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Supplemental Digital Content is available in the text., BACKGROUND: The U.S. Food and Drug Administration has to date granted approval or emergency use authorization to three vaccines against severe acute respiratory syndrome coronavirus 2 and coronavirus disease 2019. In clinical trials and real-use observational studies, the Pfizer-BioNTech BNT162b2 messenger RNA coronavirus disease 2019 vaccine, as well as the Moderna mRNA-1273 messenger RNA coronavirus disease 2019 vaccine, have demonstrated high efficacy and few adverse events. CASE SUMMARY: A 20-year-old male college student in good health developed tinnitus and hematuria shortly after vaccination and progressed swiftly to a syndrome of: systemic inflammation; acute kidney injury requiring hemodialysis; acute, bilateral, complete sensorineural hearing loss; radiographic evidence of acute multifocal ischemic strokes; pericardial effusion complicated by tamponade physiology requiring pericardial evacuation; pleural effusions requiring evacuation; and systemic capillary leak. An extensive clinical and research investigation, including cytokine analysis, whole blood cytometry by time of flight, and whole exome sequencing, did not reveal a definitive explanatory mechanism. CONCLUSION: While the overall safety profile of the BNT162b2 coronavirus disease 2019 vaccine remains excellent for the general population, rare serious events have been reported. In this report, we describe a case of multisystem inflammation and organ dysfunction of unknown mechanism beginning shortly after administration of the first dose of BNT162b2 coronavirus disease 2019 vaccine in a previously healthy recipient.

Urban water and energy systems are crucial for sustainably meeting basic service demands in cities. This paper proposes and applies a technology-independent “reference resource-to-service system” framework for concurrent evaluation of urban water and energy system interventions and their ‘nexus’ or ‘interlinkages’. In a concrete application, data that approximate New York City conditions are used to evaluate a limited set of interventions in the residential sector, spanning from low-flow toilet shifts to extensive green roof installations. Results indicate that interventions motivated primarily by water management goals can considerably reduce energy use and contribute to mitigation of greenhouse gas emissions. Similarly, energy efficiency interventions can considerably reduce water use in addition to lowering emissions. However, interventions yielding the greatest reductions in energy use and emissions are not necessarily the most water conserving ones, and vice versa. Useful further research, expanding the present analysis should consider a broader set of resource interactions, towards a full climate, land, energy and water (CLEW) nexus approach. Overall, assessing the impacts, trade-offs and co-benefits from interventions in one urban resource system on others also holds promise as support for increased resource efficiency through integrated decision making.

Necrotizing Autoimmune Myopathy (NAM) associated with 3-hydroxy-3-methylglutarylcoenzyme A Reductase (HMGCR) antibodies has been described in statin-induced and statin-naive patients. Proximal muscle weakness is the presenting symptom in HMGCR NAM. Creatine Kinase (CK) levels can exceed 10x normal values. Statininduced cases involve two thirds of HMGCR NAM patients and are more likely to respond to immunosuppressive therapy. Muscle biopsy confirms the diagnosis. We report a case with progressive oropharyngeal dysphagia as the presenting complaint with delayed response to treatment. To our knowledge, there has been only one previously reported case of statin-exposed HMGCR NAM with a similar presentation.

The neuropeptide VGF (non-acronymic) is induced by brain-derived neurotrophic factor and promotes hippocampal neurogenesis, as well as synaptic activity. However, morphological changes induced by VGF have not been elucidated. Developing hippocampal neurons were exposed to VGF through bath application or virus-mediated expression in vitro. VGF-derived peptide, TLQP-62, enhanced dendritic branching, and outgrowth. Furthermore, VGF increased dendritic spine density and the proportion of immature spines. Spine formation was associated with increased synaptic protein expression and co-localization of pre- and postsynaptic markers. Three non-synonymous single nucleotide polymorphisms (SNPs) were selected in human VGF gene. Transfection of N2a cells with plasmids containing these SNPs revealed no relative change in protein expression levels and normal protein size, except for a truncated protein from the premature stop codon, E525X. All three SNPs resulted in a lower proportion of N2a cells bearing neurites relative to wild-type VGF. Furthermore, all three mutations reduced the total length of dendrites in developing hippocampal neurons. Taken together, our results suggest VGF enhances dendritic maturation and that these effects can be altered by common mutations in the VGF gene. The findings may have implications for people suffering from psychiatric disease or other conditions who may have altered VGF levels.

This three-year project, performed by Princeton University in partnership with the University of Minnesota and Brookhaven National Laboratory, examined geologic carbon sequestration in regard to CO{sub 2} leakage and potential subsurface liabilities. The research resulted in basin-scale analyses of CO{sub 2} and brine leakage in light of uncertainties in the characteristics of leakage processes, and generated frameworks to monetize the risks of leakage interference with competing subsurface resources. The geographic focus was the Michigan sedimentary basin, for which a 3D topographical model was constructed to represent the hydrostratigraphy. Specifically for Ottawa County, a statistical analysis of the hydraulic properties of underlying sedimentary formations was conducted. For plausible scenarios of injection into the Mt. Simon sandstone, leakage rates were estimated and fluxes into shallow drinking-water aquifers were found to be less than natural analogs of CO{sub 2} fluxes. We developed the Leakage Impact Valuation (LIV) model in which we identified stakeholders and estimated costs associated with leakage events. It was found that costs could be incurred even in the absence of legal action or other subsurface interference because there are substantial costs of finding and fixing the leak and from injection interruption. We developed a model framework called RISCS, which canmore » be used to predict monetized risk of interference with subsurface resources by combining basin-scale leakage predictions with the LIV method. The project has also developed a cost calculator called the Economic and Policy Drivers Module (EPDM), which comprehensively calculates the costs of carbon sequestration and leakage, and can be used to examine major drivers for subsurface leakage liabilities in relation to specific injection scenarios and leakage events. Finally, we examined the competiveness of CCS in the energy market. This analysis, though qualitative, shows that financial incentives, such as a carbon tax, are needed for coal combustion with CCS to gain market share. In another part of the project we studied the role of geochemical reactions in affecting the probability of CO{sub 2} leakage. A basin-scale simulation tool was modified to account for changes in leakage rates due to permeability alterations, based on simplified mathematical rules for the important geochemical reactions between acidified brines and caprock minerals. In studies of reactive flows in fractured caprocks, we examined the potential for permeability increases, and the extent to which existing reactive transport models would or would not be able to predict it. Using caprock specimens from the Eau Claire and Amherstburg, we found that substantial increases in permeability are possible for caprocks that have significant carbonate content, but minimal alteration is expected otherwise. We also found that while the permeability increase may be substantial, it is much less than what would be predicted from hydrodynamic models based on mechanical aperture alone because the roughness that is generated tends to inhibit flow.« less

India is experiencing fast income growth and urbanization, and this leads to unprecedented increases in demand for building energy services and resulting energy consumption. In response to rapid growth in building energy use, the Government of India issued the Energy Conservation Building Code (ECBC) in 2007, which is consistent with and based on the 2001 Energy Conservation Act. ECBC implementation has been voluntary since its enactment and a few states have started to make progress towards mandatory implementation. Rajasthan is the first state in India to adopt ECBC as a mandatory code. The State adopted ECBC with minor additions on March 28, 2011 through a stakeholder process; it became mandatory in Rajasthan on September 28, 2011. Tamil Nadu, Gujarat, and Andhra Pradesh have started to draft an implementation roadmap and build capacity for its implementation. The Bureau of Energy Efficiency (BEE) plans to encourage more states to adopt ECBC in the near future, including Haryana, Uttar Pradesh, Karnataka, Maharashtra, West Bengal, and Delhi. Since its inception, India has applied the code on a voluntary basis, but the Government of India is developing a strategy to mandate compliance. Implementing ECBC requires coordination between the Ministry of Power and the Ministry ofmore » Urban Development at the national level as well as interdepartmental coordination at the state level. One challenge is that the Urban Local Bodies (ULBs), the enforcement entities of building by-laws, lack capacity to implement ECBC effectively. For example, ULBs in some states might find the building permitting procedures to be too complex; in other cases, lack of awareness and technical knowledge on ECBC slows down the amendment of local building by-laws as well as ECBC implementation. The intent of this white paper is to share with Indian decision-makers code enforcement approaches: through code officials, third-party inspectors, or a hybrid approach. Given the limited capacity and human resources available in the state and local governments, involving third-party inspectors could rapidly expand the capacity for plan reviews and broad implementation. However, the procedures of involving third-parties need to be carefully designed in order to guarantee a fair process. For example, there should be multiple checks and certification requirements for third-party inspectors, and the government should have the final approval when third-party inspectors are used in a project. This paper discusses different approaches of involving third-parties in ECBC enforcement; the Indian states may choose the approaches that work best in their given circumstances.« less

Nuclear energy is on the verge of a possible nuclear renaissance, driven by the simultaneous growing global demand for energy and a growing awareness of the need to combat climate change by lowering atmospheric carbon emissions. Widespread deployment of advanced nuclear technologies will require nuclear energy to be competitive in the energy market. Given the long lead-time and high cost of building capital-intensive nuclear facilities, it is important to perform analyses up-front to gain insight into what combinations of economic, environmental, technical and policy conditions will be required for nuclear to play a significant future role. This paper describes an analytical approach that can be used to define those conditions where nuclear energy could contribute. The methodology, using the MARKAL model, is both rich in technical detail and yet conceptually transparent. It is flexible, easy to modify for the needs of a particular analysis and can vary parameters of interest to address uncertainties in data and in future conditions. It can also examine the impacts of present or potential future government policies on the ultimate deployment of nuclear technologies over time. The example results provided in the paper illustrate some issues of interest to the nuclear and energy communities that can be addressed using MARKAL.Copyright © 2008 by ASME

A presentation for the FY 2007 GPRA methodology review from the Office of Nuclear Energy Research and Development.

The Office of Nuclear Energy (NE) leads the U.S. Government’s efforts to develop new nuclear energy generation technologies to meet energy and climate goals, and to develop advanced proliferation-resistant nuclear fuel technologies that maximize energy from nuclear fuel; contributes to the RD and maintains and enhances the national nuclear technology infrastructure. NE serves the present and future energy needs of the Nation by managing the safe operation and maintenance of the Department of Energy (DOE) critical nuclear in frastructure, providing nuclear technology goods and services, and conducting R&D.

Cities are responsible for nearly 75% of the world’s energy consumption; expectedly, about 90% of future growth will occur in urban areas. However, we consider that cities will be at the forefront of implementing groundbreaking technologies and policies, as evidenced in the initiatives taken by many cities here and worldwide to resolve issues in energy and climate change. In addition to affording energy and environmental benefits, investments in energy efficient and renewable technologies have huge potential to boost local economies, as demonstrated by the recent federal allocation of stimulus funding. Inclined to give priority to stopgap measures, many cities tend to regard comprehensive long-term planning as secondary. However, such solutions would bring multiple benefits to the community. The paper showcases an energy and environment systems model to provide a quantitative vision of technology and management strategy options for effectively deploying energy efficiency and renewable energy for reducing the carbon footprint, while sustainably maintaining the energy demands of the community and the servicing environmental infrastructure. We provide results of a case study completed for New York City, to showcase usefulness of long-term planning for achieving low carbon cities. Combined with appropriate stakeholder participation, such a technology explicit bottom-up approach holds the promise of influencing the current energy planning, environmental regulatory regime, including multimedia aspects of carbon control for cities locally and internationally.