Original Communications Decreased Plasma Fibronectin during Starvation in Man

ABSTRACT. This study evaluated the effect of 5 days of starvation followed b

Assessing the rapidly-emerging landscape of net zero targets

In the five years since the Paris Agreement, achieving net zero emissions has become a defining frame for climate action. We review over 4000 countries, companies, and subnational governments, which together make up the preponderance of global emissions. We find 769 of these entities have net zero targets, but only 152 meet minimum criteria for robustness, including timing, status, coverage, use of offsets, and governance. Though net zero is now widespread as a concept, its operationalization is still in its infancy. Making net zero targets robust should now be a priority for policymakers in order to deliver Paris-consistent action, as well as securing more ambitious targets. Key policy insights Net zero targets now cover two-thirds of the global economy, but robust net zero targets only cover around five percent. Strengthening targets and their implementation is particularly needed in the following areas: target status (including setting targets into law); coveraneuge of activities; limits to and transparency regarding the use of offsets; and publication of plans and of progress reports. Policymakers should aim to strengthen net zero targets by setting standards for robust net zero targets; building the capacity of entities, particularly those in the global South, to meet the technical and resource challenges required to effectively operationalize net zero emission targets

Connecting the Dots: A Rare Cause of Pulmonary Nodules in a 13-Year-Old Boy

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140177/1/ped.2014.0392.pd

The Structure and Properties of Solar Active Regions and Quiet-Sun Areas Observed in Soft X-Rays with Yohkoh/SXT and in the Extreme-Ultraviolet with SERTS

We observed two solar active regions (NOAA regions 7563 and 7565), quiet-Sun areas, and a coronal hole region simultaneously with Goddard Space Flight Center's Solar EUV Rocket Telescope and Spectrograph (SERTS) and with the Yohkoh Soft X-ray Telescope (SXT) on 1993 August 17. SERTS provided spatially resolved active region and quiet-Sun slit spectra in the 280 to 420 A wavelength range, and images in the lines of He II λ303.8, Mg IX λ368.1, Fe XV λ284.1, and Fe XVI λλ335.4 and 360.8 SXT provided images through multiple broadband filters in both the full-frame imaging mode and the partial-frame imaging mode. The SERTS images in Fe XV (log Tmax = 6.33, where Tmax is the temperature which maximizes the fractional ion abundance in the available ionization equilibrium calculations, i.e., the formation temperature) and Fe XVI (log Tmax = 6.43) exhibit remarkable morphological similarity to the SXT images. Whereas the Fe XV and XVI images outline the loop structures seen with SXT, the cooler He II (log Tmax = 4.67) and Mg IX (log Tmax = 5.98) images outline loop footpoints. In addition, the Mg IX emission outlines other structures not necessarily associated with the hot loops; these may be cool (T 1 × 106 K) loops. From the spatially resolved slit spectra, we obtained emission-line profiles for lines of He II λ303.8, Mg IX λ368.1, Fe XIII λ348.2, Si XI λ303.3, Fe XIV λ334.2, Fe XV λ284.1, and Fe XVI λ335.4 for each spatial position. Based upon the spatial variations of the line intensities, active region 7563 systematically narrows when viewed with successively hotter lines, and appears narrowest in the broadband soft X-ray emission. The active region width (full width at half-maximum intensity) diminishes linearly with log Tmax; the linear fit yields an extrapolated effective log Tmax of 6.51 ± 0.01 for the X-ray emission. The most intense, central core straddles the magnetic neutral line. Active region and quiet-Sun one-dimensional temperature scans were derived from intensity ratios of spatially resolved SERTS slit spectral lines, and from coregistered SXT filter ratios. The highest plasma temperatures were measured in the most intense, central core of region 7563. The temperatures derived from Fe XVI λ335.4/Fe XV λ284.1 and Fe XVI λ335.4/Fe XIV λ334.2 vary significantly (based upon the measurement uncertainties) but not greatly (factors of less than 1.5) across the slit. The average log T values derived from the above two ratios for region 7563 are 6.39 ± 0.04 and 6.32 ± 0.02, respectively. Somewhat larger systematic variations were obtained from all available SXT filter ratios. The average active region log T values derived from the SXT AlMgMn/thin Al, thick Al/thin Al, and thick Al/AlMgMn filter ratios are 6.33 ± 0.03, 6.45 ± 0.02, and 6.49 ± 0.03, respectively. Active region and quiet-Sun one-dimensional density scans were derived from intensity ratios of spatially resolved SERTS slit spectral lines of Fe XIII and Fe XIV. The derived densities show neither systematic nor significant variations along the slit in either the active region or the quiet-Sun, despite the fact that the intensities themselves vary substantially. This indicates that the product of the volume filling factor and the path length (fΔl) must be greater by factors of 3-5 in the active region core than in the outskirts. Furthermore, the derived active region densities are ~2 times the quiet-Sun densities. This density difference is adequate to explain the factor of ~4 intensity difference in Fe XII and Fe XIII between the active and quiet areas, but it is not adequate to explain the factor of ~8 intensity difference in Fe XIV between the active and quiet areas. We attribute the latter to a greater fΔl in the active regions. Statistically significant Doppler shifts are not detected in region 7563 or in the quiet-Sun with any of the EUV lines

A Comprehensive Pediatric Asthma Management Program Reduces Emergency Department Visits and Hospitalizations

We evaluated the impact of a comprehensive pediatric asthma management program (the Children's Asthma Wellness Program, CAWP) on the frequency of emergency department (ED) visits and hospital admissions. The CAWP generally consisted of 4 clinic sessions over a 1-year period, but some patients attended fewer clinic sessions, and some required additional clinic sessions due to incomplete asthma control. Patients were evaluated and treated by pediatric pulmonologists, nurse asthma care coordinator/educator, and social worker. We retrospectively reviewed program results over an 8-year period (2005?2013). We compared ED visits and hospital admissions before and after participation in the CAWP. There were 254 children referred to the CAWP; 172 children were enrolled. Fifty-four children (31%) received >6 sessions due to incomplete asthma control. On average, children requiring additional clinic sessions were older and more likely to be African American, hold Medicaid insurance, and have severe asthma. We obtained a minimum of 1-year preprogram and 1-year postprogram administrative data for 86 children (50%). Using each participating child as his/her own control, we found that taking part in the program decreased the risk of ED visits to 0.26 times the preprogram rate (P?Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140178/1/ped.2015.0561.pd

BioPrev-C - development and validation of a contemporary prostate cancer risk calculator

OBJECTIVES To develop a novel biopsy prostate cancer (PCa) prevention calculator (BioPrev-C) using data from a prospective cohort all undergoing mpMRI targeted and transperineal template saturation biopsy. MATERIALS AND METHODS Data of all men who underwent prostate biopsy in our academic tertiary care center between 11/2016 and 10/2019 was prospectively collected. We developed a clinical prediction model for the detection of high-grade PCa (Gleason score ≥7) based on a multivariable logistic regression model incorporating age, PSA, prostate volume, digital rectal examination, family history, previous negative biopsy, 5-alpha-reductase inhibitor use and MRI PI-RADS score. BioPrev-C performance was externally validated in another prospective Swiss cohort and compared with two other PCa risk-calculators (SWOP-RC and PBCG-RC). RESULTS Of 391 men in the development cohort, 157 (40.2%) were diagnosed with high-grade PCa. Validation of the BioPrev C revealed good discrimination with an area under the curve for high-grade PCa of 0.88 (95% Confidence Interval 0.82-0.93), which was higher compared to the other two risk calculators (0.71 for PBCG and 0.84 for SWOP). The BioPrev-C revealed good calibration in the low-risk range (0 - 0.25) and moderate overestimation in the intermediate risk range (0.25 - 0.75). The PBCG-RC showed good calibration and the SWOP-RC constant underestimation of high-grade PCa over the whole prediction range. Decision curve analyses revealed a clinical net benefit for the BioPrev-C at a clinical meaningful threshold probability range (≥4%), whereas PBCG and SWOP calculators only showed clinical net benefit above a 30% threshold probability. CONCLUSION BiopPrev-C is a novel contemporary risk calculator for the prediction of high-grade PCa. External validation of the BioPrev-C revealed relevant clinical benefit, which was superior compared to other well-known risk calculators. The BioPrev-C has the potential to significantly and safely reduce the number of men who should undergo a prostate biopsy