•There is a striking lack of, and inequity in access to, “safe” green space.•Future park access assessments should consider crime in their measures of quality.•Strategies should target park safety to ...improve access and environmental justice.
Safety is an important dimension of access to green space. When parks are perceived as unsafe, people are unlikely to derive the health and community benefits from them. In this study, we examine inequities in green space access in five medium-to-large US cities using parcel-level, network-based analysis. We quantify access using three measures: proximity, congestion-weighted acreage, and crime-constrained proximity. We find that, in the five US cities studied, there is a striking lack of access to safe parks. In addition, inequalities between socioeconomic subgroups are substantially exacerbated when considering access to safe parks, with racial/ethnic minorities and low-income communities fairly consistently worse off. The results suggest that interventions to improve park safety could result in large and immediate improvements for access and environmental justice. However, even once these inequalities are addressed, there remains significant work to provide all residents with sufficient and proximal access to green space and the wide array of benefits that it has to offer.
Large-scale land acquisitions (LSLAs) can facilitate agricultural intensification in low- and middle-income countries, but they frequently dispossess smallholders of their land and thereby generate ...tradeoffs between market-oriented production and smallholder livelihoods. Given the global prevalence of LSLAs, it is important to understand how they can be structured to reconcile these goals. This paper focuses on contract farming (CF) as a means to reorient LSLAs to more effectively support smallholder land rights and food security. We develop an agent-based model of mixed crop-livestock smallholder livelihoods and calibrate it using household survey data from four LSLAs in Ethiopia. We apply the model to examine smallholder food security and regional productivity under three conditions representing increasing smallholder autonomy over land management: LSLA with smallholder displacement, LSLA with forced CF, and opt-in CF. Our modeling results indicate that supporting smallholder land rights through CF can mitigate the tradeoffs generated by LSLA-induced displacement. LSLAs that implemented a CF scheme improved food security and generated comparable productivity increases to LSLAs with displacement. Further, allowing smallholders to decide whether to participate in a CF scheme (i.e. avoiding land acquisition) resulted in greater alignment between the two outcomes, particularly due to improved food security for poorer households. Our results suggest that to realize these benefits it is important to ensure contract compliance and thereby maintain smallholder trust in the contracting firm. Thus, LSLA governance that fosters smallholder agency, empowerment, and security of land rights could contribute to sustainable development.
Researchers and development organizations regularly grapple with competing ecological and financial strategies for building climate resilience in smallholder agricultural systems, but rarely are such ...approaches considered in tandem. Using a social-ecological simulation model, we explored how different combinations of legume cover cropping, an ecological insurance, and index-based crop insurance, a financial insurance, affect the climate resilience of mixed crop-livestock smallholder farmers over time. The model simulates interactions between soil nutrient dynamics, crop yields, and household wealth, which is carried solely in the form of livestock. We assume legume cover cropping provides biological nitrogen fixation, thereby increasing soil fertility and productivity over time, whereas microinsurance gives payouts in drought years that provide ex-post coping benefits. Our model results indicate that the benefits of cover cropping to mean household income strongly complement the shock-absorbing benefits of microinsurance. Specifically, we found: (1) insurance always provides larger benefits during and in the wake of a drought, while cover cropping progressively reduces poverty in the medium- to long-term; (2) the use of crop insurance solely as an ex-post coping strategy may not reduce the incidence of poverty; and (3) legume cover cropping offers larger relative benefits in more degraded environments and for poor farmers. These results underscore the complementary roles that ecological and financial strategies could play in building resilience in smallholder agricultural systems. The stylized model constitutes an important social-ecological foundation for future empirical research to inform agricultural innovation and sustainable development priorities.
Large-scale land transactions (LSLTs) can precipitate dramatic changes in land systems. Ethiopia has experienced one of the largest amounts of LSLTs in Africa, yet their effects on local land systems ...are poorly understood. In this study, we quantify the direct and indirect land use and land cover (LULC) changes associated with LSLTs at eight socio-environmentally diverse sites in central and western Ethiopia. To estimate these effects, we employ a novel, two-stage counterfactual analysis. We first use a region-growing procedure to identify a "control" site with comparable landscape-level characteristics to each LSLT. Then, we sample and reweight points within each control site to further improve covariate balance. This two-stage approach both controls for potential confounding factors at multiple spatial levels and reduces the costs of extensive LULC data classification. Our results show that the majority of the reported transacted area (62%) remained unconverted to large-scale agriculture. Most of the land that was developed into large-scale agriculture displaced smallholder agriculture (53%), followed by conversion of woodland/shrubland (35%) and forest (9%). Beyond their boundaries, LSLTs indirectly influenced rates of smallholder agricultural expansion and abandonment, pointing to site dependence in how LSLTs affect adjacent land systems. In particular, the low prevalence of forest within and around these LSLTs underscores a need to move beyond measures of deforestation as proxies for LSLT effects on land systems. Our two-stage approach shows promise as an efficient method for generating robust counterfactuals and thereby LULC change estimates in systems lacking wall-to-wall LULC data.
Abstract
Background
Common types of musculoskeletal conditions include pain in the neck and shoulder areas. This study seeks to identify the genetic variants associated with neck or shoulder pain ...based on a genome-wide association approach using 203 309 subjects from the UK Biobank cohort and look for replication evidence from the Generation Scotland: Scottish Family Health Study (GS:SFHS) and TwinsUK.
Methods
A genome-wide association study was performed adjusting for age, sex, BMI and nine population principal components. Significant and independent genetic variants were then sent to GS:SFHS and TwinsUK for replication.
Results
We identified three genetic loci that were associated with neck or shoulder pain in the UK Biobank samples. The most significant locus was in an intergenic region in chromosome 17, rs12453010, having P = 1.66 × 10−11. The second most significant locus was located in the FOXP2 gene in chromosome 7 with P = 2.38 × 10−10 for rs34291892. The third locus was located in the LINC01572 gene in chromosome 16 with P = 4.50 × 10−8 for rs62053992. In the replication stage, among four significant and independent genetic variants, rs2049604 in the FOXP2 gene and rs62053992 in the LINC01572 gene were weakly replicated in GS:SFHS (P = 0.0240 and P = 0.0202, respectively).
Conclusions
We have identified three loci associated with neck or shoulder pain in the UK Biobank cohort, two of which were weakly supported in a replication cohort. Further evidence is needed to confirm their roles in neck or shoulder pain.
Background
Fresh frozen plasma (FFP) transfusion is used to manage coagulopathy and bleeding in cardiac surgery patients despite uncertainty about its safety and effectiveness.
Methods
We performed a ...propensity score matched analysis of the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database including patients from 39 centres from 2005 to 2018. We investigated the association of perioperative FFP transfusion with mortality and other clinical outcomes.
Results
Of 119,138 eligible patients, we successfully matched 13,131 FFP recipients with 13,131 controls. FFP transfusion was associated with 30‐day mortality (odds ratio (OR), 1.41; 99% CI, 1.17–1.71; p < .0001), but not with long‐term mortality (hazard ratio (HR), 0.92; 99% CI, 0.85–1.00; p = .007, Holm–Bonferroni α = 0.0004). FFP was also associated with return to theatre for bleeding (OR, 1.97; 99% CI, 1.66–2.34; p < .0001), prolonged intubation (OR, 1.15; 99% CI, 1.05–1.26; p < .0001) and increased chest tube drainage (Mean difference (MD) in mL, 131; 99% CI, 120–141; p < .0001). It was also associated with reduced postoperative creatinine levels (MD in g/L, −6.33; 99% CI, −10.28 to −2.38; p < .0001).
Conclusion
In a multicentre, propensity score matched analysis, perioperative FFP transfusion was associated with increased 30‐day mortality and had variable associations with secondary clinical outcomes.
Data from clinical registries may be linked to gain additional insights into disease processes, risk factors and outcomes. Identifying information varies from full names, addresses and unique ...identification codes to statistical linkage keys to no direct identifying information at all. A number of databases in Australia contain the statistical linkage key 581 (SLK-581). Our aim was to investigate the ability to link data using SLK-581 between two national databases, and to compare this linkage to that achieved with direct identifiers or other non-identifying variables.
The Australian and New Zealand Society of Cardiothoracic Surgeons database (ANZSCTS-CSD) contains fully identified data. The Australian and New Zealand Intensive Care Society database (ANZICS-APD) contains non-identified data together with SLK-581. Identifying data is removed at participating hospitals prior to central collation and storage. We used the local hospital ANZICS-APD data at a large single tertiary centre prior to deidentification and linked this to ANZSCTS-CSD data. We compared linkage using SLK-581 to linkage using non-identifying variables (dates of admission and discharge, age and sex) and linkage using a complete set of unique identifiers. We compared the rate of match, rate of mismatch and clinical characteristics between unmatched patients using the different methods.
There were 1283 patients eligible for matching in the ANZSCTS-CSD. 1242 were matched using unique identifiers. Using non-identifying variables 1151/1242 (92.6%) patients were matched. Using SLK-581, 1202/1242 (96.7%) patients were matched. The addition of non-identifying data to SLK-581 provided few additional patients (1211/1242, 97.5%). Patients who did not match were younger, had a higher mortality risk and more non-standard procedures vs matched patients. The differences between unmatched patients using different matching strategies were small.
All strategies provided an acceptable linkage. SLK-581 improved the linkage compared to non-identifying variables, but was not as successful as direct identifiers. SLK-581 may be used to improve linkage between national registries where identifying information is not available or cannot be released.
Sustainable intensification (SI) responds to the concurrent challenges of increasing food production while reducing the environmental impacts of agriculture. As an early disclosure of innovation, ...patents are a useful indicator of technology market potential. However, we lack understanding of the extent to which current agricultural technology patents relate to the goals of SI and which kinds of technologies can potentially address SI. Here, we analyzed the diffusion and focus of more than one million patents issued during the period 1970–2022. We explored the degree to which the patents relate to SI through the co-occurrence of efficiency and environmental friendliness targets. Our results reveal that while the rate of patent issuance has dramatically increased over the past five decades, the rate at which patents diffused to different countries had decreased over time. The USA was the biggest net exporter of patents and had produced by far the most high-impact patents (in the top 1% most-cited patents). Since 1970, only 4% of agricultural patents and 6% of high-impact patents were related to SI targets (i.e., promoting both agricultural efficiency and environmental friendliness), but the attention to SI has increased over time. The most highly cited SI-related patents had become more diverse over time, shifting from digital, machine, and energy technologies in 1980s to the current era of agroecology, information, and computer networking. Our results provide an early indication of promising technologies that may play a greater role for SI in the future, subject to the challenges of market transfer and farm adoption and complemented by non-technological innovations in farm management and institutional support.
Platelet transfusion is common in cardiac surgery, but some studies have suggested an association with harm. Accordingly, we investigated the association of perioperative platelet transfusion with ...morbidity and mortality.
We conducted a retrospective analysis of prospectively collected data from the Australian Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database. We included consecutive adults from 2005 to 2018 across 40 centers. We used inverse probability of treatment weighting via entropy balancing to investigate the association of perioperative platelet transfusion with our 2 primary outcomes, operative mortality (composite of both 30-day and in-hospital mortality) and 90-day mortality, as well as multiple other clinically relevant secondary outcomes.
Among 119,132 eligible patients, 25,373 received perioperative platelets and 93,759 were considered controls. After entropy balancing, platelet transfusion was associated with reduced operative mortality (odds ratio OR, 0.63; 99% confidence interval CI, 0.47-0.84; P < .0001) and 90-day mortality (OR, 0.66; 99% CI, 0.51-0.85; P < .0001). Moreover, it was associated with reduced odds of deep sternal wound infection (OR, 0.57; 99% CI, 0.36-0.89; P = .0012), acute kidney injury (OR, 0.84; 99% CI, 0.71-0.99; P = .0055), and postoperative renal replacement therapy (OR, 0.71; 99% CI, 0.54-0.93; P = .0013). These positive associations were observed despite an association with increased odds of return to theatre for bleeding (OR, 1.55; 99% CI, 1.16-2.09; P < .0001), pneumonia (OR, 1.26; 99% CI, 1.11-1.44; P < .0001), intubation for longer than 24 hours postoperatively (OR, 1.13; 99% CI, 1.03-1.24; P = .0012), inotrope use for >4 hours postoperatively (OR, 1.14; 99% CI, 1.11-1.17; P < .0001), readmission to hospital within 30 days of surgery (OR, 1.22; 99% CI, 1.11-1.34; P < .0001), as well as increased drain tube output (adjusted mean difference, 89.2 mL; 99% CI, 77.0 mL-101.4 mL; P < .0001).
In cardiac surgery patients, perioperative platelet transfusion was associated with reduced operative and 90-day mortality. Until randomized controlled trials either confirm or refute these findings, platelet transfusion should not be deliberately avoided when considering odds of death.
Advances in Land System Science (LSS) rely on the evidence generated by different types of research activities, including place-based case studies, landscape/land-system mapping and synthesis ...research. However, these activities are usually conducted in parallel, with a lack of integration often leading to important knowledge gaps and limitations. In this article, we provide tools for the application of geographic similarity analysis (GSA), a collection of spatially-explicit methods assessing the degree of similarity between geographic locations, and thereby help to address these limitations. We identify opportunities for employing GSA to support: 1) selecting geographically representative sets of case studies; 2) integrating empirical evidence generated at different scales and levels of abstraction; and 3) facilitating context-sensitive knowledge transfer. The resulting toolbox provides approaches for facilitating researchers to get an enhanced understanding of multi-scale land change processes, as well as supporting land governance in scaling up the knowledge and solutions generated by LSS research.
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