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Importance: While cholinergic receptor nicotinic alpha 5 (CHRNA5) variants have been linked to lung cancer, chronic obstructive pulmonary disease (COPD) and smoking addiction in case-controls studies, their corelationship is not well understood and requires retesting in a cohort study.Objective: To re-examine the association between the CHRNA5 variant (rs16969968 AA genotype) and the development of lung cancer, relative to its association with COPD and smoking.Methods: In 9270 Non-Hispanic white subjects from the National Lung Screening Trial, a substudy of high-risk smokers were followed for an average of 6.4 years. We compared CHRNA5 genotype according to baseline smoking exposure, lung function and COPD status. We also compared the lung cancer incidence rate, and used multiple logistic regression and mediation analysis to examine the role of the AA genotype of the CHRNA5 variant in smoking exposure, COPD and lung cancer.Results: As previously reported, we found the AA high-risk genotype was associated with lower lung function (p=0.005), greater smoking intensity (p<0.001), the presence of COPD (OR 1.28 (95% CI 1.10 to 1.49) p=0.0015) and the development of lung cancer (HR 1.41, (95% CI 1.03 to 1.93) p=0.03). In a mediation analyses, the AA genotype was independently associated with smoking intensity (OR 1.42 (95% CI 1.25 to 1.60, p<0.0001), COPD (OR 1.25, (95% CI 1.66 to 2.53), p=0.0015) and developing lung cancer (OR 1.37, (95% CI 1.03 to 1.82) p=0.03).Conclusion: In this large-prospective study, we found the CHRNA5 rs 16 969 968 AA genotype to be independently associated with smoking exposure, COPD and lung cancer (triple whammy effect). [ABSTRACT FROM AUTHOR]

The oil and gas (O&G) industry has expanded significantly and brought to the surface large volumes of saline water called produced water (PW), which comprises of underground formation water, injection water, and chemical additives used during extraction and production. PW is traditionally managed via injection wells, evaporation/seepage pits, or recycling for on-site operations. There is increasing interest in PW treatment and reuse outside O&G fields due to freshwater scarcity and concerns about seismic events linked to deep-well injection. Adopting treated PW for reuse outside the O&G sector needs to address the challenges of complex water chemistry, limited toxicity data, and knowledge gaps for appropriate regulatory responses, including risk assessment frameworks on human health and the environment, socio-technical–economic assessments of treatment and reuse applications, and long-term demonstrations and monitoring of fit-for-purpose reuse. This opinion paper proposes a holistic, state-of-the-science pathway for PW treatment, management, and fit-for-purpose reuse outside O&G fields. • Current applications of PW treatment and reuse in the United States are studied. • Opportunities for broad PW reuse inside and outside O&G fields are emphasized. • Regulatory framework and risk assessment approaches for PW reuse are reviewed. • Challenges impeding PW reuse outside O&G fields are discussed. • Human health and environmental risk assessment framework is proposed. [ABSTRACT FROM AUTHOR]

Patrick Geddes is a recognized founder of urban and regional planning. Despite this accolade, a review of US planning programs reflects Geddes’s work largely absent from planning pedagogy. Recently interest in Geddes has revived in several fields. However, many researchers, particularly in planning, still criticize his ideas as lacking a coherent theoretical framework or as obsolete in addressing the power relations in contemporary cities and social movements. In this paper, I seek to augment recent work on Geddes as well as explore criticisms of his approach. I examined published and archival manuscripts dealing with Geddes’s approach to planning. I argue Geddes did, across his voluminous output, frame a consistent planning theory valuable for contemporary environmental planning and social movements. I conclude by calling for wider reintroduction of Geddes’s ideas into planning education and research. [ABSTRACT FROM AUTHOR]

Rationale: Although epidemiological studies consistently show that chronic obstructive pulmonary disease is associated with an increased risk of lung cancer, debate exists as to whether there is a linear relationship between the severity of airflow limitation and lung cancer risk.Objectives: We examined this in a large, prospective study of older heavy smokers from the American College of Radiology Imaging Network subcohort of the National Lung Screening Trial (ACRIN). Airflow limitation was defined by prebronchodilator spirometry subgrouped according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4.Methods: In the National Lung Screening Trial-ACRIN cohort of 18,473 screening participants, 6,436 had airflow limitation (35%) and 12,037 (65%) had no airflow limitation. From these groups, 758 lung cancer cases were prospectively identified. Participants with airflow limitation were stratified according to GOLD groups 1 (n = 1,607), 2 (n = 3,528), 3 (n = 1,083), and 4 (n = 211). Lung cancer incidence at study end (mean follow-up, 6.4 yr) was compared between the GOLD groups and those with no airflow limitation (referent group).Measurements and Main Results: Compared with those with no airflow limitation, where lung cancer incidence was 3.78/1,000 person years, incidence rates increased in a simple linear relationship: GOLD 1 (6.27/1,000 person yr); GOLD 2 (7.86/1,000 person yr); GOLD 3 (10.71/1,000 person yr); and GOLD 4 (13.25/1,000 person yr). All relationships were significant versus the reference group at a P value of 0.0001 or less.Conclusions: In a large prospective study of high-risk cigarette smokers, we report a strong linear relationship between increasing severity of airflow limitation and risk of lung cancer. [ABSTRACT FROM AUTHOR]

Rationale: Annual computed tomography (CT) is now widely recommended for lung cancer screening in the United States, although concerns remain regarding the potential harms, including those from overdiagnosis.Objectives: To examine the effect of airflow limitation on overdiagnosis by comparing lung cancer incidence, histology, and stage shift in a subgroup of the National Lung Screening Trial (NLST).Methods: In an NLST subgroup (n = 18,714), screening participants were randomized to annual computed tomography (CT, n = 9,357) or chest radiograph (n = 9,357) screening and monitored for a mean of 6.1 years. After baseline prebronchodilator spirometry, to identify the presence of airflow limitation, 18,475 subjects (99%) were assigned as having chronic obstructive pulmonary disease (COPD) or no COPD. Lung cancer prevalence, incidence, histology, and stage shift were compared after stratification by COPD.Measurements and Main Results: For screening participants with spirometric COPD (n = 6,436), there was a twofold increase in lung cancer incidence (incident rate ratio, 2.15; P < 0.001) and, when compared according to screening arm, no excess lung cancers and comparable histology. Compared with chest radiography, there was also a trend favoring reduced late-stage and increased early-stage cancers in the CT arm (P = 0.054). For those with normal baseline spirometry (n = 12,039), we found an excess of lung cancers during screening in the CT arm, almost exclusively early-stage adenocarcinoma-related cancers (histology shift and overdiagnosis). After correction for these excess cancers, stage shift was marginal (P = 0.077).Conclusions: In the CT arm of the NLST-ACRIN (American College of Radiology Imaging Network) cohort, COPD status was associated with a doubling of lung cancer incidence, no apparent overdiagnosis, and a more favorable stage shift. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we explore whether the enhancement of urban ecosystem services through large-scale, metropolitan tree-planting initiatives is being planned and executed as a component of traditional municipal government or represents new, transdisciplinary strategies in environmental governance. Drawing on qualitative interviews with stakeholders in six major cities (n =58) we further explore institutionalization of these initiatives and relationships. While much current discourse posits government cannot “go it alone” in providing preventative, “front-end” solutions to complex environmental problems, we found the public sector dominant in the visioning, planning, and management of these green infrastructure initiatives and the role of the private sector to be minimal. We also found that, despite this dominance, the initiatives had limited success in becoming institutionalized. This dichotomy reflects that while discourses labeling the public sector unable to grapple with complex environmental issues and the private sector dominant in environmental governance regimes are premature, institutionalizing the solutions into the machinery of government remains a contested arena. [Copyright &y& Elsevier]

The article presents a study on the change in attitudes toward the Negro in a Southern university in the U.S. It mentions that the background factors to be significantly related to attitude toward the Negro included the person's geographic region of origin, father's income, major field of study, religious preference and stated frequency of church attendance. In view of the social tension prevalent in the South during 1955-1958, one might reasonably expect to find a change in attitude toward desegration, at least with respect to a widening of the breach between advocates of different stands on the issue.

Background: Precision interventions using biological data may enhance smoking treatment, yet are understudied among smokers who are disproportionately burdened by smoking-related disease., Methods: We surveyed smokers in the NCI-sponsored Southern Community Cohort Study, consisting primarily of African-American, low-income adults. Seven items assessed attitudes toward aspects of precision smoking treatment, from undergoing tests to acting on results. Items were dichotomized as favorable (5 = strongly agree/4 = agree) versus less favorable (1 = strongly disagree/2 = disagree/3 = neutral); a summary score reflecting generalized attitudes was also computed. Multivariable logistic regression tested independent associations of motivation (precontemplation, contemplation, and preparation) and confidence in quitting (low, medium, and high) with generalized attitudes, controlling for sociodemographic factors and nicotine dependence., Results: More than 70% of respondents endorsed favorable generalized attitudes toward precision medicine, with individual item favorability ranging from 64% to 83%. Smokers holding favorable generalized attitudes reported higher income and education ( P < 0.05). Predicted probabilities of favorable generalized attitudes ranged from 63% to 75% across motivation levels [contemplation vs. precontemplation: adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI), 1.36-3.25, P = 0.001; preparation vs. precontemplation: AOR = 1.83, 95% CI, 1.20-2.78, P = 0.005; contemplation vs. preparation: AOR = 1.15, 95% CI, 0.75-1.77, P = 0.52] and from 59% to 78% across confidence (medium vs. low: AOR = 1.91, 95% CI, 1.19-3.07, P = 0.007; high vs. low: AOR = 2.62, 95% CI, 1.68-4.10, P < 0.001; medium vs. high: AOR = 0.73, 95% CI, 0.48-1.11, P = 0.14)., Conclusions: Among disproportionately burdened community smokers, most hold favorable attitudes toward precision smoking treatment. Individuals with lower motivation and confidence to quit may benefit from additional intervention to engage with precision smoking treatment., Impact: Predominantly favorable attitudes toward precision smoking treatment suggest promise for future research testing their effectiveness and implementation., (©2019 American Association for Cancer Research.)