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Cold‐season methane (CH4) emissions may be poorly constrained in wetland models. We examined cold‐season CH4 emissions simulated by 16 models participating in the Global Carbon Project model intercomparison and analyzed temporal and spatial patterns in simulation results using prescribed inundation data for 2000–2020. Estimated annual CH4 emissions from northern (>60°N) wetlands averaged 10.0 ± 5.5 Tg CH4 yr−1. While summer CH4 emissions were well simulated compared to in‐situ flux measurement observations, the models underestimated CH4 during September to May relative to annual total (27 ± 9%, compared to 45% in observations) and substantially in the months with subzero air temperatures (5 ± 5%, compared to 27% in observations). Because of winter warming, nevertheless, the contribution of cold‐season emissions was simulated to increase at 0.4 ± 0.8% decade−1. Different parameterizations of processes, for example, freezing–thawing and snow insulation, caused conspicuous variability among models, implying the necessity of model refinement. Plain Language Summary Wetlands in the northern high latitudes are a major source of methane (CH4) to the atmosphere, mainly during the warm season. Previously, models have assumed that cold‐season CH4 emissions are low, but recent observations suggest high‐latitude wetlands can be substantial sources even in winter. We compared CH4 emissions simulated by 16 state‐of‐the‐art wetland models, participating in a model intercomparison project with a focus on the cold‐season in northern wetlands. The model simulations indicated that nearly one third of annual emissions were simulated to occur from September to May, and CH4 emissions to the atmosphere were not negligible even under freezing air temperatures, although the results differed greatly among the models. However, field studies suggest cold‐season emissions account for an even larger fraction of annual emissions. These results highlight the contribution of cold‐season emissions to the annual CH4 budget, which future climatic warming is expected to affect severely, and they also show that simulations of cold‐season CH4 emissions from wetlands need to be improved. Key Points Cold‐season methane (CH4) emissions simulated by 16 Global Carbon Project‐CH4 wetland models were analyzed Most models underestimate the cold‐season emissions in comparison with observational data Further model improvement by including cold‐season processes is required to reduce the model bias and uncertainty

The number of students with disabilities in post-secondary institutions and in nursing programs is on the rise. With limited clinical placements, nursing programs and clinical instructors are asking how to reasonably accommodate students who identify with disabilities in clinical placements. The purpose of this paper is to explore what we know about the experiences of nursing students who identify with a disability and of instructors in nursing clinical practice. Guided by Arksey and O’Malley’s ( 2005 ) scoping review methodology, a total of 27 papers published between 1999 and 2018 were selected. Three overarching themes emerged. While students who identify with a disability experienced (a) feeling labeled and excluded they responded by (b) masking their disability and accommodation (including assisted technology accommodation) during clinical placement and (c) suggesting better policy support to highlight their strengths rather than their disability. Most surprisingly to us was the limited Canadian studies. Further education and research implications will be discussed.

In this paper, we consider recurrent behavior of bounded solutions for a functional integro-differential equation arising from heat conduction in materials with memory. Prior to the main results, we give a new version of composite theorem on measure pseudo almost automorphic functions involved in delay. Based on recently obtained results on the uniform exponential stability as well as contraction mapping principle, we prove some existence and uniqueness theorems on the recurrence of bounded mild solutions for the addressed equations with infinite delay. Finally, we finish this paper with an example on partial integro-differential equation which frequently comes to light in the study of heat conduction.

Various synchrotron radiation-based spectroscopic and microscopic techniques are used to elucidate the room-temperature ferromagnetism of carbon-doped ZnO-nanowires (ZnO-C:NW) via a mild C + ion implantation method. The photoluminescence and magnetic hysteresis loops reveal that the implantation of C reduces the number of intrinsic surface defects and increases the saturated magnetization of ZnO-NW. The interstitial implanted C ions constitute the majority of defects in ZnO-C:NW as confirmed by the X-ray absorption spectroscopic studies. The X-ray magnetic circular dichroism spectra of O and C K -edge respectively indicate there is a reduction in the number of unpaired/dangling O 2 p bonds in the surface region of ZnO-C:NW and the C 2 p -derived states of the implanted C ions strongly affect the net spin polarization in the surface and bulk regions of ZnO-C:NW. Furthermore, these findings corroborate well with the first-principles calculations of C-implanted ZnO in surface and bulk regions, which highlight the stability of implanted C for the suppression and enhancement of the ferromagnetism of the ZnO-C:NW in the surface region and bulk phase, respectively.

Among Canadians aged 25–64 years, 32% of those without disabilities have a university degree, while the figure among those with disabilities is only 13%. Mental health is defined as a state of well-being in which an individual realizes their potential, and can cope and work productively. According to Statistics Canada ( 2016 ), mental illness is the most dominating disability among Canadians between 15 and 24 years of age. Health professional programs can be an intense experience. While the number of students with mental illness in post-secondary institutions is on the rise, students and faculty are asking how to accommodate students. The purpose of this paper is to examine and map what we know about university students’ mental health experiences in health and allied healthcare university programs. We included 17 articles in our scoping review methodology. We used data between 2003 and 2017 from databases such as MEDLINE, CINAHL, ProQuest, PsycINFO, and gray search areas. Two team members independently screened for articles. Data was presented in a table guided by the research question. The scoping review revealed four broad themes: (1) prevalence; (2) environment; (3) ethics issues and relationships; and (4) coping: being silent. While mood disorder and anxiety dominated students’ experiences, most responded by being silent. Although the prevalence of mental illness and health in university has been examined in the literature from medical and psychology frameworks, there remains a paucity of literature evaluating strategies to support students, particularly accommodating students with clinical/practicum-based programs. Further clinical, education, and research implications are discussed.

Background Peri-operative hemodynamic instability (HDI) may increase peri-operative morbidity in pheochromocytoma/paraganglioma (PPGL) patients. Objective This study aimed to determine which tumor-related risk factors could lead to peri-operative HDI in unilateral or single PPGL removal. Methods Before surgery, 66 PPGL patients had at least two sets of 24 h urine collected for fractionated catecholamine analysis. At surgery, an arterial line was inserted to record systolic blood pressure (SBP), diastolic BP, and mean arterial BP (MAP). Peri-operative HDI was defined as hypertension (SBP > 160 mmHg) and/or hypotension (SBP < 90 mmHg and/or MAP < 60 mmHg) for >10 consecutive minutes either intra-operatively or within the first 12 h after surgery. Urinary fractionated catecholamines and other variables were compared between those with peri-operative HDI (group I) and those without (group II). Results A total of 15 (22.7 %) patients belonged to group I, while 51 patients belonged to group II. One (1.5 %) patient died 9 days after surgery. Relative to group II, group I had significantly higher urinary norepinephrine (NE) (5,488.0 vs. 1,980.0 nmol/L, p  < 0.001), urinary normetanephrine (5,130.9 vs. 3,853.4 nmol/L, p  = 0.045), maximum SBP at operation (188.2 vs. 167.4 mmHg, p  = 0.037), but lower MAP after operation (78.9 vs. 91.8 mmHg, p  = 0.026). Urinary NE (OD 1.02, 95 % confidence interval [CI] 1.01–1.03, p  = 0.046) was an independent risk factor for peri-operative HDI. The urinary NE level significantly correlated with maximum intra-operative SBP and MAP (r 0.692, p  < 0.001; and r 0.669, p  < 0.001, respectively) and inversely correlated with maximum post-operative MAP (r −0.305, p  = 0.040). Conclusions High pre-operative urinary NE was an independent tumor-related factor for peri-operative HDI and significantly correlated with sustained intra-operative hypertension and post-operative hypotension.

Background It remains uncertain whether a parathyroid gland (PG) that appears darkened or severely bruised but still has an attached vascular pedicle should be left in situ or taken out and auto-transplanted following total thyroidectomy. Our study aimed to examine the impact of discolored PGs (DPGs) on short- and long-term hypoparathyroidism. Methods One hundred and three patients who underwent total thyroidectomy with 4 clearly identified PGs were analyzed. Location (superior/inferior) and color of each PG were recorded. Patients without DPG were grouped into I while those with 1–2 DPGs and ≥3 DPGs were grouped into II and III, respectively. Transient hypoparathyroidism meant adjusted Ca <2.00 mol/L 24 h after surgery and/or need for supplements. Protracted hypoparathyroidism meant a subnormal PTH at 4–6 weeks and/or supplements >6 weeks. Permanent hypoparathyroidism meant supplements ≥1 year. Results Relative to I, group III had greater adjusted Ca drop at postoperative 1-h ( p  = 0.012), 24-h ( p  < 0.001) and lower day-1 PTH ( p  = 0.015). Having ≥3 DPGs (OR 14.00, 95 % CI 1.575–124.474, p  = 0.018) was an independent factor of transient hypoparathyroidism. However, permanent hypoparathyroidism rate was higher than in group I than II ( p  = 0.019). Eight patients (25.8 %) in group I had undetectable day-1 PTH, while none in group III had undetectable day-1 PTH. Graves’ disease/toxic goiter (OR 15.166, 95 % CI 2.594–88.661, p  = 0.003) and excised gland weight (OR 1.028, 95 % CI 1.010–1.046, p  = 0.003) were independent factors of ≥3 DPGs. Conclusions PG discoloration is associated with transient hypoparathyroidism while normal colored PG with seemingly adequate blood supply does not always imply functionally normal gland. These findings highlights the need for a real-time intraoperative method to assess PG viability.

Background Breast carcinoma presented with nipple discharge is a rare condition. There is theoretical concern about preserving nipple in these patients since the risk of nipple–areolar complex involvement may be greater, but not many studies in the literature have addressed on this issue. The aim of the current study was to determine the incidence and outcome of nipple preservation in breast cancer associated with nipple discharge. Methods Medical records of patients who were diagnosed to have breast carcinoma and presented with nipple discharge from May 2009 to October 2014 were retrospectively reviewed. Results Sixty patients presented with nipple discharge were diagnosed with breast cancer, which represent 3.8 % of all patients who underwent breast cancer surgery in our unit during the study period. Forty-six patients (76.7 %) had nipple discharge as their only symptom, while the rest also presented with breast mass clinically or radiologically. All patients had mammogram and ultrasound performed, and 53.3 and 63.3 % respectively showed suspicious findings. Forty-one out of 46 (89.1 %) nipple discharge cytology were inadequate or benign. Thirty-two microdochectomy were performed. Routine frozen section was utilized intra-operatively to ensure clear margins. The most common histology was ductal carcinoma in situ (DCIS) ( n  = 29, 48.3 %), followed by DCIS with invasive ductal carcinoma ( n  = 23, 38.3 %). Regarding treatment, 26 patients (43.3 %) had nipple preserved, including 21 breast conservative surgery and five nipple-sparing mastectomies. Overall, no local or systemic recurrence was observed at a median follow-up of 27 months. Ten out of 34 (29.4 %) mastectomy specimens showed NAC involvement on pathology. By comparing patients with NAC preserved to patients with NAC removed, no significant preoperative predictors were identified. Conclusion Breast carcinoma patients who present with nipple discharge usually have early-stage cancer. Presence of nipple discharge is not equivalent to NAC involvement. Nipple preservation can be oncologically safe if negative margins are ascertained.

Steroidogenesis-mediated production of neurosteroids is important for brain homeostasis. Cytochrome P450 17A1 (CYP17A1), which converts pregnenolone to dehydroepiandrosterone (DHEA) in endocrine organs and the brain, is required for prostate cancer progression and acquired chemotherapeutic resistance. However, whether CYP17A1-mediated DHEA synthesis is involved in brain tumor malignancy, especially in glioma, the most prevalent brain tumor, is unknown. To investigate the role of CYP17A1 in glioma, we determined that CYP17A1 expression is significantly increased in gliomas, which secrete more DHEA than normal astrocytes. We found that as gliomas became more malignant, both CYP17A1 and DHEA were significantly upregulated in temozolomide (TMZ)-resistant cells and highly invasive cells. In particular, the increase of CYP17A1 was caused by Sp1-mediated DNA demethylation, whereby Sp1 competed with DNMT3a for binding to the CYP17A1 promoter in TMZ-resistant glioma cells. CYP17A1 was required for the development of glioma cell invasiveness and resistance to TMZ-induced cytotoxicity. In addition, DHEA markedly attenuated TMZ-induced DNA damage and apoptosis. Together, our results suggest that components of the Sp1–CYP17A1–DHEA axis, which promotes the development of TMZ resistance, may serve as potential biomarkers and therapeutic targets in recurrent glioma.

The amyloid-β42 (Aβ42) peptide is believed to be the main culprit in the pathogenesis of Alzheimer disease (AD), impairing synaptic function and initiating neuronal degeneration. Soluble Aβ42 oligomers are highly toxic and contribute to progressive neuronal dysfunction, loss of synaptic spine density and affect long-term potentiation (LTP). We have characterized a short, L-amino acid Aβ-oligomer Interacting Peptide (AIP) that targets a relatively well-defined population of low-n Aβ42 oligomers, rather than simply inhibiting the aggregation of Aβ monomers into oligomers. Our data show that AIP diminishes the loss of Aβ42-induced synaptic spine density and rescues LTP in organotypic hippocampal slice cultures. Notably, the AIP enantiomer (comprised of D-amino acids) attenuated the rough-eye phenotype in a transgenic Aβ42 fly model and significantly improved the function of photoreceptors of these flies in electroretinography tests. Overall, our results indicate that specifically “trapping” low-n oligomers provides a novel strategy for toxic Aβ42-oligomer recognition and removal.