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A five-time Olympic gold medalist and a U.S. Olympic team physician present a fitness program based on a philosophy of applying exercise as a prescription medication, in a guide that discusses key principles in fitness and weight loss.

Autumnal hypoxia in temperate estuaries is often overlooked due to its smaller extent, weaker intensity, and sparse observations compared to summer. However, climate variability may alter its seasonality. Using 40 yr (1984–2023) of hypoxic volume data from the Chesapeake Bay, combined with numerical simulations, we examined interannual drivers of autumnal hypoxia. September wind speeds were negatively correlated with hypoxic volume (r = −0.49, p < 0.01), reflecting wind‐driven destratification. Conversely, September river discharge showed a strong positive correlation with October hypoxia (r = 0.81, p < 0.01), indicating that lagged freshwater inputs from late‐season cyclones enhance stratification and re‐establish hypoxia. Model simulations of a representative tropical cyclone confirmed this dual effect that storm winds temporarily alleviated hypoxia, but subsequent river inflows prolonged it into October. Model results highlight that physical processes largely regulate autumnal hypoxia dynamics, and suggest that more frequent intense cyclones under climate change may increase its persistence.

Charlie Brown can't stop worrying about the new school year, and he enters the school's spelling bee in order to break out of his rut and do something extraordinary.

One of the roadblocks to developing effective therapeutics for Huntington disease (HD) is the lack of animal models that develop progressive clinical traits comparable to those seen in patients. Here we report a longitudinal study that encompasses cognitive and motor assessment, and neuroimaging of a group of transgenic HD and control monkeys from infancy to adulthood. Along with progressive cognitive and motor impairment, neuroimaging revealed a progressive reduction in striatal volume. Magnetic resonance spectroscopy at 48 months of age revealed a decrease of N-acetylaspartate (NAA), further suggesting neuronal damage/loss in the striatum. Postmortem neuropathological analyses revealed significant neuronal loss in the striatum. Our results indicate that HD monkeys share similar disease patterns with HD patients, making them potentially suitable as a preclinical HD animal model.

Hypoxia in coastal waters is a pressing ecological problem caused by continued eutrophication and climatic change that has widespread consequences for metazoan life and biogeochemical cycles. Numerous studies have investigated the controls on seasonal hypoxia formation and persistence in many of the world’s large estuaries and coastal hypoxic zones, but far fewer studies have examined the controls on short-term oxygen variability that leads to diel-cycling hypoxia in shallow-water environments. We utilized a unique, comprehensive (181 stations) record of dissolved oxygen concentrations collected at shallow water sites (primarily < 2 m) at high frequency (15 min) throughout the estuarine complex of the Chesapeake Bay and its tributaries to quantify how internal and external variables co-varied with dissolved oxygen. We used a combination of time-series analysis, harmonic analysis, and machine learning (e.g., classification and regression trees (CART)) approaches to identify spatial patterns in major controls on oxygen variability and the duration of moderate hypoxia. We found that key controls on oxygen variability varied substantially over space. For example, photosynthetically active radiation (PAR) was a strong predictor of oxygen dynamics in the majority of mesohaline waters. In more fetch-exposed stations, wind strongly controlled hypoxic duration, but in eutrophic, inshore locations, chlorophyll a, or turbidity were often better predictors. Specifically, diel oxygen variability was muted in upstream regions characterized by high turbidity. The duration of low oxygen conditions, which we defined conservatively as less than 4.8 mg O2 L−1 (156 µM), was strongly controlled by temperature, and simple projections of regional warming and CART-derived oxygen thresholds suggest that the Bay could experience a 10% increase in this type of hypoxia duration by mid-to-late twenty-first century. The ratio of tidal to biological variability in oxygen was found to increase under conditions of higher turbidity, stronger wind, and lower salinity, but biological variability was typically a factor of two higher than tidal variability. Although chlorophyll-a generated high oxygen concentrations at some locations, those stations with exceptionally high chlorophyll a (> 30 µg L−1) were the most vulnerable to hypoxia. Because conventional water quality modeling frameworks are designed to capture hypoxia on relatively long time scales, these new insights can help inform updated oxygen models to support the management of shallow-water estuaries in the face of managed nutrient reductions and climate change.

Background:Osteoarthritis (OA) and metabolic conditions are major causes of disability. A growing hypothesis posits the presence of a metabolic OA phenotype where the co-occurrence of OA and metabolic conditions may worsen joint symptoms and overall health. The heightened complexity of the disease status may thus influence the choice of treatments with the possibility that pharmacological and other passive interventions are preferred to exercise and physical activity—the recommended first-line treatment for both OA and diabetes, together with diet when needed.Objectives:To explore the utilisation of treatment for OA in individuals with one or more metabolic condition(s) and individuals without metabolic conditions.Methods:This cross-sectional web-based survey study was conducted in Italy, Sweden and Russia. Individuals with self-reported OA were invited to participate in the study and were asked which treatments for OA they underwent from a list containing the most common OA treatments (i.e. surgery, electrical physical therapy, NSAIDs, acetaminophen [paracetamol], opioids, antidepressants, corticosteroid injection, hyaluronic acid injection, weight management, exercise, manual therapy, orthosis, natural therapy, homeopathy, education programmes and other physical therapies). In this study, we included people ≥40 years old. We identified two sub-groups: those with self-reported metabolic conditions (hypertension, type II diabetes, obesity [BMI ≥30], and dyslipidaemia) and those without. We estimated the prevalence and the 95% confidence interval (CI) of individuals who utilised a specific treatment separately for individuals with and without metabolic conditions. We then compared the two groups computing the prevalence ratio and its 95% CI for each treatment (prevalence OA and no metabolic conditions used as reference). The prevalences were adjusted for the different age distributions between the two groups using the direct standardisation technique to allow comparison between groups.Results:The sample comprised 401 people with OA (Italy: 111; Sweden: 193; Russia: 97; mean age 59.7 [SD:9.8]; years with OA 8.3 [SD:7.5]; female 78.3%), of whom 207 (51.6%) had at least one metabolic condition. Previous use of opioids (prevalence ratio [CI] of 1.8 [1.2-2.4]), antidepressants (1.8 [1.1-2.5]), corticosteroid injections (1.4 [1.1-1.8]) and homeopathic products (2.3 [1.4-3.2]) was higher in individuals with metabolic conditions compared to those without (Table 1). The other treatment modalities showed similar prevalence across groups, with education programs, weight management, and exercise being the most common.Conclusion:Our data suggested that individuals with and without metabolic conditions have similar rates of treatment utilisation for OA. Nonetheless pharmacological interventions including opioids, antidepressants, corticosteroid injections and homeopathic products appear to be more prevalent among OA individuals with comorbid metabolic conditions. We hypothesise that this may be due to the heightened joint pain associated with the coexistence of OA and metabolic conditions which may require additional pharmacological management.REFERENCES:NIL.Acknowledgements:This work was funded by the European Alliance of Associations for Rheumatology (EULAR): The EULAR Health Professionals in Rheumatology (HPR) Research Grant 2020.Disclosure of Interests:None declared.

Background:Osteoarthritis (OA) burdens individuals and healthcare systems across Europe. With limited curative options, symptom management becomes pivotal, yet underdiagnosis and varied healthcare professional education in OA prevail. The role of individuals in their care and the impact of their willingness, beliefs, and perceived barriers are critical.Objectives:This study aimed to assess the awareness of appropriate OA management practices, the suggested and received care pathway, explore beliefs surrounding OA management, analyse encountered obstacles, and gauge overall satisfaction with OA care in Italy, Sweden, and Russia. These countries represent the Mediterranean, Nordic, and Eastern European regions.Methods:A cross-sectional web-based online survey was conducted in Italy, Sweden, and Russia. We included participants over 40 years, who self-reported hip and/or knee OA. The survey instrument underwent a rigorous development process involving healthcare professionals and patients and comprised five sections. The initial section gathered demographic data. In the second section, participants assessed a list of treatments (Table 1) as “recommended,” “optional,” or “not recommended,” and the percentage correctly identified was calculated. Participants could also answer “I don’t know”. The third section examined both performed and suggested treatments, and the percentage of treatments falling into these categories was computed. The fourth section gauged participant agreement with statements regarding OA care (Table 2), with percentages of agreement exceeding 70% calculated. The fifth section measured overall satisfaction with OA care using a 0-100 Numerical Rating Scale.Results:A total of 401 participants were surveyed (mean age: 59.7, 78.3% female, 28% Italian, 49% Swedish, and 23% Russian). In Sweden, between the 57% (education programmes) and 72% (weight loss) correctly identified recommended treatments, while in Russia, it spanned from 34% (balance training) to 91% (maintaining a healthy weight), and in Italy, it varied between 35% (balance training) and 73% (weight loss). Awareness of optional treatments differed, with correct identification percentages ranging from 9% (antidepressant drugs) to 47% (oral anti-inflammatory drugs) in Sweden, 15% (opioids) to 38% (topical anti-inflammatory drugs) in Russia, and 11% (antidepressant drugs) to 46% (topical anti-inflammatory drugs) in Italy. For not recommended treatments, correct identification ranged from 8% (Paracetamol) to 26% (homeopathy) in Sweden, 8% (growth factor injections) to 25% (natural therapies) in Russia, and 8% (hyaluronic acid injections) to 34% (homeopathic) in Italy. Respondents frequently selected “I don’t know” for optional and not recommended treatments (up to 50-74%). The most suggested/taken treatments were oral anti-inflammatory drugs in Italy (87/81%) and Russia (97/97%) and specific physical exercise in Sweden (84/79%). The study identified consensus (>70% agreement) in perceiving OA treatments as uncertain in Russia and seeking online information for OA care in Russia and Sweden. Consensus on non-surgical treatments was only found in Sweden, emphasising exercise effectiveness for everyone. Russia and Italy believed radiographic findings were necessary before engaging in physical exercise. In Russia, the cost and lack of coverage by the public insurance/healthcare system for exercise were perceived as barriers to exercise adherence. No consensus was found regarding diet barriers. Mean (SD) satisfaction scores were 59.7 (25.0), 47.4 (28.0), and 35.2 (23.9) in Italy, Sweden, and Russia, respectively.Conclusion:Survey participants demonstrated greater awareness of recommended treatments than optional and not-recommended ones. Italy and Russia leaned towards passive treatments, in contrast to Sweden. The findings underscore the need for a comprehensive approach to educating individuals with OA, providing a thorough overview of treatment options (recommended or not) to facilitate shared decision-making with healthcare professionals.REFERENCES:NIL.Acknowledgements:This work was funded by the European Alliance of Associations for Rheumatology (EULAR) through the EULAR Health Professionals in Rheumatology (HPR) Research Grant 2020.Disclosure of Interests:None declared.

Wastewater alkalinity enhancement is a promising approach for ocean alkalinity enhancement due to its potential to deliver strong bases with minimum secondary precipitation and its potential use of the global network of wastewater treatment plants (WWTPs). WWTPs are also significant sources of CO2 due to organic matter oxidation, and integrating alkalinity addition into treatment processes may both reduce in-plant CO2 emissions and increase downstream CO2 uptake. This study presents a modeling framework that combines a modern activated sludge model-based WWTP simulator with an integrated hydrodynamic-biogeochemical-carbonate chemistry model of coastal oceans. We evaluate the effects of adding alkalinity either upstream (UpAdd) of the biological treatment stage or downstream at the discharge location (DnAdd) on WWTP carbon emission reduction and marine CO2 removal. The carbon emission from WWTPs decreases with increasing alkalinity dosage in UpAdd and can be eliminated at a dosage level that is feasible to implement. However, carbon uptake in the surrounding oceanic water is much reduced due to elevated dissolved inorganic carbon in the discharge water. DnAdd does not affect CO2 emissions from WWTPs but enhances carbon uptake in the ocean, with the net oceanic uptake of atmospheric CO2 increasing with increasing dosage level. Across all tested dosage levels, total CO2 removal, including emission reduction at the WWTPs and enhanced carbon uptake in the ocean, is 30% greater in UpAdd than in DnAdd. WWTP treatment tanks have much higher pCO2 than in the ocean, and aeration of process tanks enhances the gas transfer. The upstream alkalinity addition leads to sharp declines in pCO2 in the treatment tanks and large reductions in carbon emission from the WWTPs. These results have implications for developing strategies to reduce global carbon emission and enhance oceanic carbon burial using WWTPs as a delivery mechanism.

Featuring contributions from leading experts in science and engineering, this book explores the complex biogeochemistry of acid mine drainage, rock drainage, and acid sulfate soils. It describes how to predict, prevent, and remediate the environmental impact of acid drainage and the oxidation of sulfides, offering the latest sampling and analytical methods. Moreover, readers will discover new approaches for recovering valuable resources from acid mine drainage, including bioleaching. This book reviews the most current findings in the field, offering new insights into the underlying causes as well as new tools to minimize the harm of acid drainage.

Abstract Measurements of sediment–water fluxes of O2, NO23, NH4, and PO4 and water column and sediment variables were conducted at 348 sites in Chesapeake Bay and Maryland Coastal Bays with most (~ 76%) of the 1746 sets of measurements collected during warm seasons when these processes were most active. We performed a system-wide synthesis of these spatially extensive, long-term data to identify the primary controlling factors on sediment–water fluxes over seasonal and interannual time periods and assess the relative contribution of sediment–water fluxes to nutrient cycling across distinct regions of Chesapeake Bay and the Maryland Coastal Bays. Bay-wide spatial patterns revealed hotspots for sediment–water fluxes, and statistical models were able to explain 46% (O2), 23% (NH4), 25% (NO23), and 38% (PO4) of variability in fluxes, with solute-specific controlling variables including temperature, bottom water oxygen and nutrient concentration, and sediment organic matter. An analysis of long-term variations in fluxes at six locations in the Bay (12–17 year time series) exhibited only weak evidence of long-term trends, but interannual variability was related to both water column and sediment variables, depending on the solute of interest. Finally, we compared external loads of “new” total nitrogen and phosphorus (TN and TP) to system-wide sediment–water fluxes of NH4 and PO4 at 22 Bay tributary and Coastal Bays sites, finding that ~ 64% of sites had annual sediment recycling rates that exceeded annual external loading rates, revealing the importance of recycled nutrients in these shallow systems.