People construct simplified mental representations to plan.

One of the most striking features of human cognition is the ability to plan. Two aspects of human planning stand out-its efficiency and flexibility. Efficiency is especially impressive because plans must often be made in complex environments, and yet people successfully plan solutions to many everyday problems despite having limited cognitive resources1-3. Standard accounts in psychology, economics and artificial intelligence have suggested that human planning succeeds because people have a complete representation of a task and then use heuristics to plan future actions in that representation4-11. However, this approach generally assumes that task representations are fixed. Here we propose that task representations can be controlled and that such control provides opportunities to quickly simplify problems and more easily reason about them. We propose a computational account of this simplification process and, in a series of preregistered behavioural experiments, show that it is subject to online cognitive control12-14 and that people optimally balance the complexity of a task representation and its utility for planning and acting. These results demonstrate how strategically perceiving and conceiving problems facilitates the effective use of limited cognitive resources.

Selection in molecular evolution.

Evolution requires selection. Molecular/chemical/preDarwinian evolution is no exception. One molecule must be selected over another for molecular evolution to occur and advance. Evolution, however, has no goal. The laws of physics have no utilitarian desire, intent or proficiency. Laws and constraints are blind to "usefulness." How then were potential multi-step processes anticipated, valued and pursued by inanimate nature? Can orchestration of formal systems be physico-chemically spontaneous? The purely physico-dynamic self-ordering of Chaos Theory and irreversible non-equilibrium thermodynamic "engines of disequilibria conversion" achieve neither orchestration nor formal organization. Natural selection is a passive and after-the-fact-of-life selection. Darwinian selection reduces to the differential survival and reproduction of the fittest already-living organisms. In the case of abiogenesis, selection had to be 1) Active, 2) Pre-Function, and 3) Efficacious. Selection had to take place at the molecular level prior to the existence of non-trivial functional processes. It could not have been passive or secondary. What naturalistic mechanisms might have been at play?

Cover crop and phosphorus fertilizer management impacts on surface water quality from a no-till corn-soybean rotation.

Best management practices that reduce potential phosphorus (P) loss and provide flexibility in P fertilizer management are needed to help producers protect water quality while maintaining crop yield. This study examined the impacts of P fertilizer management (no P, fall broadcast P, and spring injected P) and cover crop use on annual concentrations and loads of sediment, total P, and dissolved reactive P (DRP) in edge-of-field runoff from a no-till corn (Zea mays)-soybean (Glycine max) rotation in the Central Great Plains, USA, from September 2015 through September 2019. The spring injected P fertilizer treatment generally had 19% less total P and 33% less DRP loss compared to the fall broadcast treatment, confirming the importance of P fertilizer management as a practice for reducing P loss. The addition of a cover crop had an inconsistent effect on total P loss, with no effect in 2016 and 2017, increasing loss in 2018 by 56%, and decreasing it in 2019 by 40%. The inconsistent impact of cover crops on total P loss was related to cover crop effects on sediment loss. Although cover crop impacts on total P losses were inconsistent, the addition of a cover crop increased DRP loss in three of four years. Cover crop use consistently reduced sediment loss, with greater sediment reduction when P fertilizer was applied. Results from this study highlight the benefit of cover crops for reducing sediment loss and the continued need for proper fertilizer management to reduce P loss from agricultural fields.

Benefits and limitations of noninvasive prenatal aneuploidy screening.

The introduction of noninvasive prenatal screening (NIPS) using cell-free DNA (cfDNA) is the newest option for aneuploidy screening during pregnancy. Compared with other aneuploidy screening options, NIPS offers a higher detection rate for trisomy 21 with a low false-positive rate. However, pretest and post-test patient counseling is essential and should include a discussion of the benefits and limitations, the screening rather than diagnostic nature of the test, and the association of a test failure with an increased risk of aneuploidy. Refer patients for genetic counseling when appropriate, particularly if test failure occurs due to a low fetal fraction or if maternal mosaicism or malignancy is suspected.

Air Quality-Related Health Benefits of Energy Efficiency in the United States.

While it is known that energy efficiency (EE) lowers power sector demand and emissions, study of the air quality and public health impacts of EE has been limited. Here, we quantify the air quality and mortality impacts of a 12% summertime (June, July, and August) reduction in baseload electricity demand. We use the AVoided Emissions and geneRation Tool (AVERT) to simulate plant-level generation and emissions, the Community Multiscale Air Quality (CMAQ) model to simulate air quality, and the Environmental Benefits Mapping and Analysis Program (BenMAP) to quantify mortality impacts. We find EE reduces emissions of NO x by 13.2%, SO2 by 12.6%, and CO2 by 11.6%. On a nationwide, summer average basis, ambient PM2.5 is reduced 0.55% and O3 is reduced 0.45%. Reduced exposure to PM2.5 avoids 300 premature deaths annually (95% CI: 60 to 580) valued at $2.8 billion ($0.13 billion to $9.3 billion), and reduced exposure to O3 averts 175 deaths (101 to 244) valued at $1.6 billion ($0.15 billion to $4.5 billion). This translates into a health savings rate of $0.049/kWh ($0.031/kWh for PM2.5 and $0.018/kWh for O3). These results illustrate the importance of capturing the health benefits of EE and its potential as a strategy to achieve air standards.

Air-quality-related health impacts from climate change and from adaptation of cooling demand for buildings in the eastern United States: An interdisciplinary modeling study.

BACKGROUND: Climate change negatively impacts human health through heat stress and exposure to worsened air pollution, amongst other pathways. Indoor use of air conditioning can be an effective strategy to reduce heat exposure. However, increased air conditioning use increases emissions of air pollutants from power plants, in turn worsening air quality and human health impacts. We used an interdisciplinary linked model system to quantify the impacts of heat-driven adaptation through building cooling demand on air-quality-related health outcomes in a representative mid-century climate scenario. METHODS AND FINDINGS: We used a modeling system that included downscaling historical and future climate data with the Weather Research and Forecasting (WRF) model, simulating building electricity demand using the Regional Building Energy Simulation System (RBESS), simulating power sector production and emissions using MyPower, simulating ambient air quality using the Community Multiscale Air Quality (CMAQ) model, and calculating the incidence of adverse health outcomes using the Environmental Benefits Mapping and Analysis Program (BenMAP). We performed simulations for a representative present-day climate scenario and 2 representative mid-century climate scenarios, with and without exacerbated power sector emissions from adaptation in building energy use. We find that by mid-century, climate change alone can increase fine particulate matter (PM2.5) concentrations by 58.6% (2.50 µg/m3) and ozone (O3) by 14.9% (8.06 parts per billion by volume [ppbv]) for the month of July. A larger change is found when comparing the present day to the combined impact of climate change and increased building energy use, where PM2.5 increases 61.1% (2.60 µg/m3) and O3 increases 15.9% (8.64 ppbv). Therefore, 3.8% of the total increase in PM2.5 and 6.7% of the total increase in O3 is attributable to adaptive behavior (extra air conditioning use). Health impacts assessment finds that for a mid-century climate change scenario (with adaptation), annual PM2.5-related adult mortality increases by 13,547 deaths (14 concentration-response functions with mean incidence range of 1,320 to 26,481, approximately US$126 billion cost) and annual O3-related adult mortality increases by 3,514 deaths (3 functions with mean incidence range of 2,175 to 4,920, approximately US$32.5 billion cost), calculated as a 3-month summer estimate based on July modeling. Air conditioning adaptation accounts for 654 (range of 87 to 1,245) of the PM2.5-related deaths (approximately US$6 billion cost, a 4.8% increase above climate change impacts alone) and 315 (range of 198 to 438) of the O3-related deaths (approximately US$3 billion cost, an 8.7% increase above climate change impacts alone). Limitations of this study include modeling only a single month, based on 1 model-year of future climate simulations. As a result, we do not project the future, but rather describe the potential damages from interactions arising between climate, energy use, and air quality. CONCLUSIONS: This study examines the contribution of future air-pollution-related health damages that are caused by the power sector through heat-driven air conditioning adaptation in buildings. Results show that without intervention, approximately 5%-9% of exacerbated air-pollution-related mortality will be due to increases in power sector emissions from heat-driven building electricity demand. This analysis highlights the need for cleaner energy sources, energy efficiency, and energy conservation to meet our growing dependence on building cooling systems and simultaneously mitigate climate change.

Response of Power Plant Emissions to Ambient Temperature in the Eastern United States.

Past studies have established strong connections between meteorology and air quality, via chemistry, transport, and natural emissions. A less understood linkage between weather and air quality is the temperature-dependence of emissions from electricity generating units (EGUs), associated with high electricity demand to support building cooling on hot days. This study quantifies the relationship between ambient surface temperatures and EGU air emissions (CO2, SO2, and NOX) using historical data. We find that EGUs in the Eastern U.S. region from 2007 to 2012 exhibited a 3.87% ± 0.41% increase in electricity generation per °C increase during summer months. This is associated with a 3.35%/°C ± 0.50%/°C increase in SO2 emissions, a 3.60%/°C ± 0.49%/°C increase in NOX emissions, and a 3.32%/°C ± 0.36%/°C increase in CO2 emissions. Sensitivities vary by year and by pollutant, with SO2 both the highest sensitivity (5.04% in 2012) and lowest sensitivity (2.19% in 2007) in terms of a regional average. Texas displays 2007-2012 sensitivities of 2.34%/°C ± 0.28%/°C for generation, 0.91%/°C ± 0.25%/°C for SO2 emissions, 2.15%/°C ± 0.29%/°C for NOX emissions, and 1.78%/°C ± 0.22%/°C for CO2 emissions. These results suggest demand-side and supply side technological improvements and fuel choice could play an important role in cost-effective reduction of carbon emissions and air pollution.

Anticipated impacts of climate change on women's health: A background primer.

Due to human activities, atmospheric greenhouse gas levels have increased dramatically, leading to an increase in the global mean surface temperature by 1.1° Celsius. Unless we can achieve a significant reduction in emissions, the global mean surface temperature will continue to rise to a dangerous level. Adverse outcomes of this warming will include extreme weather events, a deterioration of food, water and air quality, decreased food security, and an increase in vector-borne infectious disease. Political and economic instability as well as mass population migration will result in reduced access to healthcare resources. Mitigation of and adaptation to climate change will be key determinants of humanity's survival in the face of this existential crisis. Women will be more adversely affected by climate change than men, and pregnant persons will be particularly vulnerable. Particular differential impacts on women include higher heat and particulate-related morbidity and mortality; pregnancy risks including preterm birth, fetal growth lag, hypertensive disorders; and mental health impacts. To prepare for the climate crisis, it  is imperative for women's healthcare providers to assist their patients through political advocacy, provide family planning services, and focus on nutrition and lifestyle counseling.

Climate change: Overview of risks to pregnant persons and their offspring.

Climate change is one of the greatest challenges confronting humanity. Pregnant persons, their unborn children, and offspring are particularly vulnerable, as evidenced by adverse perinatal outcomes and increased rates of childhood illnesses. Environmental inequities compound the problem of maternal health inequities, and have given rise to the environmental justice movement.  The International Federation of Gynecology and Obstetrics and other major medical societies have worked to heighten awareness and address the deleterious health effects of climate change and toxic environmental exposures. As part of routine prenatal, neonatal, and pediatric care, neonatal-perinatal care providers should incorporate discussions with their patients and families on potential harms and also identify actions to mitigate climate change effects on their health. This article provides clinicians with an overview of how climate change affects their patients, practical guidance in caring for them, and a frame setting of the articles to follow. Clinicians have a critical role to play, and the time to act is now.

Multidisciplinary care of the pregnant patient with or at risk for venous thromboembolism: a recommended toolkit from the Foundation for Women and Girls with Blood Disorders Thrombosis Subcommittee.

The care of pregnant persons with/at risk of venous thromboembolism is complex and often challenging. Although guidelines have been published regarding the use of specific therapies, such as anticoagulants; in this population, none have provided guidance on how to coordinate multidisciplinary care of these patients. Here we provide an expert consensus on the role of various providers in the care of this patient population, as well as necessary resources and suggestions for best practices.

Agronomic and economic implications of cover crop and phosphorus fertilizer management practices for water quality improvement.

Phosphorus (P) fertilization practices and winter cover crops are promoted to protect water quality yet can potentially influence crop yield and profitability. This study examined the impacts of three P fertilizer management practices (no P, fall broadcast P, and spring injected P) and winter annual cover crop use on yields, net returns, and water quality in a no-till corn-soybean rotation. Treatments were replicated in a 4-yr field study where sediment, total P, and dissolved reactive P (DRP) losses in edge-of-field surface runoff were continuously monitored. Production budgets were developed for each treatment and coupled with water quality data to identify optimal practices and opportunity costs for improving water quality. Applying P fertilizers increased crop yield regardless of application method or cover crop, but the response was more pronounced in corn than soybean. The cover crop reduced corn grain yield in 1 yr with high temperature and low precipitation but did not impact grain yield in the other corn year or either year of soybean. The most profitable treatment was fall broadcast P fertilizer with no cover crop, which also had the greatest total P and DRP losses and near greatest sediment loss. The lowest-cost methods of reducing total P, DRP, and sediment losses were, respectively, no P fertilizer without a cover crop ($47.56 kg-1 total P), spring injected P fertilizer without a cover crop ($56.47 kg-1 DRP), and spring injected P fertilizer with a cover crop ($0.16 kg-1 sediment). Widespread adoption of these practices will likely require monetary incentives.

Dichotomy in the definition of prescriptive information suggests both prescribed data and prescribed algorithms: biosemiotics applications in genomic systems.

The fields of molecular biology and computer science have cooperated over recent years to create a synergy between the cybernetic and biosemiotic relationship found in cellular genomics to that of information and language found in computational systems. Biological information frequently manifests its "meaning" through instruction or actual production of formal bio-function. Such information is called prescriptive information (PI). PI programs organize and execute a prescribed set of choices. Closer examination of this term in cellular systems has led to a dichotomy in its definition suggesting both prescribed data and prescribed algorithms are constituents of PI. This paper looks at this dichotomy as expressed in both the genetic code and in the central dogma of protein synthesis. An example of a genetic algorithm is modeled after the ribosome, and an examination of the protein synthesis process is used to differentiate PI data from PI algorithms.

Nationwide and Regional PM2.5-Related Air Quality Health Benefits From the Removal of Energy-Related Emissions in the United States.

Clean energy policy can provide substantial health benefits through improved air quality. As ambitious clean energy proposals are increasingly considered and adopted across the United States (US), quantifying the benefits of removal of such large air pollution emissions sources is crucial to understanding potential societal impacts of such policy. In this study, we estimate health benefits resulting from the elimination of emissions of fine particulate matter (PM2.5), sulfur dioxide, and nitrogen oxides from the electric power, transportation, building, and industrial sectors in the contiguous US. We use EPA's CO-Benefits Risk Assessment screening tool to estimate health benefits resulting from the removal of PM2.5-related emissions from these energy-related sectors. We find that nationwide efforts to eliminate energy-related emissions could prevent 53,200 (95% CI: 46,900-59,400) premature deaths each year and provide $608 billion ($537-$678 billion) in benefits from avoided PM2.5-related illness and death. We also find that an average of 69% (range: 32%-95%) of the health benefits from emissions removal remain in the emitting region. Our study provides an indication of the potential scale and distribution of public health benefits that could result from ambitious regional and nationwide clean energy and climate mitigation policy.

Craniosynostosis: Clinical Presentation, Genetics, and Prenatal Diagnosis.

IMPORTANCE: Craniosynostosis is a fetal condition caused by premature closure of the cranial sutures. Through provider awareness, we can raise suspicion in high-risk individuals, increase prenatal detection, optimize genetic testing, perform appropriate antenatal surveillance and delivery planning, and allow for a comprehensive, multidisciplinary approach to treatment. OBJECTIVE: The aim of this study was to review what is currently known regarding the genetics, pathophysiology, diagnosis, and treatment of craniosynostosis for the obstetric care provider. EVIDENCE ACQUISITION: A comprehensive literature review was performed using the PubMed database with the search term "craniosynostosis." The search was limited to the English language. RESULTS: A total of 220 articles were identified, and a total of 53 were used in completion of this article. The results highlight the multiple factors involved with abnormal suture formation, including various genetic factors. Although rare at this time, prenatal detection can allow families to prepare and practitioners to provide appropriate clinical treatment. Both 3-dimensional sonography and magnetic resonance imaging have been identified as modalities to aid in detection for high-risk individuals. Early referral allows for less-invasive surgical outcomes with lower complication rates. RESULTS: Familiarity with craniosynostosis among obstetric providers can improve patient counseling, prenatal detection rates, and appropriate antepartum, intrapartum, and postpartum counseling.

The Universal Plausibility Metric (UPM) & Principle (UPP).

BACKGROUND: Mere possibility is not an adequate basis for asserting scientific plausibility. A precisely defined universal bound is needed beyond which the assertion of plausibility, particularly in life-origin models, can be considered operationally falsified. But can something so seemingly relative and subjective as plausibility ever be quantified? Amazingly, the answer is, "Yes." A method of objectively measuring the plausibility of any chance hypothesis (The Universal Plausibility Metric [UPM]) is presented. A numerical inequality is also provided whereby any chance hypothesis can be definitively falsified when its UPM metric of xi is < 1 (The Universal Plausibility Principle [UPP]). Both UPM and UPP pre-exist and are independent of any experimental design and data set. CONCLUSION: No low-probability hypothetical plausibility assertion should survive peer-review without subjection to the UPP inequality standard of formal falsification (xi < 1).

The capabilities of chaos and complexity.

To what degree could chaos and complexity have organized a Peptide or RNA World of crude yet necessarily integrated protometabolism? How far could such protolife evolve in the absence of a heritable linear digital symbol system that could mutate, instruct, regulate, optimize and maintain metabolic homeostasis? To address these questions, chaos, complexity, self-ordered states, and organization must all be carefully defined and distinguished. In addition their cause-and-effect relationships and mechanisms of action must be delineated. Are there any formal (non physical, abstract, conceptual, algorithmic) components to chaos, complexity, self-ordering and organization, or are they entirely physicodynamic (physical, mass/energy interaction alone)? Chaos and complexity can produce some fascinating self-ordered phenomena. But can spontaneous chaos and complexity steer events and processes toward pragmatic benefit, select function over non function, optimize algorithms, integrate circuits, produce computational halting, organize processes into formal systems, control and regulate existing systems toward greater efficiency? The question is pursued of whether there might be some yet-to-be discovered new law of biology that will elucidate the derivation of prescriptive information and control. "System" will be rigorously defined. Can a low-informational rapid succession of Prigogine's dissipative structures self-order into bona fide organization?

Comparison of BD Directigen EZ RSV and Binax NOW RSV tests for rapid detection of respiratory syncytial virus from nasopharyngeal aspirates in a pediatric population.

The BD Directigen EZ RSV (BD) assay and the Binax NOW RSV (BN) assays are lateral flow immunochromatographic assays used in the rapid diagnosis of respiratory syncytial virus (RSV) infection. A prospective study was undertaken to compare the performance characteristics of the BD and BN assays using 99 fresh nasopharyngeal aspirate specimens from children. All specimens were cultured by tube cultures and R-mix shell vials. Culture-negative specimens that tested positive by 1 or both antigen tests were analyzed by reverse transcriptase polymerase chain reaction (RT-PCR) for the presence of RSV nucleic acids. Specimens positive by culture and/or RT-PCR were considered true positives. The sensitivity, specificity, positive predictive value, and negative predictive value for BD were 90%, 94%, 94%, and 90%, respectively, and those for BN were 90%, 100%, 100%, and 90% respectively. The overall agreement between the 2 assays was 93% (confidence interval, 86.3-96.6%). Three specimens negative by both assays were positive by viral culture. The rapid lateral flow immunochromatographic assays were easy to perform and easy to interpret, and the results are available in less than 30 min. The reduced turnaround time offered by these assays is particularly useful in the rapid detection of RSV infections in children from outpatient settings.

Measuring the functional sequence complexity of proteins.

BACKGROUND: Abel and Trevors have delineated three aspects of sequence complexity, Random Sequence Complexity (RSC), Ordered Sequence Complexity (OSC) and Functional Sequence Complexity (FSC) observed in biosequences such as proteins. In this paper, we provide a method to measure functional sequence complexity. METHODS AND RESULTS: We have extended Shannon uncertainty by incorporating the data variable with a functionality variable. The resulting measured unit, which we call Functional bit (Fit), is calculated from the sequence data jointly with the defined functionality variable. To demonstrate the relevance to functional bioinformatics, a method to measure functional sequence complexity was developed and applied to 35 protein families. Considerations were made in determining how the measure can be used to correlate functionality when relating to the whole molecule and sub-molecule. In the experiment, we show that when the proposed measure is applied to the aligned protein sequences of ubiquitin, 6 of the 7 highest value sites correlate with the binding domain. CONCLUSION: For future extensions, measures of functional bioinformatics may provide a means to evaluate potential evolving pathways from effects such as mutations, as well as analyzing the internal structural and functional relationships within the 3-D structure of proteins.

Early goal directed therapy for sepsis during pregnancy.

Sepsis is a leading cause of death in pregnancy and results in significant perinatal mortality. These deaths occur despite the younger age of pregnant patients, the low rate of comorbid conditions and the potential for effective interventions that should result in rapid resolution of illness. To date, no "evidence-based" recommendations are specific to the pregnant patient who is critically ill or septic. Optimal care for the septic patient requires a multidisciplinary team with expertise in obstetrics, maternal-fetal medicine, critical care, infectious disease, anesthesia, and pharmacy. Coordination of care and good communication amongst team members is essential. Incorporation of early goal directed therapy for suspected sepsis into obstetric practice is needed to optimize maternal and neonatal outcomes.

Anticoagulants in pregnancy.

UNLABELLED: Pregnancy is a hypercoagulable state that increases the risk of thromboembolic events. These risks may be further increased in the presence of an acquired or inherited thrombophilia. Thrombophilias have been associated with both maternal and fetal complications. The use of anticoagulants during pregnancy may reduce the risk of maternal thromboses as well as the risk of adverse pregnancy outcomes. The choice of an anticoagulant requires consideration of maternal risks, potential for teratogenicity, the underlying condition necessitating the treatment, and cost. This review examines the options for anticoagulation, the clinical situations that may warrant such treatment, and factors to be considered at delivery and during the postpartum period. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader should be able to describe the roles of acquired and inherited thrombophilia in furthering the hypercoagulable state of pregnancy, identify the potential consequences of using anticoagulants during pregnancy, and summarize the treatment options when anticoagulation is required during pregnancy.