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Climate change has become an issue of great relevance in society in recent years, and the data provided by the scientific community recommend acting as soon as possible and forcefully. Scientists, politicians, the media, and thanks to the new media, citizens and other social agents participate in the debate on this issue. Despite the data and general consensus in the scientific community, the climate change debate is highly polarized, with skeptical voices denying or questioning climate change and using social media to amplify the reach of their message. This can encourage misinformation and polarization. This study tries to identify the key indicators of social skepticism around climate change through the analysis of users' social activism and behavioral patterns on Twitter. We analyze keywords, frequency, topics, and categories from a sample of 78,168 tweets. The results show, first, that there is an overlap of topics, with 24 of the 28 topics grouped in the intertopic distance map; second, that the size of the topics is relatively small and linked to specific events; and, third, that there is a significant political presence, especially from the United States. This work therefore contributes to the analysis of communication on Twitter about opinions against climate change. [ABSTRACT FROM AUTHOR]

Methicillin-resistant Staphylococcus aureus (MRSA) is a human pathogen that has diverse molecular heterogeneity. Most MRSA strains in the United States are pulsed-field gel electrophoresis USA100 sequence type (ST) 5 and USA300 ST8. Infections with MRSA ST239-III are common and found during health care-associated outbreaks. However, this strain has been rarely reported in the United States. [ABSTRACT FROM AUTHOR]

Background: Recent reports highlight the incursion of community-associated MRSA within healthcare settings. However, knowledge of this phenomenon remains limited in Latin America. The aim of this study was to evaluate the molecular epidemiology of MRSA in three tertiary-care hospitals in Medellín, Colombia. Methods: An observational cross-sectional study was conducted from 2008-2010. MRSA infections were classified as either community-associated (CA-MRSA) or healthcare-associated (HA-MRSA), with HA-MRSA further classified as hospital-onset (HAHO-MRSA) or community-onset (HACO-MRSA) according to standard epidemiological definitions established by the U.S. Centers for Disease Control and Prevention (CDC). Genotypic analysis included SCCmec typing, spa typing, PFGE and MLST. Results: Out of 538 total MRSA isolates, 68 (12.6%) were defined as CA-MRSA, 243 (45.2%) as HACO-MRSA and 227 (42.2%) as HAHO-MRSA. The majority harbored SCCmec type IVc (306, 58.7%), followed by SCCmec type I (174, 33.4%). The prevalence of type IVc among CA-, HACO- and HAHO-MRSA isolates was 92.4%, 65.1% and 43.6%, respectively. From 2008 to 2010, the prevalence of type IVc-bearing strains increased significantly, from 50.0% to 68.2% (p=0.004). Strains harboring SCCmec IVc were mainly associated with spa types t1610, t008 and t024 (MLST clonal complex 8), while PFGE confirmed that the t008 and t1610 strains were closely related to the USA300-0114 CA-MRSA clone. Notably, strains belonging to these three spa types exhibited high levels of tetracycline resistance (45.9%). Conclusion: CC8 MRSA strains harboring SCCmec type IVc are becoming predominant in Medellín hospitals, displacing previously reported CC5 HA-MRSA clones. Based on shared characteristics including SCCmec IVc, absence of the ACME element and tetracycline resistance, the USA300-related isolates in this study are most likely related to USA300-LV, the recently-described 'Latin American variant' of USA300. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus is a common cause of skin and soft-tissue infections (SSTIs) and has become the most common cause of bloodstream infections (BSIs) in recent years, but whether the strains causing these two clinical syndromes overlap has not been studied adequately. USA300/500 (clonal complex [CC] 8–sequence type [ST] 8) and USA100 (CC5-ST5) have dominated among methicillin-resistant S aureus (MRSA) strains in the United States since the early 2000s. We compared the genomes of unselected MRSA isolates from 131 SSTIs with those from 145 BSIs at a single US center in overlapping periods in 2018–2021. CC8 MRSA was more common among SSTIs, and CC5 was more common among BSIs, consistent with prior literature. Based on clustering genomes with a threshold of 15 single-nucleotide polymorphisms, we identified clusters limited to patients with SSTI and separate clusters exclusively comprising patients with BSIs. However, we also identified eight clusters that included at least one SSTI and one BSI isolate. This suggests that virulent MRSA strains are transmitted from person to person locally in the healthcare setting or the community and that single lineages are often capable of causing both SSTIs and BSIs. [ABSTRACT FROM AUTHOR]

Consumption of ultra-processed food (UPF) has been associated with several chronic diseases and poor diet quality. It is reasonable to speculate that the consumption of UPF negatively associates with flavonoid dietary intake; however, this assumption has not been previously examined. The present study aims to assess association between the dietary contribution of UPF and flavonoid intake in the US population aged 0 years and above. We performed a cross-sectional analysis of dietary data collected by 24-h recalls from 7640 participants participating in the National Health and Nutrition Examination Survey 2017–2018. Foods were classified according to the Nova classification system. The updated US Department of Agriculture (USDA) Database for the Flavonoid Content of Selected Foods (Release 3.3) database was used to estimate total and six classes of flavonoid intakes. Flavonoid intakes were compared across quintiles of dietary contribution of UPF (% of total energy intake) using linear regression models. The total and five out of six class flavonoid intakes decreased between 50 and 70 % across extreme quintiles of the dietary contribution of UPF (P for linear trend < 0·001); only isoflavones increased by over 260 %. Our findings suggest that consumption of UPF is associated with lower total and five of six class flavonoid intakes and with higher isoflavone intakes, supporting previous evidence of the negative impact of UPF consumption on the overall quality of the diet and health outcomes. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective of this article is to describe differences in the demographic and clinical characteristics, severity of illness, and outcomes in pediatric patients with different SARS-CoV-2 variants. We conducted a retrospective study of pediatric patients admitted with COVID-19 during the 3 large waves of infection within a health network in New Jersey. We included demographic characteristics, clinical features, and outcomes and compared the data with respect to the different variants. Of 351 total patients included in this study, 74 were admitted during wave 1, 94 during wave 2, and 181 during wave 3. The median age of patients decreased from wave 1 (11.5 years) to wave 3 (3 years) (P =.0034). 87.7% of the patients were unvaccinated. The overall incidence of admissions due to pneumonia related to COVID-19 decreased in wave 3. COVID-19 bronchiolitis or croup admissions occurred mostly in wave 3. There was no significant difference in the number of patients requiring intensive care in any particular wave. Length of stay decreased across the waves (P <.0001). Treatments required did not vary between the waves except for a decrease in antibiotic use with each subsequent wave (P <.0001). The impact of COVID-19 on the pediatric population differs from the adult population, and the overall number of hospitalized children has mirrored the peak in cases observed during each infection wave. Our study illustrates the changes in clinical presentation and severity observed with the different coronavirus variants. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study investigated if and how HART constructs manifested in animal-assisted therapy in counseling (AAT-C). Using a constructivist, grounded-theory approach the following HART constructs were examined: relational moments, significant human-animal relational moments, human-animal relational processing, and human-animal relational therapeutic impact. From the iterative process of multiphasic coding and constant comparison it was determined that there was consistency between HART and counselor-client participants' experiences of AAT-C. [ABSTRACT FROM AUTHOR]

This study examines the current state of assessment of computational thinking (CT) programming in public libraries in the United States. In particular, this study identifies the assessment tools and strategies that public library staff use to evaluate the success of CT youth programming, as well as how they share these assessment results, what they share, and with whom. This work also examines the perceptions of library staff on assessment of CT learning in libraries. Through our work, we highlight the need for a change of mindset in the perception of library staff toward assessment of CT learning in libraries. We also demonstrate the need for suitable assessment strategies to measure learning in CT programming in libraries beyond attendance and retention, that communicate to library staff on how they can revise their programs and to share their program impact with library stakeholders who make decisions on budget and resource allocations. [ABSTRACT FROM AUTHOR]

Background: Since the warnings by the United States (US) and European regulatory authorities in 2004 and 2005 it had been discussed whether there is some link between selective serotonin reuptake inhibitors (SSRIs) and suicidality in the pediatric population. The aim of our study was to describe trends and patterns in spontaneous reporting data referring to suicidality in children, adolescents and young adults treated with SSRI after the warnings. Methods: Descriptive analyses of reports for 0–24 year olds referring to suicide/suicidal ideations, self-harms and overdoses with SSRIs reported as suspected submitted to the US (FAERS) and the European (EudraVigilance) adverse drug reaction databases until 2019 were performed. The causal relationship was assessed in accordance with the WHO criteria for the European reports. For Germany, prescription data for SSRIs were provided and reporting rates (number of reports/number of prescriptions) were calculated for the reports with possible causal relationship (so called "confirmed reports"). Results: Since 2004, the number of reports referring to suicide/suicidal ideations, self-harm and overdoses increased steadily in the US and EU. However, only a slight increase was seen for the confirmed EU reports. After 2008, the proportion of reports informing about suicidal ideations increased, while the proportion of fatal suicide attempts decreased. Reporting rates were higher for females and adolescents (12-18 years). Conclusions: Our results demonstrate the importance of further monitoring suicidality in 0–24 year olds treated with SSRI in order to recognize suicidality early avoiding fatal suicide attempts. The higher reporting rates for females and adolescents should be further investigated. [ABSTRACT FROM AUTHOR]

Community engagement in rural libraries receives little focus and is an overlooked area of research. In this article, we report exemplars of agriculture-based community engagement in rural and Southern and Central Appalachian region of the United States. An online survey of rural library professionals demonstrates the positive impact of agriculture-based engagement activities on the overall community-engagement initiatives in this region. This article synthesizes eight distinct agriculture-based initiatives with many subprojects, lists an inventory of stakeholders involved in agriculture-based community-engagement initiatives, and highlights the challenges faced by the rural libraries. Three successful examples, namely, seed library, community gardens, and farmers' market initiatives, are presented with details to help other libraries adopt these successful community-engagement initiatives. The results show that rural libraries are very creative with their limited resources and they hit many areas of impact in the community through their community-engagement activities. [ABSTRACT FROM AUTHOR]

Whether bilingualism can improve aspects of cognitive function in late adulthood is hotly debated. A few limited studies have reported that bilingualism may provide a limited buffer against age-related cognitive decline; however, others have not. The present study furthered this inquiry by analyzing the combined effects of age and language experience upon executive function in a geographically diverse online sample. Amazon Mechanical Turk was used to recruit a sample of younger (YA) and older adults (OA) from 24 countries. A total of 81 monolingual participants (YA = 37; OA = 44) and 82 bilingual/multilingual participants (YA = 43; OA = 39) completed task-pure executive function assessments of inhibition, memory updating, and attention switching. YAs performed better than OAs on both the inhibition and updating tasks. On the attention switching task, a greater switch cost occurred when participants had less time to process a stimulus cue. Notably, no effects of language (i.e., bilingualism) were significant: no main effects or interactions with aging were found for executive function performance. The results of the present study challenge the claim that extensive experience with multiple languages can be a reliably protective factor against some normative age-related declines in executive function. [ABSTRACT FROM AUTHOR]

Research Highlights: Bottomland oaks receive less attention than upland species, however their adaptations to flooding and summer water stress will extend our understanding of the oak genus and links between physiology and leaf anatomy. Background and objectives: Determining links between leaf anatomy and physiology can aid in parameterizing dynamic global vegetation models for oak systems, therefore we sought to (1) compare leaf anatomic, nutrient, and physiological parameters for bottomland oaks differing in flood tolerance, (2) determine correlations across parameters and determine which anatomic and nutrient parameters best predict photosynthetic capacity metrics, and (3) compare these data with reported literature values for oaks across the globe. Materials and Methods: We measured CO2 response curves (A/Ci) on leaves from Nuttall, Shumard, swamp chestnut, water and white oak seedlings planted in the Southeastern United States (US) and estimated stomatal size and density, epidermal cell size, vein density, leaf mass per area (LMA) and nitrogen (N) concentrations. Principal component analysis among these leaf anatomic and nutrient parameters was used to determine the best predictors of photosynthetic parameters including Rubisco-limited carboxylation rate (VCmax) and electron transport limited carboxylation rate (Jmax). Results: We found that although physiological parameters were similar, flood-tolerant oaks had lower leaf N concentrations and larger, more infrequent stomata than less flood-tolerant species. Leaf epidermal properties were correlated withNconcentrations and a principal component capturing this correlation as well as principal components correlated with mesophyll conductance and leaf carbon concentrations were found to best explain variation in VCmax and Jmax. These Southeastern US oaks exhibited similar leaf physiological parameters and LMA as oaks reported in the literature but differed in leaf epidermal and stomatal properties as well as leaf N concentrations increasing the reported range of these parameters within the oak genus. Conclusions: Therefore, leaf anatomy and nutrient parameters as opposed to physiology differed across flood tolerance and between bottomland oaks and broader literature values. [ABSTRACT FROM AUTHOR]

Background We conducted a longitudinal study to evaluate changes in the clinical presentation and epidemiology of Staphylococcus aureus bacteremia (SAB) in an academic, US medical center. Methods Consecutive patients with monomicrobial SAB were enrolled from January 1995 to December 2015. Each person's initial bloodstream S. aureus isolate was genotyped using spa typing. Clonal complexes (CCs) were assigned using Ridom StaphType software. Changes over time in both the patient and bacterial characteristics were estimated with linear regression. Associations between genotypes or clinical characteristics and complications were estimated using multivariable regression models. Results Among the 2348 eligible participants, 54.2% had an implantable, foreign body of some type. This proportion increased significantly during the 21-year study period, by 0.96% annually (P =.002), as did comorbid conditions and acquisition outside of the hospital. Rates of any metastatic complication also significantly increased, by 0.94% annually (P =.019). Among the corresponding bloodstream S. aureus isolates, spa -CC012 (multi-locus sequence type [MLST] CC30), -CC004 (MLST CC45), -CC189 (MLST CC1), and -CC084 (MLST CC15) all significantly declined during the study period, while spa -CC008 (MLST CC8) significantly increased. Patients with SAB due to spa -CC008 were significantly more likely to develop metastatic complications in general, and abscesses, septic emboli, and persistent bacteremia in particular. After adjusting for demographic, racial, and clinical variables, the USA300 variant of spa -CC008 was independently associated with metastatic complications (odds ratio 1.42; 95% confidence interval 1.02–1.99). Conclusions Systematic approaches for monitoring complications of SAB and genotyping the corresponding bloodstream isolates will help identify the emergence of hypervirulent clones and likely improve clinical management of this syndrome. [ABSTRACT FROM AUTHOR]

Manganese pollution to plants, soils, and streams from Mn-rich mine spoils is a global and persistent issue. Some former mining sites can be revegetated readily while others struggle to support plants. We explored Mn in plants and soils following 75 years of soil development and reforestation of a pine-northern hardwood forest at the former Betts Mine in western Massachusetts, USA. We studied soils on four Mn-rich mine spoils and at two control sites: an undisturbed location adjacent to the mine and on a non-Mn mineral bearing rock formation to determine if soil conditions have influenced the uptake of Mn and Ca by vegetation. We collected mid-season foliage from five dominant canopy trees and four common understory plants and excavated three soil pits at each site during July 2018. We found that control sites had lower total Mn (980 ± 140 µg g−1) in their soils than on the mine spoil sites (5580 ± 2050 µg g−1). Our soil data indicated that < 1% of total Mn was strong acid extractable at mine spoil soils and control sites. Surprisingly, the canopy trees established on mine spoils at the Betts Mine had equal to or lower foliar Mn concentrations (840 ± 149 µg g−1) and lower Mn/Ca ratios (0.3 ± 0.1 mol mol−1) than at control sites (1667 ± 270 µg g−1; 1.1 ± 0.2 mol mol−1), refuting our hypothesis of mine spoils driving highest Mn uptake. Soil pH and physicochemical properties suggest Mn primarily exists within primary minerals or form insoluble oxides at the mine spoil sites. Our results suggest higher Ca availability and pH in soils likely reduced Mn uptake and promoted reforestation of the mine spoils. [ABSTRACT FROM AUTHOR]

Background Clinicians increasingly utilize polymyxins for treatment of serious infections caused by multidrug-resistant gram-negative bacteria. Emergence of plasmid-mediated, mobile colistin resistance genes creates potential for rapid spread of polymyxin resistance. We investigated the possible transmission of Klebsiella pneumoniae carrying mcr -1 via duodenoscope and report the first documented healthcare transmission of mcr -1–harboring bacteria in the United States. Methods A field investigation, including screening targeted high-risk groups, evaluation of the duodenoscope, and genome sequencing of isolated organisms, was conducted. The study site included a tertiary care academic health center in Boston, Massachusetts, and extended to community locations in New England. Results Two patients had highly related mcr -1–positive K. pneumoniae isolated from clinical cultures; a duodenoscope was the only identified epidemiological link. Screening tests for mcr -1 in 20 healthcare contacts and 2 household contacts were negative. Klebsiella pneumoniae and Escherichia coli were recovered from the duodenoscope; neither carried mcr -1. Evaluation of the duodenoscope identified intrusion of biomaterial under the sealed distal cap; devices were recalled to repair this defect. Conclusions We identified transmission of mcr -1 in a United States acute care hospital that likely occurred via duodenoscope despite no identifiable breaches in reprocessing or infection control practices. Duodenoscope design flaws leading to transmission of multidrug-resistant organsisms persist despite recent initiatives to improve device safety. Reliable detection of colistin resistance is currently challenging for clinical laboratories, particularly given the absence of a US Food and Drug Administration–cleared test; improved clinical laboratory capacity for colistin susceptibility testing is needed to prevent the spread of mcr -carrying bacteria in healthcare settings. [ABSTRACT FROM AUTHOR]

A strong synergy can result from China–US antimicrobial resistance (AMR) collaborations given similarities and differences between their respective healthcare systems and research infrastructures. The Antibacterial Resistance Leadership Group has employed a model of realistic growth, starting with a feasible, relatively low-resource observational study in a critical priority pathogen. This and other observational studies will provide vital scientific information required for the rational design of future interventional trials. In addition, it provides a mutual, low-risk opportunity for determining the strengths and opportunities of the research collaboration. Issues identified during the observational studies can be addressed prior to the initiation of high-resource interventional studies. Collaborative clinical AMR studies between China and the United States have tremendous potential to decrease AMR rates, improve responsible antibiotic use, and ultimately improve the lives of patients in both countries. [ABSTRACT FROM AUTHOR]

Maintenance therapy after autologous stem cell transplantation (ASCT) is recommended for use in multiple myeloma (MM); however, more data are needed on its impact on health-related quality of life (HRQoL). Presented here is an analysis of HRQoL in a Connect MM registry cohort of patients who received ASCT ± maintenance therapy. The Connect MM Registry is one of the earliest and largest, active, observational, prospective US registry of patients with symptomatic newly diagnosed MM. Patients completed the Functional Assessment of Cancer Therapy-MM (FACT-MM) version 4, EuroQol-5D (EQ-5D) questionnaire, and Brief Pain Inventory (BPI) at study entry and quarterly thereafter until death or study discontinuation. Patients in three groups were analyzed: any maintenance therapy (n = 244), lenalidomide-only maintenance therapy (n = 169), and no maintenance therapy (n = 137); any maintenance and lenalidomide-only maintenance groups were not mutually exclusive. There were no significant differences in change from pre-ASCT baseline between any maintenance (P = 0.60) and lenalidomide-only maintenance (P = 0.72) versus no maintenance for the FACT-MM total score. There were also no significant differences in change from pre-ASCT baseline between any maintenance and lenalidomide-only maintenance versus no maintenance for EQ-5D overall index, BPI, FACT-MM Trial Outcomes Index, and myeloma subscale scores. In all three groups, FACT-MM, EQ-5D Index, and BPI scores improved after ASCT; FACT-MM and BPI scores deteriorated at disease progression. These data suggest that post-ASCT any maintenance or lenalidomide-only maintenance does not negatively impact patients' HRQoL. Additional research is needed to verify these findings. [ABSTRACT FROM AUTHOR]

Primary objective: To examine the relationship between hearing protection and non-impact, blast-induced concussion in US military personnel. Research design: Retrospective cohort study. Methods and procedures: A total of 501 US service members from the Expeditionary Medical Encounter Database with hearing protection status reported either ‘worn’ or ‘not worn’ were eligible for analysis. Clinical records were reviewed for concussion diagnoses. Univariate and multiple logistic regressions were performed. Main outcomes and results: Overall, 270 (53.9%) service members sustained non-impact, blast-induced concussion and 231 (46.1%) sustained other blast injuries. Only 39.6% (107 of 270) of service members with concussion wore hearing protection at the point of injury compared with 61.0% (141 of 231) of those with other injuries (p < 0.001). After adjusting for covariates, service members wearing hearing protection had significantly lower odds of concussion compared with those not wearing hearing protection (odds ratio = 0.42, 95% confidence interval = 0.29-0.62). Conclusions: To our knowledge, this preliminary study is the first to demonstrate that hearing protection is associated with lower odds of non-impact, blast-induced concussion. The benefits of using hearing protection in terms of force readiness could be significant since many service members wounded in recent conflicts were diagnosed with concussion. [ABSTRACT FROM AUTHOR]

Background The epidemiology of antibiotic-resistant Enterobacteriaceae intestinal carriage in healthy US children has not been well characterized. Methods Children between 14 days and 14 years of age were enrolled during well-child visits in Oakland, California, Kansas City, Kansas, and Nashville, Tennessee, between December 2013 and March 2015. Data on recent antibiotic use by the child and travel and hospitalization history of all members of each child’s household were obtained with a risk-factor survey. Stool specimens collected from the subjects were screened for extended-spectrum β-lactamase-producing (ESBL-P) bacteria using CHROMagar ESBL medium. Putative ESBL-P Escherichia coli and Klebsiella colonies underwent phenotypic confirmation by double-disk synergy testing; confirmed third-generation cephalosporin-resistant (3GCR) isolates underwent additional antibiotic-susceptibility testing. Results In 519 subjects, the overall 3GCR Enterobacteriaceae carriage rate was 4.4% (n = 23) and ranged from 3.4% to 5.1% among the study sites. The ESBL-P Enterobacteriaceae carriage rate was 3.5% (n = 18). The rates of 3GCR Enterobacteriaceae carriage was highest in 1 to <2 year olds at 6.5%, and was 5.2% in <5 year-olds vs 1.7% in ≥5-year-olds (P =.11). 3GCR and ESBL-P Enterobacteriaceae carriage was associated with international travel within the previous year; 11.1% of ESBL-P Enterobacteriaceae carriers reported this history compared with 1.6% of noncarriers (P =.004). No other queried factor was found to increase risk. Of the 24 analyzed 3GCR isolates, 58% were multidrug resistant. Conclusions The 3GCR Enterobacteriaceae carriage rate exceeds 5% in healthy US children <5 years of age. International travel within the previous year increased the risk of 3GCR and ESBL-P Enterobacteriaceae carriage. In contrast, we found no differences in the rates of hospitalization or recent antibiotic exposure between carriers and noncarriers. Young children, who have the highest prevalence of colonization, might be a sentinel population to study to gain a better understanding of community sources of antibiotic-resistant Enterobacteriaceae. [ABSTRACT FROM AUTHOR]

Objective. In this report, we aim to describe the epidemiology of extended-spectrum cephalosporin-resistant (ESC-R) and carbapenem-resistant (CR) Enterobacteriaceae infections in children. Methods. ESC-R and CR Enterobacteriaceae isolates from normally sterile sites of patients aged <22 years from 4 freestanding pediatric medical centers were collected along with the associated clinical data. Results. The overall frequencies of ESC-R and CR isolates according to hospital over the 4-year study period ranged from 0.7% to 2.8%. Rates of ESC-R or CR Escherichia coli and Klebsiella pneumoniae varied according to hospital and ranged from 0.75 to 3.41 resistant isolates per 100 isolates (P < .001 for any differences). E coli accounted for 272 (77%) of the resistant isolates; however, a higher rate of resistance was observed in K pneumoniae isolates (1.78 vs 1.27 resistant isolates per 100 same-species isolates, respectively; P = .005). One-third of the infections caused by ESC-R or CR E coli were community-associated. In contrast, infections caused by ESC-R or CR K pneumoniae were more likely than those caused by resistant E coli to be healthcare- or hospital-associated and to occur in patients with an indwelling device (P ≤ .003 for any differences, multivariable logistic regression). Nonsusceptibility to 3 common non-β-lactam agents (ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole) occurred in 23% of the ESC-R isolates. The sequence type 131-associated fumC/fimH-type 40-30 was the most prevalent sequence type among all resistant E coli isolates (30%), and the clonal group 258-associated allele tonB79 was the most prevalent allele among all resistant K pneumoniae isolates (10%). Conclusions. The epidemiology of ESC-R and CR Enterobacteriaceae varied according to hospital and species (E coli vs K pneumoniae). Both community and hospital settings should be considered in future research addressing pediatric ESC-R Enterobacteriaceae infection. [ABSTRACT FROM AUTHOR]

We characterized spa types, SCC mec types, and antimicrobial resistance patterns of 516 methicillin-resistant Staphylococcus aureus (MRSA) isolates, collected between 2011 and 2014 from nares and blood cultures of United States patients. Among nares isolates, 45 spa types were observed; 29.9% were t002/SCC mec II and 30.9% were t008/SCC mec IV. Among blood isolates, 40 spa types were identified; 24.4% were t002/SCC mec II and 39.9% were type t008/SCC mec IV. Compared to data from our 2009–2010 survey, the percentage of t008/SCC mec IV isolates from nares increased significantly (20.4%–30.9%; P = 0.004) while the percentage from positive blood cultures remained similar (39.2% versus 39.9%; P = 0.921). There were also significant changes in the overall antimicrobial resistance patterns observed, including the decrease of the clindamycin, erythromycin, levofloxacin and moxifloxacin multidrug resistance pattern, likely the result of t002/SCC mec II strains being displaced by t008/SCC mec IV strains. Rates of high-level mupirocin resistance did not change significantly from our past study (4.1% compared to 4.7%; P = 0.758) but an increase in low-level resistance, particularly among t002/SCC mec II isolates, was observed. [ABSTRACT FROM AUTHOR]

The article discusses the pathogenesis and epidemiology of community-associated methicillin-resistant staphylococcus aureus (CA-MRSA). Topics discussed include the preventive and therapeutic measures for preventing the pathogen, the distinction of CA-MRSA from traditional MRSA strains, and the U.S. public health crisis due to the staphylococcus aureus infections in children.

Through analysis of two social issues that held the potential for anti-UNESCO campaigning by the American Radical Right in the 1950s – UNESCO’s much publicized Statements on Race and the use of UNESCO textbooks in public schools and libraries – I argue that micromobilization contexts can create conditions of path dependency whereby the initiation of one campaign hinders other campaigns from developing. Specific micromobilization factors – past campaigning on similar issues, tactical expectations, an available pool of skilled activists, frame resonance, a national conservative media, and amenable polities – created favorable initial conditions for anti-UNESCO censorship campaigning, while competition from activists in another social movement restricted campaign development in response to UNESCO’s Statement on Race. The micromobilization context from which the censorship campaign emerged created conditions of path dependency which limited further the viability of American Radical Rightists developing a campaign in reaction to UNESCO’s Statement on Race. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) affects about 30% of the general population in the United States and includes a spectrum of disease that includes simple steatosis, non-alcoholic steatohepatitis (NASH), fibrosis and cirrhosis. Significant insight has been gained into our understanding of the pathogenesis of NALFD; however the key metabolic aberrations underlying lipid accumulation in hepatocytes and the progression of NAFLD remain to be elucidated. Accumulating and emerging evidence indicate that hepatic mitochondria play a critical role in the development and pathogenesis of steatosis and NAFLD. Here, we review studies that document a link between the pathogenesis of NAFLD and hepatic mitochondrial dysfunction with particular focus on new insights into the role of impaired fatty acid oxidation, the transcription factor peroxisome proliferator-activated receptor-? coactivator-1a (PGC-1α), and sirtuins in development and progression of NAFLD. [ABSTRACT FROM AUTHOR]

We noted anecdotally that infections designated as health care-associated (HA-) MRSA by epidemiologic criteria seemed to be decreasing in incidence at the University of Chicago Medical Center (UCMC) after 2004. We compared MRSA patients seen at any site of clinical care at UCMC and the isolates that caused their infections in 2004-5 (n = 545) with those in 2008 (n = 135). The percent of patients with MRSA infections cultured > 2 days after hospital admission decreased from 19.5% in 2004-5 to 7.4% in 2008 (p = 0.001). The percent in 2004-5 compared with 2008 who had a hospitalization (49.1% to 26.7%, p = 0.001) or surgery (43.0% to 14.1%, p<0.001) in the previous year decreased. In 2008 a greater percent of patients was seen in the emergency department (23.1% vs. 39.3%) and a smaller percent both in intensive care units (15.6% vs. 6.7%) and in other inpatient units (40.7% vs. 32.6%) (p<0.001). The percent of patients with CA-MRSA infections by the CDC epidemiologic criteria increased from 36.5% in 2004-5 to 62.2% in 2008 (p<0.001). The percent of MRSA isolates sharing genetic characteristics of USA100 decreased from 27.9% (152/545) to 12.6% (17/135), while the percent with CA-MRSA (USA300) characteristics increased from 53.2% (290/545) to 66.7% (90/135). The percent of infections that were invasive did not change significantly. Our data suggest that HA-MRSA infections, both by epidemiologic and microbiologic criteria, relative to CA-MRSA, decreased between 2004-5 and 2008 at UCMC. [ABSTRACT FROM AUTHOR]

Background. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major health threat in the United States. Staphylococcal enterotoxin B (SEB) is a potent superantigen that contributes to its virulence. High mortality and frequent failure of therapy despite available antibiotics have stimulated research efforts to develop adjunctive therapies.Methods. Treatment benefits of SEB-specific monoclonal antibody (mAb) 20B1 were investigated in mice in sepsis, superficial skin, and deep-tissue infection models.Results. Mice challenged with a SEB-producing MRSA strain developed fatal sepsis, extensive tissue skin infection, and abscess-forming deep-seeded thigh muscle infection. Animals preimmunized against SEB or treated passively with mAb 20B1 exhibited enhanced survival in the sepsis model, whereas decrease of bacterial burden was observed in the superficial skin and deep-tissue models. mAb 20B1 bound to SEB in the infected tissue and decreased abscess formation and proinflammatory cytokine levels, lymphocyte proliferation, and neutrophil recruitment.Conclusions. mAb 20B1, an SEB-neutralizing mAb, is effective against MRSA infection. mAb 20B1 protects against lethal sepsis and reduces skin tissue invasion and deep-abscess formation. The mAb penetrates well into the abscess and binds to SEB. It affects the outcome of S. aureus infection by modulating the host's proinflammatory immune response. [ABSTRACT FROM PUBLISHER]

During the past few decades, the nursing workforce has been in crisis in the United States and around the world. Many health care organizations in developed countries recruit nurses from other countries to maintain acceptable staffing levels. The Philippines is the centre of a large, mostly private nursing education sector and an important supplier of nurses worldwide, despite its weak domestic health system and uneven distribution of health workers. This situation suggests a dilemma faced by developing countries that train health professionals for overseas markets: how do government officials balance competing interests in overseas health professionals’ remittances and the need for well-qualified health professional workforces in domestic health systems? This study uses case studies of two recent controversies in nursing education and migration to examine how Philippine government officials represent nurses when nurse migration is the subject of debate. The study finds that Philippine government officials cast nurses as global rather than domestic providers of health care, implicating them in development more as sources of remittance income than for their potential contributions to the country’s health care system. This orientation is motivated not simply by the desire for remittance revenues, but also as a way to cope with overproduction and lack of domestic opportunities for nurses in the Philippines. [ABSTRACT FROM AUTHOR]

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is a significant bacterial pathogen that poses considerable clinical and public health challenges. The majority of the CA-MRSA disease burden consists of skin and soft tissue infections (SSTI) not associated with significant morbidity; however, CA-MRSA also causes severe, invasive infections resulting in significant morbidity and mortality. The broad range of disease severity may be influenced by bacterial genetic variation. Results: We sequenced the complete genomes of 36 CA-MRSA clinical isolates from the predominant North American community acquired clonal type USA300 (18 SSTI and 18 severe infection-associated isolates). While all 36 isolates shared remarkable genetic similarity, we found greater overall time-dependent sequence diversity among SSTI isolates. In addition, pathway analysis of non-synonymous variations revealed increased sequence diversity in the putative virulence genes of SSTI isolates. Conclusions: Here we report the first whole genome survey of diverse clinical isolates of the USA300 lineage and describe the evolution of the pathogen over time within a defined geographic area. The results demonstrate the close relatedness of clinically independent CA-MRSA isolates, which carry implications for understanding CA-MRSA epidemiology and combating its spread. [ABSTRACT FROM AUTHOR]

As the New York Public Library entered the post-war era in the late 1940s, its operations fell under the zealous scrutiny of self-styled 'redhunters' intent upon rooting out library materials and staffers deemed un-American and politically subversive. The high point of attacks upon the New York Public Library came during the years 1947-54, a period that witnessed the Soviet atomic bomb, the Berlin airlift, and the Korean War. This article charts the narrow and carefully wrought trail blazed by the Library's leadership during that period. Through a reading of materials in the Library archives, we see how political pressures were perceived and handled by Library management and staff. We witness remarkable examples of brave defence of intellectual freedom alongside episodes of prudent equivocation. At the heart of the Library's situation stood the contradictions between the principled commitments of individual Library leaders and the practical political considerations underlying the Library's viability. As a general rule, the New York Public Library did not hesitate to acquire materials considered subversive by pressure groups, but the Library frequently struck a course that sought to avoid controversy when possible. [ABSTRACT FROM AUTHOR]

This research studies how organizational adoption of three different types of change - change in products, in technological processes and in administrative processes - is influenced by environmental factors such as industry regulation and market concentration and by the prior adoption of different types of change. We tested our hypotheses in the service sector, examining a sample of bank holding companies in the USA for the period 1975-1995. We found that (1) environmental factors influence rates of change in products, in technological processes and in administrative processes differently; (2) changes in products are followed by changes in both technological and administrative processes; and (3) the three types of change exhibit momentum, as firms are more likely to implement changes similar to those they have recently undertaken. We discuss the implications of our findings for the theory and management of change in organizations. [ABSTRACT FROM AUTHOR]

Autoantibodies (AAbs) to tumor-associated antigens (TAAs) have been identified in the sera of cancer patients. In a previous review published in this journal, we have focused on recent knowledge related to circulating AAbs to individual TAAs in breast carcinoma. This review will focus on recent knowledge related to AAb assays to tailor-made panels of TAAs in breast carcinoma. So far, AAb assays to the following tailor-made panels of TAAs have been assessed in breast carcinoma: (1) p53, c-myc, HER2, NYESO-1, BRCA2, and MUC1, (2) IMP1, p62, Koc, p53, c-MYC, cyclin B1, and survivin, (3) PPIA, PRDX2, FKBP52, HSP-60, and MUC1, (4) MUC1, HER2, p53, and IGFBP2, (5) p53, HER2, IGFBP-2, and TOPO2α, (6) survivin and livin, (7) ASB-9, SERAC1, and RELT, and (8) p16, p53, and c-myc. Assessment of serum AAbs to a tailor-made panel of TAAs provides better sensitivity to diagnosis of breast carcinoma than measuring serum AAbs to a single TAA. Nevertheless, measurement of serum AAbs to a panel of TAAs for screening and early diagnosis of breast carcinoma is still investigational and should be carried out along with traditional diagnostic studies. [ABSTRACT FROM AUTHOR]

To study the impact of auto-SCT on the outcomes in African Americans (AA) with multiple myeloma (MM), we evaluated 101 consecutive AA patients who underwent auto-SCT. The median PFS and OS were 15.6 and 50.8 months, respectively. The median OS from diagnosis was 60 months. Traditional pre and post transplant prognostic variables earlier examined in Caucasian Americans (CA), including beta-2 microglobulin (B2M), chromosome 13 deletion, CR status after auto-SCT, gender, stage, Ig subtype, time to transplant, number of prior regimens and presence of lytic lesions, were not predictive of improved PFS or OS on univariate analysis. Age, lower CD34 cell dose infused, history of palliative radiation therapy (XRT) prior to auto-SCT and refractory disease at the time of auto-SCT were predictive of inferior PFS. History of palliative XRT was the only predictive factor of inferior PFS and OS after auto-SCT on multivariate analysis. In conclusion, MM in AA tends to relapse early after auto-SCT. It is unclear whether early relapses impact OS. Common prognostic peritransplant variables known in CA with MM may not be applicable to AA with MM.Bone Marrow Transplantation (2009) 43, 845–851; doi:10.1038/bmt.2008.401; published online 12 January 2009 [ABSTRACT FROM AUTHOR]

This study evaluates the quality of reference transactions in academic music libraries, building upon previous research that identified music libraries as having different evaluation needs than main, multidisciplinary academic libraries. Using unobtrusive evaluation techniques, this study analyzed instant messaging/chat and e-mail reference transactions at 128 U.S. academic music libraries to determine the quality of responses provided. Differences in quality of responses between the two mediums are also analyzed. The results of this study provide a state-of-the-art view of the current media on which reference services are offered for music libraries, and the quality of those services. This work discusses the implications of the findings and provides suggestions for improving the quality of these reference services in academic music libraries. [ABSTRACT FROM AUTHOR]

BACKGROUND: The deleterious impact of uranium on human health has been linked to its radioactive and heavy metal-chemical properties. Decades of research has defined the causal relationship between uranium mining/milling and onset of kidney and respiratory diseases 25 years later. OBJECTIVE: We investigated the hypothesis that uranium, similar to other heavy metals such as cadmium, acts like estrogen. METHODS: In several experiments, we exposed intact, ovariectomized, or pregnant mice to depleted uranium in drinking water [ranging from 0.5 μg/L (0.001 μM) to 28 mg/L (120 μM). RESULTS: Mice that drank uranium-containing water exhibited estrogenic responses including selective reduction of primary follicles, increased uterine weight, greater uterine luminal epithelial cell height, accelerated vaginal opening, and persistent presence of cornified vaginal cells. Coincident treatment with the antiestrogen ICI 182,780 blocked these responses to uranium or the synthetic estrogen diethylstilbestrol. In addition, mouse dams that drank uranium-containing water delivered grossly normal pups, but they had significantly fewer primordial follicles than pups whose dams drank control tap water. CONCLUSIONS: Because of the decades of uranium mining/milling in the Colorado plateau in the Four Corners region of the American Southwest, the uranium concentration and the route of exposure used in these studies are environmentally relevant. Our data support the conclusion that uranium is an endocrine-disrupting chemical and populations exposed to environmental uranium should be followed for increased risk of fertility problems and reproductive cancers. [ABSTRACT FROM AUTHOR]

Prostate cancer is a public health problem of the elderly men. It has been estimated that one in six men will develop prostate cancer in his lifetime in the USA. There is thus a huge clinical demand for effective therapies for the prevention and treatment of the disease. Here, the scientific evidence supporting the effectiveness of melatonin in inhibiting the development and progression of prostate cancer is reviewed. The rational use of melatonin in prostate cancer prevention, stabilization of clinically localized favourable-risk prostate cancer and palliative treatment of advanced or metastatic tumour is discussed within the context of the molecular pathogenesis of the disease. [ABSTRACT FROM AUTHOR]

The article discusses the arguments presented by philosopher John Buridan regarding the soul and problems of dualism in the early 14th Century in the U.S. Distinction between the study of the soul in the context of metaphysics and in the context of natural philosophy; Reference to the De Anima of philosopher Aristotle; Analysis of the view of the soul as a single substantial form of the body.

Reports on developments in the healthcare industry in the U.S. as of July 1991. Announcement of the World Health Organization Director-General Hiroshi Nakajima, for a new paradigm for health; Unification of countries to accelerate the implementation of measures , promotion of family planning and safe motherhood; Citation of a special prize awarded to Noerine Kaleebam, director of the AIDS Support Organization in Uganda.

In the United States, fentanyl causes approximately 60,000 drug overdose deaths each year. Fentanyl is also frequently administered as an analgesic in the perioperative setting, where respiratory depression remains a common clinical problem. Naloxone is an efficacious opioid antagonist, but it possesses a short half-life and undesirable side effects. This study was conducted to test the hypothesis that d-amphetamine ameliorates respiratory depression and hastens the return of consciousness following high-dose fentanyl. Behavioral endpoints (first head movement, two paws down, and return of righting), arterial blood gas analysis and local field potential recordings from the prefrontal cortex were conducted in adult rats after intravenous administration of of fentanyl (55 µg/kg) at a dose sufficient to induce loss of righting and respiratory depression, followed by intravenous d-amphetamine (3 mg/kg) or saline (vehicle). D-amphetamine accelerated the time to return of righting by 36.6% compared to saline controls. D-amphetamine also hastened recovery of arterial pH, and the partial pressure of CO2, O2 and sO2 compared to controls, with statistically significant differences in pH after 5 min and 15 min. Local field potential recordings from the prefrontal cortex showed that within 5 min of d-amphetamine administration, the elevated broadband power <20 Hz produced by fentanyl had returned to awake baseline levels, consistent with the return of consciousness. Overall, d-amphetamine attenuated respiratory acidosis, increased arterial oxygenation, and accelerated the return of consciousness in the setting of fentanyl intoxication. This suggests that d-amphetamine may be a useful adjunct or alternative to opioid receptor antagonists such as naloxone. [ABSTRACT FROM AUTHOR]

This paper aims to analyse: (a) how the attitude towards renewable energy-based heating systems, pro-environmental behaviour and the perceived attributes of technology influence intention to convert residential heating systems from fossil fuels to biofuels, and (b) the moderating role of culture based on Hofstede's individualism dimension. A total of 425 responses were collected from a panel of internet users from representative countries in three continents (the United States, the United Kingdom and South Africa); the data analysis was carried out using structural equation models in a multigroup analysis. The results showed that attitude towards renewable energy-based heating systems is influenced by environmental variables in the United States and the United Kingdom, and by the perceived attributes of clean residential heating systems in the United States and South Africa. Attitude, in turn, impacts on the intention to convert from fossil fuels to biofuels. In addition, individualism has a moderating effect between these variables and there are intercultural differences in the degree of importance attributed to them. The study concludes the use of these energy systems as drivers of environmentally-sustainable development. [ABSTRACT FROM AUTHOR]

Within the United States solar energy industry, there is a general motto of "set it and forget it" with solar energy. This notion is derived from much of the research and reliability studies around the photovoltaic (PV) panels themselves, not necessarily the PV system as a whole (including the inverter and other components). This implies that maintenance and regular monitoring is not needed. Yet many things can go wrong to cause the actual performance to deviate from the expected performance. If failures and/or unanticipated degradation issues go undetected, they will lead to reduced energy generation (and associated electricity credits) and/or potential loss of component warranty because of manufacturer turnover. Given the size of the problem and gaps with current solutions, the authors propose that PV system owners need an unbiased third-party off-the-shelf system-level predictive maintenance tool to optimize return-on-investment and minimize time to warranty claim in PV installations. This paper reviews the literature highlighting challenges, current approaches, and opportunities for PV predictive maintenance. The paper concludes with a call to action for establishing a collaborative agenda toward prioritizing PV predictive maintenance. [ABSTRACT FROM AUTHOR]

Background Genes conferring carbapenem resistance have disseminated worldwide among Gram-negative bacteria. Here we present longitudinal changes in clinically obtained Escherichia coli isolates from 1 immunocompromised pediatric patient. This report demonstrates potential for antibiotic resistance genes and plasmids to emerge over time in clinical isolates from patients receiving intensive anticancer chemotherapy and broad-spectrum antibiotics. Methods Thirty-three isolates obtained over 7 months from 1 patient were included. Clinical data were abstracted from the medical record. For each isolate, studies included phenotypic antibacterial resistance patterns, sequence typing, bacterial isolate sequencing, plasmid identification, and antibiotic resistance gene identification. Results Sites of isolation included blood, wound culture, and culture for surveillance purposes from the perianal area. Isolates were of 5 sequence types (STs). All were resistant to multiple classes of antibiotics; 23 (69.6%) were phenotypically resistant to all carbapenems. The blaNDM-5 gene was identified in 22 (67%) isolates, all of ST-167 and ST-940, and appeared to coincide with the presence of the IncFII and IncX3 plasmid. Conclusions We present unique microbiologic data from 33 multidrug-resistant E. coli isolates obtained over the course of 7 months from an individual patient in the United States. Two E. coli sequence types causing invasive infection in the same patient and harboring the blaNDM-5 gene, encoded on the IncX3 plasmid and the IncFII plasmid, were identified. This study highlights the emergence of multidrug-resistant bacteria on antibiotic therapy and the necessity of adequate neutrophil number and function in the clearance of bacteremia. [ABSTRACT FROM AUTHOR]

Community Networks have been around us for decades being initially deployed in the USA and Europe. They were designed by individuals to provide open and free "do it yourself" Internet access to other individuals in the same community and geographic area. In recent years, they have evolved as a viable solution to provide Internet access in developing countries and rural areas. Their social impact is measurable, as the community is provided with the right and opportunity of communication. Community networks combine wired and wireless links, and the nature of the wireless medium is unreliable. This poses several challenges to the routing protocol. For instance, Link-State routing protocols deal with End-to-End Quality tracking to select paths that maximize the delivery rate and minimize traffic congestion. In this work, we focused on End-to-End Quality prediction by means of time-series analysis to foresee which paths are more likely to change their quality. We show that it is possible to accurately predict End-to-End Quality with a small Mean Absolute Error in the routing layer of large-scale, distributed, and decentralized networks. In particular, we analyzed the path ETX behavior and properties to better identify the best prediction algorithm. We also analyzed the End-to-End Quality prediction accuracy some steps ahead in the future, as well as its dependency on the hour of the day. Besides, we quantified the computational cost of the prediction. Finally, we evaluated the impact of the usage for routing of our approach versus a simplified OLSR (ETX + Dijkstra) on an overloaded network. [ABSTRACT FROM AUTHOR]