Multi-level analysis of the learning health system: Integrating contributions from research on organizations and implementation.

Introduction: Organizations and systems that deliver health care may better adapt to rapid change in their environments by acting as learning organizations and learning health systems (LHSs). Despite widespread recognition that multilevel forces shape capacity for learning within care delivery organizations, there is no agreed-on, comprehensive, multilevel framework to inform LHS research and practice.

Methods: We develop such a framework, which can enhance both research on LHSs and practical steps toward their development.

Evaluating Drought Responses of Surface Ozone Precursor Proxies: Variations With Land Cover Type, Precipitation, and Temperature.

Prior work suggests drought exacerbates US air quality by increasing surface ozone concentrations. We analyze 2005-2015 tropospheric column concentrations of two trace gases that serve as proxies for surface ozone precursors retrieved from the OMI/Aura satellite: Nitrogen dioxide (ΩNO NO proxy) and formaldehyde (ΩHCHO; VOC proxy). We find 3.

Spine biomechanical testing methodologies: The controversy of consensus vs scientific evidence.

Biomechanical testing methodologies for the spine have developed over the past 50 years. During that time, there have been several paradigm shifts with respect to techniques. These techniques evolved by incorporating state-of-the-art engineering principles, in vivo measurements, anatomical structure-function relationships, and the scientific method.

Reversible Functionalization of Clickable Polyacrylamide Gels with Protein and Graft Copolymers.

Modular strategies to fabricate gels with tailorable chemical functionalities are relevant to applications spanning from biomedicine to analytical chemistry. Here, the properties of clickable poly(acrylamide-co-propargyl acrylate) (pAPA) hydrogels are modified via sequential in-gel copper-catalyzed azide-alkyne cycloaddition (CuAAC) reactions. Under optimized conditions, each in-gel CuAAC reaction proceeds with rate constants of ~0.

New Insights From Long-Term Measurements of Inner Belt Protons (10s of MeV) by SAMPEX, POES, Van Allen Probes, and Simulation Results.

The Solar, Anomalous, and Magnetospheric Particle Explorer (SAMPEX) mission provided long-term measurements of 10s of megaelectron volt (MeV) inner belt ( < 2) protons (1992-2009) as did the Polar-orbiting Operational Environmental Satellite-18 (POES-18, 2005 to present). These long-term measurements at low-Earth orbit (LEO) showed clear solar cycle variations which anticorrelate with sunspot number. However, the magnitude of the variation is much greater than the solar cycle variation of galactic cosmic rays (>GeV) that are regarded as a source of these trapped protons.

Use of stable nitrogen isotopes to track plant uptake of nitrogen in a nature-based treatment system.

In nature-based treatment systems, such as constructed wetlands, plant uptake of nutrients can be a significant removal pathway. Current methods for quantifying plant uptake of nitrogen in constructed wetlands, which often involve harvesting biomass and assuming that all nitrogen stored in plants was derived from wastewater, are inappropriate in pilot- and full-scale systems where other sources of nitrogen are available. To improve our understanding of nitrogen cycling in constructed wetlands, we developed a new method to quantify plant uptake of nitrogen by using stable isotopes and a mixing model to distinguish between nitrogen sources.

Biodiversity policy beyond economic growth.

Increasing evidence-synthesized in this paper-shows that economic growth contributes to biodiversity loss via greater resource consumption and higher emissions. Nonetheless, a review of international biodiversity and sustainability policies shows that the majority advocate economic growth. Since improvements in resource use efficiency have so far not allowed for absolute global reductions in resource use and pollution, we question the support for economic growth in these policies, where inadequate attention is paid to the question of how growth can be decoupled from biodiversity loss.

Agitation and impulsivity in mid and late life as possible risk markers for incident dementia.

To identify knowledge gaps regarding new-onset agitation and impulsivity prior to onset of cognitive impairment or dementia the International Society to Advance Alzheimer's Research and Treatment Neuropsychiatric Syndromes (NPS) Professional Interest Area conducted a scoping review. Extending a series of reviews exploring the pre-dementia risk syndrome Mild Behavioral Impairment (MBI), we focused on late-onset agitation and impulsivity (the MBI impulse dyscontrol domain) and risk of incident cognitive decline and dementia. This scoping review of agitation and impulsivity pre-dementia syndromes summarizes the current biomedical literature in terms of epidemiology, diagnosis and measurement, neurobiology, neuroimaging, biomarkers, course and prognosis, treatment, and ongoing clinical trials.

European genetic ancestry associated with risk of childhood ependymoma.

Background: Ependymoma is a histologically defined central nervous system tumor most commonly occurring in childhood. Population-level incidence differences by race/ethnicity are observed, with individuals of European ancestry at highest risk. We aimed to determine whether extent of European genetic ancestry is associated with ependymoma risk in US populations.

Intraspecific variation in thermal acclimation and tolerance between populations of the winter ant, .

Thermal phenotypic plasticity, otherwise known as acclimation, plays an essential role in how organisms respond to short-term temperature changes. Plasticity buffers the impact of harmful temperature changes; therefore, understanding variation in plasticity in natural populations is crucial for understanding how species will respond to the changing climate. However, very few studies have examined patterns of phenotypic plasticity among populations, especially among ant populations.

Long-term digital device-enabled monitoring of functional status: Implications for management of persons with Alzheimer's disease.

Introduction: Informal caregiving is an essential element of health-care delivery. Little data describes how caregivers structure care recipients' lives and impact their functional status.

Methods: We performed observational studies of community dwelling persons with dementia (PWD) to measure functional status by simultaneous assessment of physical activity (PA) and lifespace (LS).

On the horizon-the value and promise of the global pipeline of Alzheimer's disease therapeutics.

Introduction: The recent failure of several late-stage Alzheimer's disease (AD) clinical trials focused on amyloid beta (Aβ) highlights the challenges of finding effective disease-modifying therapeutics. Despite major advances in our understanding of the genetic risk factors of disease and the development of clinical biomarkers, and that not all Aβ-based approaches are equivalent, these failures may engender skepticism regarding the value of the AD pipeline.

Methods: To investigate these concerns, we compiled a database of current Phase 2 and 3 trials based on disease-modifying targets through a query of the National Institutes of Health's ClinicalTrials.

Empirical patterns of environmental variation favor adaptive transgenerational plasticity.

Effects of parental environment on offspring traits have been well known for decades. Interest in this transgenerational form of phenotypic plasticity has recently surged due to advances in our understanding of its mechanistic basis. Theoretical research has simultaneously advanced by predicting the environmental conditions that should favor the adaptive evolution of transgenerational plasticity.

Protective microbiomes can limit the evolution of host pathogen defense.

The evolution of host immunity occurs in the context of the microbiome, but little theory exists to predict how resistance against pathogens might be influenced by the need to tolerate and regulate commensal microbiota. We present a general model to explore the optimal investment in host immunity under conditions in which the host can, versus cannot easily distinguish among commensal versus pathogenic bacteria, and when commensal microbiota can, versus cannot protect the host against the impacts of pathogen infection. We find that a loss of immune vigilance associated with innate immunity over evolutionary time can occur due to the challenge of discriminating between pathogenic and other microbe species.

Genetic and chemical divergence among host races of a socially parasitic ant.

Host-parasite associations facilitate the action of reciprocal selection and can drive rapid evolutionary change. When multiple host species are available to a single parasite, parallel specialization on different hosts may promote the action of diversifying natural selection and divergence via host race formation. Here, we examine a population of the kidnapper ant () that is an obligate social parasite of three sympatric ant species: , , and (formerly ).

Mutual fitness benefits arise during coevolution in a nematode-defensive microbe model.

Species interactions can shift along the parasitism-mutualism continuum. However, the consequences of these transitions for coevolutionary interactions remain unclear. We experimentally coevolved a novel species interaction between hosts and a mildly parasitic bacterium, , with host-protective properties against virulent .

A Novel International Partnership for Actionable Evidence on Urban Health in Latin America: LAC-Urban Health and SALURBAL.

This article describes the origins and characteristics of an interdisciplinary multinational collaboration aimed at promoting and disseminating actionable evidence on the drivers of health in cities in Latin America and the Caribbean: The Network for Urban Health in Latin America and the Caribbean and the Wellcome Trust funded SALURBAL (Salud Urbana en América Latina, or Urban Health in Latin America) Project. Both initiatives have the goals of supporting urban policies that promote health and health equity in cities of the region while at the same time generating generalizable knowledge for urban areas across the globe. The processes, challenges, as well as the lessons learned to date in launching and implementing these collaborations, are described.

Soil mixture composition alters Arabidopsis susceptibility to infection.

is a gram-negative bacterial pathogen that causes disease on more than 100 different plant species, including the model plant . Dissection of the - pathosystem has identified many factors that contribute to successful infection or immunity, including the genetics of the host, the genetics of the pathogen, and the environment. Environmental factors that contribute to a successful interaction can include temperature, light, and the circadian clock, as well as the soil environment.

Comparative genetics of invasive populations of walnut aphid, , and its introduced parasitoid, , in California.

Coevolution may be an important component of the sustainability of importation biological control, but how frequently introduced natural enemies coevolve with their target pests is unclear. Here we explore whether comparative population genetics of the invasive walnut aphid, and its introduced parasitoid, , provide insights into the localized breakdown of biological control services in walnut orchards in California. We found that sampled populations of exhibited higher estimates of genetic differentiation () than co-occurring populations of .