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This study characterized adult primary care medical assistant (MA) staffing. National Survey of Healthcare Organizations and Systems (n = 1,252) data were analyzed to examine primary care practice characteristics associated with MA per primary care clinician (PCC) staffing ratios. In 2021, few practices (11.4%) had ratios of 2 or more MAs per PCCs. Compared with system-owned practices, independent (odds ratio [OR] = 1.76, P https://doi.org/10.1370/afm.3100, INTRODUCTION Medical assistants (MAs) are among the fastest growing occupations within the US primary care workforce, (1) but little is known about organizational factors associated with MA support levels for [...]

How do countries' strategic narratives (SNs) evolve during conflicts? Are changes in sentiment in diplomatic communication related to kinetic developments? This paper assesses Russian rhetoric toward Ukraine from 2004 to 2019 by qualitatively and quantitively analyzing nearly 3,000 statements by the Russian Ministry of Foreign Affairs. During this time, Russian identity narratives changed from projecting an identity of a good neighbor and hegemon to an enemy of the Ukrainian regime--while portrayals of Ukraine evolved from that of a strategic partner to a violator of international law and aggressor. Changes in sentiment either follow policy changes, pinpoint important kinetic developments, or indicate political openings., The heart of international relations is a dynamic negotiation process in which countries use a combination of hard and soft power to attempt to achieve their objectives and preferences. A [...]

Histories of sexology often examine moments of censorship in which sexological knowledge was repressed, banned, or destroyed. Familiar examples include the Bedborough trial, which resulted in the censorship of John [...]

Background: Current measures to prevent spinal surgical site infection (SSI) lack compliance and lead to antimicrobial resistance. We aimed to examine the effectiveness of bundled preoperative intranasal photodynamic disinfection therapy (nPDT) and chlorhexidine gluconate (CHG) body wipes in the prophylaxis of spine SSIs in adults, as well as determine our institutional savings attributable to the use of this strategy and identify adverse events reported with nPDT-CHG. Methods: We performed a 14-year prospective observational interrupted time-series study in adult (age > 18 yr) patients undergoing emergent or elective spine surgery with 3 time-specific cohorts: before rollout of our institution's nPDT-CHG program (2006-2010), during rollout (2011-2014) and after rollout (2015-2019). We used unadjusted bivariate analysis to test for temporal changes across patient and surgical variables, and segmented regression to estimate the effect of nPDT-CHG on the annual SSI incidence rates per period. We used 2 models to estimate the cost of nPDT-CHG to prevent 1 additional SSI per year and the annual cumulative cost savings through SSI prevention. Results: Over the study period, 13 493 patients (mean 964 per year) underwent elective or emergent spine surgery. From 2006 to 2019, the mean age, mean Charlson Comorbidity Index (CCI) score and mean Spine Surgical Invasiveness Index (SSII) score increased from 48.4 to 58.1 years, from 1.7 to 2.6, and from 15.4 to 20.5, respectively (p < 0.001). Unadjusted analysis confirmed a significant decrease in the annual number (74.6 to 26.8) and incidence (7.98% to 2.67%) of SSIs with nPDT-CHG (p < 0.001). After adjustment for mean age, mean CCI score and mean SSII score, segmented regression showed an absolute reduction in the annual SSI incidence rate of 3.36% per year (p < 0.001). The estimated annual cost to prevent 1 additional SSI per year was about $1350-$1650, and the estimated annual cumulative cost savings were $2 484856-S2 495 016. No adverse events were reported with nPDT-CHG. Conclusion: Preoperative nPDT-CHG administration is an effective prophylactic strategy for spinal SSIs, with significant cost savings. Given its rapid action, minimal risk of antimicrobial resistance, broad-spectrum activity and high compliance rate, preoperative nPDT-CHG decolonization should be the standard of care for all patients undergoing emergent or elective spine surgery. Contexte : L'application des mesures de prévention des infections des plaies opératoires (IPO) du rachis laisse actuellement à désirer et pourrait contribuer à la résistance aux antibiotiques. Nous avons voulu vérifier l'efficacité de la thérapie photodynamique antimicrobienne (TPA) intranasale préopératoire alliée à l'utilisation de lingettes désinfectantes à la chlorhexidine (LDC) pour le corps en prophylaxie des IPO du rachis chez des adultes, calculer les économies réalisées par notre établissement grâce à la stratégie TPD-LDC et recenser ses effets indésirables. Méthodes : Nous avons procédé à une étude observationnelle de séries chronologiques interrompues échelonnée sur une période de 14 ans chez des adultes (âgés de >18 ans) soumis à une chirurgie urgente ou non urgente du rachis auprès de 3 cohortes chronologiques spécifiques : avant le déploiement de la stratégie dans notre établissement (2006-2010), puis durant (2011-2014) et après son déploiement (2015-2019). Nous avons appliqué une analyse bivariée non ajustée pour vérifier les changements dans le temps selon la patientèle et les paramètres chirurgicaux, et segmenté la régression pour estimer l'effet de la stratégie TPA-LDC sur les taux d'incidence annuels moyens d'IPO par période. Nous avons utilisé 2 modèles pour estimer le coût de la stratégie TPA-LDC apte à prévenir une IPO additionnelle par année et les économies cumulatives annuelles moyennes générées par la prévention des IPO. Résultats : Durant la période de l'étude, 13 493 malades (964 par année en moyenne) ont subi une chirurgie urgente ou non urgente du rachis. Entre 2006 et 2011 et entre 2015 et 2019, l'âge moyen, l'indice moyen de comorbidité de Charlson (ICC) et l'indice moyen d'invasivité de la chirurgie du rachis (IICR) sont passés de 48,4 à 58,1 ans, de 1,7 à 2,6 et de 15,4 à 20,5, respectivement (p < 0,001). L'analyse non ajustée a confirmé une baisse significative du nombre annuel (de 74,6 à 26,8) et de l'incidence (de 7,98% à 2,67%) des IPO associée à la stratégie TPA-LDC (p < 0,001). Après ajustement pour tenir compte de l'âge, de l'ICC et de l'IICR moyens, la régression segmentée a montré une réduction absolue du taux d'incidence annuel des IPO de 3,36% par année (p < 0,001). Le coût annuel moyen estimé pour prévenir une IPO additionnelle a été d'environ 1350$-1650$, et les économies cumulatives annuelles moyennes estimées ont été de 2484856 $-2 495 016$. Aucun effet indésirable n'a été signalé avec la stratégie TPA-LDC. Conclusion : L'application préopératoire de la stratégie TPA-LDC est une mesure prophylactique efficace pour les IPO du rachis, et donne lieu à des économies significatives. Compte tenu de sa rapidité d'action, du risque minimal de résistance aux antibiotiques, de son activité à large spectre et du taux d'observance élevé, la décolonisation préopératoire par TPA-LDC devrait être une norme de soins pour l'ensemble de la patientèle soumise à une chirurgie urgente ou non urgente du rachis., Surgical site infections (SSIs) are devastating postoperative complications associated with substantial morbidity, prolonged length of stay (LOS) and increased health care-related costs. (1) The rate of SSIs after spine surgery [...]

The current study aimed to extend existing research concerning HPV vaccination rates, sexual behaviour practices, and risk of HPV-related morbidity and mortality among Canadian university students. A survey research firm recruited an online sample of Canadian university students between 18 and 24 years of age and from across Canada for a study of student sexual health. The current report represents a secondary analysis of responses to this sexual health survey that is focused on HPV morbidity risk. An analysis sample of 1,412 university students responded to an assessment of demographic characteristics, HPV vaccination status (vaccinated or unvaccinated), and recent and lifetime sexual behaviours and condom use. Conservative estimates indicated that approximately one-quarter of university student women, at least two-thirds of university student men, and at least one-third of trans/ non-binary university students had not been vaccinated against HPV. Recent and lifetime sexual behaviours of HPV vaccinated and HPV unvaccinated university students were strikingly similar. HPV unvaccinated status, HPV-risk sexual behaviour, and HPV-related morbidity and mortality risk were very common in this national sample of Canadian university students. Cost-free catch-up HPV vaccination programs for unvaccinated university students are urgently needed to mitigate substantial HPV-related health risks in this population. KEYWORDS: HPV, HPV morbidity risk, HPV vaccine, sexual behaviour, university students, Human papillomavirus (HPV) appears to be the most common sexually transmitted infection (STI) in Canada (Marra et al., 2009; Steben & Gale-Rowe, 2014) and worldwide (Bosch et al., 2012; Bruni [...]

Native Foods: Agriculture, Indigeneity, and Settler Colonialism in American History. By Michael D. Wise. Food and Foodways. (Fayetteville: University of Arkansas Press, 2023. Pp. x, 200. Paper, $27.95, ISBN 978-1-68226238-2.) [...]

Stakeholder enthusiasm grips public companies and asset managers. Sustainability reports abound, reflecting an appetite for detailed data on company efforts to reduce carbon emissions and water usage and to protect and diversify workforces--while investors still seek returns to finance college tuition and fund retirement. But commentators and those who control public companies fail to engage on fundamental questions: Which stakeholders count? To what degree will companies sacrifice shareholder return to benefit those stakeholders? What happens when the interests of differing sets of non-shareholder stakeholders differ? Is all the commotion really necessary, given the many laws and regulations protecting such stakeholders? Whose priorities will, as a practical matter, govern the application of stakeholder theory, and will those in control of the priorities use this corporate theory to further their personal purposes? Exposition of these questions suggests serious changes in disclosures that director nominees and asset management firms must make, as well as the need for a hard look at whether stakeholder capitalism can be practiced with normative consistency., TABLE OF CONTENTS ABSTRACT 955 TABLE OF CONTENTS 956 I. INTRODUCTION 957 II. THE TWO COMPETING THEORIES OF THE CORPORATION'S ROLE IN SOCIETY 960 III. THE ODD TIMING OF THE [...]

We have all seen the headlines: No Lawyer for Miles or Legal Deserts Threaten Justice for All in Rural America. There is a substantial body of literature, across disciplines and for diverse audiences, that looks at access to justice in rural communities and geographies. However, in both the popular and scholarly imaginations, the access to justice crisis has been largely conflated with the shortage of local attorneys in rural areas: When bar associations, lawyers, and legal academics define the problem as not enough lawyers, more lawyers become the obvious solution. Consequently, programs aimed at building pipelines from law schools to rural locations and incentivizing rural practice have proliferated in central states, including South Dakota, North Dakota, Montana, Illinois, Nebraska, and Arkansas. And while there may be good reasons to want more lawyers in rural communities, we argue that more lawyers may not, in fact, be the most effective or impactful intervention in the rural access to justice crisis. This Article begins with the hypothesis that an attorney shortage and the justice gap are two distinct issues that have been uniquely conflated in the rural context and that when we begin to disentangle these problems, we better understand the complexity of each. As a starting point, we cannot measure what we cannot define. Advocates, scholars, and the legal profession lack shared definitions of both 'access to justice' and 'rural,' making measurement of rural access to justice, let alone comparisons across jurisdictions, nearly impossible. When we look at rural access to justice independently and without a bias or preference for lawyer-focused solutions, it seems less likely that more attorneys can effectively address the crisis for a multitude of reasons including rural community dynamics, information gaps, unclear demand, mismatched skills or expertise, cost, and potential conflicts. What we propose, instead, is a conceptualization of access to justice that is not centered around the lawyer, and we argue for a measurement of access to justice that does not rely on lawyers per capita or county (or anything) as its primary unit of measure. This Article, in turn, establishes the foundation for future work developing broader measures of access to justice infrastructure and proposing legal vulnerability as a concept that could help anticipate the needs of a community., INTRODUCTION I. DEFINING A CRISIS II. DEFINING RURAL A. Who is Rural? B. Where is Rural? III. DEFINING ACCESS TO JUSTICE A. __ to Justice and Access to B. What [...]

In Connette for Gullatte v. Charlotte-Mecklenburg Hospital Authority, the Supreme Court of North Carolina expanded liability for nurses. This decision signaled respect for growing nurse autonomy and will benefit patients; however, the broad holding leaves open questions for nurse practice. This Recent Development considers how the court could have better clarified nurse liability as well as the implications of this decision in the context of the North Carolina legislature's hesitance to pass a law granting nurses more independence., INTRODUCTION When a patient comes into the hospital, they are likely to interact with a number of healthcare professionals--physicians, nurses, medical technicians, and more. But what happens when something goes [...]

Generations can be useful for explaining cohort-level differences in partisan preferences. Yet a critical aspect of studying political generations is the selection of one period of dates instead of another. The common definitions of generations, popularized by the Pew Research Center, have been found to tell us a considerable amount about contemporary divides in American politics. Yet within the popular definitions of generations, age cohorts can diverge politically because their formative experiences are dissimilar. Subsets of generations can have their own political idiosyncrasies as their early experiences can differ in important ways. The traditional definition of the generations, therefore, may not be the best way to categorize generations in the USA from a political perspective. Reclassifying generational cohorts yields some important age-cohort political differences that get lost in the traditional definition of the generations, altering our perceptions of generational political attitudes. Such a categorization of the generations exhibits younger cohorts that are strongly Democratic and a middle-aged cohort that in recent presidential elections has moved strongly towards the Republicans. What stands out, however, is the politics of older Baby Boomers, who have emerged as Democratic leaning. Thus, unlike the traditional definitions of the generations, the alternative generational cohorts we present portray a generational divide that does not get consistently more Republican as one ages., Author(s): Patrick Fisher [sup.1] Author Affiliations: (1) grid.263379.a, 0000 0001 2172 0072, Department of Political Science, Seton Hall University, , 504 Jubilee Hall, 400 South Orange Avenue, 07079, South Orange, [...]

Forest restoration thinning has the potential to enhance the structural complexity and accelerate the development of large trees important to wildlife, aesthetics, and wildfire resistance. These are key objectives for the restoration of even- aged secondary forests within Redwood National Park in Humboldt County, CA, USA. We evaluated the tree growth and stand structure 10 years after two thinning methods were applied at two intensities in a 40- year-old mixed redwood (Sequoia sempervirens (Lamb. ex D. Don) Endl.)/Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco var. menziesii) stand. Heavy thinning enhanced the diameter growth of redwood and Douglas-fir trees more than light thinning. Crown thinning generally enhanced the structural diversity more than low thinning, and structural diversity increased progressively over the 10 years following thinning. Understory plant richness fluctuated between measurement years. Heavy thinning enhanced the understory shrub cover. The fastest-growing trees in heavily thinned stands were much more likely to sustain bear damage, especially redwood trees. Overall, different thinning methods and intensities induced a different suite of outcomes, yet none restored redwood dominance, but all treatments enhanced some other ecosystem values important for old-growth restoration such as large overstory trees, understory plant and shrubs, and elements of structural complexity, including tree-size variability, snags, down logs, and trees exhibiting stem or top damage. Key words: stand structure, Sequoia sempervirens, Pseudotsuga menziesii, heterogeneity, bear damage, Introduction Restoration thinning has the potential to enhance tree growth and health, biodiversity, habitat, and other ecosystem values and services, but managers need information on outcomes resulting from the application [...]

Abstract.--Risk analysis protocols for prioritizing the management of non-native species are numerous, yet few incorporate risk and management in the same analysis or accommodate a broad diversity of taxa outside [...]

Because of its extreme isolation and lack of historical connection to a mainland, the Hawaiian Archipelago is thought to have no native nonvolant terrestrial reptiles. Several squamate species have been introduced to the archipelago, likely starting with early Polynesian contact, and increasing as human traffic in the Pacific has amplified. Of the earlier introductions, one species of skink, Cryptoblepharus poecilopleurus, belongs to a genus known for its ability to naturally disperse long distances, even across oceans. The earliest herpetofaunal surveys from Hawai'i describe the skink as widespread and abundant across the archipelago. A recent phylogenetic analysis reveals substantial haplotype divergence between Hawaiian individuals and other known populations in the Pacific, raising the possibility that this species was an early and natural arrival to the archipelago before human contact. Recent surveys suggest that the species has undergone a dramatic reduction in range across the archipelago, possibly due to the invasion of highly competitive species. Given this information, we aim to further assess the origin of C. poecilopleurus in Hawai'i, determine its current range, and suggest specific needs for future work. Here, we review the earliest European voyages in the Pacific that are known to have sampled C. poecilopleurus, review literature and museum specimens to develop an understanding of this species' history in the islands, survey the island of O'ahu to characterize its current range, and provide preliminary genetic analyses to show the relationship of the Hawai'i populations to the rest of the Pacific. Keywords: Hawai'i, historical review, herpetofauna, Pacific, phylogenetics, THE HAWAIIAN ISLANDS are an isolated volcanic archipelago that supports high levels of endemism, particularly in birds, some invertebrate species groups, and plants (Stemmermann 1983, Baldwin 1997, Cowie and Holland [...]

Objectives This study aimed to examine how equity is integrated into economic evaluations of early childhood development interventions in low-and middle-income countries (LMICs), and to narratively synthesize the study characteristics and findings. Methods We conducted a scoping review by searching three electronic databases with terms including equity, early childhood development intervention, economic evaluation, and LMICs. Interventions that aimed to improve child cognitive, physical, language, motor, or social and emotional development through health, nutrition, security and safety, responsive caregiving, and early learning interventions between conception and age 8 years were considered. Studies published in English peer-reviewed journals in the year 2000 and later were included. Results The review included 24 cost-effectiveness studies out of 1460 identified articles based on eligibility criteria. The included studies addressed health, nutrition, social protection, and water, sanitation and hygiene interventions for child development. The common type of intervention was immunization. Mostly, equity was measured using household wealth or geographic areas, and the study findings were presented through subgroup analyses. The study settings were LMICs, but most studies were conducted by research teams from high-income countries. Overall, 63% of included studies reported that early childhood development interventions improved equity with greater intervention benefits observed in disadvantaged groups. Conclusions Consideration of equity in evaluations of early childhood interventions provides a more complete picture of cost-effectiveness, and can improve equity. Greater focus on promoting equity consideration, multi-sectoral interventions, and researchers in LMICs would support evidence-based interventions and policies to achieve equity in child development., Author(s): Yeji Baek [sup.1] , Zanfina Ademi [sup.1] [sup.2] , Jane Fisher [sup.1] , Thach Tran [sup.1] , Alice Owen [sup.1] Author Affiliations: (1) grid.1002.3, 0000 0004 1936 7857, School [...]

Since May 2022, laboratory-confirmed cases of mpox have been reported across nonendemic countries including the United States, mostly among men who have sex with men (1,2). Persons experiencing homelessness (PEH) [...]

Background: Surgery for degenerative spine pathologies is typically performed on a scheduled basis; however, worsening symptoms may warrant emergency surgery. An increasing number of patients requiring emergency surgery has been observed (22.6% in 2006 to 34.8% in 2019). We sought to compare the outcomes of patients who received scheduled surgery and those who required emergency surgery. Methods: All patients treated between Jan. 1, 2006, and Dec. 31, 2019, were included. Retrospective comparisons were made between patients who were scheduled (elective) for surgery and those requiring emergency surgery, patients who were scheduled for surgery and those who decompensated while on the surgical waitlist and patients who presented as de novo emergencies and those who decompensated while on the surgical waitlist. Results: Among the 6217 patients with degenerative pathologies, 4654 (74.9%) patients were scheduled (elective) for surgery and 1563 (25.1%) were patients requiring emergency surgery. Compared with patients who were scheduled, patients requiring emergency surgery had a longer length of stay (LOS) in hospital (5.1 d, interquartile range [IQR] 2.7-11.2 v. 3.6 d, IQR 1.3-6.4, p < 0.001) and lower rate of home discharge (78.6% v. 94.2%, p < 0.001). Patients requiring emergency surgery were 1.34 times more likely to have any adverse events (95% confidence interval [CI] 1.06-1.68, p = 0.01). When compared with patients who were scheduled for surgery, those who decompensated while on the surgical waitlist had longer LOS (7.0 d, IQR 3.3-15.0 v. 3.6 d, IQR 1.3-6.4, p < 0.001), less home discharge (77.6% v. 94.2%, p < 0.001) and were 2.5 times more likely to have any adverse events (95% CI 1.5-4.1, p < 0.001). Patients who decompensated had a 2.1 times higher risk of having any adverse events than patients who presented as de novo emergencies (95% CI 1.2-3.6, p< 0.001). Conclusion: We observed worse perioperative outcomes for patients requiring emergency surgery for degenerative spinal conditions than for patients who were scheduled for surgery. Patients who decompensated while on the surgical waitlist had the worst outcomes. Contexte: Le traitement chirurgical des pathologies dégénératives de la colonne vertébrale est généralement planifié; l'aggravation des symptômes peut toutefois justifier une opération d'urgence. On constate d'ailleurs qu'un pourcentage croissant de patients ont besoin d'une telle intervention (22,6% en 2006 comparativement à 34,8% en 2019). Nous avons cherché à comparer les issues des patients ayant subi une intervention planifiée avec celles des patients nécessitant une opération d'urgence. Méthodes: Tous les patients traités entre le 1er janvier 2006 et le 31 décembre 2019 ont été inclus. Nous avons établi des comparaisons rétrospectives entre les patients allant subir une intervention planifiée (non urgente) et ceux ayant besoin d'une opération d'urgence, entre les patients allant subir une intervention planifiée et ceux ayant subi une décompensation alors qu'ils étaient sur une liste d'attente, et entre les patients nécessitant une opération urgente pour une pathologie de novo et ceux ayant subi une décompensation alors qu'ils étaient sur une liste d'attente. Résultats: Parmi les 6217 patients présentant des pathologies dégénératives, 4654 (74,9%) allaient subir une intervention planifiée (non urgente) et 1563 (25,1%) avaient besoin d'une opération d'urgence. Comparativement aux premiers, ces derniers restaient plus longtemps à l'hôpital (5,1 jours [écart interquartile (EI) 2,7-11,2] c. 3,6 jours [EI 1,3-6,4], p < 0,001) et présentaient un taux de congé plus faible (78,6% c. 94,2%, p < 0,001). Ils étaient 1,34 fois plus susceptibles d'être victimes d'un événement indésirable (intervalle de confiance [IC] de 95% 1,06-1,68, p = 0,01). Comparativement aux patients pour lesquels une intervention était prévue, ceux ayant subi une décompensation alors qu'ils étaient sur une liste d'attente restaient plus longtemps à l'hôpital (7,0 jours [EI 3,3-15,0] c. 3,6 jours [EI 1,3-6,4], p < 0,001), présentaient un taux de congé plus faible (77,6% c. 94,2%, p < 0,001) et étaient 2,5 fois plus susceptibles de subir un événement indésirable (IC de 95% 1,5-4,1, p < 0,001). Les patients ayant subi une décompensation présentaient un risque 2,1 fois plus élevé d'être victimes d'un événement indésirable, comparativement aux patients nécessitant une opération urgente pour une pathologie de novo (IC de 95% 1,2-3,6, p < 0,001). Conclusion: Nous avons observé des issues périopératoires moins favorables chez les patients ayant besoin de se faire opérer d'urgence pour des pathologies dégénératives de la colonne vertébrale, comparativement à ceux pour lesquels une intervention était prévue. Les patients ayant subi une décompensation alors qu'ils étaient sur une liste d'attente présentaient les pires issues., Older age demographics have increased the demand for spinal surgery, creating an ever-increasing burden for the health care system. (1) This is especially true for degenerative spinal pathologies such as [...]

The emergence of monumentality in the Maya lowlands has been linked to political complexity. But how did the emergence of these monuments relate to changing human-environment interactions? Here, the author proposes that Maya monumentality embodies traditional ecological knowledge, or TEK. Taking the example of Tzacauil, the gathering of fieldstone for the preparation of land for cultivation is connected to agricultural intensification and the florescence of monumentality in the Late and Terminal Formative period (300 BC-AD 250). Exploration of the relationships between monumental traditions and localised TEK practices may illuminate the entanglement of complexity, subsistence and human-environment interactions in other parts of the world. Keywords: Mesoamerica, Maya Lowlands, Formative period, monumentality, traditional ecological knowledge, urban agriculture, Introduction In his brilliant exploration of subterranean worlds, Underland, the British nature writer Rob Macfarlane (2019: 138) observes that 'All cities are additions to a landscape that require subtraction from [...]

The Anaskid nematode, Sulcascaris sulcata has a worldwide distribution and utilizes benthic molluscs as an intermediate host with sea turtles (Chelonioidea) serving as definitive hosts. During the spring of 2015, sea scallops (Placopecten magellunicus) harvested along the mid-Atlantic Bight (MAB) presented with rust-colored lesions on the surface of the adductor muscles. Morphological and molecular investigations determined that the lesions were caused by an infection by third- and fourth-stage larval S, sulcata. Seasonal monitoring from 2015 to 2018 delineated a stable spatial distribution of infected scallops that corresponded to a large 2013 year-class of scallops and persistent utilization of this habitat by seasonally resident loggerhead turtles. Given the life cycle and etiology of S. sulcata, the risk to human health via direct infection or allergic reaction appears to be low, however, the spatiotemporal scale of nematode-infecled scallops resulted in fishery-level impacts with respect to the spatial distribution of fishing effort in response to product quality and depreciation of the value of landed scallops. The long-term trajectory of the epizootic remains unclear and continued monitoring of the spatiotemporal distribution of nematode-infected scallops is warranted as S. sulcata spatial distribution is likely dependent upon sea scallop abundance, which is currently trending toward more northerly portions of the MAB. KEY WORDS: Anisakidae, Sulcascaris sulcata, marine molluscs, spatiotemporal distribution, sea scallop fishery, Placopecten magellunicus, INTRODUCTION The sea scallop, Placopecten magellunicus, is an epibenthic, bivalve mollusc distributed throughout the Northwest Atlantic Ocean from Virginia to the Canadian Maritimes (Shumway & Parsons 2016). Sea scallop distribution [...]

Virtually all patients with BRAF-mutant melanoma develop resistance to MAPK inhibitors largely through nonmutational events. Although the epigenetic landscape is shown to be altered in therapy-resistant melanomas and other cancers, a specific targetable epigenetic mechanism has not been validated. Here, we evaluated the corepressor for element 1-silencing transcription factor (CoREST) epigenetic repressor complex and the recently developed bivalent inhibitor corin within the context of melanoma phenotype plasticity and therapeutic resistance. We found that CoREST was a critical mediator of the major distinct melanoma phenotypes and that corin treatment of melanoma cells led to phenotype reprogramming. Global assessment of transcript and chromatin changes conferred by corin revealed specific effects on histone marks connected to epithelial-mesenchymal transition-associated (EMT-associated) transcription factors and the dual-specificity phosphatases (DUSPs). Remarkably, treatment of BRAF inhibitor-resistant (BRAFi-R) melanomas with corin promoted resensitization to BRAFi therapy. DUSP1 was consistently downregulated in BRAFi-R melanomas, which was reversed by corin treatment and associated with inhibition of p38 MAPK activity and resensitization to BRAFi therapies. Moreover, this activity was recapitulated by the p38 MAPK inhibitor BIRB 796. These findings identify the CoREST repressor complex as a central mediator of melanoma phenotype plasticity and resistance to targeted therapy and suggest that CoREST inhibitors may prove beneficial for patients with BRAFi-resistant melanoma., Introduction Melanomas exhibit tremendous intratumoral heterogeneity and phenotype plasticity, which allows them to switch between distinctive transcriptional programs in response to external stressors, including targeted therapies (1). These transcriptional phenotypes, [...]

Platelets from patients with myeloproliferative neoplasms (MPNs) exhibit a hyperreactive phenotype. Here, we found elevated P-selectin exposure and platelet-leukocyte aggregates indicating activation of platelets from essential thrombocythemia (ET) patients. Single-cell RNA-seq analysis of primary samples revealed significant enrichment of transcripts related to platelet activation, mTOR, and oxidative phosphorylation in ET patient platelets. These observations were validated via proteomic profiling. Platelet metabolomics revealed distinct metabolic phenotypes consisting of elevated ATP generation accompanied by increases in the levels of multiple intermediates of the tricarboxylic acid cycle, but lower a-ketoglutarate ([alpha]-KG) in MPN patients. Inhibition of PI3K/AKT/mTOR signaling significantly reduced metabolic responses and hyperreactivity in MPN patient platelets, while [alpha]-KG supplementation markedly reduced oxygen consumption and ATP generation. Ex vivo incubation of platelets from both MPN patients and Jak2 V617F-knockin mice with [alpha]-KG supplementation significantly reduced platelet activation responses. Oral [alpha]-KG supplementation of Jak2 V617Fmice decreased splenomegaly and reduced hematocrit, monocyte, and platelet counts. Finally, [alpha]- KG treatment significantly decreased proinflammatory cytokine secretion from MPN [CD14.sup.+] monocytes. Our results reveal a previously unrecognized metabolic disorder in conjunction with aberrant PI3K/AKT/mTOR signaling that contributes to platelet hyperreactivity in MPN patients., Introduction Philadelphia-negative chronic myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocythemia (ET), and myelofibrosis (MF), are clonal hematopoietic disorders characterized by overproduction of mature blood cells such as erythrocytes, [...]

BACKGROUND. Accurate detection of graft-versus-host disease (GVHD) is a major challenge in the management of patients undergoing hematopoietic stem cell transplantation (HCT). Here, we demonstrated the use of circulating cell-free DNA (cfDNA) for detection of tissue turnover and chronic GVHD (cGVHD) in specific organs. METHODS. We established a cocktail of tissue-specific DNA methylation markers and used it to determine the concentration of cfDNA molecules derived from the liver, skin, lungs, colon, and specific immune cells in 101 patients undergoing HCT. RESULTS. Patients with active cGVHD showed elevated concentrations of cfDNA, as well as tissue-specific methylation markers that agreed with clinical scores. Strikingly, transplanted patients with no clinical symptoms had abnormally high levels of tissue-specific markers, suggesting hidden tissue turnover even in the absence of evident clinical pathology. An integrative model taking into account total cfDNA concentration, monocyte/macrophage cfDNA levels and alanine transaminase was able to correctly identify GVHD with a specificity of 86% and precision of 89% (AUC of 0.8). CONCLUSION. cfDNA markers can be used for the detection of cGVHD, opening a window into underlying tissue dynamics in patients that receive allogeneic stem cell transplants. FUNDING. This work was supported by grants from the Ernest and Bonnie Beutler Research Program of Excellence in Genomic Medicine, The Israel Science Foundation, the Waldholtz/Pakula family, the Robert M. and Marilyn Sternberg Family Charitable Foundation and the Helmsley Charitable Trust (to YD)., Introduction Hematopoietic stem cell transplantation (HCT) is an essential and often the sole curative treatment strategy for high risk hematologic malignancies (1). Graft-versus-host disease (GVHD), the foremost complication of allogeneic [...]

Background: Respiratory distress is the leading cause of neonatal morbidity and mortality worldwide, and prenatal exposure to air pollution is associated with adverse long-term respiratory outcomes; however, the impact of prenatal air pollution exposure on neonatal respiratory distress has not been well studied. Objectives: We examined associations between prenatal exposures to fine particular matter (P[M.sub.2.5]) and nitrogen dioxide (N[O.sub.2]) with respiratory distress and related neonatal outcomes. Methods: We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective pregnancy cohort (n = 2,001) recruited in the first trimester from 10 Canadian cities. Prenatal exposures to P[M.sub.2.5] (n = 1,321) and N[O.sub.2] (n = 1,064) were estimated using land-use regression and satellite-derived models coupled with ground-level monitoring and linked to participants based on residential location at birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between air pollution and physician-diagnosed respiratory distress in term neonates in hierarchical logistic regression models adjusting for detailed maternal and infant covariates. Results: Approximately 7% of newborns experienced respiratory distress. Neonates received clinical interventions including oxygen therapy (6%), assisted ventilation (2%), and systemic antibiotics (3%). Two percent received multiple interventions and 4% were admitted to the neonatal intensive care unit (NICU). Median P[M.sub.2.5] and N[O.sub.2] concentrations during pregnancy were 8.81 [micro]g/[m.sup.3] and 18.02ppb, respectively. Prenatal exposures to air pollution were not associated with physician-diagnosed respiratory distress, oxygen therapy, or NICU admissions. However, P[M.sub.2.5] exposures were strongly associated with assisted ventilation (OR per 1-[micro]g/[m.sup.3] increase in P[M.sub.2.5] = 1.17; 95% CI: 1.02, 1.35), multiple clinical interventions (OR per 1-[micro]g/[m.sup.3] increase in P[M.sub.2.5] = 1.16; 95% CI: 1.07, 1.26), and systemic antibiotics, (OR per 1- [micro]g/[m.sup.3] increase in P[M.sub.2.5] = 1.12; 95% CI: 1.04, 1.21). These associations were consistent across exposure periods--that is, during prepregnancy, individual trimesters, and total pregnancy--and robust to model specification. N[O.sub.2] exposure was associated with administration of systemic antibiotics (OR per 1-ppb increase in N[O.sub.2] = 1.03; 95% CI: 1.00, 1.06). Discussion: Prenatal exposures to P[M.sub.2.5] increased the risk of severe respiratory distress among term newborns. These findings support the development and prioritization of public health and prenatal care strategies to increase awareness and minimize prenatal exposures to air pollution. https://doi.org/10.1289/EHP12880, Introduction The human health impacts of air pollution have been well documented. (1-3) The Global Burden of Disease initiative identified ambient air pollution as a leading cause of global mortality [...]

Betty Bernhard's legacy in Asian theatre is due primarily to her extraordinary insight into discovering and promoting aspects of Indian performance--including Gujarati folk drama and issues of gender/sexuality--that were traditionally marginalized or overlooked; to her fundraising prowess and advocacy on behalf of Indian artists and colleagues, enabling international travel to pursue their own research and/or attend otherwise unavailable conferences and workshops; to working with those artists in training students for classic Sanskrit play productions at Pomona College; and to her own research resulting in seven crucial films/videos as well as both scholarly and practical presentations at international conferences. These efforts marked her as an important influencer well before that concept became a social media meme. Carol Fisher Sorgenfrei is Professor Emerita of Theatre at UCLA and Research Fellow Emerita at the Institute for Interweaving Performance Cultures (Free University, Berlin, Germany). She writes on postwar Japanese and cross-cultural performance and is also a director, translator, and award-winning playwright. The author of Unspeakable Acts: The Avant-Garde Theatre of Terayama Shuji and Postwar Japan and coauthor of Theatre Histories: An Introduction, she has published over 100 articles and reviews, and presented over 150 papers and keynotes. She is Associate Editor of Asian Theatre Journal and Editor of the Association for Asian Performance Newsletter. Her 17 original plays include Medea: ANoh Cycle Based on the Greek Myth, Ghost Light, Blood Wine/Blood Wedding, and A Wilderness of Monkeys., Betty Bernhard (25 June 1940-20 March 2015) pursued a career path that was radically different from most of those named Founders of the Field. Coming to Indian theater in mid-career, [...]

IT BECAME clear to me that my personal Christian faith is not tolerated or permitted in the public square, at least by some and perhaps by many.' So said the [...]

Multiple studies in Saccharomyces cerevisiae have measured the levels of gene silencing by inserting the URA3 gene at various loci and selecting against URA3-expressing cells by 5-flouroorotic acid (5-FOA). However, 5-FOA affects the cellular pools of dNTPs and can produce side effects. To circumvent this issue, we and others have introduced drug-free techniques to detect silent and active gene states. In this study, we compared three drug-free methods based on the expression of fluorescent reporters in the VIIL telomere of S. cerevisiae. Our results point out that only one of these methods is suitable for large-scale drug-free analyses of gene silencing. Key words: 5-flouroorotic acid (5-FOA), yEGFP, gene silencing, Introduction Gene silencing at the subtelomeric, rRNA gene or mating type loci of Saccharomyces cerevisiae is an extensively studied phenomenon and serves as a paradigm for gene repression and silencing [...]