Tapped Out: Threats to the Human Right to Water in the Urban United States

In the United States today, the goal of universal water service is slipping out of reach. Water costs are rising across the country, forcing many individuals to forgo running water or sanitation, or to sacrifice other essential human rights. The fixed costs of water systems have increased in recent years, driven in part by underinvestment in infrastructure. In many cities, this has been exacerbated by population shifts and the economic downturn. In this era of increasing costs and limited financial resources, water providers struggle to balance the competing priorities of modernization and universal access. This report, researched and written by students of Georgetown Law’s Human Rights Institute in the winter of 2013, details the causes, effects, and solutions to the affordability crisis affecting water in the urban United States

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes

Differential Th1/Th2 balance in peripheral blood lymphocytes from patients suffering from flea bite-induced papular urticaria

Q4Q2Artículo original7-10Background: The Th1/Th2 balance has not been characterized in patients suffering from flea bite-induced papular urticaria (FBPU). Our aim was to improve understanding of the immunopathogenesis of CD4+ and CD8+ T-cells in humans suffering from flea bite-induced papular urticaria. Methods: Peripheral blood mononuclear cells were obtained from 18 pediatric patients and 10 age-matched healthy controls. Cellular phenotypes, intracellular production of interferon gamma (IFN) and interleukin-4 (IL-4) in T-cells stimulated with polyclonal stimuli was determined by fl ow cytometry following short-term in vitro stimulation. Results: The results revealed lower frequencies of IFN-secreting (p = 0.02) and higher frequencies of IL-4-secreting (p = 0.03) CD4+ T-cells in patient lymphocyte cultures compared to healthy control cultures in the presence of polyclonal stimuli. This is the first description of differential cytokine patterns in papular urticaria patients. Conclusion: Patients suffering from papular urticaria have an atopic status compared to healthy children

Specific pattern of flea antigen recognition by IgG subclass and IgE during the progression of papular urticaria caused by flea bite

Q4Q2Artículo original197-202Background: Papular urticaria caused by flea bite presents clinical symptoms of a hypersensitivity reaction accompanied by skin lesions. However, the pattern of recognition by different antibody isotypes during the progression of the disease is unknown. This study evaluated variations in immunoglobulin E and immunoglobulin G subclass antibody responses to flea antigens during the progression of papular urticaria caused by flea bite Methods: Twenty-five patients clinically diagnosed with papular urticaria due to flea bite were included. Ten healthy children were included as controls. Recognition of antigens from complete flea body extract by patients and healthy controls was determined using immunoblot assays. Results: The results revealed that patients with 2–5 years of papular urticaria evidenced more IgE bands than those with shorter or longer durations of symptoms. In contrast, healthy children showed a predominance of immunoglobulin G1 and immunoglobulin G3. The majority of the recognised antigens were low molecular weight proteins (o90 kDa). Proteins with molecular weights between 16–20, 21–25, and 31–35 kDa showed different patterns of recognition between patients and healthy children. Conclusion: The predominant specific antibody isotypes vary according to the time elapsed since the onset of symptoms in papular urticaria caused by flea bite

Assessment of the centre of gravity technique for the solution of the facility location problem

112 Páginas.El principal objetivo de esta tesis es identificar las principales características, fortalezas y debilidades del modelo de centro de gravedad (COG) utilizado para resolver The Facility Location Problem (FLP) y analizar si la agrupación de los consumidores por medio de closterizacion algorítmica, puede mejorar la solución dada por el modelo. Los resultados obtenidos muestran que el modelo COG puede ser usado como guía y no como una herramienta definitiva para la toma de decisiones, ya que debido a su simplicidad tiene fuertes debilidades. También se muestra que al utilizar modelos de closterizacion algorítmica los resultados del modelo pueden ser mejorados considerablemente. Para finalizar se realizan sugerencias para futuras investigaciones del modelo COG

Continuing Education Courses for Orthopedic and Sports Physical Therapists in the United States Often Lack Supporting Evidence: A Review of Available Intervention Courses

Abstract Objective The purpose of this study was to characterize the extent to which orthopedic and sports-related continuing education course descriptions approved for physical therapists in the United States taught interventions supported by evidence. Methods A review was conducted of courses available on CEU Locker from January through December 2020, estimated to represent most courses nationally available to physical therapists. This review focused specifically on courses teaching interventions for musculoskeletal conditions in adults. Specifically, courses for orthopedic and sports populations were identified. All course information was extracted, including the intervention name, course description, and target audience. Finally, clinical practice guidelines (CPGs) and systematic reviews with at least moderate-level evidence published through May 1, 2021, were searched to determine if treatments were recommended or not recommended, or if no evidence existed. Results The review identified 2406 available courses extracted from the database. After excluding courses that did not meet inclusion criteria, duplicates, and those with incomplete or inadequate information, the final number was 319. Most courses (52.7%, n = 168) taught interventions not supported by a CPG or systematic review. Approximately one-third of courses (34.2%, n = 109) taught interventions that were recommended by a CPG. Many courses were targeted to multiple disciplines (38.9%, n = 124), whereas 89 (27.9%) were specifically for physical therapists, physical therapist assistants, or both. The specific target was unclear for 106 (33.2%) courses. Courses usually focused on multiple body regions, and exercise was the most included intervention. Soft-skill courses were the most supported by evidence (82.9%, n = 29), whereas those teaching modalities were the least supported (30.5%, n = 29). Conclusion Fewer than one-half of courses that focused on management of musculoskeletal disorders taught interventions supported by a CPG or systematic review, and course descriptions often misrepresented the current state of evidence. Courses required for licensure renewal might not be meeting the intended goal of keeping clinicians current with new and emerging research. Impact Relatively few continuing education courses on orthopedic and sports-related physical therapist interventions are based on evidence provided by CPGs or systematic reviews, and some continuing education options required for physical therapists to meet annual licensure renewal requirements might not be keeping therapists current with the latest evidence. This study provides data that can facilitate candid dialog within the profession about potential solutions. </jats:sec