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ObjectivesThe aim of this study was to describe the potential of 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) to identify graft vasculopathy and to investigate the influence of coronary artery bypass graft (CABG) surgery on native coronary artery disease activity and progression.BackgroundAs well as developing graft vasculopathy, CABGs have been proposed to accelerate native coronary atherosclerosis.MethodsPatients with established coronary artery disease underwent baseline 18F-NaF PET, coronary artery calcium scoring, coronary computed tomographic angiography, and 1-year repeat coronary artery calcium scoring. Whole-vessel coronary microcalcification activity (CMA) on 18F-NaF PET and change in calcium scores were quantified in patients with and without CABG surgery.ResultsAmong 293 participants (mean age 65 ± 9 years, 84% men), 48 (16%) underwent CABG surgery 2.7 years [IQR: 1.4-10.4 years] previously. Although all arterial and the majority (120 of 128 [94%]) of vein grafts showed no 18F-NaF uptake, 8 saphenous vein grafts in 7 subjects had detectable CMA. Bypassed native coronary arteries had 3 times higher CMA values (2.1 [IQR: 0.4-7.5] vs 0.6 [IQR: 0-2.7]; P < 0.001) and greater progression of 1-year calcium scores (118 Agatston unit [IQR: 48-194 Agatston unit] vs 69 [IQR: 21-142 Agatston unit]; P = 0.01) compared with patients who had not undergone CABG, an effect confined largely to native coronary plaques proximal to the graft anastomosis. In sensitivity analysis, bypassed native coronary arteries had higher CMA (2.0 [IQR: 0.4-7.5] vs 0.8 [IQR: 0.3-3.2]; P < 0.001) and faster disease progression (24% [IQR: 16%-43%] vs 8% [IQR: 0%-24%]; P = 0.002) than matched patients (n = 48) with comparable burdens of coronary artery disease and cardiovascular comorbidities in the absence of bypass grafting.ConclusionsNative coronary arteries that have been bypassed demonstrate increased disease activity and more rapid disease p

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1988., Includes bibliographical references., by Jennifer Nash., M.C.P.

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1988., Includes bibliographical references., by Jennifer Nash., M.C.P.

This project uses game theory to develop a non-cooperative game with a defender and an intruder. The defender attempts to protect critical information on his system using the available resources efficiently while the intruder seeks to obtain that information without being detected by the defender. This defender will defend using a different combination of only three defensive resources: encryption, distributed data, and fake honeypots. By quantifying each defense, a cost function was developed to analyze the deployment of the defenses. MATLAB is used to optimize a cost function in order to create probability distributions to determine the best possible combination of defenses to use., The original document contains color images.

Regulation is designed to improve the performance of individual andorganizational behavior in ways that reduce social harms, whether by improving industry’s environmental performance, increasing the safety of transportation systems, or reducing workplace risk. Regulators can direct those they govern to improve their performance in at least two basic ways. They can prescribe exactly what actions regulated entities must take to improve their performance. Or they can incorporate the regulation’s goal into the language of the rule, specifying the desired level of performance and allowing the targets of regulation to decide how to achieve that level. This second approach is the subject of this article, which summarizes the discussion at a workshop organized last year by the Regulatory Policy Program at Harvard University. The workshop brought together decisionmakers from a dozen different government agencies as well as leading researchers from the fields of economics, engineering, law, and political science. The dialogue at the workshop, as summarized in this article, builds on the experiences of different regulatory agencies that have used performance-based regulation and clarifies its advantages and disadvantages in addressing health, safety, and environmental problems.

Regulation is designed to improve the performance of individual andorganizational behavior in ways that reduce social harms, whether by improving industry’s environmental performance, increasing the safety of transportation systems, or reducing workplace risk. Regulators can direct those they govern to improve their performance in at least two basic ways. They can prescribe exactly what actions regulated entities must take to improve their performance. Or they can incorporate the regulation’s goal into the language of the rule, specifying the desired level of performance and allowing the targets of regulation to decide how to achieve that level. This second approach is the subject of this article, which summarizes the discussion at a workshop organized last year by the Regulatory Policy Program at Harvard University. The workshop brought together decisionmakers from a dozen different government agencies as well as leading researchers from the fields of economics, engineering, law, and political science. The dialogue at the workshop, as summarized in this article, builds on the experiences of different regulatory agencies that have used performance-based regulation and clarifies its advantages and disadvantages in addressing health, safety, and environmental problems.

This paper explores a surprising phenomenon: the emergence of trade associations as agents of environmental performance improvement. Trade associations in the United States have historically fought environmental regulation, not embraced it. Trade associations are generally organized to service the needs of their members, not control their behavior. Yet, since the late 1980s, seven trade associations representing manufacturing sectors have enacted codes of practice with the stated goal of enhancing member companies' environmental performance. Four of these codes have been developed by trade associations in the chemicals sector. The other trade associations represent oil, forestry, and textile industries. This paper explores why and how trade associations have attempted to exert authority over members' environmental performance. First, the specific factors that caused each trade association to develop its code are discussed. Second, the codes are compared in terms of three dimensions: the environmental practices they require, the techniques used to share values and practices among members, and the authority structures used to ensure compliance. A final section offers observations about the conditions under which codes are likely to emerge and considers their implications for public policy. By seeing where and how this trade association activity is emerging, it is possible to begin to understand the limits, and the potential, of this approach as a tool for moving firms in the direction of environmental performance improvement and sustainability., Performance Incentives Division, U.S. Environmental Protection Agency

This paper is divided into three parts. The first part explores the question of why certain trade associations have developed environmental codes for their members. The second part considers the effectiveness of trade association codes in improving environmental performance. The third section offers conclusions about where trade association codes may be achieving results., Emerging Strategies Division, U.S. Environmental Protection Agency

The goals of the EPA Office of Reinvention are the following: 1) use incentives and promote environmental management systems (EMSs) 2) provide timely and accessible compliance-assistance 3) create flexible and streamlined permitting 4) help communities make sound environmental decisions This research explores two recent initiatives related to those goals: ISO 14001 and the EPA Region I's StarTrack program. We studied ISO 14001 through two approaches: a statistical analysis of the characteristics of early adopters, and case studies at six chemical facilities, five of which had adopted the standard. To study StarTrack, we interviewed managers at four of the six facilities that have participated in the program since its inception, as well as EPA staff members at the regional and national levels, state environmental officials, and representatives of environmental advocacy groups., U.S. Environmental Protection Agency

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