Homeless shelter residents and staff may be at higher risk of SARS-CoV-2 infection. However, SARS-CoV-2 infection estimates in this population have been reliant on cross-sectional or outbreak investigation data. We conducted routine surveillance and outbreak testing in 23 homeless shelters in King County, Washington, to estimate the occurrence of laboratory-confirmed SARS-CoV-2 infection and risk factors during 1 January 2020–31 May 2021. Symptom surveys and nasal swabs were collected for SARS-CoV-2 testing by RT-PCR for residents aged ≥3 months and staff. We collected 12,915 specimens from 2,930 unique participants. We identified 4.74 (95% CI 4.00–5.58) SARS-CoV-2 infections per 100 individuals (residents: 4.96, 95% CI 4.12–5.91; staff: 3.86, 95% CI 2.43–5.79). Most infections were asymptomatic at the time of detection (74%) and detected during routine surveillance (73%). Outbreak testing yielded higher test positivity than routine surveillance (2.7% versus 0.9%). Among those infected, residents were less likely to report symptoms than staff. Participants who were vaccinated against seasonal influenza and were current smokers had lower odds of having an infection detected. Active surveillance that includes SARS-CoV-2 testing of all persons is essential in ascertaining the true burden of SARS-CoV-2 infections among residents and staff of congregate settings.

Blue carbon is identified as a natural climate solution as it provides multiple ecosystem services, including climate mitigation, adaptation, and other co-benefits. There remain ongoing challenges for blue carbon as a natural climate solution, particularly as blue carbon ecosystems are at risk from climate change. Concepts of uniformitarianism were applied to consider how the present and past behaviour of blue carbon ecosystems can inform decision-makers of blue carbon risks. Climate change may increase the capture and storage of blue carbon in the short to medium term; this is largely due to negative feedbacks between elevated atmospheric carbon dioxide and temperature, and supplemented by natural processes of sediment supply and accumulation. Opportunities for retreat and increasing carbon storage as sea levels rise are likely to be greater where sea level has a longer history of relative stability, largely in the Southern Hemisphere. Landward retreat will be crucial where millennia of sea-level rise have limited the capacity for in situ blue carbon additionality; this may be thwarted by highly developed coastal zones and coastal squeeze effects. Negative feedbacks may fail under higher emissions, greater warming and rates of sea-level rise exceeding ~5–7 mm yr.−1; this tipping point may be surpassed within the next century under a high emissions scenario. Retreat of blue carbon ecosystems to higher elevations where they are afforded protection from the effects of sea-level rise will be critical for blue carbon additionality. Carbon markets are prepared to incentivise restoration of blue carbon ecosystems as they adapt to climate change; however, knowledge gaps remain, particularly regarding the behaviour of blue carbon ecosystems in the global south. Given the momentum in blue carbon research, scientists and practitioners are well placed to continue addressing blue carbon risks.

The hypothesis that violence—especially gang violence—behaves like a contagious disease has grown in popularity in recent years. Scholars have long observed the tendency for violence to cluster in time and space, but little research has focused on empirically unpacking the mechanisms that make violence contagious. In the context of gang violence, retaliation is the prototypical mechanism to explain why violence begets violence. In this study, we leverage relational event models (REMs)—an underutilized yet particularly well-suited modeling technique to study the dynamics of inter-gang violence. We use REMs to examine gang violence’s tendency to replicate—for which retaliation is but one plausible mechanism—and its tendency to diffuse to other groups. We rely on data on conflicts between gangs in a region of Los Angeles over 3 years. We consider how the characteristics of gangs, their spatial proximity, networks of established rivalries, and the evolving history, directionality, and structure of conflicts predict future inter-gang conflicts. While retaliation is an important mechanism for the replication of violence, established rivalries, and inertia—a gang’s tendency to continue attacking the same group—are more important drivers of future violence. We also find little evidence for an emerging pecking order or status hierarchy between gangs suggested by other scholars. However, we find that gangs are more likely to attack multiple gangs in quick succession. We propose that gang violence is more likely to diffuse to other groups because of the boost of internal group processes an initial attack provides.

Mood problems are common after stroke, and screening is recommended. Training may support staff knowledge and implementation of screening, but the feasibility of training programmes in the Australian healthcare system has not been formally established. This study aimed to assess the feasibility of a mood screening training for a multidisciplinary team (MDT) of stroke clinicians working in a post-acute inpatient rehabilitation service.

Twelve staff from a rehabilitation service at a major hospital in Sydney, Australia participated in a 3-h interactive training session. The feasibility of running the course, assessment of knowledge gained via a consolidation exercise and quiz and acceptability of the training were assessed via focus groups.

The in-person modality of the training hindered recruitment and assessment of participants’ knowledge, though the actual measures themselves appeared appropriate. Nine participants provided feedback in two focus groups. Thematic analysis identified positive reactions to the training. However, low self-efficacy persisted and organisational/socio-cultural barriers to implementation emerged. Following training, the medical officers of the MDT had successfully implemented routine screening.

Overall, the training appeared acceptable and to foster knowledge in staff. However, limitations to recruitment and administering evaluations were identified. The development of flexible online training may improve future evaluations of screening training programmes/pathways.

Major depressive disorder (MDD) is the leading cause of disability worldwide. Patients with MDD have high rates of comorbidity with mental and physical conditions, one of which is chronic pain. Chronic pain conditions themselves are also associated with significant disability, and the large number of patients with MDD who have chronic pain drives high levels of disability and compounds healthcare burden. The management of depression in patients who also have chronic pain can be particularly challenging due to underlying mechanisms that are common to both conditions, and because many patients with these conditions are already taking multiple medications. For these reasons, healthcare providers may be reluctant to treat such patients. The Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines provide evidence-based recommendations for the management of MDD and comorbid psychiatric and medical conditions such as anxiety, substance use disorder, and cardiovascular disease; however, comorbid chronic pain is not addressed. In this article, we provide an overview of the pathophysiological and clinical overlap between depression and chronic pain and review evidence-based pharmacological recommendations in current treatment guidelines for MDD and for chronic pain. Based on clinical experience with MDD patients with comorbid pain, we recommend rapidly and aggressively treating depression according to CANMAT treatment guidelines, using antidepressant medications with analgesic properties, while addressing pain with first-line pharmacotherapy as treatment for depression is optimized. We review options for treating pain symptoms that remain after response to antidepressant treatment is achieved.

Substantial progress has been made in the standardization of nomenclature for paediatric and congenital cardiac care. In 1936, Maude Abbott published her Atlas of Congenital Cardiac Disease, which was the first formal attempt to classify congenital heart disease. The International Paediatric and Congenital Cardiac Code (IPCCC) is now utilized worldwide and has most recently become the paediatric and congenital cardiac component of the Eleventh Revision of the International Classification of Diseases (ICD-11). The most recent publication of the IPCCC was in 2017. This manuscript provides an updated 2021 version of the IPCCC.

The International Society for Nomenclature of Paediatric and Congenital Heart Disease (ISNPCHD), in collaboration with the World Health Organization (WHO), developed the paediatric and congenital cardiac nomenclature that is now within the eleventh version of the International Classification of Diseases (ICD-11). This unification of IPCCC and ICD-11 is the IPCCC ICD-11 Nomenclature and is the first time that the clinical nomenclature for paediatric and congenital cardiac care and the administrative nomenclature for paediatric and congenital cardiac care are harmonized. The resultant congenital cardiac component of ICD-11 was increased from 29 congenital cardiac codes in ICD-9 and 73 congenital cardiac codes in ICD-10 to 318 codes submitted by ISNPCHD through 2018 for incorporation into ICD-11. After these 318 terms were incorporated into ICD-11 in 2018, the WHO ICD-11 team added an additional 49 terms, some of which are acceptable legacy terms from ICD-10, while others provide greater granularity than the ISNPCHD thought was originally acceptable. Thus, the total number of paediatric and congenital cardiac terms in ICD-11 is 367. In this manuscript, we describe and review the terminology, hierarchy, and definitions of the IPCCC ICD-11 Nomenclature. This article, therefore, presents a global system of nomenclature for paediatric and congenital cardiac care that unifies clinical and administrative nomenclature.

The members of ISNPCHD realize that the nomenclature published in this manuscript will continue to evolve. The version of the IPCCC that was published in 2017 has evolved and changed, and it is now replaced by this 2021 version. In the future, ISNPCHD will again publish updated versions of IPCCC, as IPCCC continues to evolve.

Palmer amaranth–a fast-growing, challenging-to-control noxious weed that significantly reduces crop yields—was first found in Minnesota in September 2016 in conservation plantings sown with Palmer amaranth contaminated seed mixes. Minnesota Department of Agriculture (MDA) designated Palmer amaranth as a Prohibited Noxious Weed in 2015 and listed it as a Noxious Weed Seed in 2016 by emergency order. A genetic test to identify Palmer amaranth was simultaneously developed by multiple laboratories, providing a tool to limit its spread as a contaminant in seed. Seed companies adopted genetic testing methods for labeling seed for sale, thus reducing introductions via the seed pathway. Additionally, MDA determined that manure spread on crop fields from contaminated screenings fed to livestock resulted in new infestations. Limiting spread via these and other potential pathways was critical to successfully reducing the impact of Palmer amaranth. MDA, University of Minnesota (UMN) Extension, Conservation Corps Minnesota and Iowa (CCMI), farmers, and other partners are working to eradicate these infestations before they can spread. In 2016, 35 sites were sown with Palmer amaranth–contaminated seed mixes. Palmer amaranth was found at eight (23%) of these sites. Management with intensive scouting, torching, prescribed burning, and herbicide application was implemented in 2016 and 2017. By 2018, no Palmer amaranth was found at any of these sites. Similar success to newer infestations in 2018, 2019, and 2020 was achieved using the same methods. MDA recorded management activities and documented a comprehensive timeline of Palmer amaranth in Minnesota. This timeline provides a story of success and challenges in combating and eradicating Palmer amaranth.

We present and analyze three powerful long-term historical trends in the electrification of energy by free-fuel sources. These trends point toward a future in which energy is affordable, abundant, and efficiently deployed; with major economic, geo-political, and environmental benefits to humanity.

We present and analyze three powerful long-term historical trends in energy, particularly electrical energy, as well as the opportunities and challenges associated with these trends. The first trend is from a world containing a diversity of energy currencies to one whose predominant currency is electricity, driven by electricity’s transportability, exchangeability, and steadily decreasing cost. The second trend is from electricity generated from a diversity of sources to electricity generated predominantly by free-fuel sources, driven by their steadily decreasing cost and long-term abundance. These trends necessitate a just-emerging third trend: from a grid in which electricity is transported unidirectionally, traded at near-static prices, and consumed under direct human control; to a grid in which electricity is transported bidirectionally, traded at dynamic prices, and consumed under human-tailored artificial agential control. These trends point toward a future in which energy is not costly, scarce, or inefficiently deployed but instead is affordable, abundant, and efficiently deployed; with major economic, geo-political, and environmental benefits to humanity.

Accurate weed emergence models are valuable tools for scheduling planting, cultivation, and herbicide applications. Multiple models predicting giant ragweed emergence have been developed, but none have been validated in diverse crop rotation and tillage systems, which have the potential to influence weed emergence patterns. This study evaluated the performance of published giant ragweed emergence models across various crop rotations and spring tillage dates in southern Minnesota. Across experiments, the most robust model was a mixed-effects Weibull (flexible sigmoidal function) model predicting emergence in relation to hydrothermal time accumulation with a base temperature of 4.4 C, a base soil matric potential of −2.5 MPa, and two random effects determined by overwinter growing degree days (GDD) (10 C) and precipitation accumulated during seedling recruitment. The deviations in emergence between individual plots and the fixed-effects model were distinguished by the positive association between the lower horizontal asymptote (Drop) and maximum daily soil temperature during seedling recruitment. This finding indicates that crops and management practices that increase soil temperature will have a shorter lag phase at the start of giant ragweed emergence compared with practices promoting cool soil temperatures. Thus, crops with early-season crop canopies such as perennial crops and crops planted in early spring and in narrow rows will likely have a slower progression of giant ragweed emergence. This research provides a valuable assessment of published giant ragweed emergence models and illustrates that accurate emergence models can be used to time field operations and improve giant ragweed control across diverse cropping systems.

Ecological management of invasive weeds will require substantial increases in the application of ecological knowledge and its integration with other forms of knowledge. To enable these increases, we call for purposeful development of knowledge networks in which new knowledge about a complex situation is created by the interaction of different forms of knowledge. We believe that invasive-plant management must be based on a fine-tuning of managed ecosystems, in which operations (e.g., farm activities) are comprehensively adjusted to confront invasives with a wide array of control measures. Land managers must have the primary role in this tuning process because of their holistic knowledge of the ecosystems they manage. Additionally, such ecological management of invasives will require support from new or improved practices in many relevant sectors, e.g., involving extension workers, farm advisors, and researchers of many sorts. Knowledge networks facilitate the creation, application, and integration of knowledge that will be needed to support ecological invasive-plant management. Worldwide, knowledge networks are under very active development as promising solutions to ecological-management challenges. To develop, networks require proactive organization and facilitation. We have developed an experimental knowledge network to facilitate ecological management of field-crop weeds on the basis of collaborative learning groups that help farmers and other professionals develop necessary knowledge. These groups have been favorably evaluated by most participants, and this article describes the results of our project, including our insights into development of such networks.

Mountain glaciers in Scandinavia are currently advancing while most of the monitored mountain glaciers of the world are retreating. We examine atmospheric circulation variability and compare changes in air pressure indices to changes in the mass balance of glaciers in the northeastern part of the Atlantic Ocean. The glacier mass balance correlates well with the strength of maritime flow in both winter and summer, the presence of high pressure over the Barents Sea being a critical factor in summer. The advance of Scandinavian glaciers is due partly to persistently strong westerlies over the northeastern Atlantic during post-1980 winters and partly to cold summertime flow, which together have helped maintain positive glacier net balance by decreasing ablation since 1980.