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One of the major challenges faced by states and communities is the prevention of underage alcohol access. Underage drinking is widespread and, to a large extent, tolerated by society. It is also implicated in a range of health and social problems that are both tragic and costly. The bad news is clear and all too visible. Underage alcohol use is a serious problem. But fortunately there is good news as well: a variety of effective strategies have been developed to reduce underage drinking. These strategies can be applied in all sectors of the nation, state, and community--in all areas of the systems that produce, distribute, promote, and consume alcohol. This article will outline some of the most important strategies that can be employed by states to reduce youth access to alcohol as well as some of the ways that agencies can work together in broad efforts to reduce underage drinking. While the strategies described are usually applied at the state level, many of them can also be used by communities. The strategies outlined will draw upon the combined power of sound laws and policies, vigorous deterrence, and strong public support. Each of these elements is important individually and can make a difference in preventing underage drinking. But the elements multiply their effectiveness when they are coordinated. Coordinated efforts can ensure that laws are well designed, based on sound principles of deterrence, easy to enforce, and supported by the public. (Contains 1 figure.)

Background: flow-mediated arterial dilation (FMAD), an indicator of endothelial function, is reduced in patients with heart failure and reduced left ventricular ejection fraction (HFREF). Many elderly patients with heart failure exhibit a normal left ventricular ejection fraction (HFNEF). It is unknown whether FMAD is severely reduced in the elderly with HFNEF. Methods and Results: 30 participants >60 yr of age, 11 healthy, 9 with HFNEF, and 10 with HFREF, underwent a cardiovascular magnetic resonance (CMR) assessment of FMAD in the superficial femoral artery followed within 48 h by symptom-limited exercise with expired gas analysis. Elderly patients with HFREF and HFNEF had severely reduced peak oxygen consumption ([Vo.sub.2 peak]; 12 [+ or -] 2 and 13 [+ or -] 1 ml*[kg.sup.-1]*[min.sup.-1], respectively) vs. their healthy age-matched contemporaries (20 [+ or -] 3 ml*[kg.sup.-1]*[min.sup.-1]). FMAD was 3.8 [+ or -] 1.3% (0.85 [+ or -] 0.22 [mm.sup.2]) in patients with HFREF; it was 12.1 [+ or -] 3.6% (3.1 [+ or -] 1.2 [mm.sup.2]) and 13.7 [+ or -] 5.9% (3.9 [+ or -] 1.7 [mm.sup.2]), respectively, in patients with HFNEF and age-matched healthy older individuals. After adjustment for age and gender, the association of FMAD with [Vo.sub.2] was high in healthy and HFREF subjects (P = 0.05 and 0.02, respectively) but less so in HFNEF participants (P = 0.58). Conclusions: elderly patients with HFNEF do not exhibit marked reduction in leg FMAD. These data suggest that mechanisms other than impaired femoral arterial endothelial function contribute to the severe exercise intolerance experienced by these individuals. endothelial function; magnetic resonance imaging

Diastolic heart failure has the same impact on a person's life as systolic heart failure, although the symptoms may not be as severe. This was the conclusion of a study of 60 patients with systolic heart failure, 59 with diastolic heart failure, and 28 healthy volunteers. Diastolic heart failure is a type of heart failure in which the heart pumps blood normally but does not fill up completely between contractions.

The creation of Marine Protected Areas (MPAs) is central to the European Union's strategy for protecting and restoring marine environments. However, current research indicates that monitoring of MPAs is insufficient to ensure their protective role. In response, the European Commission encourages the development and adoption of more effective monitoring tools for MPAs. Environmental DNA (eDNA) methods may serve this function, but their use in MPA monitoring and management remains relatively unexplored. The current study addresses this gap by examining the potential for eDNA to enhance monitoring within Mediterranean MPAs, where monitoring challenges are especially severe. We addressed the gap by synthesizing the results of two analyses. First, a systematic literature review examined existing applications of eDNA metabarcoding to monitor marine habitats. From the experiences documented in the reviewed literature, we applied a SWOT analysis (a framework used to identify and analyze strengths, weaknesses, opportunities and threats) to assess the tool's appropriateness for EU monitoring requirements. Second, we probed the tool's suitability for Mediterranean MPAs with a questionnaire on monitoring and other challenges completed by the managers of 29 MPAs in the region. The findings of our SWOT analysis demonstrated that when compared to conventional monitoring methods, eDNA frequently outperformed them or acted as a crucial supplement. We also found that eDNA is suitable for most criteria set forth in EU requirements. Our questionnaire revealed monitoring strategy limitations that eDNA approaches may alleviate. Still, eDNA approaches do have drawbacks which may jeopardize its accuracy and sufficiency. Incorporating eDNA monitoring methods has great potential to enhance protection efforts in MPAs in the Mediterranean and elsewhere. Their successful adoption will require improved coordination among stakeholders and current, comprehensive, and customized recommendations for MPA managers. This will improve the overall functioning of MPA networks and thus support the role of MPAs in safeguarding vulnerable marine environments. • eDNA frequently outperformed conventional monitoring methods or acted as a crucial supplement in marine environments. • eDNA is suitable for most criteria set forth in EU requirements under the Marine Strategy Framework Directive. • eDNA approaches may alleviate monitoring strategy limitations raised by Mediterranean Marine Protected Areas managers. • eDNA approaches need further development to be fully accurate and sufficient. [ABSTRACT FROM AUTHOR]

Polychlorinated dibenzo- p -dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) are highly toxic to humans and wildlife. In the present study, PCDD/Fs were analyzed in the eggs of whiskered terns ( Chlidonias hybrida ), and genetically identified eggs from black-crowned night herons ( Nycticorax nycticorax ) sampled from two lakes in the Yangtze River Delta area, China. The median toxic equivalent (TEQ) of PCDD/Fs were 280 (range: 95–1500) and 400 (range: 220–1100) pg TEQ g −1 lw (WHO, 1998 for birds) in the eggs of black-crowned night heron and whiskered tern, respectively. Compared to known sources, concentrations of PCDDs relative to the sum of PCDD/Fs in bird eggs, demonstrated high abundance of octachlorodibenzo- p -dioxin (OCDD), 1,2,3,4,6,7,8-heptaCDD and 1,2,3,6,7,8-hexaCDD indicating pentachlorophenol (PCP), and/or sodium pentachlorophenolate (Na-PCP) as significant sources of the PCDD/Fs. The presence of polychlorinated diphenyl ethers (PCDEs), hydroxylated and methoxylated polychlorinated diphenyl ethers (OH- and MeO-PCDEs, known impurities in PCP products), corroborates this hypothesis. Further, significant correlations were found between the predominant congener CDE-206, 3′-OH-CDE-207, 2′-MeO-CDE-206 and OCDD, indicating a common origin. Eggs from the two lakes are sometimes used for human consumption. The WHO health-based tolerable intake of PCDD/Fs is exceeded if eggs from the two lakes are consumed regularly on a weekly basis, particularly for children. The TEQs extensively exceed maximum levels for PCDD/Fs in hen eggs and egg products according to EU legislation (2.5 pg TEQ g −1 lw). The results suggest immediate action should be taken to manage the contamination, and further studies evaluating the impacts of egg consumption from wild birds in China. Likewise, studies on dioxins and other POPs in common eggs need to be initiated around China. [ABSTRACT FROM AUTHOR]