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Engaging family advisors in pediatric quality improvement (QI) efforts is well-studied in intensive care but less understood in other settings. The purpose of this study was to assess the perceived impact of including a family advisor as a colead on a QI initiative that successfully improved the family-centered timing of routine morning blood tests performed on pediatric inpatients. Five structured written reflections from core QI team members were analyzed using inductive thematic analysis and 3 major themes were identified. The first found that a family advisor’s presence from the beginning of a QI initiative helps inform project design. The second determined that family partners working with residents fostered a better shared understanding of the role of trainees and caregivers in improving the quality of care. The third found that a family partner is an effective change agent to enact practice improvement, support professional development, and enhance resident education. Our qualitative analysis showed that engaging a family advisor as a colead influenced the design, implementation, and post-intervention impact of the initiative and improved family-centered outcomes.

Pyroclastic density current (PDC) deposits, especially small to medium volume events, have low preservation potential at many volcanoes, particularly when unconsolidated or deposited on steep, glaciated slopes. This may lead to an underrepresentation of these events in the eruptive record, and consequently, in hazard management planning; leaving populations on and around the volcanoes unprepared for the threat of these smaller eruptions. Therefore, it is important to investigate and recognize these smaller events in the volcanic record to create more comprehensive plans for future eruptions. Mt. Ruapehu is one of New Zealand’s most active volcanoes, last erupting in 2007. Few studies have investigated the PDC occurrence on this volcano, despite PDCs being one of the most hazardous volcanic processes. Poor preservation of PDC deposits, due to small volume, past glaciations, erosion, burial, and poor consolidation has left a significant gap in Mt. Ruapehu’s eruptive record. By identifying and characterizing PDCs on Mt. Ruapehu this paper provides an updated account of PDC occurrence on this volcano, especially for smaller scale PDCs. Comprehensive field-mapping forms the basis for this study by identifying PDC deposits from partial outcrop exposures. We use field observations of these deposits to describe the lithofacies and infer PDC behavior. Relative stratigraphy and whole-rock geochemistry are used to correlate deposits with dated units from literature and provide approximate age ranges. This study describes 12 PDC deposits representing at least 10 previously unidentified flows. Combined with PDCs identified in previous studies there is a total of 23 PDC deposits found on Mt. Ruapehu, including the PDC observed during the 1945 eruption. These PDCs have been emplaced throughout Mt. Ruapehu’s 250 ka eruptive history. The PDCs were concentrated and dominated by granular flow or granular fluid-based flow transport regimes. The lithofacies show PDCs forming from column collapse and dome collapse or explosion events. This demonstrates that Mt. Ruapehu is capable of producing a spectrum of PDC styles and sizes, something that must be considered during future hazard planning on the volcano.

Neonicotinoid pesticides can have a multitude of negative sublethal effects on bees. Understanding their impact on wild populations requires accurately estimating the dosages bees encounter under natural conditions. This is complicated by the possibility that bees might influence their own exposure: two recent studies found that bumblebees (Bombus terrestris) preferentially consumed neonicotinoid-contaminated nectar, even though these chemicals are thought to be tasteless and odourless. Here, we used Bombus impatiens to explore two elements of these reported preferences, with the aim of understanding their ecological implication and underlying mechanism. First, we asked whether preferences persisted across a range of realistic nectar sugar concentrations, when measured at a series of time points up until 24 h. Second, we tested whether bees' neonicotinoid preferences were driven by an ability to associate their post-ingestive consequences with floral stimuli such as colour, location or scent. We found no evidence that foragers preferred to consume neonicotinoid-containing solutions, despite finding effects on feeding motivation and locomotor activity in line with previous work. Bees also did not preferentially visit floral stimuli previously paired with a neonicotinoid-containing solution. These results highlight the need for further research into the mechanisms underlying bees’ responses to these pesticides, critical for determining how neonicotinoid-driven foraging preferences might operate in the real world for different bee species.

Abstract The COSINE-100 dark matter search experiment is an array of NaI(Tl) crystal detectors located in the Yangyang Underground Laboratory (Y2L). To understand measured backgrounds in the NaI(Tl) crystals we have performed Monte Carlo simulations using the Geant4 toolkit and developed background models for each crystal that consider contributions from both internal and external sources, including cosmogenic nuclides. The background models are based on comparisons of measurement data with Monte Carlo simulations that are guided by a campaign of material assays and are used to evaluate backgrounds and identify their sources. The average background level for the six crystals (70 kg total mass) that are studied is 3.5 counts/day/keV/kg in the (2–6) keV energy interval. The dominant contributors in this energy region are found to be $$^{210}$$ 210 Pb and $$^3$$ 3 H.

Self-rated health (SRH) is an independent predictor of mortality; studies have investigated correlates of SRH to explain this predictive capability. However, the interplay of a broad array of factors that influence health status may not be adequately captured with parametric multivariate regression. This study investigated associations between several health determinants and SRH using recursive partitioning methods. This non-parametric analytic approach aimed to reflect the social-ecological model of health, emphasizing relationships between multiple health determinants, including biological, behavioral, and from social/physical environments. The study sample of 3648 men and women was drawn from the year 15 (2000–2001) data collection of the CARDIA Study, USA, in order to study a young adult sample. Classification tree analysis identified 15 distinct, mutually exclusive, subgroups (eight with a larger proportion of individuals with higher SRH, and seven with a larger proportion of lower SRH), and multi-domain risk and protective factors associated with subgroup membership. Health determinant profiles were not uniform between subgroups, even for those with similar health status. The subgroup with the largest proportion of higher SRH was characterized by several protective factors, whilst that with the largest proportion of lower SRH, with several negative risk factors; certain factors were associated with both higher and lower SRH subgroups. In the full sample, physical activity, education and income were highest ranked by variable importance (random forests analysis) in association with SRH. This exploratory study demonstrates the utility of recursive partitioning methods in studying the joint impact of multiple health determinants. The findings indicate that factors do not affect SRH in the same way across the whole sample. Multiple factors from different domains, and with varying relative importance, are associated with SRH in different subgroups. This has implications for developing and prioritizing appropriate interventions to target conditions and factors that improve self-rated health status. Keywords: Self-rated health, Health determinants, Recursive partitioning methods, Classification tree analysis, Random forests

Abstract COSINE is a dark matter search experiment based on an array of low background NaI(Tl) crystals located at the Yangyang underground laboratory. The assembly of COSINE-100 was completed in the summer of 2016 and the detector is currently collecting physics quality data aimed at reproducing the DAMA/LIBRA experiment that reported an annual modulation signal. Stable operation has been achieved and will continue for at least 2 years. Here, we describe the design of COSINE-100, including the shielding arrangement, the configuration of the NaI(Tl) crystal detection elements, the veto systems, and the associated operational systems, and we show the current performance of the experiment.

IntroductionStudies of the relationship between work time and health have been inconclusive. Consequently, we sought to examine the effect of work time on progression of atherosclerosis.MethodsThis prospective study of 621 middle-aged Finnish men evaluated effects of baseline and repeat measures of work time on 11-year progression of ultrasonographically assessed carotid intima-media thickness (IMT) and interactions with cardiovascular disease. Multiple linear regression models adjusted for 21 biological, behavioral, and psychosocial risk factorsResultsWorking 3 (minimum), 5 (medium), or 7 (maximum) days per week at baseline was associated with 23%, 31%, and 40% 11-year increases in IMT, respectively. The relative change ratio (RCR) at maximum vs minimum was 1.14 for baseline days worked per week and 1.10 for hours worked per year of follow-up. Significant interactions existed between cardiovascular disease and work time. Men with ischemic heart disease (IHD) who worked the maximum of 14.5 hours per day experienced a 69% increase in IMT compared with a 29% increase in men without IHD. The RCR ratio for IHD (RCRIHD/RCRno IHD) was 1.44 for hours per day. Similarly, the RCR ratio for baseline carotid artery stenosis was 1.29 for hours per day and 1.22 for hours per year.ConclusionIncreases in work time are positively associated with progression of carotid atherosclerosis in middle-aged men, especially in those with preexisting cardiovascular disease. Our findings are consistent with the hemodynamic theory of atherosclerosis.

This is an account of the early days of research on social determinants as I experienced them. I describe my time as one of four Fellows in a new training program in Medical Sociology at Yale University and how I came to be the first Sociologist employed in the U.S. Public Health Service. I then became the first Executive Secretary of a new Study Section at NIH dealing with a small number of research grant proposals in the field of Epidemiology. My account deals with some of my experiences in this developing field, culminating with my appointment as the first Sociologist to become a Professor of Epidemiology in a School of Public Health.

Sedimentary provenance techniques have been widely applied in foreland basin settings to understand tectonic and magmatic processes by tracking the exposure and erosion of distinct sediment source areas through time. We present a case example from the Magallanes-Austral retroarc foreland basin of Chile and Argentina (51°30’S), where modal sandstone and conglomerate compositional data, detrital zircon U-Pb geochronology, and sedimentology data from the Oligocene-Miocene Río Guillermo Formation document a change in source areas during an important stage of orogenic development. In particular, our results from the ∼24.3–21.7 Ma Río Guillermo Formation record an abrupt shift from transitional to undissected arc provenance that indicate rejuvenated magmatism within the contemporary arc. Minor components of lithic grains suggest a subordinate source of recycled sediments that we interpret may have been derived from the intervening external fold-and-thrust belt, rather than directly from sources in the hinterland thrust domain. Detrital zircon U-Pb geochronology data show mostly Neogene (∼20–40 Ma) and Cretaceous (∼70–110 Ma) age groups, with minor amounts of Jurassic (∼145–155 Ma), and Paleozoic (∼260–540 Ma) age groups, which are consistent with a syndepositional arc and recycled external fold-and-thrust belt sources. Stratigraphic data suggest a vegetated, channelized braidplain environment developed above an erosional unconformity with the underlying shallow-marine Río Turbio Formation. Upsection, the Río Guillermo Formation locally transitions to a low-energy, organic-rich floodplain setting located within the upper reaches of a fluvial-tidal transition zone of the coastal plain, and the uppermost part of the formation is characterized by a coarse-grained sandy channelized braidplain environment along the foreland basin margin. Moderate sediment accumulation rates and coastal plain progradation during this period is consistent with sustained sediment flux from the Patagonian Andes and tectonic subsidence along the basin margin. Taken collectively, we propose that the abrupt provenance shift dominantly records erosion of the rejuvenated mafic volcanic arc, despite coeval changes in orogenic wedge dynamics brought about by increased plate convergence rates that drove uplift of the intervening external-fold-and-thrust belt along reactivated deep-seated high-angle basin structures.

The self-assembly of proteins into protein quaternary structures is of fundamental importance to many biological processes, and protein misassembly is responsible for a wide range of proteopathic diseases. In recent years, abstract lattice models of protein self-assembly have been used to simulate the evolution and assembly of protein quaternary structure, and to provide a tractable way to study the genotype-phenotype map of such systems. Here we generalize these models by representing the interfaces as mutable binary strings. This simple change enables us to model the evolution of interface strengths, interface symmetry, and deterministic assembly pathways. Using the generalized model we are able to reproduce two important results established for real protein complexes: The first is that protein assembly pathways are under evolutionary selection to minimize misassembly. The second is that the assembly pathway of a complex mirrors its evolutionary history, and that both can be derived from the relative strengths of interfaces. These results demonstrate that the generalized lattice model offers a powerful new idealized framework to facilitate the study of protein self-assembly processes and their evolution.

An understanding of factors influencing health in socioeconomic groups is required to reduce health inequalities. This study investigated combinations of health determinants associated with self-rated health (SRH), and their relative importance, in income-based groups.Cross-sectional data from year 15 (2000−2001) of the CARDIA study (Coronary Artery Risk Development in Young Adults, USA) - 3648 men and women (mean 40 years) - were split into 5 income-based groups. SRH responses were categorized as ‘higher’/‘lower’. Health determinants (medical, lifestyle, and social factors, living conditions) associated with SRH in each group were analyzed using classification tree analysis (CTA).Income and SRH were positively associated (p

Large uncertainties in land surface models (LSMs) simulations still arise from inaccurate forcing, poor description of land surface heterogeneity (soil and vegetation properties), incorrect model parameter values and incomplete representation of biogeochemical processes. The recent increase in the number and type of carbon cycle-related observations, including both in situ and remote sensing measurements, has opened a new road to optimize model parameters via robust statistical model–data integration techniques, in order to reduce the uncertainties of simulated carbon fluxes and stocks. In this study we present a carbon cycle data assimilation system that assimilates three major data streams, namely the Moderate Resolution Imaging Spectroradiometer (MODIS)-Normalized Difference Vegetation Index (NDVI) observations of vegetation activity, net ecosystem exchange (NEE) and latent heat (LE) flux measurements at more than 70 sites (FLUXNET), as well as atmospheric CO2 concentrations at 53 surface stations, in order to optimize the main parameters (around 180 parameters in total) of the Organizing Carbon and Hydrology in Dynamics Ecosystems (ORCHIDEE) LSM (version 1.9.5 used for the Coupled Model Intercomparison Project Phase 5 (CMIP5) simulations). The system relies on a stepwise approach that assimilates each data stream in turn, propagating the information gained on the parameters from one step to the next. Overall, the ORCHIDEE model is able to achieve a consistent fit to all three data streams, which suggests that current LSMs have reached the level of development to assimilate these observations. The assimilation of MODIS-NDVI (step 1) reduced the growing season length in ORCHIDEE for temperate and boreal ecosystems, thus decreasing the global mean annual gross primary production (GPP). Using FLUXNET data (step 2) led to large improvements in the seasonal cycle of the NEE and LE fluxes for all ecosystems (i.e., increased amplitude for temperate ecosystems). The assimilation of atmospheric CO2, using the general circulation model (GCM) of the Laboratoire de Météorologie Dynamique (LMDz; step 3), provides an overall constraint (i.e., constraint on large-scale net CO2 fluxes), resulting in an improvement of the fit to the observed atmospheric CO2 growth rate. Thus, the optimized model predicts a land C (carbon) sink of around 2.2 PgC yr−1 (for the 2000–2009 period), which is more compatible with current estimates from the Global Carbon Project (GCP) than the prior value. The consistency of the stepwise approach is evaluated with back-compatibility checks. The final optimized model (after step 3) does not significantly degrade the fit to MODIS-NDVI and FLUXNET data that were assimilated in the first two steps, suggesting that a stepwise approach can be used instead of the more “challenging” implementation of a simultaneous optimization in which all data streams are assimilated together. Most parameters, including the scalar of the initial soil carbon pool size, changed during the optimization with a large error reduction. This work opens new perspectives for better predictions of the land carbon budgets.

Quantitative palaeoclimate reconstructions provide data for evaluating the mechanisms of past, natural climate variability. Geometries of former mountain glaciers, constrained by moraine mapping, afford the opportunity to reconstruct palaeoclimate, due to the close relationship between ice extent and local climate. In this study, we present results from a series of experiments using a 2-D coupled energy balance–ice flow model that investigate the palaeoclimate significance of Last Glacial Maximum moraines within nine catchments in the central North Island, New Zealand. We find that the former ice limits can be simulated when present-day temperatures are reduced by between 4 and 7 °C, if precipitation remains unchanged from present. The spread in the results between the nine catchments is likely to represent the combination of chronological and model uncertainties. The majority of catchments targeted require temperature decreases of 5.1 to 6.3 °C to simulate the former glaciers, which represents our best estimate of the temperature anomaly in the central North Island, New Zealand, during the Last Glacial Maximum. A decrease in precipitation of up to 25 % from present, as suggested by proxy evidence and climate models, increases the magnitude of the required temperature changes by up to 0.8 °C. Glacier model experiments using reconstructed topographies that exclude the volume of post-glacial (

Pollinator nutritional ecology provides insights into plant−pollinator interactions, coevolution, and the restoration of declining pollinator populations. Bees obtain their protein and lipid nutrient intake from pollen, which is essential for larval growth and development as well as adult health and reproduction. Our previous research revealed that pollen protein to lipid ratios (P:L) shape bumble bee foraging preferences among pollen host-plant species, and these preferred ratios link to bumble bee colony health and fitness. Yet, we are still in the early stages of integrating data on P:L ratios across plant and bee species. Here, using a standard laboratory protocol, we present over 80 plant species’ protein and lipid concentrations and P:L values, and we evaluate the P:L ratios of pollen collected by three bee species. We discuss the general phylogenetic, phenotypic, behavioral, and ecological trends observed in these P:L ratios that may drive plant−pollinator interactions; we also present future research questions to further strengthen the field of pollination nutritional ecology. This dataset provides a foundation for researchers studying the nutritional drivers of plant−pollinator interactions as well as for stakeholders developing planting schemes to best support pollinators.

High gestational weight gain (GWG) in overweight/obese pregnant women increases maternal-fetal complications. We conducted a 6-week GWG intervention based on an energy balance model that includes theories of planned behavior (TPB) and self-regulation constructs to promote exercise and healthy eating motivation and behaviors. The purposes of this proof-of-concept feasibility study were to examine: (1) the energy balance model constructs over the intervention, and (2) pre-post intervention, weekly, and dose-response changes in study constructs. Methods. Overweight/obese pregnant women (N=17) were randomized to 1 of 6 conditions, increasing in intensity, and included varied combinations of components (exercise sessions, healthy eating demonstrations, etc.). Exercise and healthy eating TPB (attitude, subjective norm, perceived behavioral control, intention), and self-regulation (prospective, retrospective) constructs were collected weekly. Exercise behavior, energy intake, and GWG were collected daily. Results. We observed: (a) significant increases in exercise TPB constructs, healthy eating attitude (limit unhealthy foods), exercise/healthy eating retrospective self-regulation; (b) significant decrease in healthy eating subjective norm (limit unhealthy foods); (c) trending increases for healthy eating perceived behavioral control (limit unhealthy foods), healthy eating prospective self-regulation, and energy intake; (d) significantly higher active time, steps, and energy expenditure at W3 relative to other weeks; (e) no significant increase in GWG; and, (f) a dose response effect such that women in more intensive dosages had greater gains in exercise and healthy eating perceived behavioral control (eat healthy/limit unhealthy foods). Conclusion. Brief exposure to a theoretically-driven, GWG intervention resulted in changes to exercise and healthy eating TPB and self-regulation motivational determinants, no significant increase in GWG, and suggests intervention intensity can strengthen perceived ability to engage in exercise/healthy eating behaviors; offering initial proof-of-concept for the intervention to regulate GWG in overweight/obese pregnant women. Future research will test this intervention over the course of pregnancy to understand long-term impact on maternal-fetal health outcomes.

Control efforts to reduce infection from the parasitic flatworm Opisthorchis viverrini have progressed through understanding the epidemiology of Opisthorchis viverrini , antiparasitic drug developments, technological innovations, health education promoting cooking of fish, and improved hygienic defecation. Yet the problem persists. The case study method was used to examine the fundamental cause of the liver fluke infection problem. Evidence shows that the liver fluke–infected population does not care about living a long life. For them, suffering and death are simply a part of life, and expected. Thus, the cause(s) leading to death is not important. They believe morally bad actions, and predetermined fate associated with kamma in Buddhism, play a big role whether or not one is infected with the liver fluke. Health interventions may be made more effective if they take into account the liver fluke–infected population’s worldviews about ethics, morality, life, and death. We researchers should not feel concerned only about medically determined causes of death.

Marine environmental monitoring is undertaken to provide evidence that environmental management targets are being met. Moreover, monitoring also provides context to marine science and over the last century has allowed development of a critical scientific understanding of the marine environment and the impacts that humans are having on it. The seas around the UK are currently monitored by targeted, impact-driven, programmes (e.g., fishery or pollution based monitoring) often using traditional techniques, many of which have not changed significantly since the early 1900s. The advent of a new wave of automated technology, in combination with changing political and economic circumstances, means that there is currently a strong drive to move toward a more refined, efficient, and effective way of monitoring. We describe the policy and scientific rationale for monitoring our seas, alongside a comprehensive description of the types of equipment and methodology currently used and the technologies that are likely to be used in the future. We contextualize the way new technologies and methodologies may impact monitoring and discuss how whole ecosystems models can give an integrated, comprehensive approach to impact assessment. Furthermore, we discuss how an understanding of the value of each data point is crucial to assess the true costs and benefits to society of a marine monitoring programme.

Mating disruption is the primary control tactic used against the gypsy moth, Lymantria dispar (L.) (Lepidoptera: Lymantriidae) under the gypsy moth Slow the Spread (STS) program. In this paper, we present the results of the multiyear study designed to evaluate a new liquid SPLAT GM™ (ISCA Tech, Riverside, CA, USA) Organic formulation, which is approved by the USDA to meet National Organic Program Standards for use in organic certified farms, for its ability to disrupt gypsy moth mating, and to evaluate the environmental persistence of SPLAT GM™ and SPLAT GM™ Organic formulations. Environmental persistence of the pheromone beyond the year of application is a significant concern since STS relies on trap catch data to evaluate treatment success. The study was conducted in 2007–2012 in forested areas in Virginia and Wisconsin, USA. We observed that SPLAT GM™ Organic reduced gypsy moth trap catch by ≥90% for 10 weeks in a similar manner as SPLAT GM™ and Hercon Disrupt® II (Hercon Environmental, Emigsville, PA, USA). Although we observed persistent effects in all products one year after application, the persistence observed in SPLAT GM™ and SPLAT GM™ Organic was significantly lower than that of Hercon Disrupt® II plastic laminated flakes.

Evacuation of the population from a tsunami hazard zone is vital to reduce life-loss due to inundation. Geospatial least-cost distance modelling provides one approach to assessing tsunami evacuation potential. Previous models have generally used two static exposure scenarios and fixed travel speeds to represent population movement. Some analyses have assumed immediate departure or a common evacuation departure time for all exposed population. Here, a method is proposed to incorporate time-variable exposure, distributed travel speeds, and uncertain evacuation departure time into an existing anisotropic least-cost path distance framework. The method is demonstrated for hypothetical local-source tsunami evacuation in Napier City, Hawke's Bay, New Zealand. There is significant diurnal variation in pedestrian evacuation potential at the suburb level, although the total number of people unable to evacuate is stable across all scenarios. Whilst some fixed travel speeds approximate a distributed speed approach, others may overestimate evacuation potential. The impact of evacuation departure time is a significant contributor to total evacuation time. This method improves least-cost modelling of evacuation dynamics for evacuation planning, casualty modelling, and development of emergency response training scenarios. However, it requires detailed exposure data, which may preclude its use in many situations.