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Major Games such as the 2015 Parapan American Games in Toronto (TO2015) generate the potential to bring awareness to sport participation opportunities for people with impairment (Chalip et al, 2017). In the post-games era, it is important to examine the ways in which sport program managers recognize the outcomes of games-related leveraging initiatives. Teleconference interviews were conducted with twelve program managers in the Greater Toronto Area. The study followed an interpretive descriptive methodology and employed a theoretical construct of recognition as a novel approach to assess the legacy and social impacts of hosting parasport games. A form of thematic analysis was used to interpret interview data and bring to surface the perspectives and attitudes of sport program managers involved in any ongoing legacy initiatives. The knowledge acquired from this study suggests that a concept of recognition can support the assessment of the long-term impacts of hosting major games.

Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) is an atypical pulmonary disorder with limited understanding. Given the rare nature of this disease, it is essential to obtain adequate tissue pathology to confirm the diagnosis. This disease is mainly diagnosed in middle-aged, nonsmoking females, and it is now accepted as a precursor lesion to pulmonary carcinoid tumors. DIPNECH presents with characteristic radiographic and histologic findings, but its diagnosis, management, and prognosis are often underrecognized and poorly understood. Those with symptoms may present with shortness of breath, wheezing, and persistent cough and are often misdiagnosed with reactive airway disease. Pulmonary function testing may reveal airflow obstruction and air trapping. Imaging is characterized by multiple lung nodules, typically less than 5 mm in size, with a background mosaic attenuation on computed tomography imaging. Histologically, DIPNECH can be suspected based on the presence of hyperplastic neuroendocrine cells. DIPNECH is considered a precursor to invasive neuroendocrine tumor, and up to 50% of patients may have a well-differentiated neuroendocrine tumor at the time of presentation. Here, we present the case of a 46-year-old female with a history of ulcerative colitis on mesalamine who presented with a 6-month history of ongoing shortness of breath, chest tightness, wheezing, and cough. She was initially diagnosed with asthma before imaging later revealed as multiple pulmonary nodules with a diffuse mosaic pattern. Using robotic-assisted navigational bronchoscopy, she underwent sampling of a dominant 1.8 cm right middle lobe pulmonary nodule and pathology was consistent with low-grade neuroendocrine tumor.

Land surface models range in complexity of terrestrial evapotranspiration, yet it is unknown how model complexity translates to accuracy of modeled evapotranspiration estimates. Here, we use the International Land Model Benchmarking system to assess ET estimates from three models of varying complexity driven by the same forcing datasets: an earth system model, a terrestrial biosphere model, and a stand-alone ET model. The performance assessment includes both temporal and spatial evaluation, and different plant functional types across China. Our results indicate that the most complex model, an earth system model, performed best against the benchmarking datasets and metrics. Terrestrial biosphere model performed best in simulating inter-annual variability of ET, while earth system model performed best in simulating the seasonal cycle. The more complex models (earth system model and terrestrial biosphere model) perform better in forest, shrub and crop ecosystems, while the simpler model (stand-alone ET model) perform better in grass ecosystems. Our study demonstrates the impact of model complexity on ET estimates and highlights directions for future ET model improvements.

Hydroxychloroquine has gained popularity as a potential preventative and treatment of COVID-19 pneumonia due to its in vitro activity against the virus. These three cases of COVID-19 pneumonia of varying severities occurred in the setting of chronic hydroxychloroquine use. These cases argue against the use of hydroxychloroquine as a preventative or therapeutic option for COVID-19 pneumonia.

Evapotranspiration is one of the largest fluxes in the terrestrial water cycle, and also impacts the surface energy budget and the carbon cycle. In this dissertation, I explore how the surface energy budget contributes to ET uncertainty, I apply new satellite soil moisture observations to improve global ET estimates, and I link the carbon and water cycles from space to characterize how vegetation responds to stressful conditions.First, the differences of ground heat flux models are evaluated against 88 locations with in situ observations. I discuss the mechanisms which control ground heat flux and quantify how errors in this measurement have the potential to impact evapotranspiration. A new optimized model is presented to reduce this potential uncertainty.Second, I apply integrated observations of soil moisture and evapotranspiration to improve a satellite-based evapotranspiration algorithm. I demonstrate how observations from soil moisture improve evapotranspiration estimates in water-limited regions and use this new model with soil moisture observations from the Soil Moisture Active Passive (SMAP) mission to compute evapotranspiration globally. I compare the new model with the original model and quantify how evapotranspiration is partitioned. This is the first global satellite-derived evapotranspiration dataset to incorporate water availability limitations from SMAP.Finally, I link independent measurements of the carbon and water cycle from space. I use satellite derived transpiration and new observations of solar induced fluorescence from the Orbiting Carbon Observatory -2 (OCO-2) to characterize how vegetation responds to hotter and drier climate perturbations. Overall, this dissertation advances remote sensing evapotranspiration algorithms through quantifying the uncertainty contribution from ground heat flux models and provides a new relationship to link soil moisture observations to evapotranspiration. Additionally, I present the first study to apply transpiration and solar induced fluorescence from OCO-2 to explore how vegetation responds to hotter and drier conditions by regulating the carbon and water cycles. This dissertation delivers new ideas of how to leverage earth observing satellites to advance ET science and address knowledge gaps in the earth system.

The fate of the terrestrial biosphere is highly uncertain given recent and projected changes in climate. This is especially acute for impacts associated with changes in drought frequency and intensity on the distribution and timing of water availability. The development of effective adaptation strategies for these emerging threats to food and water security are compromised by limitations in our understanding of how natural and managed ecosystems are responding to changing hydrological and climatological regimes. This information gap is exacerbated by insufficient monitoring capabilities from local to global scales. Here, we describe how evapotranspiration (ET) represents the key variable in linking ecosystem functioning, carbon and climate feedbacks, agricultural management, and water resources, and highlight both the outstanding science and applications questions and the actions, especially from a space-based perspective, necessary to advance them.