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In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass (RYGB) or laparoscopic sleeve gastrectomy (LSG), initiation of (ie, incident) and persistence of (ie, continuation of preoperative) depression treatment are compared with matched nonsurgical controls.Bariatric surgery has been associated with short-term improvements in depression but less is known about longer term outcomes.In a retrospective cohort study, we matched 1713 Veterans with depression treatment who underwent bariatric surgery in Veterans Administration bariatric centers from fiscal year 2001 to 2016 to 15,056 nonsurgical controls using sequential stratification and examined the persistence of depression treatment via generalized estimating equations. Incidence of depression treatment was compared using Cox regression models between 2227 surgical patients and 20,939 matched nonsurgical controls without depression treatment at baseline.In surgical patients with depression treatment at baseline, the use of postsurgical depression treatment declined over time for both surgical procedures, but postsurgical patients had greater use of depression treatment at 5 years [RYGB: odds ratio=1.24, 95% confidence interval (CI): 1.04-1.49; LSG: odds ratio=1.27, 95% CI: 1.04-1.56] compared with controls. Among those without depression treatment at baseline, bariatric surgery was associated with a higher incidence of depression treatment compared with matched controls (RYGB: hazard ratio=1.34, 95% CI: 1.17-1.53; LSG: hazard ratio at 1-5 years=1.27, 95% CI: 1.10-1.47).Bariatric surgery was associated with a greater risk of postoperative incident depression treatment and greater persistence of postoperative depression treatment. Depression may worsen for some patients after bariatric surgery, so clinicians should carefully monitor their patients for depression postoperatively.

The mere exposure effect (MEE) is defined as repeated exposures to a stimulus enhancing affective evaluations of that stimulus ( Zajonc, 1968 ). The three prominent explanations of the MEE are Zajonc's “neophobia” account, the uncertainty reduction account, and the perceptual fluency approach. Zajonc's “neophobia” account posits that people have an inherent low level of fear of novel objects and exposure to the objects partially extinguishes this novelty-based fear. The uncertainty reduction account asserts that people find uncertainty aversive and habituation reduces uncertainty. The fluency account postulates that people “like” representations of things with which they are fluent. In four experiments, we induced positive and negative moods before or after target exposures. In addition to assessing the MEE in each condition, we assessed the mood induction. The central hypothesis assessed in this series was that there would be an interaction between mood and the MEE. Although the three accounts of the MEE generated divergent predictions, none of the accounts were well supported by the data. Tests for mood induction demonstrated the efficacy of the induction procedures and the MEE was consistently observed, but Bayesian analysis indicated that at least in the present preparation mood had no effect on the MEE.

A total of 960 male Cobb 500 broilers were used in a growth performance study to explore the effect of coccidial vaccination and/or coccidial challenge on blood biochemistry and veterinary postmortem metrics. Day-old chicks were randomly divided into one of the 4 experimental treatments. Treatments were arranged in a 2 × 2 factorial arrangement, with the factors being without or with vaccination (administered on day 1) or coccidial challenge (oral gavage on day 7). Growth performance was monitored on a weekly basis. Blood sample collection, as well as full veterinary necropsies, were carried out on days 6, 8, 13, 20, 27, and 34. Birds that did not receive the vaccination but were challenged with coccidiosis had higher feed conversion ratio, lower body weights, and higher mortality than the other experimental groups, and this effect was particularly evident from day 13 to day 20. Birds challenged with coccidiosis had lower plasma sodium and total carotenoid concentrations and higher potassium and globulin concentrations than nonchallenged birds. Significant interactions between age and experimental treatment for these blood parameters were observed, particularly on day 13. The necropsy results confirmed the effectiveness of the challenge and vaccination treatments, wherein birds that were challenged had higher coccidiosis scores on day 13 and day 27 than birds that were not challenged. These results demonstrate the potential for plasma sodium, potassium, total protein, total carbon dioxide, globulin, and carotenoid analysis for early diagnosis of coccidiosis in growing broiler chickens. Further work is necessary to establish whether the changes in blood biochemistry observed in the present study are transferable to alternative flocks of chicken and whether early diagnosis and intervention may mitigate performance losses associated with this disease.

Early feeding trials using peanut meal prepared from normal-oleic peanuts helped to identify peanuts as a suitable alternative feed ingredient for poultry. Yet no studies to date have examined the use of high-oleic peanuts (HO-PN) as a feed ingredient for meat type chickens. Therefore, this study aimed to determine the effect of feeding whole unblanched HO-PN on the fatty acid profile of the meat produced from broilers. At hatch male chicks were randomly placed in raised wire cages, in 10 replicate pens per treatment with 10 chicks per pen, and fed with one of the 3 isocaloric, isonitrogenous diets ad libitum for 42 days: (1) conventional control of soybean meal + corn, (2) 10 to 12% HO-PN and corn diet, or (3) control diet spiked with ≈6.0% oleic acid oil. All body weights (BW) were collected, and broiler selection for processing was determined by individual BW within one-half a standard deviation of the experiment 42-D mean BW, with one bird selected per pen (10 replicate pens per treatment, 3 treatments, 10 birds selected per treatment, yielding a total sample size of 30 birds). Performance was determined weekly and breast samples were analyzed for fatty acid and amino acid profile. All data was analyzed using analysis of variance, with t-test mean comparisons at P < 0.05. BW were similar between broilers fed the HO-PN and control diet, while feed conversion ratio of broilers fed the HO-PN diet was significantly higher at weeks 2, 4, and 6 in comparison to the other treatments (P ≤ 0.03). Broilers fed with HO-PN diet had reduced carcass and pectoralis major weights in comparison to the other treatments. Chicken breast from broilers fed the HO-PN diet had significantly reduced saturated and trans fatty acid content in comparison to the controls (P ≤ 0.0002). Although additional studies must be conducted, this study suggests that feeding whole unblanched HO-PN to broiler chickens may serve as a means to enrich the meat produced with unsaturated fatty acids.

We report the preparation of pH-responsive, ester/carboxylic acid random copolymer films via simple modification of poly(norbornene diacyl chloride) (pNBDAC), prepared via surface-initiated ring-opening metathesis polymerization, with mixtures of water and ethanol to form carboxylic acid and ethyl ester side groups. The pNBDAC film serves as a compositionally versatile platform to controllably obtain copolymers with multiple functionalities. In modifying the pNBDAC to form the copolymer film, ethanol exhibits a significantly higher reactivity with acyl chloride groups within the film than does water. The magnitude and range of the pH-responsive performance are highly dependent on the carboxylic acid content in the copolymer films, which demonstrates the effect of film hydrophilicity on the pH-responsive switching of ionic barrier properties. The resistance of the film against ion transfer can be decreased by a factor of 10

Previous studies have demonstrated that allergenic feed proteins from peanuts in the diets of layer hens are not detected in the eggs produced. Hence, in this study, we aimed to determine if soy and/or peanut proteins in poultry feed rations of broiler chickens or layer hens would be transferred or detectable in the meat or eggs produced. To meet this objective, 99 layer hens and 300 broiler chickens were equally divided into treatment groups and fed one of three experimental diets: control soybean meal and corn diet, whole unblanched high-oleic peanut and corn diet (HO PN), or a control diet spiked supplemented with oleic acid (OA) oil. At termination, broiler chickens were processed, and chicken breast samples of the left pectoralis muscle were collected, and eggs were collected from layers. Total protein extracts from pooled egg samples and chicken breast samples were subjected to enzyme-linked immunosorbent assay (ELISA) methods and immunoblotting analysis with rabbit antipeanut agglutinin antibodies and rabbit antisoy antibodies for the detection of peanut and soy proteins. Peanut and soy proteins were undetected in all pooled egg samples and individual chicken breast meat samples using immunoblotting techniques with rabbit antipeanut agglutinin and rabbit antisoy antibodies. Moreover, quantitative ELISA allergen detection methods determined all pooled egg samples and individual meat samples as "not containing" peanut or soy allergens. Therefore, this study helps to evaluate the risk associated with the potential transfer of allergenic proteins from animal feed to the products produced for human consumption.

Previous studies have identified peanut meal prepared from normal-oleic peanuts as a suitable and economical ingredient for broiler feed. However, to date, no studies have examined the use of new, high-oleic peanut (HO-PN) cultivars as a feed ingredient for poultry. This project aimed to determine the effect of HO-PNs as a feed ingredient for broiler chickens on the quality and sensory attributes of the meat produced. To test 3 experimental diets, male broiler chicks were randomly placed, at hatch, in raised-wire cages, in 10 replicate pens per treatment with 10 chicks per cage. For 6 wk, chicks were fed, ad libitum, one of the three isocaloric, isonitrogenous diets: (1) a conventional soybean meal plus corn control diet, (2) 10 to 12% HO-PN + corn diet, or (3) a control corn diet spiked with ≈6.0% oleic fatty acid oil (OA). At 42 D, 3 broilers per pen (30 per treatment) were processed to determine meat quality and for consumer evaluation. Carcass weights and breast yields were reduced in broilers fed HO-PN, while leg carcass yields were greater in broilers fed HO-PN in comparison to the other groups. Chicken breast from broilers fed HO-PN had reduced meat-pH, reduced L* color values, and increased cooked loss compared to other treatments. Nevertheless, a group of 100-consumer panelists scored all 3-treatment groups similar in terms of sensory attributes for cooked chicken. While additional studies must be performed, this study suggest that HO-PN may be a suitable broiler feed ingredient.

Broiler dietary potassium (K) and available phosphorous (AvP) have decreased in recent years but both ions are intimately involved in the elimination of hydrogen ions that are produced during rapid growth. It was hypothesized that the decrease of these dietary electrolytes was related to the development of myopathies, and thus increased dietary K and/or AvP would reduce the occurrence of breast myopathies. A total of 320 Ross male broiler chicks were placed into 16 pens and fed 2 diet series containing either decreasing AvP levels of 0.45, 0.40, and 0.35% in the starter, grower, and finisher diets, respectively (Decline), or a fixed AvP of 0.45% in all dietary phases (Fixed). To complete a 2 × 2 design either normal basal dietary K (K-) (0.86, 0.77, 0.68%) or added dietary K (K+) (1.01, 0.93, 0.88%) were also applied to starter, grower, and finisher diets, respectively. Blood physiology was measured at 29 and 42 d. Carcass data, wooden breast and white striping scores were measured at 35 and 43 d. The K+ diets improved feed conversion ratio at 35 d (1.52 vs 1.57 g: g), reduced body weight at 42 d (3524 vs 3584 g), reduced hemoglobin (6.83 vs 7.58 g/dL), and packed cell volume (20.1 vs 22.3%) at 29 d, reduced ionized blood calcium (1.42 vs 1.47 mmol/L) at 42 d, and reduced partial pressure of blood CO2 (49.1 vs 54.7 mm/Hg) at 42 d relative to broilers fed basal K- diets (P0.05). Fixed AvP diets improved feed conversion ratio at 28 and 42 d, increased percentage breast meat (28.85 vs 27.58%) and carcass water pickup (2.72 vs 1.42%) at 35 d, and reduced wooden breast (2.88 vs 3.69) at 43 d (P0.05).

Recent years have witnessed tremendous growth in the usage, research, and development of green energy, with further advancement doubtlessly on the horizon. One alternative energy technology of particular interest, currently being used and explored is the photovoltaic effect more commonly known as solar power [4]. Defined as the conversion of optical energy into electrical energy, the photovoltaic effect was first discovered in 1839 by Edmond Becquerel and may be brought to realization through the utilization of silicon semiconductor solar cells [8]. Build characteristics, such as diffusion time and temperature, alter the performance of the solar cell. The multiple parameters and conditions that are used in the building and design process can impact their efficiency [7]. These parameters can be put into datasets and used as initial conditions in a neural network. A neural network is a way to model the method by which the human brain processes information, using a large number of simulated processing units that resemble neurons. These processing units are typically arranged in layers such as an input layer, a hidden layer, and finally an output layer. Input values are usually propagated from each neuron in a layer to the neurons in the next layer before a result arrives at the output layer. The output typically has a target unit that is connected with varying weights. The network typically learns by examining records and data and generating predictions for them. Each time the network makes an incorrect prediction, it alters and adjusts the weights each iteration until the stopping criteria has been met. As the training progresses, the network becomes more accurate in replicating known outcomes. Once the known outcomes have been confirmed, the network can be applied to cases where the output is unknown. The neural network will then be able to learn by combining all of the data that is inputted [3]. The output of the neural network will be the optimal dopant diffusion time under which to produce the most efficient solar panel. In our study, we trained neural networks using different dopant diffusion times and the corresponding currents and voltages in order to determine the optimal time for producing the most power with a solar cell.

The experiment investigated the effects of limestone particle size and dietary potassium (K) on live performance, blood physiology, and muscle myopathies in broilers raised to 35 days of age. A total of 384 Ross male broilers were placed in 24 floor pens and fed four diets during the starter (0–16 days of age) and grower (17–33 days of age) periods containing two limestone particle sizes (fine: 0.2 mm and coarse: 0.9 mm), and amended with either 0% basal K (K–) or 0.2% added dietary K (K+) as potassium carbonate to complete the 2 × 2 factorial arrangement. Live performance was measured from 1–33 days of age. Blood physiology, woody breast (WB), and white striping (WS) scores were measured at 35 days of age. The K+ dietary treatment reduced (P< 0.05) feed intake and BWG when compared to K– during the starter and grower period. The K+ dietary treatment decreased blood Na (mmol/L), blood glucose (mg/dl), ionized blood Ca (mg/dl), TCO2(mmol/L), blood HCO3(mmol/L), and base excess in extracellular fluid (mmol/L) when compared to K– birds of similar body weight at 35 days of age (P≤ 0.05). Fine limestone diets tended to reduce WB scores (3.0 vs. 2.59) when compared to coarse limestone diets at 35 days of age (P= 0.08). This study demonstrated that using 0.2% of K as potassium carbonate did not negatively affect FCR even though FI and BWG were reduced. Furthermore, fine limestone has the potential to reduce WB in breast muscle tissues; however, further research is needed to confirm these outcomes.

Membrane scaling is detrimental to the efficiency of membrane desalination. While both membrane surface modification and the addition of anti-scalants have been investigated as possible methods to minimize scale formation on membrane surfaces, the efficacies of these two strategies have not been compared in the literature. In this work, we first modified a commercial polyamide reverse osmosis (RO) membrane with four different polymers to create various surface functionalities and properties. Then the anti-scaling efficiencies of the modified membranes were evaluated and compared with the use of poly(acrylic) acid (PAA) as anti-scalant in a bench-scale RO system fed with gypsum supersaturated solutions. The modified membrane with the best performance displayed limited effectiveness in delaying gypsum scaling, whereas gypsum scaling was greatly retarded in the presence of PAA. In contrary to the passive effect of membrane surface modification on gypsum scaling, anti-scalants actively disrupt gypsum crystallization. Further, we applied membrane distillation (MD) to desalinate the concentrated brines generated from RO desalination with and without anti-scalants. We demonstrated that the residual PAA in the RO brines was highly effective to alleviate gypsum scaling in MD, greatly enhancing the total water recovery of the combined RO-MD system. Our results provide comparative insights on the efficiencies of different scaling mitigation strategies in membrane desalination, and demonstrate the promising potential of applying anti-scalants to achieve high water recovery.

Locally grown feed ingredients of high energy and protein content, such as peanuts, maybe economically feasible alternatives to corn and soybean meal in broiler diets. Even though normal-oleic peanuts have been demonstrated to be a viable feed ingredient for poultry, few studies to date have examined the use of high-oleic peanuts (HO PN) as an alternative feed ingredient for broiler chickens. Thus, we aimed to determine the effect of feeding HO PN on broiler performance, nutrient digestibility, and intestinal morphology. Three isocaloric, isonitrogenous experimental diets were formulated with 1) dietary inclusion of ~10% coarse-ground whole HO PN; 2) a corn-soybean meal control diet with 5.5% added poultry fat; and 3) a control diet supplemented with 5.5% oleic fatty acid oil. Three-hundred Ross 708 broilers were randomly placed in 10 replicate pens per treatment with 10 chicks per pen and raised until 42 d. Body weights (BW) and feed intake were determined weekly, and feed conversion ratio (FCR) was calculated. Jejunum samples were collected at 42 d for histomorphometric analysis. Analysis of variance was performed on all variables using a general linear mixed model in JMP Pro14. Broilers in the HO PN group had lower (P < 0.05) BW and higher FCR than other treatment groups at weeks 2 and 6. There were no significant differences in the jejunum villi surface area between the treatment groups. However, broilers fed the HO PN diet had greater (P = 0.019) apparent metabolizable energy relative to the other treatment groups, suggesting improved nutrient uptake of dietary fats and/or carbohydrates in the HO PN treatment group. However, additional studies are warranted to further define the nutritional value of HO PN as an alternative poultry feed ingredient.

Locally grown feed ingredients of high energy and protein content, such as peanuts, maybe economically feasible alternatives to corn and soybean meal in broiler diets. Even though normal-oleic peanuts have been demonstrated to be a viable feed ingredient for poultry, few studies to date have examined the use of high-oleic peanuts (HO PN) as an alternative feed ingredient for broiler chickens. Thus, we aimed to determine the effect of feeding HO PN on broiler performance, nutrient digestibility, and intestinal morphology. Three isocaloric, isonitrogenous experimental diets were formulated with 1) dietary inclusion of ~10% coarse-ground whole HO PN; 2) a corn-soybean meal control diet with 5.5% added poultry fat; and 3) a control diet supplemented with 5.5% oleic fatty acid oil. Three-hundred Ross 708 broilers were randomly placed in 10 replicate pens per treatment with 10 chicks per pen and raised until 42 d. Body weights (BW) and feed intake were determined weekly, and feed conversion ratio (FCR) was calculated. Jejunum samples were collected at 42 d for histomorphometric analysis. Analysis of variance was performed on all variables using a general linear mixed model in JMP Pro14. Broilers in the HO PN group had lower (P < 0.05) BW and higher FCR than other treatment groups at weeks 2 and 6. There were no significant differences in the jejunum villi surface area between the treatment groups. However, broilers fed the HO PN diet had greater (P = 0.019) apparent metabolizable energy relative to the other treatment groups, suggesting improved nutrient uptake of dietary fats and/or carbohydrates in the HO PN treatment group. However, additional studies are warranted to further define the nutritional value of HO PN as an alternative poultry feed ingredient.

A total of 640 broilers were used to determine the effects of strain, sex, and age on hematology and blood chemistry using rapid detection devices. Day old chicks from two genetic lines of common fast-growing and high-yield broiler strains were sexed and allocated to 40 pens (16 birds per pen) containing either male or female and Ross or Cobb strains (n = 10). Venous blood was analyzed weekly using 2 broilers from each pen (n = 20) using the i-STAT® Alinity Handheld Clinical Analyzer, Zoetis Vetscan VS2, and iCheck™ Carotene devices at 14, 21, 28, 35, and 42 d, as well as growth performance. Post-mortem health tracking metrics were also recorded on 42 d. Broilers were deemed healthy based on posting data results and performed in accordance with industry standards with males presenting greater BW and reduced FCR than female broilers. Ross broilers displayed greater BW to 14 d with similar FCR compared with Cobb birds. Day of age had a highly significant impact on blood calcium, phosphorus, potassium, sodium, chloride, carotene, aspartate aminotransferase, creatine kinase, bile acids, uric acid, total protein, albumin, globulin, total carbon dioxide, hematocrit, and malondialdehyde. Male broilers had reduced blood sodium, chloride, carotene, uric acid, albumin, and increased total protein, glucose, and total carbon dioxide. Ross broilers had greater blood potassium, and sodium, as well as reduced uric acid, total protein, globulin, and malondialdehyde, compared with Cobb birds. These results demonstrated the effectiveness of point-of-care devices in measuring blood chemistry and hematology in modern broilers. These data can be utilized to determine normal healthy blood ranges in these types of broilers when accounting for strain, sex, and age., Broiler, Biomarkers, Blood physiology, Rapid point-of-care detection, Animal breeding, Animal product, Biochemistry, Animal physiology, Veterinary science.

The muscle myopathy wooden breast (WB) has recently appeared in broiler production and has a negative impact on meat quality. WB is described as hard/firm consistency found within the pectoralis major (PM). In the present study, we use machine learning from our PM and liver transcriptome dataset to capture the complex relationships that are not typically revealed by traditional statistical methods. Gene expression data was evaluated between the PM and liver of birds with WB and those that were normal. Two separate machine learning algorithms were performed to analyze the data set including the sequential minimal optimization (SMO) of support vector machines (SVMs) and Multilayer Perceptron (MLP) Artificial Neural Network (ANN). Machine learning algorithms were compared to identify genes within a gene expression data set of approximately 16,000 genes for both liver and PM, which can be correctly classified from birds with or without WB. The performance of both machine learning algorithms SMO and MLP was determined using percent correct classification during the cross-validations. By evaluating the WB transcriptome datasets by 5× cross-validation using ANNs, the expression of nine genes ranked based on Shannon Entropy (Information Gain) from PM were able to correctly classify if the individual bird was normal or exhibited WB 100% of the time. These top nine genes were all protein coding and potential biomarkers. When PM gene expression data were evaluated between normal birds and those with WB using SVMs they were correctly classified 95% of the time using 450 of the top genes sorted ranked based on Shannon Entropy (Information Gain) as a preprocessing step. When evaluating the 450 attributes that were 95% correctly classified using SVMs through Ingenuity Pathway Analysis (IPA) there was an overlap in top genes identified through MLP. This analysis allowed the identification of critical transcriptional responses for the first time in both liver and muscle during the onset of WB. The information provided has revealed many molecules and pathways making up a complex molecular mechanism involved with the progression of wooden breast and suggests that the etiology of the myopathy is not limited to activity in the muscle alone, but is an altered systemic pathology.

SUMMARY The objective of this study was to evaluate the effect of embryonic thermal manipulation and dietary fat source during the finisher period on carcass characteristics and breast muscle myopathies following acute heat stress. Thermal manipulation (TM) of incubation temperatures has been shown to improve bird resistance to heat stress and enhance breast muscle growth. Fat supplementation is frequently used during heat stress and fat source may alter carcass composition, as fat sources rich in unsaturated fatty acids have been shown to reduce fat pad weight. Ross 708 eggs were incubated at 37.5°C except during TM when temperature was increased to 39.5°C for 12 h daily from embryo day 7 to 16. A total of 1,080 chicks were reared under standard conditions until acute heat stress at 43 d. Dietary treatments were applied during the finisher period beginning at 28 d, with diets including 4.5% of soya oil, poultry fat, or olive oil. At 49 d, 240 male birds were processed to assess carcass and portion weights, as well as breast quality. Carcass and portion weights were decreased by TM, however percent yield was similar to the controls. A decrease in breast muscle myopathies was noted but may have been due to the lower BW of the TM birds. Interactions between the treatments suggest that TM may alter lipid metabolism. Differences in dietary fat source did not affect carcass characteristics. The reduction in breast muscle myopathies may be negated by the negative impact of TM on carcass weights.

STATEMENT: Disaster Day is a simulation event that began in the College of Nursing and has increased exponentially in size and popularity for the last 8 years. The evolution has been the direct result of reflective practice and dedicated leadership in the form of students, faculty, and administration. Its development and expansion into a robust interprofessional education activity are noteworthy because it gives health care professions students an opportunity to work in teams to provide care in a disaster setting. The authentic learning situation has enhanced student knowledge of roles and responsibilities and seems to increase collaborative efforts with other disciplines. The lessons learned and modifications made in our Disaster Day planning, implementation, and evaluation processes are shared in an effort to facilitate best practices for other institutions interested in a similar activity. Language: en

Introduction For children who have suffered a burn injury one of the greatest challenges is managing pain with an adequate yet practical burn wound dressing that will ultimately be managed at home. Medical product companies have created a variety of wound care products available on the market. These products are advertised to be more superior over one another in categories such as decrease in wound infections, minimization of pain, ease of dressing application, increased dressing wear time, and better wound healing. With all the options for burn wound care there are many factors to consider when choosing a burn dressing such as cost, ease of dressing for families at home, comfort, and efficacy. At our ten year verified pediatric burn center we have tried many different burn wound care products, however we have found Xeroform and bacitracin to be the most practical and easy to use for our patient population. Methods A retrospective chart review was performed from 2016–2018 of all cascading scald injuries to children 0–5 years of age treated at our verified pediatric burn center. 179 patients were included in this review. Of those patients a total of 52 patients were excluded, 28 patients had no follow up, 21 patients received alternate dressings, and 3 patients had full thickness injuries requiring a split thickness skin graft (STSG). Charts were reviewed for total body surface area (TBSA), length of stay (LOS), discharge dressing type, complications, and time to healing. All patients included routinely received consistent application of the Xeroform and bacitracin. Results 127 patients discharged with Xeroform dressings were included in this study with an average age of 1.4 years old (range 0–5 years) and average TBSA of 2.5% (range 0.25–13%). The average LOS was 1.6 days (range 1–10 days). In this sample 32 (25%) patients were healed within 7 days. 77 (61%) patients were healed within 7–14 days. 11 (9%) patients were healed within 14–21 days. 7 (5%) patients were healed in greater than 21 days. There were no wound complications identified within this study group. Conclusions Using Xeroform as our standard of practice has streamlined the care provided to our patients. We have demonstrated consistent effective re-epithelization, protection from infection, and ease of dressings for families and burn providers. In our experience Xeroform has provided a versatile way to care for partial thickness burn injuries. Applicability of Research to Practice We suggest Xeroform and bacitracin dressings be used for partial thickness burn injuries in patients under 5 years of age. This dressing may be superior to other products because it allows for bathing while providing good wound epithelization and is easy to use.

Laboratories need leaders who can effectively utilize the laboratories' resources, maximize the laboratories'capacity to detect disease, and advocate for laboratories in a fluctuating health care environment. To address this need, the University of Washington, USA, created the Certificate Program in Laboratory Leadership and Management in partnership with WHO Regional Office for the Eastern Mediterranean, and implemented it with 17 participants and 11 mentors from clinical and public health laboratories in 10 countries (Egypt, Iraq, Jordan, Lebanon, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, and Yemen) in 2014. Designed to teach leadership and management skills to laboratory supervisors, the programme enabled participants to improve laboratory testing quality and operations. The programme was successful overall, with 80% of participants completing it and making impactful changes in their laboratories. This success is encouraging and could serve as a model to further strengthen laboratory capacity in the Region.تنفيذ برنامج للتطوير المهني بالتوجيه في مجال قيادة وإدارة المختبرات في الشرق الأوسط وأفريقيا.لوسي برون، ديبورا كونفر، إليزابيث سكوت، لورا ليفينغستون، كاتلن برادبورن، أليكس ماك غي، توم فورتوانغلر، آن داونر، علي مُقداد، جين فريدريك فلاندين، سالماز شوتورباني، هومايون أصغر، ه. ي. طلبة، ه. جي. أحمد، علاء العلوان، روبرت مارتين.تحتاج المخترات لقادة يمكنهم الانتفاع مما فيها من موارد بفعالية، وتعظيم قدراتها لأقى قدر يتيح كشف الأمراض، ويدافعون عنها في بيئة متقلبة للرعاية الصحية. ولتلبية هذه الحاجة، أنشأت جامعة واشنطن في الولايات المتحدة الأمريكية برنامجاً لنيل شهادة القيادة والإدارة للمخترات بالشراكة مع المكتب الإقليمي لرق المتوسط لمنظمة الصحة العالمية، وفي عام 2014 تم تنفيذ البرنامج الذي ضم 17 مشاركاً و 11 موجِّهاً ينتمون إلى المخترات السريرية ومخترات الصحة العامة في 10 بلدان (مر والعراق والأردن ولبنان والمغرب وعُان وباكستان وقطر والمملكة العربية السعودية واليمن). وانطلاقاً من كون البرنامج قد تم تصميمه لتعليم المشرفن عى المخترات مهارات القيادة والإدارة، فقد وفّر البرنامج للمشاركين فيه إمكانية تحسن جودة الاختبارات والعمليات. ولقد كان البرنامج ناجحاً عى وجه الإجمال، فقد أكمل % 80 من المشاركين مشاركتهم به، وأحدثوا تغيرات ذات مردود ملحوظ في المخترات التي يعملون فيها. ويبدو نجاح البرنامج مشجعاً ويمكن أن يكون نموذجاً لتطوير المزيد من القدرات في المخترات في الإقليم.Mise en oeuvre d’un programme de mentorat en développement professionnel pour les directeurs et les cadres de laboratoire au Moyen-Orient et en Afrique du Nord.Les laboratoires ont besoin de directeurs à même d’utiliser les ressources internes de façon efficace, de maximiser leurs capacités à dépister les maladies, et d’oeuvrer pour le bien de ces établissements dans un environment de soins de santé en perpétuel changement. Pour répondre à ces besoins, l’Université de Washington (États-Unis), en partenariat avec le Bureau régional de l’OMS pour la Méditerranée orientale, a mis au point le Programme de certification en direction et gestion de laboratoire qui a été suivi par 17 participants et 11 mentors issus de laboratoires de santé clinique et publique dans 10 pays (Arabie saoudite, Égypte, Iraq, Jordanie, Liban, Maroc, Oman, Pakistan, Qatar et Yémen) au cours de l’année 2014. Conçu pour former les responsables de laboratoire aux compétences de direction et de gestion, le programme a permis aux participants de renforcer la qualité du dépistage et des opérations de leurs laboratoires. Le programme a été une réussite dans l’ensemble puisqu’il a été suivi jusqu’à son terme par 80 % des participants et que ceux-ci ont ensuite pu mettre en place des changements réels dans leurs laboratoires. Ce succès est encourageant et pourrait servir de modèle afin de renforcer davantage encore les capacités des laboratoires dans la Région.

There is an active debate regarding whether the ego depletion effect is real. A recent pre-registered experiment with the Stroop task as the depleting task and the antisaccade task as the outcome task found a medium level effect size. In the current research, we pre-registered a multi-lab collaborating project to replicate that experiment. Data from twelve labs across the globe (N = 1775) revealed a small but significant ego depletion effect, g = 0.12, CI95 = [0.02, 0.21]. The data also provided some evidence in support of a moderating effect of individual differences in lay theory about willpower, such that participants with an unlimited-resource theory evinced a weaker depletion effect. Finally, a series of auxiliary analyses provided important implications for future studies investigating the robustness of ego depletion, such that strictly controlled experimental settings and outcome tasks with medium difficulty might be better for observing a stronger depletion effect.

Copyright © 2016 Michigan State University. Amy L. Livingston and Anna Kurhajec, “Organizing Priorities: The Problem with ENDA and Burwell,” QED: A Journal in GLBTQ Worldmaking 3.1 (2016): 127–137. ISSN 2327-1574. All rights reserved. On July 8, 2014, the American Civil Liberties Union (ACLU), Gay and Lesbian Advocates and Defenders (GLAAD), Lambda Legal, the National Center for Lesbian Rights, and the Transgender Law Center issued a joint statement withdrawing their support for the federal Employment NonDiscrimination Act of 2013 (ENDA).1 ENDA would prohibit discrimination against lesbian, gay, bisexual, and transgender workers in hiring, promotion, termination, and other aspects of employment by some private and all public employers in the United States. Many iterations of ENDA have been introduced to Congress since 1994 and the latest, adopted by the Senate (but not the House) in 2013, contains a controversial religious exemption: “The Act shall not apply to a corporation, association, educational institution or institution of learning, or society that is exempt from the religious discrimination provisions of title VII of the Civil Rights Act of 1964.”2 The ACLU et al. noted in their joint statement of withdrawal that the religious exemption provision “has long been a source of significant concern to us.”3 However, ENDA’s religious exemption had not been enough of a cause for concern to warrant these organizations’ withdrawal of support until after the U.S. Supreme Court issued its ruling on Burwell v. Hobby Lobby on June 30, 2014.4 In their joint statement, the ACLU et al. claimed that their initial concerns about ENDA, which they acknowledged “could provide religiously affiliated organizations . . . a blank check to engage in workplace discrimination against LGBT people,” were intensified by the “misreading” of Burwell by “opponents of LGBT equality . . . as having broadly endorsed rights to discriminate against

The occurrence of wooden breast (WB) and white striping (WS) of broiler breast myopathies may be associated with least-cost feed formulations and the inclusion of greater amounts of synthetic amino acids. Two experiments were conducted to evaluate the effects of supplemental glutamine (Gln-/+, 0 and 1%) and arginine (Arg-/+, 0 and 0.25%) in a 2 × 2 factorial arrangement. Experiment 1 consisted of 8 replicates using 32 pens and focused on live performance to 44 d of age, carcass yield, and meat quality evaluations at 45 d of age. Live performance parameters including feed intake, BW gain, mortality, and feed conversion were evaluated. Post-harvest carcass yield, breast muscle quality (including WB and WS), proximate analysis, and mineral analysis of breast muscle and tibia bone were also evaluated. Experiment 2 comprised 4 replicates using 8 pens with weekly measurements of blood physiology and muscle myopathy development from 21 to 45 d of age. Broilers fed supplemental Gln and Arg (Gln+/Arg+) produced broilers with greater BW and improved FCR. The WB and WS severity increased with Gln+ diets, while only WB increased using Arg+ diets. Weekly observations revealed the greatest increase in WB myopathies occurred between 28 to 35 d, while WS significantly increased one week later (35 to 42 d). When comparing broilers of similar BW at 45 d, Gln+ diets resulted in greater WS scores and percentage breast muscle fat. Further analysis of WB and WS scores (independent of treatment affect) revealed that increased myopathy scores were associated with increased blood CO2, H2CO3, and reduced O2with increased meat pH, moisture content, and Ca concentration. These results indicated that increased muscle Ca is associated with increased WB, while increased dietary glutamine and lack of oxygen may have resulted in a reverse flux of the citric acid cycle and reduced electron transport chain activity resulting in increased WS.

The purpose of this study was to analyze the impact of interprofessional pediatric end-of life simulations for health professions students. A quasiexperimental design was used with three TeamSTEPPS® tools. Forty-one students were enrolled (nursing = 20, medicine = 10, pharmacy = 10, public health = 1). TeamSTEPPS 2.0 Teamwork Attitudes Questionnaire and Teamwork Perceptions Questionnaire analysis indicated a significant difference in mean pretest and posttest scores (p = .015 and p = .028, respectively). The Team Performance Observation Tool indicated statistical significance between simulations (p < .001, df = 18, r = .8). Simulations were significantly related to an increase in faculty observation scores, TeamSTEPPS 2.0 Teamwork Attitudes Questionnaire pre-post scores, and TeamSTEPPS 2.0 Teamwork Perceptions Questionnaire pre-post scores.

In a previous paper the authors use a recurrent network in the form of a NARX architecture to model the nonlinear behavior of a vacuum-tube guitar amplifier and its effects as applied to an electric guitar signal. The use of recurrent networks is important in the vacuum-tube modeling effort as the nonlinear dynamic responses are thought to be an important component in achieving the distortion that creates the sound treasured by rock guitarists and the fans of rock music. In this paper, we report on our current experiments evaluating the use of long/short-term memory (LSTM) units for modeling the dynamic nonlinear characteristics of a vacuum-tube guitar amplifier. It is our view that since LSTM units incorporate information from both recent and distant changes in state, they are useful for modeling the amplifier characteristics that produce the desired musical timbre. Our experiments involve investigating differing combinations of the hyperparameters of a deep learning network including the number of hidden layers, the number of units within each layer, and the type of unit within each layer. Model performance is evaluated using mean-square error and aural comparisons. Once the best architecture is determined, efforts will be put forth to minimize the hardware requirements for the implementation of the feedforward network.

The effects of time-limited feeding, genetic background, and egg storage on white striping (WS) and wooden breast (WB) in broilers were studied. Male chicks (240) from 2 genetic backgrounds and 2 egg storage periods were fed on either an ad libitum (AL) or time-limited (TL) program from 7 d of age. A rapid growth strain (Growth) and an enhanced yield strain (Yield) of broiler breeder males were mated to a single female line and eggs were stored for periods of either 1 to 7 d or 8 to 14 d. Body weight (BW), feed consumption, and feed conversion ratio (FCR) were determined weekly. Carcass data including WS and WB scores were collected at 42 d of age. Breast muscle scoring was conducted either visually or by hand palpation using a 1 to 4 point ordinal scale (normal to greatest severity). Data were analyzed using the Mixed procedure of SAS. The TL fed broilers presented less WS (1.64 vs. 2.87) and WB (2.14 vs. 2.89), lower BW (2.99 vs. 3.27 kg), and improved FCR (1.55 vs. 1.58 g: g), as well as reduced dressing percentage (79.5 vs. 80.1%), breast muscle yield (33.3 vs. 34.6%), and 24 h muscle pH (5.82 vs. 5.95) relative to AL broilers (P0.01). Yield broilers exhibited reduced BW (2.97 vs. 3.28 kg), lower WS (2.04 vs. 2.47), and greater WB (2.65 vs. 2.38) (P0.05) but similar dressing percentage (80.0 vs. 79.7%) and breast muscle yield (34.3 vs. 33.6%) when compared to Growth broilers. Longer egg storage generated lower BW (3.07 vs. 3.18 kg) and when fed AL, an increased WS score (2.58 vs. 3.15) compared to the shorter egg storage period (P0.05). It was concluded that WS and WB could be reduced by TL feeding and that genetic background and egg storage period may influence the expression of WS and WB.

We are grateful for the careful consideration, thoughtful comments, and insightful critiques that were provided in response to the target article (Berkman, Livingston, & Kahn, this issue). We are b...

This chapter presents a model of self-control that explains many phenomena related to self-control including ego depletion. We propose that valuation—the process of integrating multiple sources of subjective value for a given choice option—is a mechanism of self-control. The conflict between a goal and an impulse or another goal is resolved by comparing the cumulative subjective value of the choice options. A given choice option can have an arbitrary number of value sources, and these sources can shift over time depending on situational or intrapersonal constraints. We review the behavioral economics literature on three anomalies in valuation that are directly relevant to self-control (endowment, delay discounting, and diminishing marginal utility) and explain how the properties of the valuation system explain the ego-depletion effect. We close by discussing ways to improve self-control through interventions that target its sources of value, notably including identity.

Dean Spade's Normal Life: Administrative Violence, Critical Trans Politics, and the Limits of Law, Brooklyn, NY: South End Press, 2011Dean Spade's Normal Life questions the utility for "trans activism" of the legal reform strategies espoused by "lesbian and gay rights organizations" (68). But Normal Life does not simply divide trans* from "lesbian and gay" activism. Spade's "critical trans politics" is notable for its indebtedness (160) to woman of color feminist demands for multiple-axis (Crenshaw 1989), intersectional politics in response to systemic oppression. In keeping with this tradition, Spade's "critical trans politics" are composed of a set of ground-up (222-24), "process-oriented" (161) political strategies for building self-reflexive queer and antiracist social movements. As such, we think Normal Life has much to say about the promises and perils of "solidarity."As a staff organizer and a volunteer activist in higher education unions, we have an affinity for the term "solidarity." "Solidarity!" is a rallying cry, a performative declaration of collective power in response to oppression. Ideally, this declaration is predicated on an inspirational voluntary acceptance of communal risk. But in our experience, the cry "solidarity!" is also an effective tool of "secondary marginalization" (Cohen 1999; Phelan 2001). Here "solidarity!" is an homogenizing demand, often directed at women and queer people of color, to wait one's turn as a necessary sacrifice for the goals of a broader movement (Chavez 2009; Reddy 2008). Such demands constitute a continuous burden on already more marginalized members to sacrifice their particular goals as the only hope for achieving any kind of collective victory, as in "We need to focus on wages; if we win this contract, then in four years we can try for a stronger grievance procedure."Normal Life offers compelling examples of this kind of solidarity, including LGB rights movement advocacy for the "decriminalization of sodomy and the passage of sexual-orientation inclusive hate crime laws" (124). The problem with these political teloi is not only that they fail to effectively support those people ("including" LGBT people) who are most negatively affected by the U.S. criminal justice system. Rather, these particular efforts at legal reform affirmatively strengthen institutions that work disproportionate violence on the lives and bodies of trans* people in the United States (125). By demonstrating that accepting complicity with institutions of systemic oppression can never be a neutral decision along the way to a universal rights politics, Spade helps differentiate among just and unjust solidarities, performed on and at the relative margins of contemporary movements for racial, gender, economic, and sexual justice. To act justly in solidarity, movements should maintain suspicion of the seductive call of reform that may improve the lives of an elite majority or minority, while further strengthening the oppression of those who might stand to benefit the most from more difficult, dangerous, long-term efforts at systemic change.Past reviews of Normal Life have characterized Spades critical trans politics more and less favorably as "uncompromising" (Quinones 2012), an "all-or-nothing approach" that rejects LGB legal reform tactics entirely and so fails to acknowledge the ways in which movements for rights and equality have "helped to advance critical trans politics" (Levi and Shay 2012). …

Objective This article models use of emergency medical services (EMS) within a defined geographical area. Our goal was to develop an original quantitative method to delineate the need for EMS units within a geographical population. Methods Use of the EMS system within 11 municipalities was analyzed in 2007. The geospatial distributions of interventions during this year were examined, as well as the population dynamics of the region. A statistical model to determine the probability of an individual within the call area requiring an intervention was proposed using weighted population statistics and the application of an intervention probability. Results The observed interventional probability increased exponentially with age, notably after the age of 75. Areas with higher proportions of elderly residents had substantially higher rates of intervention and EMS use. Municipality H had the largest age-group of 20 to 24 years with an intervention probability of 0.34% (95% confidence interval [CI], 0.24-0.44), their more than 85-year age-group also had the largest intervention probability of 19.54% (95% CI, 15.60-23.48). Conclusions Contrary to current practice patterns of placing paramedic units in regions of greatest population density, we established a formula based on population vs intervention probability. We found the actual numbers of interventions performed are not dependent solely on population size but also are affected by the age of the population being served. This is particularly relevant to growing elderly communities. This determination will aid in the disbursement of limited prehospital resources in regions by improving availability of EMS personnel.

MUTYH-associated polyposis (MAP) is the only inherited colorectal cancer syndrome that is associated with inherited biallelic mutations in a base excision repair gene. The MUTYH glycosylase plays an important role in preventing mutations associated with 8-oxoguanine (OG) by removing adenine residues that have been misincorporated opposite OG. MAP-associated mutations are present throughout MUTYH, with a large number coding for missense variations. To date the available information on the functional properties of MUTYH variants is conflicting. In this study, a kinetic analysis of the adenine glycosylase activity of MUTYH and several variants was undertaken using a correction for active fraction to control for differences due to overexpression and purification. Using these methods, the rate constants for steps involved in the adenine removal process were determined for the MAP variants Y165C, G382D, P391L and Q324R MUTYH. Under single-turnover conditions, the rate of adenine removal for these four variants was found to be 30-40% of WT MUTYH. In addition, the ability of MUTYH and the variants to suppress mutations and complement for the absence of MutY in Escherichia coli was assessed using rifampicin resistance assays. The presence of WT and Q324R MUTYH resulted in complete suppression of the mutation frequency, while G382D MUTYH showed reduced ability to suppress the mutation frequency. In contrast, the mutation frequency observed upon expression of P391L and Y165C MUTYH were similar to the controls, suggesting no activity toward preventing DNA mutations. Notably, though all variations studied herein resulted in similar reductions in adenine glycosylase activity, the effects in the bacterial complementation are quite different. This suggests that the consequences of a specific amino acid variation on overall repair in a cellular context may be magnified.

Escherichia coli MutY has an important role in preventing mutations associated with the oxidative lesion 7,8-dihydro-8-oxo-2'-deoxyguanosine (OG) in DNA by excising adenines from OG.A mismatches as the first step of base excision repair. To determine the importance of specific steps in the base pair recognition and base removal process of MutY, we have evaluated the effects of modifications of the OG.A substrate on the kinetics of base removal, mismatch affinity and repair to G-C in an E. coli-based assay. Notably, adenine modification was tolerated in the cellular assay, whereas modification of OG resulted in minimal cellular repair. High affinity for the mismatch and efficient base removal required the presence of OG. Taken together, these results suggest that the presence of OG is a critical feature that is necessary for MutY to locate OG.A mismatches and select the appropriate adenines for excision to initiate repair in vivo before replication.

Value-based choice is the process of accumulating varied sources of subjective value for each choice option, then comparing the values to select an action. Self-control, we propose, is implemented by this simple valuation process. Self-control involves a choice among competing actions (e.g., between a goal-promoting behavior and a counter-goal impulse); self-control “success” is choosing an action consistent with the goal. In this model, self-control dilemmas are resolved by dynamically comparing the cumulative subjective value of each option. Thus, factors that increase the relative value of a goal-consistent option are hypothesized to improve self-control. We review anomalies in valuation relevant to self-control (endowment, delay discounting, and diminishing marginal utility) and explain how the properties of the valuation system explain self-control phenomena. We also describe how the valuation model integrates with existing models of self-control. Finally, we discuss how self-control can be improved through interventions that target sources of value, notably identity.