Impact of compliance to oral cysteamine treatment on the costs of Kidney failure in patients with nephropathic cystinosis in the United Kingdom.

BACKGROUND: Nephropathic Cystinosis (NC), a rare disease characterised by intra-lysosomal accumulation of cystine, results in progressive kidney failure (KF). Compliance to lifelong oral cysteamine, the only therapy, is often compromised. The relationship between compliance and costs of NC has not been previously formally assessed. The present study evaluates the impact of compliance on lifetime (direct) costs of treating KF in NC patients in the United Kingdom. METHODS: A three-state (KF-free, post-KF, death) partitioned survival model was developed for hypothetical 'Good Compliance' (GC) and 'Poor Compliance' (PC) cohorts. Survival in the KF-free state was determined by a published regression function of composite compliance score (CCS). The CCS is a summation of annual compliance scores (ACS) over treatment duration prior to KF. ACSs are indexed on annual (average) leukocyte cystine levels (LCL). The Poor Compliance cohort was defined to reflect NC patients in a previous study with a mean LCL of 2.35 nmols nmol half-cystine/mg protein over the study period - and an estimated mean ACS of 1.64 over a 13.4 year treatment duration. The Good Compliance cohort was assumed to have an ACS of 2.25 for 21 years. Major KF costs were evaluated - i.e., dialysis, kidney transplants, and subsequent monitoring. RESULTS: The mean CCS was 47 for the GC and 22 for the PC cohort respectively, corresponding to estimated lifetime KF costs of £92,370 and £117,830 respectively - i.e., a cost saving of £25,460/patient, or £1,005/patient for every 1-unit improvement in CCS. CONCLUSION: This analysis indicates that lifetime costs of KF in NC can be reduced through improved treatment compliance with oral cysteamine.

Spine Surgery and COVID-19: The Influence of Practice Type on Preparedness, Response, and Economic Impact.

STUDY DESIGN: Cross-sectional observational cohort study. OBJECTIVE: To investigate preparation, response, and economic impact of COVID-19 on private, public, academic, and privademic spine surgeons. METHODS: AO Spine COVID-19 and Spine Surgeon Global Impact Survey includes domains on surgeon demographics, location of practice, type of practice, COVID-19 perceptions, institutional preparedness and response, personal and practice impact, and future perceptions. The survey was distributed by AO Spine via email to members (n = 3805). Univariate and multivariate analyses were performed to identify differences between practice settings. RESULTS: A total of 902 surgeons completed the survey. In all, 45.4% of respondents worked in an academic setting, 22.9% in privademics, 16.1% in private practice, and 15.6% in public hospitals. Academic practice setting was independently associated with performing elective and emergent spine surgeries at the time of survey distribution. A majority of surgeons reported a >75% decrease in case volume. Private practice and privademic surgeons reported losing income at a higher rate compared with academic or public surgeons. Practice setting was associated with personal protective equipment availability and economic issues as a source of stress. CONCLUSIONS: The current study indicates that practice setting affected both preparedness and response to COVID-19. Surgeons in private and privademic practices reported increased worry about the economic implications of the current crisis compared with surgeons in academic and public hospitals. COVID-19 decreased overall clinical productivity, revenue, and income. Government response to the current pandemic and preparation for future pandemics needs to be adaptable to surgeons in all practice settings.

Renal Neoplasia in Polycystic Kidney Disease: An Assessment of Tuberous Sclerosis Complex-associated Renal Neoplasia and PKD1/TSC2 Contiguous Gene Deletion Syndrome.

To determine the incidence of renal neoplasia among patients undergoing nephrectomy for polycystic kidney disease (PKD), we queried our institutional nephrectomy registry (years 2000-2020). Approximately 4% (231 of 5757) of patients who underwent nephrectomy had PKD, and 26 of these 231 patients (11.3%) had renal neoplasia. Tumors from an additional two patients with PKD were also evaluated. Patients with PKD who had tuberous sclerosis complex (TSC)-associated renal neoplasia were screened for PKD1/TSC2 contiguous gene deletion syndrome (CGS) using single nucleotide polymorphism arrays. The median age of patients with PKD and renal neoplasia at nephrectomy was 54 yr. The median tumor size was 2.0 cm and the tumors were predominantly of low grade and stage. The tumors consisted of 23 renal cell carcinomas (RCCs), one epithelioid angiomyolipoma, and four angiomyolipomas. The median follow-up was 59.5 mo (n = 26) and only one patient with clear cell RCC developed metastases. Two patients with angiomyolipomas had PKD1/TSC2 CGS. Our results support screening of patients with PKD and TSC-associated renal neoplasia as well as TSC patients with cystic renal disease for CGS, as identification of patients with CGS can better define the manifestation and prognosis of CGS and guide counseling regarding patterns of inheritance. PATIENT SUMMARY: We identified patients with abnormal kidney cell growth (called renal neoplasia) among those undergoing removal of kidney tissue for polycystic kidney disease (PKD) and patients with a syndrome involving deletions in two genes, called PKD1/TSC2 contiguous gene deletion syndrome (CGS) at our institution. Of 231 PKD patients with removal of kidney tissue, 11.3% had renal neoplasia, and two patients with angiomyolipoma tumors had PKD1/TSC2 CGS. Detection of renal neoplasia associated with a condition called tuberous sclerosis complex in PKD may increase the identification of patients with PKD1/TSC2 CGS and guide patient counseling regarding outcomes and patterns of inheritance.

Utilization of West Virginia Pediatric Medicaid Claims Data to Guide Outpatient Antimicrobial Stewardship Interventions.

West Virginia consistently ranks in the top two nationally for per capita antibiotic prescription rates in both pediatric and adult outpatient populations. We present the first descriptive analysis evaluating outpatient prescription rates within the WV pediatric Medicaid population, which demonstrated significant antibiotic prescribing variability by provider type, specialty, and geography.

A systematic review of psychosocial interventions for Latinx and American Indian patient-family caregiver dyads coping with chronic health conditions.

Latinx and American Indians experience high rates of chronic health conditions. Family members play a significant role as informal caregivers for loved ones with chronic conditions and both patients and family caregivers report poor psychosocial outcomes. This systematic review synthesizes published studies about psychosocial interventions for Latinx and American Indian care dyads to determine: (i) the benefits of these interventions; (ii) their distinguishing features or adaptations, and; (iii) recommendations for future intervention development. Out of 366 records identified, seven studies met inclusion criteria. Interventions demonstrated benefits to outcomes such as disease knowledge, caregiver self-efficacy and burden, patient and caregiver well-being, symptom distress, anxiety and depression, and dyadic communication. Distinguishing features included tailoring to cultural values, beliefs, and delivery preferences, participants' level of acculturation, and population-specific issues such as migratory stressors and support networks. Based upon this review, six recommendations for future intervention development are put forth.

Development and Validation of a Community Assessment Survey for Diverse Rural Family Caregivers of People With Alzheimer Disease and Related Dementias.

Many individuals with Alzheimer disease and related dementias receive care from family members and friends. Rurality adds increased complexity to care, especially for diverse caregivers. This study details the development and content validation process for a community assessment survey for rural white, Latinx, and American Indian/Alaska Native Alzheimer disease and related dementias caregivers. Foundational survey items were based upon instruments validated with diverse rural caregivers. A modified Delphi process (2 rounds) was used to refine items. The process concluded when 75%+ of experts agreed that the survey was (1) inclusive of different cultural groups; (2) respectful of cultural values and norms; (3) comprehensive with respect to needs, assets, and resources, and (4) relevant to the experiences of diverse rural caregivers. Round 1 of the process (N = 9 panelists) resulted in the elimination of 2 survey sections, a greater focus on issues including transportation and roles of extended family members, and the inclusion of open-ended questions. Round 2 (N = 6 panelists) resulted in further improvements, particularly to the sections about cultural customs, beliefs, and traditions and interactions with health care and other providers. Benefits of the process included raising awareness about rural caregiving issues and maximizing data quality. Challenges included honoring the diversity of respondents' opinions and balancing research rigor with community utility. This community assessment survey may help researchers better understand the needs and culturally-based strengths of diverse rural family caregivers.

Love and peace across generations: Biobehavioral systems and global partnerships.

Children's environments - especially relationships with caregivers - sculpt not only developing brains but also multiple bio-behavioral systems that influence long-term cognitive and socioemotional outcomes, including the ability to empathize with others and interact in prosocial and peaceful ways. This speaks to the importance of investing resources in effective and timely programs that work to enhance early childhood development (ECD) and, by extension, reach communities at-scale. Given the limited resources currently devoted to ECD services, and the devastating impact of COVID-19 on children and communities, there is a clear need to spur government leaders and policymakers to further invest in ECD and related issues including gender and racial equity. This essay offers concrete examples of scholarly paradigms and leadership efforts that focus on child development to build a peaceful, equitable, just, and sustainable world. As scholars and practitioners, we need to continue to design, implement, assess, and revise high-quality child development programs that generate much-needed evidence for policy and programmatic changes. We must also invest in global partnerships to foster the next generation of scholars, practitioners, and advocates dedicated to advance our understanding of the bio-behavioral systems that underlie love, sociality, and peace across generations. Especially where supported by structural interventions, ECD programs can help create more peaceful, just, and socially equitable societies.

Adapting the telephone assessment and skill-building kit to the telehealth technology preferences of stroke family caregivers.

Family caregivers exhibit a wide variety of needs and concerns while providing care to stroke survivors after discharge to the home setting. We report the results of two related studies utilizing a multimethod design in which stroke family caregivers (N = 12; N = 10) were interviewed using open-ended questions, followed by written caregiver ratings regarding the types of telehealth technologies they preferred for the telephone assessment and skill-building kit (TASK III). Qualitative data were analyzed using content analysis procedures with a provisional "start list" of codes in a matrix template based on the types of telehealth technologies in the rating forms. Descriptive statistics were used to analyze ratings with response scales ranging from 1 = strongly disagree to 5 = strongly agree. Average ratings for the telehealth technologies for the TASK III resource guide were obtained for the mailed hard copy binder (M = 3.58-4.13; SD = 0.35-1.00), an interactive website (https://www.task3web.com/; M = 3.86-4.17; SD = .72-1.07), an eBook (M = 3.17-3.67; SD = 0.84-1.17), and a USB drive (M = 3.75-4.00; SD = .82-.96). Average ratings for the telehealth technologies for the TASK III calls with the nurse were obtained for the use of a telephone (M = 4.36-5.00; SD = 0.00-0.89), FaceTime on an iOS device (e.g., iPhone or iPad; M = 3.73-4.40; SD = 0.79-0.98), or online videoconferencing (M = 3.17-3.50; SD = 0.82-1.47). Qualitative data revealed a wide variety of preferences for each type of telehealth technology, with advantages and disadvantages of each. The findings underscored the importance of offering multiple telehealth technology options to stroke family caregivers. Future studies are recommended that employ randomized control trial methodology to test theoretically-based interventions that are based on stroke family caregiver preferences for telehealth technologies.

Assessment of mobile source air toxics in an Environmental Justice Denver community adjacent to a freeway.

Air pollutant concentrations are often higher near major roadways than in the surrounding environments owing to emissions from on-road mobile sources. In this study, we quantified the gradient in black carbon (BC) and air toxics concentrations from the I-70 freeway in the Elyria-Swansea environmental justice neighborhood in Denver, Colorado, during three measurement campaigns in 2017-2018. The average hourly upwind-downwind gradient of BC concentrations from the roadway was 500-800 ng/m3, equal to an increment of approximately 30-80% above local background levels within 180 m of the freeway. When integrated over all wind directions, the gradients were smaller, approximately 150-300 ng/m3 (~11-18%) over the course of nearly four months of measurements. No statistically significant gradient in air toxics (e.g., benzene, formaldehyde, etc.) was found, likely because the uncertainties in the mean concentrations were larger than the magnitude of the gradient (<25%). This finding is in contrast to some earlier studies in which small gradients of benzene and other VOCs were found. We estimate that sample sizes of at least 100 individual measurements would have been required to estimate mean concentrations with sufficient certainty to quantify gradients on the order of ±10% uncertainty. These gradient estimates are smaller than those found in previous studies over the past two decades; more stringent emissions standards, the local fleet age distribution, and/or the steady turnover of the vehicle fleet may be reducing the overall impact of roadway emissions on near-road communities. Implications: Gradients of near-road pollution may be declining in the near-road environment as tailpipe emissions from the vehicle fleet continue to decrease. Near-road concentration gradients of mobile source air toxics, including benzene, 1,3-butadiene, and ethylbenzene, will require higher sample sizes to quantify as emissions continue to decline.

Reallocating budgets among ongoing and emerging conservation projects.

Conserving biodiversity and combating ecological hazards require cost-effective allocation of limited resources among potential management projects. Project priorities, however, can change over time as underlying social-ecological systems progress, novel priorities emerge, and management capabilities evolve. Thus, reallocation of ongoing investments in response to shifting priorities could improve management outcomes and address urgent demands, especially when additional funding is not available immediately. Resource reallocation, however, could incur transaction costs, require additional monitoring and reassessment, and be constrained by ongoing project commitments. Such complexities may prevent managers from considering potentially beneficial reallocation strategies, reducing long-term effectiveness. We propose an iterative project prioritization approach, based on marginal return-on-investment estimation and portfolio optimization, that guides resource reallocation among ongoing and new projects. Using simulation experiments in 2 case studies, we explored how this approach can improve efficacy under varying reallocation constraints, frequencies, costs, and rates of project portfolio change. Periodic budget reallocation could enhance the management of stochastically emerging invasive weeds in Australia and thus reduce the overall risk by up to 50% compared with a static budget. Reallocation frequency and the rate of new weed incursion synergistically increased the conservation gains achieved by allowing unconstrained reallocation. Conversely, budget reallocation would not improve the International Union for Conservation of Nature conservation status of threatened Australian birds due to slow rates of transition among conservation states; extinction risk could increase if portfolio reassessment is costly. Although other project prioritization studies may recommend periodic reassessment and reallocation, our findings revealed conditions when reallocation is valuable and demonstrated a structured approach that can help conservation agencies schedule and implement iterative budget-allocation decisions cost-effectively.

Reasignación de Presupuestos entre los Proyectos de Conservación Emergentes y En Curso Resumen La conservación de la biodiversidad y el combate a los riesgos ecológicos requieren de una asignación rentable de los recursos limitados entre los proyectos potenciales de manejo. Sin embargo, las prioridades de los proyectos pueden cambiar con el tiempo conforme avanzan los sistemas socio-ecológicos subyacentes, emergen prioridades nuevas y evolucionan las capacidades de manejo. Por lo tanto, la reasignación de las inversiones en curso como respuesta a las prioridades cambiantes podría mejorar los resultados de manejo y resolver demandas urgentes, especialmente cuando el financiamiento adicional no está disponible de manera inmediata. Sin embargo, la reasignación de recursos podría incurrir en costos de transacción, requerir de monitoreo y reevaluación adicionales y estar restringida por los compromisos hechos por los proyectos en curso. Dichas complejidades pueden evitar que los administradores consideren estrategias de reasignación potencialmente benéficas, reduciendo así la efectividad a largo plazo. Proponemos un enfoque iterativo de priorización de proyectos basado en una estimación marginal de rentabilidad y en la optimización del portafolio, el cual guíe la reasignación de recursos entre los proyectos nuevos y en curso. Mediante experimentos de simulación en dos estudios de caso, exploramos cómo este enfoque puede mejorar la eficacia bajo cambiantes restricciones de reasignación, frecuencias, costos y tasas de cambio en el portafolio del proyecto. La reasignación periódica de presupuestos podría mejorar el manejo de las hierbas invasoras con surgimiento estocástico en Australia y así reducir el riesgo general hasta en un 50% en comparación con un presupuesto estático. La frecuencia de reasignación y la tasa de incursión de hierbas nuevas incrementaron de manera sinérgica las ganancias de conservación obtenidas al permitir una reasignación sin restricciones. En cambio, la reasignación de presupuestos no mejoraría el estado de conservación según la Unión Internacional para la Conservación de la Naturaleza de las aves australianas amenazadas debido a las tasas lentas de transición entre los estados de conservación; el riesgo de extinción podría incrementar si la reevaluación del portafolio es costosa. Aunque otros estudios de priorización de proyectos pueden recomendar una reevaluación y una reasignación periódicas, nuestros resultados revelaron condiciones cuando la reasignación es valiosa y demostraron una estrategia estructurada que puede ayudar a las agencias de conservación a programar e implementar decisiones iterativas de asignación de presupuestos de manera rentable.

Assessing the Early Impact of the COVID-19 Pandemic on Spine Surgery Fellowship Education.

STUDY DESIGN: This was a cross-sectional study. OBJECTIVE: The objective of this study is to report the impact of COVID-19 on spine surgery fellow education and readiness for practice. SUMMARY OF BACKGROUND DATA: COVID-19 has emerged as one of the most devastating global health crises of our time. To minimize transmission risk and to ensure availability of health resources, many hospitals have cancelled elective surgeries. There may be unintended consequences of this decision on the education and preparedness of current surgical trainees. MATERIALS AND METHODS: A multidimensional survey was created and distributed to all current AO Spine fellows and fellowship directors across the United States and Canada. RESULTS: Forty-five spine surgery fellows and 25 fellowship directors completed the survey. 62.2% of fellows reported >50% decrease in overall case volume since cancellation of elective surgeries. Mean hours worked per week decreased by 56.2%. Fellows reported completing a mean of 188.4±64.8 cases before the COVID-19 crisis and 84.1% expect at least an 11%-25% reduction in case volume compared with previous spine fellows. In all, 95.5% of fellows did not expect COVID-19 to impact their ability to complete fellowship. Only 2 directors were concerned about their fellows successfully completing fellowship; however, 32% of directors reported hearing concerns regarding preparedness from their fellows and 25% of fellows were concerned about job opportunities. CONCLUSIONS: COVID-19 has universally impacted work hours and case volume for spine surgery fellows set to complete fellowship in the middle of 2020. Nevertheless, spine surgery fellows generally feel ready to enter practice and are supported by the confidence of their fellowship directors. The survey highlights a number of opportunities for improvement and innovation in the future training of spine surgeons. LEVEL OF EVIDENCE: Level III.

There's No Harm in Talking: Re-Establishing the Relationship Between Theological and Secular Bioethics.

Theological and secular voices in bioethics have drifted into separate silos. Such a separation results in part from (1) theologians focusing less on conveying ideas in ways that contribute to a pluralistic and public bioethical discourse and (2) the dwindling receptivity of religious arguments within secular bioethics. This essay works against these drifts by putting forward an argument that does not bounce around a religious echo-chamber, but instead demonstrates how insights of Christian anthropology can be meaningfully responsive to secular bioethics' rightful concerns with inequality and injustice. We offer core concepts from Christian bioethics that encourage dialogue with secular and theological bioethicists. The theologically-grounded concepts, human dignity, sin, and the common good, provide intellectual resources to address major areas of bioethical concern that remain unresolved.

Reaching for Peak Performance During Surgical Training: The Value in Assessment Tools and Critical Performance Measures.

Peak performance is the ability to achieve optimal outcomes or performance of a given task in a consistent manner. Commonly studied in athletes and musicians, this topic is less often studied in medicine and rarely broached for trainees. However, residency is a crucial period of training where foundations for future success are sewn into habit and daily practice. As educators, we should aim to equip trainees with the tools necessary to achieve peak performance. Studies in athletes and musicians focus on achieving peak performance by setting goals, mastering skills through deliberate practice, perseverance, grit, and discipline. Mentorship is also an important element to streamline efforts for the trainee and help them to focus. In the following article, we review the current literature on applying these principles to surgical trainees to achieve peak performance.

Assessment of Ambient Air Toxics and Wood Smoke Pollution among Communities in Sacramento County.

Ambient air monitoring and phone survey data were collected in three environmental justice (EJ) and three non-EJ communities in Sacramento County during winter 2016-2017 to understand the differences in air toxics and in wood smoke pollution among communities. Concentrations of six hazardous air pollutants (HAPs) and black carbon (BC) from fossil fuel (BCff) were significantly higher at EJ communities versus non-EJ communities. BC from wood burning (BCwb) was significantly higher at non-EJ communities. Correlation analysis indicated that the six HAPs were predominantly from fossil fuel combustion sources, not from wood burning. The HAPs were moderately variable across sites (coefficient of divergence (COD) range of 0.07 for carbon tetrachloride to 0.28 for m- and p-xylenes), while BCff and BCwb were highly variable (COD values of 0.46 and 0.50). The BCwb was well correlated with levoglucosan (R2 of 0.68 to 0.95), indicating that BCwb was a robust indicator for wood burning. At the two permanent monitoring sites, wood burning comprised 29-39% of the fine particulate matter (PM2.5) on nights when PM2.5 concentrations were forecasted to be high. Phone survey data were consistent with study measurements; the only significant difference in the survey results among communities were that non-EJ residents burn with indoor devices more often than EJ residents.

Bayesian Analysis of Theoretical Rotational Constants from Low-Cost Electronic Structure Methods.

With an ever-increasing usage of electronic structure programs by the microwave spectroscopy community, there is a growing need to assess the performance of commonly used, low-cost quantum chemical methods, particularly with respect to rotational constants because these quantities are central in guiding experiments. Here, we systematically benchmark the predictive power afforded by several low-level ab initio and density functionals combined with a variety of basis sets that are commonly employed in the rotational spectroscopy literature. The data set in our analysis consists of 6916 optimized geometries of 76 representative species where high-resolution experimental gas-phase rotational constants are available. We adopted a Bayesian approach for analyzing the performance of each method and basis set combination, employing Hamiltonian Monte Carlo sampling to determine the uncertainty in theoretical predictions of rotational constants and dipole moments. Our analysis establishes a hierarchy of accuracy and uncertainty, with commonly used methods in the rotational spectroscopy literature such as B3LYP and MP2 yielding lower accuracy and higher uncertainty than newer-generation functionals such as those from the Minnesota family, and ωB97X-D, which, when paired with a modestly sized 6-31+G(d) basis, provides optimal performance with respect to computational cost. Additionally, we provide statistical scaling factors that can be used to empirically correct for vibration-rotation effects, as a means to further improve the accuracy of rotational constants predicted from these relatively low-cost theoretical methods. As part of this, we demonstrate that the uncertainties can be used in simulations of rotational spectra to cross-correlate with broadband spectra, a methodology that could be used to quickly and efficiently survey experimental spectra for new molecules.

Burden of Sciatica on US Medicare Recipients.

OBJECTIVE: This study evaluates the disease burden of sciatica on the US Medicare cohort. BACKGROUND DATA: Sciatica is a common disability that has important physical, mental, and economic effects. The Medicare Health Outcomes Survey (HOS) is a demographic and outcomes survey used to monitor the performance of Medicare Advantage health plans in the United States. The HOS includes data on demographics, chronic medical conditions, and patient-reported outcomes. METHODS: Medicare HOS data for cohorts from 2007 to 2013 were obtained. Patients were placed into two categories based on the survey results: with or without a history of sciatica. Baseline demographics, chronic medical conditions, and physical health symptoms were aggregated. In addition, average VR-12 physical component summary and mental component summary scores were calculated for each group at baseline and at 2-year follow-up. A Fisher exact test was used to assess significance for categorical variables, and a t-test was used for continuous variables. VR-12 changes as small as 1 to 2 units have been found to be clinically and socially relevant. RESULTS: The baseline cohort data of 1,000,952 patients yielded 250,869 patients (25%) who reported the diagnosis of sciatica, compared with 750,083 patients (75%) without sciatica. Patients with a history of sciatica tended to be younger, less educated, and notably with more medical comorbidities. Physical component summary outcomes were approximately 8 units lower in the sciatica group at baseline and 7 units lower at 2-year follow-up. Mental component summary outcomes were 6 units lower in the sciatica group at baseline and 5 units lower at 2-year follow-up. CONCLUSION: A large percentage of the US Medicare cohort suffers from symptomatic sciatica. Our study identified a 25% prevalence in the Medicare cohort. In addition, sciatica is associated with an increased incidence of comorbid medical conditions and poor health-related quality of life. LEVEL OF EVIDENCE: Level III STUDY DESIGN:: Observational-Cohort Study.

Measuring Spatial and Temporal PM2.5 Variations in Sacramento, California, Communities Using a Network of Low-Cost Sensors.

Low-cost sensors can provide insight on the spatio-temporal variability of air pollution, provided that sufficient efforts are made to ensure data quality. Here, 19 AirBeam particulate matter (PM) sensors were deployed from December 2016 to January 2017 to determine the spatial variability of PM2.5 in Sacramento, California. Prior to, and after, the study, the 19 sensors were deployed and collocated at a regulatory air monitoring site. The sensors demonstrated a high degree of precision during all collocated measurement periods (Pearson R2 = 0.98 - 0.99 across all sensors), with little drift. A sensor-specific correction factor was developed such that each sensor reported a comparable value. Sensors had a moderate degree of correlation with regulatory monitors during the study (R2 = 0.60 - 0.68 at two sites). In a multi-linear regression model, the deviation between sensor and reference measurements of PM2.5 had the highest correlation with dew point and relative humidity. Sensor measurements were used to estimate the PM2.5 spatial variability, finding an average pairwise coefficient of divergence of 0.22 and a range of 0.14 to 0.33, indicating mostly homogeneous distributions. No significant difference in the average sensor PM concentrations between environmental justice (EJ) and non-EJ communities (p value = 0.24) was observed.

A low cost, portable NMR probe for high pressure, MR relaxometry.

A low cost, portable, high volume, stainless steel pressure reactor is modified to easily perform magnetic resonance relaxometry at industrially relevant pressures. Unlike existing pressurization strategies common to nuclear magnetic resonance (NMR) spectroscopy, this approach is amenable to realistic samples that feature heterogeneity and have traditionally escaped NMR study at pressure. This pressure reactor/NMR probe combination is easily accommodated by most single-sided and other low magnetic field permanent magnet assemblies. The performance of the probe is demonstrated by accomplishing NMR relaxometry on polydimethylsiloxane at different pressures with two types of unilateral magnets.

Early warning signals of recovery in complex systems.

Early warning signals (EWSs) offer the hope that patterns observed in data can predict the future states of ecological systems. While a large body of research identifies such signals prior to the collapse of populations, the prediction that such signals should also be present before a system's recovery has thus far been overlooked. We assess whether EWSs are present prior to the recovery of overexploited marine systems using a trait-based ecological model and analysis of real-world fisheries data. We show that both abundance and trait-based signals are independently detectable prior to the recovery of stocks, but that combining these two signals provides the best predictions of recovery. This work suggests that the efficacy of conservation interventions aimed at restoring systems which have collapsed may be predicted prior to the recovery of the system, with direct relevance for conservation planning and policy.