Decreased air quality shows minimal influence on peak summer attendance at forested Pacific West national parks.

Wildfires are increasing in duration and intensity across the United States' Pacific West region, resulting in heightened particulate matter from smoke in the atmosphere. Levels of peak particulate matter are concurrent to peak visitor attendance at National Parks, given seasonal alignment with summer vacation travel and heightened forest fire conditions. Particulate matter threatens visitor health and safety and contributes to poor visibility and a deteriorated visitor experience. To assess visitation response to diminished air quality, we utilized wildfire-generated particulate matter (PM2.5) data in conjunction with monthly attendance records for three ecoregions containing eight national parks in Washington, Oregon, and California from 2009 to 2019. We analyzed daily PM2.5 levels from data gridded at the 10 km scale for National Park Service units by Level III forest ecoregions within the National Park Service's Pacific West Unit. Data were then compared to normalized monthly visitation trends for each of the ecoregions using two statistical methods Kendall's Tau and Analysis of Variance (ANOVA) with post-hoc Tukey tests. Results demonstrate that attendance at these national parks does not decrease in response to increased PM2.5 levels. Instead, we see several statistically significant increases in attendance across these ecoregions during periods of reduced air quality. Of 115 shifts between air quality categories during the busy season of July to September, there are no significant decreases in attendance as air quality worsens. These findings suggest that visitors are willing to tolerate reduced air quality compared to other factors such as temperature or precipitation. Given that park units within each ecoregion feature diverse historical contexts, varied built environments, and unique ecological systems, our discussion specifically addresses managerial concerns associated with maintained high levels of visitation during suboptimal, and potentially dangerous, conditions. There is substantial need for specific, scalable approaches to mitigate adverse health and experiential impacts as visitors are exposed to increased risks during a range of exertional activities associated with diverse settings.

Sense of Place and Perceived Impacts in the Rural Industrialized Nexus: Insights for Sustainability Pathways.

As representative of the water-energy-food nexus, fossil fuel development and industrial agriculture are rural industries that continue to expand and increasingly occur in the same areas. Being a top agricultural export county and the fossil fuel capital of California while ranking among the worst in the US for industrial pollution, Kern County is a poster child of rural nexus development and, thus, an essential place for initiating sustainability transitions. Such transitions rely on policy support and the adoption of methods by individuals and communities who may disagree with such changes. While sense of place and impact perceptions are recognized as playing critical roles in sustainability management, they have yet to be utilized in nexus research. A survey (N = 256) of the perceived impacts of nexus industries with place meaning and place attachment as possible drivers for perceptions was conducted in nexus industry pollution exposure risk zones. Factor analysis and bivariate correlations showed that place meaning and place attachment are drivers for perceptions while also being drivers for concern for changes in nexus industries. While perceptions of impacts indicated contested place meanings, participants strongly perceive the economy and environment as being in decline. To build support for sustainability policy, directing funds from Kern County's renewable energy industry to local sectors of society, implementation of regenerative agriculture, cooperative management, and nurturing place meaning as aligned with nature's restorative quality are important paths forward. These nexus management foci could strengthen place attachment, build trust in government, and repair environmental alienation.

Research alignment in the U.S. national park system: Impact of transformative science policy on the supply and demand for scientific knowledge for protected area management.

The US National Park System encompasses diverse environmental and tourism management regimes, together governed by the 1916 Organic Act and its dual mandate of conservation and provision of public enjoyment. However, with the introduction of transformative science policy in the 2000's, the mission scope has since expanded to promote overarching science-based objectives. Yet despite this paradigm shift instituting "science for parks, parks for science", there is scant research exploring the impact of the National Park Science Policy on the provision of knowledge. We address this gap by developing a spatiotemporal framework for evaluating research alignment, here operationalized via quantifiable measures of supply and demand for scientific knowledge. Specifically, we apply a machine learning algorithm (Latent Dirichlet analysis) to a comprehensive park-specific text corpus (combining official needs statements -i.e. demand- and scientific research metadata -i.e. supply-) to define a joint topic space, which thereby facilitates quantifying the direction and degree of alignment at multiple levels. Results indicate an overall robust degree of research alignment, with misaligned topics tending to be over-researched (as opposed to over-demanded), which may be favorable to many parks, but is inefficient from the park system perspective. Results further indicate that the transformative science policy exacerbated the misalignment in mandated research domains. In light of these results, we argue for improved decision support mechanisms to achieve more timely alignment of research efforts towards distinctive park needs, thereby fostering convergent knowledge co-production and leveraging the full value of National Parks as living laboratories.

Association of Academic Physiatrists Residency and Fellowship Program Directors' Resident Recruitment Subcouncil Position Paper on Residency Recruitment.

ABSTRACT: Residency recruitment practices have undergone significant changes in the last several years. Interviews are now conducted fully virtually leading to both positive and negative downstream effects, including decreased cost to applicants and programs, decreased time away from clinical activities, flexibility in scheduling, and increased applications for applicants and program directors. In response to these changes, the Association of Academic Physiatrists Residency and Fellowship Program Directors Council convened a workgroup consisting of program directors, program coordinators, residents, and medical students who reviewed the available literature to provide an evidence-based set of best practices for program leaders and applicants. Available data from the Association of American Medical Colleges and its relevance to future recruitment cycles are also discussed.

Do privacy assurances work? a study of truthfulness in healthcare history data collection.

Patients often provide untruthful information about their health to avoid embarrassment, evade treatment, or prevent financial loss. Privacy disclosures (e.g. HIPAA) intended to dissuade privacy concerns may actually increase patient lying. We used new mouse tracking-based technology to detect lies through mouse movement (distance and time to response) and patient answer adjustment in an online controlled study of 611 potential patients, randomly assigned to one of six treatments. Treatments differed in the notices patients received before health information was requested, including notices about privacy, benefits of truthful disclosure, and risks of inaccurate disclosure. Increased time or distance of device mouse movement and greater adjustment of answers indicate less truthfulness. Mouse tracking revealed a significant overall effect (p<0.001) by treatment on the time to reach their final choice. The control took the least time indicating greater truthfulness and the privacy + risk group took the longest indicating least truthfulness. Privacy, risk, and benefit disclosure statements led to greater lying. These differences were moderated by gender. Mouse tracking results largely confirmed the answer adjustment lie detection method with an overall treatment effect (p < .0001) and gender differences (p < .0001) on truthfulness. Privacy notices led to decreased patient honesty. Privacy notices should perhaps be administered well before personal health disclosure is requested to minimize patient untruthfulness. Mouse tracking and answer adjustment appear to be health care lie-detection methods to enhance optimal diagnosis and treatment.

Passive sampling and ecohydrologic modeling to investigate pesticide surface water loading in the Zollner Creek watershed, Oregon, USA.

In the U.S. Pacific Northwest and California contaminants entering surface water may harm Endangered Species Act (ESA) listed salmonid species and consequently there is ongoing concern regarding agricultural practices and resulting pesticide surface water loading may adversely impact salmonid species, their food web, and habitat. Characterizing pesticide exposure in surface water at the watershed scale and beyond is challenging due to uncertainty regarding pesticide use practices and sparse monitoring data. We report here a 2-year continuous deployment of passive sampling devices (PSDs) for monitoring of pesticides in surface water at the outflow of the Zollner Creek watershed located within the Willamette Basin, Oregon, USA. This watershed is predominately agricultural and within the geographic range of two ESA listed Pacific salmonid species. Grab and passive sampling monitoring data were used to evaluate the performance of a probabilistic application of the Soil and Water Assessment Tool (SWAT), a physically based process model which integrates institutional and local knowledge and expertise to investigate the relationship between land use practices and pesticide surface water loading at the watershed scale. SWAT estimated pesticide surface water concentrations for the pesticides chlorpyrifos and trifluralin followed temporal trend in PSD monitoring results and the 5th to 95th percentile range of estimated pesticide concentrations based on the probabilistic assessment encompassed 65-76% of the observed PSD concentrations. Evaluation of model estimates for metolachlor in surface water was challenged by insufficient publicly available grab sample monitoring data. A process to estimate pesticide surface water concentrations on biologically relevant time scales and comparison to screening level aquatic life benchmarks is presented. Additionally, model estimates were used to characterize the variance in surface water concentrations in this small hydrologically responsive watershed to determine grab sampling frequency adequate for model evaluation.

Multi- and Trans-Generational Effects on Daphnia Magna of Chlorpyrifos Exposures.

Chlorpyrifos, a broad-spectrum neurotoxic organophosphate insecticide, is subject to atmospheric and hydrolytic transport from application sites to aquatic ecosystems. Across the landscape, concentrations in surface water can vary spatially and temporally according to seasonal use practices. Standardized bioassays can provide a screening-level understanding of aquatic receptor acute and chronic toxicity. However, these bioassays do not address ecologically relevant exposure patterns that may impact fitness and survival within and across generations. The aim of the present study was to evaluate the utility of a second-tier, screening-level methodology employing Daphnia magna multi- and transgenerational bioassays spanning four generations to investigate the effect of variable chronic chlorpyrifos exposure. The multigenerational assay consisted of continuous chlorpyrifos exposure across four consecutive 21-day bioassays using progeny from the previous assay for each successive generation. In the transgenerational assay, only the parent (F0) generation was exposed. For both assays, survival and reproduction were assessed across treatments and generations. Results indicated that (1) following continuous chlorpyrifos exposure at ecologically relevant concentrations to four generations of D. magna, the highest treatment showed an apparent tolerance response for both survival and reproductive success in the F3 generation, and (2) chlorpyrifos exposure to the F0 generation did not result in treatment effects in the unexposed F1, F2, and F3 generations in the apical endpoints of survival and reproduction. Employing a suite of acute and chronic bioassays, including chronic exposures spanning multiple generations, allows for a more robust screening-level evaluation of the potential impact of chlorpyrifos on aquatic receptors for variable periods of exposure. Environ Toxicol Chem 2022;41:1054-1065. © 2021 SETAC.

Neurotoxicity of chlorpyrifos and chlorpyrifos-oxon to Daphnia magna.

Chlorpyrifos (CPF) is a widely used broad-spectrum organophosphate insecticide. CPF elicits neurotoxic effects in exposed organisms by inhibiting the activity of acetylcholinesterase enzymes (AChE), which prolongs nerve transmission and results in neurotoxic symptoms and death at high doses. While CPF is capable of eliciting neurotoxic effects, chlorpyrifos-oxon (CPFO) is the primary neurotoxicant agent. Aquatic organisms bioactivate CPF to CPFO through the Cytochrome P450 phase I metabolic pathway following exposure to CPF. Additionally, in the environment, CPF transforms to CPFO, primarily through photo-oxidation. As both compounds can be transported in air and water to aquatic ecosystems, there is the potential for exposure to non-target organisms. The potential for adverse impacts on aquatic receptors depends on patterns of exposure and toxicity of individual compounds and the mixture. To study the neurotoxicity of these compounds, a 48 h acute and 21 d chronic Daphnia magna bioassay was conducted independently with CPF and CPFO. Acute bioassay results show a median lethal concentration (LC50) of 0.76 µg L-1 for CPF and 0.32 µg L-1 for CPFO, suggesting that CPFO is 2.4 times more acutely toxic to D. magna. Acute assay results were also used to derive Benchmark Dose Levels of 0.58 µg L-1 for CPF and 0.25 µg L-1 for CPFO. However, neither compound elicited an effect on reproduction or growth at relevant chronic exposures. As D. magna are a small and relatively sensitive species, and the AChE inhibition adverse outcome pathway is highly conserved, these results may be cautiously extrapolated in assessing adverse impacts on aquatic receptors.1.

Improving the Assessment of Resident Competency: Physical Medicine and Rehabilitation Milestones 2.0.

ABSTRACT: In 2015, the Accreditation Council for Graduate Medical Education published the Physical Medicine and Rehabilitation Milestones 1.0 as part of the Next Accreditation System. This was the culmination of more than 20 yrs of work on the part of the Accreditation Council for Graduate Medical Education to improve graduate medical education competency assessments. The six core competencies were patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. While providing a good foundation for resident assessment, the Physical Medicine and Rehabilitation Milestones 1.0 was not without faults. With input from program directors, national organizations, and the public, the Physical Medicine and Rehabilitation Milestones 2.0 strives to further advance resident assessment, providing improvements through the integration of the harmonized Milestones and the addition of a supplemental guide.

Repetition of Computer Security Warnings Results in Differential Repetition Suppression Effects as Revealed With Functional MRI.

Computer users are often the last line of defense in computer security. However, with repeated exposures to system messages and computer security warnings, neural and behavioral responses show evidence of habituation. Habituation has been demonstrated at a neural level as repetition suppression where responses are attenuated with subsequent repetitions. In the brain, repetition suppression to visual stimuli has been demonstrated in multiple cortical areas, including the occipital lobe and medial temporal lobe. Prior research into the repetition suppression effect has generally focused on a single repetition and has not examined the pattern of signal suppression with repeated exposures. We used complex, everyday stimuli, in the form of images of computer programs or security warning messages, to examine the repetition suppression effect across repeated exposures. The use of computer warnings as stimuli also allowed us to examine the activation of learned fearful stimuli. We observed widespread linear decreases in activation with repeated exposures, suggesting that repetition suppression continues after the first repetition. Further, we found greater activation for warning messages compared to neutral images in the anterior insula, pre-supplemental motor area, and inferior frontal gyrus, suggesting differential processing of security warning messages. However, the repetition suppression effect was similar in these regions for both warning messages and neutral images. Additionally, we observed an increase of activation in the default mode network with repeated exposures, suggestive of increased mind wandering with continuing habituation.

A Systems Approach to Modeling Watershed Ecohydrology and Pesticide Transport.

Nonpoint-source pollutant surface water loading from agricultural lands, including sediment, nutrients, and pesticides, is a major concern. As contaminants entering surface water may harm endangered species, there is ongoing concern regarding the compliance of agricultural practices with the Endangered Species Act (ESA). Compliance with the ESA for the protection of threatened salmonid species is of particular concern in the Pacific Northwest region of the United States. We report here use of the Soil and Water Assessment Tool (SWAT) to characterize ecohydrology and solute transport in the Zollner Creek watershed, Willamette River basin, Oregon. Using a systems approach, integrating institutional expertise with local knowledge, we evaluated a succession of parameterization scenarios designed to sufficiently simulate watershed ecohydrology. The model was further evaluated through simulation of solute transport. Using probabilistic methods to characterize pesticide application patterns, SWAT concurrent mean estimates of daily atrazine surface water concentrations were correlated with observed instantaneous grab samples ( = 0.37) and followed the general trend of the observed data near the watershed outlet. Further development of this modeling application may provide a new understanding of continuous pesticide surface water loading at the watershed scale, allowing assessment of environmental impacts with much greater certainty, thereby facilitating consideration of refined mitigation strategies.

Critical Care of Pet Birds.

Successful care of the critical pet bird patient is dependent on preparation and planning and begins with the veterinarian and hospital staff. An understanding of avian physiology and pathophysiology is key. Physical preparation of the hospital or clinic includes proper equipment and understanding of the procedures necessary to provide therapeutic and supportive care to the avian patient. An overview of patient intake and assessment, intensive care environment, and fluid therapy is included.

DR-TAMAS: Diffeomorphic Registration for Tensor Accurate Alignment of Anatomical Structures.

In this work, we propose DR-TAMAS (Diffeomorphic Registration for Tensor Accurate alignMent of Anatomical Structures), a novel framework for intersubject registration of Diffusion Tensor Imaging (DTI) data sets. This framework is optimized for brain data and its main goal is to achieve an accurate alignment of all brain structures, including white matter (WM), gray matter (GM), and spaces containing cerebrospinal fluid (CSF). Currently most DTI-based spatial normalization algorithms emphasize alignment of anisotropic structures. While some diffusion-derived metrics, such as diffusion anisotropy and tensor eigenvector orientation, are highly informative for proper alignment of WM, other tensor metrics such as the trace or mean diffusivity (MD) are fundamental for a proper alignment of GM and CSF boundaries. Moreover, it is desirable to include information from structural MRI data, e.g., T1-weighted or T2-weighted images, which are usually available together with the diffusion data. The fundamental property of DR-TAMAS is to achieve global anatomical accuracy by incorporating in its cost function the most informative metrics locally. Another important feature of DR-TAMAS is a symmetric time-varying velocity-based transformation model, which enables it to account for potentially large anatomical variability in healthy subjects and patients. The performance of DR-TAMAS is evaluated with several data sets and compared with other widely-used diffeomorphic image registration techniques employing both full tensor information and/or DTI-derived scalar maps. Our results show that the proposed method has excellent overall performance in the entire brain, while being equivalent to the best existing methods in WM.

Developing Global Leaders for Research, Regulation, and Stewardship of Crop Protection Chemistry in the 21st Century.

To provide sufficient food and fiber to the increasing global population, the technologies associated with crop protection are growing ever more sophisticated but, at the same time, societal expectations for the safe use of crop protection chemistry tools are also increasing. The goal of this perspective is to highlight the key issues that face future leaders in crop protection, based on presentations made during a symposium titled "Developing Global Leaders for Research, Regulation and Stewardship of Crop Protection Chemistry in the 21st Century", held in conjunction with the IUPAC 13th International Congress of Pesticide Chemistry in San Francisco, CA, USA, during August 2014. The presentations highlighted the fact that leaders in crop protection must have a good basic scientific training and understand new and evolving technologies, are aware of the needs of both developed and developing countries, and have good communication skills. Concern is expressed over the apparent lack of resources to meet these needs, and ideas are put forward to remedy these deficiencies.

C8 myotome herpes zoster paresis.

Herpes zoster (HZ) infection is a reactivation of latent varicella zoster virus that causes pain and a rash in a dermatomal distribution. Previous reports suggest that 0.5-5% of HZ infections are associated with a myotomal paresis but the incidence may actually be much higher. We present a patient with HZ infection who had persistent right upper extremity weakness after resolution of the rash. Electrodiagnostic studies demonstrated decreased amplitudes in the median and ulnar nerves as well as denervation in the right C8 myotome. Repeat studies showed interval C8 reinnervation as well as normal nerve conduction studies.

Capturing significant events with neural networks.

Smartphone video capture and transmission to the Web contributes to data pollution. In contrast, mammalian eyes sense all, capture only significant events, allowing us vividly recall the causalities. Likewise in our videos, we wish to skip redundancies and keep only significantly differences, as determined by real-time local medium filters. We construct a Picture Index (PI) of one's (center of gravity changes) among zeros (no changes) as Motion Organized Sparseness (MOS). Only non-overlapping time-ordered PI pair is admitted in the outer-product Associative Memory (AM). Another outer product between PI and its image builds Hetero-AM (HAM) for fault tolerant retrievals.

True and sham acupuncture produced similar frequency of ovulation and improved LH to FSH ratios in women with polycystic ovary syndrome.

CONTEXT: Acupuncture may represent a nonpharmaceutical treatment for women with polycystic ovary syndrome (PCOS), based on four studies. OBJECTIVE: The objective of the study was to determine whether true, as compared with sham, acupuncture normalizes pituitary gonadotropin hormones and increases ovulatory frequency in women with PCOS. DESIGN: This was a randomized, double-blind, sham-controlled clinical trial (5 month protocol). SETTING: The study was conducted in central Virginia. PARTICIPANTS: Eighty-four reproductive-aged women completed the intervention. Eligibility required a PCOS diagnosis and no hormonal intervention 60 d before enrollment. INTERVENTIONS: Intervention included 12 sessions of true or sham acupuncture (Park sham device) for 8 wk. MAIN OUTCOME MEASURES: Serum LH and FSH at baseline, after intervention, and 3 months later were measured. Ovulation was measured with weekly urine or blood samples. RESULTS: Both arms demonstrated a similar mean ovulation rate over the 5 months (0.37/month among n = 40 true acupuncture and 0.40/month among n = 44 sham participants, P = 0.6), similar LH to FSH ratio improvement (-0.5 and -0.8 true and sham, respectively, P < 0.04 after intervention vs. baseline) and a similar decline in LH over the 5-month protocol (P < 0.05). Neither arm experienced a change in FSH. There were seven pregnancies (no difference by intervention, P = 0.7). Lower fasting insulin and free testosterone were highly correlated with a higher ovulation rate within the true acupuncture group only (P = 0.03), controlling for prestudy menstrual frequency and body mass index. CONCLUSION: We were unable to discern a difference between the true and sham acupuncture protocols for these women with PCOS, and both groups had a similar improvement in their LH/FSH ratio.

Meeting the challenge of identifying persistent pollutants at the state level.

In 2007, the State of Oregon enacted legislation aimed at identifying persistent pollutants that could pose a threat to waters of the State and then reducing their discharge by means of a comprehensive pollution prevention program. This legislation defined a persistent pollutant as one that is toxic and persistent or bioaccumulative; a broad definition that required evaluation of an extensive number and variety of chemicals. The Oregon Department of Environmental Quality, in consultation with a science workgroup, implemented a 12-step process for identifying and prioritizing persistent pollutants consistent with this definition. This process is characterized by (a) maximum overall transparency in its conduct, including extensive public involvement, (b) 3 levels of objective and predefined criteria for categorization of a chemical as a persistent pollutant, (c) full disclosure of values and sources for all physicochemical data used for comparison with these criteria, and (d) clear acknowledgement when a chemical was identified as a persistent pollutant for reasons other than these criteria alone. This process was used to identify those chemicals relevant as persistent pollutants and to then prioritize them in terms of their relative ability to adversely impact waters of the state, with special emphasis on impacts to aquatic receptors. An initial list of 2130 chemicals was compiled from existing lists. Criteria for toxicity, persistence, and bioaccumulative potential were defined and then used with 2 different chemical property evaluation models (PBT Profiler and EPISuite) to produce a final list of 118 chemicals. The final list includes several legacy pollutants but also contains numerous current-use pharmaceuticals, personal care products, and pesticides, approximately half of which appear only once or not at all on lists compiled by others. Although it drew from the experience of others, assembling this list proved to be an exemplar of science in the service of policy.

Flexibility for runners.

Flexibility training, commonly referred to as stretching, has become a standard part of athletic training for nearly all sports. Athletes almost universally engage in some form of flexibility training because of the perception that it prevents injury and may enhance sports performance. With specific regard to running, controversy has arisen regarding these proposed benefits of stretching. In this article, the authors seek to define flexibility training and evaluate the evidence for its clinical benefit. They also describe the components of a general lower quarter flexibility program that they encourage their patients to follow at the University of Virginia Runner's Clinic.