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When Hurricane Harvey landed along the Texas coast on August 25, 2017, it caused massive flooding and damage and displaced tens of thousands of residents of Harris County, Texas. Between August 29 and September 23, Harris County, along with community partners, operated a megashelter at NRG Center, which housed 3365 residents at its peak. Harris County Public Health conducted comprehensive public health surveillance and response at NRG, which comprised disease identification through daily medical record reviews, nightly “cot-to-cot” resident health surveys, and epidemiological consultations; messaging and communications; and implementation of control measures including stringent isolation and hygiene practices, vaccinations, and treatment. Despite the lengthy operation at the densely populated shelter, an early seasonal influenza A (H3) outbreak of 20 cases was quickly identified and confined. Influenza outbreaks in large evacuation shelters after a disaster pose a significant threat to populations already experiencing severe stressors. A holistic surveillance and response model, which consists of coordinated partnerships with onsite agencies, in-time epidemiological consultations, predesigned survey tools, trained staff, enhanced isolation and hygiene practices, and sufficient vaccines, is essential for effective disease identification and control. The lessons learned and successes achieved from this outbreak may serve for future disaster response settings. (Disaster Med Public Health Preparedness. 2019;13:97-101)
This study evaluated in a rigorous 18-month randomized controlled trial the efficacy of an enhanced vocational intervention for helping individuals with a recent first schizophrenia episode to return to and remain in competitive work or regular schooling.
Individual Placement and Support (IPS) was adapted to meet the goals of individuals whose goals might involve either employment or schooling. IPS was combined with a Workplace Fundamentals Module (WFM) for an enhanced, outpatient, vocational intervention. Random assignment to the enhanced integrated rehabilitation program (N = 46) was contrasted with equally intensive clinical treatment at UCLA, including social skills training groups, and conventional vocational rehabilitation by state agencies (N = 23). All patients were provided case management and psychiatric services by the same clinical team and received oral atypical antipsychotic medication.
The IPS–WFM combination led to 83% of patients participating in competitive employment or school in the first 6 months of intensive treatment, compared with 41% in the comparison group (p < 0.005). During the subsequent year, IPS–WFM continued to yield higher rates of schooling/employment (92% v. 60%, p < 0.03). Cumulative number of weeks of schooling and/or employment was also substantially greater with the IPS–WFM intervention (45 v. 26 weeks, p < 0.004).
The results clearly support the efficacy of an enhanced intervention focused on recovery of participation in normative work and school settings in the initial phase of schizophrenia, suggesting potential for prevention of disability.
I begin by identifying an ambiguity in the post-Hegelian literature on Immanent Critique, distinguishing two possible definitions: (a) judging an object against its ‘internal’ norms; and (b) accounting for one’s own standpoint with reference to the object. I then claim that both definitions are represented in Hegel’s Phenomenology, and develop extended interpretations of material from the Introduction in order to clarify and substantiate this thesis. This yields revisionist readings of the famous ‘internal criteria’ and ‘self examination’ tropes. My discussion builds towards elucidating the relation between the two definitions of Immanent Critique I have distinguished, as it is developed in the Phenomenology.
OBJECTIVES/SPECIFIC AIMS: Clostridium difficile infection (CDI) is the most common cause of antibiotic-associated diarrhea and an increasingly common infection in children in both hospital and community settings. Between 20% and 30% of pediatric patients will have a recurrence of symptoms in the days to weeks following an initial infection. Multiple recurrences have been successfully treated with fecal microbiota transplantation (FMT), though the body of evidence in pediatric patients is limited primarily to case reports and case series. The goal of our study was to better understand practices, success, and safety of FMT in children as well as identify risk factors associated with a failed FMT in our pediatric patients. METHODS/STUDY POPULATION: This multicenter retrospective analysis included 373 patients who underwent FMT for CDI between January 1, 2006 and January 1, 2017 from 18 pediatric centers. Demographics, baseline characteristics, FMT practices, C. difficile outcomes, and post-FMT complications were collected through chart abstraction. Successful FMT was defined as no recurrence of CDI within 60 days after FMT. Of the 373 patients in the cohort, 342 had known outcome data at two months post-FMT and were included in the primary analysis evaluating risk factors for recurrence post-FMT. An additional six patients who underwent FMT for refractory CDI were excluded from the primary analysis. Unadjusted analysis was performed using Wilcoxon rank-sum test, Pearson χ2 test, or Fisher exact test where appropriate. Stepwise logistic regression was utilized to determine independent predictors of success. RESULTS/ANTICIPATED RESULTS: The median age of included patients was 10 years (IQR; 3.0, 15.0) and 50% of patients were female. The majority of the cohort was White (89.0%). Comorbidities included 120 patients with inflammatory bowel disease (IBD) and 14 patients who had undergone a solid organ or stem cell transplantation. Of the 336 patients with known outcomes at two months, 272 (81%) had a successful outcome. In the 64 (19%) patients that did have a recurrence, 35 underwent repeat FMT which was successful in 20 of the 35 (57%). The overall success rate of FMT in preventing further episodes of CDI in the cohort with known outcome data was 87%. Unadjusted predictors of a primary FMT response are summarized. Based on stepwise logistic regression modeling, the use of fresh stool, FMT delivery via colonoscopy, the lack of a feeding tube, and a lower number of CDI episodes before undergoing FMT were independently associated with a successful outcome. There were 20 adverse events in the cohort assessed to be related to FMT, 6 of which were felt to be severe. There were no deaths assessed to be related to FMT in the cohort. DISCUSSION/SIGNIFICANCE OF IMPACT: The overall success of FMT in pediatric patients with recurrent or severe CDI is 81% after a single FMT. Children without a feeding tube, who receive an early FMT, FMT with fresh stool, or FMT via colonoscopy are less likely to have a recurrence of CDI in the 2 months following FMT. This is the first large study of FMT for CDI in a pediatric cohort. These findings, if confirmed by additional prospective studies, will support alterations in the practice of FMT in children.
Dormant states of organisms are easier to store than the living state because they tolerate larger variations in temperature, light, storage space etc., making them attractive for laboratory culture stocks and also for experiments under special circumstances, especially space flight experiments. Like several other organisms, Euglena gracilis is capable of forming desiccation tolerant resting states in order to survive periods of unfavourable environmental conditions. In earlier experiments it was found that dormant Euglena cells must not become completely desiccated. Some residual moisture is required to ensure recovery of the resting states. To analyse the water demand in recovery of Euglena resting states, cells were transferred to a defined amount of cotton wool (0.5 g). Subsequently different volumes of medium (1, 2, 3, 4, 5, 8, 10 and 20 ml) were added in order to supply humidity; a control was set up without additional liquid. Samples were sealed in transparent 50 ml falcon tubes and stored for 9 months under three different conditions:
•Constant low light conditions in a culture chamber at 20°C,
•In a black box, illuminated with short light emitting diode-light pulses provided by joule thieves and
•In darkness in a black box.
After 9 months, cells were transferred to fresh medium and cell number, photosynthetic efficiency and movement behavior was monitored over 3 weeks. It was found that cells recovered under all conditions except in the control, where no medium was supplied. Transcription levels of 21 genes were analysed with a Multiplex-polymerase chain reaction. One hour after rehydration five of these genes were found to be up-regulated: ubiquitin, heat shock proteins HSP70, HSP90, the calcium-sensor protein frequenin and a distinct protein kinase, which is involved in gravitaxis. The results indicate a transient general stress response of the cells.
Invasive species management is often more successful if desirable species are seeded after the target weed is controlled. However, control of invasive plants must be maintained following reseeding or the seeded species may fail to establish. A regional study conducted in Minnesota, North Dakota, and South Dakota evaluated the effect of aminopyralid, clopyralid, or picloram applied in the fall prior to fall-dormant seeding or seeding the following spring on cool- and warm-season native grass species establishment. Herbicides were applied at standard rates used to control invasive broadleaf weeds in the upper midwestern tallgrass prairie region of the United States. Cool-season species included Canada wildrye, green needlegrass, and intermediate wheatgrass. Warm-season species included big bluestem, little bluestem, sideoats grama, switchgrass, and Indiangrass. Aminopyralid did not reduce seedling establishment in either fall or spring seeding. Grasses generally were not affected by a pretreatment of the pyridine standards clopyralid or picloram either, with the exception of a slight reduction in fall-seeded establishment of intermediate wheatgrass. Picloram also slightly reduced fall-seeded establishment of Canada wildrye. Application of aminopyralid can safely be used to control susceptible invasive species preceding grass species establishment, with a safety margin similar to or slightly better than that with the pyridine standards clopyralid or picloram.
Organic light-emitting diodes (OLED) offer the potential to replace conventional light sources such as incandescent bulbs and fluorescent tubes. The question which thin-film technology is most favorable to produce OLED on an industrial scale is still unanswered. The most established technology for the deposition of small-molecule organic layers is vacuum thermal evaporation. A comparably novel technology is organic vapor phase deposition (OVPD), which offers some unique features in terms of adjustable process parameters such as deposition chamber pressure (P) and substrate temperature (TS). The impact of these parameters on the morphology of organic single layers as well as on the performance of OLED is mostly unknown. In this work, phosphorescent red OLED were produced with different TS and a strong influence on the device efficiency was found. Atomic force microscopy measurements were conducted to investigate the morphology of the hole injection and hole transport layers of the devices deposited at different TS. In addition to this, the influence of TS and P on the performance of fluorescent blue OLED and the morphology of organic single layers was tested. By varying TS and P for the emission layer only, current efficiencies in the range from 4.3 to 6.8 cd/A were found despite the fact that all devices had the same structure. Atomic force microscopy measurements conducted on organic single layers which were deposited at the same process conditions showed rms values ranging from 1.4 to 57 nm.
High precision radiocarbon measurements (±2.5‰ STD) were carried out on absolutely dated European oak material. These showed that significant short-term atmospheric 14C variations of up to 2 percent occurred between AD 200 and 800. These changes, reflecting a 150-to 180-year periodicity, seem to correlate with the average sunspot activity around that time. In comparison with results obtained by other authors, a very regular pattern of natural atmospheric 14C variations is exhibited.
14C calibration curves derived from South German oak tree-ring series are presented. They cover the interval between 4400 and 7200 BC complementing existing data sets and extending them to older periods. The atmospheric 14C level before 6200 BC no longer follows the long-term sinusoidal trend fitted to the bristlecone data. This observation is supported by a tentative match of the Main 9 series.
Accretion disks around rapidly rotating black holes provide one of the few plausible models for the production of intense radiation in AGNs above energies of several hundred MeV. The rapid rotation of the hole increases the binding energy per nucleon in the last stable orbit relative to the Schwarzschild case, and naturally leads to ion temperatures in the range 1012 -1013 K for sub-Eddington accretion rates. The protons in the hot inner region of a steady, two-temperature disk form a reservoir of energy that is sufficient to power the observed EGRET outbursts if the black hole mass is 1010M⊙ . Moreover, the accretion timescale for the inner region is comparable to the observed transient timescale of ~1 week. Hence EGRET outbursts may be driven by instabilities in hot, two-temperature disks around supermassive black holes. In this paper we discuss turbulent (stochastic) acceleration in hot disks as a possible source of GeV particles and radiation. We constrain the model by assuming the turbulence is powered by a collective instability that drains energy from the hot protons. We also provide some ideas concerning new, high-energy Penrose processes that produce GeV emission be directly tapping the rotational energy of Kerr black holes.
We present the largest homogeneous survey of redshift > 4.4 damped Lyα systems (DLAs) using the spectra of 163 quasars that comprise the Giant Gemini GMOS (GGG) survey. With this survey we make the most precise high-redshift measurement of the cosmological mass density of neutral hydrogen, ΩHI. After correcting for systematic effects using a combination of mock and higher-resolution spectra, we find ΩHI= 0.98+0.20-0.18 × 10−3 at 〈z〉 = 4.9, assuming a 20% contribution from lower column density systems below the DLA threshold. By comparing to literature measurements at lower redshifts, we show that ΩHI can be described by the functional form ΩHI(z) ∝ (1 + z)0.4. This gradual decrease from z = 5 to 0 suggests that in the galaxies which dominate the cosmic star formation rate, Hi is a transitory gas phase fuelling star formation which must be continually replenished by more highly-ionized gas from the intergalactic medium, and from recycled galactic winds.
On April 2, 2015, the International Tribunal for the Law of the Sea (ITLOS or Tribunal) rendered an advisory opinion on the rights and obligations of flag states and coastal states regarding illegal, unreported, and unregulated (IUU) fishing within the exclusive economic zone (EEZ). ITLOS confirmed that the full Tribunal—not just its Seabed Disputes Chamber—has jurisdiction to render advisory opinions, a matter of controversy that had previously been untested. The Tribunal also held that under the 1982 United Nations Convention on the Law of the Sea (UNCLOS or Convention), flag states have a “due diligence” obligation to ensure that vessels flying their flag do not engage in IUU fishing activities, and that the flag state may be held liable if that obligation of due diligence is breached. In addition, the Tribunal clarified that where fisheries competence has been transferred from a state to an international organization, it is the organization, not the flag state, that may face liability for a failure to have taken adequate measures to prevent IUU fishing. Finally, the Tribunal confirmed that coastal states have a duty to consult and cooperate with each other in the sustainable management of shared stocks and highly migratory species.
Nearly 258 million ha (28%) of the United States is publicly owned land that is managed by federal government agencies. For example, the US Department of Agriculture's Forest Service (USFS) manages over 77 million ha of national forests and grasslands for the benefit of the American public. Given its legal directive to manage multiple uses, it is not surprising that conflicts arise among stakeholders over how this land should be used (Lansky, 1992). The USFS has much discretion in how land is managed, yet must often balance conflicting values of public use and benefit (Nie, 2004). As national priorities, social preferences and public awareness of national forest goods, services and values have changed over time, USFS managers have faced increased pressure to balance consumptive uses with the need for environmental protection. Competing stakeholder demands coupled with increased environmental risks (wildfires, tree diseases and insect epidemics) have resulted in an escalating conservation conflict that is manifested in administrative appeals, lawsuits and a growing distrust of the agency.
Over time, the USFS has embraced new directions and management paradigms to reduce conflict. Some of these have been ecosystem management, adaptive management and now collaborative management (e.g. Holling, 1978; Maser, 1988; Franklin, 1992; Boyce and Haney, 1997; Wondolleck and Yaffee, 2000; Brown et al., 2004). These approaches reflect changing societal values, political pressures and new scientific information.
A persistent conflict has been the logging of trees in national forests and related impacts on forest ecosystems (Lansky, 1992). The USFS’ timber sale programme has supported jobs and community stability through economic development. Logging has also been a mechanism to reduce the risk of wildfire by reducing tree density (fuel for fires) and vertical stand diversity (‘ladder’ fuels; North et al., 2009). However, logging can also negatively affect forest integrity, watershed quality, wildlife, aesthetic and spiritual values of forests (Satterfield, 2002; North et al., 2009).
Many Americans hold distorted views of elected officials and, as our study shows, the blame is due partly to our ideological biases and partly to mass media. Analyzing a nationally representative online survey, we corroborate recent research that found that one in five Americans still believe president Barack Obama is a Muslim and that almost seven in ten mistakenly think Sarah Palin, and not Saturday Night Live’s Tina Fey, was the first to say “I can see Russia from my house.” Although race, political ideology, and “born-again” or evangelical Christian status were the primary drivers of misperceptions about Obama’s faith, media use had a more crucial role in predicting the more widespread misperception about Palin. Misattribution of the Fey quote to Palin was greatest among heavy viewers of traditional news media and late-night TV comedy, which is suggestive of the “lamestream media” effect often espoused by prominent Republican figures.
Porous, nanostructured silver samples were produced using a direct-write method where a nanoparticle aerosol consisting of particles with a mean size of approximately 5 nm were accelerated to speeds of approximately 1000 m/sec and impacted onto a translating substrate . The impacting particles have sufficient energy to stick to the substrate, allowing patterned thick films to be directly written from the aerosol without a mask. Unlike other low temperature processing routes for achieving patterned films, no organics are added that can interfere with postdeposition processing. Typical films are 5- 100 μm thick, up to several centimeters long, and have an as-deposited relative densities as high as 70% of bulk Ag. Compression tests were carried out in steps at room temperature and at 150°C under constant displacement rates. Local strain and densification were measured by optical profilometry between each compression step. The results can be used as a starting point to better understand the mechanisms that govern plasticity, creep, and sintering in nanostructured, porous silver at low processing temperatures.