Community-Based Health Plans for the Uninsured: Expanding Access, Enhancing Dignity

Highlights community-based initiatives in Albuquerque, New Mexico; Ingham County, Michigan; El Paso, Texas; Alameda County, California; and North Carolina that have developed health plans for uninsured individuals and families

Reaching Out: Successful Efforts to Provide Children and Families With Health Care

Interweaves personal stories and policy recommendations to offer an inventory of ideas and resources to improve enrollment rates and help more people access essential health care

Lake surface temperature [in “State of the Climate in 2017”]

Observed lake surface water temperature anomalies in 2017 are placed in the context of the recent warming observed in global surface air temperature by collating long-term in situ lake surface temperature observations from some of the world’s best-studied lakes and a satellite-derived global lake surface water temperature dataset. The period 1996–2015, 20 years for which satellite-derived lake temperatures are available, is used as the base period for all lake temperature anomaly calculations

Simulation, Experiment, and Evolution: Understanding Nucleation in Protein S6 Folding

In this study, we explore nucleation and the transition state ensemble of the ribosomal protein S6 using a Monte Carlo Go model in conjunction with restraints from experiment. The results are analyzed in the context of extensive experimental and evolutionary data. The roles of individual residues in the folding nucleus are identified and the order of events in the S6 folding mechanism is explored in detail. Interpretation of our results agrees with, and extends the utility of, experiments that shift f-values by modulating denaturant concentration and presents strong evidence for the realism of the mechanistic details in our Monte Carlo Go model and the structural interpretation of experimental f-values. We also observe plasticity in the contacts of the hydrophobic core that support the specific nucleus. For S6, which binds to RNA and protein after folding, this plasticity may result from the conformational flexibility required to achieve biological function. These results present a theoretical and conceptual picture that is relevant in understanding the mechanism of nucleation in protein folding.Comment: PNAS in pres

Climate Change and the World’s “Sacred Sea”—Lake Baikal, Siberia

Lake Baikal—the world\u27s largest, oldest, and most biotically diverse lake—is responding strongly to climate change, according to recent analyses of water temperature and ice cover. By the end of this century, the climate of the Baikal region will be warmer and wetter, particularly in winter. As the climate changes, ice cover and transparency, water temperature, wind dynamics and mixing, and nutrient levels are the key abiotic variables that will shift, thus eliciting many biotic responses. Among the abiotic variables, changes in ice cover will quite likely alter food-web structure and function most because of the diverse ways in which ice affects the lake\u27s dominant primary producers (endemic diatoms), the top predator (the world\u27s only freshwater seal), and other abiotic variables. Melting permafrost will probably exacerbate the effects of additional anthropogenic stressors (industrial pollution and cultural eutrophication) and could greatly affect ecosystem functioning

Spatial differences in dissolved silicon utilisation in Lake Baikal, Siberia: examining the impact of high diatom biomass events and eutrophication

Recent research has highlighted how Lake Baikal, Siberia, has responded to the direct and indirect effects of climate change (e.g., ice-cover duration), nutrient loading, and pollution, manifesting as changes in phytoplankton/zooplankton populations, community structure, and seasonal succession. Here, we combine and compare= analyses of chlorophyll a (an estimate of total algal biomass), carotenoid pigments (biomarkers of algal groups), and lake water silicon isotope geochemistry (d30SiDSi) to differentiate spatial patterns in dissolved silicon (DSi) uptake at Lake Baikal. A total of 15 sites across the three basins (south, central, and north) of Lake Baikal were sampled in August 2013 along a depth gradient of 0–180 m. Strong, significant correlations were found between vertical profiles of photic zone DSi concentrations and d30SiDSi compositions (r 5 20.81, p < 0.001), although these are strongest in the central basin aphotic zone (r 5 20.98, p < 0.001). Data refute the hypothesis of DSi uptake by picocyanobacteria. Algal biomass profiles and high surface d30SiDSi compositions suggest greater productivity in the south basin and more oligotrophic conditions in the north basin. d30SiDSi signatures are highest at depth (20 m) in central basin sites, indicating greater (10–40%) DSi utilization at deep chlorophyll maxima. DSi limitation occurs in the pelagic central basin, probably reflecting a high diatom biomass bloom event (Aulacoseira baicalensis). Meanwhile in the more hydrologically restricted, shallow Maloe More region (central basin), both high d30SiDSi compositions and picocyanobacteria (zeaxanthin) concentrations, respectively point to the legacy of an “Aulacoseira bloom year” and continuous nutrient supply in summer months (e.g., localized eutrophication)

Lake-wide physical and biological trends associated with warming in Lake Baikal

Eutrophication and warming of lakes are occurring globally. Lake Baikal, a large ancient lake composed of three basins, has recently experienced benthic eutrophication at local sites and lake warming in the south basin. Here, we look for signals of warming and pelagic eutrophication across the entire lake using physical and biological data collected at a subset of 79 stations sampled ca. annually (1977–2003) during the period of summer stratification. Lake-wide, surface waters warmed 2.0 °C; and, consistent with this warming, the abundance of two warm-water, cosmopolitan zooplankton taxa increased between two (pelagic cladocerans) and 12-fold (Cyclops kolensis). C. kolensis increased throughout the lake, whereas cladocerans increased significantly only in the north basin. In contrast, abundance of the cold-water endemic copepod, Epischura baikalensis, that dominates the crustacean zooplankton community, did not change. With the exception of one coastal station in the north basin, there is no evidence of pelagic eutrophication. Although chlorophyll concentrations increased 46% lake-wide (0.82 to 1.20 μg/L), the increasing trend was significant only in the south basin. Surprisingly, mean Secchi transparency increased by 1.4 m lake-wide across the 26-year time series with significant deepening of water transparency occurring in the central and north basins. This suggests a decline in productivity in the north and middle basins, but an increase in the south basin. Taken together, these findings suggest that physical and biological changes associatedwithwarming have occurred in Lake Baikal, butwide-spread pelagic eutrophication in the lake\u27s three basins has not

Validity of mobile electronic data capture in clinical studies: a pilot study in a pediatric population.

BACKGROUND: Clinical studies in children are necessary yet conducting multiple visits at study centers remains challenging. The success of "care-at-home" initiatives and remote clinical trials suggests their potential to facilitate conduct of pediatric studies. This pilot aimed to study the feasibility of remotely collecting valid (i.e. complete and correct) saliva samples and clinical data utilizing mobile technology. METHODS: Single-center, prospective pilot study in children undergoing elective tonsillectomy at the University of Basel Children's Hospital. Data on pain scores and concomitant medication and saliva samples were collected by caregivers on two to four inpatient study days and on three consecutive study days at home. A tailored mobile application developed for this study supported data collection. The primary endpoint was the proportion of complete and correct caregiver-collected data (pain scale) and saliva samples in the at-home setting. Secondary endpoints included the proportion of complete and correct saliva samples in the inpatient setting, subjective feasibility for caregivers, and study cost. RESULTS: A total number of 23 children were included in the study of which 17 children, median age 6.0 years (IQR 5.0, 7.4), completed the study. During the at-home phase, 71.9% [CI = 64.4, 78.6] of all caregiver-collected pain assessments and 53.9% [CI = 44.2, 63.4] of all saliva samples were complete and correct. Overall, 64.7% [CI = 58.7, 70.4] of all data collected by caregivers at home was complete and correct. The predominant reason for incorrectness of data was adherence to the timing of predefined patient actions. Participating caregivers reported high levels of satisfaction and willingness to participate in similar trials in the future. Study costs for a potential sample size of 100 patients were calculated to be 20% lower for the at-home than for a traditional in-patient study setting. CONCLUSIONS: Mobile device supported studies conducted at home may provide a cost-effective approach to facilitate conduct of clinical studies in children. Given findings in this pilot study, data collection at home may focus on electronic data capture rather than biological sampling

Rapid and highly variable warming of lake surface waters around the globe

In this first worldwide synthesis of in situ and satellite-derived lake data, we find that lake summer surface water temperatures rose rapidly (global mean = 0.34°C decade−1) between 1985 and 2009. Our analyses show that surface water warming rates are dependent on combinations of climate and local characteristics, rather than just lake location, leading to the counterintuitive result that regional consistency in lake warming is the exception, rather than the rule. The most rapidly warming lakes are widely geographically distributed, and their warming is associated with interactions among different climatic factors—from seasonally ice-covered lakes in areas where temperature and solar radiation are increasing while cloud cover is diminishing (0.72°C decade−1) to ice-free lakes experiencing increases in air temperature and solar radiation (0.53°C decade−1). The pervasive and rapid warming observed here signals the urgent need to incorporate climate impacts into vulnerability assessments and adaptation efforts for lakes.Peer reviewe