 standards. Furthermore, the study provides a guideline for Malaysia's industries and policy‐makers to provide them with a better understanding of the barriers and challenges that companies face in implementing ISO 14001:2015 EMS, and at the same time, help them understand the need to eliminate the difficulties of standard implementation.     

Human-, Ovine-, and Bovine-Specific Viral Source Tracking Tools to Discriminate Between the Major Fecal Sources in Agricultural Waters

This study evaluated the sources of fecal contamination in different river catchments, using a combination of microbial source tracking tools, for human, ruminant, ovine and bovine livestock, in order to define appropriate water management strategies. Every source of waterway pollution was evaluated in river water samples from one urban river catchment and two important farming regions in New Zealand. Fecal pollution was initially measured by testing Escherichia coli and evaluating the presence of human- and ruminant-associated DNA markers of Bacteroidales (BiAdo, BacHum-UCD, BacH, and BacR) and human and ruminant fecal sterols/stanols ratios. Then specific fecal pollution sources were assessed with previously reported quantitative PCR assays targeting human-, bovine-, and ovine-specific viruses: human adenoviruses (HAdV), human JC polyomaviruses, bovine polyomaviruses (BPyV), and ovine polyomaviruses (OPyV). High level of ruminant fecal contamination was detected all over the farming areas, whereas no ruminant sources were identified in the urban river sampling sites. BacR was the most frequently observed ruminant marker and OPyV and BPyV allowed the identification of ovine and bovine fecal sources. The human fecal viral marker (HAdV) was the most frequently observed human marker, highly abundant in the urban sites, and also present in farming areas. This is the first study using simultaneously the ovine and the bovine viral markers to identify and quantify both bovine and ovine fecal pollution.     

Creating Pedestrian Crash Scenarios in a Driving Simulator Environment

Objective: In 2012 in the United States, pedestrian injuries accounted for 3.3% of all traffic injuries but, disproportionately, pedestrian fatalities accounted for roughly 14% of traffic-related deaths (NHTSA 2014 NHTSA. Traffic Safety Facts 2012 Pedestrians. Washington, DC: Author; 2014. DOT HS 811 888. [Google Scholar]). In many other countries, pedestrians make up more than 50% of those injured and killed in crashes. This research project examined driver response to crash-imminent situations involving pedestrians in a high-fidelity, full-motion driving simulator. This article presents a scenario development method and discusses experimental design and control issues in conducting pedestrian crash research in a simulation environment. Driving simulators offer a safe environment in which to test driver response and offer the advantage of having virtual pedestrian models that move realistically, unlike test track studies, which by nature must use pedestrian dummies on some moving track.

Methods: An analysis of pedestrian crash trajectories, speeds, roadside features, and pedestrian behavior was used to create 18 unique crash scenarios representative of the most frequent and most costly crash types. For the study reported here, we only considered scenarios where the car is traveling straight because these represent the majority of fatalities. We manipulated driver expectation of a pedestrian both by presenting intersection and mid-block crossing as well as by using features in the scene to direct the driver's visual attention toward or away from the crossing pedestrian. Three visual environments for the scenarios were used to provide a variety of roadside environments and speed: a 20–30 mph residential area, a 55 mph rural undivided highway, and a 40 mph urban area.

Results: Many variables of crash situations were considered in selecting and developing the scenarios, including vehicle and pedestrian movements; roadway and roadside features; environmental conditions; and characteristics of the pedestrian, driver, and vehicle. The driving simulator scenarios were subjected to iterative testing to adjust time to arrival triggers for the pedestrian actions. This article discusses the rationale behind creating the simulator scenarios and some of the procedural considerations for conducting this type of research.

Conclusions: Crash analyses can be used to construct test scenarios for driver behavior evaluations using driving simulators. By considering trajectories, roadway, and environmental conditions of real-world crashes, representative virtual scenarios can serve as safe test beds for advanced driver assistance systems. The results of such research can be used to inform pedestrian crash avoidance/mitigation systems by identifying driver error, driver response time, and driver response choice (i.e., steering vs. braking).     

Evaluation of Solvita compost stability and maturity tests for assessment of quality of end-products from mixed latrine style compost toilets

It is challenging and expensive to monitor and test decentralized composting toilet systems, yet critical to prevent the mismanagement of potentially harmful and pathogenic end-product. Recent studies indicate that mixed latrine composting toilets can be inhibited by high ammonia content, a product of urea hydrolysis. Urine-diverting vermicomposting toilets are better able to accomplish the goals of remote site human waste management by facilitating the consumption of fecal matter by earthworms, which are highly sensitive to ammonia. The reliability of Solvita® compost stability and maturity tests were evaluated as a means of determining feedstock suitability for vermicomposting (ammonia) and end-product stability/completeness (carbon dioxide). A significant linear regression between Solvita® ammonia and free ammonia gas was found. Solvita® ranking of maturity did not correspond to ranking assigned by ammonium:nitrate standards. Solvita® ammonia values 4 and 5 contained ammonia levels below earthworm toxicity limits in 80% and 100% of samples respectively indicative of their use in evaluating feedstock suitability for vermicomposting. Solvita® stability tests did not correlate with carbon dioxide evolution tests nor ranking of stability by the same test, presumably due to in situ inhibition of decomposition and microbial respiration by ammonia which were reported by the Solvita® CO₂ test as having high stability values.     

p53 sequence polymorphisms in late-stage leukemic Mytilus edulis are homologous with M. trossulus p53

Mytilus edulis and M. trossulus are key species in marine intertidal communities that develop a leukemia-like haemic neoplasia at increased incidences at some polluted sites. The tumor-suppressor p53, known to be involved in this disease, was proposed as a biomarker based on sequence polymorphisms in M. trossulus. In this study, p53 mRNA sequence variations in normal and diseased M. edulis were compared with those reported previously for M. trossulus for caged individuals of both species submerged in Burrard Inlet (49°20′16.57″N 123°13′51.37″) in 2007 and 2010. Thirty-seven single nucleotide polymorphisms (SNPs) were detected in M. edulis p53 that formed high linkage disequilibrium blocks associated with late-stage leukemia (p < 0.05). These were found at loci that were more homologous with M. trossulus than with healthy M. edulis p53-predicted haplotypes. Increased susceptibility to this cancer might be due to, in part, p53 alleles containing these SNPs.