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Abstract: Terrestrial groundwater travels through subterranean estuaries before reaching the sea. Groundwater‐derived nutrients drive coastal water quality, primary production, and eutrophication. We determined how dissolved inorganic nitrogen (DIN), dissolved inorganic phosphorus (DIP), and dissolved organic nitrogen (DON) are transformed within subterranean estuaries and estimated submarine groundwater discharge (SGD) nutrient loads compiling > 10,000 groundwater samples from 216 sites worldwide. Nutrients exhibited complex, nonconservative behavior in subterranean estuaries. Fresh groundwater DIN and DIP are usually produced, and DON is consumed during transport. Median total SGD (saline and fresh) fluxes globally were 5.4, 2.6, and 0.18 Tmol yr−1 for DIN, DON, and DIP, respectively. Despite large natural variability, total SGD fluxes likely exceed global riverine nutrient export. Fresh SGD is a small source of new nutrients, but saline SGD is an important source of mostly recycled nutrients. Nutrients exported via SGD via subterranean estuaries are critical to coastal biogeochemistry and a significant nutrient source to the oceans.

This paper reports on an action research project involving the redesign, implementation and evaluation of a peer tutor program in a first year design studio in higher education. The effectiveness of the revised program, particularly its capacity to support learning for commencing students in the environment of a creative studio, is examined through focus groups with first year students and third year peer tutors. The study suggests that peer tutors play a pivotal role in the studio that is different from, but complementary to, the role of the studio tutor. When employed purposefully, peer tutors can make a significant contribution to the development of a positive studio culture and the enhancement of a collaborative community of practice, and amplify students' engagement with iterative processes of design learning. Results are discussed in relation to current theories about what constitutes a successful peer tutor program, growing evidence of the unique role played by peer tutors in design and other practice-based disciplines, and the potential contribution of peer tutors to the development of creative skills valued in 21st century design practice.

The Dual-Process Model of grieving suggests that oscillation between negative and positive emotions occurs throughout the grieving process. If either negative or positive emotions are overly emphasized the grieving process could be stymied. To determine how art therapy can support this model, this study evaluated changes in positive and negative affect of 13 grieving children after six sessions of individual art therapy. The findings showed an increase in positive affect and significant decrease in negative affect. The implication of this study is that art therapy can assist the bereaved because of its ability to promote exploration and expression of feelings that occurs in the grieving process.

BACKGROUND: Lonely peoples heightened risks for chronic health conditions and early mortality may emerge in part through cellular aging. Lonelier people have more severe sympathetic responses to acute stress, increasing their risk for herpesvirus reactivation, a possible path to shorter telomeres. Parasympathetic function may modulate this risk. PURPOSE: The current study aimed to examine the associations among loneliness, herpesvirus reactivation, and telomere length, with parasympathetic activity as a moderator, in healthy middle-aged and older adults. METHODS: A sample of 113 healthy men and women of ages 40-85 provided blood samples that were assayed for telomere length, as well as the latent herpesviruses cytomegalovirus (CMV) and Epstein-Barr virus (EBV). They also provided heart rate variability (HRV), a measure of parasympathetic activity, and reported on their feelings of loneliness. RESULTS: Lonelier people with lower HRV (i.e., lower parasympathetic activity) had greater CMV reactivation and shorter telomeres compared with their less lonely counterparts, above and beyond demographics, health behaviors, resting heart rate, and social network size. However, loneliness was not associated with viral reactivation or telomere length among those with higher HRV. In turn, greater CMV and EBV reactivation was associated with shorter telomeres. CONCLUSIONS: Taken together, these data implicate parasympathetic function in novel links between loneliness and accelerated cellular aging.

The Liver Imaging Reporting and Data System (LI-RADS®) is a comprehensive system for standardizing the terminology, technique, interpretation, reporting, and data collection of liver observations in individuals at high risk for hepatocellular carcinoma (HCC). LI-RADS is supported and endorsed by the American College of Radiology (ACR). Upon its initial release in 2011, LI-RADS applied only to liver observations identified at CT or MRI. It has since been refined and expanded over multiple updates to now also address ultrasound-based surveillance, contrast-enhanced ultrasound for HCC diagnosis, and CT/MRI for assessing treatment response after locoregional therapy. The LI-RADS 2018 version was integrated into the HCC diagnosis, staging, and management practice guidance of the American Association for the Study of Liver Diseases (AASLD). This article reviews the major LI-RADS updates since its 2011 inception and provides an overview of the currently published LI-RADS algorithms.

Speech and language therapists apply word finding therapies for people with aphasia with good outcomes on treated words but limited evidence of generalisation to untreated words. As generalisation cannot be assumed, there is a need to select words for therapy that are meaningful to people with aphasia. This study sought the views of people with aphasia to inform the stimuli for a word finding in conversation treatment. To this end, the research question was: What conversation topics do people with aphasia find most meaningful to talk about? This qualitative study used focus groups to identify meaningful conversation topics across a sample of 12 people with chronic aphasia (two groups of six). Participants were recruited from three community aphasia groups. The focus groups were videoed and transcribed. The transcription was analysed using framework analysis. A consensus decision process was then used by researchers to identify the themes with high agreement. Twenty conversation topics were generated. Consensus was that eight topics were meaningful. The three topics rated most meaningful were 1) family and friends, 2) food and drink, and 3) living with aphasia. Two topics reached consensus as not meaningful. Ten topics did not reach consensus. The conversation topics, 'family and friends', 'food and drink' and 'living with aphasia' were most meaningful to this sample of people with aphasia. Using therapy stimuli from these conversation topics has the potential to create meaningful treatments. [ABSTRACT FROM AUTHOR]