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Communities adjacent to polluting industrial facilities understand and evaluate risk in often ambivalent and contextualized ways, not only balancing economic and environmental concerns but also reflecting cultural practices, social worldviews, and trust relationships. In this case study of the Antwerp petrochemical complex, the largest in Europe, a residents' survey and interviews are used to examine how two middle-class communities coexist with the nearby petrochemical plants. The findings show that citizens in both communities are generally aware of the environmental impact and public health risk but are predominantly accepting of the industry. For both communities, the most important factor explaining acceptance is the perceived socio-economic benefit for the community, while a direct individual benefit in terms of employment does not play a significant role. In one community, risk acceptance is further strengthened by trust in companies' risk management, while in the other community, trust in regulators is more critical. The different results for both communities stress the importance of a socio-cultural perspective on risk and underline the criticality of relationships of trust. The article further discusses the implications of these findings for environmental decision-making, considering the delicate balance and the significant minority of the population who is less accepting. The present study adds to the risk perception literature by providing one of the first quantitative analyses explaining industrial risk acceptance, instead of perception, using the increasingly contested petrochemical industry as an exemplary case. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Over 300,000 patients are hospitalized annually following hip fractures in the USA. Many patients experienced inadequate analgesia. We will review the perioperative effects of the fascia iliaca compartment block (FICB) in hip fracture patients.Recent Findings: FICB by injecting local anesthetics beneath the fascia iliaca results in significant pain relief in hip fractures. Neuropathies and vascular injuries are almost unlikely. Single-shot FICB is faster to place, yet providing about 8 h of analgesia when bupivacaine is used. Continuous FICB provides prolonged titratable analgesia, improved patient satisfaction, and leads to faster hospital discharge. FICB reduces opioid consumption, decreases morbidity and mortality, reduces hospital stay, reduces delirium, and improves satisfaction. FICB should form part of a multimodal analgesic regime, in the context of a multidisciplinary approach to the management of hip fracture patients. More clinical investigations are needed to validate the long-term outcome benefits of FICB in hip fracture patients. [ABSTRACT FROM AUTHOR]

The global petrochemical industry has long been characterized by stable patterns of Western corporate and geographic leadership, but since the early 2000s, the global playing field has changed significantly. China has overtaken the US and Europe as the world's largest petrochemical producer, and other emerging economies have become global petrochemical players. Combining insights from scholarship on global corporate elites, world city networks, and relational economic geography, this article examines patterns in the corporate networks of leading petrochemical corporations. The research is based on a multiscalar corporate network analysis, applying social network analysis to identify board interlocks, joint venture interlocks, and spatial interlocks between corporations. Through analyzing corporate networks across multiple scales, the research reveals patterns of both integration and isolation within the petrochemical industry. Isolation is evident in disconnected regional corporate elite networks, where the established North Atlantic corporate elite is interconnected through board interlocks, while corporate networks in Asia and other emerging economies remain disconnected. However, high levels of integration within the industry are also evident in an interconnected international company system formed through joint venture collaborations and in overlapping subsidiary networks centered on petrochemical hubs around the world. The article argues that the results demonstrate a combination of resilience and change, or path dependence and contingency, in patterns of corporate power and collaboration. Western company networks still form the social and spatial backbone of the industry, but these have been challenged by emerging strategic centers and isolated elite networks in other parts of the world. This article contributes to debates on industrial corporate elites, multiple globalizations, and the multipolar global economy. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis is a mechanical abnormality characterized by chronic joint pain associated with degeneration of the articular cartilage, synovitis, and local inflammation, leading to loss of function and pain. A connection exists between the peripheral nervous system and inflammatory joint degeneration. The process by which inflammation is influenced by the nervous system is known as neuroinflammation. One of the neuropeptides involved in peripheral neuroinflammation is nociceptin, a peptide related to the opioid class of substances. Nociceptin has both pro- and anti-inflammatory effects. Some studies show that nociceptin can be measured in synovial fluid, while other studies have not been able to detect it. The presence of nociceptin in synovial fluid could imply a molecular role for the neuropeptide in the joint, both physiologically as well as pathophysiologically. The goal of this pilot study was to determine whether nociceptin was present in the synovial fluid of osteoarthritic knees. Methods: Patients undergoing primary total knee arthroplasty were enrolled after Institutional Review Board approval was obtained. Synovial fluid was aspirated from patients' operative knee joints and blood samples were obtained. A commercially available enzyme Immunoassay kit was used to test for nociceptin. A linear mixed-effects model was developed to account for the repeated measurements and baseline covariates. Least squares (adjusted) means were derived from the model to compare the sample types and to compare subgroups. Results: Twenty patients were included in this study. Nociceptin was detected in the synovial fluid and plasma of all patients. The mean concentration (± standard deviation) of nociceptin in synovial fluid was 28.7 ± 18.2 pg/ml. The mean concentration of nociceptin in plasma was 45.2 ± 24.3 pg/ml pre-procedure, and 40.1 ± 20.6 pg/ml post-tourniquet deflation. The nociceptin concentration in synovial fluid was significantly lower than the nociceptin concentration in plasma, both pre-procedure and post-tourniquet deflation (p = 0.002 and p = 0.016 respectively). The nociceptin concentration in both plasma and synovial fluid was significantly lower in females versus males (p = 0.012). Conclusion: We demonstrated that nociceptin is present in synovial fluid and plasma of patients undergoing total knee arthroplasty. This implies a potential role for nociceptin in modulating inflammation in osteoarthritis. Trial registration: ClinicalTrials.gov, NCT02528916. Retrospectively registered on August 19, 2015, [ABSTRACT FROM AUTHOR]

Background: The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to 'low' concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study's aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry. Methods: Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis. Results: The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required. Conclusions: The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry. [ABSTRACT FROM AUTHOR]

Background: The petrochemical industry is a major source of hazardous and toxic air pollutants that are recognised to have mutagenic and carcinogenic properties. A wealth of occupational epidemiology literature exists around the petrochemical industry, with adverse haematological effects identified in employees exposed to 'low' concentrations of aromatic hydrocarbons (benzene, toluene, ethylbenzene, and xylene). Releases from the petrochemical industry are also thought to increase the risk of cancer incidence in fenceline communities. However, this emerging and at times inconclusive evidence base remains fragmented. The present study's aim was to conduct a systematic review and meta-analysis of epidemiological studies investigating the association between incidences of haematological malignancy and residential exposure to the petrochemical industry.Methods: Epidemiological studies reporting the risk of haematological malignancies (Leukaemia, Hodgkin's lymphoma, Non-Hodgkin's lymphoma, and Multiple myeloma) were included where the following criteria were met: (i) Cancer incidence is diagnosed by a medical professional and coded in accordance to the International Classification of Diseases; (ii) A clear definition of fenceline communities is provided, indicating the proximity between exposed residents and petrochemical activities; and (iii) Exposure is representative of normal operating conditions, not emergency events. Two investigators independently extracted information on study characteristics and outcomes in accordance with PRISMA and MOOSE guidelines. Relative risks and their 95% confidence intervals were pooled across studies for the four categories of haematological malignancy, using a random effects meta-analysis.Results: The systematic review identified 16 unique studies, which collectively record the incidence of haematological malignancies across 187,585 residents living close to a petrochemical operation. Residents from fenceline communities, less than 5 km from a petrochemical facility (refinery or manufacturer of commercial chemicals), had a 30% higher risk of developing Leukaemia than residents from communities with no petrochemical activity. Meanwhile, the association between exposure and rarer forms of haematological malignancy remains uncertain, with further research required.Conclusions: The risk of developing Leukaemia appears higher in individuals living near a petrochemical facility. This highlights the need for further policy to regulate the release of carcinogens by industry. [ABSTRACT FROM AUTHOR]

A growing empirical evidence base identifies environmental noise exposure as an important health problem. While the health effects depend for a great part on personal noise sensitivity and contextual factors, in environmental policy, generic noise standards and procedures based on objective sound levels are used. In this article, the relation between objective and subjective noise exposure variables is further explored by carrying out a residents’ survey in a highly noise polluted area along two highways south of the city centre of Ghent, Belgium. The survey results show only a weak correlation between objective and subjective exposure variables, with both variables demonstrating different associations with the respondents’ background characteristics. While lower-educated and lower-income people are generally higher exposed according to the models, they do not report a higher subjective exposure. People who have been living longer in the area are not necessarily higher exposed according to the models but do report a higher subjective exposure. Most strikingly, owners of a comfortable detached house report a higher subjective exposure than renters of an apartment or small house, while the latter group is significantly higher exposed according to the models. The results support a plea for the joint evaluation of both objective and subjective noise exposure variables in environmental policy and environmental assessments. In addition, the results argue for specific attention for noise exposure of socio-economically vulnerable people and the establishment of a shared knowledge base on noise exposure with both objective and subjective information. [ABSTRACT FROM PUBLISHER]

Intraoperative thromboembolism is a well-documented complication associated with orthotopic liver transplantation (OLT) but its identification and intraoperative treatment are still an emerging topic in anesthesia. Intracardiac thrombus during OLT is associated with a high mortality rate. There are only a few reports describing the successful management of thromboembolism during OLT. We describe a case where routine intraoperative transesophageal echocardiography during a live donor liver transplantation enabled early detection of an intracardiac thrombus with subsequent successful heparin treatment. Our case suggests that if an intracardiac thrombus is identified early (before hemodynamic instability occurs), the use of IV heparin may be a safe therapeutic option. [ABSTRACT FROM AUTHOR]

While public health and urban planning were closely linked in the past, today both domains are institutionally separate. In most cases, health intersects with spatial planning processes only through obligatory evaluations, such as environmental impact assessments, or restrictive environmental legislation. This institutionalisation of health criteria in most western countries has difficulty in dealing with recent environmental health challenges, leading to continual distrust and conflict between citizens and the government. This impasse has recently been discussed by academics who acknowledge the complexity of both city and health issues. It seems, however, that the full extent of the issue has not been covered yet, leading to recommendations and frameworks that are useful but fixed and retrospective. This paper moves beyond those fixed frameworks to develop a better understanding of the complexity of the current disconnect and explores ideas for a future planning approach, grounded on new ideas of co-evolutionary and adaptive planning. [ABSTRACT FROM AUTHOR]