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Eucalyptus species play an important role in the global carbon cycle, especially in reducing the greenhouse effect as well as storing atmospheric CO₂. Thus, assessing the amount of CO₂ released by the soil in forest areas can generate important information for environmental monitoring. This study aims to verify the relation between soil carbon dioxide (CO₂) flux (FCO₂), spectral bands, and vegetation indices (VIs) derived from a UAV-based multispectral camera over an area of eucalyptus species. Multispectral imageries (green, red-edge, and near-infrared) from the Parrot Sequoia sensor, derived vegetation indices, and the FCO₂ data from a LI-COR 8100 analyzer, combined with soil moisture and temperature data, were collected and related. The vegetation indices ATSAVI (Adjusted Transformed Soil-Adjusted VI), GSAVI (Green Soil Adjusted Vegetation Index), and SAVI (Soil-Adjusted Vegetation Index), which use soil correction factors, exhibited a strong negative correlation with FCO₂ for the species E. camaldulensis, E. saligna, and E. urophylla species. A Multivariate Analysis of Variance showed significance (p < 0.01) for the species factor, which indicates that there are differences when considering all variables simultaneously. The results achieved in this study show a specific correlation between the data of soil CO₂ emission and the eucalypt species, providing a distinction of values between the species in the statistical data., (© 2024. The Author(s).)

Objectives: With support from others, individuals with depression can build skills and implement lifestyle changes that help them manage their illness. The objective of the current study was to understand how the CarePartners for Depression Program, a randomized clinical trial aimed at enhancing the role of caregivers in the management of depression, improved communication and shared understandings of depression among individuals with depression and their close others., Methods: We conducted in-depth, semi-structured interviews with individuals with depression and their caregivers who participated in the CarePartners program. Interviews were qualitatively coded using a thematic analytic framework., Results: We conducted individual interviews with 39 participants in the CarePartners program, including 18 individuals with depression, 14 out-of-home care partners, and 7 informal caregivers. Three central themes were derived from analyses: (a) The quality of interpersonal relationships influenced the management of depression; (2) having clearly defined roles for CarePartners improved communication between CarePartners and individuals with depression; and (3) shared understanding of depression improved management of depression., Discussion: Our findings established the conditions under which the management of depression was influenced in a dyadic intervention. Dyadic interventions may make it easier for individuals to support patients with depression by fostering communication and collaboration., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The 2020 environmental catastrophe in Pantanal has highlighted the fragility of environmental policies and practices for managing and fighting fires in this biome. Therefore, it is essential to know the causes and circumstances that potentiate these fires. This study aimed to: (I) assess the relationship between fire foci and carbon absorption (GPP), precipitation, and carbon dioxide (CO 2 ) flux; (ii) analyze vegetation recovery using the differenced normalized burn ratio (ΔNBR) in Brazilian Pantanal between 2001 and 2022; and (iii) identify priority areas, where the highest intensities of fire foci have occurred, in order to guide public policies in Brazil to maintain local conservation. To this purpose, fire foci were detected using data from the MODIS MOD14/MYD14 algorithm, annual precipitation with CHIRPS (Climate Hazards Group InfraRed Precipitation with Station data), and CO 2 flux using the MODIS/MODO9A1 product, and Gross Primary Production (GPP) with the MODIS/MOD17A2 product. The severity of the burned area was also assessed using the ΔNBR index and the risk areas were determined using the averages of these images. During the time series studied, a total of 300,127 fire foci were detected throughout the Pantanal, where 2020 had the highest number of foci and the lowest accumulated precipitation. The years with the highest precipitation were 2014 and 2018. The year 2018 was also the second year with the highest GPP value. The Pettit test showed a trend for 2008 and 2011 as the points of change in the CO 2 flux and GPP variables. Principal component analysis clustered fire foci and precipitation on opposite sides, as well as GPP and CO 2 flux, while ΔNBR clustered HS, MHS and MLS classes with the years 2020, 2019, 2002 and 2021. There was a high negative correlation between fire foci × rainfall and GPP × CO 2 flux. The years with the largest areas of High severity (HS), Moderate-high severity (MHS) and Moderate-low severity (MLS) classes were 2020 and 2019, respectively. The most vulnerable areas for severe fires were the municipalities of Cáceres, Poconé, and Corumbá. The major fire catastrophe in 2020 is correlated with the low precipitation in 2019, the high precipitation in 2018, and the increased GPP, as well government policies unfavorable to the environment., (© 2023. The Author(s).)

We know little about veterans' lifetime trauma exposure patterns and how such patterns are associated with mental health outcomes. This study sought to identify lifetime trauma exposure typologies among veterans and examine associations between these typologies and mental health outcomes. It used baseline data from a national longitudinal mail-based survey of 3,544 veterans and oversampled for women (51.6%) and veterans living in high crime areas (67.6%). Most veterans (94.2%) reported trauma exposure, and 80.1% reported exposure to two or more traumas. Prevalence of mental health outcomes was: 27.7% anxiety, 31.3% depression, 37.9% posttraumatic stress disorder, 44.4% alcohol use disorder, 10.4% suicide attempt, and 33.5% mental health comorbidity. Latent class analysis was used to identify patterns of lifetime trauma exposure and logistic regression was used to examine the odds of mental health outcomes as a function of class membership. Five lifetime trauma exposure typologies emerged: (1) low trauma; (2) high combat and community violence; (3) intimate partner violence trauma; (4) high global physical assault; and (5) high trauma. Classes showed differential associations with mental health outcomes. Findings have implications for clinical practice including informing providers' mental health treatment plans to correspond to each veteran's trauma exposure typology., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023. Published by Elsevier B.V.)

The emission of soil carbon dioxide (CO 2 ) in agricultural areas is a process that results from the interaction of several factors such as climate, soil, and land management practices. Agricultural practices directly affect the carbon dynamics between the soil and atmosphere. Herein, we evaluated the temporal variability (2020/2021 crop season) of soil CO 2 emissions and its relationship with related variables, such as the CO 2 flux model, enhanced vegetation index (EVI), gross primary productivity (GPP), and leaf area index (LAI) from orbital data and soil temperature, soil moisture, and soil CO 2 emissions from in situ collections from native forests, productive pastures, degraded pastures, and areas of high-yield potential soybean and low-yield potential soybean production. A significant influence (p < 0.01) was observed for all variables and between the different land uses and occupation types. September and October had lower emissions of soil CO 2 and low means of soil moisture and soil temperature, and no differences were observed among the treatments. On the other hand, there was a significant effect of the CO 2 flux model in productive pastures, high-yield potential soybean areas, and low-yield potential soybean areas. The months with the highest CO 2 flux values in the model, regardless of land use and land cover, were October and November, which is the beginning of the rainy season. There were positive correlations between soil CO 2 emissions and GPP (0.208), LAI (0.354), EVI (0.363), and soil moisture (0.280) and negative correlations between soil CO 2 emissions and soil temperature (-0.240) and CO 2 flux model (-0.314) values. Land use and land cover showed negative correlations with these variables, except for the CO 2 flux model variable. Soil CO 2 emission values were lower for high-yield potential soybean areas (averages from 0.834 to 6.835 μmol m -2 s -1 ) and low-yield potential soybean areas (from 0.943 to 5.686 μmol m -2 s -1 ) and higher for native forests (from 2.279 to 8.131 μmol m -2 s -1 ), whereas the opposite was true for the CO 2 flux model., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Little is known about the impact of perceived neighborhood danger on military veterans' mental health, a population potentially at higher risk for this experience, or whether interpersonal social support and neighborhood cohesion can help buffer against poor mental health. This study examined: (1) the impact of perceived neighborhood danger on depression and posttraumatic stress disorder (PTSD) among veterans; (2) whether interpersonal social support and neighborhood cohesion can mitigate these effects; and (3) how prior trauma history may interact with these factors. Six moderation models were examined using data from 3049 veterans enrolled in the Longitudinal Investigation of Gender, Health, and Trauma study, a mail-based survey that oversampled for veterans in high crime neighborhoods. Most notably, results indicated that perceived neighborhood danger was associated with increased depression and PTSD (all p < .001). Interpersonal social support or neighborhood cohesion mitigated the effect of perceived neighborhood danger on veterans' depression, but, only for those without prior trauma (all p < .011). For trauma-exposed veterans, interpersonal social support was more effective in mitigating the effect of perceived neighborhood danger on depression than neighborhood cohesion (p = .006). Findings help inform interventions to improve the mental health of veterans living in high crime neighborhoods., (© 2023 Society for Community Research and Action. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

This study quantifies golf course pesticide risk in five regions across the US (Florida, East Texas, Northwest, Midwest, and Northeast) and three countries in Europe (UK, Denmark, and Norway) with the objective of determining how pesticide risk on golf courses varied as a function of climate, regulatory environment, and facility-level economic factors. The hazard quotient model was used to estimate acute pesticide risk to mammals specifically. Data from 68 golf courses are included in the study, with a minimum of at least five golf courses in each region. Though the dataset is small, it is representative of the population at confidence level of 75 % with a 15 % margin of error. Pesticide risk appeared to be similar across US regions with varied climates, and significantly lower in the UK, and lowest in Norway and Denmark. In the Southern US (East Texas and Florida), greens contribute most to total pesticide risk while in nearly all other regions fairways make the greatest contribution to overall pesticide risk. The relationship between facility-level economic factors such as maintenance budget was limited in most regions of the study, except in the Northern US (Midwest, Northwest, and Northeast) where maintenance and pesticide budget correlated to pesticide risk and use intensity. However, there was a strong relationship between regulatory environment and pesticide risk across all regions. Pesticide risk was significantly lower in Norway, Denmark, and the UK, where twenty or fewer active ingredients were available to golf course superintendents, than it was in US where depending on the state between 200 and 250 pesticide active ingredients were registered for use on golf courses., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Frank Rossi reports a relationship with Petro-Canada that includes: consulting or advisory., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Introduction: General anesthesia is associated with the development of atelectasis, which may affect lung ventilation. Electrical impedance tomography (EIT) is a noninvasive imaging tool that allows monitoring in real time the topographical changes in aeration and ventilation., Objective: To evaluate the pattern of distribution of pulmonary ventilation through EIT before and after anesthesia induction in pediatric patients without lung disease undergoing nonthoracic surgery., Methods: This was a prospective observational study including healthy children younger than 5 years who underwent nonthoracic surgery. Monitoring was performed continuously before and throughout the surgical period. Data analysis was divided into 5 periods: induction (spontaneous breathing, SB), ventilation-5min, ventilation-30min, ventilation-late and recovery-SB. In addition to demographic data, mechanical ventilation parameters were also collected. Ventilation impedance (Delta Z) and pulmonary ventilation distribution were analyzed cycle by cycle at the 5 periods., Results: Twenty patients were included, and redistribution of ventilation from the posterior to the anterior region was observed with the beginning of mechanical ventilation: on average, the percentage ventilation distribution in the dorsal region decreased from 54%(IC95%:49-60%) to 49%(IC95%:44-54%). With the restoration of spontaneous breathing, ventilation in the posterior region was restored., Conclusion: There were significant pulmonary changes observed during anesthesia and controlled mechanical ventilation in children younger than 5 years, mirroring the findings previously described adults. Monitoring these changes may contribute to guiding the individualized settings of the mechanical ventilator with the goal to prevent postoperative complications., Competing Interests: Letícia C. Corrêa and Glasiele C. Alcala are employees of Timpel S.A.; Eduardo Leite and Felipe S. Rossi are Timpel S.A. consultants, Marcelo B. P. Amato is Timpel S.A. consultant and minority shareholder. The other authors declare no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2023 Nascimento et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (cardiovascular (CVD)) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioural CVD prevention programs should target these CVD risk factors simultaneously., (© 2022 John Wiley & Sons Ltd.)

Many divorcing/separating parties seeking mediation to resolve family-related issues report intimate partner violence (IPV) victimization from the other party in the case. It is imperative that mediation staff screen parties for IPV so they can make informed decisions regarding how to proceed with mediation. Existing IPV screens for mediation have significant limitations. We examined three methodological approaches using item response theory that address these limitations by increasing the efficiency and clinical utility of an existing standardized IPV screen for mediation, the Mediator's Assessment of Safety Issues and Concerns ( N = 904 mediating parties). We identified three subsets of items, with initial evidence for their validity, focused on helping mediation staff identify high levels of IPV or parties at risk for potentially negative mediation outcomes or needing specialized safety accommodations in mediation. Clinical recommendations are provided indicating which approach is most promising to be used in mediation settings. Overall, findings help advance understanding of how item response theory methodology can enhance the precision of IPV screening in mediation.

Background: Healthcare fragmentation may lead to adverse consequences and may be amplified among older, sicker patients with mental health (MH) conditions., Objective: To determine whether older Veterans with MH conditions have more fragmented outpatient non-MH care, compared with older Veterans with no MH conditions., Design: Retrospective cohort study using FY2014 Veterans Health Administration (VHA) administrative data linked to Medicare data., Participants: 125,481 VHA patients ≥ 65 years old who were continuously enrolled in Medicare Fee-for-Service Parts A and B and were at high risk for hospitalization., Main Outcome and Measures: The main outcome was non-MH care fragmentation as measured by (1) non-MH provider count and (2) Usual Provider of Care (UPC), the proportion of care with the most frequently seen non-MH provider. We tested the association between no vs. any MH conditions and outcomes using Poisson regression and fractional regression with logit link, respectively. We also compared Veterans with no MH condition with each MH condition and combinations of MH conditions, adjusting for sociodemographics, comorbidities, and drive-time to VHA specialty care., Key Results: In total, 47.3% had at least one MH condition. Compared to those without MH conditions, Veterans with MH conditions had less fragmented care, with fewer non-MH providers (IRR = 0.96; 95% CI: 0.96-0.96) and more concentrated care with their usual provider (OR = 1.08 for a higher UPC; 95% CI: 1.07, 1.09) in adjusted models. Secondary analyses showed that those with individual MH conditions (e.g., depression) had fewer non-MH providers (IRR range: 0.86-0.98) and more concentrated care (OR range: 1.04-1.20). A similar pattern was observed when examining combinations of MH conditions (IRR range: 0.80-0.90; OR range: 1.16-1.30)., Conclusions: Contrary to expectations, having a MH condition was associated with less fragmented non-MH care among older, high-risk Veterans. Further research will determine if this is due to different needs, underuse, or appropriate use of healthcare., (© 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

Objectives: To evaluate the effects of four flow rates on the functional residual capacity (FRC) and pulmonary ventilation distribution while using a high-flow nasal cannula (HFNC)., Working Hypothesis: Our hypothesis is that flow rates below 1.5 L·kg -1 ·min -1 lead to FRC loss and respiratory distress., Study Design: A single-center, prospective clinical study., Patient Selection: Infants diagnosed with acute viral bronchiolitis were given HFNC., Methodology: Through a prospective clinical study, the effects of four different flow rates, 2.0, 1.5, 1.0, and 0.5 L·kg -1 ·min -1 , on FRC and the pulmonary ventilation pattern were evaluated using electrical impedance tomography. The impedance variation (delta Z), end-expiratory lung volume (EELZ), respiratory rate, heart rate, respiratory distress score, and saturation/fraction of inspired oxygen ratio (SpO 2 /F I O 2 ), were also evaluated at each flow rate., Results: Among the 11 infants included, There was a decrease in respiratory distress score at a flow rate of 1.5 L·kg -1 ·min -1 (*p = 0.021), and at a flow rate of 2.0 L·kg -1 ·min -1 (**p = 0.003) compared to 0.5 L·kg -1 ·min -1 . There was also a small but significant increase in SpO 2 /FiO 2 at flow rates of 1.5 (*p = 0.023), and 2.0 L·kg -1 ·min -1 (**p = 0.008) compared to 0.5 L·kg -1 ·min -1 . There were no other significant changes in the clinical parameters. In the global EELZ measurements, there was a significant increase under a flow rate of 2.0 L·kg -1 ·min -1 as compared to 0.5 L·kg -1 ·min -1 (p = 0.03). In delta Z values, there were no significant variations between the different flow rates., Conclusion: The ∆EELZ increases at the highest flow rates were accompanied by decreased distress scores and improved oxygenation., (© 2022 Wiley Periodicals LLC.)

Psychological distress may impact women's risk for future intimate partner violence (IPV). Yet, limited research has utilized longitudinal research designs and there is a scarcity of research looking at the three most commonly implicated mental health factors-posttraumatic stress disorder (PTSD), depression, and alcohol use-within the same study. Research is especially scarce for women veterans, who experience substantial risk for these mental health concerns and experiencing IPV. This study examined the role of PTSD symptoms, depression symptoms, and alcohol use in increasing risk for experiencing future IPV while simultaneously accounting for the impact of recent IPV experience on subsequent mental health. This study included a sample of 1921 women veterans (M age = 36.5), who were asked to complete three mail surveys over the course of 8 months as part of a larger longitudinal survey study of US veterans' health and well-being. The survey assessed experiences of IPV, PTSD symptoms (PCL-5), depression symptoms (PHQ-9), and alcohol use (AUDIT-C) at each of the three time points. Results from separate path analysis models provided support for the role of PTSD symptoms and depression symptoms (but not alcohol use) in increasing risk for IPV experience over time. However, the path analysis models provided little support, with the exception of PTSD, for the impact of IPV experience on subsequent mental health symptoms. Findings point to the importance of better understanding the mechanisms by which PTSD and depression symptoms can increase risk for IPV to inform theory and prevention and treatment efforts. Detection and treatment of PTSD and depression symptoms among women may help reduce risk for future violence in intimate relationships.

The growth of the world population has led to the expansion of agricultural areas to produce food that meets world demand, making it necessary to increase productivity and maintain environmental sustainability in these areas. Seeking sustainable food production, the agricultural use of soil must be assessed in view of optimal use or land as natural resource, as well as minimize the effects of global warming related to land use and land cover (LULC). We hypothesize that different LULC affects Amazonian soil attributes. In this study, the effect of different LULC in the southern Brazilian Amazon, namely, native forest, pasture, and rice and soybean crops, on the spatial variability of soil fertility and texture was assessed, seeking to obtain information that will guide farmers in the near future to better exploit their areas and contribute to a more sustainable agriculture. Descriptive statistical analysis was performed for the pH, H + Al, Al, Ca, Mg, P, K, Cu, Fe, Mn, Zn, V, m, organic matter, clay, silt, and sand values from soil samples under different LULC. To verify the data normality, the Shapiro-Wilk test at 5% significance was performed. Outlier analysis using boxplot graphics, principal component analysis (PCA), and cluster analysis was performed. Data were submitted to geostatistical analysis to verify the spatial dependence degree of the variables through semivariograms for interpolated kriging maps. Except for silt, all variables were well represented in the factor map. PCA revealed that the data variability can be explained mainly by pH, V, Ca, K, and Zn values, which are inversely proportional to m, P, and sand. Through geostatistical analysis, spatial dependence ranging from moderate to strong was observed, generating reliability in the prediction of most attributes in pasture, rice, and soybean areas. Yet, a spatial dependence ranging from moderate to strong was found, generating reliability in the prediction of most attributes in pasture, rice, and soybean areas. Our findings reveal a lower fertility and higher acidity in forest areas, whereas crop areas presented the opposite result., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: Identify non-pharmacological interventions to support patient/caregiver dyads with ACSCs; review the effects of dyadic interventions on health services outcomes; and review the effectiveness of dyadic interventions on patient and caregiver biopsychosocial outcomes., Methods: A systematic review of randomized controlled trials (RCTs)., Results: Twenty-six manuscripts representing 20 unique RCTs (Mean N = 154 patients, 140 caregivers) were eligible. Eleven RCTs examined caregiving in patients with HF, seven with T2DM, one with COPD, and one with mixed ACSCs. Dyadic interventions for ACSCs were diverse in terms of length and content, with most including an educational component. Only 4/26 included studies had a low risk of bias. Interventions were most successful at improving quality of life, clinical health outcomes, health behaviors, and health services outcomes, with fewer improvements in patient mental health outcomes, psychosocial outcomes, relationship outcomes, and caregiver outcomes in general. The largest effect sizes were reported from trials focused on T2DM., Conclusions: High-quality research with consistent measuring instruments is needed to understand which interventions are associated with improved patient and caregiver outcomes., Clinical Implications: There may be clinically relevant benefits to including caregivers in interventions for patients with ACSCs, and clinicians should consider this when devising treatment plans.

Introduction: Electrical impedance tomography (EIT) is a noninvasive, radiation-free, bedside tool to monitor ventilation distribution in real time., Objective: To evaluate, in pediatric COVID-19 patients, the ventilation distribution using EIT and compare it to thoracic computed tomography (TCT) or chest radiograph results obtained in these patients., Methods: This was a prospective, observational clinical study including pediatric patients admitted to the intensive care unit of a private hospital. The patients monitored with EIT tested positive for COVID-19 and were submitted to the previously mentioned radiation exams. EIT monitoring lasted 15 min and no sedation was used., Results: Six patients were included in this study. The main differences observed in the EIT were in the right-left distribution and were compatible with the morphological changes found in the TCT or radiograph images due to COVID-19 infection., Conclusion: We conclude that EIT is ready to investigate the ventilatory profile present at different lung diseases, including COVID-19, and might postpone or mitigate the need of repeated ionizing radiation exams in the pediatric population, although larger pediatric cohorts comparing to standard radiological imaging are needed., (© 2021. The Author(s).)

The guidance on decision-making regarding deforestation in Amazonia has been efficient as a result of monitoring programs using remote sensing techniques. Thus, the objective of this study was to identify the expansion of soybean farming in disagreement with the Soy Moratorium (SoyM) in the Amazonia biome of Mato Grosso from 2008 to 2019. Deforestation data provided by two Amazonia monitoring programs were used: PRODES (Program for Calculating Deforestation in Amazonia) and ImazonGeo (Geoinformation Program on Amazonia). For the identification of soybean areas, the Perpendicular Crop Enhancement Index (PCEI) spectral model was calculated using a cloud platform. To verify areas (polygons) of largest converted forest-soybean occurrences, the Kernel Density (KD) estimator was applied. Mann-Kendall and Pettitt tests were used to identify trends over the time series. Our findings reveal that 1,387,288 ha were deforested from August 2008 to October 2019 according to PRODES data, of which 108,411 ha (7.81%) were converted into soybean. The ImazonGeo data showed 729,204 hectares deforested and 46,182 hectares (6.33%) converted into soybean areas. Based on the deforestation polygons of the two databases, the KD estimator indicated that the municipalities of Feliz Natal, Tabaporã, Nova Ubiratã, and União do Sul presented higher occurrences of soybean fields in disagreement with the SoyM. The results indicate that the PRODES system presents higher data variability and means statistically superior to ImazonGeo., (© 2021. The Author(s).)

Background: This study of dyads composed of patients in treatment for alcohol use disorders (AUDs) and their Concerned Others (COs) examined (1) COs' attendance at three types of help (educational sessions, treatment sessions with the patient, and treatment sessions without the patient) during a 3-month period after patients' admission, and (2) whether COs' use of help was associated with better treatment outcomes reported by COs about patients, and patients about themselves., Methods: Dyads (n = 277) were assessed when patients entered AUD treatment and 3 months later (80 %). COs rated their patient's AUD, and patients rated their own AUD, on the Brief Addiction Monitor. At 3-month follow-up, COs answered three items about help (education, treatment with patient, treatment without patient) from their patient's treatment program. Main analyses were analyses of covariance to examine associations between COs' help use and patients' outcomes., Results: At 3-month follow-up, COs who had obtained one type of help were significantly more likely to have also obtained the other two types of help. However, relatively few COs (39 %) obtained any type of help. COs who obtained help rated their patient as having more protection against future substance use. And, when COs had obtained help, patients rated themselves as having less risk of future substance use, and had attended a greater number of AA meetings, than when COs had not obtained help., Conclusions: Findings suggest that COs' use of help can benefit patients in AUD treatment. Clinicians and researchers should increase the availability and use of help among COs., (Published by Elsevier B.V.)

Objective: In this study, we aimed to inform clinical practice by identifying distinct subgroups of U.S. veteran psychiatry inpatients on their alcohol and drug use severity, posttraumatic stress disorder (PTSD) symptoms, and suicidal ideation over time., Method: Participants were 406 patients with co-occurring substance use and mental health disorders. A parallel latent growth trajectory model was used to characterize participants' symptom severity across 15 months posttreatment intake., Results: Four distinct classes were identified: 47% "normative improvement," 32% "high PTSD," 11% "high drug use," and 9% "high alcohol use." Eighty percent of the sample had reduced their drinking and drug intake by half from baseline to 3 months, and those levels remained stable from 3 to 15 months. The High PTSD, High Drug Use, and High Alcohol Use classes all reported levels of PTSD symptomatology at baseline consistent with a clinical diagnosis, and symptom levels remained high and stable across all 15 months. The Normative Improvement class showed declining drug and alcohol intake and was the only class exhibiting reductions in PTSD symptomatology over time. High substance use classes showed initial declines in suicidal ideation, then an increase from 9 to 15 months., Conclusions: The reduction in frequency of drinking and drug use for 80% of the sample was substantial and supports the potential efficacy of current treatment approaches. However, the high and stable levels of PTSD for more than 50% of the sample, as well as the reemergence of suicidal ideation in a sizable subgroup, underscore the difficulty in finding and linking patients to effective interventions to decrease symptomatology over time.

This study develops a framework that quantifies golf course pesticide risk, explores environmental and economic factors that may be responsible for the observed risk, develops a method to compare golf course pesticide risk to other agricultural crops and investigates how pesticide risk on golf courses can be most effectively reduced. To quantify pesticide risk, we adapt the Environmental Impact Quotient (EIQ) and hazard quotient models for use on golf courses. The EIQ model provides an estimate of overall environmental risk, while the hazard quotient model, as applied here, provides an estimate of pesticide risk to mammals. This novel framework was applied to twenty-two courses in Wisconsin and New York, USA. Using both pesticide risk models, all twenty-two golf courses showed a high coefficient of variation of pesticide risk (<0.76). Within a golf course, mean absolute pesticide risk was at least two times higher on fairways than on greens, tees, or roughs. Mean area normalized risk was at least three times higher on greens than the other three golf course components. Pesticide risk of a component-weighted average of greens, tees, fairways and roughs on each course were within the range of pesticide risk calculated for five other agricultural crops. Our data suggest that variation in pesticide risk on golf courses is related to economic factors, such as maintenance budget, and can be effectively lowered by reducing pesticide use on fairways and selecting products of lower risk. To assist golf course superintendents in developing programs that lower pesticide risk, a new metric was developed: the Risk to Intensity Quotient (RIQ). The RIQ is the ratio of pesticide risk to use intensity and quantifies the average risk of product selection by a golf course superintendent., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Michael Bekken, Carl Schimenti, and Douglas Soldat have no conflicts of interests to declare. Frank Rossi is employed part-time by Petro Canada who own Intelligro, the maker of Civitas Turf Defense™, which is discussed in this article. This relationship had no influence on this manuscript., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Objective: Growing up with an adult with an alcohol use disorder (AUD) is common and negatively affects adult functioning. This study examined two questions concerning the lived experience of growing up in a home with AUD., Method and Results: The first question asked how adults entering AUD treatment (n = 402) who had this lived experience (58%) compared to those who did not (42%) on indicators of alcohol use severity. Patients with lived experience reported alcohol use at a younger age, more times having been arrested and charged, and greater risk for future substance use. The second question examined concordance between patients and their concerned others on this lived experience (n = 277 dyads) and patients' treatment outcomes 3 months later. The associations between patients' lived experience and better treatment outcomes were stronger when patients' concerned others had a concordant lived experience. When patient-concerned other dyads reported concordant lived experiences at baseline, patients had lower substance use and risk scores at the 3-month follow-up than when the dyads reported discordant lived experiences with regard to growing up in a home with AUD; effect sizes were small., Conclusions: Concordance and discordance on this lived experience could be considered in treatment planning for patients with AUD and their concerned others. Providers could ask about each member's childhood and aim interventions at helping dyads discuss their childhoods in ways that validate each other's needs and provide emotional support, without stigmatization. Delivery may consider relationship type (spousal or other) and be in educational or treatment sessions that include the dyad or one member.

Improving patient experience is one strategy that may increase the quality of mental health care if better experience is linked to the likelihood of a potentially therapeutic dose (PTD) of treatment. This study sought to examine: (1) the proportion of women veterans who obtained a PTD of mental health treatment; and (2) the association between women's experiences with Veterans Health Administration (VHA) mental health services and obtaining a PTD of mental health treatment. We assessed patient experience via a survey that measured experiences with gender-sensitive care, ease of getting care, perceived quality of care, and extent to which care met needs. We used VHA administrative data to determine mental health utilization across a national sample of 2109 women veterans with episodes of mental health care that included psychotherapy or pharmacotherapy. Results indicated that 71% of women received a PTD. Positive ratings regarding perceived quality of care and whether care met needs were associated with higher odds of receiving a PTD of treatment. Findings provide supporting evidence for the continued necessity  of offering patient-centered mental health care to women veterans. Careful consideration of women veterans' mental health care experiences may be crucial in promoting high value mental health care for this population in VHA.

Background: Psychotherapy is the gold standard treatment for post-traumatic stress disorder (PTSD), yet psychotherapy use and retention among veterans is low. Little is known about the barriers to care and factors associated with women veterans' PTSD psychotherapy use and retention. Using a nationally representative sample of 986 women Veterans Health Administration primary care users with PTSD and a perceived need for mental health care, we examined 1) the proportion of women who used psychotherapy, 2) retention in psychotherapy among women who used any psychotherapy, and 3) individual factors related to psychotherapy use and retention., Methods: Women completed a survey on their mental health care experiences. Outpatient mental health care use in the year before the survey was obtained from Veterans Health Administration administrative data., Results: Most women (79.1%) used psychotherapy, and 41.7% of those women had a minimal therapeutic dose of psychotherapy (≥8 visits). Mental health diagnostic comorbidity and being African American/Black or identifying as neither African American/Black nor White were significantly associated with higher psychotherapy use. Mental health diagnostic comorbidity, exposure to military sexual trauma, and receiving treatment aligned with gender-related and group-related preferences were associated with higher psychotherapy retention. Being a parent was associated with lower retention., Conclusions: Although a significant proportion of women veterans with PTSD are using psychotherapy, retention is enhanced when women are able to obtain treatment aligned with their preferences. Thus, efforts to promote patient-centered, shared decisions regarding mental health treatment options could increase the efficacy and efficiency of treatment for PTSD among women., (Published by Elsevier Inc.)

Initial reports indicate widespread increases in intimate partner violence (IPV) rates during the coronavirus disease 2019 (COVID-19) pandemic. Women veterans are at particular risk for experiencing IPV, and the COVID-19 pandemic and resulting stay-at-home orders may be exacerbating this risk. IPV screening and intervention are an integral part of the care provided to women veterans in the Veteran's Health Administration (VHA). Current changes in healthcare delivery during COVID-19 may present challenges to the VHA's standard methods of initiating IPV screening and intervention with women veterans. We discuss the potential challenges VHA healthcare providers may be encountering when conducting routine IPV screening during the COVID-19 pandemic and when providing resources and support to women veterans experiencing IPV. We describe solutions to these challenges, including existing efforts led by the VHA IPV Assistance Program (IPVAP) as well as additional potential solutions. New ideas and partnerships will be critical for helping the VHA continue to assist women veterans experiencing IPV as the COVID-19 pandemic evolves. Though our focus is on women veterans and the VHA, the challenges and solutions we discuss are likely applicable to other populations experiencing IPV and other health care systems screening for IPV.

We investigated reliability and validity of the Mediator's Assessment of Safety Issues and Concerns (MASIC), a screening interview for intimate partner violence and abuse (IPV/A) in family mediation settings. Clients at three family mediation clinics in the United States and Australia (N = 391) provided reports of the other parent's IPV/A. Internal consistency of the total screen was excellent. A confirmatory factor analysis provided evidence that the MASIC assesses seven types of IPV/A: psychological abuse, coercive controlling behaviors, threats of severe violence, physical violence, severe physical violence, sexual violence, and stalking. Sex differences on differing types of violence victimization were generally consistent with previous research. Higher levels of victimization predicted self-reported consequences of abuse (e.g., fear, injuries). More abusive parties, as identified by their partners on the MASIC, had more Protective Orders and No Contact Orders and criminal convictions and crimes potentially related to IPV/A. Results provide initial evidence of the reliability and validity of the MASIC but more research is needed., (© The Author(s) 2014.)

The genus Theobroma found in the Amazon region is composed of 22 species, including Theobroma speciosum, better known as cacauí. These species are constantly threatened by forest fragmentation caused by human activities and require conservation strategies and management aimed at preserving them in their natural environments. The main objective of this study was to analyze the population structure and genetic diversity within and between natural populations of T. speciosum by using ISSR molecular markers to understand the population structure of the species. Four natural populations belonging to the Amazon rainforest (BAC, CRO, FLA, and PNA), located in the State of Mato Grosso, were selected. Amplification reactions were performed using 15 ISSR primers. A total of 101 loci were found, of which 54.46% were polymorphic at the species level. The BAC population showed higher genetic diversity (H=0.095 and I=0.144) and higher percentage of polymorphism (28.71%). The populations showed an FST value of 0.604, indicating marked genetic differentiation. The highest genetic variation was found between populations. Gene flow was low between populations, indicating genetic isolation between populations.

Objective: To evaluate the efficacy and safety of nasal continuous positive airway pressure (NCPAP) using devices with variable flow or bubble continuous positive airway pressure (CPAP) regarding CPAP failure, presence of air leaks, total CPAP and oxygen time, and length of intensive care unit and hospital stay in neonates with moderate respiratory distress (RD) and birth weight (BW) ≥ 1,500 g., Methods: Forty newborns requiring NCPAP were randomized into two study groups: variable flow group (VF) and continuous flow group (CF). The study was conducted between October 2008 and April 2010. Demographic data, CPAP failure, presence of air leaks, and total CPAP and oxygen time were recorded. Categorical outcomes were tested using the chi-square test or the Fisher's exact test. Continuous variables were analyzed using the Mann-Whitney test. The level of significance was set at p < 0.05., Results: There were no differences between the groups with regard to demographic data, CPAP failure (21.1 and 20.0% for VF and CF, respectively; p = 1.000), air leak syndrome (10.5 and 5.0%, respectively; p = 0.605), total CPAP time (median: 22.0 h, interquartile range [IQR]: 8.00-31.00 h and median: 22.0 h, IQR: 6.00-32.00 h, respectively; p = 0.822), and total oxygen time (median: 24.00 h, IQR: 7.00-85.00 h and median: 21.00 h, IQR: 9.50-66.75 h, respectively; p = 0.779)., Conclusion: In newborns with BW ≥ 1,500 g and moderate RD, the use of continuous flow NCPAP showed the same benefits as the use of variable flow NCPAP.

Neuropathic pain is a devastating neurological disease that seriously affects quality of life in patients. The mechanisms leading to the development and maintenance of neuropathic pain are still poorly understood. However, recent evidence points towards a role of spinal microglia in the modulation of neuronal mechanisms. In this context, cannabinoids are thought to modulate synaptic plasticity as well as glial functions. Here, we have investigated the effect of chronic treatment with a selective agonist of cannabinoid type 2 receptor (CB2), 1-(2',4'-dichlorophenyl)-6-methyl-N-cyclohexylamine-1,4-dihydroindeno[1,2-c]pyrazole-3 carboxamide (NESS400), on pain thresholds in the spared nerve injury (SNI) model in the mouse and on the distribution and activation of spinal microglia. Repeated treatment with NESS400 (4 mg/kg) significantly alleviated neuropathic mechanical allodynia and thermal hyperalgesia. In the dorsal horn (L4-L6) of neuropathic mice microglia activation (quantification of the length of microglial processes) and astrocytosis were associated with CB2 receptor over-expression on both cell types. Treatment with NESS400 significantly reduced the number of hypertrophic microglia while leaving microglial cell number unaffected and reduced astrogliosis. Moreover, prolonged administration of NESS400 reduced mRNA expression of pro-inflammatory markers and enhanced anti-inflammatory marker gene expression in dorsal horn extracts. In conclusion, we show that selective CB2 receptor stimulation prevents thermal hyperalgesia, alleviates mechanical allodynia and facilitates the proliferation of anti-inflammatory microglial phenotype in the ipsilateral dorsal horn of the spinal cord in SNI mice.

The authors report a case of a grade III pancreatic injury resulting from a blunt abdominal trauma, referred to our department for observation and treated with distal splenopancreatectomy. Pancreatic traumas account for approximately 3-5% of blunt abdominal injuries. In cases of isolated pancreatic injuries failure to recognise injury to the Wirsung duct is the main cause of morbidity and mortality. Spiral CT with contrast medium is the standard investigation in haemodynamically stable traumatised patients, with a sensitivity of approximately 90% in the most recent series. However, at least initially, the extent of the pancreatic damage is not proportional to the severity of the clinical and instrumental picture. The patients need to be continuously and carefully monitored and, in the case of suspected pancreatic injury, the imaging study should be repeated 12-24 hours after the trauma. In case of doubt, ERCP provides detailed information on the condition of the Wirsung duct and, in selected cases, may play a therapeutic role through the positioning of an intraductal prosthesis. The surgical management of blunt pancreatic trauma should be individualised depending on the site and severity of the injury, the interval elapsing after the trauma and the presence of associated injuries.

Introduction: Studies comparing high frequency oscillatory and conventional ventilation in acute respiratory distress syndrome have used low values of positive end-expiratory pressure and identified a need for better recruitment and pulmonary stability with high frequency., Objective: To compare conventional and high frequency ventilation using the lower inflection point of the pressure-volume curve as the determinant of positive end-expiratory pressure to obtain similar levels of recruitment and alveolar stability., Methods: After lung lavage of adult rabbits and lower inflection point determination, two groups were randomized: conventional (positive end-expiratory pressure = lower inflection point; tidal volume=6 ml/kg) and high frequency ventilation (mean airway pressures= lower inflection point +4 cmH2O). Blood gas and hemodynamic data were recorded over 4 h. After sacrifice, protein analysis from lung lavage and histologic evaluation were performed., Results: The oxygenation parameters, protein and histological data were similar, except for the fact that significantly more normal alveoli were observed upon protective ventilation. High frequency ventilation led to lower PaCO2 levels., Discussion: Determination of the lower inflection point of the pressure-volume curve is important for setting the minimum end expiratory pressure needed to keep the airways opened. This is useful when comparing different strategies to treat severe respiratory insufficiency, optimizing conventional ventilation, improving oxygenation and reducing lung injury., Conclusions: Utilization of the lower inflection point of the pressure-volume curve in the ventilation strategies considered in this study resulted in comparable efficacy with regards to oxygenation and hemodynamics, a high PaCO2 level and a lower pH. In addition, a greater number of normal alveoli were found after protective conventional ventilation in an animal model of acute respiratory distress syndrome.

Background and Purpose: N-arachidonoyl-serotonin (AA-5-HT) is an inhibitor of fatty acid amide hydrolase (FAAH)-catalysed hydrolysis of the endocannabinoid/ endovanilloid compound, anandamide (AEA). We investigated if AA-5-HT antagonizes the transient receptor potential vanilloid-1 (TRPV1) channel and, as FAAH and TRPV1 are targets for analgesic compounds, if it exerts analgesia in rodent models of hyperalgesia., Experimental Approach: AA-5-HT was tested in vitro, on HEK-293 cells overexpressing the human or the rat recombinant TRPV1 receptor, and in vivo, in rats and mice treated with formalin and in rats with chronic constriction injury of the sciatic nerve. The levels of the endocannabinoids, AEA and 2-arachidonoylglycerol, in supraspinal (periaqueductal grey, rostral ventromedial medulla), spinal or peripheral (skin) tissues were measured., Key Results: AA-5-HT behaved as an antagonist at both rat and human TRPV1 receptors (IC(50)=37-40 nM against 100 nM capsaicin). It exerted strong analgesic activity in all pain models used here. This activity was partly due to FAAH inhibition, elevation of AEA tissue levels and indirect activation of cannabinoid CB(1) receptors, as it was reversed by AM251, a CB(1) antagonist. AA-5-HT also appeared to act either via activation/desensitization of TRPV1, following elevation of AEA, or as a direct TRPV1 antagonist, as suggested by the fact that its effects were either reversed by capsazepine and 5'-iodo-resiniferatoxin, two TRPV1 antagonists, or mimicked by these compounds administered alone., Conclusions and Implications: Possibly due to its dual activity as a FAAH inhibitor and TRPV1 antagonist, AA-5-HT was highly effective against both acute and chronic peripheral pain.

Gastrointestinal stromal tumours are a heterogeneous group of neoplasms of the digestive apparatus characterised by a complex histogenesis and lines of differentiation that make it difficult to predict their biological behaviour. Expression of the c-kit receptor in about 99% of gastrointestinal stromal tumours suggests they may originate from a common mesenchymal element with a variable possibility of phenotypical differentiation. The Authors report a case of small bowel gastrointestinal stromal tumour referred to them for severe bleeding and treated surgically. They then go on to analyse the diagnostic and therapeutic problems that such tumours entail. Surgery is currently the only therapeutic option capable of improving survival in patients with gastrointestinal stromal tumours. Further studies are needed to assess the efficacy of laparoscopy and new chemotherapeutic agents.

The TurfPQ model was used to simulate the runoff of 15 pesticides commonly applied to creeping bentgrass (Agrostis stolonifera L.) fairways and greens on golf courses in the northeastern USA. Simulations produced 100-yr daily records of water runoff, pesticide runoff, and pesticide concentration in runoff for three locations: Boston, MA, Philadelphia, PA, and Rochester, NY. Results were summarized as annual and monthly means and annual maximum daily loads (AMDLs) corresponding to 10- and 20-yr return periods. Mean annual pesticide runoff loads did not exceed 3% of annual applications for any pesticide or site, and most losses were substantially less than 1% of application. However, annual or monthly mean concentrations of chlorothalonil, iprodione, and PCNB in fairway runoff often exceeded concentrations that result in 50% mortality of the affected species (LC50) for aquatic organisms. Concentrations of azoxystrobin, bensulide, cyfluthrin, and trichlorfon in extreme (1 in 10 yr or 1 in 20 yr) events often approached or exceeded LC50 levels. Concentrations of halofenozide, mancozeb, MCPP, oxadiazon, propiconazole, thiophanate-methyl, triadimefon, and trinexapac-ethyl were well below LC50 levels, and turf runoff of these chemicals does not appear to be hazardous to aquatic life in surface waters.

Alimentary tract duplications are uncommon congenital anomalies that are usually present during the first decade of life. However, a smaller number of cases may remain unsuspected until adulthood. They are most common in the ileum but can occur anywhere along the alimentary tract. Duplications may be cystic or tubular in appearance and characteristically arise from the mesenteric aspect of the intestine. Abdominal pain, nausea and/or vomiting, palpable mass, weight loss, and bleeding are the most common symptoms. This paper reports the case of a 24-year-old male with a cystic duplication of the ascending colon not correctly diagnosed prior to operation. When faced with such an abdominal cystic lesion, differential diagnoses versus duplication cyst, mesenteric cyst, choledochal cyst, giant diverticulum, and cystic tumour of the pancreas should be considered. Ultrasound and computerized tomography are good tools for diagnosis and for delineating the relationship between the cyst and peripheral structures. Surgery provides treatment and allows a final pathological diagnosis. Removal of the cyst could be considered satisfactory but resection of the duplication and the adjacent bowel is recommended because of the possibility of malignant degeneration and the risk of gastrointestinal ulceration and haemorrhage due to ectopic gastric mucosa.