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Paleoenvironmental archives in Arctic regions serve as sensitive recorders of past climate change where summer temperatures hover near freezing and small climate variations may exhibit strong threshold-crossing environment responses. Lake El'gygytgyn (Far East Russian Arctic) is a high-latitude crater impact lake that contains a continuous sediment record influenced by neither glaciation nor glacial erosion since the time of impact at 3.58 Ma. Prior research on sediments collected from Lake El'gygytygyn suggest times of permanent ice cover and anoxia corresponding to global glacial intervals, during which the sediments are laminated and are characterized by the co-occurrence of high total organic carbon, microscopic magnetite grains that show etching and dissolution, and negative excursions in bulk sediment organic matter carbon isotope (δ13C) values. Here, we investigate the abundance and carbon isotopic characteristics of lipid biomarkers recovered from Lake El'gygytygn sediments spanning marine isotope stages 1-3, to identify key sources of organic matter (OM) to lake sediments, to establish which compounds and thus OM sources drive the negative δ13C excursion exhibited by bulk sediment OM, and to explore if there are molecular and isotopic signatures of anoxia in the lake during glaciation. We find that during marine isotope stages 1-3, direct evidence for water column anoxia is lacking. A ~4‰ negative excursion in bulk sediment δ13C values during the local Last Glacial Maximum (LLGM) is accompanied by more protracted, higher magnitude negative excursions in n-alkanoic acid and n-alkanol δ13C values that begin 20 kyr in advance of the LLGM. In contrast, n-alkanes and the C30 n-alkanoic acid do not exhibit a negative δ13C excursion at this time. Our results indicate that the C24, C26 and C28 n-alkanoic acids do not derive entirely from terrestrial OM sources, while the C30 n-alkanoic acid at Lake El'gygytgyn is a robust indicator of terrestrial OM contributions. Overall, our results strongly support the presence of a nutrient-poor water column, which is mostly isolated from atmospheric carbon dioxide during glaciation at Lake El'gygytgyn. [ABSTRACT FROM AUTHOR]

Susceptibility measurements performed on initial short (3-16 m) cores taken from Lake El'gygytgyn exhibited a large range in values. This observation led to the suggestion of widespread magnetite dissolution within the sediments due to anoxic conditions within the lake. Rock magnetic properties and their comparison with magnetic susceptibility, Total Organic Carbon (TOC), and bulk δ13Corg proxies in core LZ1029-7 provide an insight into the character of the magnetic minerals present within the lake and can further the understanding of processes that may be present in the newer long core sediments Susceptibility measurements (Χ) of discrete samples corroborate the two order of magnitude difference seen in previous continuous susceptibility measurements (Κ), correlating high values with interglacial periods and low values with glacial intervals. Hysteresis parameters defined the majority of the magnetic material to be magnetite of PSD size. TOC values increase while δ13Corg values decrease in one section of LZ1029-7, which is defined as the Last Glacial Maximum (LGM), and help confine the age of the core to approximately 62 kyr. Increases in TOC during the most recent glacial interval suggest increased preservation of organic carbon during these times High TOC and low magnetic susceptibility during the LGM support the theory of perennial ice cover during glacial periods, which would lead to lake stratification and therefore anoxic bottom water conditions. Low temperature magnetic measurements also confirmed the presence of magnetite, but also indicated titanomagnetite, siderite and/or rhodochrosite, and vivianite were present. The latter three minerals are found only in anoxic environments, and further support the notion of magnetite dissolution. [ABSTRACT FROM AUTHOR]

Stable isotope data from lipid biomarkers and diatom silica recovered from lake sediment cores hold great promise for paleoclimate and paleohydrological reconstructions. However, these records rely on accurate calibration with modern precipitation and hydrologic processes. Here we investigate the stable isotopic composition of modern precipitation, streams, lake water and ice cover, and use these data to constrain isotope systematics of the Lake El'gygytgyn basin hydrology. Compound specific hydrogen isotope ratios determined from modern vegetation are compared with modern precipitation and lake core top sediments. Multi-species net (apparent) fractionation values between source water (precipitation) and leaf wax lipids (mean value is -105±13 ‰) agree with previous results in arid environments and provide a basis for application of this proxy downcore. We conclude that although there may be some bias towards winter precipitation signal, overall leaf wax lipids record annual average precipitation within the El'gygytgyn Basin. [ABSTRACT FROM AUTHOR]

Abstract Background By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Methods/Design Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. Discussion This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice. Trial Registration ACTRN12608000203358

Development of a sprayer system to use previously obtained aerial scans of Nova Scotian blueberry fields required the making of a prototype sprayer and then a full modification of a HARDI sprayer with computer controlled solenoids for each nozzle. The previously acquired aerial scans were made into Geographical Information System (GIS) files which delineated the areas of blueberry, weed, and bare ground. These were then correlated with the Global Positioning System (GPS) coordinates obtained by a receiver on the tractor. Spraying accuracy was within one meter. Deviation of spray position included GPS error (including the presence of the tree line), pixel size relative to the presence of the blueberry plants, and spray drift. The direction of travel did not affect the accuracy. The time for the initiation of spraying (to account for the delay in time for the spray to travel from the nozzle to the ground) was found to be a function of the sprayer system. The cost effectiveness of the system is largely a function of the time and personnel to make and process the aerial images to generate the GIS files. When this is automated, the process will be cost effective. [ABSTRACT FROM AUTHOR]

Blood flow restriction training (BFRT) uses occlusion during low-intensity resistance training (< 50% of 1-repetition maximum, 1RM) to reduce arterial blood flow and venous return, imposing greater metabolic stress but similar muscular hypertrophy and strength gains as high-intensity resistance training (HIRT). However, no study, to date, has incorporated BFRT in a collegiate strength and conditioning setting to assess ecological validity. We aimed to investigate the effects of adding 6-weeks of accessory BFRT or HIRT to NCAA Division III soccer players prescribed resistance training regimen on muscle strength and size. Male and female ( n = 17) athletes were randomly assigned to complete biceps curls 2x/week under BFRT or control (HIRT), following regularly scheduled strength training. Bicep strength (1RM) and circumference (BC) were assessed at weeks 0, 3, and 6 (men only). In men, for BC no significant interaction of condition x time was observed ( p = 0.861), though condition (BFRT vs Control, p = 0.025) and time ( p = 0.024) were significant. For 1RM, there was no significant interaction of condition x time (BFRT vs HIRT, p = 0.067) or of condition ( p = 0.598), but there was a significant effect of time ( p = 0.004). In women, there was no significant interaction between time and condition ( p = 0.765) or of condition ( p = 0.971) on BC, but time was significant ( p = 0.045). For 1RM, there was no significant interaction of condition x time ( p = 0.227) or of condition ( p = 0.741), but time was ( p = 0.018). In this preliminary ecological study, BFRT induced similar increases in muscle strength and circumference as HIRT in soccer players, suggesting that BFRT could be incorporated into collegiate athlete training.

Objective To describe the development process of a patient-centered initiative focused on improving primary care health outcomes of patients with intellectual and developmental disabilities (IDD) and needle-related anxiety using evidence-based practices and novel approaches that can be implemented in outpatient settings. The overall outcome of the program is to increase vaccine uptake and accessibility in the IDD population as well as improve needle-related procedures in primary care settings to be more humane and effective. Methods The development process occurred in the context of a large healthcare system serving a diverse patient population in the U.S. and was led by an expert committee made of an multidisciplinary team of physicians, psychologists, ambulatory and clinic nurses, pharmacists, and anesthesiologists committed to promoting quality healthcare for the IDD population. Committee members were recruited within the healthcare system based on their relevant expertise. The methodology included an iterative and collaborative process that took place over three development phases: ideation and design, literature review and synthesis, and expert engagement. The ideation and design phase included a series of planning meetings among the expert committee, in which committee members identified preliminary concerns based on their expertise in the field and background knowledge on the current procedures related to improving routine care for individuals with IDD and/or needle-related anxiety. The literature review and synthesis phase led to the development of an annotated bibliography of research and clinical guidelines that synthesized findings on needle anxiety in clinical care. The expert engagement phase included all Committee members meeting for a final discussion to establish a tiered approach to utilizing evidence-based strategies that could be implemented across clinics within the healthcare system.  Results The multidisciplinary team of experts developed a three-tier system, deployed sequentially as needed. The first tier focuses on training nurses in evidence-based behavioral modification strategies to implement as standard of care. The second tier uses the addition of a distraction device and topical analgesic to reduce anxiety in patients with slightly elevated procedural anxiety. The third tier involves a novel minimal sedation protocol using intranasal midazolam for patients with needle phobia that can be administered in an outpatient setting. Conclusion The Needle Anxiety Program eases the administration of needle-related medical procedures in the primary care setting for patients with IDD and needle-related anxiety. The use of evidence-based practices and a novel minimal sedation protocol for individuals with needle phobia assists in the completion of routine healthcare procedures, such as vaccinations and phlebotomy, in a patient-preferred setting. The purpose of delineating needle-related processes and procedures through the Needle Anxiety Program is to reduce health disparities for patients with IDD and promote uptake of the Needle Anxiety Program in similar healthcare settings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Rava et al.)

Objective Patients with intellectual and developmental disabilities (IDD) experience needle phobia at greater rates than individuals in the general population. Needle phobia deters patients with IDD from receiving routine medical procedures, which impacts their physical health outcomes. The aim of this quality improvement study was to assess the feasibility of a minimal sedation protocol in an outpatient care setting for patients with IDD and needle phobia. Methods The sample included 18 patients characterized as having a diagnosis of IDD only or IDD and needle phobia compared to patients with only a diagnosis of needle phobia. Reasons for referral to intervention included routine lab work, therapeutic drug monitoring, and routine vaccination. The minimal sedation intervention involved intranasal administration of a benzodiazepine (midazolam) by a registered nurse. Outcomes of interest were administration of the sedation and administration of medical orders. Results Nearly a third of patients were children (33.3%, n=6), and 39% of patients were female (n=7). Individuals with IDD (including those both with and without needle phobias) comprised 72.2% of patients (n=13). Half of intervention encounters were successful in both administering the sedation and performing the medical orders (n=9). Among individuals with IDD, 38.4% successfully completed the intervention (n=5). Conclusion This pilot study assessed the feasibility of implementing a minimal sedation protocol in primary care outpatient care settings. The preliminary results suggest that the minimal sedation protocol may improve the uptake of needle-related medical procedures for patients with IDD and/or needle phobia. The minimal sedation protocol should be studied in a larger sample and among multiple outpatient settings to establish effectiveness of the intervention., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Rava et al.)