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Sweeney L.M.,Independent Consultants | Gargas M.L.,Independent Consultants
Regulatory Toxicology and Pharmacology | Year: 2016

To help develop a comprehensive, quantitative understanding of the hazards of 1,2-dichloroethane (ethylene dichloride, EDC, CAS No. 107-06-2) exposure by the inhalation route, the results of existing subchronic studies and an extended one-generation reproductive toxicity (EOGRT) study recently conducted by the oral route in rats were extrapolated using a physiologically based pharmacokinetic (PBPK) model. The no observed adverse effects levels (NOAELs) for the endpoints of neurotoxicity and reproductive/developmental toxicity were the highest tested doses of 169 and 155 mg/kg-day, respectively. These NOAELs were equivalent to continuous exposure of rats to minimums of 76 ppm and 62 ppm EDC, respectively, using total metabolism of EDC as the dose metric that is equivalent in the oral and inhalation scenarios. In contrast, the subchronic study NOAEL of 37.5 mg/kg-day corresponded to continuous inhalation of 4.4 ppm EDC, based on equivalent extrahepatic metabolism. The selection of the internal metric which serves to establish route-to-route equivalency was found to profoundly influence the NOAEL-equivalent inhalation exposure concentration and thus will be a key determinant of inhalation toxicity reference criteria developed on the basis of EDC studies conducted by the oral route. © 2016


Tileva M.,Independent Consultants | Biermann E.,Independent Consultants
Social Science and Medicine | Year: 2011

The Iraq conflict resulted in the largest displacement in the Middle East in recent history, and provision of health services to the displaced population presents a critical challenge. With an increase in the number of people affected by complex emergencies and the number of people displaced in urban settings, the international community must adapt intervention strategies to meet the specific demands and contexts of this population. The study aimed to provide information on food security and livelihoods for Iraqi refugees in Syria and Jordan to inform humanitarian assistance planning. National cross-sectional cluster sample surveys of displaced Iraqi populations displaced were conducted in Jordan (October 2008) and Syria (March 2009). Clusters of ten households were randomly selected using probability-based sampling; a total of 1200 and 813 Iraqi households in Jordan and Syria, respectively, were interviewed about food security and receipt of humanitarian assistance. In Syria, 60% of households reported the household food situation had declined since the arrival period as compared to 46% in Jordan. Food aid receipt was reported by 18.0% of households in Jordan and 90.3% of households in Syria. In Jordan, 10.2% of households received cash assistance and in Syria 25.3% of households received cash assistance. In Jordan, cash assistance was associated with low socioeconomic status, large household size, and UNHCR registration. In Syria, female headed households, Damascus residents, families with children, and those registered with UNHCR were more likely to receive cash assistance. Food insecurity remains a concern among displaced Iraqi households in both Jordan and Syria. Improved targeting of both food and cash assistance and the expansion of cash-based programs could lead to a more effective use of funds and facilitate the implementation of assistance programs that are sustainable in the context of declining funding availability. © 2010 Elsevier Ltd.


Javier B.-P.,University of Veracruz | Obregon-Noriega V.,Independent Consultants | Grageola-Nunez J.C.,Independent Consultants | Cruz-Nieto M.A.,PRONATURA Noroeste A.C | Carmona-Islas C.,University of Veracruz
Ocean and Coastal Management | Year: 2013

In this paper we describe the development of the software TreeDSS, a user-friendly decision support system, developed as a central component of the project "The wetlands corridor of the Gulf of California (WCGC)". It aims to provide a support tool to partners of the project for structuring and solving frequent multicriteria evaluation problems, such as suitability and vulnerability assessment, resource allocation and zoning. TreeDSS basically allows users to build decision trees by coding expert knowledge using a friendly graphical interface and couples automatically with the geographic information software ArcMap 9.3 to present results both, as tables and maps, making it possible for evaluators reviewing criteria, ranges and decisions reached in real time. To illustrate how the software can be used in a real management situation, we present, as case study the development of a suitability assessment model to identify potential feeding grounds for migratory birds along the WCGC. © 2013 Elsevier Ltd.


Mehio A.K.,Boston University | Lerner J.H.,DePuy | Engelhart L.M.,DePuy | Kozma C.M.,Independent Consultants | And 3 more authors.
American Journal of Neuroradiology | Year: 2011

BACKGROUND AND PURPOSE: Previous studies evaluating vertebral augmentation procedure costs have not made detailed comparisons between vertebroplasty and kyphoplasty. Our study contrasts hospital costs for vertebroplasty versus kyphoplasty for the treatment of vertebral compression fractures in routine clinical practice in the United States. MATERIALS AND METHODS: This retrospective cohort study analyzed 2007-2008 hospital discharge and billing records from the Premier Perspective data base. The primary outcome variable, differences in total hospital cost between vertebroplasty and kyphoplasty, was assessed by using analysis of covariance. RESULTS: Three thousand six hundred seventeen patients received vertebroplasty (64% inpatient, 36% outpatient), and 8118 received kyphoplasty (54% inpatient, 46% outpatient). Approximately 75% were women, and most were white. Mean total unadjusted inpatient costs were $9837 for vertebroplasty versus $13 187 for kyphoplasty (P < .0001). Outpatient vertebroplasty costs were $3319 versus $8100 for kyphoplasty (P < .0001). Lower vertebroplasty costs were largely due to differences in hospital supply and OR. Mean vertebroplasty OR costs were $73.60 (anesthesia), $112.06 (recovery room), and $990.12 (surgery) versus $172.16 (anesthesia), $257.47 (recovery room), and $1,471.49 (surgery) with kyphoplasty. Adjustments for age, sex, admission status, and disease severity accentuated the differences. Mean adjusted inpatient costs were $11 386 for vertebroplasty versus $16 182 for kyphoplasty (P < .0001), and outpatient costs were $2997 for vertebroplasty versus $7010 for kyphoplasty (P < .0001). After adjustments for the same covariates, length-of-stay differences were no longer evident (P = .4945). CONCLUSIONS: Performing vertebroplasty versus kyphoplasty reduces hospital costs by nearly $5000 for inpatient procedures and by more than $4000 for outpatient procedures.


Tavlykaev R.,Independent Consultants | Gopalakrishnan G.K.,Independent Consultants
Proceedings - 2010 IEEE International Topical Meeting on Microwave Photonics, MWP 2010 | Year: 2010

Non-linear distortions induced by the voltage dependence of the guided mode field in electro-optical phase modulators are studied and quantified. Under very large signal modulation conditions, such distortions could impact analog link performance. ©2010 IEEE.


Lafeuille M.-H.,Groupe danalyse | Grittner A.M.,Groupe danalyse | Lefebvre P.,Groupe danalyse | Ellis L.,Health Economics and Outcomes Research | And 3 more authors.
Journal of Managed Care Pharmacy | Year: 2014

BACKGROUND: With the growing use of oral anticancer medications, understanding adherence patterns has become increasingly important. Abiraterone acetate (AA) is a prodrug of abiraterone, a novel androgen biosynthesis inhibitor. AA is approved for use in combination with prednisone for treatment of patients with metastatic castration-resistant prostate cancer. OBJECTIVE: To evaluate AA and concomitant prednisone utilization and adherence patterns for patients with prostate cancer in the United States. METHODS: This study used data from 2 administrative health care claims databases-Dataset 1: Truven Health Analytics MarketScan (December 2010 to August 2012) and Dataset 2: Symphony Health Solutions' ProMetis Lx (June 2009 to March 2013). To evaluate the consistency of medicationtaking behavior, adherence was measured using medication possession ratio (MPR), which was calculated as the sum of days of supply divided by the days on therapy in patients with at least 2 AA prescriptions. Additional outcomes included the proportion of patients taking prednisone, mean and median daily dose of AA, and concomitant prednisone use. Adherence was also studied by age, health care plan type, or previous recent chemotherapy subgroups. RESULTS: 515 patients (mean age: 72.2) and 3,228 patients (mean age: 72.2) with at least 1 AA claim were selected from Dataset 1 and Dataset 2, respectively. The mean (median) daily AA dose per person per prescription was 998.8 (1,000) mg for Dataset 1 and 994.2 (1,000) mg for Dataset 2, which is within 1% of the recommended daily dose (1,000 mg). Mean (median) MPR was 93% (98%; n = 492) in Study Population 1 and 93% (100%; n = 2,449) in Study Population 2. The mean (median) daily prednisone dose per person per prescription was similar in both datasets with 10.1 (10.0; n = 488) mg and 10.6 (10.0; n = 2,425) mg in Dataset 1 and 2, respectively. Similar adherence patterns were observed for patients in different age groups, for patients with commercial health care plans versus patients with Medicare coverage, and for patients with recent chemotherapy compared with patients without. CONCLUSIONS: Results from 2 observational studies reported high levels of adherence to AA dosing and administration patterns consistent with prescribing information. These findings provide useful insights into the treatment patterns in patients with prostate cancer treated with AA and can contribute to the current discussion in oncologic research and practice. © 2014, Academy of Managed Care Pharmacy.


Tschirley D.L.,Michigan State University | Poulton C.,Center for Development | Gergely N.,Independent consultants | Labaste P.,The World Bank | And 3 more authors.
Development Policy Review | Year: 2010

This article analyses the performance of cotton sectors across East, Southern, and West Africa, paying particular attention to the wide diversity of institutional arrangements that they now exhibit. It finds strong support for earlier contentions regarding trade-offs between competition and coordination, and between the roles of public and private sectors. New insights provide concrete and context-specific guidance to policy-makers and stakeholders regarding the key challenges they will face and the risks they will need to manage as they work to improve productivity and ensure an equitable division of benefits within cotton sectors. © The Authors 2010. Journal compilation © 2010 Overseas Development Institute.


Singh R.B.,Independent Consultants
Long Span Bridges and Roofs - Development, Design and Implementation | Year: 2013

The Planning and Design of Bridges is part art and part compromise which is most significant of aspect of Structural Engineering. It demonstrates the creative capability, imagination, innovation and exploration of the Designer .Bridge design is a Complex Engineering problem. For planning of Bridge at a particular site, it is essential to consider many factors, such as the need for a bridge, the present and future traffic, stream characteristics, subsoil condition, alternative sites, aesthetics and cost. It may not be possible always to have a wide choice of sites for a bridge. It may not be possible to have a wide choice of sites for a Bridge particularly in case of Bridges in Urban Areas & Flyovers. In India, past two decades have seen unprecedented growth of knowledge in the field concrete bridges, development of new structural forms, new methods of computer-based analysis and design and development of high strength materials. A new code IRC:112-2011 based on Limit State Method has been issued which will be very useful for design of long span bridges. Continuous Long Span Bridges spanning more than 60 m are provided over valleys, rivers .streams, marshaling yards & locations where the soil conditions, water currents, pier heights, traffic conditions etc may warrant. The design of long span Bridges is a Challenge to the ingenuity and perseverance of the Designer .Every long span Bridge poses new problems in design concepts & new construction details Long span concrete bridges are usually post tensioned pre stressed concrete and are constructed either as a continuous beam types or free cantilever structures. Many methods have been developed for continuous deck construction. If the clearance between the ground and bottom of deck is small and the soil is firm, the superstructure can be built on staging. But this method is becoming obsolete. Currently free cantilever and movable scaffold system are being used to save time and to improve safety. Arch Bridges have been built since Ancient times. There are known examples of Babylonian Masonry Arch Bridges and Chinese /Roman stone Arches. Some of them are still in use. The arch form is best suited to deep gorges with steel rocky banks which furnish natural abutments to receive the heavy thrust from the arch .The arch form is aesthetically the most pleasing and have been used in steel bridges with span range of 100-250 m Any body seeing a Bridge will have clear idea whether he or she likes it or not. The impression is independent of the Technical knowledge. It is directly inspired by the lines & proportions of the Bridge. Old Howrah bridge at Kolkata is a steel truss. Such a mighty river like Ganga could have been bridged by better looking structure. If compared with Golden Gate Bridge in Sanfransico, USA which has become a landmark of the environment. Many foreign tourist to USA with certainly go to just see and enjoy the beauty of the Bridge.


PubMed | Independent Consultants
Type: | Journal: Regulatory toxicology and pharmacology : RTP | Year: 2016

To help develop a comprehensive, quantitative understanding of the hazards of 1,2-dichloroethane (ethylene dichloride, EDC, CAS No. 107-06-2) exposure by the inhalation route, the results of existing subchronic studies and an extended one-generation reproductive toxicity (EOGRT) study recently conducted by the oral route in rats were extrapolated using a physiologically based pharmacokinetic (PBPK) model. The no observed adverse effects levels (NOAELs) for the endpoints of neurotoxicity and reproductive/developmental toxicity were the highest tested doses of 169 and 155mg/kg-day, respectively. These NOAELs were equivalent to continuous exposure of rats to minimums of 76ppm and 62ppm EDC, respectively, using total metabolism of EDC as the dose metric that is equivalent in the oral and inhalation scenarios. In contrast, the subchronic study NOAEL of 37.5mg/kg-day corresponded to continuous inhalation of 4.4ppm EDC, based on equivalent extrahepatic metabolism. The selection of the internal metric which serves to establish route-to-route equivalency was found to profoundly influence the NOAEL-equivalent inhalation exposure concentration and thus will be a key determinant of inhalation toxicity reference criteria developed on the basis of EDC studies conducted by the oral route.


SAN FRANCISCO, Nov. 7, 2016 /PRNewswire/ -- During its 2016 Convention, Rodan + Fields together with its Independent Consultants raised more than $1 million to empower students in need through the Prescription for Change® (PFC) Foundation and nonprofit partner buildOn. More than...

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