Analytical decision model for the cost-effective management of solitary pulmonary nodules

PURPOSE AND METHODS: Multiple strategies are currently being used to manage patients who present with indeterminate solitary pulmonary nodules (SPN). We have used decision-analysis models to assess the cost-effectiveness of various strategies for the diagnosis and management of SPN. Four decision strategies were compared: a wait and watch strategy, a surgery strategy, a computed tomography (CT)-based strategy, and a CT-plus-positron emission tomography (PET) strategy. An incremental cost-effectiveness ratio (ICER) was used to compare all strategies to the wait and watch strategy. RESULTS: A CT-plus-PET strategy was the most cost-effective over a large pretest likelihood (probability of having a malignant nodule), with a range of 0.12 to 0.69. Furthermore, within this likelihood range, the potential cost savings of using the CT-plus-PET strategy over the CT strategy ranged from $91 to $2,200 per patient. This translates to a yearly national savings of approximately $62.7 million. CONCLUSION: Decision-analysis modeling indicates the potential cost-effectiveness of [18F]2-fluoro-2-deoxy-D-glucose (FDG)-PET in the management of SPN. Furthermore, the decision trees developed can be used to model various features of the management of SPN, including modeling the cost-effectiveness of other newly emerging technologies.     

Environmental tobacco smoke as a source of polycyclic aromatic hydrocarbons in settled household dust

Environmental tobacco smoke is a major contributor to indoor air pollution. Dust and surfaces may remain contaminated long after active smoking has ceased (called 'thirdhand' smoke). Polycyclic aromatic hydrocarbons (PAHs) are known carcinogenic components of tobacco smoke found in settled house dust (SHD). We investigated whether tobacco smoke is a source of PAHs in SHD. House dust was collected from 132 homes in urban areas of Southern California. Total PAHs were significantly higher in smoker homes than nonsmoker homes (by concentration: 990 ng/g vs 756 ng/g, p = 0.025; by loading: 1650 ng/m(2) vs 796 ng/m(2), p = 0.012). We also found significant linear correlations between nicotine and total PAH levels in SHD (concentration, R(2) = 0.105; loading, R(2) = 0.385). Dust collected per square meter (g/m(2)) was significantly greater in smoker homes and might dilute PAH concentration in SHD inconsistently. Therefore, dust PAH loading (ng PAH/m(2)) is a better indicator of PAH content in SHD. House dust PAH loadings in the bedroom and living room in the same home were significantly correlated (R(2) = 0.468, p < 0.001) suggesting PAHs are distributed by tobacco smoke throughout a home. In conclusion, tobacco smoke is a source of PAHs in SHD, and tobacco smoke generated PAHs are a component of thirdhand smoke.     

The separation of lead from copper by co-extraction and selective stripping by LIX 64N

The extraction and stripping of lead from its acetate solution by LIX 64N diluted with Kermac 470B are reported. From these results, a process for the separation of lead from copper by co-extraction and selective stripping has been proposed. Very good co-extraction and selective stripping efficiencies were obtained which indicated that a high degree of separation between copper and lead could be achieved.     

Chemically based model to predict distribution coefficients in the Cu-LIX 65N and Cu-KELEX 100 systems

A chemically based thermodynamic model to predict the distribution coefficients have been developed for the Cu-LIX 65N and Cu-KELEX 100 systems. The predictive model makes use of the aqueous phase cupric sulfate complex stoichiometric stability constant expressed as its degree of formation, their extraction mechanism, and the equilibrium constant for the extraction reaction. The distribution coefficient of copper can be predicted by the equation K_d = k₁α_o ², where is the ratio of the equilibrated organic concentration to the equilibrated hydrogen ion concentration in the aqueous phase, k₁ is the effective equilibrium constant containing the quotient of the activity coefficients of the reacting species and α_o is the degree of formation of the free cupric ion in the equilibrated aqueous phase. Excellent agreement between the experimental data and the predicted values was obtained. Formerly Graduate Fellow, Iowa State University     

Brominated flame retardants in the atmosphere of the East-Central United States

Air samples were collected at five sites (urban, semiurban, agricultural, and remote) from Lake Michigan through the U. S. Midwest to the Gulf of Mexico every 12 days during 2002-2003 using high-volume samplers so that we could study the spatial trends of brominated flame retardants (polybrominated diphenyl ethers (PBDEs), hexabromocyclododecanes (HBCDs), and 1,2-bis(2,4,6-tribromophenoxy)-ethane (TBE)). The mean sigmaPBDE atmospheric concentration was 100 +/- 35 pg/m3 at the Chicago site, which was 3-6 times higher than that at the other sites. The sigmaPBDE atmospheric concentrations at the Chicago site were significantly higher than previous measurements made in 1997-1999. Unlike these former measurements, BDE-209 is now relatively abundant. Lower BDEs (tri- through hex-BDEs) were detected in both the particle and the gas phases, and the partitioning of these compounds between phases was highly dependent on atmospheric temperature. Higher BDEs (hepta- through deca-BDEs) were mostly detected in the particle phase. On the basis of the congener distributions in the samples, the concentrations were divided into three groups: penta-BDEs, octa-BDEs, and deca-BDEs. Penta-BDEs were the most concentrated at the Chicago site and the least concentrated at the Louisiana site; octa-BDE concentrations were low at all of the sites; deca-BDEs were the most concentrated at the Chicago site and notably high atthe Arkansas site. High concentrations of deca-BDEs, HBCDs, and TBE at the Arkansas site suggest that manufacturing areas in southern Arkansas could be the source regions. Backward trajectories for air masses with high concentrations of deca-BDEs coming to the Arkansas site suggestthat deca-BDEs bound to particles can move long distances from source regions to nonsource regions.     

Dynamic finite element modeling and fatigue damage analysis of thermite welds

Railway track comprises of continuous welded rail mounted with rail clips on sleepers integrated to a ballast track form system. Modeling the rail structure with thermite weld subjected to the complex dynamic loadings is a challenging problem. Fatigue failures at the head‐to‐web, web‐to‐foot, and foot regions of weld collar are investigated. In this paper, a combined method of multibody system dynamic analysis and dynamic finite element analysis was used. A train roll‐in experiment was conducted at a train depot test track to validate modeling results predicted at the strain gauge location. Three critical plane‐based multiaxial fatigue criterions incorporated with a smallest enclosing circle algorithm were implemented in Python code to study the fatigue behavior at weld collar. Parametric studies were also conducted to investigate the effects of track component materials, track curvature, and train velocity. This approach provides a method for predicting the failures of thermite welded joints in railway tracks.     

Spatial optimization of photovoltaic-based hydrogen-electricity supply chain through an integrated geographical information system and mathematical modeling approach

Clean Technologies and Environmental Policy - Hydrogen is a potential energy carrier for renewable energy as it has a clean emission when consumed. To implement hydrogen energy system in...     

生产微合金化钢的几点考虑

在20世纪60～80年代,连续浇铸是钢铁工业的一项重要的工艺变革。这项技术无论对提高炼钢生产效率还是改善产品质量都产生了深刻的影响。然而,为保持产品竞争力和成本效益,需要一个统筹的炼钢方法。从铁水生产开始或者从冶炼开始,经过精炼到连铸,再到轧钢和后续工序,钢产品的整条生产路线应该整体可控。关于连铸,有2个实例可以说明这种发展趋势:改进中间包设计和冶金技术,优化浸入式水口和高水平的结晶器液面控制。无止境的洁净钢研究已经从连铸机本身转到钢包冶金。同样,无缺陷表面质量研究不再简单地专注于连铸技术,同时也将炼钢考虑进去。随着结构钢品种的合金设计转变,从普通的中碳锰钢到裂纹敏感的现代低碳微合金化HSLA钢,连铸机的设计和技术发展并驾齐驱。     

Nontargeted Comprehensive Two-Dimensional Gas Chromatography/Time-of-Flight Mass Spectrometry Method and Software for Inventorying Persistent and Bioaccumulative Contaminants in Marine Environments

Analytical methods for contaminant monitoring are generally targeted; i.e., they measure defined lists of compounds. Routine monitoring projects using targeted methods are not usually designed to screen for unrecognized or novel contaminants and therefore miss compounds within the region or population of study that cause, or have the potential to cause, adverse biological impacts. We describe a nontargeted analytical method utilizing direct sample introduction coupled to comprehensive two-dimensional gas chromatography with time-of-flight mass spectrometry. To test the capabilities of this instrumental method within the context of marine contaminant surveys, we characterized a broad array of nonpolar, persistent, and bioaccumulative contaminants in Atlantic common dolphin ( Delphinus delphis ) blubber, including compounds that are not typically monitored. Compound identifications were made by searching a standard reference database, by contemporaneously analyzing mass spectra from reference standards, and by de novo interpretation. We identified a total of 271 compounds belonging to 24 classes; all compounds but 1 were halogenated. Anthropogenic contaminants and halogenated natural products were concurrently detected. A total of 86 compounds were anthropogenic contaminants that are not routinely targeted in environmental surveys, and 54 compounds were halogenated natural products. A total of 112 spectra were identified de novo, demonstrating that exclusive reliance on commercially available reference standards and mass spectral libraries may miss a significant fraction of identifiable compounds. We also cataloged 27 halogenated mass spectra that were not able to be identified. Due to the volume and complexity of the identification data, we developed custom software to organize and provide shared access to the identified mass spectra and related information. The nontargeted analytical method and data reporting system, in combination with the analysis of a high-trophic-level sentinel species, demonstrates a framework for creating an inventory of persistent and bioaccumulative contaminants in marine environments, with the future goal of suggesting new compounds for further investigation by targeted monitoring and risk assessment.