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Embodied carbon constitutes a significant portion of a building's greenhouse gas (GHG) emissions and is a key challenge for the construction and real estate sectors. Embodied carbon includes construction product manufacturing, building construction, material replacement and end of life. During the specification and procurement stage, designers and contractors have the opportunity to prioritize products with lower carbon footprints. Environmental product declarations (EPDs) are a growing source of environmental data in the construction products market, and are increasingly being used for (1) environmental performance assessment of buildings and (2) product comparison for procurement decisions during the later stages of building design. An obstacle to identifying and purchasing lower embodied carbon products is a lack of data quality and the transparency of EPDs. However, EPDs vary widely in their data quality and specificity, which can lead to inaccurate and misleading comparisons. A new method is presented to account quantitatively for estimates of variation in underlying data specificity in EPDs to enable fairer comparisons between EPDs and to motivate the reporting of actual variability and uncertainty in EPDs. The application of this approach can help purchasers to assess EPDs quantitatively. Practice relevance Life-cycle assessments (LCAs) and LCA data can be used within the construction sector to evaluate buildings and to assist in design, specification and procurement decision-making. A new method is presented to support the assessment of comparability of functionally equivalent materials and products during the specification and procurement stage. Given the known variation and lack of precision within EPDs, this method provides quantitative metrics that correlate to a qualitative interpretation of EPD precision. This method can be used by anyone who is using EPD data to make product comparisons at the specification and procurement stage: • It provides more confidence in choosing low-carbon material or product options when comparing between functionally equivalent options. • It can incentivize product manufacturers and LCA practitioners to improve data quality and transparently report known variation in their EPDs. • It may also motivate manufacturers to reduce GHGs from their products and processes.

ABSTRACTBackground: Prior assessments of public health readiness had identified gaps in radiation preparedness. In recent years, preparedness planning has involved an “all-hazards” approach. Current assessment of the national status related to radiation public health emergency preparedness capabilities at the state and local health department levels was needed.Methods: A survey of state health departments related to radiation readiness was undertaken in 2010 by the Council of State and Territorial Epidemiologists (CSTE). States with nuclear power plants were instructed to consider their responses exclusive of capabilities and resources related to the plants given that the emergency response plans for nuclear power plants are specific and unique.Results: Thirty-eight (76%) state health departments responded to the survey, including 26 of the 31 states with nuclear power plants. Specific strengths noted at the state level included that the majority of states had a written radiation response plan and most plans include a detailed section for communications issues during a radiation emergency. In addition, more than half of the states indicated that their relationship with federal partners is sufficient to provide resources for radiation emergencies, indicating the importance states placed on federal resources and expertise. Specific weaknesses are discussed and include that most states had completed little to no planning for public health surveillance to assess potential human health impacts of a radiation event; less than half had written plans to address exposure assessment, environmental sampling, human specimen collection and analysis, and human health assessment. Few reported having sufficient resources to do public health surveillance, radiation exposure assessment, laboratory functions and other capabilities.Discussion: Levels of planning, resources and partnerships varied among states, those with nuclear power plants were better prepared. Gaps were evident in all states; however and additional training and resources are needed to ensure adequate levels of preparedness.Conclusion: Overall results of this assessment indicate that in most measures of public health capacity and capability, states are poorly prepared to adequately respond to a major radiation emergency event. Specific recommendations are noted in the discussion.(Disaster Med Public Health Preparedness. 2011;5:S134-S142)

High-grade, triple-negative breast cancers and multiple-insertion, non-coaxial biopsies may be risk factors for NS. NS should be suspected on the basis of the superficial and linear pattern of disease progression in these patients.

• Percutaneous image-guided breast core needle biopsy (CNB) is the standard of care. • Breast CNB with 14-gauge, 16-gauge and 18-gauge needles has similar diagnostic accuracy. • Smaller gauge needles can be confidently used for ultrasound-guided breast CNB.

This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Declaration of InterestsWe wish to draw the attention of the Editor to the following facts which may be considered as potential conflicts of interest and to significant financial contributions to this work. Rosalind P. Candelaria, MD -Nothing to disclose. Beatriz E. Adrada, MD -Nothing to disclose. Wei Wei, MS -Nothing to disclose. Lumarie Santiago, MD -Nothing to disclose. Deanna L. Lane, MD -Nothing to disclose. Monica L. Huang, MD -Nothing to disclose. Elsa M. Arribas, MD -Nothing to disclose.