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Background The optimal timing of vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines after cellular therapy is incompletely understood. The objectives of this study are to determine whether humoral and cellular responses after SARS-CoV-2 vaccination differ if initiated <4 months versus 4–12 months after cellular therapy. Methods We conducted a multicenter, prospective, observational study at 30 cancer centers in the United States. SARS-CoV-2 vaccination was administered as part of routine care. We obtained blood prior to and after vaccinations at up to 5 time points and tested for SARS-CoV-2 spike (anti-S) IgG in all participants and neutralizing antibodies for Wuhan D614G, Delta B.1.617.2, and Omicron B.1.1.529 strains, as well as SARS-CoV-2–specific T-cell receptors, in a subgroup. Results We enrolled 466 allogeneic hematopoietic cell transplantation (HCT) (n = 231), autologous HCT (n = 170), and chimeric antigen receptor T-cell (CAR-T-cell) therapy (n = 65) recipients between April 2021 and June 2022. Humoral and cellular responses did not significantly differ among participants initiating vaccinations <4 months versus 4–12 months after cellular therapy. Anti-S IgG ≥2500 U/mL was correlated with high neutralizing antibody titers and attained by the last time point in 70%, 69%, and 34% of allogeneic HCT, autologous HCT, and CAR-T-cell recipients, respectively. SARS-CoV-2–specific T-cell responses were attained in 57%, 83%, and 58%, respectively. Pre–cellular therapy SARS-CoV-2 infection or vaccination and baseline B-cell count were key predictors of post–cellular therapy immunity. Conclusions These data support mRNA SARS-CoV-2 vaccination prior to, and reinitiation 3 to 4 months after, cellular therapies with allogeneic HCT, autologous HCT, and CAR-T-cell therapy. [ABSTRACT FROM AUTHOR]

Compared to other health professions, physiotherapy is a relatively new profession in Malawi and the United States, yet in both countries, past colonialism has influenced current physiotherapy education and research. The authors of this article are from Malawi and the United States, and they worked collaboratively to explore the impact of colonialization on physiotherapy education and research in their respective locations, and to discuss the similarities and contextual differences. Decolonializing physiotherapy education and research must begin by identifying how colonialization currently manifests within the profession. The purpose of this article is to spark discussion about colonialization in physiotherapy education and research. Although decolonialization literature specific to physiotherapy is limited, the literature gathered about physiotherapy and other health professions prompted generative discussion and reflection among the authors. These discussions and reflections led to student-driven recommendations that are outlined in this article and could be included in the decolonialization efforts in physiotherapy. We propose that reflecting on how colonialism has influenced physiotherapy education and research could lead to international collaborations that support decolonialization in physiotherapy. [ABSTRACT FROM AUTHOR]

Drawing a referent of a to-be-remembered word often results in better recognition and recall of this word relative to a control task in which the word is written, a pattern dubbed the drawing effect. Although this effect is not always found in pure lists, we report three experiments in which the drawing effect emerged in both pure- and mixed-lists on recognition and recall tests, though the effect was larger in mixed lists. Our experiments then compared drawing effects on memory between pure- and mixed-list contexts to determine whether the larger mixed-list drawing effect reflected a benefit to draw items, a cost to write items, or a combination. In delayed recognition and free-recall tests, a mixed-list benefit emerged for draw items in which memory for mixed-list draw items was greater than pure-list draw items. This mixed-list drawing benefit was accompanied by a mixed-list writing cost compared to pure-list write items, indicating that the mixed-list drawing effect does not operate cost-free. Our findings of a pure-list drawing effect are consistent with a memory strength account, however, the larger drawing effect in mixed lists suggest that participants may also deploy a distinctiveness heuristic to aid retrieval of drawn items. [ABSTRACT FROM AUTHOR]

Introduction: Severe trauma-induced blood loss can lead to metabolic acidosis, shock, and death. Identification of abnormalities in the bicarbonate and serum markers may be seen before frank changes in vital signs in the hemorrhaging trauma patient, allowing for earlier lifesaving interventions. In this study the author aimed to evaluate the usefulness of serum bicarbonate and other lab markers as predictors of mortality in trauma patients within 30 days after injury. Methods: This retrospective, propensity-matched cohort study used the TriNetX database, covering approximately 92 million patients from 55 healthcare organizations in the United States, including 3.8 million trauma patients in the last two decades. Trauma patients were included if they had lab measurements available the day of the event. The analysis focused on mortality within 30 days post-trauma in comparison to measured lab markers. Cohorts were formed based on ranges of bicarbonate, lactate, and base excess levels. Results: Before propensity score matching, a total of 1,275,363 trauma patients with same-day bicarbonate, lactate, or base excess labs were identified. A significant difference in mortality was found across various serum bicarbonate lab ranges compared to the standard range of 21-27 milliequivalents per liter (mEq/L), post-propensity score matching. The relative risk of death was 6.806 for bicarbonate ≤5 mEq/L; 8.651 for 6-10; 6.746 for 11-15; 2.822 for 16-20; and 1.015 for bicarbonate ≥28. Serum lactate also displayed significant mortality outcomes when compared to a normal level of ≤2 millimoles per liter. Base excess showed similar significant correlation at different values compared to a normal base excess of-2 to 2 mEq/L. Conclusion: This study, approximately 100 times larger than prior studies, associated lower bicarbonate levels with increased mortality in the trauma patient. While lactate and base excess offer prognostic value, lower bicarbonate values have a higher relative risk of death. The greater predictive value of bicarbonate and accessibility during resuscitations suggests that it may be the superior prognostic marker in trauma. [ABSTRACT FROM AUTHOR]

Introduction: Students who are enrolled in professional education programs such as occupational therapy may have inherent attitudes towards the future clients they work with. These attitudes may be influenced by the level of their professional education as well as cultural values of their country of origin. Purpose: The purpose of the study was to examine occupational therapy students' attitudes towards individuals with disabilities from an international, cross-cultural perspective and to investigate the possible impact of professional education on students' attitudes. Method: 485 occupational therapy students from 11 university programs (3 from Australia, 3 from the United Kingdom, 3 from the United States, and 2 from Taiwan) completed the "Interactions with Disabled Person's" (IDP) scale. Results: Significant differences were found between occupational therapy students from Australia, Taiwan, the United States, and the United Kingdom on the following IDP variables: overall attitude towards individuals with disabilities, "discomfort", "sympathy", "uncertainty", "coping", "fear", and "vulnerability". Significant differences between first year students as a total group and final year students as a total group were found on their overall attitudes towards individuals with disabilities, "discomfort", and "uncertainty". Conclusion/implications: The attitudes towards individuals with disabilities among first year and final year occupational therapy students varies between countries and the students' year level also impacts on their attitudes towards individuals with a disability. (Contains 3 tables.)

Background COVID-19 vaccines are available for adolescents in the United States, but many parents are hesitant to have their children vaccinated. The advice of primary care professionals strongly influences vaccine uptake. Objective We examined the willingness of primary care professionals (PCPs) to recommend COVID-19 vaccination for adolescents. Methods Participants were a national sample of 1,047 US adolescent primary care professionals. They participated in an online survey in early 2021, after a COVID-19 vaccine had been approved for adults but before approval for adolescents. Respondents included physicians (71%), advanced practice providers (17%), and nurses (12%). We identified correlates of willingness to recommend COVID-19 vaccination for adolescents using logistic regression. Results The majority (89%) of respondents were willing to recommend COVID-19 vaccination for adolescents, with advanced practice providers and nurses being less likely than paediatricians to recommend vaccination (84% vs. 94%, aOR 0.47, 95% CI 0.23–0.92). Respondents who had received at least one dose of a COVID-19 vaccine were more likely to recommend adolescent vaccination (92% vs. 69%, aOR 4.20, 95% CI 2.56–6.87) as were those with more years in practice (94% vs. 88%, aOR 2.93, 95% CI 1.79–4.99). Most respondents (96%) said they would need some measure of support in order to provide COVID-19 vaccination to adolescents, with vaccine safety and efficacy information being the most commonly cited need (80%). Conclusion Adolescent primary care professionals were generally willing to recommend COVID-19 vaccination. However, most indicated a need for additional resources to be able to administer COVID-19 vaccines at their clinic. [ABSTRACT FROM AUTHOR]

Diversification of police forces is widely promoted as a reform for reducing racial disparities in police-civilian interactions and increasing police legitimacy. Despite these potential benefits, nearly every municipal police department in the United States remains predominately White and male. Here, we investigate whether the scale and persistence of minority underrepresentation in policing might partly be explained by a lack of support for diversification among voters and current police officers. Across two studies (N = 2, 661) sampling the US adult population and residents from a city with one of the least representative police forces in the country, individuals significantly overestimate officer diversity at both the local and national levels. We find that correcting these biased beliefs with accurate information reduces trust in police and increases support for hiring new officers from underrepresented groups. In the municipal sample, these corrections also cause an increase in residents' willingness to vote for reforms to diversify their majority White police department. Additional paired decision-making experiments (N = 1, 663) conducted on these residents and current police officers demonstrate that both prefer hiring new officers from currently underrepresented groups, independent of civil service exam performance and other hiring criteria. Overall, these results suggest that attitudes among voters and police officers are unlikely to pose a major barrier to diversity reforms. [ABSTRACT FROM AUTHOR]

Kombucha is a fermented sweetened tea with a mixed fermenting culture of yeast and acetic acid bacteria. While the history of kombucha is not completely clear, it is now available around the world and has shown an increase in availability and demand in the United States market. The proponents of kombucha consumption tout the varied health benefits it can provide. The final kombucha flavor and composition is a function of both the initial tea used and the fermentation process. While the ascribed benefits are varied and numerous, the number of direct studies has been limited. This review focuses on the current state of understanding of the chemical composition and the potential health effects both positive and negative reported in the literature. [ABSTRACT FROM AUTHOR]

Colorectal cancer (CRC) is the third-leading cause of cancer-related deaths in the United States and worldwide. Obesity—a worldwide public health concern—is a known risk factor for cancer including CRC. However, the mechanisms underlying the link between CRC and obesity have yet to be fully elucidated in part because of the molecular heterogeneity of CRC. We hypothesized that obesity modulates CRC in a consensus molecular subtype (CMS)-dependent manner. RNA-seq data and associated tumor and patient characteristics including body weight and height data for 232 patients were obtained from The Cancer Genomic Atlas–Colon Adenocarcinoma (TCGA-COAD) database. Tumor samples were classified into the four CMSs with the CMScaller R package; body mass index (BMI) was calculated and categorized as normal, overweight, and obese. We observed a significant difference in CMS categorization between BMI categories. Differentially expressed genes (DEGs) between obese and overweight samples and normal samples differed across the CMSs, and associated prognostic analyses indicated that the DEGs had differing associations on survival. Using Gene Set Enrichment Analysis, we found differences in Hallmark gene set enrichment between obese and overweight samples and normal samples across the CMSs. We constructed Protein-Protein Interaction networks and observed differences in obesity-regulated hub genes for each CMS. Finally, we analyzed and found differences in predicted drug sensitivity between obese and overweight samples and normal samples across the CMSs. Our findings support that obesity impacts the CRC tumor transcriptome in a CMS-specific manner. The possible associations reported here are preliminary and will require validation using in vitro and animal models to examine the CMS-dependence of the genes and pathways. Once validated the obesity-linked genes and pathways may represent new therapeutic targets to treat colon cancer in a CMS-dependent manner. [ABSTRACT FROM AUTHOR]

Background: Children with a history of acute provoked neonatal seizures are at high risk for disability, often requiring developmental services. The coronavirus disease 2019 (COVID-19) pandemic has led to widespread changes in how health care is delivered. Our objective was to determine the magnitude of service interruption of among children born between October 2014 and December 2017 and enrolled in the Neonatal Seizure Registry (NSR), a nine-center collaborative of pediatric centers in the United States.Methods: This is a prospective cohort study of children with acute provoked seizures with onset ≤44 weeks' gestation and evaluated at age three to six years. Parents of children enrolled in the NSR completed a survey about their child's access to developmental services between June 2020 and April 2021.Results: Among 144 children enrolled, 72 children (50%) were receiving developmental services at the time of assessment. Children receiving services were more likely to be male, born preterm, and have seizure etiology of infection or ischemic stroke. Of these children, 64 (89%) experienced a disruption in developmental services due to the pandemic, with the majority of families (n = 47, 73%) reporting that in-person services were no longer available.Conclusions: Half of children with acute provoked neonatal seizures were receiving developmental services at ages three to six years. The COVID-19 pandemic has led to widespread changes in delivery of developmental services. Disruptions in services have the potential to impact long-term outcomes for children who rely on specialized care programs to optimize mobility and learning. [ABSTRACT FROM AUTHOR]

Background: Many law enforcement agencies across the United States equip their officers with the life-saving drug naloxone to reverse the effects of an opioid overdose. Although officers can be effectively trained to administer naloxone, and hundreds of law enforcement agencies carry naloxone to reverse overdoses, little is known about what happens on scene during an overdose call for service from an officer's perspective, including what officers perceive their duties and responsibilities to be as the incident evolves. Methods: The qualitative study examined officers' experiences with overdose response, their perceived roles, and what happens on scene before, during, and after an overdose incident. In-person interviews were conducted with 17 officers in four diverse law enforcement agencies in the United States between January and May 2020. Results: Following an overdose, the officers described that overdose victims are required to go to a hospital or they are taken to jail. Officers also described their duties on scene during and after naloxone administration, including searching the belongings of the person who overdosed and seizing any drug paraphernalia. Conclusion: These findings point to a pressing need for rethinking standard operating procedures for law enforcement in these situations so that the intentions of Good Samaritan Laws are upheld and people get the assistance they need without being deterred from asking for future help. [ABSTRACT FROM AUTHOR]

Someone who first traverses the Midwest may understandably believe the fields of corn, soybeans, wheat, and cotton seem endless. These monotonous fields, however, fuel an agricultural industry that contributes trillions of dollars to the United States' gross domestic product (GDP). What is more, these fields are a necessity to nourish families from Maine to California. In order to maintain millions of acres of crops across the Midwest, farmers must plant unique seeds, and then fend off corrosive weeds that harm and destroy their valuable cash crops. These weeds are both evasive and powerful; they can decimate entire fields at a time. In order to effectively combat these weeds, farmers often rely upon synthetic herbicides. It is the EPA's responsibility, moreover, to analyze and approve herbicides that are more beneficial than costly to society. Herbicides, and the seeds they are meant to protect, are predominately manufactured by a select few agricultural conglomerates that dominate the agricultural industry. This market concentration drastically limits the amount of seeds and herbicides that farmers may choose from when preparing for planting season. In addition to corn, soybeans and cotton are massive contributors to the agricultural industry as a whole. The most popular herbicide used by soybean and cotton farmers across the country is dicamba; it is highly effective against destructive weeds. Dicamba is solely produced by three of the largest agricultural entities in the world. Despite its effectiveness, dicamba comes with a significant cost: it has the tendency to drift to other, untargeted fields when used. If a nearby field is not planted with seeds that are resistant to dicamba, the field may be completely ravaged by the powerful herbicide. In 2020, this drifting issue became so severe that the Ninth Circuit deemed the use of dicamba illegal; this occurred in the middle of growing season. Put differently, millions of farmers were left defenseless to powerful weeds during the most critical months in American agriculture. As an act of emergency, the EPA reinstated dicamba to avoid a disastrous growingseason. The herbicide's brief absence nevertheless sent shockwaves through all of agriculture. Litigation surrounding dicamba illustrates the herbicide's uncertain future. In the meantime, however, farmers are left with two choices. On one hand, a soybean or cotton farmer can purchase dicamba-resistant seeds and herbicides from large agriculture conglomerates. The risk involved in this decision is that dicamba could get taken off the market at an inopportune time; ravenous weeds could then decimate the farmer's crops and income. On the other hand, a soybean or cotton farmer could purchase nondicamba products and avoid the risk of their herbicide being taken off the market. The risk in this instance, of course, is that a neighbor using dicamba could destroy all nondicamba-tolerant fields in the general area. In sum, farmers cultivating millions of acres across the country are handcuffed. Prior to planting their crops, farmers must make substantial investments that severely lack certainty. This Note proposes an alteration to the procedures applied by the EPA when approving herbicides for public use. If herbicide producers are incentivized to manufacture herbicides that may not decimate the hard work of one's neighbor, a realistic scenario exists where cotton and soybean farmers will not only invest with confidence, but also without fear. [ABSTRACT FROM AUTHOR]

Cardiovascular disease (CVD) is the leading cause of death in the United States and worldwide. A major risk factor for this condition is increased serum low-density lipoprotein cholesterol (LDL-C) levels for which statins have been successful in reducing serum LDL-C to healthy concentrations. However, patients who are statin intolerant or those who do not achieve their treatment goals while on high-intensity statin therapy, such as those with familial hypercholesterolemia, remain at risk. With the discovery of PCSK9 inhibitors, the ability to provide more aggressive treatment for patients with homozygous and heterozygous familial hypercholesterolemia has increased. Ezetimibe reduces LDL-C by 15%-20% when combined with statin. 2 , 3 Protein convertase subtilisin/kexin type 9 (PCSK9) inhibitors have been found to achieve profound reductions in LDL-C (54%-74%) when added to statins. They have shown dramatic effects at lowering major adverse cardiovascular events (MACE) in high-risk patients 4 with LDL-C levels ≥70 mg/dL and can be used in populations that are statin intolerant or not at goal levels with maximally tolerated statin therapy. PCSK9 inhibitors also produce minimal side effects. Myopathy, a common side effect for patients on statins, has been rare in patients on PCSK9 inhibitors. Randomized trials have shown that reduction in LDL-C has translated to clinical benefits even in patients who have not achieved their LDL-C target. [ABSTRACT FROM AUTHOR]

Political scientists regularly measure anti-Black prejudice in the survey context using racial resentment, an indirect measure that blends racial animus with traditional moral values. Explicit prejudice, a direct measure based in beliefs about the group-level inferiority of Blacks, is used less frequently. We investigate whether these attitudes predict anti-Black discrimination and evaluations of the fairness of intergroup inequality. Study 1 used the Ultimatum Game to obtain a behavioral measure of racial discrimination and found whites engaged in anti-Black discrimination. Explicit prejudice explained which whites discriminated, whereas resentment did not. In study 2, white third-party observers evaluated intergroup interactions in the Ultimatum Game, and explicit prejudice explained racially biased fairness evaluations, but resentment did not. This demonstrates that resentment and prejudice are distinct constructs and that explicit prejudice has clear behavioral implications. We also find that explicit prejudice is widespread among white Americans and significantly less partisan than resentment. [ABSTRACT FROM AUTHOR]

Background: Repeated use of chemical irritants for crowd-control by local and federal law enforcement during sustained racial justice protests in the U.S. has raised concerns about potential adverse health effects. The objective of this study was to describe the health consequences of exposure to tear gas agents and associated healthcare utilization among adults reporting recent exposure to tear gas.Methods: A cross-sectional, self-administered web-based survey of a convenience sample of 2257 adults reporting recent exposure to tear gas in Portland, Oregon (U.S.), administered between July 30, 2020-August 20, 2020. Descriptive analyses were conducted on socioeconomic characteristics, reported health issues, utilization of healthcare services, and frequency of reported exposure to tear gas. Associations between reported mental health issues, healthcare utilization and race and/or ethnic categories were assessed using a chi-square test. For tests of association, racial and/or ethnic categories were divided into White/Non-Hispanic only and all other racial/ethnic categories due to a small number of Black, American Indian or Alaska Native, Asian/Pacific Islander, Hispanic participants and participants with multiple race and/or ethnic background. Effect sizes for the differences were expressed as Cramer's V, a metric that measures associations between nominal responses. The Cochran-Armitage trend test was used to assess the relationship between health issues and the number of reported days of exposure to tear gas (i.e., a proxy dose of exposure) grouped into 1 day, 2-4 days, and ≥ 5 days. Missing data (item non-response) were omitted from the analysis.Results: Almost all respondents (2116; 93.8%) reported physical (2114; 93.7%) or psychological (1635; 72.4%) health issues experienced immediately after (2105; 93.3%) or days following (1944; 86.1%) the exposure. A slightly higher proportion experienced delayed head or gastrointestinal tract issues compared with immediate complaints. The majority (1233; 54.6%) reported receiving or planning to seek medical or mental care. We observed a positive exposure-response trend for all except mouth-related delayed issues (p < 0.01).Conclusion: Persons who reported exposer to tear gas agents also reported physical and psychological health issues over a multiple-day period. Health issues reported increased with the frequency of reported exposure, indicating a potential dose-response; these health effects often led to healthcare utilization. This study provides evidence of potential unexpected harms of tear gas in civilians. [ABSTRACT FROM AUTHOR]

Introduction: Approximately the same percentage of male high school students in the United States currently uses conventional smokeless tobacco as smokes cigarettes, resulting in toxin exposure.Methods: This study assessed tobacco product use (smokeless, combustible, and electronic cigarettes) and nicotine and carcinogen exposures in a sample of 594 male rural high school baseball players-a population traditionally at risk for smokeless tobacco use. Salivary specimens were assayed for cotinine (a biomarker of nicotine exposure) and urine specimens for 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL, a biomarker of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) using liquid chromatography-tandem mass spectrometry.Results: The prevalence of past 30-day use of any tobacco product was 29%. Past 7-day smokeless tobacco use (prevalence: 13%) was associated with the highest levels of cotinine and NNAL observed in the sample, whether smokeless tobacco was used exclusively (geometric means: cotinine 11.1 ng/mL; NNAL 31.9 pg/mg-creatinine) or in combination with combustible products (geometric means: cotinine 31.6 ng/mL; NNAL 50.0 pg/mg creatinine). Cotinine and NNAL levels were incrementally higher in each increasing category of smokeless tobacco use frequency. However, observed levels were lower than previously reported for adults, likely reflecting less smokeless use per day among adolescents.Conclusions: Based on these biomarker observations, adolescents who use conventional smokeless tobacco products are exposed to substantial levels of nicotine and NNK. Although exposed to lower levels than adult smokeless users, the findings are concerning given the young age of the sample and tendency for smokeless tobacco users to increase use intensity over time.Implications: This study demonstrates that adolescents using smokeless tobacco are exposed to levels of nicotine and NNK that increase with use frequency and that exceed exposures among peers using other tobacco products. Youth smokeless tobacco use in the United States has not declined along with youth smoking prevalence, giving greater importance to this health concern. To reduce youth (and adult) exposures, needed actions include effective smokeless tobacco use prevention, potentially in combination with reducing the levels of harmful and potentially harmful chemicals in smokeless tobacco products currently popular among adolescents. [ABSTRACT FROM AUTHOR]

We investigate the earnings effects of marriage among same-sex couples in the United States. Gays and lesbians in the United States have only recently been allowed to enter into legally recognized marriages. As such, we know little about the impact of same-sex marriage on the economic lives of gays and lesbians. We use data from the 2013 to 2017 American Community Survey to show that married gay men experience a 3% marriage earnings premium and lesbian women experience a 6% marriage earnings premium relative to their unmarried cohabiting counterparts. The marriage premium for gay men is smaller than that of heterosexual married men, but the lesbian marriage premium is similar in size to the premium for heterosexual women. In both cases, we show that the marriage premium is larger relative to single gay men and lesbian women in the 2013 to 2017 National Health Interview Surveys. We also find that the marriage premium is more than two times larger among individuals who earn more than their partners, and marriage increases intrahousehold differences in labor market outcomes. This pattern is consistent with a common explanation of the earnings premium experienced by heterosexual men and women: marriage increases investments in relationships that affect patterns of household specialization. Therefore, our results suggest that the effect of marriage on how households organize their time is general and not unique to different-sex households. [ABSTRACT FROM AUTHOR]

Why have decades of high and rising inequality in the United States not increased public support for redistribution? An established theory in political science holds that Americans' distrust of government decreases their support for redistribution, but empirical support draws primarily on regression analyses of national surveys. I discuss the untestable assumptions required for identification with regression modeling and propose an alternative design that uses randomized experiments about political corruption to identify the effect of trust in government on support for redistribution under weaker assumptions. I apply this to three survey experiments and estimate the effects that large, experimentally induced increases in political trust have on support for redistribution. Contrary to theoretical predictions, estimated effects are substantively negligible, statistically indistinguishable from zero, and comparable to estimates from two placebo experiments. I discuss implications for theory building about causes of support for redistribution in an era of rising inequality and eroding confidence in government. [ABSTRACT FROM AUTHOR]

In an urban adolescent population, we evaluated sources of exposure to secondhand smoke exposure (SHS), examined differences in exposure by race/ethnicity, age and sex, and determined the relationship between exposure source(s) and the biomarkers cotinine and NNAL. Participants were recruited from a public hospital-based outpatient clinic in San Francisco, CA, USA. Of a sample of N = 298 adolescents screened, 235 were biologically confirmed to be exposed to tobacco smoke. Of those, N = 16 were active smokers and N = 219 were exposed to SHS; 91 (39%) were heavily SHS exposed (median cotinine = 0.76 ng/mL) and 128 (54%) had light SHS exposure (median cotinine = 0.11 ng/mL). Within those SHS exposed, the most common source of exposure was in a public area. No significant racial/ethnic differences were found, although African American adolescents were more likely to live in a home that allowed smoking. Older adolescents were more likely to be exposed across several difference sources, and females more likely to be exposed in a car and in public areas. Past 7-day exposure in the home, in a car, and current blunt use were significantly related to biomarkers of exposure. Urban adolescents are exposed to SHS across a variety of sources. Although exposure in a public area is most common, exposure in the home and in cars significantly influences tobacco biomarker levels. Interventions to reduce exposure would have the greatest impact in this population if they focused on reducing exposure in the home and in cars. History of blunt use is a strong determinant of tobacco exposure. [ABSTRACT FROM AUTHOR]

Research illustrates the importance of help-seeking for intimate partner violence (IPV) survivors. However, mandatory reporting (MR) laws can affect help-seeking by requiring some sources of support to report survivors to formal systems. This convergent mixed methods study of 2462 survivors surveyed through the National Domestic Violence Hotline explores how MR laws impact survivors' help-seeking, the outcomes of their help-seeking, and whether their race, gender, and/or sexual orientation influenced their experiences. Findings indicated that MR laws reduce help-seeking for over a third of survivors, provider warnings about MR often reduce survivors' ability to receive the support they seek, and reports when triggered make the situation worse for most survivors. Significant differences emerged by gender identity and race/ethnicity, emphasizing unique contexts for trans and gender non-conforming survivors and survivors of color. We provide policy and practice implications given these unintended harms of MR laws for IPV survivors. [ABSTRACT FROM AUTHOR]

Objective: Electronic nicotine delivery systems (ENDS), commonly referred to as "e-cigarettes", have grown in popularity, features and device types. This study explores how device type influences users' experiences and how experiences shape use behaviors, beliefs, and attitudes about ENDS. Methods: In 2016, we conducted 23 focus groups in 4 US cities with a total of 156 participants who were current adult ENDS users. We segmented participants by age, geographic location, and device type used. A moderator's guide was used to gather data on attitudes, beliefs, and use behaviors. Results: Discussions revealed commonalities between cigalike and tank users such as use to quit or cut down on cigarette smoking as a primary motivation and difficulty describing frequency and quantity of use. Distinctions between device users also emerged. Features that appealed to cigalike users included the simplicity of the device (eg, small size, ease of use); conversely, tank users described as benefits their ability to modify devices and customize experiences (eg, adjust the battery, nicotine level, and flavor). Importantly, users of both types expressed satisfaction with their device. Conclusion: The study found notable differences in attitudes and behaviors between device users such as valued device attributes, knowledge about nicotine concentration, and importance of flavors, providing further evidence that device type affects user experience. [ABSTRACT FROM AUTHOR]

The article highlights some laws in the U.S. that has proved important in defining American copyright law for recorded music or art. Topics discussed include decision of the U.S. Court of Appeals for the Sixth Circuit in the case "Bridgeport Music Inc. v. Dimension Films;" the U.S. Supreme Court's decision in the case "Feist Publications, Inc. v. Rural Television Service Co.;" and provisions of the U.S. Copyright Act that grant rights exclusively to authors and inventors.

Most research into the connections between water and energy, water and food, and food and energy has been scientific and technical; little research has examined the public’s understandings of these connections. This article studies these understandings and awareness of nexus issues using a 2015 national public opinion survey on the water–energy–food nexus. Responses from this representative sample of U.S. adults are used to create “awareness measures” for elements of the nexus—water and energy, water and food, and energy and food—which are then used as independent variables to investigate the extent to which awareness is associated with support for public policies designed to address these nexus interconnections. All three measures are significantly correlated to support for policy options. Results suggest that awareness of the water–energy–food nexus may represent conditions necessary for supporting policies and that building such awareness could represent an important pathway for increasing support for policy interventions. [ABSTRACT FROM AUTHOR]

In this commentary, we revisit “NCLB and the Demand for Highly Qualified Teachers: Challenges and Solutions for Rural Schools,” an article we published in this journal in 2005. We consider the predictions we made then about the impact of the Highly Qualified Teacher mandate on special education teacher (SET) shortages in rural states and regions, acknowledging that we overlooked the diversity of rural areas and their differentiated needs in our original article. We then update strategies and programs for preparing, recruiting, and retaining SETs in rural schools and discuss the implications of the Every Student Succeeds Act, which has replaced the No Child Left Behind Act, for special education in rural areas. We note with optimism the resilience that rural areas have exhibited in the face of teacher shortages and see hope in recent technology applications and other context-based strategies. [ABSTRACT FROM AUTHOR]

Recent legislation and education standards focus on the importance of developing students' academic and professional writing skills. Research on the teaching of writing has articulated the types of texts and features of writing that students need to produce to succeed. At the same time, studies of writing in adult education have found that limited time is devoted to writing instruction. The experiences and needs of adults learning English as an additional language (L2 learners) are often not understood and met by teachers, and teachers often have limited professional development in the effective teaching of writing to adults. This article reviews this research and reports the results of a survey of over 400 teachers of L2 learners in adult education across the United States about their teaching of writing. The results show some positive trends and a number of challenges. As a field, we need to work together to understand the qualities of academic and professional writing that students need to produce and to implement effective instruction in adult education, community college, and university programs. [ABSTRACT FROM AUTHOR]

Emissions from flares constitute unburned hydrocarbons, carbon monoxide (CO), soot, and other partially burned and altered hydrocarbons along with carbon dioxide (CO2) and water. Soot or visible smoke is of particular concern for flare operators/regulatory agencies. The goal of the study is to develop a computational fluid dynamics (CFD) model capable of predicting flare combustion efficiency (CE) and soot emission. Since detailed combustion mechanisms are too complicated for (CFD) application, a 50-species reduced mechanism, LU 3.0.1, was developed. LU 3.0.1 is capable of handling C4hydrocarbons and soot precursor species (C2H2, C2H4, C6H6). The new reduced mechanism LU 3.0.1 was first validated against experimental performance indicators: laminar flame speed, adiabatic flame temperature, and ignition delay. Further, CFD simulations using LU 3.0.1 were run to predict soot emission and CE of air-assisted flare tests conducted in 2010 in Tulsa, Oklahoma, using ANSYS Fluent software. Results of non-premixed probability density function (PDF) model and eddy dissipation concept (EDC) model are discussed. It is also noteworthy that when used in conjunction with the EDC turbulence-chemistry model, LU 3.0.1 can reasonably predict volatile organic compound (VOC) emissions as well. Implications: A reduced combustion mechanism containing 50 C1–C4species and soot precursors has been developed and validated against experimental data. The combustion mechanism is then employed in the computational fluid dynamics (CFD) of modeling of soot emission and combustion efficiency (CE) of controlled flares for which experimental soot and CE data are available. The validated CFD modeling tools are useful for oil, gas, and chemical industries to comply with U.S. Environmental Protection Agency’s (EPA) mandate to achieve smokeless flaring with a high CE. [ABSTRACT FROM AUTHOR]

Youths who have been in foster care face many challenges in accessing and completing postsecondary education. The Chafee Education and Training Vouchers (ETV) program is a federally funded program that assists current and former foster youths in accessing postsecondary learning opportunities by providing scholarship money for their education. This study used an online survey to gather information from ETV program participants about their sources of emotional, academic, and financial support during both secondary and postsecondary education. Findings indicate that youths involved in the ETV program report relatively high levels of out-of-school time involvement during secondary school, multiple opportunities for meaningful connections with caring adults, and a strong sense of personal responsibility. They also report high levels of financial stress and challenges in accessing appropriate resources while in postsecondary educational settings. The article concludes with a discussion of the implications for research and practice. [ABSTRACT FROM AUTHOR]

A growing body of international legal principles recognizes the right of indigenous people to water resources as a key component of their rights to self-determination, land, and economic self-sufficiency. These legal norms impose obligations on states both to recognize this right and to take affirmative steps to allow indigenous people to realize it. While the United States has not formally acceded to many of the applicable international instruments, the primary principles are embodied in instruments it has joined, and, in addition, some of these principles may constitute customary international law that applies regardless of accession. Part I of this Article examines this body of legal principles as they relate to indigenous people's access to water resources and also examines the international institutions which have been set up to interpret and implement these principles. Part II discusses the bipartisan federal policy over the last five decades in the United States to promote and protect the self-determination of Indian Tribes and the specific actions the United States has taken over that time period concerning Indian water rights. Finally, Part III discusses how international legal principles and mechanisms might be used to support a more comprehensive approach by the United States to address the unmet water needs of Tribes, rather than the current approach that focuses primarily on the adjudication and settlement of individual Tribes' legal claims to water. [ABSTRACT FROM AUTHOR]

Length-weight relationships ( LWR) using 3876 individuals were determined for 39 species sampled in estuarine systems in the main Hawaiian Islands, including 33 species of fish from 21 families, five species of crustaceans (prey) from two families, and one mollusk species. For 17 species, LWRs were estimated for the first time. For another 14 species their LWRs were newly reported for Hawaiian waters, including seven introduced taxa that are well established in the islands' estuaries. The LWRs for all taxa include juvenile and sub-adult size ranges commonly encountered in Hawaiian estuaries. [ABSTRACT FROM AUTHOR]

Background Differences in carcinogen exposure from different cigarette products could contribute to differences in smoking-associated cancer incidence among Chinese compared with US smokers. Methods Urine concentrations of metabolites of nicotine, the tobacco-specific nitrosamine (TSNA) 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and polycyclic aromatic hydrocarbon metabolites (PAHs) were compared in 238 Chinese and 203 US daily smokers. Results Comparing Chinese versus US smokers, daily nicotine intake and nicotine intake per cigarette smoked were found to be similar. When normalised for cigarettes per day, urine NNAL excretion was fourfold higher in US smokers, while the excretion of urine metabolites of the PAHs fluorene, phenanthrene and pyrene metabolites was 50% to fourfold higher in Chinese smokers (all, p<0.0001). Similar results were seen when NNAL and PAHs excretion was normalised for daily nicotine intake. Conclusions Patterns of carcinogen exposure differ, with lower exposure to TSNA and higher exposure to PAHs in Chinese compared with US smokers. These results most likely reflect country differences in cigarette tobacco blends and manufacturing processes, as well as different environmental exposures. Trial registration number NCT00264342. [ABSTRACT FROM AUTHOR]

Objective. Energy insecurity may result in adverse consequences for children's health, particularly for children with special health needs or chronic health conditions. We aimed to determine whether a multimodal intervention addressing energy insecurity within the framework of a medical-legal partnership (MLP) resulted in an increase in the provision of certifications of medical need for utility coverage in an inner city academic primary care practice. Methods. Working within a medical-legal partnership, we standardized criteria for providers approving medical need utility certification requests. We compared prior-year utility certification requests and approvals (pre-intervention) with the intervention year for families who reported energy insecurity on a waiting-room screening questionnaire. Results. Between the first and second years of the study, certification of medical need approvals increased by 65%, preventing utility shut-offs for 396 more families with vulnerable children. Conclusions. Energy insecurity can be screened for and addressed in a busy urban practice, potentially improving the wellbeing of vulnerable children. [ABSTRACT FROM AUTHOR]

The Whistleblower Protection Act (WPA) of 1989 was enacted to provide protection to employees who report wrongdoing on the part of their employers. This study analyzed whether the provisions in the WPA actually protect federal government employees from retaliation by their federal government employers. The research focused on a legal analysis of federal employee WPA claims litigated in federal court. Furthermore, within those cases, the claims were separated by issues—national security, environmental issues, and government ethics—to get a fuller understanding of WPA issues. The findings of the analysis suggested that the WPA did not provide adequate protections for employees. Out of 151 appellate cases that were identified and reviewed in the study, 79% of cases were ruled in favor of defendants—federal agencies. Out of 142 cases involving government ethics and administration issues, 79% of cases were lost by employees. In issues involving the environment, 100% of cases resulted in a loss for employees. Out of four cases involving national security, 75% were lost by federal employees. The results lead to the conclusion that either the WPA as written or the manner in which courts are interpreting the WPA is not consistent with the intent of the legislation—to protect employees. The article further analyses the Whistleblower Protection Enhancement Act (WPEA) of 2012 and whether it cures the defects in the WPA. The analysis shows that the WPEA may not live up to its promise. [ABSTRACT FROM PUBLISHER]

The characterization of knock intensity distributions can provide useful insights into the process and help to improve knock control system designs. In this paper, an extensive statistical analysis is performed on knock intensity data recorded under a broad range of operating conditions. First, the critical issue of whether the data exhibit any cycle-to-cycle correlations is investigated, and it is shown that knock intensity closely approximates a cyclically independent random process. The study then focuses on the variation of knock intensity distributions with operating condition, and on the quantification of these distributions using simple scalar measures. The relationship between knock event distributions and knock intensity distributions is also investigated, and it is shown that knock event data are binomially distributed regardless of the underlying knock intensity distribution. This supports ongoing efforts to exploit binomial probability theory in knock event simulation and controller design. [ABSTRACT FROM PUBLISHER]

Cotton gin trash is a byproduct of the cotton industry that consists of any remaining plant material leftover after the ginning process. The objective of this study was to determine intake, animal performance, and safety of using loose or baled gin trash in beef cattle diets. Sixteen crossbred, non-lactating, gestating cows and 8 crossbred, gestating heifers were randomly assigned to one of two groups consisting of 8 cows and 4 heifers per group for a 60-day intake trial utilizing the Calan Gate ® system. After a training period, each group was assigned to receive one of two dietary treatments: 1) ad libitum baled cotton gin trash or 2) ad libitum loose cotton gin trash, each with 2.2 kg of a 50:50 mixture of corn gluten feed and soyhull pellets per day to meet nutritional requirements for their stage of production. Animal body weight (BW) and body condition scores (BCS) were recorded at days 0, 30, and 60. Jugular blood samples were collected weekly to monitor clinical animal immune responses due to feeding cotton gin trash containing cotton defoliant residue (4.84 ppm and 1.98 ppm tribufos for baled and loose, respectively). Intake was greater (P < 0.0001) for cattle consuming loose than baled gin trash. All cattle maintained or gained BW across treatments during the trial. On average throughout the study cattle consuming baled gin trash had greater BCS (P = 0.0173) than cattle fed loose gin trash, although animals maintained a BCS of 6 or greater during the study. Red blood cell count, hemoglobin, hematocrit, and white blood cell count were within normal ranges for beef cattle during the trial. Cotton gin trash in either loose or baled form can be used to maintain non-lactating, bred cows with little additional energy supplementation, providing an outlet for cotton byproduct usage in beef operations in the Southeast United States. [ABSTRACT FROM AUTHOR]

This section provides several papers presented to the Pasco Hernando County Early Learning Coalition Conference in Florida in November 2012. Early educators contributed papers on encouraging literacy and communication in young children. Shelton K. Gilyard Jr. of the University of South Florida in Tampa presented a paper on the use of interactive video gaming to encourage children with autism to participate in physical activity.