For the first four billion years of Earth's history, climate was marked by apparent stability and warmth despite the Sun having lower luminosity
. Proposed mechanisms for maintaining an elevated ...partial pressure of carbon dioxide in the atmosphere (Formula: see text) centre on a reduction in the weatherability of Earth's crust and therefore in the efficiency of carbon dioxide removal from the atmosphere
. However, the effectiveness of these mechanisms remains debated
. Here we use a global carbon cycle model to explore the evolution of processes that govern marine pH, a factor that regulates the partitioning of carbon between the ocean and the atmosphere. We find that elevated rates of 'reverse weathering'-that is, the consumption of alkalinity and generation of acidity during marine authigenic clay formation
-enhanced the retention of carbon within the ocean-atmosphere system, leading to an elevated Formula: see text baseline. Although this process is dampened by sluggish kinetics today, we propose that more prolific rates of reverse weathering would have persisted under the pervasively silica-rich conditions
that dominated Earth's early oceans. This distinct ocean and coupled carbon-silicon cycle state would have successfully maintained the equable and ice-free environment that characterized most of the Precambrian period. Further, we propose that during this time, the establishment of a strong negative feedback between marine pH and authigenic clay formation would have also enhanced climate stability by mitigating large swings in Formula: see text-a critical component of Earth's natural thermostat that would have been dominant for most of Earth's history. We speculate that the late ecological rise of siliceous organisms
and a resulting decline in silica-rich conditions dampened the reverse weathering buffer, destabilizing Earth's climate system and lowering baseline Formula: see text.
Design Thinking in Health Care Altman, Myra; Huang, Terry T K; Breland, Jessica Y
Preventing chronic disease,
09/2018, Letnik:
15
Journal Article
Recenzirano
Odprti dostop
Applying Design Thinking to health care could enhance innovation, efficiency, and effectiveness by increasing focus on patient and provider needs. The objective of this review is to determine how ...Design Thinking has been used in health care and whether it is effective.
We searched online databases (PubMed, Medline, Web of Science, CINAHL, and PyscINFO) for articles published through March 31, 2017, using the terms "health," "health care," or "healthcare"; and "Design Thinking," "design science," "design approach," "user centered design," or "human centered design." Studies were included if they were written in English, were published in a peer-reviewed journal, provided outcome data on a health-related intervention, and used Design Thinking in intervention development, implementation, or both. Data were collected on target users, health conditions, intervention, Design Thinking approach, study design or sample, and health outcomes. Studies were categorized as being successful (all outcomes improved), having mixed success (at least one outcome improved), or being not successful (no outcomes improved).
Twenty-four studies using Design Thinking were included across 19 physical health conditions, 2 mental health conditions, and 3 systems processes. Twelve were successful, 11 reported mixed success, and one was not successful. All 4 studies comparing Design Thinking interventions to traditional interventions showed greater satisfaction, usability, and effectiveness.
Design Thinking is being used in varied health care settings and conditions, although application varies. Design Thinking may result in usable, acceptable, and effective interventions, although there are methodological and quality limitations. More research is needed, including studies to isolate critical components of Design Thinking and compare Design Thinking-based interventions with traditionally developed interventions.
Measures of the built environment such as neighborhood walkability have been associated with health behaviors such as physical activity, the lack of which in turn may contribute to the development of ...diseases such as obesity, diabetes, cardiovascular disease, and cancer. However, limited research has examined these measures in association with health-related quality of life (HR-QoL), particularly in minoritized populations. We examined the relationship between perceived neighborhood environment and HR-QoL in a sample of mostly Black and Latino residents in New York City (NYC).
This study utilized the baseline survey data from the Physical Activity and Redesigned Community Spaces (PARCS) Study among 1252 residents 34.6% Black, 54.1% Latino, 80.1% female, mean(±SD) age = 38.8 ± 12.5) in 54 park neighborhoods in NYC. Perceived built environment was measured using Neighborhood Environment and Walkability Survey, and mental and physical HR-QoL was estimated using Short Form (SF)-12. Using factor analysis, we identified two subscales of neighborhood walkability: enablers (e.g., trails, sidewalks, esthetics) vs. barriers (e.g., high crime and traffic). In addition, we included a third subscale on neighborhood satisfaction. Generalized Estimating Equation models adjusted for demographics and BMI and accounted for the clustering effect within neighborhood. Multiple imputation was used to account for missing data.
Mental HR-QoL was associated with barriers of walkability (β ± SE = - 1.63 ± 0.55, p < 0.01) and neighborhood satisfaction (β ± SE = 1.55 ± 0.66, p = 0.02), after adjusting for covariates. Physical HR-QoL was associated with only barriers of walkability (β ± SE = - 1.13 ± 0.57, p < 0.05).
Among NYC residents living in minoritized neighborhoods, mitigating negative aspects of the neighborhood environment may be more crucial than adding positive features in terms of HR-QoL. Our study points to the need to investigate further the role of the built environment in urban, minoritized communities.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
4.
NAFLD - sounding the alarm on a silent epidemic Lazarus, Jeffrey V; Colombo, Massimo; Cortez-Pinto, Helena ...
Nature reviews. Gastroenterology & hepatology,
07/2020, Letnik:
17, Številka:
7
Journal Article
IMPORTANCE: Rural populations have a higher prevalence of obesity and poor access to weight loss programs. Effective models for treating obesity in rural clinical practice are needed. OBJECTIVE: To ...compare the Medicare Intensive Behavioral Therapy for Obesity fee-for-service model with 2 alternatives: in-clinic group visits based on a patient-centered medical home model and telephone-based group visits based on a disease management model. DESIGN, SETTING, AND PARTICIPANTS: Cluster randomized trial conducted in 36 primary care practices in the rural Midwestern US. Inclusion criteria included age 20 to 75 years and body mass index of 30 to 45. Participants were enrolled from February 2016 to October 2017. Final follow-up occurred in December 2019. INTERVENTIONS: All participants received a lifestyle intervention focused on diet, physical activity, and behavior change strategies. In the fee-for-service intervention (n = 473), practice-employed clinicians provided 15-minute in-clinic individual visits at a frequency similar to that reimbursed by Medicare (weekly for 1 month, biweekly for 5 months, and monthly thereafter). In the in-clinic group intervention (n = 468), practice-employed clinicians delivered group visits that were weekly for 3 months, biweekly for 3 months, and monthly thereafter. In the telephone group intervention (n = 466), patients received the same intervention as the in-clinic group intervention, but sessions were delivered remotely via conference calls by centralized staff. MAIN OUTCOMES AND MEASURES: The primary outcome was weight change at 24 months. A minimum clinically important difference was defined as 2.75 kg. RESULTS: Among 1407 participants (mean age, 54.7 SD, 11.8 years; baseline body mass index, 36.7 SD, 4.0; 1081 77% women), 1220 (87%) completed the trial. Mean weight loss at 24 months was –4.4 kg (95% CI, –5.5 to –3.4 kg) in the in-clinic group intervention, –3.9 kg (95% CI, –5.0 to –2.9 kg) in the telephone group intervention, and –2.6 kg (95% CI, –3.6 to –1.5 kg) in the in-clinic individual intervention. Compared with the in-clinic individual intervention, the mean difference in weight change was –1.9 kg (97.5% CI, –3.5 to –0.2 kg; P = .01) for the in-clinic group intervention and –1.4 kg (97.5% CI, –3.0 to 0.3 kg; P = .06) for the telephone group intervention. CONCLUSIONS AND RELEVANCE: Among patients with obesity in rural primary care clinics, in-clinic group visits but not telephone-based group visits, compared with in-clinic individual visits, resulted in statistically significantly greater weight loss at 24 months. However, the differences were small in magnitude and of uncertain clinical importance. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02456636
Type 2 diabetes is a significant and increasing burden in adolescents and young adults. Clear strategies for research, prevention, and treatment of the disease in these vulnerable patients are ...needed. Evidence suggests that type 2 diabetes in children is different not only from type 1 but also from type 2 diabetes in adults. Understanding the unique pathophysiology of type 2 diabetes in youth, as well as the risk of complications and the psychosocial impact, will enable industry, academia, funding agencies, advocacy groups, and regulators to collectively evaluate both current and future research, treatment, and prevention approaches. This Consensus Report characterizes type 2 diabetes in children, evaluates the fundamental differences between childhood and adult disease, describes the current therapeutic options, and discusses challenges to and approaches for developing new treatments.
Since the hyaloid artery does not close normally until about four to six weeks before full-term development, prematurity could be an important factor not only in preventing normal involution but also ...in producing an overgrowth of supporting tissue. The sporadic persistence of tunica vasculosa lentis in full-term infants is usually limited to one eye as if the lack of involution were a purely local disturbance. Should this group of cases be not a most unusual coincidence, but a complication in extreme prematurity, then it is important not only to establish the frequency but also to work out promptly the most satisfactory therapy.
Background Group model building is a process of engaging stakeholders in a participatory modeling process to elicit their perceptions of a problem and explore concepts regarding the origin, ...contributing factors, and potential solutions or interventions to a complex issue. Recently, it has emerged as a novel method for tackling complex, long-standing public health issues that traditional intervention models and frameworks cannot fully address. However, the extent to which group model building has resulted in the adoption of evidence-based practices, interventions, and policies for public health remains largely unstudied. The goal of this systematic review was to examine the public health and healthcare applications of GMB in the literature and outline how it has been used to foster implementation and dissemination of evidence-based interventions. Methods We searched PubMed, Web of Science, and other databases through August 2022 for studies related to public health or health care where GMB was cited as a main methodology. We did not eliminate studies based on language, location, or date of publication. Three reviewers independently extracted data on GMB session characteristics, model attributes, and dissemination formats and content. Results Seventy-two studies were included in the final review. Majority of GMB activities were in the fields of nutrition (n = 19, 26.4%), health care administration (n = 15, 20.8%), and environmental health (n = 12, 16.7%), and were conducted in the United States (n = 29, 40.3%) and Australia (n = 7, 9.7%). Twenty-three (31.9%) studies reported that GMB influenced implementation through policy change, intervention development, and community action plans; less than a third reported dissemination of the model outside journal publication. GMB was reported to have increased insight, facilitated consensus, and fostered communication among stakeholders. Conclusions GMB is associated with tangible benefits to participants, including increased community engagement and development of systems solutions. Transdisciplinary stakeholder involvement and more rigorous evaluation and dissemination of GMB activities are recommended.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: This work tested the rates at which Chinese children with either language delay or familial history of dyslexia at age 5 manifested dyslexia at age 7, identified which cognitive skills ...at age 5 best distinguished children with and without dyslexia at age 7, and examined how these early abilities predicted subsequent literacy skills.
Method: Forty‐seven at‐risk children (21 who were initially language delayed and 26 with familial risk) and 47 control children matched on age, IQ, and mothers’ education were tested on syllable awareness, tone detection, rapid automatized naming, visual skill, morphological awareness, and word reading at age 5 and subsequently tested for dyslexia on a standard Hong Kong measure at age 7.
Results: Of those with an early language delay, 62% subsequently manifested dyslexia; for those with familial risk, the rate of dyslexia was 50%. Those with dyslexia were best distinguished from those without dyslexia by the age‐5 measures of morphological awareness, rapid automatized naming, and word reading itself; other measures did not distinguish the groups. In a combined regression analysis across all participants, morphological awareness uniquely explained word reading accuracy and rapid automatized naming uniquely explained timed word reading at age 7, with all other measures statistically controlled. Separate stepwise regression analyses by group indicated that visual skill uniquely explained subsequent literacy skills in the at‐risk group only, whereas tone and syllable awareness were unique predictors of literacy skills in the control group only.
Conclusions: Both early language delay and familial risk strongly overlap with subsequent dyslexia in Chinese children. Overall, rapid automatized naming and morphological awareness are relatively strong correlates of developmental dyslexia in Chinese; visual skill and phonological awareness may also be uniquely associated with subsequent literacy development in at‐risk and typically developing children, respectively.
The ability to visualize endogenous proteins in living neurons provides a powerful means to interrogate neuronal structure and function. Here we generate recombinant antibody-like proteins, termed ...Fibronectin intrabodies generated with mRNA display (FingRs), that bind endogenous neuronal proteins PSD-95 and Gephyrin with high affinity and that, when fused to GFP, allow excitatory and inhibitory synapses to be visualized in living neurons. Design of the FingR incorporates a transcriptional regulation system that ties FingR expression to the level of the target and reduces background fluorescence. In dissociated neurons and brain slices, FingRs generated against PSD-95 and Gephyrin did not affect the expression patterns of their endogenous target proteins or the number or strength of synapses. Together, our data indicate that PSD-95 and Gephyrin FingRs can report the localization and amount of endogenous synaptic proteins in living neurons and thus may be used to study changes in synaptic strength in vivo.
•Recombinant intrabodies (FingRs) generated with mRNA display bind PSD-95 or Gephyrin•PSD-95 and Gephyrin FingRs accurately label endogenous targets in living neurons•Transcriptional control matches expression of FingRs to targets, reducing background•PSD-95 and Gephyrin FingRs do not affect neuronal morphology or function
New methods are needed to monitor synaptic structure in vivo in real time. Gross et al. report the generation of genetically encoded intrabodies (FingRs) that bind Gephryn and PSD-95 and can be used to fluorescently label inhibitory and excitatory synapses.
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