Integrative analysis of transcriptome and target metabolites uncovering flavonoid biosynthesis regulation of changing petal colors in Nymphaea 'Feitian 2'.

BACKGROUND: Nymphaea (waterlily) is known for its rich colors and role as an important aquatic ornamental plant globally. Nymphaea atrans and some hybrids, including N. 'Feitian 2,' are more appealing due to the gradual color change of their petals at different flower developmental stages. The petals of N. 'Feitian 2' gradually change color from light blue-purple to deep rose-red throughout flowering. The mechanism of the phenomenon remains unclear. RESULTS: In this work, flavonoids in the petals of N. 'Feitian 2' at six flowering stages were examined to identify the influence of flavonoid components on flower color changes. Additionally, six cDNA libraries of N. 'Feitian 2' over two blooming stages were developed, and the transcriptome was sequenced to identify the molecular mechanism governing petal color changes. As a result, 18 flavonoid metabolites were identified, including five anthocyanins and 13 flavonols. Anthocyanin accumulation during flower development is the primary driver of petal color change. A total of 12 differentially expressed genes (DEGs) in the flavonoid biosynthesis pathway were uncovered, and these DEGs were significantly positively correlated with anthocyanin accumulation. Six structural genes were ultimately focused on, as their expression levels varied significantly across different flowering stages. Moreover, 104 differentially expressed transcription factors (TFs) were uncovered, and three MYBs associated with flavonoid biosynthesis were screened. The RT-qPCR results were generally aligned with high-throughput sequencing results. CONCLUSIONS: This research offers a foundation to clarify the mechanisms underlying changes in the petal color of waterlilies.

Women's involvement in decision-making and association with reproductive health behaviors: findings from a cross-sectional survey in Niger.

BACKGROUND: Though women in Niger are largely responsible for the familial health and caretaking, prior research shows limited female autonomy in healthcare decisions. This study extends current understanding of women's participation in decision-making and its influence on reproductive health behaviors. METHODS: Cross-sectional survey with married women (15-49 years, N = 2,672) in Maradi and Zinder Niger assessed women's participation in household decision-making in health and non-health issues. Analyses examined [1] if participation in household decision-making was associated with modern contraceptive use, antenatal care (ANC) attendance, and skilled birth attendance at last delivery and [2] what individual, interpersonal, and community-level factors were associated with women's participation in decision-making. RESULTS: Only 16% of the respondents were involved-either autonomously or jointly with their spouse-in all three types of household decisions: (1) large purchase, (2) visiting family/parents, and (3) decisions about own healthcare. Involvement in decision making was significantly associated with increased odds of current modern contraceptive use [aOR:1.36 (95% CI: 1.06-1.75)] and four or more ANC visits during their recent pregnancy [aOR:1.34 (95% CI: 1.00-1.79)], when adjusting for socio-demographic characteristics. There was no significant association between involvement in decision-making and skilled birth attendance at recent delivery. Odds of involvement in decision-making was significantly associated with increasing age and household wealth status, listening to radio, and involvement in decision-making about their own marriage. CONCLUSION: Women's engagement in decision-making positively influences their reproductive health. Social and behavior change strategies to shift social norms and increase opportunities for women's involvement in household decision making are needed. For example, radio programs can be used to inform specific target groups on how women's decision-making can positively influence reproductive health while also providing specific actions to achieve change. Opportunities exist to enhance women's voice either before women enter marital partnerships or after (for instance, using health and social programming).

'Counselling is not just providing information': perceptions of caregivers and stakeholders on the design of nutrition and health counselling interventions for families with young children in rural Kenya.

BACKGROUND: Globally, a fifth of the children continue to face chronic undernutrition with a majority of them situated in the Low- and Middle-Income Countries (LMIC). The rising numbers are attributed to aggravating factors like limited nutrition knowledge, poor feeding practices, seasonal food insecurity, and diseases. Interventions targeting behaviour change may reduce the devastating nutrition situation of children in the LMICs. OBJECTIVE: For the co-design of a Behaviour Change Communication (BCC) intervention for young children in rural Kenya, we aimed to identify the experiences, barriers, facilitators, and preferences of caregivers and stakeholders regarding nutrition and health counselling. DESIGN: We employed a qualitative study design and used a semi-structured interview guide. The in-depth interviews were recorded, transcribed, and analysed using content analysis, facilitated by the software NVivo. SETTING: Health and Demographic Surveillance System (HDSS) area in Siaya County, rural Kenya. PARTICIPANTS: We interviewed 30 caregivers of children between 6 and 23 months of age and 29 local stakeholders with experience in implementing nutrition projects in Kenya. RESULTS: Nutrition and health counselling (NHC) was usually conducted in hospital settings with groups of mothers. Barriers to counselling were long queues and delays, long distances and high travel costs, the inapplicability of the counselling content, lack of spousal support, and a high domestic workload. Facilitators included the trust of caregivers in Community Health Volunteers (CHVs) and counselling services offered free of charge. Preferences comprised (1) delivering of counselling by CHVs, (2) offering individual and group counselling, (3) targeting male and female caregivers. CONCLUSION: There is a disconnect between the caregivers' preferences and the services currently offered. Among these families, a successful BCC strategy that employs nutrition and health counselling should apply a community-based communication channel through trusted CHVs, addressing male and female caregivers, and comprising group and individual sessions.

Predicting suitable areas for Metcalfa pruinosa (Hemiptera: Flatidae) under climate change and implications for management.

Climate change is a prominent factor reshaping the distribution of invasive species. Metcalfa pruinosa (Say 1830) (Hemiptera: Flatidae), native to North America, has invaded other continents and poses a serious threat to various agricultural crops and the human residential environment. Understanding the distribution of M. pruinosa based on climatic conditions is a critical first step to prevent its further invasion. Therefore, based on its occurrence records and associated environmental variables, a Maxent model was developed to predict suitable areas for this species in the present and future on a global scale. The model exhibited outstanding performance, with a mean area under the receiver operating characteristic curve and true skill statistic values of 0.9329 and 0.926, respectively. The model also indicated that annual precipitation (Bio12) and max temperature of the warmest month (Bio5) were the key environmental variables limiting the distribution of M. pruinosa. Moreover, the model revealed that the current suitable area is 1.01 × 107 km2 worldwide, with southern China, southern Europe, and the eastern United States predicted to be the primary and highly suitable areas in the latter 2 regions. This area is expected to increase under future climate scenarios, mainly in the northern direction. The study's findings contribute to our understanding of climate change's impact on M. pruinosa distribution, and they will aid governments in developing appropriate pest management strategies, including global monitoring and strict quarantine measures.

The practices of heat adaptation among elderly in Dezful: A qualitative study.

BACKGROUND: Useful experiences of the elderly in adapting to the environment may play an important role in formulating future policies. This study was conducted to explain the past experiences of the elderly in Dezful in adapting to heat. MATERIALS AND METHODS: This study was conducted with a qualitative research approach and a qualitative content analysis method in 2020 and 2021. The experiences of 18 elderly in Dezful were collected through semi-structured interviews via recording, face-to-face interviews, and data observation. Sampling was performed by the purpose-based method, and the data of this stage were analyzed using a content analysis approach using the Zhang and Wildemuth method. RESULTS: During the data analysis process, three main themes were extracted, including psychophysiological, socioeconomic, and environmental adaptation. Also, twelve subthemes including changes in physiological conditions, urban architecture, house architecture, diet, clothing, business conditions, mindset, life conditions, and the use of factors (spirituality, experience, and natural capacities) were extracted. CONCLUSION: Explaining the experiences of the elderly in Dezful, who have lived with heat for many years, can provide better identification of solutions and more tangible experiences of adaptation to heat for other communities. These experiences can be used in urban, cultural, and social planning.

Assessment of the effects of climate change on water balance components in the upper Erer subbasin, Ethiopia.

Eastern Ethiopia watersheds are located in transition zone from Arid to semi-humid climate and in expanding to westwards the west annual rainfall is highly declining. This paper explains future hydrological response impacts under changing climate using ensemble average of the CORDEX RCMs for historical (1979-2014) and future (2024-2070) periods. The result revels the monthly average temperature varies (0.04-6.25°C) for RCP-4.5, while it varies (0.03-6.59°oC) for RCP-8.5. The monthly average rainfall to be decline by 90.71 mm and rise by 211. 22 mm for RCP-4.5, while it is going to decline by 84.97 mm and rise by 235.62 mm for RCP-8.5. The adjusted SWAT model was used to detect the changes of projected hydrological response from reference period. Balance components of the baseline period was compared to future period. The result shows the change in decrease of annual mean surface flow (4.98 %-5.63 %), groundwater flow (5.63 %-6.68 %), evapotranspiration (2.45 %-2.57 %) and water yield (5.54 %-5.21 %) to be expected from RCP-4.5 to RCP-8.5. The findings of this paper provide valuable assistance to water resource planners by enhancing their comprehension of change in climate effects at local level.

What the eyes, confidence, and partner's identity can tell about change of mind.

Perceptual confidence reflects the ability to evaluate the evidence that supports perceptual decisions. It is thought to play a critical role in guiding decision-making. However, only a few empirical studies have actually investigated the function of perceptual confidence. To address this issue, we designed a perceptual task in which participants provided a confidence judgment on the accuracy of their perceptual decision. Then, they viewed the response of a machine or human partner, and they were instructed to decide whether to keep or change their initial response. We observed that confidence predicted participants' changes of mind more than task difficulty and perceptual accuracy. Additionally, interacting with a machine, compared to a human, decreased confidence and increased participants tendency to change their initial decision, suggesting that both confidence and changes of mind are influenced by contextual factors, such as the identity of a partner. Finally, variations in confidence judgments but not change of mind were correlated with pre-response pupil dynamics, indicating that arousal changes are linked to confidence computations. This study contributes to our understanding of the factors influencing confidence and changes of mind and also evaluates the possibility of using pupil dynamics as a proxy of confidence.

Toward solving the global green-green dilemma between wind energy production and bat conservation.

Wind energy production is growing rapidly worldwide in an effort to reduce greenhouse gas emissions. However, wind energy production is not environmentally neutral. Negative impacts on volant animals, such as bats, include fatalities at turbines and habitat loss due to land-use change and displacement. Siting turbines away from ecologically sensitive areas and implementing measures to reduce fatalities are critical to protecting bat populations. Restricting turbine operations during periods of high bat activity is the most effective form of mitigation currently available to reduce fatalities. Compensating for habitat loss and offsetting mortality are not often practiced, because meaningful offsets are lacking. Legal frameworks to prevent or mitigate the negative impacts of wind energy on bats are absent in most countries, especially in emerging markets. Therefore, governments and lending institutions are key in reconciling wind energy production with biodiversity goals by requiring sufficient environmental standards for wind energy projects.

Experimental heatwaves reduce the effectiveness of ejaculates at occupying female reproductive tracts in a model insect.

Globally, heatwaves have become more common with hazardous consequences on biological processes. Research using a model insect (Tribolium castaneum) found that 5-day experimental heatwave conditions damaged several aspects of male reproductive biology, while females remained unaffected. However, females' reproductive fitness may still be impacted, as insects typically store sperm from multiple males in specialized organs for prolonged periods. Consequently, using males which produce sperm with green fluorescent protein (GFP)-tagged sperm nuclei, we visualized in vivo whether thermal stress affects the ejaculate occupancy across female storage sites under two scenarios; (i) increasing time since insemination and (ii) in the presence of defending competitor sperm. We reconfirmed that sperm from heatwave-exposed males sired fewer offspring with previously mated females and provided new scenarios for in vivo distributions of heat-stress-exposed males' sperm. Sperm from heatwave-exposed males occupied a smaller area and were at lower densities across the females' storage sites. Generally, sperm occupancy decreased with time since insemination, and sperm from the first male to mate dominated the long-term storage site. Reassuringly, although heated males' ejaculate was less successful in occupying female tracts, they were not lost from female storage at a faster rate and were no worse than control males in their offensive ability to enter storage sites occupied by competitor sperm. Future work should consider the potential site-specificity of factors influencing sperm storage where amenable.

Color and flexural properties of nanoparticles-modified denture base resin: An in vitro comparative study.

Objectives: Reinforcement of polymethylmethacrylate (PMMA) denture base resins (DBRs) with inorganic fillers with superior properties and accepted aesthetics are favored and still a big dilemma. This study was undertaken to evaluate the color change, flexural strength, and modulus of elasticity of heat-polymerized DBR material modified with silver nanoparticles (AgNPs) and zirconium dioxide nanoparticles (ZNPs). Methods: Sixty acrylic specimens (30/color test, 30/flexural properties) were fabricated and divided according to nanoparticles type and addition into 3 groups (n = 10). Group-I; unmodified specimens, Group-II; modified specimens with 0.5wt% AgNPs (PMMA/AgNPs), and Group-III; modified specimens with 7.5wt% ZNPs (PMMA/ZNPs). Disc-shape (20 × 3 mm) and bar-shape (65 × 10 × 2.5 mm) specimens were fabricated for color and flexural properties, respectively. The spectrophotometer was used for evaluation of the color change (∆E). The flexural strength and elastic modulus evaluation was carried out using a 3-point bending test (5 mm/min). Tukey's post hoc and one-way ANOVA were used to analyze the data at a significant level P ≤ 0.05. Results: PMMA/AgNPs group exhibited a significant increase in color change when compared with PMMA/ZNPs. PMMA/ZNPs showed significantly the highest flexural strength value when compared with unmodified and PMMA/AgNPs groups (P < 0.001), however, there was an absence of significant differences in terms of flexural strength values between PMMA/AgNPs and unmodified groups (P > 0.05). PMMA/AgNPs insignificantly increased its modulus of elasticity strength (P = 0.09410) while PMMA/ZNPs significantly increased its modulus of elasticity strength (P = 0.00396). Conclusion: The AgNPs and ZNPs addition to PMMA increased the color change and AgNPs change the color of DBRs. The flexural attributes of DBRs have been increased by ZNPs.

Correlates of climate change skepticism.

While much research has examined the correlates of climate change beliefs from an alarmist perspective, less work has systematically measured climate change skepticism. This study aims to create a comprehensive tool capturing climate skeptics' beliefs and test its association with individual difference variables. 502 European adults completed a 22-item questionnaire on climate change (CC) skepticism as well as measures of ambiguity tolerance, belief in a just world (BJW), dark-side personality traits, and self-esteem. Principal components analysis revealed a four dimension structure of CC. Political ideology was the most consistent and significant predictor across the climate change skepticism factors. Dark-side traits, also played a role. Future research should further validate this measure and explore how climate change information could be tailored to different audiences. Understanding the nuances and causes of climate skepticism can enable more effective communication to promote sustainability.

Determining the Public Health Impact of Climate Change: A National Study Using a Health Impact Assessment Approach in Wales.

Objective: Climate change is recognised as the biggest threat to global health of the 21st century and impacts on health and wellbeing through a range of factors. Due to this, the need to take action in order to protect population health and wellbeing is becoming ever more urgent. Methods: In 2019, Public Health Wales carried out a comprehensive mixed-method Health Impact Assessment (HIA) of climate change. Unlike other risk assessments, it appraised the potential impact of climate change on health and inequalities in Wales through participatory workshops, stakeholder consultations, systematic literature reviews and case studies. Results: The HIA findings indicate potential impacts across the wider determinants of health and wellbeing. For example, air quality, excess heat/cold, flooding, economic productivity, infrastructure, and community resilience. A range of impacts were identified across population groups, settings, and geographical areas. Conclusion: These findings can inform decision-makers to prepare for climate change plans and policies using an evidence-informed approach. The work has demonstrated the value of a HIA approach by mobilising a range of evidence through a transparent process, resulting in transferrable learning for others.

Role of transcriptional regulation in auxin-mediated response to abiotic stresses.

Global climate change (GCC) is posing a serious threat to organisms, particularly plants, which are sessile. Drought, salinity, and the accumulation of heavy metals alter soil composition and have detrimental effects on crops and wild plants. The hormone auxin plays a pivotal role in the response to stress conditions through the fine regulation of plant growth. Hence, rapid, tight, and coordinated regulation of its concentration is achieved by auxin modulation at multiple levels. Beyond the structural enzymes involved in auxin biosynthesis, transport, and signal transduction, transcription factors (TFs) can finely and rapidly drive auxin response in specific tissues. Auxin Response Factors (ARFs) such as the ARF4, 7, 8, 19 and many other TF families, such as WRKY and MADS, have been identified to play a role in modulating various auxin-mediated responses in recent times. Here, we review the most relevant and recent literature on TFs associated with the regulation of the biosynthetic, transport, and signalling auxin pathways and miRNA-related feedback loops in response to major abiotic stresses. Knowledge of the specific role of TFs may be of utmost importance in counteracting the effects of GCC on future agriculture and may pave the way for increased plant resilience.

Land use change and coastal water darkening drive synchronous dynamics in phytoplankton and fish phenology on centennial timescales.

At high latitudes, the suitable window for timing reproductive events is particularly narrow, promoting tight synchrony between trophic levels. Climate change may disrupt this synchrony due to diverging responses to temperature between, for example, the early life stages of higher trophic levels and their food resources. Evidence for this is equivocal, and the role of compensatory mechanisms is poorly understood. Here, we show how a combination of ocean warming and coastal water darkening drive long-term changes in phytoplankton spring bloom timing in Lofoten Norway, and how spawning time of Northeast Arctic cod responds in synchrony. Spring bloom timing was derived from hydrographical observations dating back to 1936, while cod spawning time was estimated from weekly fisheries catch and roe landing data since 1877. Our results suggest that land use change and freshwater run-off causing coastal water darkening has gradually delayed the spring bloom up to the late 1980s after which ocean warming has caused it to advance. The cod appear to track phytoplankton dynamics by timing gonadal development and spawning to maximize overlap between offspring hatch date and predicted resource availability. This finding emphasises the importance of land-ocean coupling for coastal ecosystem functioning, and the potential for fish to adapt through phenotypic plasticity.

Effectiveness of Interventions for Changing More Than One Behavior at a Time to Manage Chronic Conditions: A Systematic Review and Meta-analysis.

BACKGROUND: Health behaviors play a significant role in chronic disease management. Rather than being independent of one another, health behaviors often co-occur, suggesting that targeting more than one health behavior in an intervention has the potential to be more effective in promoting better health outcomes. PURPOSE: We aimed to conduct a systematic review and meta-analysis of randomized trials of interventions that target more than one behavior to examine the effectiveness of multiple health behavior change interventions in patients with chronic conditions. METHODS: Five electronic databases (Web of Science, PubMed, CINAHL, EMBASE, and Cochrane) were systematically searched in November 2023, and studies included in previous reviews were also consulted. We included randomized trials of interventions aiming to change more than one health behavior in individuals with chronic conditions. Two independent reviewers screened and extracted data, and used Cochrane's Risk of Bias 2 tool. Meta-analyses were conducted to estimate the effects of interventions on change in health behaviors. Results were presented as Cohen's d for continuous data, and risk ratio for dichotomous data. RESULTS: Sixty-one studies were included spanning a range of chronic diseases: cardiovascular (k = 25), type 2 diabetes (k = 15), hypertension (k = 10), cancer (k = 7), one or more chronic conditions (k = 3), and multiple conditions (k = 1). Most interventions aimed to change more than one behavior simultaneously (rather than in sequence) and most targeted three particular behaviors at once: "physical activity, diet and smoking" (k = 20). Meta-analysis of 43 eligible studies showed for continuous data (k = 29) a small to substantial positive effect on behavior change for all health behaviors (d = 0.081-2.003) except for smoking (d = -0.019). For dichotomous data (k = 23) all analyses showed positive effects of targeting more than one behavior on all behaviors (RR = 1.026-2.247). CONCLUSIONS: Targeting more than one behavior at a time is effective in chronic disease management and more research should be directed into developing the science of multiple behavior change.

Many recommendations suggest engaging in more than one health behavior to manage a chronic disease; however, most research trying to understand or support health behavior tends to focus on only one behavior. We wanted to clarify if interventions aiming to support people in changing more than one health behavior are effective and promote better health outcomes. We aimed to conduct a systematic review to summarize the effects of studies reporting randomized trials of interventions that target more than one behavior in people with a chronic condition. We found and analyzed 61 studies published up to November 2023 covering people with a variety of chronic diseases: cardiovascular conditions, type 2 diabetes, hypertension, cancer, and, in some studies, people with multiple conditions. Most interventions tried to change three particular behaviors at once (physical activity, diet, and smoking) and, overall, interventions that tried to change more than one behavior had positive effects on diet, physical activity, medication adherence, and alcohol consumption, but not smoking cessation. Findings highlight the benefits of targeting more than one behavior in health behavior change interventions. Future research could seek to identify if findings are similar across settings and populations and how they can inform routine healthcare and self-management interventions.

Assessment of land use and land cover change detection and prediction using deep learning techniques for the southwestern coastal region, Goa, India.

Understanding the connections between human activities and the natural environment depends heavily on information about land use and land cover (LULC) in the form of accurate LULC maps. Environmental monitoring using deep learning (DL) is rapidly growing to preserve a sustainable environment in the long term. For establishing effective policies, regulations, and implementation, DL can be a valuable tool for assessing environmental conditions and natural resources that will positively impact the ecosystem. This paper presents the assessment of land use and land cover change detection (LULCCD) and prediction using DL techniques for the southwestern coastal region, Goa, also known as the tourist destination of India. It consists of three components: (i) change detection (CD), (ii) quantification of LULC changes, and (iii) prediction. A new CD assessment framework, Spatio-Temporal Encoder-Decoder Self Attention Network (STEDSAN), is proposed for the LULCCD process. A dual branch encoder-decoder network is constructed using strided convolution with downsampling for the encoder and transpose convolution with upsampling for the decoder to assess the bitemporal images spatially. The self-attention (SA) mechanism captures the complex global spatial-temporal (ST) interactions between individual pixels over space-time to produce more distinct features. Each branch accepts the LULC map of 2 years as one of its inputs to determine binary and multiclass changes among the bitemporal images. The STEDSAN model determines the patterns, trends, and conversion from one LULC type to another for the assessment period from 2005 to 2018. The binary change maps were also compared with the existing state of the art (SOTA) CD methods, with STEDSAN having an overall accuracy of 94.93%. The prediction was made using an recurrent neural network (RNN) known as long short term memory network (LSTM) for the year 2025. Experiments were conducted to determine area-wise changes in several LULC classes, such as built-up (BU), crops (kharif crop (KC), rabi crop (RC), zaid crop (ZC), double/triple (D/T C)), current fallow (CF), plantation (PL), forests (evergreen forest (EF), deciduous forest (DF), degraded/scurb forest (D/SF) ), littoral swamp (LS), grassland (GL), wasteland (WL), waterbodies max (Wmx), and waterbodies min (Wmn). As per the analysis, over the period of 13 years, there has been a net increase in the amount of BU (1.25%), RC (1.17%), and D/TC( 2.42%) and a net decrease in DF (3.29%) and WL(1.44%) being the most dominant classes being changed. These findings will offer a thorough description of identifying trends in coastal areas that may incorporate methodological hints for future studies. This study will also promote handling the spatial and temporal complexity of remotely sensed data employed in categorizing the coastal LULC of a heterogeneous landscape.

Research on the impact of climate change on the income gap between urban and rural areas-empirical analysis based on provincial panel data in China.

Narrowing the income gap between urban and rural areas is the key to achieving common prosperity in China. On the basis of analyzing the mechanism of climate change's impact on urban-rural income gap, this article empirically analyzes the impact of climate change on urban-rural income gap using provincial-level panel data of 30 provinces in China from 2011 to 2020. Research indicates that climate change significantly impacts the urban-rural income gap at the 1% significance level, implying that climate change exacerbates the urban-rural income gap. This widening effect varies significantly across different regions, particularly in the western regions and areas with lower fiscal support for agriculture. Further analysis reveals that there is a mediating role between the total agricultural output value and resource mismatch in the impact of climate change on urban-rural income inequality; the digital rural construction plays a regulatory role in the impact of climate change on the urban-rural income gap. On this basis, policy recommendations are proposed to promote the development of climate-resilient agriculture, improve the meteorological forecast and early warning system, increase financial support, and optimize the allocation of agricultural resources.

The Primary Care and Environmental Health e-Learning Course to Integrate Environmental Health in General Practice: Before-and-After Feasibility Study.

BACKGROUND: Environmental and behavioral factors are responsible for 12.6 million deaths annually and contribute to 25% of deaths and chronic diseases worldwide. Through the One Health initiative, the World Health Organization and other international health organizations plan to improve these indicators to create healthier environments by 2030. To meet this challenge, training primary care professionals should be the priority of national policies. General practitioners (GPs) are ready to become involved but need in-depth training to gain and apply environmental health (EH) knowledge to their practice. In response, we designed the Primary Care Environment and Health (PCEH) online course in partnership with the Occitanie Regional Health Agency in France. This course was used to train GP residents from the Montpelier-Nimes Faculty of Medicine in EH knowledge. The course was organized in 2 successive parts: (1) an asynchronous e-learning modular course focusing on EH knowledge and tools and (2) 1 day of face-to-face sessions. OBJECTIVE: This study assessed the impact of the e-learning component of the PCEH course on participants' satisfaction, knowledge, and behavior changes toward EH. METHODS: This was a pilot before-and-after study. Four modules were available in the 6-hour e-learning course: introduction to EH, population-based approach (mapping tools and resources), clinical cases, and communication tools. From August to September 2021, we recruited first-year GP residents from the University of Montpellier (N=130). Participants' satisfaction, knowledge improvements for 19 EH risks, procedure to report EH risks to health authorities online, and behavior change (to consider the possible effects of the environment on their own and their patients' health) were assessed using self-reported questionnaires on a Likert scale (1-5). Paired Student t tests and the McNemar χ2 test were used to compare quantitative and qualitative variables, respectively, before and after the course. RESULTS: A total of 74 GP residents completed the e-learning and answered the pre- and posttest questionnaires. The mean satisfaction score was 4.0 (SD 0.9) out of 5. Knowledge scores of EH risks increased significantly after the e-learning course, with a mean difference of 30% (P<.001) for all items. Behavioral scores improved significantly by 18% for the participant's health and by 26% for patients' health (P<.001). These improvements did not vary significantly according to participant characteristics (eg, sex, children, place of work). CONCLUSIONS: The e-learning course improved knowledge and behavior related to EH. Further studies are needed to assess the impact of the PCEH course on clinical practice and potential benefits for patients. This course was designed to serve as a knowledge base that could be reused each year with a view toward sustainability. This course will integrate new modules and will be adapted to the evolution of EH status indicators and target population needs.

Assessing future intra-basin water availability in madagascar: Accounting for climate change, population growth, and land use change.

The Major River Basins in Madagascar (MRBM) play a crucial role in providing water to the Malagasy population as well as the ecosystem. Little is known about the impact of climate change on these basins, and it is not clear what factors have the most significant impact on them. There are two central objectives of this study: 1. To assess the future potential water available for daily life and agriculture use across the MRBM. 2. To compare the projected change within the MRBM with the historical trends analysis and identify the water-stressed basins. In this paper, a new method for assessing the future available Intra-basin water resources combined with the impacts of climate change, land use, and population is proposed. Three imbalance indicators are introduced to quantify the spatial availability (indicator N°1), distribution (indicator N°2), and variability (indicator N°3) of the Potential Water Resources (PWR) available and have been applied to the MRBM. Under the SSP2-4.5 scenario, results showed a decreasing trend of the PWR in most of the basins by 2050 with a rise in evapotranspiration and a decline in precipitation. The increasing trend and uneven distribution of the population and agricultural land upstream/downstream are found to cause the reduction of the PWR available per capita (by 37 %) and agriculture area (by 69 %) across the MRBM. This study predicts water scarcity for most of the basins by 2050, especially in the Mangoro and Onilahy Basins. Upstream populations are expected to grow in Mahajamba, Mahavavy, Betsiboka, Manambolo, Tsiribihina, Mangoro, Onilahy, Mananara, and Mandrare basins, along with an expansion of the downstream agricultural land in Sofia, Betsiboka, Manambolo, Mangoky, and Mandrare basins. These findings enhance the cause-effect relationship between climate change, land use change, population growth, and water scarcity in the MRBM. Urgent action is therefore needed for an efficient and sustainable management of these water-stressed basins.

Gray-white matter contrast reversal on T1-weighted spin-echo in postmortem brain.

PURPOSE: The image contrast of postmortem magnetic resonance imaging (MRI) may differ from that of antemortem MRI because of circulator arrest, changes in postmortem tissue, and low-body-temperature scanning conditions. In fact, we have found that the signal intensity of white matter (WM) on T1-weighted spin-echo (T1WSE) images of the postmortem brain was lower than that of gray matter (GM), which resulted in image contrast reversal between GM and WM relative to the living brain. However, the reason for this phenomenon is unclear. Therefore, the aim of this study is to clarify the reason why image contrast reversal occurs between GM and WM of the postmortem brain. MATERIALS AND METHODS: Twenty-three corpses were included in the study (mean age, 60.6 years; range: 19-60 years; mean rectal temperature at scan, 6.9℃; range: 4-11℃). On a 1.5 T MRI system, postmortem T1W-SE MRI of the brain was conducted in the 23 corpses prior to medico-legal autopsy. Next, T1 and T2 of the GM and WM at the level of the basal ganglia were determined in the same participants using inversion recovery and multiple SE sequences, respectively. The proton density (PD) was also calculated from the T1 and T2 images (in the same slice). RESULTS: T1W-SE image contrast between the GM and WM of all postmortem brains was inverted relative to the living brain. T1 (579 ms in GM and 307 ms in WM) and PD (64 in GM and 44 in WM) of the postmortem brain decreased compared with the living brain. While T1 of WM/GM remained below 1 even postmortem, the PD of WM/GM decreased. T2 (110 ms in GM and 98 ms in WM) of the postmortem brain did not differ from the living brain. CONCLUSION: The decrease in PD of WM/GM in the postmortem brain may be the major driver of contrast reversal between the GM and WM relative to the living brain.