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Timely incision and drainage (ID) is first line management for anorectal abscesses. We aimed to define current practices in anorectal abscess management and identify factors associated with abscess recurrence and fistula formation.Index episodes of anorectal abscesses treated with ID in 2014-2018 at a multi-hospital healthcare system were included. Association with one-year abscess recurrence or fistula formation was evaluated using Cox proportional hazard regression. Fistulae were captured only among patients without fistulae at the index operation.A total of 458 patients met study criteria. One-year rate of abscess recurrence or fistula formation was 20.3%. When compared to bedside procedures, drainage in the operating room was associated with a reduced risk of either recurrence or fistula formation (aHR 0.20 [95%CI 0.114-0.367]).Improved exposure and patient comfort in the operating room may allow more complete drainage contributing to decreased rates of abscess recurrence or fistula formation.

To assess barriers to and facilitators of abortion provision among abortion-trained primary care providers.We conducted 21 qualitative in-depth interviews with 20 abortion-trained family physicians and one internal medicine physician in five New England states. We dual-coded interviews, using a consensus method to agree upon final coding schema. Through iterative dialogue, using an inductive content analysis approach, we synthesized the themes and identified patterns within each domain of inquiry.The most commonly reported barriers were a lack of organizational support, the Hyde Amendment, which prevents the use of federal funds for most abortion care, and the mifepristone Risk Evaluation and Mitigation Strategy, a federal regulation which prohibits routine mifepristone pharmacy dispensing. The logistical barriers created by these policies require cooperation from additional stakeholders, creating more opportunities for abortion stigma and moral opposition to arise. Other salient barriers included inter-specialty tension (particularly with obstetrician-gynecologists), perceived need for pre-abortion ultrasound, absence of a clinician support network, and lack of knowledge of existing resources for establishing abortion care in primary care.Increased abortion provision in primary care is one of many necessary responses to the human rights crisis produced by the Dobbs decision. Eliminating the Hyde Amendment and ending federal regulations restricting pharmacy dispensing of mifepristone are key interventions to address barriers to primary care abortion provision. Building interspecialty partnerships between family medicine and OB/GYN and spreading awareness of the evidence-based ultrasound-as-needed protocol and other educational resources are also likely to increase primary care abortion access.By exploring barriers to and facilitators of primary care abortion provision, this study outlines a targeted approach to support increased access to abortions. In states with legal abortion post-Roe, it is important that motivated and trained primary care providers can offer abortions, rather than referring patients to overburdened specialty clinics.

Background: Access to high-quality dietary intake data is central to many nutrition, epidemiology, economic, environmental, and policy applications. When data on individual nutrient intakes are available, they have not been consistently disaggregated by sex and age groups, and their parameters and full distributions are often not publicly available. Objectives: We sought to derive usual intake distributions for as many nutrients and population subgroups as possible, use these distributions to estimate nutrient intake inadequacy, compare these distributions and evaluate the implications of their shapes on the estimation of inadequacy, and make these distributions publicly available. Methods: We compiled dietary data sets from 31 geographically diverse countries, modeled usual intake distributions for 32 micronutrients and 21 macronutrients, and disaggregated these distributions by sex and age groups. We compared the variability and skewness of the distributions and evaluated their similarity across countries, sex, and age groups. We estimated intake inadequacy for 16 nutrients based on a harmonized set of nutrient requirements and bioavailability estimates. Last, we created an R package-nutriR-to make these distributions freely available for users to apply in their own analyses. Results: Usual intake distributions were rarely symmetric and differed widely in variability and skewness across nutrients and countries. Vitamin intake distributions were more variable and skewed and exhibited less similarity among countries than other nutrients. Inadequate intakes were high and geographically concentrated, as well as generally higher for females than males. We found that the shape of usual intake distributions strongly affects estimates of the prevalence of inadequate intakes. Conclusions: The shape of nutrient intake distributions differs based on nutrient and subgroup and strongly influences estimates of nutrient intake inadequacy. This research represents an important contribution to the availability and application of dietary intake data for diverse subpopulations around the world.

Introduction Suicide rates are extremely high among emergency department patients seen for deliberate self-harm. Inpatient hospitalization is often recommended for these patients, but evidence on the suicide prevention impacts of hospitalization is scarce. Confounding by indication and challenges to implementing randomized designs are barriers to advances in this field. Methods Investigators used 2009–2012 statewide data on 57,312 self-harm emergency department patients from California, linked to mortality records. Naive 12-month and 30-day suicide risks were estimated among patients who were hospitalized versus those who were discharged. Then, generalized random forest methods were applied to estimate the average treatment impacts of hospitalization on suicide, conditioning on observable covariates. Associations were calculated separately for sex- and age-specific subgroups. Analyses were conducted in February 2019–August 2021. Results In naive analyses, suicide risk was significantly higher in hospitalized than in discharged patients in each subgroup. In 12-month models accounting for the observed covariates through generalized random forest methods, hospitalized male patients had 5.4 more suicides per 1,000 patients (95% CI=3.0, 7.8), hospitalized patients aged 10–29 years had 2.4 more suicides per 1,000 (95% CI=1.1, 3.6), and those aged ≥50 years had 5.8 more suicides per 1,000 (95% CI=0.5, 11.2) than corresponding discharged patients. Hospitalization was not significantly associated with suicide among female patients or patients aged 30–49 years in generalized random forest analyses. Patterns were similar in 30-day generalized random forest models. Conclusions Emergency department personnel intend to hospitalize self-harm patients with high suicide risk; this study suggests that this goal is largely realized. Analyses that control for confounding by observable covariates did not find clear evidence that hospitalization reduces suicide risk and could not rule out the possibility of iatrogenic effects.

We sought to examine the frequency of pediatric critical procedures performed in a national group of emergency physicians.We performed a retrospective analysis of an administrative billing and coding dataset for procedural performance documentation verification from 2014 to 2018. We describe and compare incident rates of pediatric (age18 years) patient critical procedure performance by emergency physicians in general emergency departments (EDs), pediatric EDs, and freestanding ED/urgent care centers. Critical procedures were endotracheal intubation, electrical cardioversion, central venous placement, intraosseous access, and chest tube insertion.Among 2290 emergency physicians working in 186 EDs (1844 working in 129 general EDs, 125 in 8 pediatric EDs, and 321 in 49 freestanding EDs/urgent cares), a total of 2233 pediatric critical procedures were performed during the study period. Many physicians at general EDs and freestanding EDs/urgent cares performed zero pediatric procedures per year (53.9% and 89% respectively). Per 1000 ED visits seen (All patient ages), physicians working in general EDs performed fewer pediatric critical procedures than physicians in pediatric EDs (0.12/1000 visits vs 0.68/1000 visits; rate difference = 0.56, 95% confidence interval [CI] 0.51-0.61). Per 1000 clinical hours worked, physicians working in general EDs performed 0.26 procedures compared to 1.66 for physicians in pediatric EDs (rate difference = 1.39; 95% CI 1.27-1.52).Pediatric critical procedures are rarely performed by emergency physicians and are exceedingly rare in general EDs and freestanding EDs/urgent cares. The rarity of performance of these skills has implications for ED pediatric readiness.

BACKGROUND: Legumes are an excellent plant source of the limiting indispensable amino acid (IAA) lysine in vegetarian, cereal-based diets. However, their digestibility is poor largely because of their antiprotease content. Extrusion can enhance digestibility by inactivating trypsin inhibitors and thus potentially improve the protein quality of legumes. OBJECTIVE: We measured the digestibility of extruded chickpea and yellow pea protein with use of a dual stable isotope method in moderately stunted South Indian primary school children. METHODS: Twenty-eight moderately stunted children (height-for-age z scores −3.0 SD) aged 6–11 y from low to middle socioeconomic status were randomly assigned to receive a test protein (extruded intrinsically [(2)H]-labeled chickpea or yellow pea) along with a standard of U-[(13)C]-spirulina protein to measure amino acid (AA) digestibility with use of a dual stable isotope method. Individual AA digestibility in the test protein was calculated by the ratios of AA enrichments in the test protein to the standard protein in the food and their appearance in blood plasma collected at 6 and 6.5 h during the experiment, representing a plateau state. RESULTS: The mean AA digestibility of extruded chickpea and yellow pea protein in moderately stunted children (HAZ; −2.86 to −1.2) was high and similar in both extruded test proteins (89.0% and 88.0%, respectively, P = 0.83). However, lysine and proline digestibilities were higher in extruded chickpea than yellow pea (79.2% compared with 76.5% and 75.0% compared with 72.0%, respectively, P

Two core nutrient intake reference values (NRVs) are required for assessing the adequacy and safety of nutrient intakes for population groups: the average requirement (AR) and the tolerable upper level of intake (UL). Applications of such assessments include providing advice to improve intakes, formulating complementary foods, estimating the amounts of nutrients to be added to fortified foods and monitoring changes in intake, and product labeling at the global, national, or regional level. However, there is a lack of unity across country-level organizations in the methodological approach used to derive NRVs, and ARs and ULs are lacking in many compilations, thus limiting the ability to assess nutrient intakes for their population groups. Because physiological requirements vary little across populations globally, and setting reference values requires determining an acceptable level of uncertainty, it is feasible to adapt current recommendations from different sources to harmonize these core reference values. The objective of this review is to demonstrate an approach for harmonizing the NRVs for ARs (here termed “H-ARs”) and ULs (“H-ULs”) that can be applied on a global scale to assessing intakes across populations. The approach incorporates the framework and terminology recommended by reports from the United Nations University, the National Academies of Sciences, Engineering, and Medicine (NASEM), the Institute of Medicine (IOM), and the European Food Safety Authority (EFSA). After reviewing available alternatives, the proposed harmonized values were selected from standards set by EFSA (for Europe) and the IOM (for the United States and Canada), giving priority to those published most recently. Justifications for the proposed values are presented, along with discussion of their limitations. Ideally, these methods should be further reviewed by an international group of experts. Meanwhile, the H-ARs and H-ULs suggested in this review can be used to assess intakes of populations for many applications in global and regional contexts.

Background Choline is an essential nutrient for brain growth and other processes in the developing neonate. The impact of a maternal plant-based diet on the choline composition of breast milk is unknown. Objective We assessed the water-soluble choline content of milk from lactating women in the United States following 3 dietary patterns: vegan, vegetarian, and nonvegetarian. Methods We conducted a cross-sectional study of 74 healthy lactating women who provided a single breast-milk sample using a standardized collection protocol. Participants completed a food-frequency screener and were classified as follows: nonvegetarians (NONVEG) consumed meat; vegetarians (VEGT) consumed milk, dairy, and/or fish; and vegans (VEGAN) consumed animal products less than monthly. Primary outcomes measured were the concentration (in milligrams per liter) and distribution (percentage) of choline from the following water-soluble forms: free choline, phosphocholine (PCho), and glycerophosphocholine (GPC). Differences between diet groups were evaluated with ANOVA. Results There was a wide range in breast-milk total water-soluble choline (4-301 mg/L), with no significant difference (P > 0.05) by maternal diet pattern. There were differences in choline forms, with VEGAN having a greater mean ± SD concentration and distribution of choline derived from GPC (62.7 ± 25.3 mg/L) than VEGT (47.7 ± 21.2 mg/L) and NONVEG (42.4 ± 14.9 mg/L) (P = 0.0052). There was a lower mean ± SD percentage of choline from PCho (P = 0.0106) in VEGAN (32.5% ± 18.3%) than in VEGT (46.1% ± 18.3%) and NONVEG (44.8% ± 15.7%). Lactation stage and maternal BMI were significantly associated with some choline forms. Conclusions There was a wide range of water-soluble choline concentrations in the milk of healthy lactating women following vegan, vegetarian, and nonvegetarian diets, with no observed difference in total water-soluble choline concentration by maternal diet. This suggests that maternal plant-based diet by itself is not a risk factor for low breast-milk choline.

Neutrophils are a crucial first line of defense against infection, migrating rapidly into tissues where they deploy granule components and toxic oxidants for efficient phagocytosis and microbe killing. Subsequent apoptosis and clearance of dying neutrophils are essential for control of infection and resolution of the inflammatory response. A subset of microbial pathogens survive exposure to neutrophils by manipulating phagocytosis, phagosome-granule fusion, oxidant production, and lifespan. Elucidating how they accomplish this unusual feat provides new insights into normal neutrophil function. In this review, we highlight recent discoveries about the ways in which neutrophils use cell-intrinsic mechanisms to control infection, and how these defenses are subverted by pathogens.

Nationally representative data from mother–child dyads that capture human milk composition (HMC) and associated health outcomes are important for advancing the evidence to inform federal nutrition and related health programs, policies, and consumer information across the governments in the United States and Canada as well as in nongovernment sectors. In response to identified gaps in knowledge, the National Institute of Diabetes and Digestive and Kidney Diseases of the NIH sponsored the “Workshop on Human Milk Composition—Biological, Environmental, Nutritional, and Methodological Considerations” held 16–17 November 2017 in Bethesda, Maryland. Through presentations and discussions, the workshop aimed to 1) share knowledge on the scientific need for data on HMC; 2) explore the current understanding of factors affecting HMC; 3) identify methodological challenges in human milk (HM) collection, storage, and analysis; and 4) develop a vision for a research program to develop an HMC data repository and database. The 4 workshop sessions included 1) perspectives from both federal agencies and nonfederal academic experts, articulating scientific needs for data on HMC that could lead to new research findings and programmatic advances to support public health; 2) information about the factors that influence lactation and/or HMC; 3) considerations for data quality, including addressing sampling strategies and the complexities in standardizing collection, storage, and analyses of HM; and 4) insights on how existing research programs and databases can inform potential visions for HMC initiatives. The general consensus from the workshop is that the limited scope of HM research initiatives has led to a lack of robust estimates of the composition and volume of HM consumed and, consequently, missed opportunities to improve maternal and infant health.

Laboratory determination of carbon content in 30-50 kg soil samples is described. The method is based on the tagged neutron technique. Procedure for carbon determination in such samples was developed based on a physical model and Monte-Carlo simulations (Geant4) of neutron stimulated gamma spectra. Measurement results of samples with different density and moisture demonstrate good agreement with standard dry combustion analysis. Thus, this method can be recommended as an alternative for laboratory determination of carbon in 30-50 kg soil samples.

BackgroundBreast milk is the sole source of nutrition for exclusively breastfed infants in the first 6 mo of life, yet few studies have measured micronutrient concentrations in breast milk in light of maternal diet and subsequent infant micronutrient intakes.ObjectivesWe evaluated the adequacy of micronutrient intakes of exclusively breastfed Indonesian infants by measuring milk volume and micronutrient concentrations and assessed maternal micronutrient intakes and their relationship with milk concentrations.MethodsMother-infant (2-5.3 mo) dyads (n=113) were recruited for this cross-sectional study. Volume of breast-milk intake via the deuterium dose-to-mother technique over 14 d and analyzed micronutrient concentrations were used to calculate micronutrient intakes of exclusively breastfed infants. Maternal 3-d weighed food records were collected to assess median (IQR) micronutrient intakes. Multivariate regression analyses examined the association of usual maternal micronutrient intakes with milk micronutrient concentrations after adjustment for confounding variables.ResultsMean±SD intake of breast-milk volume was 787±148 mL/d. Median daily infant intakes of iron, zinc, selenium, magnesium, sodium, and B-vitamins (thiamin, riboflavin, niacin, pantothenic acid, B-6, and B-12) were below their respective Adequate Intakes. Inadequacies in maternal intakes (as %40% for calcium, niacin, and vitamins A, B-6, and B-12. Significant positive associations existed between maternal usual intakes of vitamin A, niacin and riboflavin and milk retinol, nicotinamide, and free riboflavin concentrations in both unadjusted and adjusted (for infant age, milk volume, and parity) analyses (all P&nbsp

This study investigates consumer behavior in anticipation of the United States Energy Independence and Security Act (EISA) energy mandate that effectively banned production and import (not the sale) of incandescent light bulbs. We use the gradual implementation of U.S. EISA energy standards, where only 100-watt incandescent bulbs were initially banned, to estimate a series of difference-in-difference models that examine consumer behavior. Our results show that stockpiling in response to the EISA mandate resulted in a 96.9% increase in 100-watt incandescent bulbs sold per store per week. A back-of-the-envelope calculation shows stockpiling reduced private energy savings between $7 million and $21 million in Ohio and between $199 million and $589 million in the United States. Stockpiling also reduced social carbon cost savings between $56 million and $166 million across the United States.

Background and purpose Little is known about the experience of Muslims with diabetes while fasting during Ramadan in the United States. Providing quality care for Muslim patients requires being aware of Islamic beliefs and practices, particularly in regard to healthcare ramifications. Therefore, the aims of this study were to (a) explore the beliefs which influence the experience and practices of diabetes management among Muslims in the United States during Ramadan, and (b) explore perspectives of Muslims with diabetes on their experience with healthcare providers providing support during their fasting experience. Methods Using an exploratory design, semi-structured interviews were conducted for qualitative analyses. A purposive sample of 14 Muslim patients with diabetes was recruited from mosques located across North Carolina. Results Analyses revealed six subthemes on their “feelings” that were inherent to their experiences of managing diabetes while fasting during Ramadan. These were organized into two main themes: (1) having diabetes and fasting during Ramadan and (2) fasting challenges. Having diabetes and fasting during Ramadan focused on the experience of fasting and comprised four “feelings”: (1) feeling spiritually connected, (2) feeling socially connected, (3) feeling physically healthy, and (4) feeling religiously obligated. The second theme focused on fasting challenges and included (1) feeling sick and dehydrated, and (2) feeling vulnerable and poorly understood by healthcare providers. Conclusion This is the first known study to explore the experience of Muslims with diabetes while fasting during Ramadan in the United States. Our findings offer important insights into how Muslims manage their diabetes while fasting and the missed opportunities for relevant conversations when partnering with healthcare providers during Ramadan. The importance of cultural competency across healthcare systems in the United States cannot be overemphasized. Healthcare providers need to hold conversations embracing shared decision-making to resolve healthcare dilemmas resulting from cultural differences, expand cultural knowledge, and adapt services to meet culturally-unique needs of their patients.

BackgroundInfantile beriberi-related mortality is still common in South and Southeast Asia. Interventions to increase maternal thiamine intakes, and thus human milk thiamine, are warranted; however, the required dose remains unknown.ObjectivesWe sought to estimate the dose at which additional maternal intake of oral thiamine no longer meaningfully increased milk thiamine concentrations in infants at 24 wk postpartum, and to investigate the impact of 4 thiamine supplementation doses on milk and blood thiamine status biomarkers.MethodsIn this double-blind, 4-parallel arm randomized controlled dose-response trial, healthy mothers were recruited in Kampong Thom, Cambodia. At 2 wk postpartum, women were randomly assigned to consume 1 capsule, containing 0, 1.2 (estimated average requirement), 2.4, or 10 mg of thiamine daily from 2 through 24 weeks postpartum. Human milk total thiamine concentrations were measured using HPLC. An Emax curve was plotted, which was estimated using a nonlinear least squares model in an intention-to-treat analysis. Linear mixed-effects models were used to test for differences between treatment groups. Maternal and infant blood thiamine biomarkers were also assessed.ResultsIn total, each of 335 women was randomly assigned to1 of the following thiamine-dose groups: placebo (n=83), 1.2 mg (n=86), 2.4 mg (n=81), and 10 mg (n=85). The estimated dose required to reach 90% of the maximum average total thiamine concentration in human milk (191 µg/L) is 2.35 (95% CI: 0.58, 7.01) mg/d. The mean±SD milk thiamine concentrations were significantly higher in all intervention groups (183±91, 190±105, and 206±89 µg/L for 1.2, 2.4, and 10 mg, respectively) compared with the placebo group (153±85 µg/L; P&nbsp

This article examines the May 2021 report by the International Maritime Organization on the outcome of the Maritime Safety Committee’s Working Group that conducted the Regulatory Scoping Exercise for the Use of Maritime Autonomous Surface Ships (MASS), with particular attention on the report’s conclusions regarding MASS and the 1972 Collision Regulations (COLREGS). The article criticizes the report’s conclusions to the extent they suggest that the operation of some MASS categories can be reconciled with the existing COLREGS rules by mere rule interpretations or the use of equivalences and warns that reliance on either approach would likely dilute the rules in their application to the far more numerous manned vessels. The article concludes that the advent of MASS will require amendments to the COLREGS.

We examine the impact of constructing a new, large scale natural gas pipeline on environmental outcomes and fuel consumption patterns in China. We use the construction of three natural gas pipelines in China, constructed at different times but operated by the same state-owned enterprise, as a quasi-experiment to estimate the impact of pipeline projects as a driver of changes in air quality. We then estimate the impact of the pipeline on firm and household energy choices providing a mechanism to explain the reductions in air pollution we find. The difference-in-differences estimates indicate that placing the pipeline into operation significantly reduced emission intensity and led to an increase in natural gas intensity and decrease in coal intensity in industrial sectors with more limited impacts on residential energy consumption.

In the event of a flood disaster, first response agencies need inundation maps produced in near real time (NRT). Such maps can be generated using satellite-based information. In this study, we developed mapping techniques that rely on synthetic aperture radar (SAR) on-board earth-orbiting platforms. SAR provides valid ground surface measurements through cloud cover with high resolution and sampling frequency that has recently increased through multiple missions. Despite numerous efforts, automatic processing of SAR data to derive accurate inundation maps still poses challenges. To address them, we have developed an NRT system named RAdar-Produced Inundation Diary (RAPID). RAPID integrates four processing steps: classification based on statistics, morphological processing, multi-threshold-based compensation, and machine-learning correction. Besides SAR data, the system integrates multisource remote-sensing data products, including land cover classification, water occurrence, hydrographical, water type, and river width products. In comparison to expert handmade flood maps, the fully-automated RAPID system exhibited “overall,” “producer,” and “user” accuracies of 93%, 77%, and 75%, respectively. RAPID accommodates commonly encountered over- and under-detections caused by noise-like speckle, water-like radar response areas, strong scatterers, and isolated inundation areas—errors that are in common practice to ignore, mask out, or be filtered out by coarsening the effective resolution. RAPID can serve as the kernel algorithm to derive flood inundation products from satellites—both existing and to be launched—equipped with high-resolution SAR sensors, including Envisat, Radarsat, NISAR, Advanced Land Observation Satellite (ALOS)-1/2, Sentinel-1, and TerraSAR-X.

This paper investigates the capitalized value of interconnected active transportation infrastructure in Franklin County, Ohio. We expand on the existing literature on preferences for local amenities by examining the impact of connections between local amenities and active transportation infrastructure on the sales price of single family homes. Hedonic results indicate that proximity to bike facilities results in positive capitalization, with on-road facilities driving this result. Extending the analysis to examine interconnectivity, we find that bike facility capitalization is heterogeneous depending on the types of local amenities and infrastructure links. For example, on-road facility connections with bus stop locations decrease nearby home values, while on-road facilities linked to local open space increase the value of proximate homes. Together, these results provide evidence that connectivity is an important input to active transportation planning.

This paper proposes a set of perspectives for studying innovation ecosystems that are based on ecological research. Our perspectives are based on fundamental similarities between natural and business systems. We suggest that innovation ecosystems can be defined as pathways of interlinked business models. Pathways are characterised by the flows they convey not the types of business model that support the flows. These pathways convey material and informational resources, as well as value. Like the nutrient and energy pathways in natural ecosystems. Pathways help to recycle scarce resources such as customer attention and customer-derived information. Business model descriptions are similar to an organism’s genome in that they describe limitations on sensing, acting and understanding. We conceptualise this as the ‘umwelt’; the self-world. These limitations have implications for how firms and customers interact with customers. They have other implications for how firms interact with each other in business model communities and how they accommodate each other. We illustrate and test these ecological perspectives using a case study of a healthcare smartphone app’s ecosystem. We find that our perspectives can be used as novel methods of studying interactions between business models; or to study ecosystem building.

The trace fossil Skolithos, with its simple, vertical to very slightly inclined, tubular form, is widely recognized and globally distributed in early Cambrian to Holocene strata, representing deep-sea to continental paleoenvironments. The type species, Skolithos linearis, was first described in 1840 by Samuel S. Haldeman, based on his observations of early Cambrian quartzite at Chickies Rock, a well-known landmark on the east bank of the Susquehanna River, in Pennsylvania. The original description was meager; no illustrations were published, no holotype was established, and no specimens directly associated with Haldeman are known to exist today. A “neoholotype” proposed by Howell (1943) is invalid, as it does not conform to requirements of the International Code of Zoological Nomenclature. As a result, the iconic ichnogenus Skolithos is inadequately characterized and some of the numerous ichnospecies that have subsequently been named are not unequivocally assignable to it. In order to stabilize this important ichnogenus and to provide a basis for the taxonomic revision it urgently requires, we have studied S. linearis at its type locality. Our new material is described and illustrated here, and we have designated a neotype, accessioned by the U.S. National Museum of Natural History (Smithsonian Institution). The stratigraphy and regional geologic setting of Chickies Rock, the sedimentology and environment of deposition of cross-bedded quartzite with abundant S. linearis constituting classic “pipe rock,” and the structural deformation of this fabric are reviewed. Given the simple morphology of Skolithos, disparate organisms in several phyla have been proposed as its maker. We concur in the general view that Cambrian trace fossils assigned to S. linearis were most probably made by burrowing phoronids or polychaete annelids. The global abundance of largely monospecific pipe rock in analogous Cambro-Ordovician settings is recognized as a characteristic feature of the ecology of shallow-marine environments of that time. The stage has now been set for a thorough re-evaluation of all existing ichnospecies assigned and related to the ichnogenus Skolithos.

An associated particle imaging (API) experimental setup with nanosecond precision electronics was constructed and tested. This API setup has the ability to measure alpha-gamma coincidence (timing) spectra, time correlated energy gamma spectra, and energy correlated timing spectra. The speed of 14.1 MeV neutron was defined from measurement of carbon energy correlated timing spectra. The measured value (5.2 cm/ns) agreed with reference data that confirmed a proper working setup and authenticated experimental results. Test experiments with graphite samples demonstrated that the minimal detectible level (MDL) of carbon with the appropriate timing window in API mode is 2.5 times lower than in continuous mode. Results indicate that this API method is quite promising for soil carbon analysis due to significantly improved MDL.

This paper assesses the conceptualizations and analytical uses of complexity. Throughout the paper, we carefully eschew ontological issues, and sort out the epistemology of complexity. We try to explain why the ontology of complexity makes no sense to us, much like significance is neither material nor ontological. Our tool of choice is levels of analysis. First, we analyze the conceptualization of complexity. Much discussion of complexity is confused because complexity is mistaken as a material issue. Complexity arises from the way the situation is addressed, and is not material in itself. Even so, complexity does seem to have material ramifications without being itself a straightforward material distinction. We use an illustrative parallel example where genetic dominance is shown not to be material while having material consequences, but only after a gene is asserted to be dominant on normative criteria. Secondly, the paper compares two analytical approaches based on complexity, namely Robert Rosen’s work and Joseph Tainter’s work. In Rosennean complexity a system is complex if not all its constituent models are simulable, if certainty is denied. In that sense, complexity cannot be defined. Rosen’s distinction is between simple and complex systems makes complexity an all or nothing proposition. Complexification is seen by Tainter as a device used by societies to solve their problems. This leads to complexity being a matter of degree in successive societal complexifications, perhaps from Neolithic hunter-gatherers to industrial societies.

The nutritional profile of human milk varies significantly between women, and the impact of maternal diet on these variations is not well understood.We analyzed breast-milk vitamin B-12 concentration and vitamin B-12 supplement use pattern among women who adhered to different dietary patterns: vegan, vegetarian, and nonvegetarian.A total of 74 milk samples, 26 from vegan, 22 from vegetarian, and 26 from nonvegetarian breastfeeding mothers, were analyzed.The prevalences of low vitamin B-12 (310 pmol/L) were 19.2% for vegans, 18.2% for vegetarians, and 15.4% for nonvegetarians, which was not significant by diet group (P = 1.00). The median (quartile 1, quartile 3) vitamin B-12 values were 558 pmol/L (331, 759 pmol/L) for vegans, 509 pmol/L (368, 765 pmol/L) for vegetarians, and 444 pmol/L (355, 777 pmol/L) for nonvegetarians (P = 0.890). The use of individual vitamin B-12 supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and nonvegetarians (3.9%) (P = 0.001). In linear regression analysis, the use of individual vitamin B-12 supplements was a significant positive predictor of milk vitamin B-12 concentration (β ± SE: 172.9 ± 75.2; standardized β = 0.263; P = 0.024; R2 = 0.069), the use of a multivitamin had a significant negative relation with milk vitamin B-12 concentrations (β ± SE -222.0 ± 98.7; standardized β = -0.258; P = 0.028, R2 = 0.067;), whereas the use of a B-complex vitamin and prenatal vitamin were not predictive of vitamin B-12 milk concentration (P 0.05).Almost 20% of our study participants were classified as having low breast-milk vitamin B-12 concentrations (310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low vitamin B-12 were taking vitamin B-12 supplements at doses in excess of the Recommended Dietary Allowance, which suggests that more research is needed to determine breast-milk adequacy values.

The recent boom in the extraction of natural gas from subsurface shale deposits due to advances in hydraulic fracturing and horizontal drilling technologies has raised concern around environmental risks. Reliable measures of how residents view these risks are therefore a necessary first step in evaluating policies that regulate the industry through risk mitigation measures. We conduct a choice experiment targeting residents in an area of Ohio with significant shale drilling activity, and find that households are willing to pay to avoid high intensities of shale development and truck traffic. Our analysis presents new policy-relevant evidence of preferences associated with unconventional shale gas reserves, and highlights the tradeoffs between activity intensity at each site and the number of sites in aggregate.