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The Fourth National Climate Assessment (NCA4) is the most comprehensive report to date assessing climate change science, impacts, risks, and adaptation in the United States. The 1,500 page report covers a breadth of topics, ranging from foundational physical science to climate change response options. Here we present information on indicators and impacts of climate change in the human environment featured in NCA4 Volume II, focusing on: air quality, forest disturbance and wildfire, energy systems, and water resources. Observations, trends, and impacts of these aspects of our changing climate will be discussed, along with implications for the future. Implications: People of the United States are already being affected by our changing climate. Information on observed changes and impacts that affect human welfare and society, along with projections for the future, is highly valuable for informing decision-makers, including utility managers, emergency planners, and other stakeholders, about climate risk assessment, adaptation, and mitigation options. more...

Escape from threats has paramount importance for survival. However, it is unknown if a single circuit controls escape from innate and conditioned threats. The hypothalamic dorsal premammillary nucleus (PMd) may control escape, as it is activated by escape-inducing threats and projects to the region most implicated in flight, the dorsolateral periaqueductal gray (dlPAG). We show that in mice cholecystokinin (cck)-expressing PMd cells are activated during escape, but not other defensive behaviors. PMd-cck ensemble activity can also predict future escape. Furthermore, PMd inhibition decreases escape speed from both innate and conditioned threats. Inhibition of the PMd-cck projection to the dlPAG also decreased escape speed. Lastly, human fMRI data show that a posterior hypothalamic-to-dlPAG pathway increased activity during exposure to aversive images, indicating that a similar pathway may possibly have a related role in humans. Our data identify the PMd as a central node of the escape network. more...

Introduction There is growing interest in skincare products designed for men. This pilot study evaluated the efficacy and tolerability of a comprehensive antioxidant product in men. Methods This 12‐week study evaluated improvements from baseline in erythema, lines/wrinkles, skin tone, texture, brightness, dryness/flaking and pores (6‐point scale), global improvements (5‐point scale), and sebum levels following daily application in males with mild to moderate photodamaged skin. Subject self‐assessments and adverse events (AEs) were captured. Results Twenty‐two subjects completed the study. Early mean percent improvements from baseline were demonstrated in all categories at week 4 with visible improvements in skin tone (29%; p = .0001) and pores (28%; p < .0001). Reductions in skin surface sebum levels (forehead region) from baseline were demonstrated at 8 (p < .0001) and 12 (p < .0003) weeks. Ninety‐six percent of subjects reported overall visible improvement of their skin and that the study product calmed/soothed skin, reducing redness and irritation after shaving. One subject reported mild dryness. Conclusion Once daily application of a comprehensive topical antioxidant designed for men led to significant improvements in skin appearance, substantial reductions in skin surface sebum levels, and was well tolerated with a high level of subject satisfaction over 12 weeks. more...

There is emerging evidence for links between relationship factors and sleep quality. Existing research linking attachment orientation to sleep quality has yielded inconsistent effects, has focused on younger samples, and has not considered underlying mechanisms of action. This research addressed these gaps in two studies that investigated the links between attachment orientation and sleep quality in both younger/middle-aged (Study 1) and older (Study 2) adult couples using Actor–Partner Interdependence Models. We also tested mediating effects of relationship-specific security and negative affect. In both studies, participants completed surveys assessing their attachment orientation, sleep quality, and the proposed mediators. Both studies revealed that relationship-specific security and negative affect mediated the negative association between insecure attachment and one’s own sleep quality. This research enhances our understanding of how attachment orientation affects sleep quality, provides a foundation for future research on relationship influences on sleep, and suggests avenues for improving sleep quality. more...

Objectives were to evaluate the relationships between ambient temperature (AT) and respiration rate (RR) and ruminal temperature (RT) of calf-fed Holstein steers during the extreme heat characteristic of the months of August and September in the Southern California desert region. Holstein steers (n = 21; one steer per pen; initial BW = 422 ±15 kg) were utilized in 28-d experiment (August 17 – September 14, 2021). Steers were blocked by initial shrunk weight (220 d before the initiation of the experiment) and randomly assigned to 21 pens (5 steers per pen). Pens were 62 m2 with 25 m2 overhead shade, automatic waterers and 2.4 m fence-line feed bunks. All steers were fed a steam-flaked corn-based growing-finishing diet. A bolus measuring temperature activity (smaXtec Basic, Smaxtec Animal Care GmbH, Austria) was placed in the rumen of each steer 55 d before the initiation of the experiment (June 22, 2021). During the experimental period, the respiration rate of one calf per pen was collected weekly. Respiration rate was obtained at 1100 h by counting the number of flank movements per minute. Ambient temperature at 1100 h averaged 37.6 ± 2.3° C for the experimental period. Temperature-humidity-index (THI) at 1100 h averaged 83.5 ± 1.7 (steers experienced “danger” or “emergency” THI categories through the entire 28 d trial). As AT increased from the minimum of 22.9° C to a maximum of 39.8° C, RR increased from 58.6 ± 12.9 breaths/min to 103.9 ± 16.9 breaths/min (RR = -54.9 + 4.13 AT, P < 0.01, r2 = 0.65). Likewise, RR increased with increasing RT (RR = -1259 + 33.7 RT, P < 0.01, r2 = 0.92) as RT increased. As ambient temperature increased, ruminal temperature increased (RT = 35.9 + 0.117 AT, P< 0.01, r2 = 0.65), though never exceeding 40.6° C. more...

The infant gut microbiome contains a portion of bacteria that originate from the maternal gut. In the infant gut these bacteria encounter a new metabolic environment that differs from the adult gut, consequently requiring adjustments in their activities. We utilized community RNA sequencing data (metatranscriptomes) from ten mother-infant dyads participating in the NiPPeR Study to characterize bacterial gene expression shifts following mother-to-infant transmission. Maternally derived bacterial strains adapted by large scale gene expression shifts following the transmission to the infant gut, with 12,564 activated and 14,844 deactivated gene families, including 1,007 transferases and 85 bacteriophage genes. The implicated genes were most numerous and the magnitude shifts greatest in Bacteroides spp. This study demonstrates environment-dependent, strain-specific shifts in gut bacteria function and underscores the importance of metatranscriptomic analysis in microbiome studies. more...

In most women ≥ 70 years old with hormone-receptor-positive breast cancer, axillary staging and adjuvant radiotherapy provide no survival advantage over surgery and hormone therapy alone. Despite recommendations for their omission, sentinel lymph node biopsy (SLNB) and adjuvant radiotherapy rates remain high. While treatment side effects are well documented, less is known about the incremental spending associated with SLNB and adjuvant radiotherapy.Using a statewide multipayer claims registry, we examined spending associated with breast cancer treatment in a retrospective cohort of women ≥ 70 years old undergoing surgery.9074 women ≥70 years old underwent breast cancer resection between 2012 and 2019, with 78% (n = 7122) receiving SLNB and/or adjuvant radiotherapy within 90 days of surgery. Women undergoing SLNB were more likely to receive radiation (51% vs. 28%; p0.001 and OR = 2.68). Average 90-day spending varied substantially based upon treatment received, ranging from US$10,367 (breast-conserving surgery alone) to US$27,370 (mastectomy with SLNB and adjuvant radiotherapy). The relative increases in 90-day treatment spending in the breast-conserving surgery cohort was 65% for SLNB, 82% for adjuvant radiotherapy, and 120% for both treatments.SLNB and adjuvant radiotherapy have significant spending implications in older women with breast cancer, even though they are unlikely to improve survival. more...

Understanding genetic diversity and structure in a rare species is critical for prioritizing bothin situandex situconservation efforts. One such rare species isPhysaria filiformis(Brassicaceae), a threatened, winter annual plant species. The species has a naturally fragmented distribution, occupying three different soil types spread across four disjunct geographical locations in Missouri and Arkansas. The goals of this study were to understand: (1) whether factors associated with fragmentation and small population size (i.e., inbreeding, genetic drift or genetic bottlenecks) have reduced levels of genetic diversity, (2) how genetic variation is structured and which factors have influenced genetic structure, and (3) how much extant genetic variation ofP.filiformisis currently publicly protected and the implications for the development of conservation strategies to protect its genetic diversity. Using 16 microsatellite markers, we genotyped individuals from 20 populations ofP.filiformisfrom across its geographical range and one population ofPhysaria gracilisfor comparison and analyzed genetic diversity and structure. Populations ofP.filiformisshowed comparable levels of genetic diversity to its congener, except a single population in northwest Arkansas showed evidence of a genetic bottleneck and two populations in the Ouachita Mountains of Arkansas showed lower genetic variation, consistent with genetic drift. Populations showed isolation by distance, indicating that migration is geographically limited, and analyses of genetic structure grouped individuals into seven geographically structured genetic clusters, with geographic location/spatial separation showing a strong influence on genetic structure. At least one population is protected for all genetic clusters except one in north-central Arkansas, which should therefore be prioritized for protection. Populations in the Ouachita Mountains were genetically divergent from the rest ofP.filiformis; future morphological analyses are needed to identify whether it merits recognition as a new, extremely rare species. more...

Importance Through the Choosing Wisely campaign, surgical specialties identified 4 low-value breast cancer operations. Preliminary data suggest varying rates of deimplementation and have identified patient-level and clinician-level determinants of continued overuse. However, little information exists about facility-level variation or determinants of differential deimplementation. Objective To identify variation and determinants of persistent use of low-value breast cancer surgical care. Design, Setting, and Participants Retrospective cohort study in which reliability-adjusted facility rates of each procedure were calculated using random-intercept hierarchical logistic regression before and after evidence demonstrated that each procedure was unnecessary. The National Cancer Database is a prospective cancer registry of patients encompassing approximately 70% of all new cancer diagnoses from more than 1500 facilities in the United States. Data were analyzed from November 2019 to August 2020. The registry included women 18 years and older diagnosed as having breast cancer between 2004 and 2016 and meeting inclusion criteria for each Choosing Wisely recommendation. Main Outcomes and Measures Rate of each low-value breast cancer procedure based on facility type and breast cancer volume categories before and after the release of data supporting each procedure’s omission. Results The total cohort included 920 256 women with a median age of 63 years. Overall, 86% self-identified as White, 10% as Black, 3% as Asian, and 4.5% as Hispanic. Most women in this cohort were insured (51% private and 47% public), were living in a metropolitan or urban area (88% and 11%, respectively), and originated from the top half of income-earning households (65.5%). While there was significant deimplementation of axillary lymph node dissection and lumpectomy reoperation in response to guidelines supporting omission of these procedures, rates of contralateral prophylactic mastectomy and sentinel lymph node biopsy in older women increased during the study period. Academic research programs and high-volume facilities overall demonstrated the greatest reduction in use of these low-value procedures. There was significant interfacility variation for each low-value procedure. Facility-level axillary lymph node dissection rates ranged from 7% to 47%, lumpectomy reoperation rates ranged from 3% to 62%, contralateral prophylactic mastectomy rates ranged from 9% to 67%, and sentinel lymph node biopsy rates ranged from 25% to 97%. Pearson correlation coefficient for each combination of 2 of the 4 procedures was less than 0.11, suggesting that hospitals were not consistent in their deimplementation performance across all 4 procedures. Many were high outliers in one procedure but low outliers in another. Conclusions and Relevance Interfacility variation demonstrates a performance gap and an opportunity for formal deimplementation efforts targeting each procedure. Several facility-level characteristics were associated with differential deimplementation and performance. more...

Supplemental Material, sj-docx-1-spr-10.1177_02654075211003331 for Individual and relational differences in desire for touch in romantic relationships by Brittany K. Jakubiak, Julian D. Fuentes and Brooke C. Feeney in Journal of Social and Personal Relationships more...

Additional file 4. Supplementary Table 3

Animals must balance needs to approach threats for risk assessment and to avoid danger. The dorsal periaqueductal gray (dPAG) controls defensive behaviors, but it is unknown how it represents states associated with threat approach and avoidance. We identified a dPAG threatavoidance ensemble in mice that showed higher activity farther from threats such as the open arms of the elevated plus maze and a predator. These cells were also more active during threat avoidance behaviors such as escape and freezing, even though these behaviors have antagonistic motor output. Conversely, the threat approach ensemble was more active during risk assessment behaviors and near threats. Furthermore, unsupervised methods showed that avoidance/approach states were encoded with shared activity patterns across threats. Lastly, the relative number of cells in each ensemble predicted threat avoidance across mice. Thus, dPAG ensembles dynamically encode threat approach and avoidance states, providing a flexible mechanism to balance risk assessment and danger avoidance. more...

The neural circuitry mediating taste has been mapped out from the periphery to the cortex, but genetic identity of taste-responsive neurons has remained elusive. Here, we describe a population of neurons in the gustatory region of the parabrachial nucleus that express the transcription factor Satb2 and project to taste-associated regions, including the gustatory thalamus and insular cortex. Using calcium imaging in awake, freely licking mice, we show that Satb2 neurons respond to the five basic taste modalities. Optogenetic activation of these neurons enhances taste preferences, whereas chronic inactivation decreases the magnitude of taste preferences in both brief- and long-access taste tests. Simultaneous inactivation of Satb2 and calcitonin gene-related peptide neurons in the PBN abolishes responses to aversive tastes. These data suggest that taste information in the parabrachial nucleus is conveyed by multiple populations of neurons, including both Satb2 and calcitonin gene-related peptide neurons., The genetic identity of taste-responsive neurons has not been determined. The authors describe neurons in the gustatory region of the parabrachial nucleus that express the transcription factor Satb2, project to taste-associated regions, and modulate taste preferences. more...

Additional file 3. Supplementary Table 2

Additional file 1: Supplementary File 1: Interview schedule. Supplementary File 2: Online questionnaire content

Escape from threats has paramount importance for survival. However, it is unknown if a single circuit controls escape vigor from innate and conditioned threats. Cholecystokinin (cck)-expressing cells in the hypothalamic dorsal premammillary nucleus (PMd) are necessary for initiating escape from innate threats via a projection to the dorsolateral periaqueductal gray (dlPAG). We now show that in mice PMd-cck cells are activated during escape, but not other defensive behaviors. PMd-cck ensemble activity can also predict future escape. Furthermore, PMd inhibition decreases escape speed from both innate and conditioned threats. Inhibition of the PMd-cck projection to the dlPAG also decreased escape speed. Intriguingly, PMd-cck and dlPAG activity in mice showed higher mutual information during exposure to innate and conditioned threats. In parallel, human functional magnetic resonance imaging data show that a posterior hypothalamic-to-dlPAG pathway increased activity during exposure to aversive images, indicating that a similar pathway may possibly have a related role in humans. Our data identify the PMd-dlPAG circuit as a central node, controlling escape vigor elicited by both innate and conditioned threats. more...

Additional file 2. Supplementary Table 1

Background Vaginal seeding is the administration of maternal vaginal bacteria to babies following birth by caesarean section (CS), intended to mimic the microbial exposure that occurs during vaginal birth. Appropriate development of the infant gut microbiome assists early immune development and might help reduce the risk of certain health conditions later in life, such as obesity and asthma. We aimed to explore the views of pregnant women on this practice. Methods We conducted a sequential mixed-methods study on the views of pregnant women in New Zealand (NZ) on vaginal seeding. Phase one: brief semi-structured interviews with pregnant women participating in a clinical trial of vaginal seeding (n = 15); and phase two: online questionnaire of pregnant women throughout NZ (not in the trial) (n = 264). Reflexive thematic analysis was applied to interview and open-ended questionnaire data. Closed-ended questionnaire responses were analysed using descriptive statistics. Results Six themes were produced through analysis of the open-ended data: “seeding replicates a natural process”, “microbiome is in the media”, “seeding may have potential benefits”, “seeking validation by a maternity caregiver”, “seeding could help reduce CS guilt”, and “the unknowns of seeding”. The idea that vaginal seeding replicates a natural process was suggested by some as an explanation to help overcome any initial negative perceptions of it. Many considered vaginal seeding to have potential benefit for the gut microbiome, while comparatively fewer considered it to be potentially beneficial for specific conditions such as obesity. Just under 30% of questionnaire respondents (n = 78; 29.5%) had prior knowledge of vaginal seeding, while most (n = 133; 82.6%) had an initially positive or neutral reaction to it. Few respondents changed their initial views on the practice after reading provided evidence-based information (n = 60; 22.7%), but of those who did, most became more positive (n = 51; 86.4%). Conclusions Given its apparent acceptability, and if shown to be safe and effective for the prevention of early childhood obesity, vaginal seeding could be a non-stigmatising approach to prevention of this condition among children born by CS. Our findings also highlight the importance of lead maternity carers in NZ remaining current in their knowledge of vaginal seeding research. more...