scholarly journals Mortality Implications of Increased Active Mobility for a Proposed Regional Transportation Emission Cap-and-Invest Program

2021 ◽  
Author(s):  
Matthew Raifman ◽  
Kathy Fallon Lambert ◽  
Jonathan I. Levy ◽  
Patrick L. Kinney
Keyword(s):  
Urban Areas ◽  
Assessment Tool ◽  
Cost Effective ◽  
Economic Assessment ◽  
World Health ◽  
Investment Allocation ◽  
Transportation Sector ◽  
The Usa ◽  
Pedestrian Infrastructure ◽  
Health Organization

AbstractThe transportation sector is now the primary contributor to greenhouse gas emissions in the USA. The Transportation Climate Initiative (TCI), a partnership of 12 states and the District of Columbia currently under development, would implement a cap-and-invest program to reduce transportation sector emissions across the Northeast and Mid-Atlantic region, including substantial investment in cycling and pedestrian infrastructure. Using outputs from an investment scenario model and the World Health Organization Health Economic Assessment Tool methodology, we estimate the mortality implications of increased active mobility and their monetized value for three different investment allocation scenarios considered by TCI policymakers. We conduct these analyses for all 378 counties in the TCI region. We find that even for the scenario with the smallest investment in active mobility, when it is fully implemented, TCI would result in hundreds of fewer deaths per year across the region, with monetized benefits in the billions of dollars annually. Under all scenarios considered, the monetized benefits from deaths avoided substantially exceed the direct infrastructure costs of investment. We conclude that investing proceeds in active mobility infrastructure is a cost-effective way of reducing mortality, especially in urban areas, providing a strong motivation for investment in modernization of the transportation system and further evidence of the health co-benefits of climate action.

scholarly journals Squamous cell carcinoma mimics small cell carcinoma of the lung: a case report

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Michael Kmeid ◽  
Breanne Gillie ◽  
Armand Asarian ◽  
Philip Xiao
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Squamous Cell ◽  
Lung Tumors ◽  
Small Cell ◽  
World Health ◽  
Lung Cancers ◽  
Lung Carcinomas ◽  
The Usa ◽  
Health Organization

Abstract Squamous cell carcinomas (SCC) accounts for roughly 20% of lung cancers in the USA. The 2015 World Health Organization classification of lung tumors further categorizes SCC as three subtypes: keratinizing, non-keratinizing and basaloid variant. The non-keratinizing subtype is a poorly differentiated tumor that can present histologically in different ways, and one of which is a rare variant that strongly resembles small cell carcinoma. As a result, histological diagnosis alone is not sufficient to properly diagnose lung carcinomas. Immunohistochemistry has been increasingly used over the past few years to differentiate between lung tumors. The combination of morphological and immunohistochemical staining should be the mainstay for diagnosis of all lung carcinomas as more targeted therapies become more available.

Reflections on FDA and WHO recommendations concerning clinical trials

1989 ◽  
Vol 4 (2) ◽  
pp. 117-122 ◽  
Author(s):  
J.-F. Dreyfus ◽  
D. Cremniter ◽  
J.D. Guelfi
Keyword(s):  
Clinical Trials ◽  
Drug Users ◽  
Objective Evaluation ◽  
World Health ◽  
Measuring Instruments ◽  
New Techniques ◽  
The Usa ◽  
The One ◽  
Health Organization

SummaryWe are still confronted by numerous different nosographic models and problems concerning the objective evaluation of patients progress during treatment. It is interesting to consider the consequences of this situation in psychiatry which still involves a relative diversity of practical methods used in clinical trials. The recommendations of the USA Food and Drug Administration, on the one hand, constitute a highly structured and precise reference. The World Health Organization, on the other hand, promulgates general recommendations resulting from a compromise designed to satisfy the greatest number of clinicians.Despite the apparently diverse principles and the different practical methods they propose, both those sets of recommendations have been useful in inspiring clinicians to reflect upon these different methodological approaches. The qualities of the inclusion criteria used in the study of patients and the sensitivity of the different measuring instruments have allowed psychotropic drug users as well as producers to recognize the need for a certain rigour in clinical trials.The FDA and WHO guidelines have certainly improved the quality of clinical trials in psychopharmacology. However, they also represent a source of resistance to innovation.A series of consensus meetings to first reconcile US and European points of view and later to include new techniques in the recognized sets of methods would therefore be helpful.

scholarly journals Improving the Role and Contribution of Pharmacokinetic Analyses in Antimalarial Drug Clinical Trials

2014 ◽  
Vol 58 (10) ◽  
pp. 5643-5649 ◽  
Author(s):  
Katherine Kay ◽  
Eva Maria Hodel ◽  
Ian M. Hastings
Keyword(s):  
Antimalarial Drug ◽  
Theoretical Data ◽  
Drug Efficacy ◽  
Cost Effective ◽  
Field Studies ◽  
World Health ◽  
Efficacy Trials ◽  
Drug Concentrations ◽  
Health Organization ◽  
Study Designs

ABSTRACTIt is now World Health Organization (WHO) policy that drug concentrations on day 7 be measured as part of routine assessment in antimalarial drug efficacy trials. The rationale is that this single pharmacological measure serves as a simple and practical predictor of treatment outcome for antimalarial drugs with long half-lives. Herein we review theoretical data and field studies and conclude that the day 7 drug concentration (d7c) actually appears to be a poor predictor of therapeutic outcome. This poor predictive capability combined with the fact that many routine antimalarial trials will have few or no failures means that there appears to be little justification for this WHO recommendation. Pharmacological studies have a huge potential to improve antimalarial dosing, and we propose study designs that use more-focused, sophisticated, and cost-effective ways of generating these data than the mass collection of single d7c concentrations.

scholarly journals An IoT Architecture for Assessing Road Safety in Smart Cities

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Abd-Elhamid M. Taha
Keyword(s):  
Road Safety ◽  
Markov Models ◽  
Smart Cities ◽  
Dynamic Assessment ◽  
Route Planning ◽  
Cost Effective ◽  
World Health ◽  
Road Users ◽  
Health Organization ◽  
The Impact

The Safe System (SS) approach to road safety emphasizes safety-by-design through ensuring safe vehicles, road networks, and road users. With a strong motivation from the World Health Organization (WHO), this approach is increasingly adopted worldwide. Considerations in SS, however, are made for the medium-to-long term. Our interest in this work is to complement the approach with a short-to-medium term dynamic assessment of road safety. Toward this end, we introduce a novel, cost-effective Internet of Things (IoT) architecture that facilitates the realization of a robust and dynamic computational core in assessing the safety of a road network and its elements. In doing so, we introduce a new, meaningful, and scalable metric for assessing road safety. We also showcase the use of machine learning in the design of the metric computation core through a novel application of Hidden Markov Models (HMMs). Finally, the impact of the proposed architecture is demonstrated through an application to safety-based route planning.

scholarly journals Strengths and weaknesses of the Brazilian regulation on biosimilars: A critical view of the regulatory requirements for biosimilars in Brazil

2018 ◽  
Vol 10 (12) ◽  
pp. 253-259 ◽  
Author(s):  
Marcos Renato de Assis ◽  
Valdair Pinto
Keyword(s):  
Conflicts Of Interest ◽  
Expression System ◽  
World Health ◽  
Regulatory Requirements ◽  
Biological Products ◽  
Synthetic Drugs ◽  
Comparability Exercise ◽  
The Face ◽  
The Usa ◽  
Health Organization

Biological products or biopharmaceuticals are medicinal products derived from living systems and manufactured by modern biotechnological methods that differ widely from the traditional synthetic drugs. Monoclonal antibodies are the most rapidly growing type of biologic. They are much larger and more complex molecules with inherent diversity; therefore, different manufacturers cannot produce identical biological products, even with the same type of host expression system and equivalent technologies. Thus, legal follow-on biologics manufactured and marketed after patent expiration are usually referred to as biosimilars. Biosimilarity is based on a comparability exercise whereby unavoidable clinical differences are evaluated and must meet equivalence or non-inferiority criteria. Biosimilars need to comply with different regulatory requirements for market authorization in different sites. There are several other related issues that need to be defined by the national authorities, such as interchangeability, labeling and prescribing information. The Brazilian health surveillance agency follows the key principles established by the World Health Organization for the assessment of biosimilarity, although does not adopt the name ‘biosimilar’. However, the agency also made a compromise on a standalone application pathway that does not require the usual comparability exercise with the reference product, originating nonbiosimilar copies. Interchangeability and the use of nonproprietary names are not regulated, giving rise to pressures on physicians and conflicts of interest in the decision making on biosimilar use. The scope of this article is to present the Brazilian regulation on biosimilars, its strengths and weaknesses, and to discuss it in the face of regulations in the USA and Europe.

scholarly journals Motion – Screening and Surveillance of Barrett’s Epithelium Is Practical and Cost Effective: Arguments against the Motion

2002 ◽  
Vol 16 (8) ◽  
pp. 541-545 ◽  
Author(s):  
Naoki Chiba
Keyword(s):  
Cost Effective ◽  
World Health ◽  
Endoscopic Screening ◽  
Effective Screening ◽  
Screening And Surveillance ◽  
Screening Protocol ◽  
Surveillance Programs ◽  
Prolongation Of Life ◽  
Health Organization ◽  
Very High

The issue of whether to screen individuals for Barrett’s esophagus (BE) to prevent esophageal adenocarcinoma (EAC) is highly controversial. Important considerations are that BE is not highly prevalent in the general population and that not many patients with BE develop or die from EAC. Studies that suggest an improved prognosis from surveillance programs are susceptible to lead-time bias. Most of the principles for effective screening, as outlined by the World Health Organization, are not met by endoscopic screening and surveillance protocols. The diagnosis of BE (and dysplasia) is often unclear. Most patients with BE are not identified by screening, and few deaths would be prevented by surveillance. A decision analysis found that the most cost effective screening protocol would be every five years, but the costs associated with prolongation of life are very high, even if a group at high risk for EAC could be identified.

scholarly journals The influence of medical and geographical factors on the appearance and development of allergic rhinitis and eczema among school children in Belgrade

2014 ◽  
Vol 94 (2) ◽  
pp. 65-82
Author(s):  
Sanja Topalovic
Keyword(s):  
Allergic Rhinitis ◽  
School Children ◽  
Urban Areas ◽  
International Study ◽  
World Health ◽  
Geographical Factors ◽  
Asthma And Allergy ◽  
City Core ◽  
Health Organization

Allergic rhinitis and eczema represent ailments which are increasingly linked with urban areas. Although they do not belong to illnesses which are predominantly caused by geographical factors, their importance for the development of these illnesses will be considered in this paper. As an example of the influence of urban environment on the development of these illnesses, the city core of Belgrade (the area included in the General Urban Plan) is taken into consideration. The emphasis is put especially on the quality of air, industry, traffic and the conditions for living. The research is based on tracking these illnesses among children, considering the frequent appearance of these illnesses especially among school children. The survey, whose results were partly presented in this research paper, was an important method for examining the subject matter of this paper. Namely, the above mentioned survey was realized in the International Study of Asthma and Allergy among children (ISAAC), which was conducted by World Health Organization (WHO), 156 centres from 56 countries took part. Among them, there were four centres from Serbia: Belgrade, Nis, Podgorica and Sombor.

scholarly journals Analysis of the Research Hotspot of Drug Treatment of Tuberculosis: A Bibliometric Based on the Top 50 Cited Literatures

2022 ◽  
Vol 2022 ◽  
pp. 1-17
Author(s):  
Ying Xiong ◽  
Jingwen Wei ◽  
Yujia Cai ◽  
Yang Zhang ◽  
Li Feng ◽  
...  
Keyword(s):  
Drug Treatment ◽  
New England ◽  
Web Of Science ◽  
World Health ◽  
Future Research ◽  
First Line ◽  
Resistant Tuberculosis ◽  
The Usa ◽  
Health Organization ◽  
Study Type

Objective. The objective of the current study was to analyze the research hotspot of drug treatment for tuberculosis via top literatures. Materials and Methods. A retrospective analysis was performed on June 7th, 2021. Literatures were searched on the Web of Science Core Collection to identify the top 50 cited literatures related to drug treatment of tuberculosis. The characteristics of the literatures were identified. The outcomes included authorship, journal, study type, year of publication, and institution. Cooccurrence network analysis and visualization were conducted using the VOS viewer (Version 1.6.16; Leiden University, Leiden, The Netherlands). Results. The top 50 cited literatures were cited 308 to 2689 times and were published between 1982 and 2014. The most studied drugs were the first-line drugs such as isoniazid and rifampicin ( n = 22 ), and drug-resistant tuberculosis was most frequently reported ( n = 16 ). They were published in 18 journals, and the New England Journal of Medicine published the most literatures ( n = 18 ), followed by the American Journal of Respiratory and Critical Care Medicine ( n = 7 ), and the Lancet ( n = 6 ). The authors were from 13 countries, and the authors from the USA published most of the literatures ( n = 30 ), while authors from other countries published less than five literatures. The CDC in the USA ( n = 4 ), the World Health Organization (WHO) ( n = 3 ), and the American Philosophical Society ( n = 3 ) were the leading institutions, and only two authors published at least two top-cited literatures as first authors. Conclusions. This study provides insights into the development and most important literatures on drug therapy for tuberculosis and evidence for future research on tuberculosis treatment.

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