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Peatlands cover approximately 12% of the Canadian landscape and play an important role in the carbon cycle through their centennial- to millennial-scale storage of carbon under waterlogged and anoxic conditions. In recognizing the potential of these ecosystems as natural climate solutions and therefore the need to include them in national greenhouse gas inventories, the Canadian Model for Peatlands module (CaMP v. 2.0) was developed by the Canadian Forest Service. Model parameterization included compiling peat profiles across Canada to calibrate peat decomposition rates from different peatland types, to define typical bulk density profiles, and to describe the hydrological (i.e., water table) response of peatlands to climatic changes. A total of 1217 sites were included in the dataset from published and unpublished sources. The CORESITES table contains site location and summary data for each profile, as well as an estimate of total carbon mass per unit area (in megagrams of C per hectare). Total carbon mass per unit area at each location was calculated using bulk density and carbon content through each profile. The PROFILES table contains data for depth (in centimeters), bulk density (in grams per cubic meter), ash and carbon content (in percentage), and material descriptions for contiguous samples through each peat profile. Data gaps for bulk density and C content were filled using interpolation, regression trees, and assigned values based on material description and/or soil classification to allow for the estimation of total carbon mass per unit area. A subset of the sites (N = 374) also have pH and pore water trace-elemental geochemistry data and are found in the WATER table. The REFERENCES table contains the full citation of each source of the data and is linked to each core location through the SOURCEDATA table. The LOOKUP table defines codes in the database that required more space that what was sufficient in the metadata tables. The data can be accessed on Open Government Canada and will be useful for future work on carbon stock mapping and ecosystem modeling. All metadata and data are provided © Her Majesty the Queen in Right of Canada, 2023 and information contained in this publication may be reproduced for personal or public noncommercial purposes with attribution, whereas commercial reproduction and distribution are prohibited except with written permission from NRCan; complete details are noted in the Supporting Information file Metadata S1 (see Class III.B.3: Copyright restrictions).
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AIMS: The aim of the present study was to investigate whether the predictability of fronto-parallel trunk rotations (lateral body sway) could serve as a frame of reference to monitor recovery after total knee arthroplasty (TKA). METHODS: Before surgery, 11 TKA patients were asked to perform a treadmill walking task at three different speeds. In addition, their gait abilities were scored on three standard clinical walking tests. The treadmill walking task was repeated at three different timepoints following surgery, i.e., at 3, 6 and 12 months post-TKA. The movements of the trunk were digitized with an inertial sensor to capture the amplitude and the sample entropy (SEn) of the lateral body sway that were evaluated in separate ANOVAs. RESULTS: Before surgery the TKA group showed larger body sway (P = 0.025) with smaller SEn values (P = 0.038), which both restored to levels of healthy adults in the 12 months following surgery. Systematic correlations between the SEn values and the clinical test scores were found. CONCLUSIONS: The current findings show that movement behavior of the trunk in the fronto-parallel plane was affected by knee osteoarthritis and suggest that the predictability of the lateral body sway may serve as an index of recovery after TKA.
Subject(s)
Arthroplasty, Replacement, Knee , Gait , Osteoarthritis, Knee , Postural Balance , Humans , Arthroplasty, Replacement, Knee/rehabilitation , Male , Female , Aged , Osteoarthritis, Knee/surgery , Osteoarthritis, Knee/physiopathology , Postural Balance/physiology , Gait/physiology , Middle Aged , Recovery of Function , Exercise Test/methods , Walking/physiologyABSTRACT
The uptake of carbon dioxide (CO2) by terrestrial ecosystems is critical for moderating climate change1. To provide a ground-based long-term assessment of the contribution of forests to terrestrial CO2 uptake, we synthesized in situ forest data from boreal, temperate and tropical biomes spanning three decades. We found that the carbon sink in global forests was steady, at 3.6 ± 0.4 Pg C yr-1 in the 1990s and 2000s, and 3.5 ± 0.4 Pg C yr-1 in the 2010s. Despite this global stability, our analysis revealed some major biome-level changes. Carbon sinks have increased in temperate (+30 ± 5%) and tropical regrowth (+29 ± 8%) forests owing to increases in forest area, but they decreased in boreal (-36 ± 6%) and tropical intact (-31 ± 7%) forests, as a result of intensified disturbances and losses in intact forest area, respectively. Mass-balance studies indicate that the global land carbon sink has increased2, implying an increase in the non-forest-land carbon sink. The global forest sink is equivalent to almost half of fossil-fuel emissions (7.8 ± 0.4 Pg C yr-1 in 1990-2019). However, two-thirds of the benefit from the sink has been negated by tropical deforestation (2.2 ± 0.5 Pg C yr-1 in 1990-2019). Although the global forest sink has endured undiminished for three decades, despite regional variations, it could be weakened by ageing forests, continuing deforestation and further intensification of disturbance regimes1. To protect the carbon sink, land management policies are needed to limit deforestation, promote forest restoration and improve timber-harvesting practices1,3.
Subject(s)
Carbon Dioxide , Carbon Sequestration , Forests , Internationality , Trees , Carbon Dioxide/metabolism , Carbon Dioxide/analysis , Climate Change , Conservation of Natural Resources , Ecosystem , Forestry/legislation & jurisprudence , Forestry/statistics & numerical data , Forestry/trends , Fossil Fuels/adverse effects , Fossil Fuels/supply & distribution , Taiga , Trees/metabolism , Trees/growth & development , Tropical ClimateABSTRACT
OBJECTIVE: Which theoretical and practical competences do the neurological and psychiatric case histories of the Hippocratic Corpus convey? MATERIAL AND METHODS: The 431 Hippocratic case histories have been studied for reports and communication on the diagnostics, treatment and prognosis of single persons and groups of patients suffering from neurological and psychiatric diseases. RESULTS: In the 7 books of the Hippocratic Epidemics, a total of 128 patients with neurological and psychiatric symptoms are described. Epidemic fever and its variants were the leading predisposing conditions and the main symptoms were delirium, coma, insomnia, headache, speech disorders and convulsions. A number of patients with phrenitis and opisthotonos are also reported. The majority of the sick persons were male, were teenagers or adults and 47 of them are mentioned by name. The patient's information about the course is often just as informative as the doctor's observations. Treatment was limited to physical and dietary measures. DISCUSSION: The Hippocratic physician diagnosed and attempted to treat a large number of neurological and psychiatric diseases. The often almost continuous observations of the patients led to astonishingly precise predictions of the course and the prospects of recovery. Numerous symptoms described in the case studies, including carphologia and opisthotonus, have entered the neurological vocabulary. The retrospective etiological analysis of the reports leads to the almost explicit identification of neurosyphilis and encephalitis lethargica. The therapeutic measures described by the author were, as the changeable course of the diseases shows, only of limited effectiveness despite a very differentiated application over time, both against the underlying diseases and the neurological and psychiatric complications.
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In the longitudinal, retrospective study, the ability of the FRAX, Garvan, and POL-RISK algorithms to predict osteoporotic fractures was compared in a group of 457 women. Using the rigid threshold of 10% showed a significant discrepancy in sensitivity and specificity of all tools. New thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds allow for improving the diagnostic accuracy of all three calculators. INTRODUCTION: The aim of the longitudinal, retrospective study was to compare three tools designed to assess fracture risk: FRAX, Garvan, and POL-RISK in their prediction of fracture incidence. MATERIAL: The study group consisted of 457 postmenopausal women with a mean age of 64.21 ± 5.94 years from the Gliwice Osteoporosis (GO) Study. Comprehensive data on clinical factors related to fractures were collected for all participants. Bone densitometry was performed at the proximal femur using the Prodigy device (GE, USA). Fracture risk was established using the FRAX, Garvan, and POL-RISK algorithms. Data on the incidence of osteoporotic fractures were collected over the last 10 years. RESULTS: During the period of observation 72, osteoporotic fractures occurred in 63 subjects. For a preliminary comparison of the predictive value of analyzed diagnostic tools, the fracture risk threshold of 10% was used. For FRAX, the fracture probability exceeding 10% was observed only in 11 subjects who experienced fractures; thus, the fracture was properly predicted only in 22.9% of women. For Garvan, the respective value was 90.5%, and for POL-RISK, it was 98.4%. That gave a very low true positive value for FRAX and a very high false positive value for Garvan and POL-RISK. Based on ROC curves, new thresholds for high risk of fractures were established for each calculator separately: 6.3% for FRAX major fracture, 20.0% for Garvan any fracture, and 18.0% for POL-RISK any fracture. Such thresholds improve the diagnostic accuracy of all compared fracture prediction tools. CONCLUSION: The current study showed that different fracture risk assessment tools, although having similar clinical purposes, require different cut-off thresholds for making therapeutic decisions. Better identification of patients requiring therapy based on such an approach may help reduce the number of new fractures.
Subject(s)
Algorithms , Osteoporosis, Postmenopausal , Osteoporotic Fractures , Humans , Female , Osteoporotic Fractures/epidemiology , Middle Aged , Risk Assessment/methods , Aged , Retrospective Studies , Osteoporosis, Postmenopausal/epidemiology , Osteoporosis, Postmenopausal/complications , Longitudinal Studies , Bone Density , Postmenopause , Risk Factors , Incidence , Sensitivity and Specificity , Absorptiometry, Photon/statistics & numerical dataABSTRACT
BACKGROUND: Electronic Patient-reported outcome measures (ePROMs) are increasingly used in radiotherapy departments. However, the impact of ePROM integration on patients' perceptions of healthcare providers, particularly in terms of empathy and professionalism, remains unclear. Thus, this study aims to assess the patients' views on healthcare professionals during ePROM-based consultations. METHODS: In this randomized trial, radiotherapy patients were enrolled and asked to evaluate video vignettes of consultations between a radiation oncologist and a patient. Two scenarios were shown in random order, one vignette portrayed a paper-chart-based clinic visit, and the other a consultation in which ePROMs were implemented. Established questionnaires such as Physician Compassion Questionnaire (PCQ), Jefferson Patient Perception of Physician Empathy (JPP), Physician Professionalism Questionnaire (PPQ) and Global Consultation Rating Scale (GCRS) were used to rate the healthcare professional. The primary endpoint was physician compassion. RESULTS: Between May and August 2022, 152 patients, predominantly with malignancies of the breast, prostate, and brain participated. Patients rated the physician in ePROM-based consultations with higher mean scores for physician compassion compared to paper chart-based ones (36.4 vs. 34.2, p = 0.029). No negative impact of ePROMs was observed in terms of professionalism, global rating or physician empathy. Despite a shorter duration of the visit and reduced eye contact, 63 % of patients ultimately favored ePROM-based consultations. CONCLUSION: The ePREFERENCE trial shows that the implementation of ePROMs in clinic visits during radiotherapy treatment positively impacts the patients' perception of the physician's compassion. ePROMs can therefore not only be considered a useful tool to improve workflows but are also broadly accepted by patients.
Subject(s)
Empathy , Patient Reported Outcome Measures , Physician-Patient Relations , Humans , Male , Female , Middle Aged , Aged , Surveys and Questionnaires , Neoplasms/radiotherapy , Neoplasms/psychology , AdultABSTRACT
OBJECTIVE: Which theoretical and practical competences do the urologic case histories of the Hippocratic Corpus convey? MATERIALS AND METHODS: The 431 Hippocratic case histories have been studied for reports and communication on diagnostic methods, treatment, and prognosis related to urologic diseases. RESULTS: Within the seven books of the Hippocratic Epidemics, a total of 69 patients with urologic symptoms are described; in 21 cases the urologic disease is dominant. The leading clinical signs were urine discoloration and urinary sediment, polyuria, testicular swelling and pain, hematuria, stranguria, anuria, and renal pain, the most frequent diseases were nephritis and urolithiasis. Most patients were men in juvenile and adult age; 33 sick persons are named. The statements of patients regarding the course of their illness were often sparse. Diagnostic tests were restricted to inspection and palpation. Otherwise, treatment was confined to conservative measures. The dietary decisions for treatment of nephritis were differentiated but nonuniform. CONCLUSION: The Hippocratic physician diagnosed and treated diseases of the urinary tract. Inflammatory conditions and traumatic lesions are described in detail. Highest priority was awarded to uroscopy. Nephritis was a widespread disorder und usually associated with other symptoms, above all fever. The urinary tract was often regarded as an indicator of physical and mental health. Conservative treatment measures dominate in the case reports.
Subject(s)
Urologic Diseases , History, Ancient , Humans , Male , Urologic Diseases/diagnosis , Urologic Diseases/history , Urologic Diseases/therapy , Urologic Diseases/epidemiology , Greece, Ancient , Urology/history , Female , AdultABSTRACT
Exposure to environmental hazards is an important determinant of health, and the frequency and severity of exposures is expected to be impacted by climate change. Through a partnership with the U.S. National Aeronautics and Space Administration, the U.S. Centers for Disease Control and Prevention's National Environmental Public Health Tracking Network is integrating timely observations and model data of priority environmental hazards into its publicly accessible Data Explorer (https://ephtracking.cdc.gov/DataExplorer/). Newly integrated data sets over the contiguous U.S. (CONUS) include: daily 5-day forecasts of air quality based on the Goddard Earth Observing System Composition Forecast, daily historical (1980-present) concentrations of speciated PM2.5 based on the modern era retrospective analysis for research and applications, version 2, and Moderate Resolution Imaging Spectroradiometer (MODIS) daily near real-time maps of flooding (MCDWD). Data integrated into the CDC Tracking Network are broadly intended to improve community health through action by informing both research and early warning activities, including (a) describing temporal and spatial trends in disease and potential environmental exposures, (b) identifying populations most affected, (c) generating hypotheses about associations between health and environmental exposures, and (d) developing, guiding, and assessing environmental public health policies and interventions aimed at reducing or eliminating health outcomes associated with environmental factors.
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OBJECTIVE: The adjacent vessel sign (AVS) is a descriptor for differentiating malignant from benign breast lesions on breast MRI (bMRI). This investigation was designed to verify the previous reports on the diagnostic accuracy of AVS and to assess correlation between AVS, histopathological diagnosis, lesion size and lesion grade. MATERIALS AND METHODS: This study was approved by the local ethical committee. Experienced radiologists evaluated 1,084 lesions. The exclusion criteria were no histological verification after bMRI and breast interventions that were done up to one year before bMRI (surgery, core biopsy, chemo- or radiation therapy). The native and dynamic contrast-enhanced T1-weighted series were acquired using standardized protocols. The AVS was rated positive if a vessel leading to a lesion could be visualized. Prevalence of an AVS was correlated with the lesions' size, grade and histology using Chi-square-tests. RESULTS: The AVS was significantly associated with malignancy (p 2 cm more often presented with an AVS than did those malignant lesions < 2 cm (p < 0.0001; sensitivity: 65%, PPV: 90%). There was no correlation of the AVS with the tumor grade. The prevalence of an AVS didn't significantly differ between invasive lobular carcinomas versus ductal carcinomas. In situ cancers were less frequently associated with an AVS (p < 0.001). CONCLUSION: The adjacent vessel sign was significantly associated with malignancy. Thus, it can be used to accurately assess breast lesions on bMRI. In this study, the AVS was particularly associated with advanced and invasive carcinomas.
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Middle Aged , Young Adult , Breast/pathology , Breast Neoplasms/pathology , Contrast Media , Diagnosis, Differential , Gadolinium DTPA , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Neoplasms, Ductal, Lobular, and Medullary/pathology , Observer Variation , Predictive Value of Tests , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
The aging process is related to several changes in cardiovascular, metabolic and autonomic functions. However, descriptions of changes in arterial pressure (AP), baroreflex sensitivity and associated variations of serum glucose and insulin are controversial. The aim of this paper was to study AP, sensitivity and changes in plasma levels of glucose and insulin of young (10 weeks, 239 ñ 4.3 g) and aged (18-24 months, 412 ñ 8.5 g) male Wistar rats AP pulses were videotaped and processed on a microcomputer, using an analog-to-digital converter (beat-to-beat analysis). Baroreflex sensitivity was evaluated measuring heart rate changes induced by mean arterial pressure (MAP) variations produced by phenylephrine and socium nitroprosside injection (N = 10 in each group). Plasma glucose (N = 10 in each group) and plasma insulin (N = 6 in each group) were quantified by a colorimetric enzymatic test and radioimmunoassay,respectively. Ther were no differences in systolic, diastolic or mean AP (110 ñ 5 vs 107 ñ 3 mmHg) between aged and young rats. The tachycardic reponse to the reduction of AP was impaired in aged compared to young rats (-1.95 ñ 0.29 vs -3.26 ñ 0.49 bpm/mmHg), while the bradycardic response to increases in AP was similar (-1.02 ñ 0.22 vs -1.5 ñ 0.26 bpm/mmHg). Basal levels of glucose (83 ñ 6 vs 62 ñ 4mg/dl) and insulin (8.3 ñ 2 vs 4 ñ 0.5 µU/ml) were different. Thus, the reflex tachycardia evoked by a fall in AP is depressed in old rats. The observed higher basal insulin and glucose levels in aged rats may contribute to the imapairment of the baroreflex control