The impact of regulatory changes on the providers of treatment for opioid dependence

In 2000, changes in federal law allowed physicians to receive waivers to use narcotic medications, such as buprenorphine, for treatment of opioid dependence. As of 2006, physicians have been allowed to treat up to 100 patients after spending one year at a 30-patient limit. Physicians may choose to discontinue use of buprenorphine after the patient has successfully discontinued use of the substance of abuse ( withdrawal ), or physicians can keep patients on buprenorphine indefinitely ( maintenance ). The model in this dissertation assumes that demand for treatment of opioid dependence is exogenous but that demand for maintenance treatment can be induced by the physician. Using data from quarterly surveys of physicians from 2006 to 2010, this dissertation analyzes the impact of the higher caseload limit on the number of patients and the treatment path chosen by the physician. It finds support for the conclusion that physicians treat more patients after an increase in the caseload limit. The impact is particularly strong for maintenance, suggesting that the caseload limit discourages maintenance treatment. The dissertation also finds that this effect is stronger for physicians in primary-care type specialties

Drought drove forest decline and dune building in eastern upper Michigan, USA, as the upper Great Lakes became closed basins

Current models of landscape response to Holocene climate change in midcontinent North America largely reconcile Earth orbital and atmospheric climate forcing with pollen-based forest histories on the east and eolian chronologies in Great Plains grasslands on the west. However, thousands of sand dunes spread across 12,000 km2 in eastern upper Michigan (EUM), more than 500 km east of the present forest-prairie ecotone, present a challenge to such models. We use 65 optically stimulated luminescence (OSL) ages on quartz sand deposited in silt caps (n = 8) and dunes (n = 57) to document eolian activity in EUM. Dune building was widespread ca. 10–8 ka, indicating a sharp, sustained decline in forest cover during that period. This decline was roughly coincident with hydrologic closure of the upper Great Lakes, but temporally inconsistent with most pollen-based models that imply canopy closure throughout the Holocene. Early Holocene forest openings are rarely recognized in pollen sums from EUM because faint signatures of non-arboreal pollen are largely obscured by abundant and highly mobile pine pollen. Early Holocene spikes in nonarboreal pollen are recorded in cores from small ponds, but suggest only a modest extent of forest openings. OSL dating of dune emplacement provides a direct, spatially explicit archive of greatly diminished forest cover during a very dry climate in eastern midcontinent North America ca. 10–8 ka

Nudging pro-environmental behavior: evidence and opportunities

Human actions are responsible for many of our greatest environmental challenges. Studies from the human behavioral sciences show that minor features of decision settings can have major effects on people’s choices. While such behavioral insights have positively influenced individual health and financial decisions, less is known about whether and how these insights can encourage choices that are better for the environment. We review 160 experimental interventions that attempt to alter behavior in six domains where decisions have large environmental impacts: family planning, land management, meat consumption, transportation choices, waste production, and water use. Claims that social influence (norms) and simple adjustments to automatic settings (defaults) can influence pro-environmental decisions are supported by the evidence. Yet for other interventions, knowledge gaps preclude clear conclusions and policy applications. To address these gaps, we identify four opportunities for future research and encourage collaboration between scholars and practitioners to embed tests of behavioral interventions within environmental programs.We thank the Gund Institute for Environment for their Collaboration Grant to BF which made this work possible. Thanks to the University of Vermont’s James Marsh Professor-at-Large and Burack Distinguished Lecture Series for supporting SP and AB respectively

Eliminating lead exposure from drinking water—A global call to action

Each year, approximately 900,000 people die from exposure to lead [1]. But the full impacts of lead exposure are far more insidious. Lead is a potent neurotoxin that impairs brain function and irreversibly harms children’s cognitive development. Any exposure to lead can be damaging. Recent studies estimate that 800 million children globally (approximately 1 in 3) have blood lead concentrations above 5 micrograms per deciliter and that lead exposure may be responsible for 30% of all intellectual disabilities of unknown origin [2, 3]. Lead exposure increases disease burden, estimated at over 21 million disability-adjusted life years (DALYs) yearly, primarily due to cardiovascular diseases and mental disorders. This disease burden attributed to lead has increased globally since 1990, because of population growth and aging [4]. Additional research has shown evidence of a direct dose-response relationship between children’s blood lead levels and reductions in IQ which decreases lifetime earnings [5, 6]. This makes lead a public health threat and a key environmental risk factor that exacerbates long-term inequalities affecting especially marginalized groups. Important sources of exposure include batteries, paint, food containers, drinking water systems, and leaded gasoline (now banned in all countries)

LSST: from Science Drivers to Reference Design and Anticipated Data Products

(Abridged) We describe here the most ambitious survey currently planned in the optical, the Large Synoptic Survey Telescope (LSST). A vast array of science will be enabled by a single wide-deep-fast sky survey, and LSST will have unique survey capability in the faint time domain. The LSST design is driven by four main science themes: probing dark energy and dark matter, taking an inventory of the Solar System, exploring the transient optical sky, and mapping the Milky Way. LSST will be a wide-field ground-based system sited at Cerro Pach\'{o}n in northern Chile. The telescope will have an 8.4 m (6.5 m effective) primary mirror, a 9.6 deg$^2$ field of view, and a 3.2 Gigapixel camera. The standard observing sequence will consist of pairs of 15-second exposures in a given field, with two such visits in each pointing in a given night. With these repeats, the LSST system is capable of imaging about 10,000 square degrees of sky in a single filter in three nights. The typical 5$\sigma$ point-source depth in a single visit in $r$ will be $\sim 24.5$ (AB). The project is in the construction phase and will begin regular survey operations by 2022. The survey area will be contained within 30,000 deg$^2$ with $\delta<+34.5^\circ$, and will be imaged multiple times in six bands, $ugrizy$, covering the wavelength range 320--1050 nm. About 90\% of the observing time will be devoted to a deep-wide-fast survey mode which will uniformly observe a 18,000 deg$^2$ region about 800 times (summed over all six bands) during the anticipated 10 years of operations, and yield a coadded map to $r\sim27.5$. The remaining 10\% of the observing time will be allocated to projects such as a Very Deep and Fast time domain survey. The goal is to make LSST data products, including a relational database of about 32 trillion observations of 40 billion objects, available to the public and scientists around the world.Comment: 57 pages, 32 color figures, version with high-resolution figures available from https://www.lsst.org/overvie

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure

Skinks of Oceania, New Guinea, and Eastern Wallacea: an underexplored biodiversity hotspot

© 2023 The Authors. Published by CSIRO Publishing. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1071/PC22034Context: Skinks comprise the dominant component of the terrestrial vertebrate fauna in Oceania, New Guinea, and Eastern Wallacea (ONGEW). However, knowledge of their diversity is incomplete, and their conservation needs are poorly understood. Aims: To explore the diversity and threat status of the skinks of ONGEW and identify knowledge gaps and conservation needs. Methods: We compiled a list of all skink species occurring in the region and their threat categories designated by the International Union for Conservation of Nature. We used available genetic sequences deposited in the National Center for Biotechnology Information’s GenBank to generate a phylogeny of the region’s skinks. We then assessed their diversity within geographical sub-divisions and compared to other reptile taxa in the region. Key results: Approximately 300 species of skinks occur in ONGEW, making it the second largest global hotspot of skink diversity following Australia. Many phylogenetic relationships remain unresolved, and many species and genera are in need of taxonomic revision. One in five species are threatened with extinction, a higher proportion than almost all reptile families in the region. Conclusions: ONGEW contain a large proportion of global skink diversity on <1% of the Earth’s landmass. Many are endemic and face risks such as habitat loss and invasive predators. Yet, little is known about them, and many species require taxonomic revision and threat level re-assessment. Implications: The skinks of ONGEW are a diverse yet underexplored group of terrestrial vertebrates, with many species likely facing extreme risks in the near future. Further research is needed to understand the threats they face and how to protect themDGC was supported by a grant from the Australian Research Council (FT200100108). Solomon Islands fieldwork by RMB and colleagues was supported by a grant from the US National Science Foundation (DEB-1557053). Research on New Guinea skinks by AS and colleagues, including fieldwork, was supported by Binational Science Foundation grants (2012143 to SM and AA and 002030900 to AS), a Naomi Foundation through the Tel Aviv University GRTF program grant (064181317 to AS), US National Science Foundation grants (DEB-0103794 and DEB-0743890 to FK and AA and DEB-1146033 and DEB-1926783 to CCA), and a National Geographic Explorer’s Grant (NGS-53506R-18) to CCA. RNF and JQR research in the Pacific Islands has been funded by many groups including Mohamed bin Zayed, Conservation International, Island Conservation, Wildlife Conservation Society, IUCN Oceania, SPREP, CEPF, San Diego Zoo Global, University of the South Pacific, and the U.S. Geological Survey.Published versio

The human body at cellular resolution: the NIH Human Biomolecular Atlas Program

Abstract: Transformative technologies are enabling the construction of three-dimensional maps of tissues with unprecedented spatial and molecular resolution. Over the next seven years, the NIH Common Fund Human Biomolecular Atlas Program (HuBMAP) intends to develop a widely accessible framework for comprehensively mapping the human body at single-cell resolution by supporting technology development, data acquisition, and detailed spatial mapping. HuBMAP will integrate its efforts with other funding agencies, programs, consortia, and the biomedical research community at large towards the shared vision of a comprehensive, accessible three-dimensional molecular and cellular atlas of the human body, in health and under various disease conditions