Objectives. Incidental findings on computed tomography (CT) scans are common. We sought to examine rates of findings and disclosure among discharged patients who received a CT scan in the ED. Methods. Retrospective chart review (Aug-Oct 2009) of 600 patients age 18 and older discharged home from an urban Level 1 trauma center. CT reports were used to identify incidental findings and discharge paperwork was used to determine whether the patient was informed of these findings. Results. There were 682 CT scans among 600 patients: 199 Abdomen & Pelvis, 405 Head, and 78 Thorax. A total of 348 incidental findings were documented in 228/682 (33.4%) of the scans, of which 34 (9.8%) were reported to patients in discharge paperwork. Patients with 1 incidental finding were less likely to receive disclosure than patients with 2 or more (P = .010). Patients age <60 were less likely to have incidental findings (P < .001). There was no significant disclosure or incidental finding difference by gender. Conclusions. While previous research suggests that CT incidental findings are often benign, reporting to patients is recommended but this is rarely happening.

Traditional biomass stoves are a major global contributor to emissions that impact climate change and health. This paper reports emission factors of particulate matter (PM 2.5 ), carbon monoxide (CO), organic carbon (OC), black carbon (EC), optical absorption, and scattering from 46 South Asian, 48 Tibetan, and 4 Ugandan stoves. These measurements plus a literature review provide insight into the robustness of emission factors used in emission inventories. Tibetan dung stoves produced high average PM 2.5 emission factors (23 and 43 gkg −1 for chimney and open stoves) with low average EC (0.3 and 0.7 gkg −1 , respectively). Comparatively, PM 2.5 from South Asian stoves (7 gkg −1 ) was in the range of previous measurements and near values used in inventories. EC emission factors varied between stoves and fuels (p < 0.001), without corresponding differences in absorption; stoves that produced little EC, produced enough brown carbon to have about the same absorption as stoves with high EC emissions. In Tibetan dung stoves, for example, OC contributed over 20% of the absorption. Overall, EC emission factors were not correlated with PM 2.5 and were constrained to low values, relative to PM 2.5 , over a wide range of combustion conditions. The average measured EC emission factor (1 gkg −1 ), was near current inventory estimates.

IntroductionWe present a novel airway simulation tool that recreates the dynamic challenges associated with emergency airways. The Suction-Assisted Laryngoscopy Assisted Decontamination (SALAD) simulation system trains providers to use suction to manage emesis and bleeding complicating intubation.MethodsWe modified a standard difficult-airway mannequin head (Nasco, Ft. Atkinson, WI) with hardware-store equipment to enable simulation of vomiting or hemorrhage during intubation. A pre- and post-survey was used to assess the effectiveness of the SALAD simulator. We used a 1–5 Likert scale to assess confidence in managing the airway of a vomiting patient and comfort with suction techniques before and after the training exercise.ResultsForty learners participated in the simulation, including emergency physicians, anesthesiologists, paramedics, respiratory therapists, and registered nurses. The average Likert score of confidence in managing the airway of a vomiting or hemorrhaging patient pre-session was 3.10±0.49, and post-session 4.13±0.22. The average score of self-perceived skill with suction techniques in the airway scenario pre-session was 3.30±0.43, and post-session 4.03±0.26. The average score for usefulness of the session was 4.68±0.15, and the score for realism of the simulator was 4.65±0.17.ConclusionA training session with the SALAD simulator improved trainee’s confidence in managing the airway of a vomiting or hemorrhaging patient. The SALAD simulation system recreates the dynamic challenges associated with emergency airways and holds promise as an airway training tool.

New substances destined for import into, or manufacture in, Canada must be reported to Environment Canada and Health Canada under the New Substances Notification Regulations (Chemicals and Polymers) (NSNR). With the use of information provided by the notifier, and other complementary information available to the 2 departments, the New Substances Program conducts ecological and human health risk assessments. Over the past 10 y, more than 750 ecotoxicity studies have been submitted to the New Substances Program of Environment Canada under the NSNR. Most of these experimental studies are not publicly available but are useful in the ecological risk assessment of new substances and for the development of Quantitative Structure-Activity Relationships (QSARs). In this paper, we describe the development and validation of a computer-based scoring system and our approach in the development of scoring methods used to assess the quality and usability of ecotoxicity studies with fish, Daphnia spp., and green algae. Results of ranking exercises conducted with these methods are described and discussed, together with the potential use of these results in a regulatory context. In addition, the methods are discussed in comparison with other similar evaluation schemes described in the literature.

Emission factors of carbon monoxide (CO), particulate matter (PM 2.5 ), organic carbon (OC), and elemental carbon (EC), as well as combustion efficiency and particle optical properties were measured during 37 uncontrolled cooking tests of residential stoves in Yunnan Province, China. Fuel mixtures included coal, woody biomass, and agricultural waste. Compared to previously published emission measurements of similar stoves, these measurements have higher CO and PM 2.5 emission factors. Real-time data show two distinct burn phases: a devolatilization phase after fuel addition with high PM 2.5 emissions and a solid-fuel combustion phase with low PM 2.5 emissions. The average emission factors depend on the relative contributions of these phases, which are affected by the services provided by the stoves. Differences in stove and fuel characteristics that are not represented in emission inventories affect the variability of emission factors much more than do the type of solid fuel or stove. In developing inventories with highly variable sources such as residential solid-fuel combustion, we suggest that (1) all fuels should be accounted for, not just the primary fuel; (2) the household service provided should be emphasized rather than specific combinations of solid fuels and devices; and (3) the devolatilization phase should be explicitly measured and represented.