New York State Climate Impacts Assessment Chapter 05: Ecosystems.

The people of New York have long benefited from the state's diversity of ecosystems, which range from coastal shorelines and wetlands to extensive forests and mountaintop alpine habitat, and from lakes and rivers to greenspaces in heavily populated urban areas. These ecosystems provide key services such as food, water, forest products, flood prevention, carbon storage, climate moderation, recreational opportunities, and other cultural services. This chapter examines how changes in climatic conditions across the state are affecting different types of ecosystems and the services they provide, and considers likely future impacts of projected climate change.

Adverse events and perceived abandonment: learning from patients' accounts of medical mishaps.

Background: Adverse medical events affect 10% of American households annually, inducing a variety of harms and attitudinal changes. The impact of adverse events on perceived abandonment by patients and their care partners has not been methodically assessed.

Objective: To identify ways in which providers, patients and families responded to medical mishaps, linking these qualitatively and statistically to reported feelings of abandonment and sequelae induced by perceived abandonment.

Alternative Payment Models and Performance in Federally Qualified Health Centers.

Importance: Several state Medicaid agencies have transitioned from traditional fee-for-service to a value-centric alternative payment model (APM) to reimburse federally qualified health centers (FQHCs). Little is known about the effects of this shift on FQHC performance.

Objective: To assess the association between APMs and the clinical performance, payer mix, risk profile, and financial sustainability of FQHCs.

"Nothing Is More Powerful than Words:" How Patient Experience Narratives Enable Improvement.

Background And Objectives: Patient experience narratives (narratives) are an increasingly important element of both measurement approaches and improvement efforts in healthcare. Prior studies show that narratives are considered by both clinicians and staff to be an appealing, meaningful, and credible form of evidence on performance. They also suggest that making concrete use of narratives within organizational settings to improve care can be complex and challenging.

Intracameral Injection in Rats with Low Risk of Adverse Effects.

Intracameral injection is a standard administration routine in ophthalmology. The application of intracameral injection in rodents for research is challenging due to the limiting dimensions and anatomy of the eye, including the small aqueous humor volume, the lens curvature, and lens thickness. Potential damage during intracameral injections introduces adverse effects and experimental variability.

Enabling countries to manage outbreaks: statistical, operational, and contextual analysis of the early warning and response system (EWARS-csd) for dengue outbreaks.

Introduction: Dengue is currently the fastest-spreading mosquito-borne viral illness in the world, with over half of the world's population living in areas at risk of dengue. As dengue continues to spread and become more of a health burden, it is essential to have tools that can predict when and where outbreaks might occur to better prepare vector control operations and communities' responses. One such predictive tool, the Early Warning and Response System for climate-sensitive diseases (EWARS-csd), primarily uses climatic data to alert health systems of outbreaks weeks before they occur.

Leukemic Retinopathy: A Diagnostic Clue for Initial Detection and Prognosis of Leukemia.

Leukemia is a systemic malignancy that can compromise various physiological functions, including vision. We report a case of a 37-year-old male presenting with worsening bilateral central vision loss, fatigue, shortness of breath, and ankle edema. Ophthalmic examination revealed extensive retinal hemorrhages, Roth spots, and subhyaloid hemorrhages, consistent with leukemic retinopathy.

Bilateral, Simultaneous Central Serous Chorioretinopathy in Association With Oral Contraception Use.

This report describes a case of bilateral, simultaneous central serous chorioretinopathy (CSCR) in a young woman on oral contraceptive pills (OCP). A 21-year-old woman with a negative past medical history presented with sudden onset of bilateral decreased vision shortly after starting OCP. Comprehensive ocular examination revealed bilateral central serous chorioretinopathy (CSCR), confirmed on retinal optical coherence tomography (OCT) and intravenous fluorescein angiography.

Leveraging Patients' Creative Ideas for Innovation in Health Care.

Unlabelled: Policy Points Patients' creative ideas may inform learning and innovation that improve patient-centered care. Routinely collected patient experience surveys provide an opportunity to invite patients to share their creative ideas for improvement. We develop and assess a methodological strategy that validates question wording designed to elicit creative ideas from patients.

How exposure to patient narratives affects stereotyped choices of primary care clinicians.

In this paper, we examine whether patient narratives alter the impact of stereotyping on choice of primary care clinicians: in this case, the common presumption that female doctors will be more attentive to empathic relationships with patients. 1052 individuals were selected from a nationally representative Internet panel to participate in a survey experiment. Participants were given performance data about 12 fictitious primary care physicians, including a randomized set of narrative feedback from patients.

Learning from patients: The impact of using patients' narratives on patient experience scores.

Background: Enthusiasm has grown about using patients' narratives-stories about care experiences in patients' own words-to advance organizations' learning about the care that they deliver and how to improve it, but studies confirming association have not been published.

Purpose: We assessed whether primary care clinics that frequently share patients' narratives with their staff have higher patient experience survey scores.

Approach: We conducted a 1-year study of 5,545 adult patients and 276 staff affiliated with nine clinics in one health system.

When Mistakes Multiply: How Inadequate Responses to Medical Mishaps Erode Trust in American Medicine.

In this essay, we explore consequences of the systemic failure to track and to publicize the prevalence of patient-safety threats in American medicine. Tens of millions of Americans lose trust in medical care every year due to safety shortfalls. Because this loss of trust is long-lasting, the corrosive effects build up over time, yielding a collective maelstrom of mistrust among the American public.

Gaps in benefits, awareness, and comprehension that leave those with long COVID vulnerable.

Objectives: The COVID-19 pandemic has left many suffering from long COVID, an episodic and debilitating chronic condition affecting people's ability to work and manage medical expenses. Though the Biden Administration has committed to conducting research and building support programs to alleviate the strain on those affected, in practice, static eligibility criteria for unemployment and disability benefits, patchy insurance coverage, and insufficient paid leave programs have left many people vulnerable. Given the magnitude of long COVID and the dearth to date of large-scale studies about its financial consequences, a focused qualitative analysis of lived experiences is warranted to understand and highlight gaps in the policy landscape.

Assessing an innovative method to promote learning from patient narratives: Findings from a field experiment in ambulatory care.

Objective: To assess whether an online interactive report designed to facilitate interpretation of patients' narrative feedback produces change in ambulatory staff learning, behavior at the individual staff and practice level, and patient experience survey scores.

Data Sources And Setting: We studied 22 ambulatory practice sites within an academic medical center using three primary data sources: 333 staff surveys; 20 in-depth interviews with practice leaders and staff; and 9551 modified CG-CAHPS patient experience surveys augmented by open-ended narrative elicitation questions.

Study Design: We conducted a cluster quasi-experimental study, comparing 12 intervention and 10 control sites.

In ovo probiotic supplementation promotes muscle growth and development in broiler embryos.

In chickens, muscle development during embryonic growth is predominantly by myofiber hyperplasia. Following hatch, muscle growth primarily occurs via hypertrophy of the existing myofibers. Since myofiber number is set at hatch, production of more muscle fibers during embryonic growth would provide a greater myofiber number at hatch and potential for posthatch muscle growth by hypertrophy.

Enterotoxemia produced by lambda toxin-positive type D in 2 neonatal goat kids.

Enterotoxemia caused by type D usually affects sheep and goats ≥ 2-wk-old. The main clinical signs and lesions of the disease are produced by the epsilon toxin (ETX) elaborated by this microorganism. However, ETX is produced in the form of a mostly inactive prototoxin that requires protease cleavage for activation.

Amdoparvovirus-associated disease in striped skunks ().

Disease caused by the archetypical amdoparvovirus (APV), Aleutian mink disease virus (AMDV), has been well studied, but APV infections in other carnivores are poorly understood. Skunk amdoparvovirus (SKAV), one of a handful of newly discovered APVs, is apparently species-specific in striped skunks () and has a high prevalence across North America. We have evaluated the infection status and viral tissue distribution in a cohort of 26 free-ranging California skunks from a single rehabilitation facility who were euthanized due to poor prognosis for recovery from neurologic disease.

The Role of CD36/GPIV in Platelet Biology.

CD36 (also known as platelet glycoprotein IV) is expressed by a variety of different cell entities, where it possesses functions as a signaling receptor, but additionally acts as a transporter for long-chain fatty acids. This dual function of CD36 has been investigated for its relevance in immune and nonimmune cells. Although CD36 was first identified on platelets, the understanding of the role of CD36 in platelet biology remained scarce for decades.

Copper-free click bioconjugation of technetium-99m complexes using strained cyclononyne derivatives.

Click chemistry, in particular copper-free click reactions, has gained growing interest for radiolabelling purposes in the field of radiopharmaceutical sciences. [Tc][Tc(CO)(HO)] works as an excellent starting complex for the radiolabelling of biomolecules under mild conditions. A new chelator, investigated for the copper-free strain-promoted cycloaddition (SPAAC), was synthesised containing the 2,2'-dipicolylamine (DPA) moiety for the Tc-tricarbonyl core and compared with a DPA chelator based on activated esters for conventional radiolabelling.

Finite-time Lyapunov fluctuations and the upper bound of classical and quantum out-of-time-ordered expansion rate exponents.

This Letter demonstrates for chaotic maps [logistic, classical, and quantum standard maps (SMs)] that the exponential growth rate (Λ) of the out-of-time-ordered four-point correlator is equal to the classical Lyapunov exponent (λ) plus fluctuations (Δ^{(fluc)}) of the one-step finite-time Lyapunov exponents (FTLEs). Jensen's inequality provides the upper bound λ≤Λ for the considered systems. Equality is restored with Λ=λ+Δ^{(fluc)}, where Δ^{(fluc)} is quantified by k-higher-order cumulants of the (covariant) FTLEs.

Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.

Objective: To evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience.

Data Sources: Data came from 163 participants recruited from a probability-based online panel of U.S.

Preschoolers' attention to and learning from on-screen characters that vary by effort and efficiency: An eye-tracking study.

Prior findings are mixed regarding the extent to which children understand others' effort in early childhood. Especially, little is known about how character effort impacts children's selective attention and learning. This study examined preschoolers' visual attention to and learning from two on-screen characters: One character exerting high effort with low efficiency and another character exerting low effort with high efficiency in solving problems successfully.