scholarly journals Environmental and Patient Impact of Applying a Point-of-Care Ultrasound Model in Primary Care: Rural vs. Urban Centres

2020 ◽  
Vol 17 (9) ◽  
pp. 3333
Author(s):  
Francesc X Marín-Gomez ◽  
Jacobo Mendioroz Peña ◽  
Vicenç Canal Casals ◽  
Marcos Romero Mendez ◽  
Ana Darnés Surroca ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Primary Care ◽  
Air Pollution ◽  
Air Pollutants ◽  
Point Of Care ◽  
Motor Vehicles ◽  
Point Of Care Ultrasound ◽  
Major Contributor ◽  
Specialized Service ◽  
The Impact

Motor vehicles are a major contributor to air pollution, and the exposure to this human-caused air pollution can lead to harmful health effects. This study evaluates the impact of the provision of point-of-care ultrasounds (POCUS) by primary care (PC) to avoid the patient’s need to travel to a specialized service. The study estimates the costs and air pollution avoided during 2019. The results confirm that performing this ultrasound at the point of care reduces the emission of 61.4 gr of carbon monoxide, 14.8 gr of nitric oxide and 2.7 gr of sulfur dioxide on each trip. During the study, an average of 17.8 km, 21.4 min per trip and almost 2000 L of fuel consumed in a year were avoided. Performing POCUS from PC reduces fuel consumption and the emission of air pollutants and also saves time and money. Furthermore, only 0.3% of the scans had to be repeated by radiologists. However, more studies with more participants need to be done to calculate the exact impact that these pollution reductions will have on human health.

scholarly journals Relationship Between Air Pollution and the Concentration of Nitric Oxide in the Exhaled Air (FeNO) in 8–9-Year-Old School Children in Krakow

2021 ◽  
Vol 18 (13) ◽  
pp. 6690
Author(s):  
Marta Czubaj-Kowal ◽  
Ryszard Kurzawa ◽  
Henryk Mazurek ◽  
Michał Sokołowski ◽  
Teresa Friediger ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Air Pollution ◽  
Air Pollutants ◽  
Primary Schools ◽  
Significant Relationships ◽  
Exhaled Air ◽  
Nitric Oxide Concentration ◽  
Positive Correlations ◽  
The Impact ◽  
The Relationship

The consequences of air pollution pose one of the most serious threats to human health, and especially impact children from large agglomerations. The measurement of nitric oxide concentration in exhaled air (FeNO) is a valuable biomarker in detecting and monitoring airway inflammation. However, only a few studies have assessed the relationship between FeNO and the level of air pollution. The study aims to estimate the concentration of FeNO in the population of children aged 8–9 attending the third grade of public primary schools in Krakow, as well as to determine the relationship between FeNO concentration and dust and gaseous air pollutants. The research included 4580 children aged 8–9 years who had two FeNO measurements in the winter–autumn and spring–summer periods. The degree of air pollution was obtained from the Regional Inspectorate of Environmental Protection in Krakow. The concentration of pollutants was obtained from three measurement stations located in different parts of the city. The FeNO results were related to air pollution parameters. The study showed weak but significant relationships between FeNO and air pollution parameters. The most significant positive correlations were found for CO8h (r = 0.1491, p < 0.001), C6H6 (r = 0.1420, p < 0.001), PM10 (r = 0.1054, p < 0.001) and PM2.5 (r = 0.1112, p < 0.001). We suggest that particulate and gaseous air pollutants impact FeNO concentration in children aged 8–9 years. More research is needed to assess the impact of air pollution on FeNO concentration in children. The results of such studies could help to explain the increase in the number of allergic and respiratory diseases seen in children in recent decades.

scholarly journals The role of point-of-care ultrasound in the diagnosis of pericardial effusion: a single academic center retrospective study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Matthew G. Hanson ◽  
Barry Chan
Keyword(s):  
Pericardial Effusion ◽  
Point Of Care ◽  
Physical Exam ◽  
Right Atrial ◽  
Point Of Care Ultrasound ◽  
X Ray ◽  
Average Systolic Blood Pressure ◽  
Time To Diagnosis ◽  
Clinically Significant ◽  
The Impact

Abstract Background Symptomatic pericardial effusion (PCE) presents with non-specific features and are often missed on the initial physical exam, chest X-ray (CXR), and electrocardiogram (ECG). In extreme cases, misdiagnosis can evolve into decompensated cardiac tamponade, a life-threatening obstructive shock. The purpose of this study is to evaluate the impact of point-of-care ultrasound (POCUS) on the diagnosis and therapeutic intervention of clinically significant PCE. Methods In a retrospective chart review, we looked at all patients between 2002 and 2018 at a major Canadian academic hospital who had a pericardiocentesis for clinically significant PCE. We extracted the rate of presenting complaints, physical exam findings, X-ray findings, ECG findings, time-to-diagnosis, and time-to-pericardiocentesis and how these were impacted by POCUS. Results The most common presenting symptom was dyspnea (64%) and the average systolic blood pressure (SBP) was 120 mmHg. 86% of people presenting had an effusion > 1 cm, and 89% were circumferential on departmental echocardiogram (ECHO) with 64% having evidence of right atrial systolic collapse and 58% with early diastolic right ventricular collapse. The average time-to-diagnosis with POCUS was 5.9 h compared to > 12 h with other imaging including departmental ECHO. Those who had the PCE identified by POCUS had an average time-to-pericardiocentesis of 28.1 h compared to > 48 h with other diagnostic modalities. Conclusion POCUS expedites the diagnosis of symptomatic PCE given its non-specific clinical findings which, in turn, may accelerate the time-to-intervention.

scholarly journals The modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rui Zhang ◽  
Yujie Meng ◽  
Hejia Song ◽  
Ran Niu ◽  
Yu Wang ◽  
...  
Keyword(s):  
Air Pollution ◽  
High Temperature ◽  
Air Pollutants ◽  
Meteorological Data ◽  
Effect Of Temperature ◽  
Distributed Lag ◽  
Modification Effect ◽  
Incidence Risk ◽  
The Impact ◽  
The Relationship

Abstract Background Although exposure to air pollution has been linked to many health issues, few studies have quantified the modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China. Methods The data of daily incidence of influenza and the relevant meteorological data and air pollution data in Ningbo from 2014 to 2017 were retrieved. Low, medium and high temperature layers were stratified by the daily mean temperature with 25th and 75th percentiles. The potential modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo was investigated through analyzing the effects of air pollutants stratified by temperature stratum using distributed lag non-linear model (DLNM). Stratified analysis by sex and age were also conducted. Results Overall, a 10 μg/m3 increment of O3, PM2.5, PM10 and NO2 could increase the incidence risk of influenza with the cumulative relative risk of 1.028 (95% CI 1.007, 1.050), 1.061 (95% CI 1.004, 1.122), 1.043 (95% CI 1.003, 1.085), and 1.118 (95% CI 1.028, 1.216), respectively. Male and aged 7–17 years were more sensitive to air pollutants. Through the temperature stratification analysis, we found that temperature could modify the impacts of air pollution on daily incidence of influenza with high temperature exacerbating the impact of air pollutants. At high temperature layer, male and the groups aged 0–6 years and 18–64 years were more sensitive to air pollution. Conclusion Temperature modified the relationship between air pollution and daily incidence of influenza and high temperature would exacerbate the effects of air pollutants in Ningbo.

scholarly journals Relationship between preterm birth and air pollution in Santos, Sao Paulo, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M E L Brandao ◽  
B A L F Braga ◽  
M L C Martins ◽  
P L A A Pereira
Keyword(s):  
Air Pollution ◽  
Preterm Birth ◽  
Air Pollutants ◽  
First Trimester ◽  
Sao Paulo ◽  
São Paulo ◽  
Air Humidity ◽  
Relative Air Humidity ◽  
The Impact ◽  
Fourth Quartile

Abstract Santos is a seaboard Brazilian city recognized by its port activity where the road and rail infrastructure along with the large transportation operation, displays an important factor to contribute with all kinds of toxic and air pollutants. Recent studies have suggested associations between air pollution and various birth outcomes. Pollutant gases such as NOx, O3 and particulate matter PM2,5, PM10 have been cited as factors involved in such outcomes. The present study aims to assess the relationship between atmospheric pollutants and perinatal outcomes in the city of Santos from Jan. 2012 to Dec. 2015. Cross-sectional study that analyzed 10.319 singleton births in an area set with 2 km radius of the monitoring stations. Birth weight and information on mother and pregnancy were obtained at the Brazilian “Born Alive National Information System”. Daily records of air pollutants (PM10, PM2.5, NO2 and O3), temperature and relative air humidity, for the study period, were obtained from São Paulo State Environmental Agency (CETESB). Associations between preterm birth and air pollutants mean levels at each gestational trimester were investigated using multiple logistic regression model controlled by the variables: infant sex, type of delivery, maternal education. prenatal care, and number of previous live births, temperature and relative air humidity. NO2 e PM2,5 was not associated with preterm birth. O3 was significantly associated in the first trimester in the fourth quartile (OR = 1,47 CI 95% 1,05; 2,07). PM10 was significantly associated in the first trimester for the fourth quartile (OR = 1,28 CI 95% 1,00; 1,64), second trimester for the second quartile (OR = 1,37 CI 95% 1,07; 1,77). Conclusions the results shows evidence that maternal exposure to air pollution especially during the first trimester of pregnancy may contribute to preterm birth. Further actions are needed towards controlling air pollution are strongly recommended for promoting early-life health. Key messages This is the first research of this kind that was made in Santos. It brings important evidence of the impact in the life of the population, especially those whose is not even born yet. It can be used as a resource to guide public policies in health, especially the guidelines that dictate the concentration of air pollutants and air quality.

scholarly journals Cause-and-effect relationships between air pollution and health conditions in population

2020 ◽  
Vol 5 (4) ◽  
pp. 230-234
Author(s):  
I. I. Berezin ◽  
Yu. Yu. Eliseev ◽  
A. K. Sergeev
Keyword(s):  
Air Pollution ◽  
Allergic Rhinitis ◽  
Bronchial Asthma ◽  
Respiratory System ◽  
Air Pollutants ◽  
Preventive Measures ◽  
Industrial City ◽  
Cause And Effect ◽  
The Impact

Objectives to reveal cause-and-effect relationships in the system "air pollution morbidity of the population" in a large industrial city. Material and methods.The dynamics of the pollutants concentration, such as formaldehyde and benzopyrene, through the period of 20152017 was analyzed in relation to the indicators of the morbidity of the respiratory system in the population of Samara. In particular, the study focused on the ratio of allergic rhinitis and asthma cases and the concentration of the formaldehyde and benzopyrene. Results.The incidence of respiratory diseases and the general morbidity increased both among children (by 46.7%) and adults (by 11.4%). There was the causal correlation between the effect of benzopyrene on the development of allergic rhinitis and bronchial asthma in children(r = 0.57 and r = 0.76) and in adults (r = 0.45 and r = 0.51) in Samara. The significant differences between the level of the pollutants and the frequency of the respiratory system diseases were registered in children and adults in different areas of Samara. Discussion.As a result of the increase of the maximum allowable concentration (MAC) of formaldehyde in atmospheric air, this pollutant has now ceased to be a priority. The revealed negative correlations point to the absence of an adverse effect of formaldehyde on the development of allergic rhinitis and bronchial asthma in both children and adults in Samara. Conclusion.According to the results of the study, the preventive measures aimed at reducing the impact of main air pollutants on the health of children and adults in Samara were suggested. Their implementation is possible by the immediate informing of the executive authorities to ensure they can make timely management decisions to improve the quality of the environment.

Transboundary air pollution and respiratory disease mortality: evidence from European countries

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jonathan Spiteri ◽  
Philip von Brockdorff
Keyword(s):  
Air Pollution ◽  
Air Pollutants ◽  
Respiratory Diseases ◽  
Mortality Rates ◽  
Content Type ◽  
Transboundary Air Pollution ◽  
Per Capita ◽  
Cross Country ◽  
And Control ◽  
The Impact

PurposeThe aim of this paper is to quantify the impact of transboundary air pollutants, particularly those related to urban traffic, on health outcomes. The importance of focusing on the health implications of transboundary pollution is due to the fact that these emissions originate from another jurisdiction, thus constituting international negative externalities. Thus, by isolating and quantifying the impact of these transboundary air pollutants on domestic health outcomes, the authors can understand more clearly the extent of these externalities, identify their ramifications for health and emphasise the importance of cross-country cooperation in the fight against air pollution.Design/methodology/approachThe authors employ panel data regression analysis to look at the relationship between emissions of transboundary air pollution and mortality rates from various respiratory diseases among a sample of 40 European countries, over the period 2003–2014. In turn, the authors use annual data on transboundary emissions of sulphur oxides (SOx), nitrogen oxides (NOx) and fine particulate matter (PM2.5), together with detailed data on the per capita incidence of various respiratory diseases, including lung cancer, asthma and chronic obstructive pulmonary disease (COPD). The authors consider a number of different regression equation specifications and control for potential confounders like the quality of healthcare and economic prosperity within each country.FindingsThe results show that transboundary emissions of PM2.5 are positively and significantly related to mortality rates from asthma in our sample of countries. Quantitatively, a 10% increase in PM2.5 transboundary emissions per capita from neighbouring countries is associated with a 1.4% increase in the asthma mortality rate within the recipient country or roughly 200 deaths by asthma per year across our sample.Originality/valueThese findings have important policy implications for cross-country cooperation and regulation in the field of pollution abatement and control, particularly since all the countries under consideration form a part of the UN's Convention on Long-Range Transboundary Air Pollution (CLRTAP), a transnational cooperative agreement aimed at curtailing such pollutants on an international level.

Deep Learning-based Framework for Smart Sustainable Cities

2019 ◽  
Vol 15 (4) ◽  
pp. 76-107
Author(s):  
Nagarathna Ravi ◽  
Vimala Rani P ◽  
Rajesh Alias Harinarayan R ◽  
Mercy Shalinie S ◽  
Karthick Seshadri ◽  
...  
Keyword(s):  
Neural Network ◽  
Air Pollution ◽  
Deep Learning ◽  
Air Pollutants ◽  
Human Life ◽  
Deep Belief Network ◽  
Motor Vehicles ◽  
Human Beings ◽  
Long Term Effects ◽  
Belief Network

Pure air is vital for sustaining human life. Air pollution causes long-term effects on people. There is an urgent need for protecting people from its profound effects. In general, people are unaware of the levels to which they are exposed to air pollutants. Vehicles, burning various kinds of waste, and industrial gases are the top three onset agents of air pollution. Of these three top agents, human beings are exposed frequently to the pollutants due to motor vehicles. To aid in protecting people from vehicular air pollutants, this article proposes a framework that utilizes deep learning models. The framework utilizes a deep belief network to predict the levels of air pollutants along the paths people travel and also a comparison with the predictions made by a feed forward neural network and an extreme learning machine. When evaluating the deep belief neural network for the case study undertaken, a deep belief network was able to achieve a higher index of agreement and lower RMSE values.

scholarly journals P025: Checking the pulse in the 21st century: inter-observer reliability of carotid pulse detection by point-of-care ultrasound

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S73-S74
Author(s):  
D. Smith ◽  
J. Chenkin ◽  
R. Simard
Keyword(s):  
Cardiac Arrest ◽  
Healthcare Provider ◽  
Point Of Care ◽  
Rank Test ◽  
Point Of Care Ultrasound ◽  
Current Standard ◽  
Observer Reliability ◽  
Pulse Palpation ◽  
Before And After ◽  
The Impact

Introduction: Detection of a pulse is crucial to decision-making in the care of patients who are in cardiac arrest, however, the current standard of manual pulse palpation is unreliable. An emerging alternative is the use of point-of-care ultrasound (POCUS) for direct assessment of the carotid pulse. The primary objective of this study is to determine the inter-observer reliability for healthcare provider interpretation of the carotid pulse by POCUS in patients who are peri-arrest or in cardiac arrest. Methods: We conducted a web-based survey of healthcare providers. Participants were shown a tutorial demonstrating POCUS detection of the carotid pulse and then asked to interpret 15 carotid pulse ultrasound clips from patients who were peri-arrest or in cardiac arrest. The primary outcome was inter-observer reliability for carotid pulse assessment. Secondary outcomes included inter-observer reliability stratified by healthcare provider role and POCUS experience, mean tutorial duration, mean pulse assessment duration, rate of pulse assessments < 10 seconds, and change in participant confidence before and after the study. Inter-observer reliability was determined by Krippendorff's α. Change in participant confidence was determined by Wilcoxon signed-rank test. Results: 68 participants completed our study, with a response rate of 75% (68/91). There was near perfect inter-observer reliability for pulse assessment amongst all study participants (α=0.874, 95% CI 0.869, 0.879). Senior residents (n = 24) and POCUS experts (n = 6) demonstrated the highest rates of inter-observer reliability, α=0.902 (95% CI 0.888, 0.914) and α=0.925 (95% CI 0.869, 0.972), respectively. All sub-groups had α greater than 0.8. Mean tutorial duration was 31 seconds (SD = 17.5) with maximum duration of 55 seconds. Mean pulse assessment duration was 7.7 seconds (SD = 5.2) with 76% of assessments completed within 10 seconds. Participant confidence before and after the study significantly increased from a median of 2 to a median of 4 on a 5-point Likert-type scale (z = 6.3, p < .001). Conclusion: Interpretation of the carotid pulse by POCUS showed near perfect inter-observer reliability for patients who were peri-arrest or in cardiac arrest. Participants required minimal training and indicated improved POCUS pulse assessment confidence after the study. Further work must be done to determine the impact of POCUS pulse assessment on the resuscitation of patients in cardiac arrest.

scholarly journals Fine-Grained Spatiotemporal Analysis of the Impact of Restricting Factories, Motor Vehicles, and Fireworks on Air Pollution

2020 ◽  
Vol 17 (13) ◽  
pp. 4828
Author(s):  
Mei Yang ◽  
Hong Fan ◽  
Kang Zhao
Keyword(s):  
Air Pollution ◽  
Air Quality ◽  
Spatiotemporal Analysis ◽  
Yangtze River Delta ◽  
Influential Factors ◽  
Motor Vehicles ◽  
Emission Scenarios ◽  
Fine Grained ◽  
The Impact ◽  
Pm2.5 Concentration

Aiming at improving the air quality and protecting public health, policies such as restricting factories, motor vehicles, and fireworks have been widely implemented. However, fine-grained spatiotemporal analysis of these policies’ effectiveness is lacking. This paper collected the hourly meteorological and PM2.5 data for three typical emission scenarios in Hubei, Beijing–Tianjin–Hebei (BTH), and Yangtze River Delta (YRD). Then, this study simulated the PM2.5 concentration under the same meteorological conditions and different emission scenarios based on a reliable hourly spatiotemporal random forest model ( R 2 exceeded 0.84). Finally, we investigated the fine-grained spatiotemporal impact of restricting factories, vehicles, and fireworks on PM2.5 concentrations from the perspective of hours, days, regions, and land uses, excluding meteorological interference. On average, restricting factories and vehicles reduced the PM2.5 concentration at 02:00, 08:00, 14:00, and 20:00 by 18.57, 16.22, 25.00, and 19.07 μ g / m 3 , respectively. Spatially, it had the highest and quickest impact on Hubei, with a 27.05 μ g / m 3 decrease of PM2.5 concentration and 17 day lag to begin to show significant decline. This was followed by YRD, which experienced a 23.52 μ g / m 3 decrease on average and a 23 day lag. BTH was the least susceptible; the PM2.5 concentration decreased by only 8.2 μ g / m 3 . In addition, influenced by intensive human activities, the cultivated, urban, and rural lands experienced a larger decrease in PM2.5 concentration. These empirical results revealed that restricting factories, vehicles, and fireworks is effective in alleviating air pollution and the effect showed significant spatiotemporal heterogeneity. The policymakers should further investigate influential factors of hourly PM2.5 concentrations, combining with local geographical and social environment, and implement more effective and targeted policies to improve local air quality, especially for BTH and the air quality at morning and night.

scholarly journals The Efficiency of Economic Performance, Electricity Consumption, and Environmental Pollutants in Taiwan

2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Wen-jie Zou ◽  
Tai-Yu Lin ◽  
Yung-ho Chiu ◽  
Ting Teng ◽  
Kuei Ying Huang
Keyword(s):  
Air Pollution ◽  
Economic Development ◽  
Air Pollutants ◽  
Electricity Consumption ◽  
Living Environment ◽  
Air Pollutant ◽  
Disposable Income ◽  
Pollutant Emissions ◽  
Motor Vehicles ◽  
Overall Efficiency

Finding the balance between economic development and environmental protection is a major problem for many countries around the world. Air pollution caused by economic growth has caused serious damage to humans’ living environment, and as improving energy and resource efficiencies is the first priority, many countries are targeting to move towards a sustainable environment and economic development. This study uses the modified dynamic SBM (slack-based measure) model to explore the economic efficiency and air pollutants emission efficiency in Taiwan’s counties and cities from 2012 to 2015 by taking labor, motor vehicles, and electricity consumption as inputs and average disposable income as output. Particulate matter (PM2.5), nitrogen oxide emissions (NO2), and sulfur oxide emissions (SO2) are undesirable outputs, whereas factory fixed assets are a carry-over variable, and the results show the following: (1) the regions with the best overall efficiency between 2012 and 2015 include Taipei City, Keelung City, Hsinchu City, Chiayi City, and Taitung County; (2) in counties and cities with poor overall efficiency performance, the average disposable income per household has no significant relationship with air pollutant emissions; (3) in counties and cities where overall efficiency is poor, the average efficiency of each household’s disposable income is small; and (4) except for the five counties and cities with the best overall performance, the three air pollutants in the other fourteen counties and cities are high. Overall, the air pollution of most areas needs improvement.

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