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Like all utilities, Idaho Power places safety and reliability at the heart of its operations. It never stops working to make the grid safer and more resilient, and to protect [...]

Solfataric alteration at the South Sulfur Bank of the former Kilauea caldera produced opal, Mg- and Fe-rich smectites, gypsum, and jarosite through silica replacement of pyroclastic Keanakako’i ash and leaching of basaltic lavas. This site on the island of Hawaii serves as an analog for formation of several minerals found in altered deposits on Mars. Two distinct alteration environments were characterized in this study, including a light-toned, high-silica, friable outcrop adjacent to the vents and a bedded outcrop containing alternating orange/tan layers composed of smectite, gypsum, jarosite, hydrated silica, and poorly crystalline ferric oxide phases. This banded unit likely represents the deposition of pyroclastic material with variations in chemistry over time that was subsequently altered via moderate hydrothermal and pedogenic processes and leaching of basaltic caprock to enhance the Si, Al, Mg, Fe, and Ca in the altered layers. In the light-toned, friable materials closest to the vents along the base of the outcrop, glassy fragments were extensively altered to opal-A plus anatase.

Understanding wastewater treatment processes is key to ensuring finished quality for discharge into the environment.

To study the spatial interactions among cancer and non-cancer cells1, we here examined a cohort of 131 tumour sections from 78 cases across 6 cancer types by Visium spatial transcriptomics (ST). This was combined with 48 matched single-nucleus RNA sequencing samples and 22 matched co-detection by indexing (CODEX) samples. To describe tumour structures and habitats, we defined ‘tumour microregions’ as spatially distinct cancer cell clusters separated by stromal components. They varied in size and density among cancer types, with the largest microregions observed in metastatic samples. We further grouped microregions with shared genetic alterations into ‘spatial subclones’. Thirty five tumour sections exhibited subclonal structures. Spatial subclones with distinct copy number variations and mutations displayed differential oncogenic activities. We identified increased metabolic activity at the centre and increased antigen presentation along the leading edges of microregions. We also observed variable T cell infiltrations within microregions and macrophages predominantly residing at tumour boundaries. We reconstructed 3D tumour structures by co-registering 48 serial ST sections from 16 samples, which provided insights into the spatial organization and heterogeneity of tumours. Additionally, using an unsupervised deep-learning algorithm and integrating ST and CODEX data, we identified both immune hot and cold neighbourhoods and enhanced immune exhaustion markers surrounding the 3D subclones. These findings contribute to the understanding of spatial tumour evolution through interactions with the local microenvironment in 2D and 3D space, providing valuable insights into tumour biology.

Understanding the increased use and practicality of water reuse will help operators when reuse is implemented in their system.

Understanding how the laboratory is integral with the success of plant operations is key for operators to improve treatment processes and expand their knowledge.

Understanding the importance of quality assurance and quality control practices in the process control laboratory is key for operators to produce reliable data and make informed treatment decisions.

Alpha-1 antitrypsin (AAT) is a glycoprotein produced by hepatocytes in the liver and phagocytes (Kessenich & Bacher, 2014). In lung epithelial cells, these glycoproteins are produced in smaller amounts. AAT [...]

Understanding how industrial pretreatment programs protect public health and the environment gives operators a more complete picture of an often‐overlooked area of the water industry.

Understanding how basic safety practices can affect the daily work of operators can reduce the chance of harm to personnel and infrastructure.

Flow imaging microscopy (FIM) combines a flow cytometer's fluidic architecture with a microscope's spatial resolution to allow morphometric analysis of objects in suspensions such as water. FIM's real‐time analysis and identification of potential cyanotoxin producers help utilities understand population dynamics to maintain healthier source waters and reduce response times when a bloom is indicated. Case studies show FIM's advantages and limitations in harmful algal bloom monitoring programs for reservoir management and water treatment.

Understanding how to control macroorganisms in source water and during treatment can help operators suppress their proliferation in the distribution system and prevent customer complaints.

Approximately 18,000 people are brought to the United States each year and are forced or coerced into labor or sex work. Raising awareness and providing information to all healthcare workers [...]

Water treatment plant operators need to understand federal and state laws as well as the standards that apply to water treatment systems. They should also understand how drinking water regulations are administered and why compliance is essential to providing safe drinking water to the public.

The purpose was to examine the effectiveness of a signage intervention in a university library to promote the use of active (AB) compared to inactive (IB) study breaks. College-age students (n=458) were observed over three weeks; pre, intervention, and post-intervention. Table tents and signs posted in the library encouraged students to take AB. Two trained researchers collected data using systematic observation. AB was higher during the intervention compared to pre- and post- (p Keywords: Study break, physical activity, sedentary behavior, INTRODUCTION Sedentary time has proven to be detrimental to our health, and research has shown that individuals accruing more time sitting are less likely to engage in moderate or vigorous [...]

Understanding how current regulatory requirements came to be can help operators see how required water quality analyses play their part in protecting public health and the environment.

Chromatin accessibility is essential in regulating gene expression and cellular identity, and alterations in accessibility have been implicated in driving cancer initiation, progression and metastasis1–4. Although the genetic contributions to oncogenic transitions have been investigated, epigenetic drivers remain less understood. Here we constructed a pan-cancer epigenetic and transcriptomic atlas using single-nucleus chromatin accessibility data (using single-nucleus assay for transposase-accessible chromatin) from 225 samples and matched single-cell or single-nucleus RNA-sequencing expression data from 206 samples. With over 1 million cells from each platform analysed through the enrichment of accessible chromatin regions, transcription factor motifs and regulons, we identified epigenetic drivers associated with cancer transitions. Some epigenetic drivers appeared in multiple cancers (for example, regulatory regions of ABCC1and VEGFA; GATA6 and FOX-family motifs), whereas others were cancer specific (for example, regulatory regions of FGF19, ASAP2and EN1, and the PBX3 motif). Among epigenetically altered pathways, TP53, hypoxia and TNF signalling were linked to cancer initiation, whereas oestrogen response, epithelial–mesenchymal transition and apical junction were tied to metastatic transition. Furthermore, we revealed a marked correlation between enhancer accessibility and gene expression and uncovered cooperation between epigenetic and genetic drivers. This atlas provides a foundation for further investigation of epigenetic dynamics in cancer transitions.

Understanding how to effectively communicate and work with customers can help mitigate situations quickly and build confidence in the water system as well as utility staff.

Regular monitoring of particle concentration in conjunction with turbidity analysis provides supplementary data that can provide important water quality information. Particle analysis using flow imaging microscopy (FIM) can help operators better understand various treatment processes and algae growth in source waters. Specific size ranges can be monitored using FIM for target pathogens such as Cryptosporidiumand Giardia.

The use of heroin is alarmingly high in the United States. Through education and advocacy, nurses can make a difference in treatment. Screening and inter-professional care are ways to combat this problem., The use of heroin is alarmingly high in the United States. The Centers for Disease Control and Prevention (CDC, 2015) estimated nearly 700,000 Americans used heroin in 2013. The number [...]

An increasingly important focus for health care facilities is investing in the human capital that is so vital to the provision of patient care. While investments in caregivers can come in the form of educational credits and clinical ladder programs, investments in provider health and safety are vital for maintaining a viable workforce. Being proactive and taking decisive action to address preventable injuries to nursing and support staff is critical to maintaining a healthy workforce and bottom line. The risk of significant bodily injury in the medical field is real, and these scenarios play out daily in facilities across the nation. This article will highlight the important role that safe patient handling programs play in increasing employee satisfaction, preventing injuries, and reducing worker compensation claims., Four nurses assist in rolling a 300pound, unresponsive ICU patient who is unable to follow commands. Can this intervention be performed without injury? In another scenario, a nurse accepts the [...]

Influenza is a respiratory virus that can cause mild-to-severe illness. The most serious complications are pneumonia, myocarditis, myositis, encephalitis, sepsis, and respiratory and kidney failure. Nurses can use education effectively to prevent people from developing the flu and help reduce morbidity among those who may be exposed to the flu., According to the Centers for Disease Control and Prevention (CDC, 2015), the word influenza comes from the Italian 'influence of the stars' and was coined in the mid-1500s. One theory [...]

The Committee on Canadian Issues (CCI) is unique among GFOA's standing committees. It is tasked with helping GFOA meet the needs of its Canadian members, giving the U.S.-based association's staff [...]

Small cell lung cancer (SCLC) exists broadly in four molecular subtypes: ASCL1, NEUROD1, POU2F3 and Inflammatory. Initially, SCLC subtypes were thought to be mutually exclusive, but recent evidence shows intra-tumoural subtype heterogeneity and plasticity between subtypes. Here, using a CRISPR-based autochthonous SCLC genetically engineered mouse model to study the consequences of KDM6A/UTX inactivation, we show that KDM6A inactivation induced plasticity from ASCL1 to NEUROD1 resulting in SCLC tumours that express both ASCL1 and NEUROD1. Mechanistically, KDM6A normally maintains an active chromatin state that favours the ASCL1 subtype with its loss decreasing H3K4me1 and increasing H3K27me3 at enhancers of neuroendocrine genes leading to a cell state that is primed for ASCL1-to-NEUROD1 subtype switching. This work identifies KDM6A as an epigenetic regulator that controls ASCL1 to NEUROD1 subtype plasticity and provides an autochthonous SCLC genetically engineered mouse model to model ASCL1 and NEUROD1 subtype heterogeneity and plasticity, which is found in 35–40% of human SCLCs.

Understanding how to use different types of process control tests to maintain optimal corrosion control conditions can guide operators in their response.

Alert levels can be established using baseline data to trigger action in source water management and/or water treatment.

Background Exposure to bloodborne pathogens poses a serious risk to healthcare workers. As more primary care providers are being asked to perform occupational health services, the evaluation and treatment of bloodborne pathogen (BBP) exposures can be overwhelming. Lack of knowledge about how to handle these encounters can lead to poor outcomes, including conversion to human immunodeficiency virus (HIV) and hepatitis B virus if not handled properly. To assist providers with understanding best practices for the management of exposures, a detailed protocol and targeted education were developed. The protocol addressed the importance of evaluating the source patient for HIV, hepatitis B virus, and hepatitis C virus; injured workers were assessed for the same items, tetanus status, and the need for post-exposure prophylaxis (PEP).Methods A retrospective chart review for 12 months before the implementation of the protocol and eight months after implementation was completed to assess compliance with five evidence-based criteria and the appropriate use of PEP when indicated.Findings Variables of interest included (a) correct identification of the source patient, (b) accuracy of source patient labs, (c) completion of same-day employee labs, (d) accuracy of employee labs, and (e) evaluation of the employee's tetanus status. The rate of completion of these categories ranged from 14% to 43% in pre-protocol cases (n= 7), and 100% in post-protocol cases (n= 7).Conclusions The combination of targeted education and a detailed protocol for evaluating and treating BBP exposures resulted in increased compliance with best-practice care; the project also improved employee satisfaction.

Understanding the differences between types of organic contaminants and their regulatory requirements helps operators maintain a well‐operating treatment plant.

John J. Miller is the New York Police Department's Deputy Commissioner for Intelligence & Counterterrorism. He is former Deputy Director of the Intelligence Analysis Division at the Office of the Director of National Intelligence and served as Assistant Director of the Federal Bureau of Investigation. He was also the Commanding Officer, Counter Terrorism & Criminal Intelligence Bureau of the Los Angeles Police Department. During his previous work as a journalist, Deputy Commissioner Miller interviewed Usama bin Ladin for ABC News. Ambassador Michael Sheehan serves as Distinguished Chair of the Combating Terrorism Center at West Point. A 1977 graduate of the United States Military Academy, he was the former Assistant Secretary of Defense for Special Operations and Low-Intensity Conflict. From 2003 to 2006, Ambassador Sheehan served as the New York Police Department's Deputy Commissioner for Counterterrorism., Sheehan: You have a unique background and historical perspective on the evolution of the terrorist threat. Walk us through how things have changed. Miller: There's a pre-9/11 world and there's [...]

Hair is a natural polymeric composite primarily composed of tight macrobundles of keratin proteins, which are highly responsive to external stimuli, similarly to the hydrogels and other natural fibrous gel systems like collagen and fibrin.

Understanding how to use customer complaints to improve water quality can help operators take corrective action.

Much has been written about the inclusion of holistic nursing philosophy and practices in undergraduate nursing education, but their inclusion and influence in advanced practice nursing education have not been fully explored. Supporting a holistic paradigm and model of care founded on evidenced-based clinical theory allows for expanded nursing practice and health care options for patients. Holistic nursing aligns with culturally competent, patient-centered care and is consistent with how our current health care landscape has evolved in recent years. Health care reform highlights a new direction in practice toward self-transformation, accountability, natural treatment options, and a patient's active role in health care decisions. To demonstrate the role, this article will address how advanced practice holistic nurses meet the International Council of Nurses Criteria for Advanced Practice and is substantially equivalent and exceeds current APRN competencies.

•Response associates with higher T cell to AML ratio, whereas resistance is marked by insufficient clearing of diseased progenitor cells.•Distinct T-cell phenotypes of bone marrow and extramedullary AML are linked to differential efficacy of ipilimumab treatment.

Understanding how different types of laboratory analyses can be used to make determinations on unknown samples can guide operators in their response.

Growing up is really scary for a lot of people. I've had many times where I feel so overwhelmed by a big moment that could mark adulthood. Your feelings are [...]

Use the TPACK learning-by-design method to turn a good lesson into a great one by incorporating technology that enhances--but doesn't overshadow--the learning objectives. Then tweak it until you get it [...]

Understanding how to use different types of process control tests to detect nitrification can guide water plant operators in their response.

Cell therapies have yielded durable clinical benefits for patients with cancer, but the risks associated with the development of therapies from manipulated human cells are understudied. For example, we lack a comprehensive understanding of the mechanisms of toxicities observed in patients receiving T cell therapies, including recent reports of encephalitis caused by reactivation of human herpesvirus 6 (HHV-6)1. Here, through petabase-scale viral genomics mining, we examine the landscape of human latent viral reactivation and demonstrate that HHV-6B can become reactivated in cultures of human CD4+T cells. Using single-cell sequencing, we identify a rare population of HHV-6 ‘super-expressors’ (about 1 in 300–10,000 cells) that possess high viral transcriptional activity, among research-grade allogeneic chimeric antigen receptor (CAR) T cells. By analysing single-cell sequencing data from patients receiving cell therapy products that are approved by the US Food and Drug Administration2or are in clinical studies3–5, we identify the presence of HHV-6-super-expressor CAR T cells in patients in vivo. Together, the findings of our study demonstrate the utility of comprehensive genomics analyses in implicating cell therapy products as a potential source contributing to the lytic HHV-6 infection that has been reported in clinical trials1,6–8and may influence the design and production of autologous and allogeneic cell therapies.

Adherens junctions (AJs) create spatially, chemically and mechanically discrete microdomains at cellular interfaces. Here, using a mechanogenetic platform that generates artificial AJs with controlled protein localization, clustering and mechanical loading, we find that AJs also organize proteolytic hotspots for γ-secretase with a spatially regulated substrate selectivity that is critical in the processing of Notch and other transmembrane proteins. Membrane microdomains outside of AJs exclusively organize Notch ligand–receptor engagement (LRE microdomains) to initiate receptor activation. Conversely, membrane microdomains within AJs exclusively serve to coordinate regulated intramembrane proteolysis (RIP microdomains). They do so by concentrating γ-secretase and primed receptors while excluding full-length Notch. AJs induce these functionally distinct microdomains by means of lipid-dependent γ-secretase recruitment and size-dependent protein segregation. By excluding full-length Notch from RIP microdomains, AJs prevent inappropriate enzyme–substrate interactions and suppress spurious Notch activation. Ligand-induced ectodomain shedding eliminates size-dependent segregation, releasing Notch to translocate into AJs for processing by γ-secretase. This mechanism directs radial differentiation of ventricular zone-neural progenitor cells in vivo and more broadly regulates the proteolysis of other large cell-surface receptors such as amyloid precursor protein. These findings suggest an unprecedented role of AJs in creating size-selective spatial switches that choreograph γ-secretase processing of multiple transmembrane proteins regulating development, homeostasis and disease.

Understanding different types of drinking water sources is key for operators to provide effective treatment.

PRACTICE RECOMMENDATIONS * Administer the valgus stress test, the 'milking maneuver,' and the moving valgus stress test to athletes suspected of having ulnar collateral ligament injury. (C) * Treat Little [...]

I. Introduction 395 II Public-Private Partnership (PPPs) 397 A. Defining PPPs 397 B. Use of PPPs 397 C. Under developed Legal Framework for PPPs 398 III. History of U.S. Electric [...]