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Food production environments in low- and middle-income countries (LMICs) are recognized as posing significant and increasing risks to antimicrobial resistance (AMR), one of the greatest threats to global public health and food security systems. In order to maximize and expedite action in mitigating AMR, the World Bank and AMR Global Leaders Group have recommended that AMR is integrated into wider sustainable development strategies. Thus, there is an urgent need for tools to support decision makers in unravelling the complex social and environmental factors driving AMR in LMIC food-producing environments and in demonstrating meaningful connectivity with other sustainable development issues. Here, we applied the Driver-Pressure-State-Impact-Response (DPSIR) conceptual framework to an aquaculture case study site in rural Bangladesh, through the analysis of distinct social, microbiological, and metagenomic data sets. We show how the DPSIR framework supports the integration of these diverse data sets, first to systematically characterize the complex network of societal drivers of AMR in these environments and second to delineate the connectivity between AMR and wider sustainable development issues. Our study illustrates the complexity and challenges of addressing AMR in rural aquaculture environments and supports efforts to implement global policy aimed at mitigating AMR in aquaculture and other rural LMIC food-producing environments.

During clinical experiences, physician assistant (PA) students are required to participate in the management of multiple patients simultaneously. One method of preparing students for clinical experiences is through the use of simulation. Simulation allows development of decision-making and teamwork skills. 1,2 A previous study of nursing students in a multiple-patient simulation demonstrated improved student readiness to care for multiple patients. 2 The present study evaluated the effect of using simulation on PA student comfort with managing multiple patients in an emergency room setting.Four PA programs participated in this quasi-experimental pretest-posttest design. Four simulation days were held, each with 4 standardized cases. Half of the students acted as standardized patients, while the remainder of the students managed patients in small groups. Surveys were administered before and after the emergency medicine course. Descriptive statistics and statistical analysis for significance were performed using Excel and SPSS.Posttest results indicated significant improvement in student confidence in emergency scenarios, ability to perform a focused medical history, ability to choose and interpret laboratory values, time management, prioritizing patients in a simulated environment, and selecting appropriate treatment. Students reported satisfaction with the experience, feedback, and debriefing. Participation in these simulations increased student interest in pursuing a position in emergency medicine upon graduation.In clinical rotations, PA students are expected to manage multiple patients with a variety of conditions. In this study, students were initially uncomfortable managing multiple patients. Student comfort increased after a simulation experience. Increased opportunities for students to select appropriate diagnostics and treatment may increase their overall comfort in management of patients during rotations.

Immune monitoring in cancer immunotherapy involves screening CD8+ T-cell responses against neoantigens, the tumor-specific peptides presented by Major histocompatibility complex Class I (MHCI) on the cell surface. High-throughput immune monitoring requires methods to produce and characterize small quantities of thousands of MHCI-peptide complexes that may be tested for a patient's T-cell response. MHCI synthesis has been achieved using a photocleavable peptide that is exchanged by the neoantigen; however, assays that measure peptide exchange currently disassemble the complex prior to analysis─precluding direct molecular characterization. Here, we use native mass spectrometry (MS) to profile intact recombinant MHCI complexes and directly measure peptide exchange. Coupled with size-exclusion chromatography or capillary-zone electrophoresis, the assay identified all tested human leukocyte antigen (HLA)/peptide combinations in the nanomole to picomole range with minimal run time, reconciling the synthetic and analytical requirements of MHCI-peptide screening with the downstream T-cell assays. We further show that the assay can be "multiplexed" by measuring exchange of multiple peptides simultaneously and also enables calculation of Vc

In the summer months, the waters of the Sargasso Sea are nutrient-limited and strongly stratified, serving as a model system for the predicted warmer and nutrient-limited oceans of the Anthropocene. The dominant microorganisms of surface waters are key drivers of the global carbon cycle. However, the viruses of the Sargasso Sea that shape these host communities and influence host biogeochemical function are not well understood. Here, we apply a hybrid sequencing approach that combines short- and long reads to survey Sargasso Sea phage communities via metagenomics at the viral maximum (80m) and mesopelagic (200m) depths. Taxonomically, we identified 2,301 Sargasso Sea phage populations (~species-level taxonomy) across 186 genera. Over half of the phage populations lacked representation in other global ocean viral metagenomes, whilst 177 phage genera lacked representation in phage isolate databases. Viral fraction and cell-associated viral communities captured in short-read data were distinct and decoupled at both depths, possibly indicating low active lytic viral replication in the Sargasso Sea, with viral turnover occurring across periods longer than the sampling period of three days. Inclusion of long read data was critical for (1) the identification of 79 ecologically important and common viral genomes; (2) capturing the extent of viral genome microdiversity; and (3) enabling the recovery of hypervariable regions in viral genomes predicted to encode proteins involved in host recognition, DNA synthesis and DNA packaging. Host prediction was only possible for ~4% of viral populations. Genomes of phages known to infect Prochlorococcus and Pelagibacter were poorly represented in our data, supporting recent evidence of low infection levels in the dominant bacterial taxa of oligotrophic regions.SubjectsBioinformatics, Genomics, Marine Biology, Microbiology, VirologySequence data accession numbersPRJNA767318

Most food access studies focus on large cities, examine traditional grocery stores, and only consider operational food outlets. This siloed approach exposes a gap in food access literature. Therefore, as a part of our assessment of Flint’s food landscape, we examined closed food outlets in the city and surrounding townships. We investigated the relationship between the racial composition of census tracts and the number and type of defunct food outlets identified. We used Data Axle to collect and verify data on open and closed food outlets between September 2020 and December 2021. We made a final verification of the food outlet closures in June 2022. We used ArcGIS 10.8.1 and SPSS Version 28 to map and analyze the data. We used negative binomial regression models to determine differences in the likelihood of having an additional closed food outlet in census tracts with low and high percentages of Black residents. We also investigated the relationship between a census tract’s median income and the likelihood of having an additional closed food outlet. There were 173 closed food outlets; 81 were in Flint, and 92 were in surrounding townships. The most frequently closed food outlets were restaurants; they accounted for 45.1% of the closures. The mean number of closed food venues in census tracts where less than 40% of the residents were Black was 1.5. The mean was similar in census tracts where 40% or more of the residents were Black; it was 1.6. This difference was not significant. However, the median income of a census tract was a significant predictor of the likelihood of having an additional closed food outlet. Every one-thousand-dollar increase in median income resulted in a 2% less likelihood of having an additional closed food outlet. The results of this study show that there is more to the food landscape of a city than its operational food outlets. Focusing exclusively on active food outlets does not accurately depict a city's food infrastructure.

The primary objective of this study was to describe the food landscape of Flint, Michigan, and the surrounding townships. We investigated the relationship between the location of food outlets and the racial composition of census tracts. We collected data from multiple sources; however, Data Axle, a repository of information on the U.S. and Canadian businesses, was our primary data source. Data were collected and verified between September 2020 and December 2021. The final fact-checking was completed in June 2022. We used ArcGIS 10.8.1 and SPSS Version 28 to map and analyze the data. We conducted negative binomial regression analyses to identify the difference in the likelihood of finding food retailers in census tracts where the percentage of Black residents was low and those where the percentage of Blacks was high. The article examines 1,137 food retailers in the study area: 407 were in Flint, and the remainder in the surrounding townships. Restaurants—especially fast food and take-out establishments—dominated the food environment. In addition, small groceries and convenience stores proliferated in the grocery store category. The racial composition of the census tracts mattered. Census tracts in which more than 40% of the residents are Black have a mean of 7.6 food outlets. In comparison, census tracts in which 40% or less of the residents are Black have a mean of 11.3 food outlets; the difference is significant. Census tracts with a high percentage of Blacks also had significantly fewer restaurants. The results of this study show Flint’s food landscape to be more complex and robust than described in earlier studies. It underscores the point that researchers should not rely solely on documenting the presence of supermarkets or traditional grocery stores when addressing food insecurity and food access. In the case of Flint, such food outlets comprise only 2.2% of the food landscape. Focusing exclusively on these food retailers misses several important types of food venues that residents rely on to secure food. This siloed approach also ignores the resilience and ingenuity of residents to respond to limited access to traditional food retailers.

Whole Trait Theory defines personality as a density distribution of one’s momentary behavior, complete with all of its parameters (e.g., mean, SD, skew, kurtosis). Two questions regarding these parameters remain largely unexamined: (1) are individual differences in these parameters stable? And (2) do scores on standard personality tests correspond to these parameters? The current study (N = 209) employed an experience sampling design (Nobs ≈ 8300) to examine the stability of density distribution parameters and the relationship between standard personality test scores and density distribution parameters of 10 behaviors/emotions and 8 situation characteristics. Results showed that, (a) individual differences in density distribution parameters are moderately stable and (b) at the bivariate level, personality was associated with numerous distribution parameters for a number of behaviors/emotions, and situations. However, when the appropriate statistical controls were taken into account, these associations diminished. While individual differences in density distribution parameters we moderately stable, standard personality measures rarely correspond to any other parameters of density distributions once the mean of the density distribution is known. Emotionality and eXtraversion appear as exceptions to this general pattern. These results imply that both theory and measurement in personality should be cognizant of within-person variability in behavior.

Poor communication is a main cause of poor discharge planning. Although empathic processes underlie communication competence, the extent to which discharge team empathy has been studied is unclear. This paper will summarize interventions that incorporate empathic processes for effective interprofessional team communication. Guided by the SANRA scale, this narrative review presents research (2013–2019) on interprofessional communication and empathy interventions during discharge planning activities. Database searches yielded 2357 abstracts; ten fulfilled inclusion criteria. Limited studies exist with diverse interventions (simulation, process observations, video-enhanced learning, or TeamSTEPPS) that were mostly atheoretical and quasi-experimental, and samples of pre- and post-licensure clinicians ranging in size from 7 to 132. Evidence suggests that there is benefit to engaging in team-based discharge planning simulation when that simulation includes content on roles, debriefing, exercises in self-reflection, and use of video-feedback. As guided by theory, further benefits can be gained by incorporating empathic processes into interprofessional communication interventions.

To elucidate temporal sequences among and between person and situation variables, this work examines cross-measurement spillovers between situation experiences S (on the Situational Eight DIAMONDS characteristics [Duty, Intellect, Adversity, Mating, pOsitivity, Negativity, Deception, Sociality]) and personality states P (on the Big Six HEXACO dimensions [Honesty/Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness to Experience]) in experience sampling data. Multi-level modeling of lagged data at tn-1 and non-lagged data at tn grants the opportunity to examine (a) the stability (P → P, S → S), (b) cross-sectional associations (S ↔ P), and (c) cross-lagged associations among and between situation experiences and personality states (S → P, P → S). Findings indicated that there were (a) moderate stability paths, (b) small to moderate cross-sectional paths, and (c) only very small cross-lagged paths (though the different situation characteristics and personality states showed differential tendencies toward no directionality, S → P or P → S unidirectionality, or bidirectionality). Findings are discussed in light of refining studies on dynamic person–situation transactions.

What is the role of the situation in situational judgment tests (SJTs)? Lievens and Motowidlo (2016) assert that SJTs are somewhat of a misnomer because they do not actually measure how individuals would behave in a given situation per se. According to these researchers, SJTs assess general domain knowledge—whether potential employees recognize the “utility of expressing certain traits” (p. 4). As a result, SJTs map onto personality measures, which are a summary of behavior across time and situations. SJTs provide predictive validity in part because they tap into personality. However, rather than renaming SJTs, it is possible to reintroduce the concept of a situation to provide even greater predictive power. Thus, the goals of this commentary are to (a) clarify what constitutes a situation, (b) describe what SJTs might actually measure, and (c) set forth a path for a taxonomy of workplace situations.

BACKGROUND CONTEXT The fundamental shift from volume to value in health care delivery has seen an increase in alternative payment models such as the Bundled Payments for Care Improvement Initiative (BPCI). The Centers for Medicaid and Medicare Services (CMS) implemented the most recent iteration of BPCI, BPCI Advanced (A) in 2018. BPCI-A is a retrospective payment model that provides a lump payment for a 90-day episode of care. BPCI-A for spine includes the diagnosis related groups (DRG) for cervical spine surgery (C_PSF, 471,472,473), lumbar spinal fusion (L_PSF, 459-460), and lumbar decompression/discectomy (Decomp, 518, 519, 520). In preparation for BPCI participation, our center instituted care delivery improvements based on CMS evaluation of our historical data that was utilized to determine eligibility for participation and from patient input. Care improvements included a weekly multidisciplinary stakeholder meeting and assignment of a full-time nurse care coordinator to cover BPCI-A patients from both the orthopedic/neurosurgery service lines. PURPOSE The purpose of the study was to determine whether patient outcomes, including length of stay, readmission rates and ED visits, changed following participation in BPCI compared with historical data. STUDY DESIGN/SETTING A retrospective and prospective claims data review of all Medicare patients into specified spine surgery DRGs. PATIENT SAMPLE This study included 358 retrospective patients, 63 prospective patients with minimum of 6 months of follow-up. OUTCOME MEASURES Emergency department (ED) utilization and readmission rates. METHODS As part of the BPCI-A application process, retrospective patient data from January 1, 2013 through November 30, 2017 were provided to CMS to determine bundle-specific target prices. BPCI-A began on October 1, 2019 and analyses included those patients whose participation ended by September 30, 2019 (BPCI group, n=63) and those included in the CMS historical review (pre-BPCI group, n=358). Patient and surgery characteristics including age, body mass index (BMI), gender, race, age-adjusted Charlson Comorbidity Index (CCI) scores, admission source, patient class, discharge disposition, length of stay (LOS), service line, surgeon and DRG were collected. Outcomes included ED visit utilization and readmissions. Descriptive statistics were performed and continuous variables were evaluated for normality using the Shapiro-Wilk test and through evaluation of histograms. Differences between pre-BPCI and BPCI groups were evaluated using Wilcoxon Rank Sum tests due to non-normal distributions, for continuous variables, and chi-square or exact tests for categorical variables, as appropriate. The odds of readmission or ED utilization were compared between BPCI and pre-BPCI groups using logistic regression. Analyses adjusted for potential confounders. RESULTS This study included 358 pre-BPCI and 63 BPCI patients (8 Decomp, 27 C_PSF, 30 L_PSF). We found no significant differences in age (median (IQR):70.3(9.2) vs 70.2(12.4) years), BMI (30.2(9.5) vs 31.4(9.1) kg/m2), LOS (4(3) vs 3(5) days), gender (51.7 vs 46.0% women), race (94.7 vs 96.8% white), MCC DRG (12.6 vs 17.5%) or discharge home (59.8% vs 61.9%, all p>0.05) in pre-BPCI vs BPCI patients, respectively. Patient class differences were noted (pre-BPCI:11.7 vs BPCI: 22.2% inpatient, p=0.024). Overall, the ED visit rates were similar in pre-BPCI (26.5%) vs BPCI patients (30.2%, p=0.551) though readmission rates were slightly lower following BPCI participation (15.9% vs 26.8%, p=0.065). There was also a trend for lower number of readmissions after BPCI (p=0.044) and analyses adjusted for service line and patient class revealed a greater odds of readmission in the pre-BPCI group vs BPCI (OR=2.53, 95%CI=1.14-5.58, p=0.022). Analyses stratified by bundles showed lower readmission rates in BPCI (8%) vs pre-BPCI group (27.5%, p=0.035) and a trend for lower readmission numbers (p=0.043) in the L_PSF bundle. However, no differences were noted in the Decomp or C_PSF bundles or for ED visits in any bundle (p>0.05). CONCLUSIONS Participation in spine bundled payments (BPCI-A) at a large academic medical center was associated with significantly lower readmission rates. Alignment of all stakeholder interests via a bundled payment framework may help mobilize additional health system resources to improve patients’ outcomes. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.

The joint influence of persons and situations on behavior has long been posited by personality and social psychological theory (Funder, 2006; Lewin, 1951). However, a lack of tools for real-time behavioral and situation assessment has left direct investigations of this sort immobilized. This study combines recent advances in situation assessment and experience sampling methodology to examine the simultaneous effects of personality traits and situation characteristics on real-time expressions of behavior and emotion in N = 210 participants. The results support an additive model such that both personality traits and situation characteristics independently predict real-time expressions of behavior and emotion. These results have implications for several prominent theoretical perspectives in personality, including both trait and cognitive theories.

It has long been recognized that sovereign states could resist the enforcement of arbitration awards against their property in foreign jurisdictions by asserting immunity from suit. In many instances, this 'obstacle' to enforcement was tempered by the fact that a state could only claim immunity in respect of its governmental, as opposed to commercial, activities. In Hong Kong, this is no longer the case following the decision in Democratic Republic of the Congo and others v. FG Hemisphere Associates L.L.C., rendering it much more difficult to enforce awards against the assets of foreign states in Hong Kong and leading to concerns that the decision will impact negatively on Hong Kong's standing as a pre-eminent international arbitration seat. This article will examine the decision and those concerns.

IMPORTANCE: Despite the growing popularity of cosmetic procedures, the sociocultural and quality-of-life factors that motivate patients to undergo such procedures are not well understood. OBJECTIVE: To estimate the relative importance of factors that motivate patients to seek minimally invasive cosmetic procedures. DESIGN, SETTING, AND PARTICIPANTS: This prospective, multicenter observational study was performed at 2 academic and 11 private dermatology practice sites that represented all US geographic regions. Adult patients presenting for cosmetic consultation or treatment from December 4, 2016, through August 9, 2017, were eligible for participation. EXPOSURES: Participants completed a survey instrument based on a recently developed subjective framework of motivations and a demographic questionnaire. MAIN OUTCOMES AND MEASURES: Primary outcomes were the self-reported most common motivations in each quality-of-life category. Secondary outcomes were other frequently reported motivations and those associated with specific procedures. RESULTS: Of 529 eligible patients, 511 agreed to participate, were enrolled, and completed the survey. Typical respondents were female (440 [86.1%]), 45 years or older (286 [56.0%]), white (386 [75.5%]), and college educated (469 [91.8%]) and had previously received at least 2 cosmetic procedures (270 [52.8%]). Apart from motivations pertaining to aesthetic appearance, including the desire for beautiful skin and a youthful, attractive appearance, motives related to physical health, such as preventing worsening of condition or symptoms (253 of 475 [53.3%]), and psychosocial well-being, such as the desire to feel happier and more confident or improve total quality of life (314 of 467 [67.2%]), treat oneself or celebrate (284 of 463 [61.3%]), and look good professionally (261 of 476 [54.8%]) were commonly reported. Motivations related to cost and convenience were rated as less important (68 of 483 [14.1%]). Most motivations were internally generated, designed to please the patients and not others, with patients making the decision to undergo cosmetic procedures themselves and spouses seldom being influential. Patients younger than 45 years were more likely to undertake procedures to prevent aging (54 of 212 [25.5%] vs 42 of 286 [14.7%] among patients ≥45 years; P

When people are endowed with an object, they demand more money in order to part with it than they would be willing to pay to acquire it in the first place. This phenomenon is known as the endowment effect. From a behavioral finance point of view, the effect is interesting because the asymmetry between people's willingness to pay to acquire the object versus to part with it seems to be triggered by mere ownership of the object. In this paper, we propose that the endowment effect is due to discrepancies in the affective equilibria between owners and potential buyers of an endowment. We define an affective equilibrium as the price or range of prices for which traders forecast equal post-trade happiness for themselves and for their trading partners. In three studies, we obtain empirical findings that are consistent with this explanation and that also demonstrate erroneous affective forecasting in endowment owners and potential buyers. We discuss these findings in relation to the endowment effect literature. W...

International audience; Prevention of mineral fouling, known as scale, is a long-standing problem in a wide variety of industrial applications, such as oil production, water treatment, and many others. The build-up of inorganic scale such as calcium carbonate on surfaces and facilities is undesirable as it can result in safety risks and associated flow assurance issues. To date the overwhelming amount of research has mainly focused on chemical inhibition of scale bulk precipitation and little attention has been paid to deposition onto surfaces. The development of novel more environmentally-friendly strategies to control mineral fouling will most probably necessitate a multifunctional approach including surface engineering. In this study, we demonstrate that liquid infused porous surfaces provide an appealing strategy for surface modification to reduce mineral scale deposition. Microporous polypyrrole (PPy) coatings were fabricated onto stainless steel substrates by electrodeposition in potentiostatic mode. Subsequent infusion of low surface energy lubricants (fluorinated oil Fluorinert FC-70 and ionic liquid 1-Butyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (BMIm)) into the porous coatings results in liquid-repellent slippery surfaces.To assess their ability to reduce surface scaling the coatings were subjected to a calcium carbonate scaling environment and the scale on the surface was quantified using Inductively Coupled Plasma Atomic Emission Spectroscopy (ICP-AES). PPy surfaces infused with BMIm (and Fluorinert to a lesser extent) exhibit remarkable antifouling properties with the calcium carbonate deposition reduced by 18 times in comparison to untreated stainless steel. These scaling tests suggest a correlation between the stability of the liquid infused surfaces in artificial brines and fouling reduction efficiency. The current work shows the great potential of such novel coatings for the management of mineral scale fouling.

Taxonomies of person characteristics are well developed, whereas taxonomies of psychologically important situation characteristics are underdeveloped. A working model of situation perception implies the existence of taxonomizable dimensions of psychologically meaningful, important, and consequential situation characteristics tied to situation cues, goal affordances, and behavior. Such dimensions are developed and demonstrated in a multi-method set of 6 studies. First, the �Situational Eight DIAMONDS� dimensions Duty, Intellect, Adversity, Mating, pOsitivity, Negativity, Deception, and Sociality (Study 1) are established from the Riverside Situational Q-Sort (Sherman, Nave, & Funder, 2010, 2012, 2013; Wagerman & Funder, 2009). Second, their rater agreement (Study 2) and associations with situation cues and goal/trait affordances (Studies 3 and 4) are examined. Finally, the usefulness of these dimensions is demonstrated by examining their predictive power of behavior (Study 5), particularly vis-a-vis measures of personality and situations (Study 6). Together, we provide extensive and compelling evidence that the DIAMONDS taxonomy is useful for organizing major dimensions of situation characteristics. We discuss the DIAMONDS taxonomy in the context of previous taxonomic approaches and sketch future research directions. (PsycINFO Database Record (c) 2014 APA, all rights reserved)

SUMMARY The terrestrial slug Arion subfuscus secretes a glue that is a dilute gel with remarkable adhesive and cohesive strength. The function of this glue depends on metals, raising the possibility that metal-catalyzed oxidation plays a role. The extent and time course of protein oxidation was measured by immunoblotting to detect the resulting carbonyl groups. Several proteins, particularly one with a relative molecular mass (Mr) of 165×103, were heavily oxidized. Of the proteins known to distinguish the glue from non-adhesive mucus, only specific size variants were oxidized. The oxidation appears to occur within the first few seconds of secretion. Although carbonyls were detected by 2,4-dinitrophenylhydrazine (DNPH) in denatured proteins, they were not easily detected in the native state. The presence of reversible cross-links derived from carbonyls was tested for by treatment with sodium borohydride, which would reduce uncross-linked carbonyls to alcohols, but stabilize imine bonds formed by carbonyls and thus lead to less soluble complexes. Consistent with imine bond formation, sodium borohydride led to a 20–35% decrease in the amount of soluble protein with a Mr of 40–165 (×103) without changing the carbonyl content per protein. In contrast, the nucleophile hydroxylamine, which would competitively disrupt imine bonds, increased protein solubility in the glue. Finally, the primary amine groups on a protein with a Mr of 15×103 were not accessible to acid anhydrides. The results suggest that cross-links between aldehydes and primary amines contribute to the cohesive strength of the glue.