RESUMO
The immune system is unique in its dynamic interplay between numerous cell types. However, a system-wide view of how immune cells communicate to protect against disease has not yet been established. We applied high-resolution mass-spectrometry-based proteomics to characterize 28 primary human hematopoietic cell populations in steady and activated states at a depth of >10,000 proteins in total. Protein copy numbers revealed a specialization of immune cells for ligand and receptor expression, thereby connecting distinct immune functions. By integrating total and secreted proteomes, we discovered fundamental intercellular communication structures and previously unknown connections between cell types. Our publicly accessible (http://www.immprot.org/) proteomic resource provides a framework for the orchestration of cellular interplay and a reference for altered communication associated with pathology.
Assuntos
Células Sanguíneas/fisiologia , Imunidade Celular , Mapas de Interação de Proteínas , Proteoma , Proteômica , Animais , Secreções Corporais , Comunicação Celular , Simulação por Computador , Humanos , Espectrometria de Massas , Apoio SocialRESUMO
Anecdotal evidence indicates that people believe that morality is declining1,2. In a series of studies using both archival and original data (n = 12,492,983), we show that people in at least 60 nations around the world believe that morality is declining, that they have believed this for at least 70 years and that they attribute this decline both to the decreasing morality of individuals as they age and to the decreasing morality of successive generations. Next, we show that people's reports of the morality of their contemporaries have not declined over time, suggesting that the perception of moral decline is an illusion. Finally, we show how a simple mechanism based on two well-established psychological phenomena (biased exposure to information and biased memory for information) can produce an illusion of moral decline, and we report studies that confirm two of its predictions about the circumstances under which the perception of moral decline is attenuated, eliminated or reversed (that is, when respondents are asked about the morality of people they know well or people who lived before the respondent was born). Together, our studies show that the perception of moral decline is pervasive, perdurable, unfounded and easily produced. This illusion has implications for research on the misallocation of scarce resources3, the underuse of social support4 and social influence5.
Assuntos
Cultura , Ilusões , Princípios Morais , Humanos , Ilusões/psicologia , Relação entre Gerações , Envelhecimento/psicologia , Viés , Viés de Atenção , Apoio Social/psicologia , Influência dos ParesRESUMO
Social anthropology and ethnographic studies have described kinship systems and networks of contact and exchange in extant populations1-4. However, for prehistoric societies, these systems can be studied only indirectly from biological and cultural remains. Stable isotope data, sex and age at death can provide insights into the demographic structure of a burial community and identify local versus non-local childhood signatures, archaeogenetic data can reconstruct the biological relationships between individuals, which enables the reconstruction of pedigrees, and combined evidence informs on kinship practices and residence patterns in prehistoric societies. Here we report ancient DNA, strontium isotope and contextual data from more than 100 individuals from the site Gurgy 'les Noisats' (France), dated to the western European Neolithic around 4850-4500 BC. We find that this burial community was genetically connected by two main pedigrees, spanning seven generations, that were patrilocal and patrilineal, with evidence for female exogamy and exchange with genetically close neighbouring groups. The microdemographic structure of individuals linked and unlinked to the pedigrees reveals additional information about the social structure, living conditions and site occupation. The absence of half-siblings and the high number of adult full siblings suggest that there were stable health conditions and a supportive social network, facilitating high fertility and low mortality5. Age-structure differences and strontium isotope results by generation indicate that the site was used for just a few decades, providing new insights into shifting sedentary farming practices during the European Neolithic.
Assuntos
Antropologia Cultural , Linhagem , Meio Social , Adulto , Criança , Feminino , Humanos , Masculino , Agricultura/história , Sepultamento/história , Pai/história , Fertilidade , França , História Antiga , Mortalidade/história , Irmãos , Apoio Social/história , Isótopos de Estrôncio/análise , Mães/históriaRESUMO
As part of our commitment to amplifying the voices of underrepresented scientists, we are publishing the insights and experiences of a panel of underrepresented scientists. In this segment, we asked about support systems-the types of support that are most helpful (and less helpful), how to find a supportive network, and how institutions can better support underrepresented scientists. These are the personal opinions of the authors and may not reflect the views of their institutions.
Assuntos
Pesquisa Biomédica/ética , Grupos Minoritários/psicologia , Pesquisadores/psicologia , Adulto , Pesquisa Biomédica/organização & administração , Diversidade Cultural , Feminino , Humanos , Masculino , Relações Raciais/psicologia , Apoio Social , Estados UnidosRESUMO
Social capital-the strength of an individual's social network and community-has been identified as a potential determinant of outcomes ranging from education to health1-8. However, efforts to understand what types of social capital matter for these outcomes have been hindered by a lack of social network data. Here, in the first of a pair of papers9, we use data on 21 billion friendships from Facebook to study social capital. We measure and analyse three types of social capital by ZIP (postal) code in the United States: (1) connectedness between different types of people, such as those with low versus high socioeconomic status (SES); (2) social cohesion, such as the extent of cliques in friendship networks; and (3) civic engagement, such as rates of volunteering. These measures vary substantially across areas, but are not highly correlated with each other. We demonstrate the importance of distinguishing these forms of social capital by analysing their associations with economic mobility across areas. The share of high-SES friends among individuals with low SES-which we term economic connectedness-is among the strongest predictors of upward income mobility identified to date10,11. Other social capital measures are not strongly associated with economic mobility. If children with low-SES parents were to grow up in counties with economic connectedness comparable to that of the average child with high-SES parents, their incomes in adulthood would increase by 20% on average. Differences in economic connectedness can explain well-known relationships between upward income mobility and racial segregation, poverty rates, and inequality12-14. To support further research and policy interventions, we publicly release privacy-protected statistics on social capital by ZIP code at https://www.socialcapital.org .
Assuntos
Status Econômico , Amigos , Renda , Capital Social , Mobilidade Social , Adulto , Criança , Relações Comunidade-Instituição , Conjuntos de Dados como Assunto , Status Econômico/estatística & dados numéricos , Mapeamento Geográfico , Humanos , Renda/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Racismo , Mídias Sociais/estatística & dados numéricos , Mobilidade Social/estatística & dados numéricos , Apoio Social , Estados Unidos , VoluntáriosRESUMO
Negative or antagonistic relationships are common in human social networks, but they are less often studied than positive or friendly relationships. The existence of a capacity to have and to track antagonistic ties raises the possibility that they may serve a useful function in human groups. Here, we analyze empirical data gathered from 24,770 and 22,513 individuals in 176 rural villages in Honduras in two survey waves 2.5 y apart in order to evaluate the possible relevance of antagonistic relationships for broader network phenomena. We find that the small-world effect is more significant in a positive world with negative ties compared to an otherwise similar hypothetical positive world without them. Additionally, we observe that nodes with more negative ties tend to be located near network bridges, with lower clustering coefficients, higher betweenness centralities, and shorter average distances to other nodes in the network. Positive connections tend to have a more localized distribution, while negative connections are more globally dispersed within the networks. Analysis of the possible impact of such negative ties on dynamic processes reveals that, remarkably, negative connections can facilitate the dissemination of information (including novel information experimentally introduced into these villages) to the same degree as positive connections, and that they can also play a role in mitigating idea polarization within village networks. Antagonistic ties hold considerable importance in shaping the structure and function of social networks.
Assuntos
População Rural , Apoio Social , Humanos , Honduras , Rede Social , Masculino , Feminino , Relações Interpessoais , Análise de Rede SocialRESUMO
Cancer care delivery is being shaped by growing numbers of cancer survivors coupled with provider shortages, rising costs of primary treatment and follow-up care, significant survivorship health disparities, increased reliance on informal caregivers, and the transition to value-based care. These factors create a compelling need to provide coordinated, comprehensive, personalized care for cancer survivors in ways that meet survivors' and caregivers' unique needs while minimizing the impact of provider shortages and controlling costs for health care systems, survivors, and families. The authors reviewed research identifying and addressing the needs of cancer survivors and caregivers and used this synthesis to create a set of critical priorities for care delivery, research, education, and policy to equitably improve survivor outcomes and support caregivers. Efforts are needed in 3 priority areas: 1) implementing routine assessment of survivors' needs and functioning and caregivers' needs; 2) facilitating personalized, tailored, information and referrals from diagnosis onward for both survivors and caregivers, shifting services from point of care to point of need wherever possible; and 3) disseminating and supporting the implementation of new care methods and interventions.
Assuntos
Sobreviventes de Câncer , Cuidadores , Política de Saúde , Acessibilidade aos Serviços de Saúde/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Melhoria de Qualidade/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pesquisa Biomédica/métodos , Pesquisa Biomédica/organização & administração , Sobreviventes de Câncer/estatística & dados numéricos , Criança , Pré-Escolar , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/organização & administração , Feminino , Disparidades nos Níveis de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Área Carente de Assistência Médica , Pessoa de Meia-Idade , Avaliação das Necessidades , Avaliação de Processos e Resultados em Cuidados de Saúde , Assistência Centrada no Paciente/métodos , Assistência Centrada no Paciente/organização & administração , Encaminhamento e Consulta/organização & administração , Apoio Social , Estados Unidos , Adulto JovemRESUMO
Social networks shape and reflect economic life. Prior studies have identified long ties, which connect people who lack mutual contacts, as a correlate of individuals' success within firms and places' economic prosperity. However, we lack population-scale evidence of the individual-level link between long ties and economic prosperity, and why some people have more long ties remains obscure. Here, using a social network constructed from interactions on Facebook, we establish a robust association between long ties and economic outcomes and study disruptive life events hypothesized to cause formation of long ties. Consistent with prior aggregated results, administrative units with a higher fraction of long ties tend to have higher-income and economic mobility. Individuals with more long ties live in higher-income places and have higher values of proxies for economic prosperity (e.g., using more Internet-connected devices and making more donations). Furthermore, having stronger long ties (i.e., with higher intensity of interaction) is associated with better outcomes, consistent with an advantage from the structural diversity constituted by long ties, rather than them being weak ties per se. We then study the role of disruptive life events in the formation of long ties. Individuals who have migrated between US states, have transferred between high schools, or have attended college out-of-state have a higher fraction of long ties among their contacts many years after the event. Overall, these results suggest that long ties are robustly associated with economic prosperity and highlight roles for important life experiences in developing and maintaining long ties.
Assuntos
Renda , Apoio Social , Humanos , Rede SocialRESUMO
Demographers have long attempted to project future changes in the size and composition of populations, but have ignored what these processes will mean for the size, composition, and age distribution of family networks. Kinship structures matter because family solidarity-a crucial source of informal care for millions of people around the world-is conditional on kin being alive. Here, we present innovative projections of biological kin for the 1950 to 2100 period and discuss what they imply for the availability of informal care. Overall, we project that the number of living kin for individuals will decline dramatically worldwide. While a 65-yo woman in 1950 could expect to have 41 living kin, a 65-yo woman in 2095 is projected to have just 25 [18.8 to 34.7] relatives (lower and upper 80% projection intervals). This represents a 38% [15 to 54] global decline. The composition of family networks is also expected to change, with the numbers of living grandparents and great-grandparents markedly increasing, and the numbers of cousins, nieces and nephews, and grandchildren declining. Family networks will age considerably, as we project a widening age gap between individuals and their kin due to lower and later fertility and longer lifespans. In Italy, for example, the average age of a grandmother of a 35-yo woman is expected to increase from 77.9 y in 1950 to 87.7 y [87.1 to 88.5] in 2095. The projected changes in kin supply will put pressure on the already stretched institutional systems of social support, as more individuals age with smaller and older family networks.
Assuntos
Família , Avós , Feminino , Humanos , Apoio Social , Longevidade , FertilidadeRESUMO
Nearly five billion people around the world now use social media, and this number continues to grow. One of the primary goals of social media platforms is to capture and monetize human attention. One means by which individuals and groups can capture attention and drive engagement on these platforms is by sharing morally and emotionally evocative content. We review a growing body of research on the interrelationship of social media and morality as well its consequences for individuals and society. Moral content often goes viral on social media, and social media makes moral behavior (such as punishment) less costly. Thus, social media often acts as an accelerant for existing moral dynamics, amplifying outrage, status seeking, and intergroup conflict while also potentially amplifying more constructive facets of morality, such as social support, prosociality, and collective action. We discuss trends, heated debates, and future directions in this emerging literature.
Assuntos
Mídias Sociais , Humanos , Princípios Morais , Punição , Apoio SocialRESUMO
BACKGROUND: Health-related quality of life (HRQOL) has become increasingly important for breast cancer survivors, but clinically relevant declines often persist for many years after treatment. This study aimed to investigate whether social relationships can mitigate or prevent this decline in HRQOL. METHODS: Data were used from the German population-based Mamma Carcinoma Risk Factor Investigation (MARIE) cohort of 2022 breast cancer cases with follow-up information for more than 15 years after diagnosis. Correlations between social integration, social support, and global health status (GHS) as an overall measure of HRQOL were analyzed, and linear regression analysis was performed with structural equation modeling. RESULTS: The majority of participants reported high levels of social integration and social support and moderate levels of GHS. Social integration 5 years after diagnosis was associated with GHS 5 years after diagnosis (ß = 1.12; 95% CI, 0.25-1.99), but no longitudinal effects were found. Social support 5 years after diagnosis was associated with better GHS 5 years (ß = 0.42; 95% CI, 0.36-0.48) and 10 years after diagnosis (ß = 0.12; 95% CI, 0.02-0.22), whereas social support 10 years after diagnosis was associated with GHS 10 years (ß = 0.29; 95% CI, 0.20-0.39) and 15 years after diagnosis (ß = 0.10; 95% CI, 0.01-0.21). CONCLUSIONS: These results confirm that social relationships positively influence HRQOL in long-term breast cancer survivors and that their association should receive more attention clinically and beyond routine care.
Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Qualidade de Vida , Apoio Social , Humanos , Feminino , Neoplasias da Mama/psicologia , Sobreviventes de Câncer/psicologia , Pessoa de Meia-Idade , Idoso , Adulto , Nível de Saúde , Estudos de Coortes , Alemanha/epidemiologia , Integração SocialRESUMO
BACKGROUND: Reducing the burden of falls and fall-related admissions to hospital and care homes is an important policy area because falls cause significant injury leading to a reduced quality of life. We investigated the effect of the environment around people's homes on the risk of falls for older people in Wales. METHODS: In this longitudinal cohort study, we created a dynamic national e-cohort of individuals aged 60 years or older living in Wales between Jan 1, 2010, and Dec 31, 2019. Using the Secure Anonymised Information Linkage Databank, we linked routinely collected, anonymised health-data on general practitioner (GP) appointments; hospital and emergency admissions; and longitudinal individual-level demographic data to metrics detailing the built environment and deprivation as determined by the Welsh Index of Multiple Deprivation. Using adjusted cox regression models, we assessed how the risk of a fall changed with sex, age, deprivation quintile, urban or rural classification, household occupancy, care status, frailty, dementia diagnosis, and built environment metrics. Built environments of urban and rural areas are very different, so we stratified our analysis by urbanicity to compare these associations in each setting. FINDINGS: We analysed 5â536â444 person-years of data from 931â830 individuals (sex: 51·5% female, 48·5% male; age: 69·2% aged 60-64 years, 12·3% aged 65-69 years, 13·3% aged 70-79 years, 4·4% aged 80-89 years, and 0·7% aged ≥90 years). 154â060 (16·5%) had a fall between joining the cohort and Dec 31, 2019. Men had a lower risk of falling than women (adjusted hazard ratio [aHR] 0·736 [0·729-0·742]), and the risk increased with age compared with individuals aged 60-64 years (1·395 [1·378-1·412] for 65-69 years, 1·892 [1·871-1·913] for 70-79 years, 2·668 [2·623-2·713] for 80-89 years, 3·196 [3·063-3·335] for ≥90 years) and with frailty compared with fit individuals (1·609 [1·593-1·624] for mild frailty, 2·263 [2·234-2·293] for moderate frailty, and 2·833 [2·770-2·897] for severe frailty). Those living in rural areas were less likely to fall than those in urban areas (0·711 [0·702-0·720]). All p values were less than 0·0001. INTERPRETATION: Although preliminary, these results corroborate current knowledge that as we age and become frailer, the risk of falling increases. The effect of urbanicity on risk of fall suggests that the built environment could be associated with fall risk. We only detected falls that caused emergency or hospital admission, leading to potential selection bias. Nevertheless, this research could help guide policy to reduce the incidence of injuries caused by falls in older people. FUNDING: Health and Care Research Wales.
Assuntos
Fragilidade , Humanos , Masculino , Feminino , Idoso , Estudos de Coortes , Estudos Longitudinais , Fragilidade/epidemiologia , Qualidade de Vida , Acidentes por Quedas , Apoio Social , Avaliação de Resultados em Cuidados de SaúdeRESUMO
BACKGROUND: To date, almost no research on the psychosocial implications of albinism has been conducted in France and an exploration of albinism-related experiences could be beneficial, in order to better understand this condition. The aim of this study was to examine how French people with albinism and their parents live with and adapt to this condition in all the areas of their lives. METHODS: Semi-structured phone interviews were conducted with 9 parent-child dyads, each participating separately. Participants were recruited by convenience sampling, thanks to the combined efforts of a patient association (Genespoir) and professionals from the partner medical referral centers involved in the project. Dyads in which the individual with albinism had any comorbidity were excluded. The interviews were then transcribed and subjected to in-depth thematic analysis. Two codebooks were constructed in a mirrored process: one for people with albinism; the other for their parents. They were finally merged at the end of the coding step. RESULTS: Four main categories were identified: personal perceptions and social representations of albinism, difficulties and obstacles encountered by people with albinism, resources and facilitators, and the importance of parent-child functioning. The results indicated that experiences of stigmatization during childhood and adolescence are common and that people with albinism face challenges in adapting to certain obstacles related to their visual impairments (VI) (e.g., inability to drive a car; eye strain...). Parents emerged as one, if not as the main, source of support for people with albinism throughout their development. Although external support systems exist to assist them in various aspects of their lives, some of them primarily rely on their own personal resources to cope. CONCLUSIONS: This research highlights the importance of a systemic and transdisciplinary approach to make sure families receive the support that best meets their needs.
Assuntos
Albinismo , População Europeia , Apoio Familiar , Pais , Adolescente , Adulto , Humanos , Albinismo/epidemiologia , Albinismo/psicologia , População Europeia/psicologia , França , Pais/psicologia , Pesquisa Qualitativa , Estigma Social , Apoio SocialRESUMO
OBJECTIVE: This systematic review and meta-analysis examined the effectiveness of social-support-based weight-loss interventions in adult populations with excess weight or obesity. METHODS: We performed a systematic review of randomized controlled trials that reported on the effectiveness of weight-loss interventions which incorporated a social connectedness component. To this end, we conducted a rigorous database search of MEDLINE, Embase, PsycINFO, CINAHL, Cochrane, and PubMed for relevant articles. The quality of eligible trials was evaluated by the Cochrane Risk-of-Bias2 tool. Five meta-analyses on intervention effectiveness in terms of weight loss were executed at 2-4-month assessment, 6-month assessment, end of intervention, and 3- and 6-month follow-up. RESULTS: Twenty-four trials involving couples or peers targeting weight loss in 4 919 adults with BMI ≥ 25 met inclusion criteria. Meta-analyses detected no significant effect of social-support-based weight-loss interventions at either 2-4 month or 6-month assessment. There were, however, significant effects at end of intervention [95% CI 0.39, p = 0.04] and at 3-month [95% CI 0.63, p < 0.01] and 6-month [95% CI 0.34, p = 0.05] follow-up. CONCLUSIONS: There seem to be a significant effect at the end of intervention and 3- and 6-month follow-up. However, further high-quality studies are needed before drawing any clear conclusions. TRIAL REGISTRATION: PROSPERO 2020 CRD42020173696.
Assuntos
Obesidade , Apoio Social , Redução de Peso , Programas de Redução de Peso , Humanos , Programas de Redução de Peso/métodos , Obesidade/terapia , Obesidade/psicologia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Disparities exist in pediatric liver transplant (LT). We characterized barriers and facilitators to providing transplant and social care within pediatric LT clinics. This was a multicenter qualitative study. We oversampled caregivers reporting household financial strain, material economic hardship, or demonstrating poor health literacy. We also enrolled transplant team members. We conducted semistructured interviews with participants. Caregiver interviews focused on challenges addressing transplant and household needs. Transplant provider interviews focused on barriers and facilitators to providing social care within transplant teams. Interviews were recorded, transcribed, and coded according to the Capability, Opportunity, Motivation-Behavior model. We interviewed 27 caregivers and 27 transplant team members. Fifty-two percent of caregivers reported a household income <$60,000, and 62% reported financial resource strain. Caregivers reported experiencing (1) high financial burdens after LT, (2) added caregiving labor that compounds the financial burden, (3) dependency on their social network's generosity for financial and logistical support, and (4) additional support being limited to the perioperative period. Transplant providers reported (1) relying on the pretransplant psychosocial assessment for identifying social risks, (2) discomfort initiating social risk discussions in the post-transplant period, (3) reliance on social workers to address new social risks, and (4) social workers feeling overburdened by quantity and quality of the social work referrals. We identified barriers to providing effective social care in pediatric LT, primarily a lack of comfort in assessing and addressing new social risks in the post-transplant period. Addressing these barriers should enhance social care delivery and improve outcomes for these children.
Assuntos
Cuidadores , Transplante de Fígado , Pesquisa Qualitativa , Humanos , Transplante de Fígado/psicologia , Transplante de Fígado/efeitos adversos , Transplante de Fígado/estatística & dados numéricos , Transplante de Fígado/economia , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Cuidadores/economia , Masculino , Feminino , Criança , Pré-Escolar , Adulto , Adolescente , Apoio Social , Lactente , Efeitos Psicossociais da Doença , Entrevistas como Assunto , Atitude do Pessoal de Saúde , Pessoa de Meia-Idade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde/economia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/economia , Acessibilidade aos Serviços de Saúde/organização & administração , Adulto JovemRESUMO
BACKGROUND: Older adults' use of social care and their healthcare utilization are closely related. Residents of care homes access emergency care more often than the wider older population; however, less is known about emergency care use across other social care settings. SOURCES OF DATA: A systematic review was conducted, searching six electronic databases between January 2012 and February 2022. AREAS OF AGREEMENT: Older people access emergency care from a variety of community settings. AREAS OF CONTROVERSY: Differences in study design contributed to high variation observed between studies. GROWING POINTS: Although data were limited, findings suggest that emergency hospital attendance is lowest from nursing homes and highest from assisted living facilities, whilst emergency admissions varied little by social care setting. AREAS TIMELY FOR DEVELOPING RESEARCH: There is a paucity of published research on emergency hospital use from social care settings, particularly home care and assisted living facilities. More attention is needed on this area, with standardized definitions to enable comparisons between studies.
Assuntos
Serviços Médicos de Emergência , Humanos , Idoso , Hospitalização , Casas de Saúde , Atenção à Saúde , Apoio SocialRESUMO
Chronic hepatitis B infection (CHB) affects 300 million people worldwide and is being targeted by the United Nations 2030 Sustainable Development Goals (SDGs) and the World Health Organisation (WHO), working towards elimination of hepatitis B virus (HBV) as a public health threat. In this piece, we explore the evidence and potential impact of peer support to enhance and promote interventions for people living with CHB. Peer support workers (PSWs) are those with lived experience of an infection, condition or situation who work to provide support for others, aiming to improve education, prevention, treatment and other clinical interventions and to reduce the physical, psychological and social impacts of disease. Peer support has been shown to be a valuable tool for improving health outcomes for people living with human immunodeficiency virus (HIV) and hepatitis C virus (HCV), but to date has not been widely available for communities affected by HBV. HBV disproportionately affects vulnerable and marginalised populations, who could benefit from PSWs to help them navigate complicated systems and provide advocacy, tackle stigma, improve education and representation, and optimise access to treatment and continuity of care. The scale up of peer support must provide structured and supportive career pathways for PSWs, account for social and cultural needs of different communities, adapt to differing healthcare systems and provide flexibility in approaches to care. Investment in peer support for people living with CHB could increase diagnosis, improve retention in care, and support design and roll out of interventions that can contribute to global elimination goals.