Bridging the Climate Information Gap: A Framework for Engaging Knowledge Brokers and Decision Makers in State Climate Assessments

Large-scale analyses like the National Climate Assessment (NCA) contain a wealth of information critical to national and regional responses to climate change but tend to be insufficiently detailed for action at state or local levels. Many states now engage in assessment processes to meet information needs for local authorities. The goals of state climate assessments (SCAs) should be to provide relevant, actionable information to state and local authorities, and to generate primary sources, build networks and inform stakeholders. To communicate local climate impacts to decision makers, SCAs should express credibility, salience and legitimacy. They can provide information (e.g., case studies, data sets) and connect stakeholders to the NCA and its process. Based on our experience in the Vermont Climate Assessment (VCA), we present a framework to engage decision makers in SCAs using a fluid network of scientific experts and knowledge brokers to conduct subject area prioritization, data analysis and writing. The VCA addressed economic, environmental and social impacts of climate change at local scales to increase resiliency and manage risk. Knowledge brokers communicated VCA findings through their own stakeholder networks. We include a qualitative impact evaluation, and believe our framework for interaction among scientists, knowledge brokers and stakeholders to be an effective structure for SCAs and a transformative experience for students

Role of the Perigenual Anterior Cingulate and Orbitofrontal Cortex in Contingency Learning in the Marmoset.

Two learning mechanisms contribute to decision-making: goal-directed actions and the "habit" system, by which action-outcome and stimulus-response associations are formed, respectively. Rodent lesion studies and human neuroimaging have implicated both the medial prefrontal cortex (mPFC) and the orbitofrontal cortex (OFC) in the neural basis of contingency learning, a critical component of goal-directed actions, though some published findings are conflicting. We sought to reconcile the existing literature by comparing the effects of excitotoxic lesions of the perigenual anterior cingulate cortex (pgACC), a region of the mPFC, and OFC on contingency learning in the marmoset monkey using a touchscreen-based paradigm, in which the contingent relationship between one of a pair of actions and its outcome was degraded selectively. Both the pgACC and OFC lesion groups were insensitive to the contingency degradation, whereas the control group demonstrated selectively higher performance of the nondegraded action when compared with the degraded action. These findings suggest the pgACC and OFC are both necessary for normal contingency learning and therefore goal-directed behavior.This research was supported by a Programme Grant [G0901884] from the Medical Research Council UK (MRC) to ACR, and a Wellcome Trust Senior Investigator Award [104631 /Z/14/Z] to TWR. SAWJ was supported by a BCNI-MRC studentship. The authors wish to thank C. H Parkinson and R. Underwood for preparation of the histological material. T.W.R. consults for Cambridge Cognition, Lilly, Lundbeck, Teva, Shire Pharmaceuticals and Merck, Sharp and Dohme. He has received research grants from Lilly, Lundbeck and GSK. The remaining authors have no potential competing financial interests to disclose.This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/cercor/bhw06

Text2Face: 3D Morphable Faces from Text

We present the first 3D morphable modelling approach, whereby 3D face shape can be directly and completely defined using a textual prompt. Building on work in multi-modal learning, we extend the FLAME head model to a common imageand-text latent space. This allows for direct 3D Morphable Model (3DMM) parameter generation and therefore shape manipulation from textual descriptions. Our method, Text2Face, has many applications; for example: generating police photofits where the input is already in natural language. It further enables multimodal 3DMM image fitting to sketches and sculptures, as well as images

Assessment of novel gear designs to reduce interactions between species

This project tested modified gillnets designed by commercial net fishers in the Queensland East Coast Inshore Finfish Fishery (ECIFF) to try and identify gears that would mitigate and/or improve interactions between fishing nets and Species of Conservation Interest (SOCI). The study also documents previously unrecognised initiatives by pro-active commercial net fishers that reflect a conservation-minded approach to their fishing practices, which is the opposite of what is perceived publicly. Between 2011 and 2014, scientists from James Cook University and the Queensland Department of Agriculture and Fisheries teamed with commercial fishers representing the Queensland Seafood Industry Association and the Moreton Bay Seafood Industry Association to conduct field trials of various modified net designs under normal fishery conditions. Trials were conducted in Moreton Bay (southern part of the fishery) and Bowling Green Bay (northern) and tested different net designs developed by fishers to improve the nature of interactions between net fishing gear and SOCI

Inverse association between blood pressure and pulse oximetry accuracy: an observational study in patients with suspected or confirmed COVID-19 infection

BackgroundPulse oximeters are a standard non-invasive tool to measure blood oxygen levels, and are used in multiple healthcare settings. It is important to understand the factors affecting their accuracy to be able to use them optimally and safely. This analysis aimed to explore the association of the measurement error of pulse oximeters with systolic BP, diastolic BP and heart rate (HR) within ranges of values commonly observed in clinical practice.MethodsThe study design was a retrospective observational study of all patients admitted to a large teaching hospital with suspected or confirmed COVID-19 infection from February 2020 to December 2021. Data on systolic and diastolic BPs and HR levels were available from the same time period as the pulse oximetry measurements.ResultsData were available for 3420 patients with 5927 observations of blood oxygen saturations as measured by pulse oximetry and ABG sampling within 30 min. The difference in oxygen saturation using the paired pulse oximetry and arterial oxygen saturation difference measurements was inversely associated with systolic BP, increasing by 0.02% with each mm Hg decrease in systolic BP (95% CI 0.00% to 0.03%) over a range of 80–180 mm Hg. Inverse associations were also observed between the error for oxygen saturation as measured by pulse oximetry and with both diastolic BP (+0.03%; 95% CI 0.00% to 0.05%) and HR (+0.04%; 95% CI 0.02% to 0.06% for each unit decrease in the HR).ConclusionsCare needs to be taken in interpreting pulse oximetry measurements in patients with lower systolic and diastolic BPs, and HRs, as oxygen saturation is overestimated as BP and HR decrease. Confirmation of the oxygen saturation with an ABG may be appropriate in some clinical scenarios

Gender equality and religion:a multi-faith exploration of young adults’ narratives

This paper presents findings from research on young adults in the UK from diverse religious backgrounds. Utilizing questionnaires, interviews, and video diaries it assesses how religious young adults understood and managed the tensions in popular discourse between gender equality as an enshrined value and aspirational narrative, and religion as purportedly instituting gender inequality. We show that, despite varied understandings, and the ambivalence and tension in managing ideal and practice, participants of different religious traditions and genders were committed to gender equality. Thus, they viewed gender-unequal practices within their religious cultures as an aberration from the essence of religion. In this way, they firmly rejected the dominant discourse that religion is inherently antithetical to gender equality

Pulse oximeter measurements vary across ethnic groups: an observational study in patients with COVID-19

The pulse oximeter provides regular non-invasive measurements of blood oxygenation and is used in a wide range of clinical settings [1]. The light wave transmission that this technology uses is modified by skin pigmentation and thus may vary by skin colour. A recent study of paired measures of oxygen saturation from pulse oximetry and arterial blood gas reported differing outputs in patients with black skin compared to patients with white skin that has the potential to adversely impact on patient care [2]

Respiratory rate responses to both hypercapnia and acidaemia are modified by age in patients with acidosis

ObjectiveTo explore the associations between arterial pO2, pCO2 and pH and how these are modified by age.MethodsAn analysis of 2598 patients admitted with a diagnosis of Covid-19 infection to a large UK teaching hospital.ResultsThere were inverse associations for arterial pO2, pCO2 and pH with respiratory rate. The effects of pCO2 and pH on respiratory rate were modified by age; older patients had higher respiratory rates at higher pCO2 (p = 0.004) and lower pH (p = 0.007) values.ConclusionsThis suggests that ageing is associated with complex changes in the physiological feedback loops that control respiratory rate. As well as having clinical relevance, this may also impact on the use of respiratory rate in early warning scores across the age range

Chest Radiograph Scoring Alone or Combined with Other Risk Scores for Predicting Outcomes in COVID-19

Background Radiographic severity may help predict patient deterioration and outcomes from COVID-19 pneumonia. Purpose To assess the reliability and reproducibility of three chest radiograph reporting systems (radiographic assessment of lung edema [RALE], Brixia, and percentage opacification) in patients with proven SARS-CoV-2 infection and examine the ability of these scores to predict adverse outcomes both alone and in conjunction with two clinical scoring systems, National Early Warning Score 2 (NEWS2) and International Severe Acute Respiratory and Emerging Infection Consortium: Coronavirus Clinical Characterization Consortium (ISARIC-4C) mortality. Materials and Methods This retrospective cohort study used routinely collected clinical data of patients with polymerase chain reaction-positive SARS-CoV-2 infection admitted to a single center from February 2020 through July 2020. Initial chest radiographs were scored for RALE, Brixia, and percentage opacification by one of three radiologists. Intra- and interreader agreement were assessed with intraclass correlation coefficients. The rate of admission to the intensive care unit (ICU) or death up to 60 days after scored chest radiograph was estimated. NEWS2 and ISARIC-4C mortality at hospital admission were calculated. Daily risk for admission to ICU or death was modeled with Cox proportional hazards models that incorporated the chest radiograph scores adjusted for NEWS2 or ISARIC-4C mortality. Results Admission chest radiographs of 50 patients (mean age, 74 years ± 16 [standard deviation]; 28 men) were scored by all three radiologists, with good interreader reliability for all scores, as follows: intraclass correlation coefficients were 0.87 for RALE (95% CI: 0.80, 0.92), 0.86 for Brixia (95% CI: 0.76, 0.92), and 0.72 for percentage opacification (95% CI: 0.48, 0.85). Of 751 patients with a chest radiograph, those with greater than 75% opacification had a median time to ICU admission or death of just 1-2 days. Among 628 patients for whom data were available (median age, 76 years [interquartile range, 61-84 years]; 344 men), opacification of 51%-75% increased risk for ICU admission or death by twofold (hazard ratio, 2.2; 95% CI: 1.6, 2.8), and opacification greater than 75% increased ICU risk by fourfold (hazard ratio, 4.0; 95% CI: 3.4, 4.7) compared with opacification of 0%-25%, when adjusted for NEWS2 score. Conclusion Brixia, radiographic assessment of lung edema, and percentage opacification scores all reliably helped predict adverse outcomes in SARS-CoV-2 infection. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Little in this issue

Does childhood trauma predict poorer metacognitive abilities in people with first-episode psychosis?

Research suggests that people with first-episode psychosis (FEP) report more childhood traumas and have lower metacognitive abilities than non-clinical controls. Childhood trauma negatively affects metacognitive development in population studies, while the association remains largely unexplored in FEP populations. Metacognition refers to the identification of thoughts and feelings and the formation of complex ideas about oneself and others. This study hypothesized that childhood trauma would be associated with lower metacognitive abilities in people with FEP. In a representative sample of 92 persons with non-affective FEP, we assessed childhood trauma, metacognitive abilities and symptoms of psychosis. We used the Childhood Trauma Questionnaire (CTQ) and the Metacognitive Assessment Scale––Abbreviated which includes Self-reflectivity, Awareness of the Mind of the Other, Decentration and Mastery. Hierarchical regression analyses were performed with metacognitive domains as outcome variables and childhood traumas as independent variables, while controlling for age, gender, first-degree psychiatric illness and negative symptoms. We found few significant associations between the different types of childhood trauma and metacognitive domains, and they suggested childhood trauma are associated with better metacognitive abilities. Study limitations included the cross-sectional design and use of self-report measures. Future studies could preferably be prospective and include different measures of psychopathology and neuropsychology