Early life lead exposure from private well water increases juvenile delinquency risk among US teens.

Early life exposure to environmental lead (Pb) has been linked to decreased IQ, behavior problems, lower lifetime earnings, and increased criminal activity. Beginning in the 1970s, limits on Pb in paint, gasoline, food cans, and regulated water utilities sharply curtailed US environmental Pb exposure. Nonetheless, hundreds of thousands of US children remain at risk. This study reports on how unregulated private well water is an underrecognized Pb exposure source that is associated with an increased risk of teenage juvenile delinquency. We build a longitudinal dataset linking blood Pb measurements for 13,580 children under age 6 to their drinking water source, individual- and neighborhood-level demographics, and reported juvenile delinquency records. We estimate how early life Pb exposure from private well water influences reported delinquency. On average, children in homes with unregulated private wells had 11% higher blood Pb than those with community water service. This higher blood Pb was significantly associated with reported delinquency. Compared to children with community water service, those relying on private wells had a 21% (95% CI: 5 to 40%) higher risk of being reported for any delinquency and a 38% (95% CI: 10 to 73%) increased risk of being reported for serious delinquency after age 14. These results suggest that there could be substantial but as-yet-unrecognized social benefits from intervention programs to prevent children's exposure to Pb from private wells, on which 13% of the US population relies.

Children drinking private well water have higher blood lead than those with city water.

Although the Flint, Michigan, water crisis renewed concerns about lead (Pb) in city drinking water, little attention has been paid to Pb in private wells, which provide drinking water for 13% of the US population. This study evaluates the risk of Pb exposure in children in households relying on private wells. It is based on a curated dataset of blood Pb records from 59,483 North Carolina children matched with household water source information. We analyze the dataset for statistical associations between children's blood Pb and household drinking water source. The analysis shows that children in homes relying on private wells have 25% increased odds (95% CI 6.2 to 48%, P < 0.01) of elevated blood Pb, compared with children in houses served by a community water system that is regulated under the Safe Drinking Water Act. This increased Pb exposure is likely a result of corrosion of household plumbing and well components, because homes relying on private wells rarely treat their water to prevent corrosion. In contrast, corrosion control is required in regulated community water systems. These findings highlight the need for targeted outreach to prevent Pb exposure for the 42.5 million Americans depending on private wells for their drinking water.

Image-Based Analysis of Weathered Slag for Calculation of Transport Properties and Passive Carbon Capture.

Weathering of silicate-rich industrial wastes such as slag can reduce emissions from the steelmaking industry. During slag weathering, different minerals spontaneously react with atmospheric CO2 to produce calcite. Here, we evaluate the CO2 uptake during slag weathering using image-based analysis. The analysis was applied to an X-ray computed tomography (XCT) dataset of a slag sample associated with the former Ravenscraig steelworks in Lanarkshire, Scotland. The element distribution of the sample was studied using scanning electron microscopy (SEM), coupled with energy-dispersive spectroscopy (EDS). Two advanced image segmentation methods, namely trainable WEKA segmentation in the Fiji distribution of ImageJ and watershed segmentation in Avizo ® 9.3.0, were used to segment the XCT images into matrix, pore space, calcite, and other precipitates. Both methods yielded similar volume fractions of the segmented classes. However, WEKA segmentation performed better in segmenting smaller pores, while watershed segmentation was superior in overcoming the partial volume effect presented in the XCT data. We estimate that CO2 has been captured in the studied sample with an uptake between 20 and 17 kg CO2/1,000 kg slag for TWS and WS, respectively, through calcite precipitation.

Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial.

BACKGROUND: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions. METHODS: We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437. FINDINGS: Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts. INTERPRETATION: Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer. FUNDING: WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac.

Citywide cluster randomized trial to restore blighted vacant land and its effects on violence, crime, and fear.

Vacant and blighted urban land is a widespread and potentially risky environmental condition encountered by millions of people on a daily basis. About 15% of the land in US cities is deemed vacant or abandoned, an area roughly the size of Switzerland. In a citywide cluster randomized controlled trial, we investigated the effects of standardized, reproducible interventions that restore vacant land on the commission of violence, crime, and the perceptions of fear and safety. Quantitative and ethnographic analyses were included in a mixed-methods approach to more fully test and explicate our findings. A total of 541 randomly sampled vacant lots were randomly assigned into treatment and control study arms; outcomes from police and 445 randomly sampled participants were analyzed over a 38-month study period. Participants living near treated vacant lots reported significantly reduced perceptions of crime (-36.8%, P < 0.05), vandalism (-39.3%, P < 0.05), and safety concerns when going outside their homes (-57.8%, P < 0.05), as well as significantly increased use of outside spaces for relaxing and socializing (75.7%, P < 0.01). Significant reductions in crime overall (-13.3%, P < 0.01), gun violence (-29.1%, P < 0.001), burglary (-21.9%, P < 0.001), and nuisances (-30.3%, P < 0.05) were also found after the treatment of vacant lots in neighborhoods below the poverty line. Blighted and vacant urban land affects people's perceptions of safety, and their actual, physical safety. Restoration of this land can be an effective and scalable infrastructure intervention for gun violence, crime, and fear in urban neighborhoods.

Effect of Remediating Blighted Vacant Land on Shootings: A Citywide Cluster Randomized Trial.

Objectives. To determine if remediating blighted vacant urban land reduced firearm shooting incidents resulting in injury or death.Methods. We conducted a cluster randomized controlled trial in which we assigned 541 randomly selected vacant lots in Philadelphia, Pennsylvania, to 110 geographically contiguous clusters and randomly assigned these clusters to a greening intervention, a less-intensive mowing and trash cleanup intervention, or a no-intervention control condition. The random assignment to the trial occurred in April and June 2013 and lasted until March 2015. In a difference-in-differences analysis, we assessed whether the 2 treatment conditions relative to the control condition reduced firearm shootings around vacant lots.Results. During the trial, both the greening intervention, -6.8% (95% confidence interval [CI] = -10.6%, -2.7%), and the mowing and trash cleanup intervention, -9.2% (95% CI = -13.2%, -4.8%), significantly reduced shootings. There was no evidence that the interventions displaced shootings into adjacent areas.Conclusions. Remediating vacant land with inexpensive, scalable methods, including greening or minimal mowing and trash cleanup, significantly reduced shootings that result in serious injury or death.Public Health Implications. Cities should experiment with place-based interventions to develop effective firearm violence-reduction strategies.Trial Registration. This trial was registered with the International Standard Randomized Controlled Trial Number (study ID ISRCTN92582209; http://www.isrctn.com/ISRCTN92582209).

Neighborhood Interventions to Reduce Violence.

Violence is a widespread problem that affects the physical, mental, and social health of individuals and communities. Violence comes with an immense economic cost to its victims and society at large. Although violence interventions have traditionally targeted individuals, changes to the built environment in places where violence occurs show promise as practical, sustainable, and high-impact preventive measures. This review examines studies that use quasi-experimental or experimental designs to compare violence outcomes for treatment and control groups before and after a change is implemented in the built environment. The most consistent evidence exists in the realm of housing and blight remediation of buildings and land. Some evidence suggests that reducing alcohol availability, improving street connectivity, and providing green housing environments can reduce violent crimes. Finally, studies suggest that neither transit changes nor school openings affect community violence.

Metasomatism and the crystallization of zircon megacrysts in Archaean peridotites from the Lewisian complex, NW Scotland.

Zircon megacrysts are locally abundant in 1-40 cm-thick orthopyroxenite veins within peridotite host rocks in the Archaean Lewisian gneiss complex from NW Scotland. The veins formed by metasomatic interaction between the ultramafic host and Si-rich melts are derived from partial melting of the adjacent granulite-facies orthogneisses. The interaction produced abundant orthopyroxene and, within the thicker veins, phlogopite, pargasite and feldspathic bearing assemblages. Two generations of zircon are present with up to 1 cm megacrystic zircon and a later smaller equant population located around the megacryst margins. Patterns of zoning, rare earth element abundance and oxygen isotopic compositions indicate that the megacrysts crystallized from crustal melts, whereas the equant zircon represents new neocryst growth and partial replacement of the megacryst zircon within the ultramafic host. Both zircon types have U-Pb ages of ca. 2464 Ma, broadly contemporaneous with granulite-facies events in the adjacent gneisses. Zircon megacrysts locally form > 10% of the assemblage and may be associated to zones of localized nucleation or physically concentrated during movement of the siliceous melts. Their unusual size is linked to the suppression of zircon nucleation and increased Zr solubility in the Si-undersaturated melts. The metasomatism between crustal melts and peridotite may represent an analog for processes in the mantle wedge above subducting slabs. As such, the crystallization of abundant zircon in ultramafic host rocks has implications for geochemistry of melts generated in the mantle and the widely reported depletion of high field strength elements in arc magmas.

Urban Blight Remediation as a Cost-Beneficial Solution to Firearm Violence.

OBJECTIVES: To determine if blight remediation of abandoned buildings and vacant lots can be a cost-beneficial solution to firearm violence in US cities. METHODS: We performed quasi-experimental analyses of the impacts and economic returns on investment of urban blight remediation programs involving 5112 abandoned buildings and vacant lots on the occurrence of firearm and nonfirearm violence in Philadelphia, Pennsylvania, from 1999 to 2013. We adjusted before-after percent changes and returns on investment in treated versus control groups for sociodemographic factors. RESULTS: Abandoned building remediation significantly reduced firearm violence -39% (95% confidence interval [CI] = -28%, -50%; P < .05) as did vacant lot remediation (-4.6%; 95% CI = -4.2%, -5.0%; P < .001). Neither program significantly affected nonfirearm violence. Respectively, taxpayer and societal returns on investment for the prevention of firearm violence were $5 and $79 for every dollar spent on abandoned building remediation and $26 and $333 for every dollar spent on vacant lot remediation. CONCLUSIONS: Abandoned buildings and vacant lots are blighted structures seen daily by urban residents that may create physical opportunities for violence by sheltering illegal activity and illegal firearms. Urban blight remediation programs can be cost-beneficial strategies that significantly and sustainably reduce firearm violence.

The Effect of a Sunday Liquor-Sales Ban Repeal on Crime: A Triple-Difference Analysis.

BACKGROUND: This study investigates whether alcohol availability in state-run liquor stores affects crime nearby. In 2003, Pennsylvania repealed its Sunday alcohol-sales ban for a portion of its state-run liquor stores. We capitalize on this change in alcohol policy to assess the effect of alcohol availability on crime occurring within the vicinity of liquor stores that opened on Sundays in Philadelphia. METHODS: We employed a difference-in-difference-in-differences model that compared reported crime before versus after the change in alcohol policy, Sundays versus other days of the week, and the fraction of liquor stores affected versus not affected by the repeal. We used crime incident data in Philadelphia between 1998 and 2011. RESULTS: The repeal was associated with a significant increase in total and property-crime incidents occurring around Sunday-open state liquor stores in low-socioeconomic-status neighborhoods. We found no evidence of the displacement of crime to nearby areas. CONCLUSIONS: This is the first triple-difference alcohol study that attempts to isolate the micro-spatial effects of a shift in alcohol availability on local crime patterns, and shows that the repeal of Sunday alcohol-sales restrictions may increase crime in poor urban areas.

Environmental behaviour of iron and steel slags in coastal settings.

Iron and steel slags have a long history of both disposal and beneficial use in the coastal zone. Despite the large volumes of slag deposited, comprehensive assessments of potential risks associated with metal(loid) leaching from iron and steel by-products are rare for coastal systems. This study provides a national-scale overview of the 14 known slag deposits in the coastal environment of Great Britain (those within 100 m of the mean high-water mark), comprising geochemical characterisation and leaching test data (using both low and high ionic strength waters) to assess potential leaching risks. The seaward facing length of slag deposits totalled at least 76 km, and are predominantly composed of blast furnace (iron-making) slags from the early to mid-20th Century. Some of these form tidal barriers and formal coastal defence structures, but larger deposits are associated with historical coastal disposal in many former areas of iron and steel production, notably the Cumbrian coast of England. Slag deposits are dominated by melilite phases (e.g. gehlenite), with evidence of secondary mineral formation (e.g. gypsum, calcite) indicative of weathering. Leaching tests typically show lower element (e.g. Ba, V, Cr, Fe) release under seawater leaching scenarios compared to deionised water, largely ascribable to the pH buffering provided by the former. Only Mn and Mo showed elevated leaching concentrations in seawater treatments, though at modest levels (<3 mg/L and 0.01 mg/L, respectively). No significant leaching of potentially ecotoxic elements such as Cr and V (mean leachate concentrations <0.006 mg/L for both) were apparent in seawater, which micro-X-Ray Absorption Near Edge Structure (µXANES) analysis show are both present in slags in low valence (and low toxicity) forms. Although there may be physical hazards posed by extensive erosion of deposits in high-energy coastlines, the data suggest seawater leaching of coastal iron and steel slags in the UK is likely to pose minimal environmental risk.

Disparities in criminal court referrals to drug treatment and prison for minority men.

OBJECTIVES: We investigated the extent to which racial/ethnic disparities in prison and diversion to drug treatment were explained by current arrest and criminal history characteristics among drug-involved offenders, and whether those disparities decreased after California's Proposition 36, which mandated first- and second-time nonviolent drug offenders drug treatment instead of prison. METHODS: We analyzed administrative data on approximately 170,000 drug-involved arrests in California between 1995 and 2005. We examined odds ratios from logistic regressions for prison and diversion across racial/ethnic groups before and after Proposition 36. RESULTS: We found significant disparities in prison and diversion for Blacks and Hispanics relative to Whites. These disparities decreased after controlling for current arrest and criminal history characteristics for Blacks. Proposition 36 was also associated with a reduction in disparities, but more so for Hispanics than Blacks. CONCLUSIONS: Disparities in prison and diversion to drug treatment among drug-involved offenders affect hundreds of thousands of citizens and might reinforce imbalances in criminal justice and health outcomes. Our study indicated that standardized criminal justice policies that improved access to drug treatment might contribute to alleviating some share of these disparities.

Effect of Abandoned Housing Interventions on Gun Violence, Perceptions of Safety, and Substance Use in Black Neighborhoods: A Citywide Cluster Randomized Trial.

Importance: Structural racism has resulted in long-standing disinvestment and dilapidated environmental conditions in Black neighborhoods. Abandoned houses signal neglect and foster stress and fear for residents, weakening social ties and potentially contributing to poor health and safety. Objective: To determine whether abandoned house remediation reduces gun violence and substance-related outcomes and increases perceptions of safety and use of outdoor space. Design, Setting, and Participants: This cluster randomized trial was conducted from January 2017 to August 2020, with interventions occurring between August 2018 and March 2019. The study included abandoned houses across Philadelphia, Pennsylvania, and surveys completed by participants living nearby preintervention and postintervention. Data analysis was performed from March 2021 to September 2022. Interventions: The study consisted of 3 arms: (1) full remediation (installing working windows and doors, cleaning trash, weeding); (2) trash cleanup and weeding only; and (3) a no-intervention control. Main Outcomes and Measures: Difference-in-differences mixed-effects regression models were used to estimate the effect of the interventions on multiple primary outcomes: gun violence (weapons violations, gun assaults, and shootings), illegal substance trafficking and use, public drunkenness, and perceptions of safety and time outside for nearby residents. Results: A master list of 3265 abandoned houses was randomly sorted. From the top of this randomly sorted list, a total of 63 clusters containing 258 abandoned houses were formed and then randomly allocated to 3 study arms. Of the 301 participants interviewed during the preintervention period, 172 (57.1%) were interviewed during the postintervention period and were included in this analysis; participants were predominantly Black, and most were employed. Study neighborhoods were predominantly Black with high percentages of low-income households. Gun violence outcomes increased in all study arms, but increased the least in the full remediation arm. The full housing remediation arm, compared with the control condition, showed reduced weapons violations by -8.43% (95% CI, -14.68% to -1.19%), reduced gun assaults by -13.12% (95% CI, -21.32% to -3.01%), and reduced shootings by a nonsignificant -6.96% (95% CI, -15.32% to 3.03%). The trash cleanup arm was not associated with a significant differential change in any gun violence outcome. Instances of illegal substance trafficking and use and public drunkenness outcomes were not significantly affected by the housing remediation or trash cleanup treatment. Perceptions of neighborhood safety and time spent outside were unaffected by the intervention. The study arms did differ in a baseline characteristic and some preintervention trends, which raises questions regarding other potential nonmeasured differences between study arms that could have influenced estimates. No evidence of displacement of gun violence outcomes was found. Conclusions and Relevance: In this cluster randomized controlled trial among low-income, predominantly Black neighborhoods, inexpensive, straightforward abandoned housing remediation was directly linked to significant relative reductions in weapons violations and gun assaults, and suggestive reductions in shootings. Trial Registration: isrctn.org Identifier: ISRCTN14973997.

Urban landscapes and legacy industry provide hotspots for riverine greenhouse gases: A source-to-sea study of the River Clyde.

There is growing global concern that greenhouse gas (GHG) emissions from water bodies are increasing because of interactions between nutrient levels and climate warming. This paper investigates key land-cover, seasonal and hydrological controls of GHGs by comparison of the semi-natural, agricultural and urban environments in a detailed source-to-sea study of the River Clyde, Scotland. Riverine GHG concentrations were consistently oversaturated with respect to the atmosphere. High riverine concentrations of methane (CH4) were primarily associated with point source inflows from urban wastewater treatment, abandoned coal mines and lakes, with CH4-C concentrations between 0.1 - 44 µg l-1. Concentrations of carbon dioxide (CO2) and nitrous oxide (N2O) were mainly driven by nitrogen concentrations, dominated by diffuse agricultural inputs in the upper catchment and supplemented by point source inputs from urban wastewater in the lower urban catchment, with CO2-C concentrations between 0.1 - 2.6 mg l-1 and N2O-N concentrations between 0.3 - 3.4 µg l-1. A significant and disproportionate increase in all GHGs occurred in the lower urban riverine environment in the summer, compared to the semi-natural environment, where GHG concentrations were higher in winter. This increase and change in GHG seasonal patterns points to anthropogenic impacts on microbial communities. The loss of total dissolved carbon, to the estuary is approximately 48.4 ± 3.6 Gg C yr-1, with the annual inorganic carbon export approximately double that of organic carbon and four times that of CO2, with CH4 accounting for 0.03%, with the anthropogenic impact of disused coal mines accelerating DIC loss. The annual loss of total dissolved nitrogen to the estuary is approximately 4.03 ± 0.38 Gg N yr-1 of which N2O represents 0.06%. This study improves our understanding of riverine GHG generation and dynamics which can contribute to our knowledge of their release to the atmosphere. It identifies where action could support reductions in aquatic GHG generation and emission.

Microstructural analysis of slag properties associated with calcite precipitation due to passive CO2 mineralization.

CO2 mineralization in slag has gained significant attention since it occurs with minimal human intervention and energy input. While the amount of theoretical CO2 that can be captured within slag has been quantified based on slag composition in several studies, the microstructural and mineralogical effects of slag on its ability to capture CO2 have not been fully addressed. In this work, the CO2 uptake within legacy slag samples is analyzed through microstructural characterization. Slag samples were collected from the former Ravenscraig steelmaking site in Lanarkshire, Scotland. The collected samples were studied using X-ray Computed Tomography (XCT) to understand the distribution and geometry of pore space, as well as with scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS) to visualize the distribution of elements within the studied samples. Electron backscatter diffraction (EBSD) was used to study the minerals distribution. The samples were also characterized through X-ray diffraction (XRD) and X-ray fluorescence (XRF), and the amount of captured CO2 was quantified using thermogravimetric analysis (TGA). Our results demonstrate that CO2 uptake occurs to the extent of ∼9-30 g CO2/ kg slag. The studied samples are porous in nature, with pore space occupying up to ∼30% of their volumes, and they are dominated by åkermanite-gehlenite minerals which interact with the atmospheric CO2 slowly at ambient conditions. EDS and EBSD results illustrate that the precipitated carbonate in slag is calcite, and that the precipitation of calcite is accompanied by the formation of a Si-O-rich layer. The provided analysis concludes that the porous microstructure as well as the minerals distribution in slag should be considered in forecasting and designing large-scale solutions for passive CO2 mineralization in slag.

Accuracy and precision of compounded ciclosporin capsules and solution.

BACKGROUND: The prescribing of compounded products that mimic US Federal Drug Administration approved drugs in the USA is inappropriate. Among the reasons are the lack of premarket regulatory assessment and the potential for an inferior product. This study describes the accuracy and precision of ciclosporin (CsA) strength when compounded as capsules (10 and 300 mg) and solutions (50 and 150 mg/mL). METHODS: Preparation choices reflected current prescribing practices. Each was acquired by prescription from five pharmacies at three different times, 14-45 days apart. Atopica(®) (10 and 100 mg; Novartis, Greensboro, NC, USA) and three human generics (50 and 100 mg capsules and 100 mg/mL solution) were positive controls. Physical characteristics were assessed. Accuracy (percentage predicted) was based on CsA strength measured by high-performance liquid chromatography and precision was based on replications (n = 3) from each pharmacy. RESULTS: Accuracy of positive controls ranged from 92 to 103%. For compounded solutions, physical characteristics differed markedly between but not within pharmacies. Capsule accuracy was 10 ± 0.98 mg (101%) for 10 mg and 290 ± 9.6 mg (97%) for 300 mg; and solution accuracy was 45 ± 9.9 mg/mL (90%) for 50 mg/mL and 127 ± 18 mg/mL (85%) for 150 mg/mL. The precision for 50 mg/mL oral solution was 0.67-11%, and for 150 mg/mL, 3.7-14%. Accuracy for all preparations varied, with the least accurate deviating by 34% from labelled strength. Precision for all capsules ranged from 0.6 to 8.7%. CONCLUSIONS AND CLINICAL IMPORTANCE: Compounded CsA solutions may deviate by more than 10% from the labelled strength. Bioavailability and clinical efficacy of compounded CsA remain unknown, and such products should be prescribed only in appropriate circumstances.

The utilization of alkaline wastes in passive carbon capture and sequestration: Promises, challenges and environmental aspects.

Alkaline wastes have been the focus of many studies as they act as CO2 sinks and have the potential to offset emissions from mining and steelmaking industries. Passive carbonation of alkaline wastes mimics natural silicate weathering and provides a promising alternative pathway for CO2 capture and storage as carbonates, requiring marginal human intervention when compared to ex-situ carbonation. This review summarizes the extant research that has investigated the passive carbonation of alkaline wastes, namely ironmaking and steelmaking slag, mine tailings and demolition wastes, over the past two decades. Here we report different factors that affect passive carbonation to address challenges that this process faces and to identify possible solutions. We identify avenues for future research such as investigating how passive carbonation affects the surrounding environment through interaction with the biosphere and the hydrosphere. Future research should also consider economic analyses to provide investors with an in-depth understanding of passive carbonation techniques. Based on the reviewed materials, we conclude that passive carbonation can be an important contributor to climate change mitigation strategies, and its potential can be intensified by applying simple waste management practices.

Advancing health equity through integrated biology and population health research: A community-based sample cortisol feasibility and exploratory study.

Background: Community-based research inclusive of self-assessment and objective environmental metrics can be enhanced by the collection of biomarker data in unity toward assessing the health impacts of the totality of environmental stress driven by structural racism. Cortisol dynamic range (CDR), a measure of chronic stress burden, may underpin place-based connections to health, but a gap remains in elucidating community-based CDR methodology. Purpose: To 1) assess the feasibility of cortisol collection and CDR measurement in a community-based study with home-based, participant-directed specimen collection, and 2) explore the association between CDR and other individual and environmental measures in a sample of predominantly Black participants. Methods: In this cross-sectional, observational study in predominantly Black urban neighborhoods, participants (n = 73) completed health assessments and in-home, self-collected salivary cortisol. For feasibility, CDR (peak-nadir) was compared to cortisol awakening response (CAR) slope over time. Comparisons of CDR quartile by person and place variables were explored (ANOVA). Results: The cohort (77% Black, 39.7% <$15 k/year income, high perceived stress) completed 98.6% of cortisol collection timepoints. CDR was calculated in all participants without interruptions to sleep-wake cycle as seen with CAR collection. Participants in the lowest quartile of CDR were the oldest (p = 0.03) with lowest reported mental health (p = 0.048) with no associations seen for CAR. Conclusion: Participant-collected CDR is more feasible than cortisol measures dependent on slopes over time in a community-based, predominately Black cohort with exploratory findings supporting relevance to outcomes of interest to future work. Future community-based studies should integrate CDR with environment and psychosocial measures.

A difference-in-differences analysis of health, safety, and greening vacant urban space.

Greening of vacant urban land may affect health and safety. The authors conducted a decade-long difference-in-differences analysis of the impact of a vacant lot greening program in Philadelphia, Pennsylvania, on health and safety outcomes. "Before" and "after" outcome differences among treated vacant lots were compared with matched groups of control vacant lots that were eligible but did not receive treatment. Control lots from 2 eligibility pools were randomly selected and matched to treated lots at a 3:1 ratio by city section. Random-effects regression models were fitted, along with alternative models and robustness checks. Across 4 sections of Philadelphia, 4,436 vacant lots totaling over 7.8 million square feet (about 725,000 m(2)) were greened from 1999 to 2008. Regression-adjusted estimates showed that vacant lot greening was associated with consistent reductions in gun assaults across all 4 sections of the city (P < 0.001) and consistent reductions in vandalism in 1 section of the city (P < 0.001). Regression-adjusted estimates also showed that vacant lot greening was associated with residents' reporting less stress and more exercise in select sections of the city (P < 0.01). Once greened, vacant lots may reduce certain crimes and promote some aspects of health. Limitations of the current study are discussed. Community-based trials are warranted to further test these findings.

The effect of less-lethal weapons on injuries in police use-of-force events.

OBJECTIVES: We investigated the effect of the use of less-lethal weapons, conductive energy devices (CEDs), and oleoresin capsicum (OC) spray on the prevalence and incidence of injuries to police officers and civilians in encounters involving the use of force. METHODS: We analyzed data from 12 police departments that documented injuries to officers and civilians in 24,380 cases. We examined monthly injury rates for 2 police departments before and after their adoption of CEDs. RESULTS: Odds of injury to civilians and officers were significantly lower when police used CED weapons, after control for differences in case attributes and departmental policies restricting use of these weapons. Monthly incidence of injury in 2 police departments declined significantly, by 25% to 62%, after adoption of CED devices. CONCLUSIONS: Injuries sustained during police use-of-force events affect thousands of police officers and civilians in the United States each year. Incidence of these injuries can be reduced dramatically when law enforcement agencies responsibly employ less-lethal weapons in lieu of physical force.