Do Interns Learn On-The-Job How to Obtain Proper Informed Consent for Surgical Procedures?

OBJECTIVE: Obtaining surgical informed consent (SIC) is a critical skill most residents are expected to learn "on-the-job." This study sought to quantify the effect of 1 year of clinical experience on performance obtaining SIC in the absence of formal informed consent education. DESIGN: In this case-control cohort study, PGY1 and PGY2 surgical residents in an academic program were surveyed regarding their experiences and confidence in obtaining SIC; then assessed obtaining informed consent for a right hemicolectomy from a standardized patient. SETTING: Single academic general surgery residency program in Buffalo, NY. PARTICIPANTS: Ten PGY1 and eight PGY2 general surgery residents were included in the study, after excluding residents with additional years of training. RESULTS: PGY2 residents had significantly more experience obtaining SIC compared to PGY1 residents (median response: ">50" vs "between 6 and 15," p = 0.001), however there was no difference in self-reported confidence in ability obtaining SIC (mean 3.2/5 in PGY1 vs 3.4/5 in PGY2, p = 0.61), self-reported knowledge of SIC (mean 3.1/5 in PGY1 vs 3.6/5 in PGY2, p = 0.15), performance on a test regarding SIC (mean score 9.0/20, SD 3.9 for PGY1 vs mean score 9.6/20, SD 3.5, t = 0.387, p = 0.739) or performance during a standardized patient interview (mean 11.2/20, SD 2.78 for PGY1 vs mean 11.4/20, SD 1.51 for PGY2, p = 0.87). In the interviews all residents addressed general risks (bleeding/infection), however both groups performed worse in addressing procedure-specific risks including anastomotic leak as risk for hemicolectomy. CONCLUSIONS: A year of clinical training between PGY1 to PGY2 did not improve performance in obtaining surgical informed consent when lacking formal education, despite self-confidence in their ability. A curriculum covering the content, delivery and assessment of informed consent should be initiated for residents upon arrival to surgical training.

Using an AI-based avatar for interviewer training at Children's Advocacy Centers: Proof of Concept.

This proof-of- concept study focused on interviewers' behaviors and perceptions when interacting with a dynamic AI child avatar alleging abuse. Professionals (N = 68) took part in a virtual reality (VR) study in which they questioned an avatar presented as a child victim of sexual or physical abuse. Of interest was how interviewers questioned the avatar, how productive the child avatar was in response, and how interviewers perceived the VR interaction. Findings suggested alignment between interviewers' virtual questioning approaches and interviewers' typical questioning behavior in real-world investigative interviews, with a diverse range of questions used to elicit disclosures from the child avatar. The avatar responded to most question types as children typically do, though more nuanced programming of the avatar's productivity in response to complex question types is needed. Participants rated the avatar positively and felt comfortable with the VR experience. Results underscored the potential of AI-based interview training as a scalable, standardized alternative to traditional methods.

Interviewing young offenders about child-on-child sexual abuse.

This study compared two versions of the NICHD Protocol for interviewing young suspected sexual offenders: the Revised Suspect Protocol (RSP) and the Standard Suspect Protocol (SSP). The RSP incorporated relevant evidence-based practices informed by research on the value of (a) effectively explaining the suspects' rights, (b) rapport building and support, and (c) appropriate questioning strategies. Interviewers using the RSP communicated the children's rights more effectively (reading them more often, checking, verifying, and correcting understanding) and provided more support. In the substantive phase, they remained supportive while recall prompts dominated the questioning. Compared to children in the SSP group, children in the RSP condition understood their rights better, were more responsive during rapport-building, and reacted to interviewer support in the substantive phase with increased responsiveness, which in turn, predicted reduced reluctance, increased emotional expression, and greater informativeness. They were also more likely to make full rather than partial confessions than children in the SSP group. Full confessions were positively predicted by the appropriate communication of legal rights, interviewer support, and reliance on open-ended prompts, thereby confirming the superiority of the RSP relative to the SSP.

Parental positive affect and negative affect in same- and different-sex parent families: no associations with parental gender and caregiving role.

Positive and negative parental affect influence developing parent-child attachment relationships, especially during infancy as well as children's social-emotional, academic, and behavioral functioning later in life. Increasingly, because both mothers and fathers can play central caregiving roles, the parenting qualities of both parents demand consideration. Therefore, this study investigated whether parental gender and caregiving role were associated with mothers' and fathers' positive affect and negative affect during interactions with their 4-month-old firstborn infant, while determining whether parenting stress, infant temperament, having a singleton/twin, and living in the Netherlands, France, or the United Kingdom were related to parental positive affect and negative affect. In all, 135 different-sex, same-sex male, and same-sex female couples (113 fathers and 157 mothers, comprising 147 primary, and 123 secondary caregivers) who conceived through artificial reproductive techniques were studied. The couples were videorecorded at home while in feeding, cleaning, and playing contexts to assess the levels of positive and negative parental affect. In addition, the couples completed questionnaires about their caregiving role, parenting stress, and the infants' temperament. Mixed linear models indicated that the levels of positive and negative parental affect toward the infant in all contexts were not related to parental gender, caregiving role, the interaction between parental gender and caregiving role, parenting stress, infant temperament, or singleton/twin status. However, the target parental behaviors were related to the country of origin, suggesting differences among Dutch, French, and British parents. Overall, we found no evidence that gender or caregiving roles were associated with the levels of positive and negative affect shown by the parents.

Do stimulation and support in the early childhood home environment and best friendship quality in adolescence predict adult personality?

BACKGROUND: The aim of this study was to determine whether stimulation and support in early childhood and best friendship quality in adolescence predict adult personality. PARTICIPANTS AND PROCEDURE: We used data from 123 individuals from an ongoing longitudinal study, with multiple assessment phases and modalities (observation, parental rating, self-report) to investigate prospective associations between stimulation and support in the home in early childhood (age 1-2), best friendship quality in adolescence (age 15), and the Big Five personality traits in adulthood (age 29) controlling for temperament, socioeconomic status (SES), and gender. RESULTS: After controlling for temperament, SES, and gender, we found that early childhood stimulation and support was related to adult openness to experiences, but not the other four traits, and that best friendship quality in adolescence was related to adult extraversion and agreeableness, but not conscientiousness, neuroticism, or openness to experiences. CONCLUSIONS: The study contributes to research indicating that while personalities are relatively stable, they are not fixed at an early age and may be related to experiences and salient relationships throughout development. There is a dearth of research investigating such associations and the available findings are inconsistent. Conclusions about the relations between experiences such as stimulation and support in the home in early childhood or best friendship quality in adolescence and adult personality should thus be viewed skeptically until replicated.

Increasing prevalence of designer benzodiazepines in impaired driving: A 5-year analysis from 2017 to 2021.

Designer benzodiazepine (DBZD) use has been increasing over the past decade and poses a threat to human health and safety, particularly when involved in driving under the influence of drug (DUID) cases. Over a 5-year period between 2017 and 2021, there were 1,145 reported DBZDs in 805 blood samples submitted from law enforcement agencies for DUID testing. Eleven different DBZDs were detected, including three metabolite pairs: etizolam/alpha-hydroxyetizolam, clonazolam/8-aminoclonazolam, diclazepam/delorazepam, flualprazolam, flubromazolam, flubromazepam, bromazolam and bromazepam. Etizolam/alpha-hydroxyetizolam (n = 485) and flualprazolam (n = 149) were the most frequently detected DBZDs, at 60% and 18%, respectively. Driving behavior, standardized field sobriety test performance and physical observations of individuals suspected of DUIDs, whose blood sample was toxicologically confirmed for one or more DBZDs, were consistent with the effects caused by central nervous system depressants. Each DBZD has its own unique timeline, and toxicology testing had to be frequently updated to reflect the state of the novel psychoactive substance market. DBZDs play a role in impaired driving and can be the sole intoxicant in DUID cases.

N,N-Dimethylpentylone (dipentylone)-A new synthetic cathinone identified in a postmortem forensic toxicology case series.

Synthetic cathinones emerged on the novel psychoactive substance (NPS) drug market as alternatives to controlled stimulants and entactogens such as methamphetamine and 3,4-methylenedioxymethamphetamine. The majority of synthetic cathinones can be subclassified into two groups: beta-keto amphetamines (i.e., NPS with the suffix "drone") and beta-keto methylenedioxyamphetamines (i.e., NPS with the suffix "lone"). Although a significant number of beta-keto amphetamines have been identified, beta-keto methylenedioxyamphetamines have dominated the NPS market, including notable drugs like methylone, butylone, N-ethyl pentylone (ephylone), eutylone and now N,N-dimethylpentylone. N,N-Dimethylpentylone, also known as dipentylone or beta-keto-dimethylbenzodioxolylpentanamine, emerged into the illicit drug supply <2 months of the international control of eutylone (September 2021). A novel standard addition method was developed and validated for N,N-dimethylpentylone, pentylone and eutylone, and 18 postmortem cases were quantitated using the method described in this manuscript. The resulting blood concentration range for N,N-dimethylpentylone in this case series was 3.3 to 970 ng/mL (median: 145 ng/mL, mean: 277 ± 283 ng/mL). Pentylone, a metabolite of N,N-dimethylpentylone, was detected in all cases (range: 1.3-420 ng/mL, median: 31 ng/mL and mean: 88 ± 127 ng/mL). Due to the rise in identifications of N,N-dimethylpentylone in postmortem investigations as well as the potential misidentification of N,N-dimethylpentylone as N-ethyl pentylone, samples testing positive for pentylone should be additionally confirmed for the presence of N,N-dimethylpentylone. Based on prior trends of new synthetic cathinones, it can be theorized that N,N-dimethylpentylone may predominate the US synthetic stimulant market for the next 1-2 years; however, given the emergence of additional closely related isomeric compounds, it is important to utilize methodology capable of differentiating N,N-dimethylpentylone from its isomers (N-isopropylbutylone, N-ethyl pentylone, N-ethyl N-methyl butylone, hexylone, N-propylbutylone, diethylone and tertylone).

Nonverbal Emotions While Disclosing Child Abuse: The Role of Interviewer Support.

Statements by alleged victims are important when child abuse is prosecuted; triers-of-fact often attend to nonverbal emotional expressions when evaluating those statements. This study examined the associations among interviewer supportiveness, children's nonverbal emotions, and informativeness during 100 forensic interviews with alleged victims of child abuse. Raters coded the silent videotapes for children's nonverbal emotional expressions while other raters coded the transcripts for interviewer support, children's verbal emotions, and informativeness. Results showed that children's nonverbal signals were more common than and preceded the verbal signs. Interviewer support was associated with children's expressivity. When children expressed more nonverbal emotions, they were more responsive during the pre-substantive phases and more informative about the abuse. Nonverbal emotions partially mediated the association between support and informativeness. The findings underline the value of nonverbal emotional expression during forensic interviews and demonstrate how the interviewers' supportive demeanor can facilitate children's emotional displays and increase informativeness.

Digital temperance: adapting an ancient virtue for a technological age.

In technological societies where excessive screen use and internet addiction are becoming constant temptations, the valuable yet intoxicating pleasures of digital technology suggest a need to recover and repurpose temperance, a virtue emphasized by ancient and medieval philosophers. This article reconstructs this virtue for our technological age by reclaiming the most relevant features of Aristotle's and Aquinas's accounts and suggesting five critical revisions needed to adapt the virtue for a contemporary context. The article then draws on this critical interpretation, along with empirical research analyzing the value and dangers of digital technology, to construct a normative account of digital temperance, a virtue that finds a mean between "digital insensibility," the vice of deficiency, and "digital overindulgence," the vice of excess. We conclude by showing how this virtue of digital temperance can help to promote human flourishing in a world saturated with tempting technology.

More extensive land loss expected on coastal deltas due to rivers jumping course during sea-level rise.

River deltas are home to hundreds of millions of people worldwide and are in danger of sinking due to anthropogenic sea-level rise, land subsidence, and reduced sediment supply. Land loss is commonly forecast by averaging river sediment supply across the entire delta plain to assess whether deposition can keep pace with sea-level rise. However, land loss and deposition vary across the landscape because rivers periodically jump course, rerouting sediment to distinct subregions called delta lobes. Here, we developed a model to forecast land loss that resolves delta lobes and tested the model against a scaled laboratory experiment. Both the model and the experiment show that rivers build land on the active lobe, but the delta incurs gradual land loss on inactive lobes that are cut off from sediment after the river abandons course. The result is a band of terrain along the coast that is usually drowned but is nonetheless a sink for sediment when the lobe is active, leaving less of the total sediment supply available to maintain persistent dry land. Land loss is expected to be more extensive than predicted by classical delta-plain-averaged models. Estimates for eight large deltas worldwide suggest that roughly half of the riverine sediment supply is delivered to terrain that undergoes long periods of submergence. These results draw the sustainability of deltas further into question and provide a framework to plan engineered diversions at a pace that will mitigate land loss in the face of rising sea levels.

Orbital and In-Situ Investigation of Periodic Bedrock Ridges in Glen Torridon, Gale Crater, Mars.

Gale crater, the field site for NASA's Mars Science Laboratory Curiosity rover, contains a diverse and extensive record of aeolian deposition and erosion. This study focuses on a series of regularly spaced, curvilinear, and sometimes branching bedrock ridges that occur within the Glen Torridon region on the lower northwest flank of Aeolis Mons, the central mound within Gale crater. During Curiosity's exploration of Glen Torridon between sols ∼2300-3080, the rover drove through this field of ridges, providing the opportunity for in situ observation of these features. This study uses orbiter and rover data to characterize ridge morphology, spatial distribution, compositional and material properties, and association with other aeolian features in the area. Based on these observations, we find that the Glen Torridon ridges are consistent with an origin as wind-eroded bedrock ridges, carved during the exhumation of Mount Sharp. Erosional features like the Glen Torridon ridges observed elsewhere on Mars, termed periodic bedrock ridges (PBRs), have been interpreted to form transverse to the dominant wind direction. The size and morphology of the Glen Torridon PBRs are consistent with transverse formative winds, but the orientation of nearby aeolian bedforms and bedrock erosional features raise the possibility of PBR formation by a net northeasterly wind regime. Although several formation models for the Glen Torridon PBRs are still under consideration, and questions persist about the nature of PBR-forming paleowinds, the presence of PBRs at this site provides important constraints on the depositional and erosional history of Gale crater.

Amplification of downstream flood stage due to damming of fine-grained rivers.

River dams provide many benefits, including flood control. However, due to constantly evolving channel morphology, downstream conveyance of floodwaters following dam closure is difficult to predict. Here, we test the hypothesis that the incised, enlarged channel downstream of dams provides enhanced water conveyance, using a case study from the lower Yellow River, China. We find that, although flood stage is lowered for small floods, counterintuitively, flood stage downstream of a dam can be amplified for moderate and large floods. This arises because bed incision is accompanied by sediment coarsening, which facilitates development of large dunes that increase flow resistance and reduce velocity relative to pre-dam conditions. Our findings indicate the underlying mechanism for such flood amplification may occur in >80% of fine-grained rivers, and suggest the need to reconsider flood control strategies in such rivers worldwide.

Where rivers jump course.

Rivers can abruptly shift pathways in rare events called avulsions, which cause devastating floods. The controls on avulsion locations are poorly understood as a result of sparse data on such features. We analyzed nearly 50 years of satellite imagery and documented 113 avulsions across the globe that indicate three distinct controls on avulsion location. Avulsions on fans coincide with valley-confinement change, whereas avulsions on deltas are primarily clustered within the backwater zone, indicating a control by spatial flow deceleration or acceleration during floods. However, 38% of avulsions on deltas occurred upstream of backwater effects. These events occurred in steep, sediment-rich rivers in tropical and desert environments. Our results indicate that avulsion location on deltas is set by the upstream extent of flood-driven erosion, which is typically limited to the backwater zone but can extend far upstream in steep, sediment-laden rivers. Our findings elucidate how avulsion hazards might respond to land use and climate change.

Emotional valence and the types of information provided by children in forensic interviews.

BACKGROUND: Emotions can powerfully affect memory retrieval although this effect has seldom been studied in everyday contexts. OBJECTIVE: This study aimed to explore the association between children's verbal emotional expressions and the type of information reported during forensic interviews. PARTICIPANTS AND SETTING: The sample included 198 interviews with 4- to 14-year-old (M = 9.36, SD = 2.37) alleged victims of repeated physical abuse perpetrated by family members conducted using the Revised NICHD Protocol which emphasizes a supportive interviewing style. METHODS: Interview videos were transcribed and each conversational turn was coded to reflect the amount and type of children's verbal emotional expressions, forensic information provided, interviewers' demeanor, and type of question asked. RESULTS: The verbal expression of negative emotions was positively associated with the production of more central details (ß = 0.29, SE = 0.05, p < 0.001) and peripheral details (ß = 0.66, SE = 0.07, p < 0.001), while the verbal expression of positive emotions was correlated with peripheral details (ß = 0.29, SE = 0.15, p = 0.047). The verbal expression of negative emotions was associated with the production of more specific details (ß = 0.73, SE = 0.06, p < 0.001]) and less generic information (ß = -0.39, SE = 0.18, p = 0.029) whereas positive emotions were associated only with increased specific information (ß = 0.28, SE = 0.12, p = 0.025). CONCLUSIONS: These findings highlight how emotional expression, especially of negative emotions, enhances the quantity and quality of children's reports in forensic contexts.

Glacial isostatic adjustment directed incision of the Channeled Scabland by Ice Age megafloods.

During the last deglaciation, dozens of glacial outburst floods-among the largest known floods on Earth-scoured the Channeled Scabland landscape of eastern Washington. Over this same period, deformation of the Earth's crust in response to the growth and decay of ice sheets changed the topography by hundreds of meters. Here, we investigated whether glacial isostatic adjustment affected routing of the Missoula floods and incision of the Channeled Scabland from an impounded, glacial Lake Columbia. We used modern topography corrected for glacial isostatic adjustment as an input to flood models that solved the depth-averaged, shallow water equations and compared the results to erosion constraints. Results showed that floods could have traversed and eroded parts of two major tracts of the Channeled Scabland-Telford-Crab Creek and Cheney-Palouse-near 18 ka, whereas glacial isostatic adjustment limited flow into the Cheney-Palouse tract at 15.5 ka. Partitioning of flow between tracts was governed by tilting of the landscape, which affected the filling and overspill of glacial Lake Columbia directly upstream of the tracts. These results highlight the impact of glacial isostatic adjustment on megaflood routing and landscape evolution.

Within family patterns of relative parental involvement across two generations of Swedish parents.

This prospective longitudinal study investigated father involvement relative to mother involvement in parent dyads across two generations from the same family. Relative parental involvement was operationalized using measures of how much parents shared parenting responsibilities and to whom their children turned preferentially in various situations. We hypothesized mean level increases towards more equal involvement for fathers and mothers across generations as well as intergenerational continuity of within-family patterns for both aspects of parental involvement. The longitudinal study involved 144 families and their first-born children, followed since 1982. The analyses involved the families of the 74 children who were parents themselves by age 33. Father involvement was lower than mother involvement in both generations. Results revealed mean level changes towards more equal sharing of responsibilities in the second generation, but no intergenerational changes in the likelihood that children would be more likely to turn to their fathers in various situations. There was intergenerational continuity within families in child preferences but not in the sharing of responsibilities. Together these findings imply that child preferences are related to within-family influences whereas other factors affect parents' sharing of responsibilities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A Novel Collaborative Care Program to Augment Nursing Home Care During and After the COVID-19 Pandemic.

The 2019 novel coronavirus (COVID-19) pandemic created an immediate need to enhance current efforts to reduce transfers of nursing home (NH) residents to acute care. Long-Term Care Plus (LTC+), a collaborative care program developed and implemented during the COVID-19 pandemic, aimed to enhance care in the NH setting while also decreasing unnecessary acute care transfers. Using a hub-and-spoke model, LTC+ was implemented in 6 hospitals serving as central hubs to 54 geographically associated NHs with 9574 beds in Toronto, Canada. LTC+ provided NHs with the following: (1) virtual general internal medicine (GIM) consultations; (2) nursing navigator support; (3) rapid access to laboratory and diagnostic imaging services; and (4) educational resources. From April 2020 to June 2021, LTC+ provided 381 GIM consultations that addressed abnormal bloodwork (15%), cardiac problems (13%), and unexplained fever (11%) as the most common reasons for consultation. Sixty-five nurse navigator calls addressed requests for non-GIM specialist consultations (34%), wound care assessments (14%), and system navigation (12%). One hundred seventy-seven (46%, 95% CI 41%-52%) consults addressed care concerns sufficiently to avoid the need for acute care transfer. All 36 primary care physicians who consulted the LTC+ program reported strong satisfaction with the advice provided. Early results demonstrate the feasibility and acceptability of an integrated care model that enhances care delivery for NH residents where they reside and has the potential to positively impact the long-term care sector by ensuring equitable and timely access to care for people living in NHs. It represents an important step toward health system integration that values the expertise within the long-term care sector.

Impact of River Channel Lateral Migration on Microbial Communities across a Discontinuous Permafrost Floodplain.

Permafrost soils store approximately twice the amount of carbon currently present in Earth's atmosphere and are acutely impacted by climate change due to the polar amplification of increasing global temperature. Many organic-rich permafrost sediments are located on large river floodplains, where river channel migration periodically erodes and redeposits the upper tens of meters of sediment. Channel migration exerts a first-order control on the geographic distribution of permafrost and floodplain stratigraphy and thus may affect microbial habitats. To examine how river channel migration in discontinuous permafrost environments affects microbial community composition, we used amplicon sequencing of the 16S rRNA gene on sediment samples from floodplain cores and exposed riverbanks along the Koyukuk River, a large tributary of the Yukon River in west-central Alaska. Microbial communities are sensitive to permafrost thaw: communities found in deep samples thawed by the river closely resembled near-surface active-layer communities in nonmetric multidimensional scaling analyses but did not resemble floodplain permafrost communities at the same depth. Microbial communities also displayed lower diversity and evenness in permafrost than in both the active layer and permafrost-free point bars recently deposited by river channel migration. Taxonomic assignments based on 16S and quantitative PCR for the methyl coenzyme M reductase functional gene demonstrated that methanogens and methanotrophs are abundant in older permafrost-bearing deposits but not in younger, nonpermafrost point bar deposits. The results suggested that river migration, which regulates the distribution of permafrost, also modulates the distribution of microbes potentially capable of producing and consuming methane on the Koyukuk River floodplain. IMPORTANCE Arctic lowlands contain large quantities of soil organic carbon that is currently sequestered in permafrost. With rising temperatures, permafrost thaw may allow this carbon to be consumed by microbial communities and released to the atmosphere as carbon dioxide or methane. We used gene sequencing to determine the microbial communities present in the floodplain of a river running through discontinuous permafrost. We found that the river's lateral movement across its floodplain influences the occurrence of certain microbial communities-in particular, methane-cycling microbes were present on the older, permafrost-bearing eroding riverbank but absent on the newly deposited river bars. Riverbank sediment had microbial communities more similar to those of the floodplain active-layer samples than permafrost samples from the same depth. Therefore, spatial patterns of river migration influence the distribution of microbial taxa relevant to the warming Arctic climate.

Infants' stress responses and protest behaviors at childcare entry and the role of care providers.

During the transition from home to childcare, 70 15-month-old infants were videotaped, and their negative emotions were rated. Infants' attachments to mothers were assessed prior to child care entry and to care providers five months later using the Strange Situation Procedure (SSP). Infant heart rate was monitored at home, during adaptation to childcare (mothers present), and during subsequent separations. Respiratory sinus arrhythmia (RSA) was computed from the beat-to-beat measures of heart rate to reflect vagal tone, which is reduced during chronic states of stress, and was collected upon Arrival, during in-group Play, and when in the Group more generally. All infants responded to childcare entry with low RSA levels indicating stress. However, during adaptation with the mother present, RSA was higher for securely attached infants. On the first separation day, 35.3% of the infants fussed and cried extensively. These intense protests predicted later secure attachments to care providers, which adaptively helped to reduce stress, especially in infants who protested extensively, as if summoning their mothers back. Because extensive protest suggests limited regulatory capacities, infants risk overburdening the stress system when left unsupported.

Coal fly ash is a major carbon flux in the Chang Jiang (Yangtze River) basin.

Fly ash-the residuum of coal burning-contains a considerable amount of fossilized particulate organic carbon (FOCash) that remains after high-temperature combustion. Fly ash leaks into natural environments and participates in the contemporary carbon cycle, but its reactivity and flux remained poorly understood. We characterized FOCash in the Chang Jiang (Yangtze River) basin, China, and quantified the riverine FOCash fluxes. Using Raman spectral analysis, ramped pyrolysis oxidation, and chemical oxidation, we found that FOCash is highly recalcitrant and unreactive, whereas shale-derived FOC (FOCrock) was much more labile and easily oxidized. By combining mass balance calculations and other estimates of fly ash input to rivers, we estimated that the flux of FOCash carried by the Chang Jiang was 0.21 to 0.42 Mt C⋅y-1 in 2007 to 2008-an amount equivalent to 37 to 72% of the total riverine FOC export. We attributed such high flux to the combination of increasing coal combustion that enhances FOCash production and the massive construction of dams in the basin that reduces the flux of FOCrock eroded from upstream mountainous areas. Using global ash data, a first-order estimate suggests that FOCash makes up to 16% of the present-day global riverine FOC flux to the oceans. This reflects a substantial impact of anthropogenic activities on the fluxes and burial of fossil organic carbon that has been made less reactive than the rocks from which it was derived.