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Purpose: Disproportionally high rates of coronavirus disease 2019 (COVID-19) have been noted among communities with limited English proficiency, resulting in an unmet need for improved multilingual care and interpreter services. To enhance multilingual care, the authors created a freely available web application, RadTranslate, that provides multilingual radiology examination instructions. The purpose of this study was to evaluate the implementation of this intervention in radiology.Methods: The device-agnostic web application leverages artificial intelligence text-to-speech technology to provide standardized, human-like spoken examination instructions in the patient's preferred language. Standardized phrases were collected from a consensus group consisting of technologists, radiologists, and ancillary staff members. RadTranslate was piloted in Spanish for chest radiography performed at a COVID-19 triage outpatient center that served a predominantly Spanish-speaking Latino community. Implementation included a tablet displaying the application in the chest radiography room. Imaging appointment duration was measured and compared between pre- and postimplementation groups.Results: In the 63-day test period after launch, there were 1,267 application uses, with technologists voluntarily switching exclusively to RadTranslate for Spanish-speaking patients. The most used phrases were a general explanation of the examination (30% of total), followed by instructions to disrobe and remove any jewelry (12%). There was no significant difference in imaging appointment duration (11 ± 7 and 12 ± 3 min for standard of care versus RadTranslate, respectively), but variability was significantly lower when RadTranslate was used (P = .003).Conclusions: Artificial intelligence-aided multilingual audio instructions were successfully integrated into imaging workflows, reducing strain on medical interpreters and variance in throughput and resulting in more reliable average examination length. [ABSTRACT FROM AUTHOR]

As interest in natural climate mitigation solutions continues to grow, there is an essential role for coastal and ocean ecosystems ("blue carbon") to play. To meet mitigation targets, however, it is crucial that human actions to protect or restore blue carbon sinks are based on solid science and actionable human management opportunities to increase sinks and reduce emissions from ecosystem loss. Here, we reaffirm the role of coastal wetlands in climate mitigation opportunities. We update the state of the science regarding existing blue carbon pathways and explore expanding the blue carbon opportunities to new systems. Specifically, we analyze new science for those blue carbon pathways we categorize as "emerging" (e.g., management interventions involving macroalgae - both cultivated and wild, tidal flats, and marine sediments) where human action may be able to increase these sinks, but we currently have insufficient information to ensure that their climate mitigation benefit is additional. We revisit those that are "non-actionable" (e.g., management interventions involving calcifying organisms and marine fauna) where the scientific evidence is clear that there is no mitigation benefit, or the science is too uncertain to claim that human action can definitively increase these carbon sinks. With limited funding for climate action, it is critical that efforts focus on projects with the most mitigation potential. Blue carbon management is only one piece in the climate mitigation challenge, but it is an important one. Continued scientific research and investment in developing policy pathways is warranted for these actionable and emerging systems. At the same time, the world must continue to work to decrease emissions rapidly, invest in other natural climate solutions, and scale renewable energy technologies. [ABSTRACT FROM AUTHOR]

Abstract Background Literature on population awareness about actual causes of cancer is growing but comparatively little is known about the prevalence of people's belief concerning mythical causes of cancer. This study aimed to estimate the prevalence of these beliefs and their association with socio-demographic characteristics and health behaviours. Methods A survey containing validated measures of beliefs about actual and mythical cancer causes and health behaviours (smoking, alcohol consumption, physical activity, fruit and vegetable consumption, overweight) was administered to a representative English population sample (N = 1330). Results Awareness of actual causes of cancer (52% accurately identified; 95% confidence interval [CI] 51–54) was greater than awareness of mythical cancer causes (36% accurately identified; 95% CI 34–37; P < 0.01). The most commonly endorsed mythical cancer causes were exposure to stress (43%; 95% CI 40–45), food additives (42%; 95% CI 39–44) and non-ionizing electromagnetic frequencies (35%; 95% CI 33–38). In adjusted analysis, greater awareness of actual and mythical cancer causes was independently associated with younger age, higher social grade, being white and having post-16 qualifications. Awareness of actual but not mythical cancer causes was associated with not smoking and eating sufficient fruit and vegetables. Conclusions Awareness of actual and mythical cancer causes is poor in the general population. Only knowledge of established risk factors is associated with adherence to behavioural recommendations for reducing cancer risk. Highlights • Approximately half of known lifestyle-related risk factors were not recognised by the general public in England. • Belief in mythical risk factors was common, particularly stress, food additives and electromagnetic frequencies. • Knowledge of actual but not mythical cancers causes was associated with health-protective behaviours. [ABSTRACT FROM AUTHOR]

The reaction of 2 equiv of 1-acyloxyalkyl-1-iodides with vitamin C 5,6-acetonide gave mixtures of products that were O -alkylated on the 3-position and either O -alkylated, 7 , or O -acylated, 8 , on the 2-position. The 8 products comprised the majority of the mixtures: 56:54 to 94:6. The 3-alkylated-2-acylated prodrugs, 8 , hydrolyzed to vitamin C 5,6-acetonide chemically at pH 7.4 with half-lives of 6–12 h. [ABSTRACT FROM AUTHOR]

Background Parent ratings on questionnaires may provide valid and cost-effective tools for screening cognitive development of children at risk of developmental delay. Aims In this study, we examined the convergent validity of combining parent-based reports of non-verbal cognitive abilities (PARCA3) and verbal abilities (CDI-III) in relation to the Bayley-III cognitive scale in 3-year-olds born late pre-term. Methods Mothers of 185 late-preterm children were asked to complete the PARCA3 and the CDI-III shortly before children reached age three; children were then assessed using the Bayley-III close to their third birthday. Results The two maternal questionnaires were significantly and moderately correlated with the Bayley-III cognitive scores. Together the maternal ratings accounted for 15% of the variance in the Bayley-III cognitive scores, after controlling for other covariates in regression analysis. In particular, the PARCA3 contributed significantly to explain variance in the Bayley-III cognitive scores when controlling for the CDI-III. However, the CDI-III was also independently associated with the Bayley-III cognitive scores. Conclusions Parent ratings of child cognition and language together may provide cost-effective screening of development in “at risk” preschoolers. [ABSTRACT FROM AUTHOR]

Inhabited islands are susceptible to natural hazards, such as wildfires. To avoid disasters, preventative measures and guidelines need to be in place to strengthen community resilience. If these fail, evacuation is often the only choice. However, island evacuation is a vastly understudied problem in both research and practice, particularly for islands without permanent road connections to the mainland that require marine evacuation. Multiple vessel trips are necessary to evacuate the population from suitable access points, which previous studies did not entertain. Furthermore, most existing studies either focus on evacuations from an academic, or from a government perspective. Instead, this paper presents a collaborative approach. It applies a recently developed evacuation routing model that optimizes the evacuation plan for Bowen Island in Canada through minimizing the expected evacuation time across disaster scenarios. These were designed with the participation of a broad range of stakeholders, from local residents and volunteer groups to agencies from all levels of government and companies, which integrates both academic and practical perspectives to maximize solution quality. Different options for fleet sizes, staging locations and scenarios were considered. The results show that the optimized evacuation time for Bowen Island varies between 1 and 8 h, as it strongly depends on the disaster scenario, the evacuation fleet, and can be accelerated by temporary staging areas. The suitability of the approach for evacuation studies can be confirmed through the identification of key improvements for increased community resilience and the inclusion of the results in the official Bowen Island evacuation plan. [ABSTRACT FROM AUTHOR]

Abstract: Background: Late preterm infants (LPIs), born at 34+0 to 36+6weeks of gestation contribute a significant proportion of all neonatal intensive care (NIC) admissions and are regarded as being at risk of adverse outcomes compared to term-born infants. Aim: To explore the health outcomes and family functioning of LPIs who required neonatal intensive care, at three years of age. Study design and subjects: This cohort study included 225 children born late preterm, between 1 January and 31 December 2006 in Northern Ireland. Children admitted for NIC (study group, n=103) were compared with children who did not require NIC or who required special care only for up to three days (comparison group, n=122). Outcome measures: Health outcomes were measured using the Health Status Questionnaire, health service usage by parent report and family functioning using the PedsQL™ Family Impact Module. Results: LPIs who required NIC revealed similar health outcomes at three years in comparison to those who did not. Despite this, more parents of LPIs who required NIC reported visiting their GP and medical specialists during their child's third year of life. Differences in family functioning were also observed with mothers of LPIs who required NIC reporting, significantly lower levels of social and physical functioning, increased difficulties with communication and increased levels of worry. Conclusions: LPIs were observed to have similar health outcomes at three years of age regardless of NIC requirement. The increase in GP and medical specialist visits and family functioning difficulties observed among those infants who required NIC merits further investigation. [Copyright &y& Elsevier]

Taxonomic knowledge is critical to understanding, cataloguing, and assessing biodiversity, and is central to measuring and achieving conservation goals, including the Post-2020 Framework of the Convention on Biological Diversity. Taxonomy is a centuries-old discipline, but its tools, diversity of users, and applications are constantly expanding and evolving. The lack of trackable and interoperable taxonomic data inhibits data integration and knowledge transfer across communities and disciplines, constraining conservation applications. We propose a globally integrated structure of taxonomy composed of six elements to increase understanding of taxonomic interoperability status across the fields of taxonomy, biodiversity, and conservation. Normalizing taxonomic integration assessments by data aggregators and users will help inform and track progress towards cross-group name integration, biodiversity synthesis science, and applications. All aspects of biodiversity research, from taxonomy to conservation, rely on data associated with species names. Effective integration of names across multiple fields is paramount and depends on the coordination and organization of taxonomic data. We assess current efforts and find that even key applications for well-studied taxa still lack commonality in taxonomic information required for integration. We identify essential taxonomic elements from our interoperability assessment to support improved access and integration of taxonomic data. A stronger focus on these elements has the potential to involve taxonomic communities in biodiversity science and overcome broken linkages currently limiting research capacity. We encourage a community effort to democratize taxonomic expertise and language in order to facilitate maximum interoperability and integration. [ABSTRACT FROM AUTHOR]

Connectivity underpins the persistence of life; it needs to inform biodiversity conservation decisions. Yet, when prioritising conservation areas and developing actions, connectivity is not being operationalised in spatial planning. The challenge is the translation of flows associated with connectivity into conservation objectives that lead to actions. Connectivity is nebulous, it can be abstract and mean different things to different people, making it difficult to include in conservation problems. Here, we show how connectivity can be included in mathematically defining conservation planning objectives. We provide a path forward for linking connectivity to high-level conservation goals, such as increasing species' persistence. We propose ways to design spatial management areas that gain biodiversity benefit from connectivity. There is a disconnect between global high-level conservation goals and on-the-ground actions such as maintaining ecosystem services or persistence and local planning of protected areas. Dynamic processes such as ecological connectivity underpin species persistence and ecosystem resilience but are difficult to represent in mathematical spatial planning problems for protected areas. Quantitative and SMART (specific – measurable – action-oriented – realistic – time-bound) conservation objectives can provide a link between high-level conservation goals and local or regional design and implementation of functionally connected protected area networks. With current implementation gaps of protected area commitments and increasing climate change threats, there is tremendous opportunity to use quantifiable objectives for ecological connectivity as a vehicle to future-proof protected area networks to help achieve global conservation goals. [ABSTRACT FROM AUTHOR]

In recent years, the prevalence of childhood emotional abuse has surpassed other forms of maltreatment. Childhood verbal abuse (CVA) is a key attribute of emotional abuse, yet CVA is not recognized as its own form of maltreatment and thus, has not received adequate attention. Clear terminology, definitions, and measures are needed to aid in assessing the occurrence and impact of CVA for its recognition and prevention. We aim to synthesize the evidence on the terms, definitions, and measurements of CVA and identify outcomes associated with CVA. A systematic review focused on adult perpetration of CVA among children and adolescents using clinical, community-based, and population-based samples. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed and four databases were utilized in May 2022: PsycINFO, MEDLINE, EMBASE, and ProQuest. A total of 149 quantitative and 17 qualitative studies were identified. Across studies reviewed, the most common perpetrators of CVA were parents, mothers, and teachers. Definitional themes for CVA included negative speech volume, tone, and speech content, and their immediate impact. The most frequent measures cited were Adverse Childhood Experiences Study (ACE) Questionnaire and the Conflict Tactics Scale (CTS); 50 % used self-created measures. CVA was associated with a range of internalizing and externalizing outcomes across the lifespan. Recognizing CVA as a form of maltreatment will be a starting point for its identification and prevention. Primary prevention of CVA using trauma-informed approaches must include adult training on the importance of safety, support, and nurturance during verbal communication with children. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown that emergency physicians have an increased risk of shift work sleep disorder, potentially compromising their health, wellness, and effectiveness as a physician.Objectives: This study explores the effect of shift work on sleep in emergency doctors. The hypothesis of the evaluation is that daytime sleep onset would lead to the poorest sleep, implying poor recovery after a night shift.Methods: Sleep patterns were examined in emergency physicians in an academic emergency department. Twenty-seven individuals completed data collection, wearing wrist actigraphy devices over 3 months. Time of sleep onset was categorized as falling into 1 of 3 ranges: interval 1-day sleepers (6:00 am-2:00 pm), interval 2-evening sleepers (2:00 pm-10:00 pm), or interval 3-night sleepers (10:00 pm-6:00 am). Data from each interval were analyzed for median duration, sleep latency, and night-time interruptions.Results: Daytime sleep sessions had a median total sleep duration of 5.3 ± 2 h, much less than 7.3 ± 1.8 h (interval 2-evening), and 7.0 ± 1.1 h (interval 3-night). Interval 2 sleepers experienced the highest number of nightly awakenings (1.5) and the longest sleep latency (36.5 min). Day sleepers (interval 1), assumed to be predominantly physicians recovering from night shifts, had significantly less sleep than both evening and night sleepers (p < 0.01), experiencing a 23.0% decrease in overall median sleep duration.Conclusions: This study provides statistical findings that those working the night shift experience significantly less sleep than emergency physicians working other shifts. [ABSTRACT FROM AUTHOR]

• Across 40 protected areas, temperature is predicted to increase ∼3 °C by 2050. • 31 protected areas are predicted to lose 100% of their baseline climatic space. • 17 protected areas may lose climate variability (homogenization), decreasing species' niches. • The effect of non-analogue conditions on species and ecosystems is largely unknown. • We propose a vulnerability index to categorise natural protected areas. Climate change threatens Earth's biodiversity, although its impacts are variable and depend on the capacity of species and ecosystems to cope with the magnitude and speed of change. Natural protected areas (NPAs) constitute potential refugia for species' persistence and for sustaining the provisioning of ecosystem services. Biosphere reserves are NPAs that are less altered by human actions and provide habitat to endemic, threatened or endangered species. Here, we aim to evaluate the threat imposed by climate change on the network of biosphere reserves in Mexico. Focusing on five bioclimatic variables, we computed the climatic space – measured as an n -dimensional hypervolume – of 40 NPAs. Increases in temperature are predicted for all NPAs by 2050, whereas decreases in annual rainfall are predicted for 30 NPAs. By 2050, 31 NPAs that provide habitat to 22,866 recorded species are predicted to lose 100% of their baseline climatic space, shifting to completely novel climates. On average, the other nine NPAs are predicted to lose 55.7% (SD = 26.7%) of their baseline climatic space, while 54.5% (SD = 32.5%) of the future climatic space will be novel. Seventeen NPAs may lose climate variability (homogenization), decreasing species' niches. The extent to which non-analogue conditions will remain within the tolerance of species and ecosystems is currently unknown. Finally, we propose a vulnerability index to categorise NPAs based on their loss of existing climatic space, total geographic area, species richness, and uniqueness of species composition, finding los Tuxtlas and Tiburon Ballena as the most and least vulnerable NPAs, respectively. [ABSTRACT FROM AUTHOR]