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Increasingly, studies compare risk and protective factors for involvement in violent and nonviolent terrorist behaviors. This exploratory study investigates whether this distinction is sufficient, or whether it should be disaggregated further into more granular terrorist roles and behaviors. Using data on 404 referrals to a UK countering violent extremism Prevent hub specializing in mental health and associated needs, we compare violent and nonviolent referrals, and then more specific behaviors (vulnerability, proactive extremism, foreign fighting, and violence planning). Bivariate and multivariate analyses show there is value in disaggregating beyond the binary violence versus nonviolence distinction, as more (and more detailed) relationships emerged when using the disaggregated set of behaviors. While gender did not differentiate violent and nonviolent referrals, women were more likely to be referred for radicalization vulnerability or potential foreign fighting. Extreme right-wing and extreme Islamist referrals were no more or less violent overall, but Islamist referrals were disproportionately referred for both the most and least violent behaviors. Personality and developmental disorders were associated with violence, and disaggregated behaviors provided detailed insight into the drivers of these associations. These exploratory findings, while interesting, likely do not generalize beyond our specific sample. Instead, this study's value lies in demonstrating the utility for both research and, eventually, practice of disaggregating beyond violence and nonviolence. The results demonstrate clear operational implications for threat assessment in the need to include a more refined set of risk factors to aid in assessing risk of more relevant outcomes than terrorist involvement overall., (© 2024 The Author(s). Journal of Forensic Sciences published by Wiley Periodicals LLC on behalf of American Academy of Forensic Sciences.)

Background: Professional guidelines and state Medicaid policies encourage pediatricians to provide oral health screening, anticipatory guidance, and fluoride varnish application to young patients. Because oral health activities are becoming more common in medical offices, the objective of this study was to assess pediatricians' attitudes and practices related to oral health and examine changes since 2008., Methods: As part of the 2012 Periodic Survey of Fellows, a random sample of 1638 members of the American Academy of Pediatrics was surveyed on their participation in oral health promotion activities. Univariate statistics were used to examine pediatricians' attitudes, practices, and barriers related to screening, risk assessment, counseling, and topical fluoride application among patients from birth to 3 years of age. Bivariate statistics were used to examine changes since 2008., Results: Analyses were limited to 402 pediatricians who provided preventive care (51% of all respondents). Most respondents supported providing oral health activities in medical offices, but fewer reported engaging in these activities with most patients. Significantly more respondents agreed they should apply fluoride varnish (2008, 19%; 2012, 41%), but only 7% report doing so with >75% of patients. Although significantly more respondents reported receiving oral health training, limited time, lack of training and billing remain barriers to delivering these services., Conclusions: Pediatricians continue to have widespread support for, but less direct involvement with oral health activities in clinical practice. Existing methods of training should be examined to identify methods effective at increasing pediatricians' participation in oral health activities., (Published by Elsevier Inc.)

Objective. (1) To describe an innovative program training US pediatricians to be Chapter Oral Health Advocates (COHAs). (2) To provide insight into COHAs' experiences disseminating oral health knowledge to fellow pediatricians. Patients and Methods. Interviews with 40 COHAs who responded to an email request, from a total of 64 (62% response). Transcripts were analyzed for common themes about COHA activities, facilitators, and barriers. Results. COHAs reported positive experiences at the AAP oral health training program. A subset of academic COHAs focused on legislative activity and another on resident education about oral health. Residents had an easier time adopting oral health activities while practicing pediatricians cited time constraints. COHAs provided insights into policy, barriers, and facilitators for incorporating oral health into practice. Conclusions. This report identifies factors influencing pediatricians' adoption of oral health care into practice. COHAs reported successes in training peers on integrating oral health into pediatric practice, identified opportunities and challenges to oral health implementation in primary care, and reported issues about the state of children's oral health in their communities. With ongoing support, the COHA program has a potential to improve access to preventive oral health services in the Medical Home and to increase referrals to a Dental Home.

Objective: Primary care providers need effective strategies for substance use screening and brief counseling of adolescents. We examined the effects of a new computer-facilitated screening and provider brief advice (cSBA) system., Methods: We used a quasi-experimental, asynchronous study design in which each site served as its own control. From 2005 to 2008, 12- to 18-year-olds arriving for routine care at 9 medical offices in New England (n = 2096, 58% females) and 10 in Prague, Czech Republic (n = 589, 47% females) were recruited. Patients completed measurements only during the initial treatment-as-usual study phase. We then conducted 1-hour provider training, and initiated the cSBA phase. Before seeing the provider, all cSBA participants completed a computerized screen, and then viewed screening results, scientific information, and true-life stories illustrating substance use harms. Providers received screening results and "talking points" designed to prompt 2 to 3 minutes of brief advice. We examined alcohol and cannabis use, initiation, and cessation rates over the past 90 days at 3-month follow-up, and over the past 12 months at 12-month follow-up., Results: Compared with treatment as usual, cSBA patients reported less alcohol use at follow-up in New England (3-month rates 15.5% vs 22.9%, adjusted relative risk ratio [aRRR] = 0.54, 95% confidence interval 0.38-0.77; 12-month rates 29.3% vs 37.5%, aRRR = 0.73, 0.57-0.92), and less cannabis use in Prague (3-month rates 5.5% vs 9.8%, aRRR = 0.37, 0.17-0.77; 12-month rates 17.0% vs 28.7%, aRRR = 0.47, 0.32-0.71)., Conclusions: Computer-facilitated screening and provider brief advice appears promising for reducing substance use among adolescent primary care patients.

The mentally ill are overrepresented in the statistics of individuals killed or injured by police and it is understandable that police would seek a weapon, such as a TASER, that is less lethal than a firearm. However, it appears that use of TASERs is not without risk, especially in certain groups, including the mentally ill. The risk of injury to vulnerable people with a mental illness from TASER weapons must be weighed against the risk that escalation to lethal force may cause if a person with an acute mental illness requires restraint. When police officers are carrying out their duties under mental health legislation it is recommended that TASERs be used only when an individual is imminently likely to sustain or to cause grievous bodily harm. This article recommends changes to the Western Australian Police TASER training programs and proposes mandatory medical assessments after the use of TASER restraint.

Objective: Pediatricians have regular opportunities to perform screening dental examinations on young children and to educate families on preventive oral health. We sought to assess pediatricians' current attitudes and practices related to oral health of children 0-3 years old., Methods: A Periodic Survey of Fellows, focused on oral health in pediatricians' office settings, was sent to 1618 postresidency fellows of the American Academy of Pediatrics., Results: The response rate was 68%. More than 90% of pediatricians said that they should examine their patients' teeth for caries and educate families about preventive oral health. However, in practice, only 54% of pediatricians reported examining the teeth of more than half of their 0-3-year-old patients. Four percent of pediatricians regularly apply fluoride varnish. The most common barrier to participation in oral health-related activities in their practices was lack of training, which was cited by 41%. Less than 25% of pediatricians had received oral health education in medical school, residency, or continuing education. Most pediatricians (74%) reported that availability of dentists who accept Medicaid posed a moderate to severe barrier for 0-3-year-old Medicaid-insured patients to obtain dental care., Conclusions: Pediatricians see it within their purview to educate families about preventive oral health and to assess for dental caries. However, many pediatricians reported barriers to fully implementing preventive oral health activities into their practices. Pediatricians and dentists need to work together to improve the quality of preventive oral health care available to all young children.

Background: There is a lack of access to oral health services for American children. Some propose that pediatricians be trained to deliver preventive screening and education to families until they access a dental home. However, little is known about the current oral health training provided during pediatric residency. OBJECTIVE. The purpose of this work was to evaluate the oral health training that pediatricians receive during residency and their attitudes toward performing basic oral health screenings., Methods: The American Academy of Pediatrics Survey of Graduating Residents is an annual, randomly sampled national survey of graduating pediatric residents. The 2006 Survey of Graduating Residents surveyed 611 residents and examined their perception of their oral health training and their attitudes about performing oral health screenings., Results: Thirty-five percent of residents received no oral health training during residency. Of those who did, 73% had <3 hours of training, and only 14% had clinical observation time with a dentist. Seventy-one percent felt that they had too little oral health training, and only 21% felt that their residency was very good or excellent in preparing them to perform oral health-risk assessments. Residents felt confident in their ability to offer anticipatory guidance but not to do the more technical oral health screenings. The majority of residents believed that pediatricians should conduct basic oral health screenings. Multiple regression analysis indicated that residents who received >or=3 hours of oral health training, who applied for jobs in the inner city, and whose career goal was to work in primary practice are those most likely to support this idea., Conclusions: Pediatric residents currently receive little training in oral health, and the majority wish for more. This study shows that oral health training during residency can increase pediatrician confidence in participating in important oral health promotion tasks, including anticipatory guidance, oral screenings, and oral health-risk assessment.

Background: The Centers for Disease Control and Prevention reports that topical fluoride application may prevent early childhood caries in high-risk populations. Yet, there are few published descriptions of caries prevention curricula for primary care residents., Methods: In 2003, the New Hampshire-Dartmouth Family Practice Residency hired a dentist and a hygienist to develop and implement a didactic and practical oral health curriculum., Results: Over 2 years, faculty and residents competent with oral health screening and fluoride varnish application rose from 0% to 69% to 100%. In the same period, the percentage of well-child visits (ages 6 months to 3 years) with documented oral health screening and fluoride varnish application rose from 0% to 80% to 91%., Conclusions: Our successful model of teaching early childhood caries prevention services within the well-child visit could be replicated by other residency programs. Programs may need start-up funding for initial training by dental professionals.

Objectives: Primary care lacks emphasis on oral health (OH) despite its major effects on one's overall health. This mixed-methods bibliometric study was conducted to assess the content of OH in primary care journals., Methods: Sixty-seven of the most influential journals were identified from primary care specialties and disciplines using Scopus CiteScore metrics and expert opinion. For each specialty, one journal was chosen as the "core journal." A search string was then developed to extract OH related articles found within a ten-year time frame (2012-2021) which were subsequently analyzed for OH content, trends, and article type., Results: Of the 1784 articles extracted, 1068 met inclusion criteria. When compared with the total number of articles published by journals in any category, OH articles comprised less than 1% of total articles published between 2012 and 2021. Family medicine showed a borderline significant increase in OH articles over this time period while pediatrics showed a significant decline. Among the core journals, there was a statistically significant decline in OH articles published in geriatrics and pediatrics. Case reports and review articles were the most common type of OH article published. General oral lesions and population-specific OH delivery were the most common topics published., Conclusion: This review highlights the relatively low prevalence of OH articles in primary care journals and defines the most prevalent types of OH articles. Further studies are needed to understand the reasons for the lack of OH articles in primary care journals and the implications for primary care providers and learners., (© 2025 American Association of Public Health Dentistry.)

Overcoming acquired resistance to Osimertinib remains a critical challenge in treating NSCLC. This research indicates that Osimertinib-resistant cells exhibit a strong dependence on glutamine metabolism. However, targeting GLS1 shows limited anticancer effects, probably because it cannot fully block the glutamine metabolic pathway. The investigation reveals that a more effective strategy involves simultaneously inhibiting both ASCT2 and GLS1. After confirming the efficacy of this dual-targeting approach against Osimertinib-resistant cells in preclinical models, the potential of utilizing a broad-spectrum glutamine metabolism antagonist is further explored to achieve superior antitumor efficacy. DON, broad-spectrum glutamine antagonist, presents toxicity issues. Herein, the high NQO1 expression in Osimertinib-resistant NSCLC cells is leveraged to design an NQO1-responsive DON prodrug, 10e (LBJ-10e). This prodrug demonstrates superior safety compared to natural DON and greater antitumor activity against resistant tumors compared to the clinical phase II drug DRP104. These findings may address the clinical limitations of GLS1 allosteric inhibitors and underscore prodrug strategies in effectively treating Osimertinib-resistant lung cancer, providing a foundation for future clinical trials., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Birds, bats and ants are recognised as significant arthropod predators. However, empirical studies reveal inconsistent trends in their relative roles in top-down control across strata. Here, we describe the differences between forest strata in the separate effects of birds, bats and ants on arthropod densities and their cascading effects on plant damage. We implemented a factorial design to exclude vertebrates and ants in both the canopy and understorey. Additionally, we separately excluded birds and bats from the understorey using diurnal and nocturnal exclosures. At the end of the experiments, we collected all arthropods and assessed herbivory damage. Arthropods responded similarly to predator exclusion across forest strata, with a density increase of 81% on trees without vertebrates and 53% without both vertebrates and ants. Additionally, bird exclusion alone led to an 89% increase in arthropod density, while bat exclusion resulted in a 63% increase. Herbivory increased by 42% when vertebrates were excluded and by 35% when both vertebrates and ants were excluded. Bird exclusion alone increased herbivory damage by 28%, while the exclusion of bats showed a detectable but non-significant increase (by 22%). In contrast, ant exclusion had no significant effect on arthropod density or herbivory damage across strata. Our results reveal that the effects of birds and bats on arthropod density and herbivory damage are similar between the forest canopy and understorey in this temperate forest. In addition, ants were not found to be significant predators in our system. Furthermore, birds, bats and ants appeared to exhibit antagonistic relationships in influencing arthropod density. These findings highlight, unprecedentedly, the equal importance of birds and bats in maintaining ecological balance across different strata of a temperate forest., (© 2024 The Author(s). Journal of Animal Ecology © 2024 British Ecological Society.)

Research Highlight: Sivault, E., Kollross, J., Jorge, L., Finnie, S., Diez Mendez, D., Fernandez Garzon, S., Maraia, H., Lenc, J., Libra, M., Masashi, M., Nakaji, T., Nakamura, M., Sreekar, R., Sam, L., Abe, T., Weiss, M., & Sam, K. (2024). Insectivorous birds and bats outperform ants in the top-down regulation of arthropods across strata of a Japanese temperate forest. Journal of Animal Ecology. https://doi.org/10.1111/1365-2656.14146. Top-down predators exert strong effects on prey populations. Theoretical and empirical studies investigating the cascading effects of predators on biodiversity dynamics and ecosystem functionality have been central to advancing ecology and conservation biology. Yet, how intraguild predation and niche overlap drive the strength and direction of trophic cascades across forest strata is still barely understood. In a study published in this issue, Sivault et al. (2024) investigated the impacts of excluding vertebrate (birds and bats) and invertebrate (ants) predators on arthropod herbivores and plant damage in understory and canopy forest strata. The study finds that birds and bats (but not ants) have negative impacts on herbivore density, which, in turn, benefits plants by reducing leaf damage. Additionally, the effects of vertebrate predators are similar across strata. The authors also show that herbivore density and herbivory are greater in the understory compared to the canopy strata. Sivault et al. (2024) demonstrate that intraguild predation and niche overlap dictate the strength and direction of trophic cascades in forest ecosystems. In addition, these findings shed new light on forest ecology and conservation, especially considering the potential negative effects of climate change on top predators., (© 2024 The Author(s). Journal of Animal Ecology © 2024 British Ecological Society.)

Purpose: Osteosarcoma, a highly malignant primary bone tumor primarily affecting adolescents, frequently develops resistance to initial chemotherapy, leading to metastasis and limited treatment options. Our study aims to uncover novel therapeutic targets for metastatic and recurrent osteosarcoma., Methods: In this study, we proved the potential of modulating the YAP1-regulated glutamine metabolic pathway to augment the response of OS to DFMO. We initially employed single-cell transcriptomic data to gauge the activation level of polyamine metabolism in MTAP-deleted OS patients. This was further substantiated by transcriptome sequencing data from recurrent and non-recurrent patient tissues, confirming the activation of polyamine metabolism in progressive OS. Through high-throughput drug screening, we pinpointed CIL56, a YAP1 inhibitor, as a promising candidate for a combined therapeutic strategy with DFMO. In vivo, we utilized PDX and CDX models to validate the therapeutic efficacy of this drug combination. In vitro, we conducted western blot analysis, qPCR analysis, immunofluorescence staining, and PuMA experiments to monitor alterations in molecular expression, distribution, and tumor metastasis capability. We employed CCK-8 and colony formation assays to assess the proliferative capacity of cells in the experimental group. We used flow cytometry and reactive oxygen probes to observe changes in ROS and glutamine metabolism within the cells. Finally, we applied RNA-seq in tandem with metabolomics to identify metabolic alterations in OS cells treated with a DFMO and CIL56 combination. This enabled us to intervene and validate the role of the YAP1-mediated glutamine metabolic pathway in DFMO resistance., Results: Through single-cell RNA-seq data analysis, we pinpointed a subset of late-stage OS cells with significantly upregulated polyamine metabolism. This upregulation was further substantiated by transcriptomic profiling of recurrent and non-recurrent OS tissues. High-throughput drug screening revealed a promising combination strategy involving DFMO and CIL56. DFMO treatment curbs the phosphorylation of YAP1 protein in OS cells, promoting nuclear entry and initiating the YAP1-mediated glutamine metabolic pathway. This reduces intracellular ROS levels, countering DFMO's anticancer effect. The therapeutic efficacy of DFMO can be amplified both in vivo and in vitro by combining it with the YAP1 inhibitor CIL56 or the glutaminase inhibitor CB-839. This underscores the significant potential of targeting the YAP1-mediated glutamine metabolic pathway to enhance efficacy of DFMO., Conclusion: Our findings elucidate YAP1-mediated glutamine metabolism as a crucial bypass mechanism against DFMO, following the inhibition of polyamine metabolism. Our study provides valuable insights into the potential role of DFMO in an "One-two Punch" therapy of metastatic and recurrent osteosarcoma., (© 2024. Springer Nature Switzerland AG.)

Background: Most studies regarding the oral health knowledge of medical practitioners are based on surveys., Aim: To assess medical practitioners' knowledge in diagnosing and managing children oral health issues using eye tracking technology., Design: Forty-one medical practitioners completed a cross-sectional survey questionnaire and subsequently viewed 5 clinical images of children's oral cavities to indicate the issues observed and their management. Tobii eye tracking device captured each participant's visual search behaviours and mean length of fixation (LOF) for each area of interest (AOI). Participant self-reported confidence in examining the oral cavity, and qualification level was recorded for data analysis., Results: No correlation between time spent viewing the soft tissues and self-reported confidence examining the oral cavity was observed (P = .25). Self-reported confidence in examining the oral cavity was not associated with a correct diagnosis. LOF on the decayed teeth was significantly associated with a correct diagnosis of 'caries' (P < .05), and paediatric training was associated with a correct diagnosis of dental caries (P < .05)., Conclusion: Medical practitioners' diagnosis and management were poorly correlated with their objective visual search behaviours of the intraoral images. Self-reported confidence in examining and managing oral issues was not correlated with a correct diagnosis, with the majority not confident of examining children oral cavity., (© 2020 BSPD, IAPD and John Wiley & Sons Ltd.)

The increasing frequency and severity of heatwaves will intensify stress on plants. Given regional variation in heatwave exposure and expected differences in thermal tolerance between species it is unlikely that all plant species will be affected equally by climate change. However, little is currently known about variation in the responses of plants to heat stress, or how those responses differ among closely related species adapted to different environments. Here we quantify the response of 17 Acacia species (175 RNA-seq libraries), from across Australia's diverse biomes, to a multi-day experimental heatwave treatment to identify variation in transcriptomic and physiological responses to heat stress. Genes with known heat response functions showed consistent responses across Acacia species. Up to 10% of all genes and over 100 gene families showed significant clinal variation in the magnitude of their expression plasticity across species. Specifically, gene families linked to the temperature stress response were overrepresented among significant relationships with home range temperature conditions. Gene expression responses seen on the first day of the heatwave were more frequently associated with home range climates, while expression responses by day four were more commonly related to photosystem II acclimation. Comparative transcriptomics on non-model species has the potential to provide key information on stress response plasticity, especially when linked with our understanding of model species. Our study indicates that the pressing challenge to identifying potentially vulnerable species to climate change could be benefited by the further exploration of clinal variation in transcriptome plasticity., (© 2024 The Author(s). Molecular Ecology published by John Wiley & Sons Ltd.)

Terrestriality is relatively rare in the predominantly arboreal primate order. How frequently, and when, terrestriality appears in primate evolution, and the factors that influence this behavior, are not well understood. To investigate this, we compiled data describing terrestriality in 515 extant nonhuman primate taxa. We describe the geographic and phylogenetic distribution of terrestriality, including an ancestral state reconstruction estimating the frequency and timing of evolutionary transitions to terrestriality. We review hypotheses concerning the evolution of primate terrestriality and test these using data we collected pertaining to characteristics including body mass and diet, and ecological factors including forest structure, food availability, weather, and predation pressure. Using Bayesian analyses, we find body mass and normalized difference vegetation index are the most reliable predictors of terrestriality. When considering subsets of taxa, we find ecological factors such as forest height and rainfall, and not body mass, are the most reliable predictors of terrestriality for platyrrhines and lemurs., (© 2024 The Authors. Evolutionary Anthropology published by Wiley Periodicals LLC.)

The strong correlation between chlorophyll fluorescence (ChlF) parameters and photosynthesis highlights the need for a comprehensive spatial representation of ChlF parameters within the canopy. Such an approach is essential to advance our understanding and to improve the representation and modeling of water and carbon fluxes at scales ranging from the leaf to the canopy level. However, the challenge remains in determining how to effectively describe and track the variability of ChlF parameters within the canopy. In this study, we determined the variation in leaf biophysical and chemical traits and ChlF parameters along the vertical height of the canopy for several species in a temperate deciduous forest. We observed general associations of height with leaf biophysical and chemical traits and ChlF parameters, although these relationships were species-dependent. In addition, leaf biophysical and chemical traits, particularly light-harvesting pigments, showed significant effects on ChlF parameters. To effectively track variation in ChlF parameters within the canopy, we used gradient-boosted regression (GBR) models driven by leaf traits and species, which explained more than 80% of the variation in all ChlF parameters. Our study demonstrates the feasibility of utilizing leaf biophysical and chemical traits to predict vertical variation in ChlF parameters and provide supportive data for modeling canopy photosynthesis., (© 2024 The Author(s). Physiologia Plantarum published by John Wiley & Sons Ltd on behalf of Scandinavian Plant Physiology Society.)

This article advances ideas presented at a National Academies of Sciences, Engineering, and Medicine workshop in 2022 that highlighted clinical practice and policy recommendations for delivering universal, family-focused substance use preventive interventions in pediatric primary care. Pediatric primary care is a natural setting in which to offer families universal anticipatory guidance and links to systematic prevention programming; also, several studies have shown that offering effective parenting programs in primary care is feasible. The article describes a blueprint for designing a pragmatic national agenda for universal substance use prevention in primary care that builds on prior work. Blueprint practice schematics leverage efficacious family-focused prevention programs, identify key program implementation challenges and resources, and emphasize adopting a core element approach and utilizing digital interventions. Blueprint policy schematics specify avenues for improving cross-sector policy and resource alignment and collaboration; expanding, diversifying, and strengthening the prevention workforce; and enhancing financing for family-focused prevention approaches. The article then draws from these schematics to assemble a candidate universal prevention toolkit tailored for adolescent patients that contains four interlocking components: education in positive parenting practices, parent and youth education in substance use risks, a parent-youth structured interaction task, and parent and youth linkage to in-person and web-based prevention resources., (© 2023. Society for Prevention Research.)

Abstract: Many interdisciplinary oral health education programs have been implemented for pediatric primary care providers (e.g., pediatric nurse practitioner [PNP]) to raise awareness and gain skills related to the prevention of early childhood caries (ECC). However, no studies have evaluated if these educational programs provided to PNPs during their training resulted in clinical practice behavior changes. A 33-item survey was designed on a web-based platform (Survey Monkey) and distributed to 71 PNP graduates. The survey included demographics, current clinical practice, clinical practice behaviors, and perceived barriers to practice. Descriptive statistics were used to assess the survey items and thematic analyses on the open-ended questions. The survey response rate was 70% (50/71 PNPs). Most practicing PNPs were in acute care or specialty clinics (n = 33; 66%) where oral health was not part of the focused visit. Majority used knowledge learned in assessment and anticipatory guidance skills. However, only 14% of primary care providers were applying fluoride varnish with 10% billing for this procedure. Barriers to application were time, available supplies, COVID protocols, lack of support staff, or not billing due to minimal reimbursement. Many primary care-trained PNPs were practicing in acute or subspecialty areas where prevention of ECC is not viewed as part of their focused visit. Pediatric nurse practitioners working in primary care demonstrated some clinical practice changes. However, areas for improvement are time to perform a risk assessment and application of fluoride varnish, access to these supplies, and standard billing and insurance reimbursement for these preventable services., Competing Interests: Competing interests: The authors and coauthors have no financial or conflicts of interest to disclose. The authors acknowledge the continued funding support by the Health Resources and Services Administration [Grant ID: D88HP20129 and D88HP39034]., (Copyright © 2022 American Association of Nurse Practitioners.)

Although the importance of natural habitats to pollinator diversity is widely recognized, the value of forests to pollinating insects has been largely overlooked in many parts of the world. In this review, we (i) establish the importance of forests to global pollinator diversity, (ii) explore the relationship between forest cover and pollinator diversity in mixed-use landscapes, and (iii) highlight the contributions of forest-associated pollinators to pollination in adjacent crops. The literature shows unambiguously that native forests support a large number of forest-dependent species and are thus critically important to global pollinator diversity. Many pollinator taxa require or benefit greatly from resources that are restricted to forests, such as floral resources provided by forest plants (including wind-pollinated trees), dead wood for nesting, tree resins, and various non-floral sugar sources (e.g. honeydew). Although landscape-scale studies generally support the conclusion that forests enhance pollinator diversity, findings are often complicated by spatial scale, focal taxa, landscape context, temporal context, forest type, disturbance history, and external stressors. While some forest loss can be beneficial to pollinators by enhancing habitat complementarity, too much can result in the near-elimination of forest-associated species. There is strong evidence from studies of multiple crop types that forest cover can substantially increase yields in adjacent habitats, at least within the foraging ranges of the pollinators involved. The literature also suggests that forests may have enhanced importance to pollinators in the future given their role in mitigating the negative effects of pesticides and climate change. Many questions remain about the amount and configuration of forest cover required to promote the diversity of forest-associated pollinators and their services within forests and in neighbouring habitats. However, it is clear from the current body of knowledge that any effort to preserve native woody habitats, including the protection of individual trees, will benefit pollinating insects and help maintain the critical services they provide., (© 2023 Cambridge Philosophical Society. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Background: Children with cystic fibrosis (CF) are usually managed by hospital-based, multidisciplinary teams (MDTs). This study aimed to investigate oral health perspectives, training, and practices of health professionals working with children with CF., Methods: Data were collected through an online survey distributed to health professionals caring for children with CF by the CF Director in 12 Australian hospitals. The questions related to perspectives, training, and dental referral/advice relating to oral health for children with CF. The data were analyzed using descriptive statistics., Results: Forty-four participants (26 physicians, 8 nurses, 6 physiotherapists, 2 dieticians, 1 psychologist, and 1 pharmacist) completed the survey. Most (n = 33, 75%) indicated they rarely/never check or discuss dental health. Of those who did, most reported lacking skills to inspect teeth and discuss dental health. Frequently reported barriers were lack of skills, training, knowledge, and time. Most respondents (n = 30, 68%) indicated they rarely/never recommend patients to see the dentist. The most frequently reported barrier to referrals was not considering it part of their role (43%)., Conclusions: Closer working relations between CF units and dental teams may remove barriers that prevent non-dental clinicians from supporting patients with CF maintain oral health. Better integration of dental care within the MDT through improved professional training, increased referral practices, and availability of digital resources may help to improve dental care for all children, including children and adolescents with CF., (© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)

Objectives: To evaluate child-level dental utilization and expenditure outcomes based on if and where children received fluoride varnish (FV) at quality improvement (QI) medical practices, at non-QI medical practices, at dental practices, or those who never received FV from any practice., Design: Retrospective claims-based analysis cohort study., Setting: Children with Medicaid insurance through an Ohio pediatric accountable care organization., Participants: Children aged 1 to 5 years with 1 or more well-child visits between 2015 and 2017., Intervention: FV receipt versus no FV. Among children who received FV, categorized if FV delivered by a QI-participating medical provider, a non-QI-participating medical provider, and a dental provider., Main Outcome Measure: Dental claims from 2014 to 2019 were collected for preventive dental visits, caries-related treatment visits, dental general anesthesia (GA) visit, and emergency department visit for a dental problem to examine utilization patterns, expenditures, and dental outcomes., Results: The QI group had a significantly higher incidence of preventive dental visits than the dental (incidence rate ratio [IRR] = 0.93; 95% confidence interval [CI], 0.91-0.96) or non-QI groups (IRR = 0.86; 95% CI, 0.84-0.88). Compared with the QI group, the non-QI (adjusted odds ratio [aOR] = 2.6; 95% CI, 2.4-2.9) and dental (aOR = 2.9; 95% CI, 2.6-3.3) groups were significantly more likely to have caries-related treatment visits. The dental group children were significantly more likely to have dental treatment under GA than the QI group (aOR = 5.3; 95% CI, 2.0-14.4)., Conclusions: Children seen at QI practices appear to have an increased uptake of preventive dental services, which may explain the lower incidence of dental caries visits and GA treatment., Competing Interests: C.G. and H.M. were paid employees of Partners For Kids during the study period. The authors have no conflicts of interest to disclose., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Tropical forests harbour the highest levels of terrestrial biodiversity and represent some of the most complex ecosystems on Earth, with a significant portion of this diversity above ground. Although the vertical dimension is a central aspect of the ecology of forest communities, there is little consensus as to prominence, evenness, and consistency of community-level stratification from ground to canopy. Here, we gather the results of 62 studies across the tropics to synthesise and assess broad patterns of vertical stratification of abundance and richness in vertebrates, the best studied taxonomic group for which results have not been collated previously. Our review of the literature yielded sufficient data for bats, small mammals, birds and amphibians. We show that variation in the stratification of abundance and richness exists within and among all taxa considered. Bat richness stratification was variable among studies, although bat abundance was weighted towards the canopy. Both bird richness and abundance stratification were variable, with no overriding pattern. On the contrary, both amphibians and small mammals showed consistent patterns of decline in abundance and richness towards the canopy. We descriptively characterise research trends in drivers of stratification cited or investigated within studies, finding local habitat structure and food distribution/foraging to be the most commonly attributed drivers. Further, we analyse the influence of macroecological variables on stratification patterns, finding latitude and elevation to be key predictors of bird stratification in particular. Prominent differences among taxa are likely due to taxon-specific interactions with local drivers such as vertical habitat structure, food distribution, and vertical climate gradients, which may vary considerably across macroecological gradients such as elevation and biogeographic realm. Our study showcases the complexity with which animal communities organise within tropical forest ecosystems, while demonstrating the canopy as a critical niche space for tropical vertebrates, thereby highlighting the inherent vulnerability of tropical vertebrate communities to forest loss and canopy disturbance. We recognise that analyses were constrained due to variation in study designs and methods which produced a variety of abundance and richness metrics recorded across different arrangements of vertical strata. We therefore suggest the application of best practices for data reporting and highlight the significant effort required to fill research gaps in terms of under-sampled regions, taxa, and environments., (© 2022 Cambridge Philosophical Society.)

Insect life cycles are short-term and therefore sensitive to immediate changes triggered by climate, vegetation structure, or land use management; hence, the insect populations shape the communities and functional relationships in tropical forests. In this study, we hypothesized that seasonal variations of the dipteran families respond in different ways to changes of weather conditions, thereby affecting their population dynamics. In a one-hectare plot, we surveyed the fly community inhabiting the understory of a Neotropical rainforest. Over a yearly cycle, we used three Malaise traps operated continuously for 365 days and recorded a total of 68,465 fly specimens belonging to 48 families of Diptera, 15 of which were most abundant, accounting for 99.2% of all sampled individuals. The results of the trapping frequency indices (TFIs) exhibited significant population fluctuations in 12 of the 15 most abundant families, which were particularly correlated with temperature or precipitation. Based on such variations, we identified four seasonal patterns as follows: (i) Spring-Autumn bimodal pattern (Cecidomyiidae, Sciaridae, Phoridae, Stratiomyidae); (ii) Spring pattern (Mycetophilidae, Dolichopodidae, Ceratopogonidae); (iii) Autumn pattern (Chironomidae, Psychodidae); (iv) Winter pattern (Empididae, Tipulidae, Ditomyiidae). From a functional perspective, we found the prevalence of families with saprophagous larvae, in addition to phytophagous, fungivores, and predacious. Our results suggest a key role played by the Diptera community on structuring the functional clusters, both in terms of taxonomic composition and on seasonal shifts of abundance, thus influencing the dynamic processes of nutrient cycling in the understory., (© 2022. Sociedade Entomológica do Brasil.)

Background: Caries risk assessment (CRA) tools may assist in identifying children at risk of early childhood caries., Aim: To complete a systematic review of CRA and develop a Canadian CRA tool for preschool children for use in non-dental clinical settings., Design: Systematic searches of relevant databases were conducted. Potential variables were based on strength of associations (odd ratios, relative risk, hazard ratios, etc), frequency of occurrence, and existing CRA tools. Quality of the evidence assessments were performed by at least two review teams through consensus following GRADE., Results: Overall, 25 publications met the inclusion criteria, all prospective in design. Based on this review, variables to be considered when developing a new CRA tool for use with preschool children are as follows: age, socioeconomic status, family toothbrushing habits, fluoride exposure, infant feeding practices, dietary habits/behaviours, dental home, caries experience, visible plaque, and enamel defects. The environmental scan identified 22 CRA tools suggesting other additional variables to consider including in a CRA tool, including special healthcare needs, enamel defects, and dental attendance., Conclusions: This review informed the development of a Canadian CRA tool for use by primary healthcare professionals, which may improve access to oral health assessments and increase interprofessional collaboration., (© 2021 BSPD, IAPD and John Wiley & Sons Ltd.)

Abstract: The aim of this study was to describe the patients' nursing care needs in a forensic psychiatric setting in line with the NANDA-I classification. Ten patients sentenced to forensic psychiatric care were interviewed. Data were analyzed by means of directed content analysis with a deductive approach, where we used "served time" as a factor in the analysis, thus creating three categories: newly arrived patients with a length of stay of only a couple of years, patients with a length of stay of around 5 years, and patients with a length of stay of more than 5 years. Thirteen NANDA-I diagnoses were identified during the analyses, distributed on seven different domains. When distributing the given NANDA-I diagnoses according to the created categories, an explanatory pattern emerged, and three themes became apparent: denial, insight, and listlessness. Considering the differences in views, the patients' own recognition of what is a problem, a potential, or a risk could improve a "working relation" and, eventually, a recovery. NANDA-I nursing diagnoses may improve individualized and person-centered care as NANDA-I makes care continuously consistent over time., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 International Association of Forensic Nurses.)

Objectives: The purpose of this study was to evaluate whether Public Health Dental Hygiene Practitioner (PHDHP) referrals to pediatric dentists were more successful for children younger than 3 years old and those with dental caries., Methods: We reviewed the electronic health records of 1,450 children, age 1 to 12 years, who completed a dental visit with a PHDHP in 2017 at UPMC Children's Hospital of Pittsburgh's (CHP) Primary Care Center. We tracked whether children who visited the onsite PHDHP accepted a referral to CHP pediatric dentists, and if so, whether they successfully completed the referral., Results: Of the 1,450 children who visited the PHDHP, 67 percent (n = 973) accepted a referral to CHP pediatric dentists. Of these referrals, 32 percent (312/973) were successfully fulfilled. The proportions of accepted and fulfilled referrals were significantly higher for children older than 3 years old and those with dental caries. After controlling for child age, gender, and insurance status, children with dental caries had 5.7 times greater odds of successful referral from the PHDHP to the pediatric dentist compared to children without dental caries (95 percent CI 4.1-7.9)., Conclusions: PHDHPs were more successful referring children older than 3 years old and those with dental caries to pediatric dentists. PHDHPs are allied dental health professionals that can be effective at referring children to pediatric dentists when they have dental caries. Additional strategies are needed to enhance the success rate of dental referrals for young children under 3 years old., (© 2020 American Association of Public Health Dentistry.)

Biodiversity faces many threats and these can interact to produce outcomes that may not be predicted by considering their effects in isolation. Habitat loss and fragmentation (hereafter 'fragmentation') and altered fire regimes are important threats to biodiversity, but their interactions have not been systematically evaluated across the globe. In this comprehensive synthesis, including 162 papers which provided 274 cases, we offer a framework for understanding how fire interacts with fragmentation. Fire and fragmentation interact in three main ways: (i) fire influences fragmentation (59% of 274 cases), where fire either destroys and fragments habitat or creates and connects habitat; (ii) fragmentation influences fire (25% of cases) where, after habitat is reduced in area and fragmented, fire in the landscape is subsequently altered because people suppress or ignite fires, or there is increased edge flammability or increased obstruction to fire spread; and (iii) where the two do not influence each other, but fire interacts with fragmentation to affect responses like species richness, abundance and extinction risk (16% of cases). Where fire and fragmentation do influence each other, feedback loops are possible that can lead to ecosystem conversion (e.g. forest to grassland). This is a well-documented threat in the tropics but with potential also to be important elsewhere. Fire interacts with fragmentation through scale-specific mechanisms: fire creates edges and drives edge effects; fire alters patch quality; and fire alters landscape-scale connectivity. We found only 12 cases in which studies reported the four essential strata for testing a full interaction, which were fragmented and unfragmented landscapes that both span contrasting fire histories, such as recently burnt and long unburnt vegetation. Simulation and empirical studies show that fire and fragmentation can interact synergistically, multiplicatively, antagonistically or additively. These cases highlight a key reason why understanding interactions is so important: when fire and fragmentation act together they can cause local extinctions, even when their separate effects are neutral. Whether fire-fragmentation interactions benefit or disadvantage species is often determined by the species' preferred successional stage. Adding fire to landscapes generally benefits early-successional plant and animal species, whereas it is detrimental to late-successional species. However, when fire interacts with fragmentation, the direction of effect of fire on a species could be reversed from the effect expected by successional preferences. Adding fire to fragmented landscapes can be detrimental for species that would normally co-exist with fire, because species may no longer be able to disperse to their preferred successional stage. Further, animals may be attracted to particular successional stages leading to unexpected responses to fragmentation, such as higher abundance in more isolated unburnt patches. Growing human populations and increasing resource consumption suggest that fragmentation trends will worsen over coming years. Combined with increasing alteration of fire regimes due to climate change and human-caused ignitions, interactions of fire with fragmentation are likely to become more common. Our new framework paves the way for developing a better understanding of how fire interacts with fragmentation, and for conserving biodiversity in the face of these emerging challenges., (© 2021 Cambridge Philosophical Society.)

Bactrocera tryoni is a polyphagous fruit fly that is predicated to have continuous breeding in tropical and subtropical Australia as temperature and hosts are not limiting. Nevertheless, in both rainforest and tropical agricultural systems, the fly shows a distinct seasonal phenology pattern with an autumn decline and a spring emergence. Temperature based population models have limited predictive capacity for this species and so the driver(s) for the observed phenology patterns are unknown. Using a demographic approach, we studied the age-structure of B. tryoni populations in subtropical Australia in an agricultural system, with a focus on times of the year when marked changes in population abundance occur. We found that the age-structure of the population varied with season: summer and autumn populations were composed of mixed-age flies, while late-winter and early-spring populations were composed of old to very old individuals. When held at a constant temperature, the longevity of adult reference cohorts (obtained from field infested fruits) also showed strong seasonality; the adults of spring and early autumn populations were short-lived, while late autumn and late winter adults were long-lived. While still expressing in modified landscapes, the data strongly suggests that B. tryoni has an endogenous mechanism which would have allowed it to cope with changes in the breeding resources available in its endemic monsoonal rainforest habitat, when fruits would have been abundant in the late spring and summer (wet season), and rare or absent during late autumn and winter (dry season).

Abnormal tumor microenvironment (TME) facilitates tumor proliferation and metastasis and establishes physiological barriers for effective transport of therapeutics inside the tumor, posing great challenges for cancer treatment. We designed a core-satellite size transformable nanoframework (denoted as T-PFRT) that can synchronously adapt to and remold TME for augmenting photodynamic therapy to inhibit tumor growth and prevent tumor metastasis. Upon matrix metalloproteinase 2 (MMP2)-responsive dissociation of the nanoframework in TME, the core structure loaded with TGFβ signaling pathway inhibitor and oxygen-carrying hemoglobin aims to stroma remodeling and hypoxia relief, allowing photosensitizer-encapsulated satellite particles to penetrate to deep-seated tumor for oxygen-fueled photodynamic therapy. T-PFRT could overcome the stroma and hypoxia barriers for delivering therapeutics and gain excellent therapeutic outcomes in the treatment of primary and metastatic tumors., (© 2021 Wiley-VCH GmbH.)

Vertical stratification (VS) is a widespread phenomenon in plant and animal communities in forests and a key factor for structuring their species richness and biodiversity, particularly in tropical forests. The organisms composing forest communities adjust and shape the complex three-dimensional structure of their environment and inhabit a large variety of niches along the vertical gradient of the forest. Even though the degree of VS varies among different vertebrate groups, patterns of compositional stratification can be observed across taxa. Communities of birds, bats, primates, and non-flying small mammals are vertically stratified in terms of abundance, species richness, diversity, and community composition. Frugivorous members of these taxa play important roles as seed dispersers and forage on fruit resources that, in turn, vary in quantity and nutritional value along the vertical gradient. As a consequence, plant-seed disperser interaction networks differ among strata, which is manifested in differences in interaction frequencies and the degree of mutual specialization. In general, the canopy stratum is composed of strong links and generalized associations, while the lower strata comprise weaker links and more specialized interactions. Investigating the VS of communities can provide us with a better understanding of species habitat restrictions, resource use, spatial movement, and species interactions. Especially in the face of global change, this knowledge will be important as these characteristics can imply different responses of species and taxa at a fine spatial scale., (© 2020 The Authors. Biological Reviews published by John Wiley & Sons Ltd on behalf of Cambridge Philosophical Society.)

Vegetation in tropical Asia is highly diverse due to large environmental gradients and heterogeneity of landscapes. This biodiversity is threatened by intense land use and climate change. However, despite the rich biodiversity and the dense human population, tropical Asia is often underrepresented in global biodiversity assessments. Understanding how climate change influences the remaining areas of natural vegetation is therefore highly important for conservation planning. Here, we used the adaptive Dynamic Global Vegetation Model version 2 (aDGVM2) to simulate impacts of climate change and elevated CO 2 on vegetation formations in tropical Asia for an ensemble of climate change scenarios. We used climate forcing from five different climate models for representative concentration pathways RCP4.5 and RCP8.5. We found that vegetation in tropical Asia will remain a carbon sink until 2099, and that vegetation biomass increases of up to 28% by 2099 are associated with transitions from small to tall woody vegetation and from deciduous to evergreen vegetation. Patterns of phenology were less responsive to climate change and elevated CO 2 than biomes and biomass, indicating that the selection of variables and methods used to detect vegetation changes is crucial. Model simulations revealed substantial variation within the ensemble, both in biomass increases and in distributions of different biome types. Our results have important implications for management policy, because they suggest that large ensembles of climate models and scenarios are required to assess a wide range of potential future trajectories of vegetation change and to develop robust management plans. Furthermore, our results highlight open ecosystems with low tree cover as most threatened by climate change, indicating potential conflicts of interest between biodiversity conservation in open ecosystems and active afforestation to enhance carbon sequestration., (© 2020 The Authors. Global Change Biology published by John Wiley & Sons Ltd.)

Aim: Many Australian children have dental decay in their deciduous teeth. Poor oral health can negatively impact a child's ability to eat, speak, sleep and socialise, with adverse impacts later in life. Paediatricians are well placed to examine children's teeth and to provide advice and education about oral health. Using a sample of Australian paediatricians, we aimed to determine: (i) self-reported oral health knowledge and skills, (ii) frequency of office-based oral health-related discussions, (iii) perceived role of paediatricians and (iv) barriers to oral health-related discussions., Methods: Members of a national network of paediatricians - the Australian Paediatric Research Network - completed a multi-topic survey, which included questions designed to assess oral health knowledge, current practice and barriers to oral health-related discussions., Results: Of 430 active members, 178 (41%) completed the survey. Few paediatricians reported very good/excellent ability to assess plaque build-up (8%) and dental caries (17%). Only 10% reported broaching the issue of oral health with all patients. Significant barriers included lack of professional training (52%) and other more pressing issues needing to be addressed (67%)., Conclusions: The increasing (and inequitable) rates of dental decay in Australian children mean that paediatricians should play a key role in the management of children's oral health. Many paediatricians reported a lack of specific training in oral health and limited ability to assess children and educate families. Despite the traditional divide between medicine and oral health, this study highlights the opportunity for Australian paediatricians to improve oral health through early intervention in the consultation room and beyond., (© 2019 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)

Background and Purpose: Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting., Methods: The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral. All caregiver/child dyads age birth to 5 years presenting to the pediatric clinic were eligible (n = 47)., Conclusions: Most children (n = 35, 91.1%) were scored as high risk for caries development. Of those with first tooth eruption (n = 36), ten had healthy teeth (27.8%) and seven had seen a dentist in the past 3 months (19.4%). All others were referred to a dentist (n = 29) and 21 families (72.4%) completed the referral., Implications for Practice: In fewer than 5 min per appointment (x = 4.73 min), the primary care provider integrated oral health screening, education, and referral into the well-child visit. Oral health is part of total health, and thus should be incorporated into routine well-child visits., (©2017 American Association of Nurse Practitioners.)