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Myelodysplastic neoplasms (MDS) are a collection of hematopoietic disorders with widely variable prognoses and treatment options. Accurate pathologic diagnoses present challenges because of interobserver variability in interpreting morphology and quantifying dysplasia. We compared local clinical site diagnoses with central, adjudicated review from 918 participants enrolled in the ongoing National Heart, Lung, and Blood Institute National MDS Natural History Study, a prospective observational cohort study of participants with suspected MDS or MDS/myeloproliferative neoplasms (MPNs). Locally, 264 (29%) were diagnosed as having MDS, 15 (2%) MDS/MPN overlap, 62 (7%) idiopathic cytopenia of undetermined significance (ICUS), 0 (0%) acute myeloid leukemia (AML) with

The number of people living with dementia is rising globally as life expectancy increases. Dementia is a multifactorial disease. Due to the ubiquity of radiation exposure in medical and occupational settings, the potential association between radiation and dementia, and its subtypes (Alzheimer's and Parkinson's disease), is of particular importance. There has also been an increased interest in studying radiation induced dementia risks in connection with the long-term manned space travel proposed by The National Aeronautics and Space Administration (NASA). Our aim was to systematically review the literature on this topic, and use meta-analysis to generate a summary measure of association, assess publication bias and explore sources of heterogeneity across studies. We identified five types of exposed populations for this review: 1. survivors of atomic bombings in Japan; 2. patients treated with radiation therapy for cancer or other diseases; 3. occupationally exposed workers; 4. those exposed to environmental radiation; and 5. patients exposed to radiation from diagnostic radiation imaging procedures. We included studies that considered incident or mortality outcomes for dementia and its subtypes. Following PRISMA guidelines, we systematically searched the published literature indexed in PubMed between 2001 and 2022. We then abstracted the relevant articles, conducted a risk-of-bias assessment, and fit random effects models using the published risk estimates. After we applied our eligibility criteria, 18 studies were identified for review and retained for meta-analysis. For dementia (all subtypes), the summary relative risk was 1.11 (95% CI: 1.04, 1.18; P = 0.001) comparing individuals receiving 100 mSv of radiation to those with no exposure. The corresponding summary relative risk for Parkinson's disease incidence and mortality was 1.12 (95% CI 1.07, 1.17; P

IntroductionGlobally, 600,000 mothers (15-49 years) die every year due to pregnancy and childbirth-related complications. Wide variations are seen in cultural practices and beliefs surrounding this period of a woman's life. The present study explores the cultural beliefs and practices of women and families during pregnancy and the postnatal period in order to understand what behavioral management strategies are required to improve maternal and infant outcomes during pregnancy and the postpartum period.MethodsThe study was conducted in a rural area of Punjab, from December 2019 to March 2021. A total of 20 women (up to 3 months postpartum, age >18 years, were interviewed.ResultsIn general, women described eating varied and fairly healthy diets during pregnancy, especially nutritious warm food, following traditional practices. Other cultural practices included restrictions on movement and mobile phone use and the use of unsafe home remedies to promote infant safety and wellbeing, such as using gripe water, applying black pencil to the baby's eyes, and feeding the baby honey. A few were not inclined to engage with these and other cultural expectations, preferring instead to follow contemporary practices influenced by social media. These practices included being accompanied by a family member during delivery, celebrating the baby's birth regardless of sex, and early bathing post-delivery.DiscussionIt can be concluded that while many traditional practices are still followed in India, there are new beliefs and behaviors arising from an intersection between culture and technology. Developing strategies that acknowledge older beliefs and modern approaches is essential to promoting better antenatal and postpartum care.

A recent push toward addressing antiracism in science reveals a need to integrate discussions of racism, social justice, and equity into undergraduate STEM classes. Toward this end, in Fall 2020, a theme of "Racism is a Public Health Emergency" was incorporated as an overlay for an existing undergraduate biochemistry curriculum. This theme was used throughout the entire semester and involved discussions of racism, social justice, and equity that were directly integrated with the science content of the course. Students enrolled in the class were surveyed at the end of the semester regarding their perceptions of integrating discussions of racism, social justice, and/or equity into chemistry courses. Students indicated that the inclusion of the overlay increased the relevance of the course material, indicated a high level of understanding of the impact of bias and race on the field of biochemistry, and expressed overwhelmingly positive views regarding future inclusion of similar themes of equity and antiracism in chemistry courses. Additionally, student scores and answers on common final exam questions were compared to previous semesters, revealing that the inclusion of this overlay did not negatively impact coverage of biochemistry content.

A global-scale horizontally and vertically resolved ozone climatology provides detailed insights into ozone variability. Here, the seasonal, annual and decadal monthly Trajectory-mapped Ozonesonde dataset for the Stratosphere and Troposphere (TOST) ozone climatology is improved and updated over 1970–2021. TOST is gridded at 5°×5°×1 km (latitude, longitude and altitude) from the surface to 26 km by the geometric coordinate and from the surface to 20 hPa at 26 pressure levels by the pressure coordinate, with the most recent ozonesonde data re-evaluated following the ASOPOS-2 guidelines (Smit and Thompson, 2021). Comparison between ozonesonde and trajectory-derived ozone shows good agreement for each decade, altitude and station, with relative differences (RDs) of 2 %–4 % in the troposphere and 0.5 % in the stratosphere. TOST also aligns well with aircraft, the Satellite Aerosol and Gas Experiment (SAGE) and the Microwave Limb Sounder (MLS) datasets. The updated TOST improves data coverage in all latitude bands and altitudes and reduces RD by 14 %–17 % compared to the previous version, taking advances in trajectory simulations and twice as many ozonesonde profiles. Higher uncertainties in TOST are where data are sparse, i.e., southern high latitudes, tropics and pre-1980s, and where variability is high, i.e., at the surface and upper troposphere–lower stratosphere (UTLS). Caution should therefore be taken when using TOST in these spaces and times. TOST captures global ozone distributions and temporal variations, showing an overall non-significant change in lower stratospheric ozone after 1998. TOST offers users a dataset with a long record, global coverage and high vertical resolution. [ABSTRACT FROM AUTHOR]

Evapotranspiration (ET) is commonly estimated using the Penman-Monteith equation, which assumes that the plant canopy is a big leaf (BL) and the water flux from vegetation is regulated by canopy stomatal conductance (Gs). However, BL has been found to be unsuitable for terrestrial biosphere models built on the carbon-water coupling principle because it fails to capture daily variations of gross primary productivity (GPP). A two-big-leaf scheme (TBL) and a two-leaf scheme (TL) that stratify a canopy into sunlit and shaded leaves have been developed to address this issue. However, there is a lack of comparison of these upscaling schemes for ET estimation, especially on the difference between TBL and TL. We find that TL shows strong performance (r2 = 0.71, root-mean-square error = 0.05 mm/h) in estimating ET at nine eddy covariance towers in Canada. BL simulates lower annual ET and GPP than TL and TBL. The biases of estimated ET and GPP increase with leaf area index (LAI) in BL and TBL, and the biases of TL show no trends with LAI. BL miscalculates the portions of light-saturated and light-unsaturated leaves in the canopy, incurring negative biases in its flux estimation. TBL and TL showed improved yet different GPP and ET estimations. This difference is attributed to the lower Gs and intercellular CO2 concentration simulated in TBL compared to their counterparts in TL. We suggest to use TL for ET modeling to avoid the uncertainty propagated from the artificial upscaling of leaf-level processes to the canopy scale in BL and TBL.

The magnitude and variability of the terrestrial CO2 sink remain uncertain, partly due to limited global information on ecosystem nitrogen (N) and its cycle. Without N constraint in ecosystem models, the simulated benefits from CO2 fertilization and CO2-induced increases in water use efficiency (WUE) may be overestimated. In this study, satellite observations of a relative measure of chlorophyll content are used as a proxy for leaf photosynthetic N content globally for 2003–2011. Global gross primary productivity (GPP) and evapotranspiration are estimated under elevated CO2 and N-constrained model scenarios. Results suggest that the rate of global GPP increase is overestimated by 85% during 2000–2015 without N limitation. This limitation is found to occur in many tropical and boreal forests, where a negative leaf N trend indicates a reduction in photosynthetic capacity, thereby suppressing the positive vegetation response to enhanced CO2 fertilization. Based on our carbon-water coupled simulations, enhanced CO2 concentration decreased stomatal conductance and hence increased WUE by 10% globally over the 1982 to 2015 time frame. Due to increased anthropogenic N application, GPP in croplands continues to grow and offset the weak negative trend in forests due to N limitation. Our results also show that the improved WUE is unlikely to ease regional droughts in croplands because of increases in evapotranspiration, which are associated with the enhanced GPP. Although the N limitation on GPP increase is large, its associated confidence interval is still wide, suggesting an urgent need for better understanding and quantification of N limitation from satellite observations.

ObjectiveThe Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are two of the more well-known food assistance programmes in the USA. The current study describes food consumption patterns of children aged 1-5 years living in households dually enrolled in these two programmes v. households enrolled only in WIC.DesignFood consumption and SNAP participation were assessed using data from the 2014 Survey of Los Angeles County (LAC) WIC Participants and the Follow-Up Survey of the same households that were also SNAP beneficiaries. Telephone interviews were conducted with WIC parents regarding each child's (i.e. beneficiary's) food consumption patterns. Follow-up interviews were conducted with those who reported receiving SNAP. Multivariable regression analyses were performed to assess the relationships between food and beverage consumption and dual v. single food assistance programme participation.SettingLAC, California.SubjectsChildren of WIC-enrolled households in LAC during 2014 (n 3248). This included a sub-sample of dual WIC- and SNAP-enrolled households (n 1295). Survey participants were the beneficiaries' parents.ResultsChildren from dually enrolled households consumed 1·03 (P

In this study, high-quality soil moisture data derived from the Soil Moisture Active Passive (SMAP) satellite measurements are evaluated from a perspective of improving the estimation of the global gross primary production (GPP) using a process-based ecosystem model, namely, the Boreal Ecosystem Productivity Simulator (BEPS). The SMAP soil moisture data are assimilated into BEPS using an ensemble Kalman filter. The correlation coefficient (r) between simulated GPP from the sunlit leaves and Sun-induced chlorophyll fluorescence (SIF) measured by Global Ozone Monitoring Experiment-2 is used as an indicator to evaluate the performance of the GPP simulation. Areas with SMAP data in low quality (i.e., forests), or with SIF in low magnitude (e.g., deserts), or both are excluded from the analysis. With the assimilated SMAP data, the r value is enhanced for Africa, Asia, and North America by 0.016, 0.013, and 0.013, respectively (p

This action research was to answer the pedagogical question: How effective can a branching story approach be as a motivational tool for elementary reading instruction? A branching story was created with hyperlinks built into a Powerpoint story. The young readers could interact with options at different turning points of the story, which activated the readers' curiosity, and promoted their decision making and thinking skills. The study was carried out in an all-girl school, Saudi Arabia. A class of 20 fourth-graders participated in the study. For data collection and analyses, the students were assigned into four groups based on their previous reading achievements and interests. Students' responses to comprehension questions were tabulated. The unit-end survey results were analyzed. A majority of the participating students overwhelmingly enjoyed the experience. They were motivated to achieve the project goals sooner than planned. Kinesthetic learners demonstrated their academic potentials well beyond their performance under the traditional reading instruction.