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We investigated a large multistate outbreak that occurred in the United States in 2015–2016. Epidemiologic, laboratory, and traceback studies were conducted to determine the source of the infections. We identified 907 case-patients from 40 states with illness onset dates ranging from July 3, 2015 to March 2, 2016. Sixty-three percent of case-patients reported consuming cucumbers in the week before illness onset. Ten illness sub-clusters linked to events or purchase locations were identified. All sub-clusters investigated received cucumbers from a single distributor which were sourced from a single grower in Mexico. Seventy-five cucumber samples were collected, 19 of which yielded the outbreak strain. Whole genome sequencing performed on 154 clinical isolates and 19 cucumber samples indicated that the sequenced isolates were closely related genetically to one another. This was the largest US foodborne disease outbreak in the last ten years and the third largest in the past 20 years. This was at least the fifth multistate outbreak caused by contaminated cucumbers since 2010. The outbreak is noteworthy because a recall was issued only 17 days after the outbreak was identified, which allowed for the removal of the contaminated cucumbers still available in commerce, unlike previous cucumber associated outbreaks. The rapid identification and response of multiple public health agencies resulted in preventing this from becoming an even larger outbreak.
Mycobacterium marinum, a bacterium found in freshwater and saltwater, can infect persons with direct exposure to fish or aquariums. During December 2013, the New York City Department of Health and Mental Hygiene learned of four suspected or confirmed M. marinum skin or soft tissue infections (SSTIs) among persons who purchased whole fish from Chinese markets. Ninety-eight case-patients with non-tuberculous mycobacteria (NTM) SSTIs were identified with onset June 2013–March 2014. Of these, 77 (79%) were female. The median age was 62 years (range 30–91). Whole genome sequencing of clinical isolates revealed two main clusters and marked genetic diversity. Environmental samples from distributors yielded NTM though not M. marinum. We compared 56 case-patients with 185 control subjects who shopped in Chinese markets, frequency-matched by age group and sex. Risk factors for infection included skin injury to the finger or hand (odds ratio [OR]: 15·5; 95% confidence interval [CI]: 6·9–37·3), hand injury while preparing fish or seafood (OR 8·3; 95% CI 3·8–19·1), and purchasing tilapia (OR 3·6; 95% CI 1·1–13·9) or whiting (OR 2·7; 95% CI 1·1–6·6). A definitive environmental outbreak source was not identified.
Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
The Cosmic Background Explorer, launched November 18, 1989, has nearly completed its first full mapping of the sky with all three of its instruments: a Far Infrared Absolute Spectrophotometer (FIRAS) covering 0.1 to 10 mm, a set of Differential Microwave Radiometers (DMR) operating at 3.3, 5.7, and 9.6 mm, and a Diffuse Infrared Background Experiment (DIRBE) spanning 1 to 300 µm in ten bands. A preliminary map of the sky derived from DIRBE data is presented. Initial cosmological implications include: a limit on the Comptonization y parameter of 10−3, on the chemical potential μ parameter of 10−2, a strong limit on the existence of a hot smooth intergalactic medium, and a confirmation that the dipole anisotropy has the spectrum expected from a Doppler shift of a blackbody. There are no significant anisotropies in the microwave sky detected, other than from our own galaxy and a cosθ dipole anisotropy whose amplitude and direction agree with previous data. At shorter wavelengths, the sky spectrum and anisotropies are dominated by emission from ‘local’ sources of emission within our Galaxy and Solar System. Preliminary comparison of IRAS and DIRBE sky brightnesses toward the ecliptic poles shows the IRAS values to be significantly higher than found by DIRBE at 100 μm. We suggest the presence of gain and zero-point errors in the IRAS total brightness data. The spacecraft, instrument designs, and data reduction methods are described.
Background: Little knowledge exists on the availability of academic and community paediatric neurology positions. This knowledge is crucial for making workforce decisions. Our study aimed to: 1) obtain information regarding the availability of positions for paediatric neurologists in academic centres; 2) survey paediatric neurology trainees regarding their perceptions of employment issues and career plans; 3) survey practicing community paediatric neurologists 4) convene a group of paediatric neurologists to develop consensus regarding how to address these workforce issues. Methods: Surveys addressing workforce issues regarding paediatric neurology in Canada were sent to: 1) all paediatric neurology program directors in Canada (n=9) who then solicited information from division heads and from paediatric neurologists in surrounding areas; 2) paediatric neurology trainees in Canada (n=57) and; 3) community paediatric neurologists (n=27). A meeting was held with relevant stakeholders to develop a consensus on how to approach employment issues. Results: The response rate was 100% from program directors, 57.9% from residents and 44% from community paediatric neurologists. We found that the number of projected positions in academic paediatric neurology is fewer than the number of paediatric neurologists that are being trained over the next five to ten years, despite a clinical need for paediatric neurologists. Paediatric neurology residents are concerned about job availability and desire more career counselling. Conclusions: There is a current and projected clinical demand for paediatric neurologists despite a lack of academic positions. Training programs should focus on community neurology as a viable career option.
Micronutrient deficiencies and suboptimal energy intake are widespread in rural Kenya, with detrimental effects on child growth and development. Sporadic school feeding programmes rarely include animal source foods (ASF). In the present study, a cluster-randomised feeding trial was undertaken to determine the impact of snacks containing ASF on district-wide, end-term standardised school test scores and nutrient intake. A total of twelve primary schools were randomly assigned to one of three isoenergetic feeding groups (a local plant-based stew (githeri) with meat, githeri plus whole milk or githeri with added oil) or a control group receiving no intervention feeding. After the initial term that served as baseline, children were fed at school for five consecutive terms over two school years from 1999 to 2001. Longitudinal analysis was used controlling for average energy intake, school attendance, and baseline socio-economic status, age, sex and maternal literacy. Children in the Meat group showed significantly greater improvements in test scores than those in all the other groups, and the Milk group showed significantly greater improvements in test scores than the Plain Githeri (githeri+oil) and Control groups. Compared with the Control group, the Meat group showed significant improvements in test scores in Arithmetic, English, Kiembu, Kiswahili and Geography. The Milk group showed significant improvements compared with the Control group in test scores in English, Kiswahili, Geography and Science. Folate, Fe, available Fe, energy per body weight, vitamin B12, Zn and riboflavin intake were significant contributors to the change in test scores. The greater improvements in test scores of children receiving ASF indicate improved academic performance, which can result in greater academic achievement.
Raising money is hard work. You have to be prepared. Anytime a potential investor senses that you have not properly prepared for a meeting, you instantly will have lost any chance of landing this person as an investor. When I was raising some stage 2 financing for Fingerlakes Aquaculture, I had a meeting with a group of potential investors in Boston, friends and acquaintances of my angel investor, Peter (I think I’ve mentioned him before). We met in the high-rent financial district. Big buildings … marble hallways … all that type of stuff. I had spent many hours refining my presentation down to about twenty minutes to cover selected details so they would ask for more information that I could tell them was covered in the full business plan and that I had copies with me for them if interested. Part of my presentation was to actually prepare some tilapia fillets from my farm so the guests could really “get a taste of what it was all about.” (This was back in 1999, when most people had no idea what a tilapia fillet tasted like or even what a tilapia was!) The meeting was to start at 11:00 a.m. I was getting ready to start my presentation, including the cooking arrangements for the fillets. The invitees (there were five in total) got there about ten to fifteen minutes early and started chatting with my angel investor Peter. It didn’t take long before they became so curious about the product and what it tasted like that I had no choice (in my opinion) but to go ahead with that segment of the presentation, even though it was supposed to be at the end of my planned presentation right about lunch time (I thought this would be perfect timing). They all loved the product. Two of the people in attendance became investors in my company. I never did get to show them my PowerPoint presentation. But if I had, it was a good one. I was prepared.
Genius is 1% inspiration and 99% perspiration. Accordingly a genius is often merely a talented person who has done all of his or her homework.
Launching your business beyond the friends and family stage will require you to rewrite your business plan, probably for the umpteenth time! I will guarantee you one thing: the circle of professional acquaintances that you had thought might invest in your company … well, most won’t … and the ones who do invest, will have a lot of advice for you, and probably more than you want! Advice can be a good thing, but when one investor says, “Go right,” and the next investor says, “Go left,” you’ll likely find yourself wondering which direction is correct. But, you must do something!
I have been pretty successful in raising capital for my start-ups. My business plans were a critical component of my successful fundraising. Were they perfect? No, but these plans raised money! In fact, one of the VC investors said several times that she thought my business plan for my aquaculture tilapia start-up was one of the best business plans she had ever read. Her VC firm required a supporting partner (a proponent was required before this venture firm would make an investment) to make a personal investment in any company that is submitted to the VC group for consideration. After the initial acceptance, the tilapia business several years later ended up under new management and despite the earlier VC’s praise for the original plan, one of the first objectives of the new management team was to write a “really good” business plan. My “best she’d read” plan got tossed out the window. What does this tell you?
Entrepreneurship is the recognition and pursuit of opportunity without regard to the resources you currently control, with confidence that you can succeed, with the flexibility to change course as necessary, and the will to rebound from setbacks.
I remain grateful for some good early advice. I had several inventions that had been taken to financial success by others. The benefactors sometimes said thank you. This made me all the more eager to take one of my own ideas to the real world. I had convinced myself that financial success and glory eagerly awaited me.
About fifteen years ago, I launched my first major entrepreneurial effort that revolved around proprietary technology used to produce seafood indoors in an environmentally responsible manner at a competitive price. The market for such a technology had to be huge I kept reminding myself, because seafood was (and still is) a significant contributor to the U.S. trade deficit.
Associate yourself with men of good quality if you esteem your own reputation. It is better be alone than in bad company.
I was getting pretty close to starting my fish business; I was concluding some final negotiations to secure the capital I needed to implement the business plan strategy (I needed $500,000). As you get involved in this entrepreneurship arena, you’ll quickly discover that there is a lot of parallel processing going on. You will need to juggle several activities concurrently in order to pull this business launch off successfully. My situation was that I knew I was going to need a general manager (GM) about the same day I broke ground on the fish production building. So, about three months before I thought I needed my GM, I initiated a concerted effort to find a competent GM, who would be my first paid employee. I spread the word through my contact list and a national online site for aquaculture. I also received a call from Dr. Tom Fields, a colleague at a private fish farm near Saratoga Springs, New York, with whom we (Cornell University) had done business with over the years.
Authors, educators and successful entrepreneurs wrote this textbook with the primary goal of maximising your chance of entrepreneurial success. It is designed to encourage those wanting to start a business and those who have already begun. It includes guidance, instruction and practical lessons for the prospective entrepreneur. The book focuses on early stage financing of a start-up company, beginning with an emphasis on constructing an effective business plan, including writing techniques to help convey your message, and preparing solid financial statements. This 'why' and 'how' of writing a business plan is followed by recommendations on raising outside capital. Important topics include developing your marketing strategy, recruiting and managing creatives and managers, and retaining effective employees. Legal structures, negotiation strategies, and economic evaluation of opportunities are also discussed. The book concludes with a chapter on project management. It includes many engineering economy topics, sufficient for those taking the FE exam.
People are definitely a company’s greatest asset. It doesn’t make any difference whether the product is cars or cosmetics. A company is only as good as the people it keeps.
Mary Kay Ash (1915–2001; U.S. Business Executive)
You’re making great progress. You’ve got a board, you are about to hire two key employees, and you are just about ready to start executing your company business strategy. But, you need a company structure to embody these attributes. In fact, you can’t even open a bank account without an Employer’s Identification Number (EIN). This is no simple decision. In particular, your board (typically made up of “older” types) will probably steer you in the direction of a conventional commercial corporation, aka C-Corp. Why, because they are familiar with it. People just about always think what they are familiar with is best, else why would they have been doing it all these years? I believe that a limited liability corporation (LLC) is probably your best bet at this point of your company history for a variety of reasons we discuss in this chapter. I’m not a lawyer, and this is where you should seek legal advice once you think you know what you want to do. In fact, never go to a lawyer and ask them an open-ended question such as “What should I do?” They will just about always guide you in the most conservative direction legally, and this may not be best for your company.
Types of Ownership Structures
Before you can decide on an ownership structure for your business, you should learn a little bit about how each structure works. As a good reference on deciding which ownership structure is most suitable for your business, read “Choosing the Best Ownership Structure for Your Business” (go to www.nolo.com/lawcenter).