Estimating exposure to hydrogen sulfide from animal husbandry operations using satellite ammonia as a proxy: Methodology demonstration.

Husbandry trace gases that have climate change implications such as carbon dioxide (CO2), methane (CH4) and ammonia (NH3) can be quantified through remote sensing; however, many husbandry gases with health implications such as hydrogen sulfide (H2S), cannot. This pilot study demonstrates an approach to derive H2S concentrations by coupling in situ and remote sensing data. Using AMOG (AutoMObile trace Gas) Surveyor, a mobile air quality and meteorology laboratory, we measured in situ concentrations of CH4, CO2, NH3, H2S, and wind at a southern California university research dairy. Emissions were 0.13, 1.93, 0.022 and 0.0064 Gg yr-1; emission factors (EF) were 422, 6333, 74, and 21 kg cow-1 yr-1, respectively, for the 306 head herd. Contributing to these strong EF were spillway emissions from a grate between the main cowshed and the waste lagoon identified in airborne remote sensing data acquired by the hyperspectral thermal infrared imager, Mako. NH3 emissions from the Chino Dairy Complex, also in southern California, were calculated from Infrared Atmospheric Sounding Interferometer (IASI) satellite data for 2008-2017 using average morning winds, yielding a flushing time of 2.7 h, and 8.9 Gg yr-1. The ratio of EF(H2S) to EF(NH3) for the research dairy from AMOG data were applied to IASI NH3 emissions to derive H2S exposure concentration maps for the Chino area, which ranged to 10-30 ppb H2S for many populated areas. Combining remote sensing with in situ concentrations of multiple emitted gases can allow derivation of emissions at the sub-facility, facility, and larger scales, providing spatial and temporal coverage that can translate into exposure estimates for use in epidemiology studies and regulation development. Furthermore, with high fidelity information at the sub-facility level we can identify best practices and opportunities to sustainably and holistically reduce husbandry emissions.

How does a drug court experience influence student pharmacists?

INTRODUCTION: Drug court is a highly structured, community-based criminal justice alternative to imprisonment and probation that incorporates chemical dependency treatment for offenders with a substance abuse diagnosis. Drug court provides a unique learning experience for pharmacy students. METHODS: Students from Purdue University College of Pharmacy and the University of Minnesota College of Pharmacy participated in drug court and provided written reflections regarding their experiences. Analysis of reflections explored how students' life experiences might be associated with their understanding of substance use disorder, and how the drug court experience might impact students' attitudes regarding substance use disorder as well as professional and personal development. RESULTS: Consensual qualitative analysis of student pharmacist reflections of the drug court experience led to eleven distinct themes: description of the student experience at drug court; past experiences and exposures; past perceptions and judgments; stereotype deconstruction; empathy development; development of impartiality and fair-minded approach; situational appreciation; analytical thinking; role of the pharmacist; metacognition; and science of substance use disorder. DISCUSSION: Colleges of pharmacy wishing to provide students with an opportunity for personal and professional development focused on substance use disorder and recovery should explore experiential learning opportunities in drug court settings. CONCLUSIONS: The drug court experience allows student pharmacist learners to gain a deeper personal understanding of substance use disorder while examining their own biases. Students reported that this experience challenges them to rethink notions of "good" and "bad" and reflect on personal preconceived views about substance use disorder and morality.

Validation of mobile in situ measurements of dairy husbandry emissions by fusion of airborne/surface remote sensing with seasonal context from the Chino Dairy Complex.

Mobile in situ concentration and meteorology data were collected for the Chino Dairy Complex in the Los Angeles Basin by AMOG (AutoMObile trace Gas) Surveyor on 25 June 2015 to characterize husbandry emissions in the near and far field in convoy mode with MISTIR (Mobile Infrared Sensor for Tactical Incident Response), a mobile upwards-looking, column remote sensing spectrometer. MISTIR reference flux validated AMOG plume inversions at different information levels including multiple gases, GoogleEarth imagery, and airborne trace gas remote sensing data. Long-term (9-yr.) Infrared Atmospheric Sounding Interferometer satellite data provided spatial and trace gas temporal context. For the Chino dairies, MISTIR-AMOG ammonia (NH3) agreement was within 5% (15.7 versus 14.9 Gg yr-1, respectively) using all information. Methane (CH4) emissions were 30 Gg yr-1 for a 45,200 herd size, indicating that Chino emission factors are greater than previously reported. Single dairy inversions were much less successful. AMOG-MISTIR agreement was 57% due to wind heterogeneity from downwind structures in these near-field measurements and emissions unsteadiness. AMOG CH4, NH3, and CO2 emissions were 91, 209, and 8200 Mg yr-1, implying 2480, 1870, and 1720 head using published emission factors. Plumes fingerprinting identified likely sources including manure storage, cowsheds, and a structure with likely natural gas combustion. NH3 downwind of Chino showed a seasonal variation of a factor of ten, three times larger than literature suggests. Chino husbandry practices and trends in herd size and production were reviewed and unlikely to add seasonality. Higher emission seasonality was proposed as legacy soil emissions, the results of a century of husbandry, supported by airborne remote sensing data showing widespread emissions from neighborhoods that were dairies 15 years prior, and AMOG and MISTIR observations. Seasonal variations provide insights into the implications of global climate change and must be considered when comparing surveys from different seasons.

Direct Oral Anticoagulant Use in Atypical Thrombosis-Related Conditions.

OBJECTIVE: To review the published literature for evidence of the efficacy and safety of direct oral anticoagulants (DOACs) when used in the management of atypical thrombosis-related conditions. DATA SOURCES: A comprehensive MEDLINE database search (1948 to July 2017) and EMBASE search (1980 to July 2017) were conducted using the search terms direct oral anticoagulant in combination with acute coronary syndrome (ACS), antiphospholipid antibody syndrome (APLAS), and cancer-associated thrombosis (CAT). STUDY SELECTION AND DATA EXTRACTION: The literature search was limited to studies that were conducted in humans and published in English. Clinical trials, observational studies, and case series were selected. DATA SYNTHESIS: A total of 20 published studies were selected from the literature. Only 1 randomized controlled study showed a significant reduction in cardiovascular outcomes on DOAC use in ACS patients but at the expense of increased bleeding. For the use of DOACs in APLAS, the evidence from case series seems to suggest low incidence of thromboembolic events or recurrent thrombosis in low-risk patients. Finally, in cancer patients, DOACs were comparable to warfarin in preventing CAT in 8 studies of different designs. Major bleeding with DOACs was not significantly lower than in patients who received an enoxaparin/warfarin regimen. CONCLUSIONS: Until more evidence from the ongoing clinical trials is available, DOACs may not be favorable add-on therapy in ACS patients receiving standard antiplatelet therapy but may be alternative to warfarin in preventing or treating thrombosis in low-risk APLAS patients as well as in cases of CAT in which patients have to be managed with warfarin.