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In this study, our goal was to adapt the moss layer transfer technique (MLTT), first developed to restore degraded Sphagnum‐dominated peatland explicitly with a bryophyte layer, to a former in‐situ oil sands well‐pad constructed with nearby mineral fill in northwestern Alberta, Canada. Mineral fill was either completely removed or partially removed with residual fill buried under excavated and decompacted peat, followed by the transfer of donor moss collected from nearby linear features with different plant communities in peatlands. Three years after MLTT, peatland vegetation covers 63% of the site. Carex spp. dominate with 36% coverage, followed by mosses at 12%, including 3% Sphagnum spp. and 8% fen mosses, and shrubs at 8%. Different substrate adjustment treatments and types of donor moss had negligible impact on vegetation development although areas without MLTT remained devoid of mosses and had the lowest peatland species cover. Instead, surface elevation, moisture conditions, and substrate chemistry played important roles in shaping the vegetation communities. The prompt introduction and establishment of peatland donor species through MLTT was crucial to the overall re‐establishment of peatland vegetation. This is the first full pad scale study to prove that a flat, moist peat surface created by the removal and/or burial of mineral fill can support peatland vegetation development, particularly ground layer bryophytes. Overall, the reclaimed well‐pad appears to be on trajectory toward becoming a functional peatland and our approaches should be considered and tested in future well‐pad reclamation trials. [ABSTRACT FROM AUTHOR]

Across Canada's boreal forest, disturbances from in situ oil sands mining, including well‐pads, significantly impact vast areas of the landscape. The creation of well‐pads requires removal of vegetation and placement of mineral fill, which essentially stops any carbon (C) sequestration on the once peatland ecosystem. It is important that, once no longer in use, these well‐pads are restored as long‐term C (peat) accumulation is what defines peatland ecosystem. However, little is known about the recovery of greenhouse gas exchange post‐restoration of these features. We studied a decommissioned well‐pad located in a treed poor fen that was restored using three soil adjustment treatments (SATs): (1) complete mineral fill removal (Peat‐Dec); (2) partial pad removal and burial under peat layer (BUPL); and (3) mixing mineral and peat by inversion (Mixed‐P‐M). The recreated peat surface was revegetated with donor peatland species using the moss layer transfer technique (MLTT). The objectives of this paper were to (1) quantify plot‐scale seasonal carbon dioxide (CO2) and methane (CH4) exchange of the SATs, 2–4 years post‐restoration compared to reference sites and (2) determine the influence of several environmental variables on CO2 and CH4 exchange. All SATs proved effective in recreating a soil surface needed to support peatland vegetation as shown by similar rates of net ecosystem exchange (NEE). Equally, both types of vegetation reintroduced led this site on a trajectory toward functioning as a net C sink. [ABSTRACT FROM AUTHOR]

Purpose: To review the evidence and provide clinical recommendations for the management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: This guideline is based on a systematic review of randomized controlled trials from database inception to January 2, 2019. The target audience for the guideline includes all primary care clinicians, and the target patient population includes adults who are experiencing acute exacerbations of COPD. This guideline was developed using a modified version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, a transparent approach to evaluating the certainty of the evidence and determining the strength of recommendations. Recommendation 1: The American Academy of Family Physicians (AAFP) recommends that clinicians prescribe systemic antibiotics for adults with acute exacerbations of COPD to improve clinical cure and reduce clinical failure (weak recommendation, moderate quality of evidence). Choice of antibiotic should be based on local resistance patterns, affordability, and patient history and preferences because there is insufficient evidence to support a preferential recommendation. Recommendation 2: The AAFP recommends that clinicians prescribe corticosteroids for adults with acute exacerbations of COPD to reduce clinical failure (weak recommendation, low quality of evidence). There is insufficient evidence to guide the dose, route of administration, or duration of treatment. [ABSTRACT FROM AUTHOR]

Purpose: To review the evidence and provide clinical recommendations for the screening and treatment of depression in patients who have had a recent acute coronary syndrome event. Methods: This guideline is based on a systematic review of randomized controlled trials and observational studies from January 1, 2003, to August 15, 2017. It is an update to a previous systematic review published in May 2005, which included studies up to March 2004. The target audience for the guideline includes all primary care clinicians, and the target patient population includes adults who are within the three months following an acute coronary syndrome event (unstable angina or myocardial infarction). This guideline was developed using a modified version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, a transparent approach to evaluating the certainty of the evidence and determining the strength of recommendations. Recommendation 1: The American Academy of Family Physicians recommends that clinicians screen for depression, using a standardized depression screening tool, in patients who have recently experienced an acute coronary syndrome event (weak recommendation, low-quality evidence). Individuals should undergo further assessment to confirm the diagnosis of depression (good practice point). Recommendation 2: The American Academy of Family Physicians strongly recommends that clinicians prescribe antidepressant medication, preferably selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, and/or cognitive behavior therapy to improve symptoms of depression in patients who have a history of acute coronary syndrome and have been diagnosed with depression (strong recommendation, moderate-quality evidence). [ABSTRACT FROM AUTHOR]

Across Canada's boreal forest, linear disturbances, including cutlines such as seismic lines and roads, crisscross the landscape to facilitate resource exploration and extraction; many of these linear disturbances cross peatland ecosystems. Changes in tree canopy cover and the compression of the peat by heavy equipment alter local thermal, hydrological, and ecological conditions, likely changing carbon exchange on the disturbance, and possibly in the adjacent peatland. We measured bulk density, water table, soil temperature, plant cover, and CO2 and CH4 flux along triplicate transects crossing a winter road through a wooded fen near Peace River, Alberta, Canada. Sample plots were located 1, 5, and 10 m from the road on both sides with an additional three plots on the road. Productivity of the overstory trees, when present, was also determined. The winter road had higher bulk density, shallower water table, higher graminoid cover, and thawed earlier than the adjacent peatland. Tree productivity and CO2 flux varied between the plots, and there was no clear pattern in relation to distance from the road. The plots on the winter road acted as a greater CO2 sink and greater CH4 source compared to the adjacent peatland with plots on the winter road emitting on average (standard error) 479 (138) compared to 41 (10) mg CH4 m−2 day−1 in the adjacent peatland. Considering both gases, global warming potential increased from 70 to 250 g CO2e m−2 year−1 in the undisturbed area to 2100 g CO2e m−2 year−1 on the winter road. Although carbon fluxes on any given cutline through peatland will vary depending on level of compaction, line width and vegetation community shifts, the large number of linear disturbances in Canada's boreal forest and slow recovery on peatland ecosites suggest they could represent an important anthropogenic greenhouse gas source. [ABSTRACT FROM AUTHOR]

The article comments on the U.S. Preventive Services Task Force's (USPSTF) recently updated recommendation statement, lowering the starting age for colorectal cancer screening. It notes that the American Academy of Family Physicians (AAFP) disagrees with USPSTF for lack of evidence to assess its benefits and harms. Also discussed is the potential cost to patients and the health care system of lowering the screening age to 45.

The article comments on the U.S. Preventive Services Task Force's (USPSTF) updated recommendation statement, lowering the starting age for colorectal cancer screening. It notes that the American Academy of Family Physicians (AAFP) disagrees with USPSTF for lack of evidence to assess its benefits and harms. Also discussed is the potential cost to patients and the health care system of lowering the screening age to 45.

Purpose: To review the evidence and provide clinical recommendations for appropriate blood pressure treatment targets for adults with hypertension. [ABSTRACT FROM AUTHOR]