Shale gas development impacts on surface water quality in Pennsylvania

Concern has been raised in the scientific literature about the environmental implications of extracting natural gas from deep shale formations, and published studies suggest that shale gas development may affect local groundwater quality. The potential for surface water quality degradation has been discussed in prior work, although no empirical analysis of this issue has been published. The potential for large-scale surface water quality degradation has affected regulatory approaches to shale gas development in some US states, despite the dearth of evidence. This paper conducts a large-scale examination of the extent to which shale gas development activities affect surface water quality. Focusing on the Marcellus Shale in Pennsylvania, we estimate the effect of shale gas wells and the release of treated shale gas waste by permitted treatment facilities on observed downstream concentrations of chloride (Cl⁻) and total suspended solids (TSS), controlling for other factors. Results suggest that (i) the treatment of shale gas waste by treatment plants in a watershed raises downstream Cl⁻ concentrations but not TSS concentrations, and (ii) the presence of shale gas wells in a watershed raises downstream TSS concentrations but not Cl⁻ concentrations. These results can inform future voluntary measures taken by shale gas operators and policy approaches taken by regulators to protect surface water quality as the scale of this economically important activity increases.     

New era of personalized medicine: Advanced therapy medicinal products in Europe

Advanced therapy medicinal products are human medical therapies based on genes, cells, or tissues, and due to their characteristics, they offer new innovative opportunities for the treatment of diseases and injuries, especially for diseases beyond the reach of traditional approaches. These therapies are at the forefront of innovation and have historically been very controversial, although in the last decade they have gained prominence while the number of new advanced therapies has increased every year. In this regard, despite the controversy they may generate, they are expected to dominate the market in the coming decades. Technologies based on advanced therapies are the present and future of medicine and bring us closer to the long-awaited precision medicine. Here we review the field as it stands today, with a focus on the molecular mechanisms that guided the different advanced therapies approved by the European Medicines Agency, their current status, and their legal approval.     

Capabilities Approach: Contextualizing Participants’ Perspectives on Systems Barriers to Recovery

Mental health resources are designed to facilitate recovery for adults with psychiatric disabilities. Two participants of an autovideography intervention described systems barriers to recovery. Researchers employed narrative analysis, guided by the capabilities approach, to evaluate how participants storied their experiences. Participants made meaning from encounters with barriers in ways that oppose the spirit and advancement of recovery while engendering adaptive preferences. Findings indicate that inadequate resources attenuate wellbeing by increasing barriers that actively oppose recovery, and positive reframing of unaccommodating environments reinforces adaptive preferences and incapacity. Adequate resources are essential for successful recovery transformation within the mental health system.     

Analysis of quantitative and qualitative measures of attachment in patients with fibromyalgia: The influence on nursing care

Attachment has been associated to fibromyalgia; however, this relationship has not been studied from the perspective of nursing care. In this study, in which 146 women with fibromyalgia participated, higher scores for anxiety and depression were found among those with fearful attachment. Additionally, attachment, as a quantitative measure, has also been associated to the functional limitation of the patients. Therefore, we propose the inclusion of attachment in the care of patients with fibromyalgia.     

A case of canine chimerism diagnosed using coat color tests

Through the use of PCR based coat color tests, we were able to diagnose a dog that exhibits an unusual coat color phenotype as an XX/XX chimera. Coat color alleles vary widely among dog breeds, presenting a novel method for detecting chimerism using diagnostic tests for known coat color alleles.     

Statistician expert witnesses in agreement on relative hazards

'If anticoagulants had been administered sooner, my client would not have died' was a central claim put to us, as statistician expert witnesses, by a Claimant's and Defendant's lawyers. To assist other litigants, and without identifying the specific case, we set out the study types that contribute to the evidence base, and their limitations. We then explain why it is difficult to adduce evidence about the relative risk of dying from pulmonary embolism within 12 hours of admission to accident and emergency even when it is well accepted that anticoagulation reduces the risk of dying within the next seven days of patients at objectively confirmed risk of pulmonary embolism. No matter how much we may want an answer, or how tragic an individual outcome, we can only work from the available evidence or work to improve the evidence base, which needs to be resourced.