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Scientific understanding of the global carbon cycle is required for developing national and international policy to mitigate fossil fuel CO2 emissions by managing terrestrial carbon uptake. Toward that understanding and as a contribution to the REgional Carbon Cycle Assessment and Processes (RECCAP) project, this paper provides a synthesis of net land–atmosphere CO2 exchange for North America (Canada, United States, and Mexico) over the period 1990–2009. Only CO2 is considered, not methane or other greenhouse gases. This synthesis is based on results from three different methods: atmospheric inversion, inventory-based methods and terrestrial biosphere modeling. All methods indicate that the North American land surface was a sink for atmospheric CO2, with a net transfer from atmosphere to land. Estimates ranged from −890 to −280 Tg C yr−1, where the mean of atmospheric inversion estimates forms the lower bound of that range (a larger land sink) and the inventory-based estimate using the production approach the upper (a smaller land sink). This relatively large range is due in part to differences in how the approaches represent trade, fire and other disturbances and which ecosystems they include. Integrating across estimates, "best" estimates (i.e., measures of central tendency) are −472 ± 281 Tg C yr−1 based on the mean and standard deviation of the distribution and −360 Tg C yr−1 (with an interquartile range of −496 to −337) based on the median. Considering both the fossil fuel emissions source and the land sink, our analysis shows that North America was, however, a net contributor to the growth of CO2 in the atmosphere in the late 20th and early 21st century. With North America's mean annual fossil fuel CO2 emissions for the period 1990–2009 equal to 1720 Tg C yr−1 and assuming the estimate of −472 Tg C yr−1 as an approximation of the true terrestrial CO2 sink, the continent's source : sink ratio for this time period was 1720:472, or nearly 4:1.

We summarise the contemporary carbon budget of South America and relate it to its dominant controls: population and economic growth, changes in land use practices and a changing atmospheric environment and climate. Component flux estimate methods we consider sufficiently reliable for this purpose encompass fossil fuel emission inventories, biometric analysis of old-growth rainforests, estimation of carbon release associated with deforestation based on remote sensing and inventories, and agricultural export data. Alternative methods for the estimation of the continental-scale net land to atmosphere CO2 flux, such as atmospheric transport inverse modelling and terrestrial biosphere model predictions, are, we find, hampered by the data paucity, and improved parameterisation and validation exercises are required before reliable estimates can be obtained. From our analysis of available data, we suggest that South America was a net source to the atmosphere during the 1980s (~ 0.3–0.4 Pg C a−1) and close to neutral (~ 0.1 Pg C a−1) in the 1990s. During the latter period, carbon uptake in old-growth forests nearly compensated for the carbon release associated with fossil fuel burning and deforestation. Annual mean precipitation over tropical South America as inferred from Amazon River discharge shows a long-term upward trend. Although, over the last decade dry seasons have tended to be drier, with the years 2005 and 2010 in particular experiencing strong droughts. On the other hand, precipitation during the wet seasons also shows an increasing trend. Air temperatures have also increased slightly. Also with increases in atmospheric CO2 concentrations, it is currently unclear what effect these climate changes are having on the forest carbon balance of the region. Current indications are that the forests of the Amazon Basin have acted as a substantial long-term carbon sink, but with the most recent measurements suggesting that this sink may be weakening. Economic development of the tropical regions of the continent is advancing steadily, with exports of agricultural products being an important driver and witnessing a strong upturn over the last decade.

Los esfuerzos de conservación en la región neotropical están limitados por la falta de información disponible sobre las especies, ya que muchas no han sido descritas o se tiene poca información sobre ellas. La Red Internacional de Inventarios Forestales (BIOTREE-NET) concentra y facilita el acceso a la información y el intercambio entre investigadores, gestores y conservacionistas, organizando y estandarizando los datos de especies de árboles procedentes de inventarios forestales en la región mesoamericana en una única base de datos que incluya información espacial. Este artículo explica el ámbito y objetivos de la red, describe la estructura de la base de datos e identifica los principales avances realizados, así como los retos y perspectivas futuras. La base de datos contiene más de 50 000 registros de árboles de unas 5000 especies, distribuidas en más de 2000 parcelas muestreadas desde el suroeste de México hasta Panamá. La información es heterogénea, tanto en su naturaleza y forma como en la cobertura geográfica de los inventarios. La base de datos tiene una estructura relacional, con 12 tablas interconectadas, incluyendo información sobre las parcelas, los nombres de las especies, el diámetro a la altura del pecho de los árboles medidos y sus atributos funcionales. Se ha desarrollado un sistema para la corrección de errores tipográficos y la estandarización taxonómica y nomenclatural utilizando como referencia The Plant List (http://theplantlist.org/). También se han generado modelos de distribución potencial para cerca de 1700 especies utilizando distintos métodos y en el futuro se prevé habilitar también el acceso público a los modelos de distribución de especies a través del portal web (http://portal.biotreenet.com). Aunque BIOTREE-NET ha contribuido al desarrollo de mejores modelos de distribución, su mayor potencial radica, en nuestra opinión, en el estudio a nivel de comunidades. Finalmente, se reconoce la necesidad de expandir la red a través de la participación de más investigadores interesados en colaborar con datos para ampliar el conocimiento sobre la biodiversidad forestal en la región neotropical.

Despite the wealth of research showing that psychological contract breach (PCB) has negative outcomes for individuals, knowledge about the influence of the social context in which breaches are experienced is still scarce. This is surprising, as scholars have argued that work climates, such as when unit members are generally highly committed, could buffer an individual’s negative experiences at work. Yet, to date, the unit climate and PCB literatures have largely remained separated and our main goal is to integrate these fields. This is especially timely and relevant, because recent work in the unit climate literature indicates that merely looking at the average climate level might not be enough, because the climate’s strength (i.e., the agreement or homogeneity within the unit) could also provide important social cues. Building on these recent advances, we develop and test a theoretical framework which links both climate concepts to PCB. More specifically, we hypothesized that especially when all unit members are highly and homogeneously committed, an employee would reframe their PCB in such a way that it would less adversely affect work engagement and turnover intentions. Using data from 1,272 employees across 36 healthcare units, multilevel structural path analyses supported this three-way interaction. By answering recent calls for more “social PCB research” and integrating the unit climate and PCB literatures, we aim to provide guidance to scholars and practitioners who want to understand in more depth the social context’s influence on PCB.

Illicit Financial Flows (IFF) – such as corruption and money laundering – have a significant negative impact on the enjoyment of human rights. Combating IFF is an integral part of the 2030 Agenda for Sustainable Development. SDG 16 explicitly promulgates the relation between the rule of law, social security and the fight against IFF. Cross-border data access and exchange by enforcement authorities is crucial to map and disrupt IFF, punish suspects and take away their criminally earned assets. At the same time, human rights restrain national enforcement authorities when combatting IFF. States must abstain from undue interference with individuals’ privacy rights, such as the storage of information relating to an individual’s private life and the sharing of such information. Pursuant to article 8 ECHR, interference with the right to respect for private – in accordance with the law – is only permissible if this is necessary in a democratic society, e.g. in the interests of national security and public safety. In this article we explore the balance between individual rights and states’ responsibilities in the fight against IFF; between privacy and the common good of fighting bad money. To what extent may privacy concerns be an obstacle to investigate global IFF? Our conclusion is that there is an imbalance. We suggest that human dignity and human security should be given more weight in the balancing of human rights in this context.

Abstract Background Between 2007 and 2011 several thousands of calves died from bovine neonatal pancytopenia (BNP), a bleeding syndrome triggered by vaccine induced alloantibodies from the dams. Following withdrawal of the involved bovine viral diarrhoea virus (BVDv) vaccine, the incidence of this condition rapidly decreased, with no reported cases in the last 5 years. Here, we report a recent immune-mediated pancytopenia in three calves from two different suckler herds, clinically indistinguishable from BNP. Case presentation Three Belgian Blue suckler calves from two different farms, aged around two weeks, showed multiple bleedings disseminated on the skin and petechiae and ecchymoses on the mucosae. Blood examination confirmed anaemia, leukopenia and thrombocytopenia. BVDv infection was excluded. Despite blood transfusion and cortisone therapy, all three animals died. Necropsy and histology confirmed bone marrow depletion. Binding of IgG from the dams on leukocytes of the calves was demonstrated by flow cytometry. Two calves, originating from the same farm, received colostrum from the same dam. None of the calves were given colostrum replacers or colostrum supplements. No link with the BNP causing BVDv vaccine could be evidenced. However, dams had been vaccinated against bovine herpesvirus 1, parainfluenza-3 virus, bovine respiratory syncytial virus and bluetongue virus serotype 8. Conclusions Alloimmune mediated pancytopenia was evidenced in three animals, clinically and pathologically indistinguishable from BNP. Whether this disease is again vaccine mediated remains to be determined.

Arrhythmogenic cardiomyopathy is a genetically inherited disease caused by deletion of an arginine in Phospholamban (PLN), a small protein that regulates intracellular calcium levels. Here the authors show that zebrafish with the PLN p.Arg14del mutation develop severe cardiomyopathy which is preceded by contractile dysfunction and altered calcium dynamics and istaroxime is identified as a small molecule that can rescues some of these phenotypes.

Abstract Background The presence of in-house attending trauma surgeons has improved efficiency of processes in the treatment of polytrauma patients. However, literature remains equivocal regarding the influence of the presence of in-house attendings on mortality. In our hospital there is a double trauma surgeon on-call system. In this system an in-house trauma surgeon is 24/7 backed up by a second trauma surgeon to assist with urgent surgery or multiple casualties. The aim of this study was to evaluate outcome in severely injured patients in this unique trauma system. Methods From 2014 to 2021, a prospective population-based cohort consisting of consecutive polytrauma patients aged ≥ 15 years requiring both urgent surgery (≤ 24h) and admission to Intensive Care Unit (ICU) was investigated. Demographics, treatment, outcome parameters and pre- and in-hospital transfer times were analyzed. Results Three hundred thirteen patients with a median age of 44 years (71% male), and median Injury Severity Score (ISS) of 33 were included. Mortality rate was 19% (68% due to traumatic brain injury). All patients stayed ≤ 32 min in ED before transport to either CT or OR. Fifty-one percent of patients who needed damage control surgery (DCS) had a more deranged physiology, needed more blood products, were more quickly in OR with shorter time in OR, than patients with early definitive care (EDC). There was no difference in mortality rate between DCS and EDC patients. Fifty-six percent of patients had surgery during off-hours. There was no difference in outcome between patients who had surgery during daytime and during off-hours. Death could possibly have been prevented in 1 exsanguinating patient (1.7%). Conclusion In this cohort of severely injured patients in need of urgent surgery and ICU support it was demonstrated that surgical decision making was swift and accurate with low preventable death rates. 24/7 Physical presence of a dedicated trauma team has likely contributed to these good outcomes.

Literature on Shared Mental Models (SMMs) has been burgeoning in recent years and this has provided increasingly detailed insight and evidence into the importance of SMMs within specific contexts. However, because past research predominantly focused on SMM structure as measured by diverse, context-dependent measures, a consolidated multi-dimensional measure of perceived SMMs that can be used across diverse team contexts is currently lacking. Furthermore, different conceptualizations of the dimensionality of SMMs exist, which further impedes the comparison between studies. These key limitations might hinder future development in the SMM literature. We argue that the field of SMMs has now matured enough that it is possible to take a deductive approach and evaluate the prior studies in order to refine the key SMMs dimensions, operationalizations, and measurement. Hence, we take a three-stage approach to consolidate existing literature scale-based measures of SMMs, using four samples. Ultimately, this leads to a 20-item five-dimensional scale (i.e., equipment, execution, interaction, composition, and temporal SMMs) – the Five Factor Perceived Shared Mental Model Scale (5-PSMMS). Our scale provides scholars with a tool which enables the measurement, and comparison, of SMMs across diverse team contexts. It offers practitioners the option to more straightforwardly assess perceived SMMs in their teams, allowing the identification of challenges in their teams and facilitating the design of appropriate interventions.

Abstract Background There is significant need for accurate diagnostic tools for Cryptosporidium spp. and Giardia duodenalis infections in resource limited countries where diarrhoeal disease caused by these parasites is often prevalent. The present study assessed the diagnostic performance of three commercially available rapid diagnostic tests (RDTs) based on faecal-antigen detection for Cryptosporidium spp. and/or G. duodenalis infections in stool samples of children admitted with severe acute malnutrition (SAM) and diarrhoea. An established multiplex PCR was used as reference test. Methods Stool samples from children with SAM and diarrhoea enrolled in a randomized controlled trial (registered at clinicaltrials.gov/ct2/show/NCT02246296) in Malawi (n = 175) and Kenya (n = 120) between December 2014 and December 2015 were analysed by a multiplex PCR for the presence of Cryptosporidium spp., G. duodenalis or Entamoeba histolytica parasite DNA. Cryptosporidium-positive samples were species typed using restriction fragment length polymorphism analysis. A sub-sample of the stool specimens (n = 236) was used for testing with three different RDTs. Diagnostic accuracy of the tests under evaluation was assessed using the results of PCR as reference standard using MedCalc software. Pearson Chi-square test and Fisher’s exact test were used to determine (significant) difference between the number of cryptosporidiosis or giardiasis cases found by PCR in Malawi and Kenya. The overall diagnostic accuracy of each RDT was calculated by plotting a receiver operating characteristic (ROC) curve for each test and to determine the area under the curve (AUC) using SPSS8 software. Results Prevalence of Cryptosporidium spp. by PCR was 20.0 and 21.7% in Malawi and Kenya respectively, mostly C. hominis. G. duodenalis prevalence was 23.4 and 5.8% in Malawi and Kenya respectively. E. histolytica was not detected by PCR. RDT testing followed the same pattern of prevalence. RDT sensitivities ranged for cryptosporidiosis from 42.9 to 76.9% and for G. duodenalis from 48.2 to 85.7%. RDT specificities ranged from 88.4 to 100% for Cryptosporidium spp. and from 91.2 to 99.2% for G. duodenalis infections. Based on the estimated area under the curve (AUC) values, all tests under evaluation had an acceptable overall diagnostic accuracy (> 0.7), with the exception of one RDT for Cryptosporidium spp. in Malawi. Conclusions All three RDTs for Cryptosporidium spp. and Giardia duodenalis evaluated in this study have a moderate sensitivity, but sufficient specificity. The main value of the RDTs is within their rapidness and their usefulness as screening assays in surveys for diarrhoea.

Prolific research suggests identity associates with pro-environmental behaviours (PEBs) that are individual and/or group focused. Individual PEB is personally driven, self-reliant, and are conducted on one's own (e.g., home recycling). Group focused PEB is other people-reliant and completed as part of a group (e.g., attending meetings of an environmental organisation). A wide range of identities have been related to PEBs. For example, a recent systematic qualitative review revealed 99 different types of identities studied in a PEB context. Most studies were correlational, few had an experimental design. However, the relationships between all these identities and PEBs have so far not been tested quantitatively with meta-analytical techniques. As such, a clear overview of this field is currently lacking. Due to the diverse nature of the field, a priori hypotheses were not possible and relatively broad definitions of identity had to be used to encompass all types of identities and the diverse meanings of identity that have been included in PEB research. What prior theory did allow for was to assess the distinction between two main types of identity, namely how people label, describe, and recognise oneself individually (individual identity), or as part of a group (group identity). Our overall goal was thus to assess the current state of knowledge on identities and PEBs. In 104 studies using a meta-regression following the preferred reporting items for systematic reviews and meta-analyses guidelines, our random-effects meta-analysis showed that the overall concept of identity associated with PEB with a medium Pearson's r (Aim 1). Furthermore, we found that individual identities associated more strongly with PEBs than group identities (Aim 2). The associations between individual and group identities were stronger when the identity and PEB were from the same category (e.g., when both were group-focused; Aim 3). Methodologically, the findings revealed that group identities and group PEBs were most strongly associated for self-reported rather than observed PEBs (Aim 4). Overall identity associated most strongly with group PEBs in the field rather than in the lab (Aim 5) and in student- rather than non-student samples (Aim 6). We discuss the theoretical and practical implications.

IntroductionA trend has evolved towards rib fixation for flail chest although evidence is limited. Little is known about rib fixation for multiple rib fractures without flail chest. The aim of this study is to compare rib fixation with nonoperative treatment for both patients with flail chest and patients with multiple rib fractures.Methods and analysisIn this study protocol for a multicentre prospective cohort study, all patients with three or more rib fractures admitted to one of the five participating centres will be included. In two centres, rib fixation is performed and in three centres nonoperative treatment is the standard-of-care for flail chest or multiple rib fractures. The primary outcome measures are intensive care unit length of stay and hospital length of stay for patients with a flail chest and patients with multiple rib fractures, respectively. Propensity score matching will be used to control for potential confounding of the relation between treatment modality and length of stay. All analyses will be performed separately for patients with flail chest and patients with multiple rib fractures without flail chest.Ethics and disseminationThe regional Medical Research Ethics Committee UMC Utrecht approved a waiver of consent (reference number WAG/mb/17/024787 and METC protocol number 17–544/C). Patients will be fully informed of the purpose and procedures of the study, and signed informed consent will be obtained in agreement with the General Data Protection Regulation. Study results will be submitted for peer review publication.Trial registration numberNTR6833

Background. Adequate pain control is essential in the treatment of patients with traumatic rib fractures. Although epidural analgesia is recommended in international guidelines, the use remains debatable and is not undisputed. The aim of this study was to describe the efficacy and safety of epidural analgesia in patients with multiple traumatic rib fractures. Methods. A retrospective cohort study was performed. Patients with ≥3 rib fractures following blunt chest trauma who received epidural analgesia between January 2015 and January 2018 were included. The main outcome parameters were the success rate of epidural analgesia and the incidence of medication-related side effects and catheter-related complications. Results. A total of 76 patients were included. Epidural analgesia was successful in a total of 45 patients (59%), including 22 patients without and in 23 patients with an additional analgesic intervention. In 14 patients (18%), epidural analgesia was terminated early without intervention due to insufficient sensory blockade (n=4), medication-related side effects (n=4), and catheter-related complications (n=6). In 17 patients (22%), the epidural catheter was removed after one or multiple additional interventions due to insufficient pain control. Minor epidural-related complications or side effects were encountered in 36 patients (47%). One patient had a major complication (opioid intoxication). Conclusion. Epidural analgesia was successful in 59% of patients; however, 30% needed additional analgesic interventions. As about half of the patients had epidural-related complications, it remains debatable whether epidural analgesia is a sufficient treatment modality in patients with multiple rib fractures.

Background: The Dutch Active Healthy Kids (AHK) Report Card+ (RC+) consolidates and translates research and assesses how the Netherlands is being responsible in providing physical activity (PA) opportunities for youth (< 18 years) with a chronic disease or disability. The aim of this article is to summarize the results of the Dutch RC+.Methods: Nine indicators were graded using the AHK Global Alliance RC development process, which includes a synthesis of best available research, surveillance, policy and practice findings, and expert consensus. Two additional indicators were included: weight status and sleep.Results: Grades assigned were: Overall Physical Activity, D; Organized Sports Participation, B–; Active Play, C–; Active Transportation, A–; Sedentary Behavior, C; Sleep C; For Weight Status, Family and Peers, School, Community and Built Environment, Government Strategies, and Investments all INC.Conclusions: The youth with disabilities spend a large part of the day sedentary, since only 26% of them met the PA norm for healthy physical activity. Potential avenues to improve overall physical activity are changing behaviors regarding sitting, screen time, and active play. The Netherlands is on track regarding PA opportunities for youth with disabilities, however they are currently not able to participate unlimited in sports and exercise.