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Large stocks of soil carbon (C) and nitrogen (N) in northern permafrost soils are vulnerable to remobilization under climate change. However, there are large uncertainties in present-day greenhouse gas (GHG) budgets. We compare bottom-up (data-driven upscaling and process-based models) and top-down (atmospheric inversion models) budgets of carbon dioxide (CO2), methane (CH4) and nitrous oxide (N2O) as well as lateral fluxes of C and N across the region over 2000–2020. Bottom-up approaches estimate higher land-to-atmosphere fluxes for all GHGs. Both bottom-up and top-down approaches show a sink of CO2 in natural ecosystems (bottom-up: −29 (−709, 455), top-down: −587 (−862, −312) Tg CO2-C yr−1) and sources of CH4 (bottom-up: 38 (22, 53), top-down: 15 (11, 18) Tg CH4-C yr−1) and N2O (bottom-up: 0.7 (0.1, 1.3), top-down: 0.09 (−0.19, 0.37) Tg N2O-N yr−1). The combined global warming potential of all three gases (GWP-100) cannot be distinguished from neutral. Over shorter timescales (GWP-20), the region is a net GHG source because CH4 dominates the total forcing. The net CO2 sink in Boreal forests and wetlands is largely offset by fires and inland water CO2 emissions as well as CH4 emissions from wetlands and inland waters, with a smaller contribution from N2O emissions. Priorities for future research include the representation of inland waters in process-based models and the compilation of process-model ensembles for CH4 and N2O. Discrepancies between bottom-up and top-down methods call for analyses of how prior flux ensembles impact inversion budgets, more and well-distributed in situ GHG measurements and improved resolution in upscaling techniques.

Nitrous oxide (N2O) is a long-lived greenhouse gas that affects atmospheric chemistry and climate. In this work, we use satellite measurements of N2O, ozone (O3), and temperature from the Aura Microwave Limb Sounder (MLS) instrument to calculate stratospheric loss of N2O, and thus its atmospheric lifetime. Using three chemistry transport models simulating the Aura period 2005–2017, we verify the stratospheric sink using MLS data and follow that loss signal down to the surface and compare with surface observations. Stratospheric loss has a strong seasonal cycle and is further modulated by the Quasi-Biennial Oscillation (QBO); these cycles are seen equally in both observations and the models. When filtered for interannual variability, the modeled surface signal is QBO-caused, and it reproduces the observed pattern, highlighting the potential role of the QBO in tropospheric chemistry and composition, as well as in model evaluation. The observed annual surface signal in the northern hemisphere matches well with the models run without emissions, indicating the annual cycle is driven mostly by stratosphere-troposphere exchange (STE) flux of N2O-depleted air and not surface N2O emissions. In the southern hemisphere (SH), all three models disagree and thus provide no guidance, except for indicating that modeling annual STE in the SH remains a major model uncertainty. Parallel model simulations of CFCl3, which has greater stratospheric loss that N2O and possibly surreptitious emissions, show that its interannual variations parallel those of N2O, and thus the observed N2O variability can identify the stratospheric component of the observed CFCl3 variability.

A dental patient with post-traumatic stress disorder (PTSD) may present with greater dental and behavioral challenges than most dental patients. The background review of PTSD's initiating factors, diagnostic criteria, and medical management should help practitioners better understand and manage these challenges. Many of the challenges the clinician may encounter and managing recommendations are described. A case report of a PTSD patient complaining of constant bilateral tooth pain of the maxillary and mandibular bicuspids and molars is presented. Recommended techniques for identifying the tooth pain source and contributing factors are provided. The primary contributing factor for the patient's tooth pain was determined to be his severe tooth clenching activity. A maxillary acrylic appliance provided some pain reduction and a subsequent mandibular soft occlusal appliance worn opposing the maxillary appliance provided additional relief. [ABSTRACT FROM AUTHOR]

In 2007, the World Cancer Research Fund/American Institute for Cancer Research produced food, nutrition and physical activity recommendations for personal and public health goals for reducing cancer risk. A companion publication, Policy and Action for Cancer Prevention, addresses the external influences on people's eating and physical activity habits over a lifetime and evaluates potential actions to change these behaviours. The Policy Report makes recommendations for policies and actions that will help achieve the public health goals for reducing cancer risk. The recommendations are addressed to policy-makers and decision-takers at international, national and local level. These recommendations, if implemented, will help influence and change the lifestyle choices that people make, thereby reducing the risk of cancer and other chronic diseases within the population. The overarching message of the Policy Report is that public health is everyone's business. The protection and improvement of public health does not happen by accident - it requires policies and actions to be implemented by all relevant sectors of society. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the epidemiology of type 1 diabetes in children in Philadelphia, Pennsylvania, from 1995 through 1999 and compare these data with previous cohorts. RESEARCH DESIGN AND METHODS: This is a report of a retrospective population-based registry maintained since 1985. Hospital records meeting the following criteria were reviewed: newly diagnosed type 1 diabetes, age 0-14 years, residing in Philadelphia at the time of diagnosis, and diagnosed from 1 January 1995 to 31 December 1999. The secondary source of validation was the School District of Philadelphia. Incidence rates by race and age were compared with 1985-1989 and 1990-1994 cohorts. RESULTS: A total of 234 case subjects were identified, and the registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 14.8 per 100,000/year. Incidence rates in Hispanic children (15.5 per 100,000/year) and white children (12.8 per 100,000/year) have been relatively stable over 15 years. The incidence in black children (15.2 per 100,000/year), however, has increased dramatically, rising 64% in children 5-9 years of age (14.9 per 100,000/year) and 37% in the 10- to 14-year age-group (26.9 per 100,000/year). CONCLUSIONS: The overall incidence of type 1 diabetes in Philadelphia is increasing and is similar to other U.S. registries. These are the first data reporting a higher incidence in black children in a registry of children 0-14 years of age. The etiology of the marked increase in incidence in the black population is unknown and underscores the need to establish type 1 diabetes as a reportable disease, so that environmental risk factors may be thoroughly investigated. [ABSTRACT FROM AUTHOR]

LIBQUAL+ is a tool designed to measure user perceptions of service quality in academic libraries. This web-based protocol was recently completed by 20,416 participants representing forty-three universities. For the purposes of the present report these data were evaluated to address two research questions: (a) how reliable were the LIBQUAL+ scores?; and (b) what were the dimensions underlying user perceptions of library service quality? The second question focuses upon identifying the most appropriate scales to report LIBQUAL+ scores to librarians using the protocol to improve service quality. [ABSTRACT FROM AUTHOR]

Outlines a three-year evaluation study of the effectiveness of the Wessex Healthy Schools Award (WHSA) intervention in changing health promotion policy and practice in school. Diagram of the WHSA evaluation plan; Selection of pupil results comparing intervention and control schools at baseline and follow-up; Performance of intervention schools in comparison to control schools.

Infections due to Coxiella burnetii, the causative organism of Q fever, are extremely rare in North America. Endocarditis due to the organism has an unusual presentation and poses echocardiographic and laboratory challenges in establishing a diagnosis. We describe the presentation and clinical course of a 40-year-old American man with Q fever endocarditis and briefly discuss the salient issues regarding this entity. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome (SARS) is a recently recognized febrile respiratory illness that first appeared in southern China in November 2002, has since spread to several countries, and has resulted in more than 8000 cases and more than 750 deaths. The disease has been etiologically linked to a novel coronavirus that has been named the SARS-associated coronavirus. It appears to be spread primarily by large droplet transmission. There is no specific therapy, and management consists of supportive care. This article summarizes currently available information regarding the epidemiology, clinical features, etiologic agent, and modes of transmission of the disease, as well as infection control measures appropriate to contain SARS. [ABSTRACT FROM AUTHOR]

Record breaking atmospheric methane growth rates were observed in 2020 and 2021 (15.2±0.5 and 17.8±0.5 parts per billion per year), the highest since the early 1980s. Here we use an ensemble of atmospheric inversions informed by surface or satellite methane observations to infer emission changes during these two years relative to 2019. Results show global methane emissions increased by 20.3±9.9 and 24.8±3.1 teragrams per year in 2020 and 2021, dominated by heightened emissions from tropical and boreal inundated areas, aligning with rising groundwater storage and regional warming. Current process-based wetland models fail to capture the tropical emission surges revealed by atmospheric inversions, likely due to inaccurate representation of wetland extents and associated methane emissions. Our findings underscore the critical role of tropical inundated areas in the recent methane emission surges and highlight the need to integrate multiple data streams and modeling tools for better constraining tropical wetland emissions., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

We have used spin-echo small-angle neutron scattering (SESANS) to probe the hierarchy of structures present in polymer-carbon nanocomposites, with length scales spanning over three orders of magnitude, from 10 nm to 16 μm. The data processing and reduction show a unified approach across two SESANS instruments (TU Delft and Larmor at the ISIS neutron source) and yield consistent data that are able to be modelled using well-established hierarchical models in freely available software such as SasView. Using this approach, we are able to extend the measured length scales by over an order of magnitude compared to traditional scattering methods. This yields information about the structure in the bulk that is inaccessible with conventional scattering techniques (SANS/SAXS) and points to a way for interrogating and investigating polymer nanocomposites routinely across multiple length scales.

Parks have the potential to encourage physical activity among urban communities. However, existing research on the link between park use and physical activity has produced inconsistent results. Mixed findings in the past may be due in part to differences in park quality across studies. The aim of this study was to explore the association between park use and physical activity among New York City adults in low-income communities that recently received city-sponsored park renovation as part of the Community Parks Initiative (CPI). Using population-weighted survey data from eight neighborhoods with recent park renovation (n = 2,000), we measured associations between park use frequency (≥ once/week vs. < once/week) and self-reported physical activity (high vs. low-moderate based on the International Physical Activity Questionnaire). We adjusted models for age, sex, education, race/ethnicity, income, study site, and use of other (non-CPI) parks, and conducted stratified analysis for demographic variables with significant interactions with park use. After adjusting for covariates, we observed a positive association between park use and physical activity (prevalence ratio [PR] = 1.30, 95% CI = 1.16-1.46). Greater frequency of park use was more strongly associated with high physical activity among adults ≤ 50 y (PR = 1.39, 95% CI = 1.14-1.69), individuals with annual household income < $25,000 (PR = 1.54, 95% CI = 1.13-2.08), and Latinos (PR = 1.77, 95% CI = 1.44-2.18). Our findings suggest that high-quality parks might be particularly beneficial for promoting physical activity among those with a lower socioeconomic background and in younger and Latino adults, emphasizing the importance of continued investment in park revitalization among urban communities of color., (© 2024. W. Montague Cobb-NMA Health Institute.)

Background: Good Samaritan Laws are a harm reduction policy intended to facilitate a reduction in fatal opioid overdoses by enabling bystanders, first responders, and health care providers to assist individuals experiencing an overdose without facing civil or criminal liability. However, Good Samaritan Laws may not be reaching their full impact in many communities due to a lack of knowledge of protections under these laws, distrust in law enforcement, and fear of legal consequences among potential bystanders. The purpose of this study was to develop a systems-level understanding of the factors influencing bystander responses to opioid overdose in the context of Connecticut's Good Samaritan Laws and identify high-leverage policies for improving opioid-related outcomes and implementation of these laws in Connecticut (CT)., Methods: We conducted six group model building (GMB) workshops that engaged a diverse set of participants with medical and community expertise and lived bystander experience. Through an iterative, stakeholder-engaged process, we developed, refined, and validated a qualitative system dynamics (SD) model in the form of a causal loop diagram (CLD)., Results: Our resulting qualitative SD model captures our GMB participants' collective understanding of the dynamics driving bystander behavior and other factors influencing the effectiveness of Good Samaritan Laws in the state of CT. In this model, we identified seven balancing (B) and eight reinforcing (R) feedback loops within four narrative domains: Narrative 1 - Overdose, Calling 911, and First Responder Burnout; Narrative 2 - Naloxone Use, Acceptability, and Linking Patients to Services; Narrative 3 - Drug Arrests, Belief in Good Samaritan Laws, and Community Trust in Police; and Narrative 4 - Bystander Naloxone Use, Community Participation in Harm Reduction, and Cultural Change Towards Carrying Naloxone., Conclusions: Our qualitative SD model brings a nuanced systems perspective to the literature on bystander behavior in the context of Good Samaritan Laws. Our model, grounded in local knowledge and experience, shows how the hypothesized non-linear interdependencies of the social, structural, and policy determinants of bystander behavior collectively form endogenous feedback loops that can be leveraged to design policies to advance and sustain systems change., (© 2024. The Author(s).)

Excess iron has been shown to promote tumor growth in animals whereas iron deficiency has been associated with reduced or slowed tumor growth. The objective of this analysis was to estimate the associations between serum iron biomarkers and tumor size at diagnosis and metastatic status in a sample of breast cancer cases from the Sister Study.The analytic sample included 2,494 incident breast cancer cases with information on tumor size and iron biomarkers, including serum iron (mcg/dL), ferritin (mcg/dL), and percent transferrin saturation, measured in serum collected at baseline. We used Spearman rank correlation and linear regression models to assess the associations between one SD changes in serum iron biomarker levels and natural log of tumor size (cm) adjusting for body mass index and age at study entry.We did not find strong associations between any of the three serum iron biomarkers and tumor size. Adjusted regression slopes (95% confidence interval) were -0.016 (-0.048 to 0.016) for serum iron, -0.032 (-0.064 to <0.001) for ferritin, and -0.010 (-0.043 to 0.023) for transferrin saturation.This study did not provide evidence supporting the hypothesis of a positive association between breast cancer tumor size at diagnosis and prediagnostic serum iron levels. Conflicting evidence between this study and previous research in animal models suggests that iron in the human tumor microenvironment may operate independently of circulating iron or body iron stores.Iron has shown protumorigenic activity in animal models, but our data do not support a positive relationship between breast tumor growth and iron status., Significance: Using a large sample of women from a U.S. prospective cohort, we assessed associations between several serum iron measures at baseline and breast cancer tumor size and metastatic status. All estimated associations were close to zero with no evidence to support our hypothesis of higher body iron levels associated with larger tumor size. These results suggest the human tumor microenvironment operates independently of circulating serum iron levels., (© 2024 The Authors; Published by the American Association for Cancer Research.)

The impact of adverse listening conditions on spoken language perception is well established, but the role of suboptimal viewing conditions on signed language processing is less clear. Viewing angle, i.e. the physical orientation of a perceiver relative to a signer, varies in many everyday deaf community settings for L1 signers and may impact comprehension. Further, processing from various viewing angles may be more difficult for late L2 learners of a signed language, with less variation in sign input while learning. Using a semantic decision task in a distance priming paradigm, we show that British Sign Language signers are slower and less accurate to comprehend signs shown from side viewing angles, with L2 learners in particular making disproportionately more errors when viewing signs from side angles. We also investigated how individual differences in mental rotation ability modulate processing signs from different angles. Speed and accuracy on the BSL task correlated with mental rotation ability, suggesting that signers may mentally represent signs from a frontal view, and use mental rotation to process signs from other viewing angles. Our results extend the literature on viewpoint specificity in visual recognition to linguistic stimuli. The data suggests that L2 signed language learners should maximise their exposure to diverse signed language input, both in terms of viewing angle and other difficult viewing conditions to maximise comprehension., (© 2024. The Author(s).)

We report on the mechanism of enhancing the luminance and external quantum efficiency (EQE) by developing nanostructured channels in hybrid (organic/inorganic) light-emitting transistors (HLETs) that combine a solution-processed oxide and a polymer heterostructure. The heterostructure comprised two parts: (i) the zinc tin oxide/zinc oxide (ZTO/ZnO), with and without ZnO nanowires (NWs) grown on the top of the ZTO/ZnO stack, as the charge transport layer and (ii) a polymer Super Yellow (SY, also known as PDY-132) layer as the light-emitting layer. Device characterization shows that using NWs significantly improves luminance and EQE (≈1.1% @ 5000 cd m -2 ) compared to previously reported similar HLET devices that show EQE < 1%. The size and shape of the NWs were controlled through solution concentration and growth time, which also render NWs to have higher crystallinity. Notably, the size of the NWs was found to provide higher escape efficiency for emitted photons while offering lower contact resistance for charge injection, which resulted in the improved optical performance of HLETs. These results represent a significant step forward in enabling efficient and all-solution-processed HLET technology for lighting and display applications., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Purpose: To apply principles of group model building (GMB), a participatory systems science approach, to identify barriers and opportunities for collective impact around nutrition programming to reduce cancer risk for immigrant communities in an urban environment., Methods: We convened four in-person workshops applying GMB with nine community partners to generate causal loop diagrams (CLDs)-a visual representation of hypothesized causal relationships between variables and feedback structures within a system. GMB workshops prompted participants to collaboratively identify programmatic goals and challenges related to (1) community gardening, (2) nutrition education, (3) food assistance programs, and (4) community-supported agriculture. Participants then attended a plenary session to integrate findings from all workshops and identify cross-cutting ideas for collective action., Results: Several multilevel barriers to nutrition programming emerged: (1) food policies center the diets and practices of White Americans and inhibit culturally tailored food guidelines and funding for culturally appropriate nutrition education; (2) the lack of culturally tailored nutrition education in communities is a missed opportunity for fostering pride in immigrant food culture and sustainment of traditional food practices; and (3) the limited availability of traditional ethnic produce in food assistance programs serving historically marginalized immigrant communities increases food waste and worsens food insecurity., Conclusion: Emergent themes coalesced around the need to embed cultural tailoring into all levels of the food system, while also considering other characteristics of communities being reached (e.g., language needs). These efforts require coordinated actions related to food policy and advocacy, to better institutionalize these practices within the nutrition space., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

To assess the clinical impacts of prenatal consultation with a multidisciplinary cleft team on infants with cleft lip with or without cleft palate (CL ± P)., Retrospective cases series., Tertiary pediatric hospital., Infants with CL ± P whose mothers received prenatal consultation with a pediatric otolaryngology team from June 2005 to December 2019 were identified. A random sample of infants with CL ± P without prenatal consultation from June 2005 to December 2019 was also identified., The primary outcomes were the length of hospitalization during the first 12 weeks of life, timing of surgical repair, length of postsurgical hospitalization, and number of unplanned clinic visits and phone calls for feeding evaluation., Time to cleft lip repair differed significantly between the 2 groups with repair performed at 13.4 (±0.9) weeks for the prenatal consultation group (n = 73) and 15.3 (±2.1) weeks for the control group (n = 80), ( P  < .05). If hospitalization was required for feeding difficulties during the first 12 weeks of life, length of stay was 4.9 (± 1.7) days for infants with prenatal consultation and 11.5 (± 7.2) days for control infants ( P  < .05). Unplanned clinic visits with a speech-language pathologist (SLP) for feeding difficulties were needed for 2.7% of prenatal consultation infants and 11.3% of control infants ( P  < .05)., Prenatal consultation regarding CL ± P resulted in infants with decreased duration of early hospitalizations, earlier cleft lip repair, and decreased engagement with the SLP feeding clinic for feeding difficulties when compared with infants without prenatal consultation.