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1.
Glob Chang Biol ; 29(23): 6812-6827, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37815703

RESUMO

Peatlands of the central Congo Basin have accumulated carbon over millennia. They currently store some 29 billion tonnes of carbon in peat. However, our understanding of the controls on peat carbon accumulation and loss and the vulnerability of this stored carbon to climate change is in its infancy. Here we present a new model of tropical peatland development, DigiBog_Congo, that we use to simulate peat carbon accumulation and loss in a rain-fed interfluvial peatland that began forming ~20,000 calendar years Before Present (cal. yr BP, where 'present' is 1950 CE). Overall, the simulated age-depth curve is in good agreement with palaeoenvironmental reconstructions derived from a peat core at the same location as our model simulation. We find two key controls on long-term peat accumulation: water at the peat surface (surface wetness) and the very slow anoxic decay of recalcitrant material. Our main simulation shows that between the Late Glacial and early Holocene there were several multidecadal periods where net peat and carbon gain alternated with net loss. Later, a climatic dry phase beginning ~5200 cal. yr BP caused the peatland to become a long-term carbon source from ~3975 to 900 cal. yr BP. Peat as old as ~7000 cal. yr BP was decomposed before the peatland's surface became wetter again, suggesting that changes in rainfall alone were sufficient to cause a catastrophic loss of peat carbon lasting thousands of years. During this time, 6.4 m of the column of peat was lost, resulting in 57% of the simulated carbon stock being released. Our study provides an approach to understanding the future impact of climate change and potential land-use change on this vulnerable store of carbon.


Assuntos
Carbono , Áreas Alagadas , Congo , Solo , Ciclo do Carbono
2.
Sci Rep ; 13(1): 12315, 2023 07 29.
Artigo em Inglês | MEDLINE | ID: mdl-37516765

RESUMO

Tropical peatlands are carbon-dense ecosystems because they accumulate partially-decomposed plant material. A substantial fraction of this organic matter may derive from fine root production (FRP). However, few FRP estimates exist for tropical peatlands, with none from the world's largest peatland complex in the central Congo Basin. Here we report on FRP using repeat photographs of roots from in situ transparent tubes (minirhizotrons), measured to 1 m depth over three one-month periods (spanning dry to wet seasons), in a palm-dominated peat swamp forest, a hardwood-dominated peat swamp forest, and a terra firme forest. We find FRP of 2.6 ± 0.3 Mg C ha-1 yr-1, 1.9 ± 0.5 Mg C ha-1 yr-1, and 1.7 ± 0.1 Mg C ha-1 yr-1 in the three ecosystem types respectively (mean ± standard error; no significant ecosystem type differences). These estimates fall within the published FRP range worldwide. Furthermore, our hardwood peat swamp estimate is similar to the only other FRP study in tropical peatlands, also hardwood-dominated, from Micronesia. We also found that FRP decreased with depth and was the highest during the dry season. Overall, we show that minirhizotrons can be used as a low-disturbance method to estimate FRP in tropical forests and peatlands.


Assuntos
Ecossistema , RNA Longo não Codificante , Áreas Alagadas , Congo , Florestas , Solo
4.
Nature ; 612(7939): 277-282, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36323786

RESUMO

The forested swamps of the central Congo Basin store approximately 30 billion metric tonnes of carbon in peat1,2. Little is known about the vulnerability of these carbon stocks. Here we investigate this vulnerability using peat cores from a large interfluvial basin in the Republic of the Congo and palaeoenvironmental methods. We find that peat accumulation began at least at 17,500 calibrated years before present (cal. yr BP; taken as AD 1950). Our data show that the peat that accumulated between around 7,500 to around 2,000 cal. yr BP is much more decomposed compared with older and younger peat. Hydrogen isotopes of plant waxes indicate a drying trend, starting at approximately 5,000 cal. yr BP and culminating at approximately 2,000 cal. yr BP, coeval with a decline in dominant swamp forest taxa. The data imply that the drying climate probably resulted in a regional drop in the water table, which triggered peat decomposition, including the loss of peat carbon accumulated prior to the onset of the drier conditions. After approximately 2,000 cal. yr BP, our data show that the drying trend ceased, hydrologic conditions stabilized and peat accumulation resumed. This reversible accumulation-loss-accumulation pattern is consistent with other peat cores across the region, indicating that the carbon stocks of the central Congo peatlands may lie close to a climatically driven drought threshold. Further research should quantify the combination of peatland threshold behaviour and droughts driven by anthropogenic carbon emissions that may trigger this positive carbon cycle feedback in the Earth system.


Assuntos
Carbono , Solo , Congo
5.
New Phytol ; 232(4): 1591-1602, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34018616

RESUMO

Mangroves are among the world's most carbon-dense ecosystems, but have suffered extensive deforestation, prompting reforestation projects. The effects of mangrove reforestation on belowground carbon dynamics are poorly understood. In particular, we do not know how fine root production develops following mangrove reforestation, despite fine root production being a major carbon sink and an important control of mangrove soil accretion. Using minirhizotrons, we investigated fine root production and its depth variation along a chronosequence of mature Vietnamese mangroves. Our results showed that fine root production decreases strongly with stand age in the uppermost 32 cm of our soil profiles. In younger mangrove stands, fine root production declines with depth, possibly due to a vertical gradient in soil nutrient availability; while root production in the oldest stand is low at all depths and exhibits no clear vertical pattern. A major fraction of fine root production occurs deeper than 30 cm, depths that are commonly omitted from calculations of mangrove carbon budgets. Younger mangroves may accrue shallow soil organic matter faster than older mangroves. Therefore, root productivity and forest stand age should be accounted for when forecasting mangrove carbon budgets and resistance to sea-level rise.


Assuntos
Ecossistema , Áreas Alagadas , Carbono , Sequestro de Carbono , Florestas , Solo
6.
Phys Rev Lett ; 126(9): 095101, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33750160

RESUMO

Collisionless shocks are ubiquitous in the Universe and often associated with a strong magnetic field. Here, we use large-scale particle-in-cell simulations of nonrelativistic perpendicular shocks in the high-Mach-number regime to study the amplification of the magnetic field within shocks. The magnetic field is amplified at the shock transition due to the ion-ion two-stream Weibel instability. The normalized magnetic field strength strongly correlates with the Alfvénic Mach number. Mock spacecraft measurements derived from particle-in-cell simulations are fully consistent with those taken in situ at Saturn's bow shock by the Cassini spacecraft.

7.
Glob Chang Biol ; 26(3): 1899-1907, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31750606

RESUMO

Mangroves are among the world's most carbon-dense ecosystems, but they are threatened by rapid climate change and rising sea levels. The accumulation and decomposition of soil organic matter (SOM) are closely tied to mangroves' carbon sink functions and resistance to rising sea levels. However, few studies have investigated the response of mangrove SOM dynamics to likely future environmental conditions. We quantified how mangrove SOM decay is affected by predicted global warming (+4°C), sea level changes (simulated by altering of the inundation duration to 0, 2, and 6 hr/day), and their interaction. Whilst changes in inundation duration between 2 and 6 hr/day did not affect SOM decay, the treatment without inundation led to a 60% increase. A warming of 4°C caused SOM decay to increase by 21%, but longer inundation moderated this temperature-driven increase. Our results indicate that (a) sea level rise is unlikely to decrease the SOM decay rate, suggesting that previous mangrove elevation gain, which has allowed mangroves to persist in areas of sea level rise, might result from changes in root production and/or mineral sedimentation; (b) sea level fall events, predicted to double in frequency and area, will cause periods of intensified SOM decay; (c) changing tidal regimes in mangroves due to sea level rise might attenuate increases in SOM decay caused by global warming. Our results have important implications for forecasting mangrove carbon dynamics and the persistence of mangroves and other coastal wetlands under future scenarios of climate change.


Assuntos
Ecossistema , Solo , Sequestro de Carbono , Mudança Climática , Áreas Alagadas
8.
Sci Rep ; 9(1): 17939, 2019 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-31784556

RESUMO

Peatlands are globally important stores of carbon (C) that contain a record of how their rates of C accumulation have changed over time. Recently, near-surface peat has been used to assess the effect of current land use practices on C accumulation rates in peatlands. However, the notion that accumulation rates in recently formed peat can be compared to those from older, deeper, peat is mistaken - continued decomposition means that the majority of newly added material will not become part of the long-term C store. Palaeoecologists have known for some time that high apparent C accumulation rates in recently formed peat are an artefact and take steps to account for it. Here we show, using a model, how the artefact arises. We also demonstrate that increased C accumulation rates in near-surface peat cannot be used to infer that a peatland as a whole is accumulating more C - in fact the reverse can be true because deep peat can be modified by events hundreds of years after it was formed. Our findings highlight that care is needed when evaluating recent C addition to peatlands especially because these interpretations could be wrongly used to inform land use policy and decisions.

9.
Plant Methods ; 15: 101, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467587

RESUMO

BACKGROUND: Fine root production is one of the least well understood components of the carbon cycle in terrestrial ecosystems. Minirhizotrons allow accurate and non-destructive sampling of fine root production. Small and large scale studies across a range of ecosystems are needed to have baseline data on fine root production and further assess the impact of global change upon it; however, the expense and the low adaptability of minirhizotrons prevent such data collection, in worldwide distributed sampling schemes, in low-income countries and in some ecosystems (e.g. tropical forested wetlands). RESULTS: We present EnRoot, a narrow minirhizotron of 25 mm diameter, that is partially 3D printable. EnRoot is inexpensive (€150), easy to construct (no prior knowledge required) and adapted to a range of ecosystems including tropical forested wetlands (e.g. mangroves, peatlands). We tested EnRoot's accuracy and precision for measuring fine root length and diameter, and it yielded Lin's concordance correlation coefficient values of 0.95 for root diameter and 0.92 for length. As a proof of concept, we tested EnRoot in a mesocosm study, and in the field in a tropical mangrove. EnRoot proved its capacity to capture the development of roots of a legume (Medicago sativa) and a mangrove species (seedlings of Rhizophora mangle) in laboratory mesocosms. EnRoot's field installation was possible in the root-dense tropical mangrove because its narrow diameter allowed it to be installed between larger roots and because it is fully waterproof. EnRoot compares favourably with commercial minirhizotrons, and can image roots as small as 56 µm. CONCLUSION: EnRoot removes barriers to the extensive use of minirhizotrons by being low-cost, easy to construct and adapted to a wide range of ecosystem. It opens the doors to worldwide distributed minirhizotron studies across an extended range of ecosystems with the potential to fill knowledge gaps surrounding fine root production.

10.
Proc Natl Acad Sci U S A ; 115(19): 4851-4856, 2018 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-29666256

RESUMO

Widespread establishment of peatlands since the Last Glacial Maximum represents the activation of a globally important carbon sink, but the drivers of peat initiation are unclear. The role of climate in peat initiation is particularly poorly understood. We used a general circulation model to simulate local changes in climate during the initiation of 1,097 peatlands around the world. We find that peat initiation in deglaciated landscapes in both hemispheres was driven primarily by warming growing seasons, likely through enhanced plant productivity, rather than by any increase in effective precipitation. In Western Siberia, which remained ice-free throughout the last glacial period, the initiation of the world's largest peatland complex was globally unique in that it was triggered by an increase in effective precipitation that inhibited soil respiration and allowed wetland plant communities to establish. Peat initiation in the tropics was only weakly related to climate change, and appears to have been driven primarily by nonclimatic mechanisms such as waterlogging due to tectonic subsidence. Our findings shed light on the genesis and Holocene climate space of one of the world's most carbon-dense ecosystem types, with implications for understanding trajectories of ecological change under changing future climates.


Assuntos
Carbono/metabolismo , Aquecimento Global , Modelos Biológicos , Solo , Áreas Alagadas
11.
Glob Chang Biol ; 24(2): 738-757, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29055083

RESUMO

The most carbon (C)-dense ecosystems of Amazonia are areas characterized by the presence of peatlands. However, Amazonian peatland ecosystems are poorly understood and are threatened by human activities. Here, we present an investigation into long-term ecohydrological controls on C accumulation in an Amazonian peat dome. This site is the oldest peatland yet discovered in Amazonia (peat initiation ca. 8.9 ka BP), and developed in three stages: (i) peat initiated in an abandoned river channel with open water and aquatic plants; (ii) inundated forest swamp; and (iii) raised peat dome (since ca. 3.9 ka BP). Local burning occurred at least three times in the past 4,500 years. Two phases of particularly rapid C accumulation (ca. 6.6-6.1 and ca. 4.9-3.9 ka BP), potentially resulting from increased net primary productivity, were seemingly driven by drier conditions associated with widespread drought events. The association of drought phases with major ecosystem state shifts (open water wetland-forest swamp-peat dome) suggests a potential climatic control on the developmental trajectory of this tropical peatland. A third drought phase centred on ca. 1.8-1.1 ka BP led to markedly reduced C accumulation and potentially a hiatus during the peat dome stage. Our results suggest that future droughts may lead to phases of rapid C accumulation in some inundated tropical peat swamps, although this can lead ultimately to a shift to ombrotrophy and a subsequent return to slower C accumulation. Conversely, in ombrotrophic peat domes, droughts may lead to reduced C accumulation or even net loss of peat. Increased surface wetness at our site in recent decades may reflect a shift towards a wetter climate in western Amazonia. Amazonian peatlands represent important carbon stores and habitats, and are important archives of past climatic and ecological information. They should form key foci for conservation efforts.


Assuntos
Carbono/química , Solo , Áreas Alagadas , Secas , Peru , Rios , Fatores de Tempo
12.
Ann Rev Mar Sci ; 9: 173-203, 2017 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-27359052

RESUMO

The events that followed the Tohoku earthquake and tsunami on March 11, 2011, included the loss of power and overheating at the Fukushima Daiichi nuclear power plants, which led to extensive releases of radioactive gases, volatiles, and liquids, particularly to the coastal ocean. The fate of these radionuclides depends in large part on their oceanic geochemistry, physical processes, and biological uptake. Whereas radioactivity on land can be resampled and its distribution mapped, releases to the marine environment are harder to characterize owing to variability in ocean currents and the general challenges of sampling at sea. Five years later, it is appropriate to review what happened in terms of the sources, transport, and fate of these radionuclides in the ocean. In addition to the oceanic behavior of these contaminants, this review considers the potential health effects and societal impacts.


Assuntos
Acidente Nuclear de Fukushima , Poluentes Radioativos da Água , Radioisótopos de Césio , Oceanos e Mares , Oceano Pacífico , Monitoramento de Radiação , Movimentos da Água
14.
Sci Rep ; 6: 23961, 2016 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-27045989

RESUMO

Many studies have reported evidence for solar-forcing of Holocene climate change across a range of archives. These studies have compared proxy-climate data with records of solar variability (e.g. (14)C or (10)Be), or have used time series analysis to test for the presence of solar-type cycles. This has led to some climate sceptics misrepresenting this literature to argue strongly that solar variability drove the rapid global temperature increase of the twentieth century. As proxy records underpin our understanding of the long-term processes governing climate, they need to be evaluated thoroughly. The peatland archive has become a prominent line of evidence for solar forcing of climate. Here we examine high-resolution peatland proxy climate data to determine whether solar signals are present. We find a wide range of significant periodicities similar to those in records of solar variability: periods between 40-100 years, and 120-140 years are particularly common. However, periodicities similar to those in the data are commonly found in random-walk simulations. Our results demonstrate that solar-type signals can be the product of random variations alone, and that a more critical approach is required for their robust interpretation.

15.
Sci Rep ; 5: 17951, 2015 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-26647837

RESUMO

Permafrost peatlands contain globally important amounts of soil organic carbon, owing to cold conditions which suppress anaerobic decomposition. However, climate warming and permafrost thaw threaten the stability of this carbon store. The ultimate fate of permafrost peatlands and their carbon stores is unclear because of complex feedbacks between peat accumulation, hydrology and vegetation. Field monitoring campaigns only span the last few decades and therefore provide an incomplete picture of permafrost peatland response to recent rapid warming. Here we use a high-resolution palaeoecological approach to understand the longer-term response of peatlands in contrasting states of permafrost degradation to recent rapid warming. At all sites we identify a drying trend until the late-twentieth century; however, two sites subsequently experienced a rapid shift to wetter conditions as permafrost thawed in response to climatic warming, culminating in collapse of the peat domes. Commonalities between study sites lead us to propose a five-phase model for permafrost peatland response to climatic warming. This model suggests a shared ecohydrological trajectory towards a common end point: inundated Arctic fen. Although carbon accumulation is rapid in such sites, saturated soil conditions are likely to cause elevated methane emissions that have implications for climate-feedback mechanisms.

16.
Science ; 349(6255): 1537-41, 2015 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-26404835

RESUMO

Antarctic ice-core data reveal that the atmosphere experienced abrupt centennial increases in CO2 concentration during the last deglaciation (~18 thousand to 11 thousand years ago). Establishing the role of ocean circulation in these changes requires high-resolution, accurately dated marine records. Here, we report radiocarbon data from uranium-thorium-dated deep-sea corals in the Equatorial Atlantic and Drake Passage over the past 25,000 years. Two major deglacial radiocarbon shifts occurred in phase with centennial atmospheric CO2 rises at 14.8 thousand and 11.7 thousand years ago. We interpret these radiocarbon-enriched signals to represent two short-lived (less than 500 years) "overshoot" events, with Atlantic meridional overturning stronger than that of the modern era. These results provide compelling evidence for a close coupling of ocean circulation and centennial climate events during the last deglaciation.


Assuntos
Antozoários/química , Atmosfera/química , Aquecimento Global , Camada de Gelo , Animais , Clima , Oceanos e Mares , Datação Radiométrica , Tório/análise , Urânio/análise
17.
PLoS One ; 8(11): e76093, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24223697

RESUMO

Electronic annotation of scientific data is very similar to annotation of documents. Both types of annotation amplify the original object, add related knowledge to it, and dispute or support assertions in it. In each case, annotation is a framework for discourse about the original object, and, in each case, an annotation needs to clearly identify its scope and its own terminology. However, electronic annotation of data differs from annotation of documents: the content of the annotations, including expectations and supporting evidence, is more often shared among members of networks. Any consequent actions taken by the holders of the annotated data could be shared as well. But even those current annotation systems that admit data as their subject often make it difficult or impossible to annotate at fine-enough granularity to use the results in this way for data quality control. We address these kinds of issues by offering simple extensions to an existing annotation ontology and describe how the results support an interest-based distribution of annotations. We are using the result to design and deploy a platform that supports annotation services overlaid on networks of distributed data, with particular application to data quality control. Our initial instance supports a set of natural science collection metadata services. An important application is the support for data quality control and provision of missing data. A previous proof of concept demonstrated such use based on data annotations modeled with XML-Schema.


Assuntos
Armazenamento e Recuperação da Informação , Biologia Computacional , Humanos , Disseminação de Informação , Anotação de Sequência Molecular , Controle de Qualidade , Semântica , Software , Vocabulário Controlado
18.
Nature ; 457(7229): 577-80, 2009 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-19177128

RESUMO

The addition of iron to high-nutrient, low-chlorophyll regions induces phytoplankton blooms that take up carbon. Carbon export from the surface layer and, in particular, the ability of the ocean and sediments to sequester carbon for many years remains, however, poorly quantified. Here we report data from the CROZEX experiment in the Southern Ocean, which was conducted to test the hypothesis that the observed north-south gradient in phytoplankton concentrations in the vicinity of the Crozet Islands is induced by natural iron fertilization that results in enhanced organic carbon flux to the deep ocean. We report annual particulate carbon fluxes out of the surface layer, at three kilometres below the ocean surface and to the ocean floor. We find that carbon fluxes from a highly productive, naturally iron-fertilized region of the sub-Antarctic Southern Ocean are two to three times larger than the carbon fluxes from an adjacent high-nutrient, low-chlorophyll area not fertilized by iron. Our findings support the hypothesis that increased iron supply to the glacial sub-Antarctic may have directly enhanced carbon export to the deep ocean. The CROZEX sequestration efficiency (the amount of carbon sequestered below the depth of winter mixing for a given iron supply) of 8,600 mol mol(-1) was 18 times greater than that of a phytoplankton bloom induced artificially by adding iron, but 77 times smaller than that of another bloom initiated, like CROZEX, by a natural supply of iron. Large losses of purposefully added iron can explain the lower efficiency of the induced bloom(6). The discrepancy between the blooms naturally supplied with iron may result in part from an underestimate of horizontal iron supply.


Assuntos
Carbono/metabolismo , Ferro/metabolismo , Água do Mar/química , Regiões Antárticas , Clorofila/análise , Clorofila/metabolismo , Clorofila A , Eutrofização , Geografia , Sedimentos Geológicos/química , Oceanos e Mares , Fitoplâncton/metabolismo , Estações do Ano , Fatores de Tempo
19.
J Morphol ; 262(2): 659-66, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15449326

RESUMO

The paired pallial organs of pleurotomariids (slit shells) are generally interpreted as representing the primitive gastropod condition. Relatively few individual pleurotomariids have been observed alive; most anatomical descriptions have been based on retracted, preserved material. In this study, live animals were observed in still and moving water, videotaped, photographed, and relaxed prior to anatomical description. The pleurotomariid Perotrochus maureri formed a siphon with its mantle at the posterior end of the slit in the shell. As expected, water was expelled from the mantle cavity through this siphon. Dye released along the aperture, the area traditionally considered to be the incurrent window, was never observed to enter the mantle cavity. Instead, water entered through the slit just anterior to the siphon. A similar pattern was observed in the deep-slit pleurotomariid Entemnotrochus adansonianus. Thus the "anal" slit provided the sites for the incurrent as well as the excurrent windows. This surprising flow pattern is inconsistent with the traditional scenario of early gastropod evolution.


Assuntos
Caramujos/anatomia & histologia , Caramujos/fisiologia , Água/fisiologia , Animais , Comportamento Animal , Comportamento Alimentar , Processamento de Imagem Assistida por Computador
20.
Pediatr Dent ; 26(1): 79-86, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15080364

RESUMO

PURPOSE: The purpose of this study was to determine pediatric dentists' participation in the California Medicaid program and investigate barriers to participation. METHODS: A 24-question mail-in survey with a follow-up was sent to all pediatric dentists in California with questions including demographics, Medicaid participation, and barriers to participation. Data were analyzed using descriptive statistics, chi-square tests, bivariate analysis, and multivariate logistic regression. RESULTS: Pediatric dentists returned 364 useable mail-in surveys for a response rate of 70%. Forty-five percent participated in the Medicaid program, one third of which would accept all patients and two thirds of which placed some restriction on their participation. Twenty-five percent of respondents had at least 10% Medicaid patients in their practice, and 25% accepted 6 or more new Medicaid patients per month. Dentists in rural areas were significantly more likely than those in urban or suburban areas to accept a new Medicaid patient (P < .05). Eighty-nine percent of all respondents reported low fees and 82% reported broken appointments as important reasons for not participating or limiting participation. CONCLUSIONS: Participation of California pediatric dentists in Medicaid is low compared to other states that have participation studies. Pediatric dentists in rural areas are most likely to participate. Among the reasons that contribute to California dentists not participating in the Medicaid program, the major ones appear to be low fees, broken appointments, and denial of payment.


Assuntos
Atitude do Pessoal de Saúde , Medicaid , Odontopediatria , Adulto , Idoso , Agendamento de Consultas , California , Honorários Odontológicos/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Medicaid/estatística & dados numéricos , Pessoa de Meia-Idade , Odontopediatria/estatística & dados numéricos , Administração da Prática Odontológica/estatística & dados numéricos , Mecanismo de Reembolso/estatística & dados numéricos , Serviços de Saúde Rural/estatística & dados numéricos , Serviços de Saúde Suburbana/estatística & dados numéricos , Estados Unidos , Serviços Urbanos de Saúde/estatística & dados numéricos
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