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Pre-term or full-term childbirth can be experienced as physically or psychologically traumatic. Cumulative and trans-generational effects of traumatic stress on both psychological and physical health indicate the ethical requirement to investigate appropriate preventative treatment for stress symptoms in women following a routine traumatic experience such as childbirth. The objective of this review was to investigate the effectiveness of early psychological interventions in reducing or preventing post-traumatic stress symptoms and post-traumatic stress disorder in post-partum women within twelve weeks of a traumatic birth. Randomised controlled trials and pilot studies of psychological interventions preventing or reducing post-traumatic stress symptoms or PTSD, that included women who had experienced a traumatic birth, were identified in a search of Cochrane Central Register of Randomised Controlled Trials, MEDLINE, Embase, Psychinfo, PILOTS, CINAHL and Proquest Dissertations databases. One author performed database searches, verified results with a subject librarian, extracted study details and data. Five authors appraised extracted data and agreed upon risk of bias. Analysis was completed with Rev Man 5 software and quality of findings were rated according to Grading of Recommendation, Assessment, Development, and Evaluation. Eleven studies were identified that evaluated the effectiveness of a range of early psychological interventions. There was firm evidence to suggest that midwifery or clinician led early psychological interventions administered within 72 hours following traumatic childbirth are more effective than usual care in reducing traumatic stress symptoms in women at 4-6 weeks. Further studies of high methodological quality that include longer follow up of 6-12 months are required in order to substantiate the evidence of the effectiveness of specific face to face and online early psychological intervention modalities in preventing the effects of stress symptoms and PTSD in women following a traumatic birth before introduction to routine care and practice. CRD42020202576, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=202576.

This study examines the effects of financial reporting complexity on investors' trading behavior. I find that more complex (longer and less readable) filings are associated with lower overall trading, and that this relationship appears due to a reduction in small investors' trading activity. Additional evidence suggests that the association between report complexity and lower abnormal trading is driven by both cross-sectional variation in firms' disclosure attributes and variations in disclosure complexity over time. Given regulatory concerns over plain English disclosures and the trend toward more disclosure, my investigation into the effects of reporting complexity on small and large investors should be of interest to regulators concerned with reporting clarity and leveling the playing field across classes of investors.

During summer and fall 2023, Louisiana experienced a historic local drought while dry conditions elsewhere in the central US withheld vital runoff from the Mississippi River, leading to below‐normal discharge into the Gulf of Mexico. Thus, by late October 2023, Louisiana was gripped by two super‐imposed water crises: a severe local drought and saltwater contamination in the Mississippi River channel. This study frames the development of the water emergency through the lens of flash drought using the Evaporative Demand Drought Index (EDDI). The EDDI shows south Louisiana experience a flash drought during June 2023, while the Mississippi River basin was subsequently characterized by large expanses of high‐percentile EDDI in August‐September 2023 shortly before the saltwater intrusion episode along the lower Mississippi River. Over the last 15 years, MRB‐wide EDDI percentile has oscillated between years‐long elevated and depressed states, accounting for 23.7% of the monthly discharge anomaly near New Orleans. Plain Language Summary In 2023, Louisiana experienced one of its driest and hottest summers on record. While drought developed across the state, rain shortfalls further north led to low water levels in the Mississippi River, a major navigation corridor and drinking water source for the state. As river levels fell, seawater moved into the channel, threatening to contaminate the water supply with salt. The statewide drought, particularly in coastal Louisiana, is shown to have developed rapidly during June 2023 through a process called flash drought. Meanwhile, high evaporation rates and low rainfall upriver exacerbated Louisiana's water shortage by limiting runoff into the Mississippi River. Over the last 15 years, evaporative demand over the Mississippi River watershed varies closely with river discharge near New Orleans, and even corresponds to river conditions more closely than rainfall itself. Key Points Louisiana experienced 5 months of exceptional evaporative demand and low precipitation, including a flash drought during June 2023 Historically low flows on the lower Mississippi River in fall 2023 were accompanied by several episodes of high evaporative demand upbasin Basin‐wide high evaporative demand coincides with low discharge near New Orleans, with a trend toward this combination since the 2019 flood

Ecotourism Development in Costa Rica: The Search for Oro Verde, by Andrew P. Miller, examines the use of ecotourism as a development strategy in Costa Rica and its applicability to other Central American states. Ecotourism provides an important environmental check on industry, giving the environment a voice by making its preservation an economic necessity due to the number of people who derive their income from it. The move away from agriculture to ecotourism is a natural fit because many of those who are engaged in agriculture have extensive knowledge of plants and animals that can be utilized by the ecotourism industry.

People with chronic tetraplegia, due to high-cervical spinal cord injury, can regain limb movements through coordinated electrical stimulation of peripheral muscles and nerves, known as functional electrical stimulation (FES). Users typically command FES systems through other preserved, but unrelated and limited in number, volitional movements (eg, facial muscle activity, head movements, shoulder shrugs). We report the findings of an individual with traumatic high-cervical spinal cord injury who coordinated reaching and grasping movements using his own paralysed arm and hand, reanimated through implanted FES, and commanded using his own cortical signals through an intracortical brain–computer interface (iBCI). We recruited a participant into the BrainGate2 clinical trial, an ongoing study that obtains safety information regarding an intracortical neural interface device, and investigates the feasibility of people with tetraplegia controlling assistive devices using their cortical signals. Surgical procedures were performed at University Hospitals Cleveland Medical Center (Cleveland, OH, USA). Study procedures and data analyses were performed at Case Western Reserve University (Cleveland, OH, USA) and the US Department of Veterans Affairs, Louis Stokes Cleveland Veterans Affairs Medical Center (Cleveland, OH, USA). The study participant was a 53-year-old man with a spinal cord injury (cervical level 4, American Spinal Injury Association Impairment Scale category A). He received two intracortical microelectrode arrays in the hand area of his motor cortex, and 4 months and 9 months later received a total of 36 implanted percutaneous electrodes in his right upper and lower arm to electrically stimulate his hand, elbow, and shoulder muscles. The participant used a motorised mobile arm support for gravitational assistance and to provide humeral abduction and adduction under cortical control. We assessed the participant's ability to cortically command his paralysed arm to perform simple single-joint arm and hand movements and functionally meaningful multi-joint movements. We compared iBCI control of his paralysed arm with that of a virtual three-dimensional arm. This study is registered with ClinicalTrials.gov, number NCT00912041. The intracortical implant occurred on Dec 1, 2014, and we are continuing to study the participant. The last session included in this report was Nov 7, 2016. The point-to-point target acquisition sessions began on Oct 8, 2015 (311 days after implant). The participant successfully cortically commanded single-joint and coordinated multi-joint arm movements for point-to-point target acquisitions (80–100% accuracy), using first a virtual arm and second his own arm animated by FES. Using his paralysed arm, the participant volitionally performed self-paced reaches to drink a mug of coffee (successfully completing 11 of 12 attempts within a single session 463 days after implant) and feed himself (717 days after implant). To our knowledge, this is the first report of a combined implanted FES+iBCI neuroprosthesis for restoring both reaching and grasping movements to people with chronic tetraplegia due to spinal cord injury, and represents a major advance, with a clear translational path, for clinically viable neuroprostheses for restoration of reaching and grasping after paralysis. National Institutes of Health, Department of Veterans Affairs.

The little red hen finds none of her lazy friends willing to help her plant, harvest, or grind wheat into flour, but all are eager to eat the bread she makes from it.

Although Arctic tundra has been estimated to cover only 8% of the global land surface, the large and potentially labile carbon pools currently stored in tundra soils have the potential for large emissions of carbon (C) under a warming climate. These emissions as radiatively active greenhouse gases in the form of both CO2 and CH4 could amplify global warming. Given the potential sensitivity of these ecosystems to climate change and the expectation that the Arctic will experience appreciable warming over the next century, it is important to assess whether responses of C exchange in tundra regions are likely to enhance or mitigate warming. In this study we compared analyses of C exchange of Arctic tundra between 1990 and 2006 among observations, regional and global applications of process-based terrestrial biosphere models, and atmospheric inversion models. Syntheses of flux observations and inversion models indicate that the annual exchange of CO2 between Arctic tundra and the atmosphere has large uncertainties that cannot be distinguished from neutral balance. The mean estimate from an ensemble of process-based model simulations suggests that Arctic tundra has acted as a sink for atmospheric CO2 in recent decades, but based on the uncertainty estimates it cannot be determined with confidence whether these ecosystems represent a weak or a strong sink. Tundra was 0.6 °C warmer in the 2000s compared to the 1990s. The central estimates of the observations, process-based models, and inversion models each identify stronger sinks in the 2000s compared with the 1990s. Some of the process models indicate that this occurred because net primary production increased more in response to warming than heterotrophic respiration. Similarly, the observations and the applications of regional process-based models suggest that CH4 emissions from Arctic tundra have increased from the 1990s to 2000s because of the sensitivity of CH4 emissions to warmer temperatures. Based on our analyses of the estimates from observations, process-based models, and inversion models, we estimate that Arctic tundra was a sink for atmospheric CO2 of 110 Tg C yr−1 (uncertainty between a sink of 291 Tg C yr−1 and a source of 80 Tg C yr−1) and a source of CH4 to the atmosphere of 19 Tg C yr−1 (uncertainty between sources of 8 and 29 Tg C yr−1). The suite of analyses conducted in this study indicate that it is important to reduce uncertainties in the observations, process-based models, and inversions in order to better understand the degree to which Arctic tundra is influencing atmospheric CO2 and CH4 concentrations. The reduction of uncertainties can be accomplished through (1) the strategic placement of more CO2 and CH4 monitoring stations to reduce uncertainties in inversions, (2) improved observation networks of ground-based measurements of CO2 and CH4 exchange to understand exchange in response to disturbance and across gradients of climatic and hydrological variability, and (3) the effective transfer of information from enhanced observation networks into process-based models to improve the simulation of CO2 and CH4 exchange from Arctic tundra to the atmosphere.