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Objectives: Popliteal artery entrapment syndrome (PAES) is a rare condition where musculoskeletal structures compress the popliteal artery (POPA) leading to vascular compromise. This study investigates the effect of dynamic plantar‐ and dorsi‐flexion loading on POPA hemodynamic parameters to develop a robust diagnostic ultrasound‐based protocol for diagnosing functional PAES. Methods: Healthy individuals (n = 20), recreational athletes (n = 20), and symptomatic (n = 20) PAES patients were consented. Triplex ultrasound imaging of lower limb arteries was performed (n = 120 limbs). Proximal and distal POPA's in dorsi‐/plantar‐flexion, in prone and erect positions, were imaged at rest and flexion. Peak systolic velocities (cm/s) and vessel diameter (antero‐posterior, cm) was measured. Results: Distal vessel occlusion was noted across all three groups whilst prone during plantar‐flexion (62.7%). POPA occlusion was only noted in the proximal vessel within the patient group (15.8%). When prone, 50% of control (n = 40 limbs), 70% of athletes (n = 40 limbs), and 65% of patients (n = 40 limbs) had distal POPA occlusion in plantar‐flexion. When prone, recreational athletes (5%), and patients (12.5%) had distal POPA compression under dorsi‐flexion. POPA occlusions with the patient in erect position were only noted in the symptomatic patient group under both dorsi‐flexion (15.8%) and plantar‐flexion (23.7%). Conclusion: Compression of the POPA on ultrasound should not be the sole diagnostic criteria for PAES. POPA compression exists in asymptomatic individuals, primarily under prone plantar‐flexion. To reduce false positives, ultrasound‐based protocols should focus on scanning patients in the erect position only to diagnose PAES, rather than asymptomatic POPA compression. A distinction should be made between the two. [ABSTRACT FROM AUTHOR]

Legal Consciousness and the Implementation of Equality and Human Rights Law in England and Wales: Increasingly, Western governments need not only get things done, but get things done well. In this regard, equality and human rights standards provide a significant framework for governments to improve the quality of their performance. Regulators, inspectorates and ombuds (RIOs) are particularly important in this regard as they are in a privileged position to monitor and assess the implementation of equality and human rights standards by governments. However, as yet, the performance of RIOs has been underwhelming. To investigate this underperformance, this article explores the legal consciousness (i.e. understandings and perceptions of the law) of the individuals responsible for the implementation of equality and human rights laws within a sample of RIOs in England and Wales. Two different types of legal consciousness are identified: law as sacrosanct and law as malleable. The article then explores how these different types of legal consciousness influence implementation. It concludes by highlighting factors that influence an individual's legal consciousness and ways that these can be enhanced to improve the quality of implementation in the future. [ABSTRACT FROM AUTHOR]

10.1055/s-0038-1625961 8 Klasan A., Tay M.L., Frampton C., Young S.W. High usage of medial unicompartmental knee arthroplasty negatively influences total knee arthroplasty revision rate. 25971779 24 Hafkamp F.J., de Vries J., Gosens T., Oudsten B.L.D. The Relationship Between Psychological Aspects and Trajectories of Symptoms in Total Knee Arthroplasty and Total Hip Arthroplasty. J. 2013; 103: 63-67 19 Pollock M., Somerville L., Firth A., Lanting B. Outpatient Total Hip Arthroplasty, Total Knee Arthroplasty, and Unicompartmental Knee Arthroplasty: A Systematic Review of the Literature. 10.1080/17453674.2017.1410958 22 Husted C., Gromov K., Hansen H.K., Troelsen A., Kristensen B.B., Husted H. Outpatient total hip or knee arthroplasty in ambulatory surgery center versus arthroplasty ward: A randomized controlled trial. [Extracted from the article]

Pharmacogenomics (PGx)‐based personalized medicine (PM) is increasingly utilized to guide treatment decisions for many drug‐disease combinations. Notably, London Health Sciences Centre (LHSC) has pioneered a PGx program that has become a staple for London‐based specialists. Although implementational studies have been conducted in other jurisdictions, the Canadian healthcare system is understudied. Herein, the multistakeholder perspectives on implementational drivers and barriers are elucidated. Using a mixed‐method qualitative model, key stakeholders, and patients from LHSC's PGx‐based PM clinic were interviewed and surveyed, respectively. Interview transcripts were thematically analyzed in a stepwise process of customer profiling, value mapping, and business model canvasing. Value for LHSC located specialist users of PGx was driven by the quick turnaround time, independence of the PGx clinic, and the quality of information. Engagement of external specialists was only limited by access and awareness, whereas other healthcare nonusers were limited by education and applicability. The major determinant of successful adoption at novel sites were institutional champions. Patients valued and approved of the service, expressed a general willingness to pay, but often traveled far to receive genotyping. This paper discusses the critical pillars of education, awareness, advocacy, and efficiency required to address implementation barriers to healthcare service innovation in Canada. Further adoption of PGx practices into Canadian hospitals is an important factor for advancing system‐level changes in care delivery, patient experiences, and outcomes. The findings in this paper can help inform efforts to advance clinical PGx practices, but also the potential adoption and implementation of other innovative healthcare service solutions. [ABSTRACT FROM AUTHOR]

The business model canvas is a popular tool used to develop value-driven business models. Specific emphasis is placed on understanding what customers value and providing users with steps on how to design and deliver value for their customers. In health care, creating and delivering value for patients is an often-discussed topic, with the provision of patient-centered care becoming a standard for many health care organizations. While patients play a key role in determining value, providers are the key to delivering value. Therefore, effective health care management relies on integrating multiple perspectives from key stakeholders. This process requires consideration of the key needs that must be addressed, the resources and capabilities necessary to meet these needs, and the interests and values specific to each set of stakeholders. The business model canvas lends itself well to health care service planning as it incorporates the factors described above into the business model's conceptualization and subsequent realization. This article outlines how the business model canvas was applied to assess the needs of physician stakeholders to help guide the expansion of a pharmacogenomic-based precision medicine clinic that conducts genetic testing for patients at risk of experiencing adverse drug reactions. The article provides a detailed description of how the business model canvas was used and adapted to understand physician's responsibilities and challenges related to drug prescription and dosing, and how the clinic could address physician needs and create value by mapping clinic services onto physician needs and wants. Interviews were conducted with physicians and the data were analyzed following the recommendations of the developers of the business model canvas. The article examines the strengths and limitations of the business model canvas and discusses its applicability to a health care setting. [ABSTRACT FROM AUTHOR]

The business model canvas is a popular tool used to develop value-driven business models. Specific emphasis is placed on understanding what customers value and providing users with steps on how to design and deliver value for their customers. In health care, creating and delivering value for patients is an often-discussed topic, with the provision of patient-centered care becoming a standard for many health care organizations. While patients play a key role in determining value, providers are the key to delivering value. Therefore, effective health care management relies on integrating multiple perspectives from key stakeholders. This process requires consideration of the key needs that must be addressed, the resources and capabilities necessary to meet these needs, and the interests and values specific to each set of stakeholders. The business model canvas lends itself well to health care service planning as it incorporates the factors described above into the business model's conceptualization and subsequent realization. This article outlines how the business model canvas was applied to assess the needs of physician stakeholders to help guide the expansion of a pharmacogenomic-based precision medicine clinic that conducts genetic testing for patients at risk of experiencing adverse drug reactions. The article provides a detailed description of how the business model canvas was used and adapted to understand physician's responsibilities and challenges related to drug prescription and dosing, and how the clinic could address physician needs and create value by mapping clinic services onto physician needs and wants. Interviews were conducted with physicians and the data were analyzed following the recommendations of the developers of the business model canvas. The article examines the strengths and limitations of the business model canvas and discusses its applicability to a health care setting. [ABSTRACT FROM AUTHOR]

We show that the boundary of any bounded strongly pseudoconvex complete circular domain in C2 must contain points that are exceptionally tangent to a projective image of the unit sphere. [ABSTRACT FROM AUTHOR]

This article identifies, compares, and assesses residential models of care to treat infectious complications among people who inject drugs (PWID) through intravenous antibiotic (IV) therapy. Database searches in Ovid MEDLINE, Embase, PsycINFO, and the Cumulative Index to Nursing and Allied Health Literature Studies were performed. A Google web search was also performed. Studies published in English between 2000 and May 2017 that presented data on an out-of-hospital residential program for IV antibiotic treatment of infectious complications among PWID were included. Of the 2355 unique articles screened, 218 were reviewed in their entirety and three were included. Across the three included studies, no mortalities were reported during the study. Each study reported similar outcomes compared to in-hospital care. In the two studies reporting costs, residential care was substantially less expensive. This review indicates that residential treatment appears to be beneficial to PWID, hospitals, and the health care system. [ABSTRACT FROM AUTHOR]

Background: Despite an acute knee injury being a major risk factor for osteoarthritis, the factors that initiate and maintain this risk of longer-term knee symptoms are poorly understood. Bioactive lipids derived from omega-3 and -6 polyunsaturated fatty acids have key roles in the regulation of the inflammatory response and have been linked to joint damage and osteoarthritis pain in translational models. Hypothesis: There would be associations between systemic levels of bioactive lipids and knee symptoms longitudinally after an acute knee injury and related knee surgery. Study Design: Controlled laboratory study. Methods: This study analyzed a subset of young, active adults who had sustained an acute knee injury (recruited via a surgical care pathway) and healthy age- and sex-matched controls. Surgery, if performed, was conducted after the baseline serum sample was taken and before the 3-month and 2-year visits. Liquid chromatography–tandem mass spectrometry of 41 bioactive lipids was carried out in sera of (1) 47 injured participants (median age, 28 years) collected at baseline (median, 24 days after injury), 3 months, and 2 years, along with the Knee injury and Osteoarthritis Outcome Score, and (2) age- and sex-matched controls. Results: Levels of the omega-3 polyunsaturated fatty acids eicosapentaenoic acid (P ≤.0001) and docosahexaenoic acid (P ≤.0001) and the pro-resolving lipid mediators 17– and 14–hydroxydocosahexaenoic acid, and 18-hydroxyeicosapentaenoic acid were all significantly greater at baseline in injured participants compared with the later time points and also higher than in healthy controls (P =.0019 and P ≤.0001, respectively). Levels of pro-inflammatory prostaglandins E2 and D2, leukotriene B4, and thromboxane B2 were significantly lower at baseline compared with the later time points. Higher levels of 8,9–, 11,12–, and 14,15–dihydroxyeicosatrienoic acid (DHET) were cross-sectionally associated with more severe knee pain/symptoms according to the Knee injury and Osteoarthritis Outcome Score at 2 years (P =.0004, R 2 = 0.251; P =.0002, R 2 = 0.278; and P =.0012, R 2 = 0.214, respectively). Conclusion: The profile of pro-resolving versus pro-inflammatory lipids at baseline suggests an initial activation of pro-resolution pathways, followed by the later activation of pro-inflammatory pathways. Clinical Relevance: In this largely surgically managed cohort, the association of soluble epoxide hydrolase metabolites, the DHETs, with more severe knee symptoms at 2 years provides a rationale for further investigation into the role of this pathway in persisting knee symptoms in this population, including potential therapeutic strategies. [ABSTRACT FROM AUTHOR]

The advent of chimeric antigen receptor T (CAR‐T) and the burgeoning field of cellular therapy has revolutionized the treatment of relapsed/refractory leukemia and lymphoma. This personalized "living therapy" is highly effective against a number of malignancies, but this efficacy is tempered by side effects relatively unique to immunotherapies, including CAR‐T. The overwhelming release of cytokines and chemokines by activated CAR‐T and other secondarily activated immune effector cells can lead to cytokine release syndrome (CRS), which can have clinical and pathophysiology similarities to systemic inflammatory response syndrome and macrophage activating syndrome/hemophagocytic lymphohistiocytosis. Tocilizumab, an anti‐IL6 receptor antibody, was recently FDA approved for treatment of CRS after CAR‐T based on its ability to mitigate CRS in many patients. Unfortunately, some patients are refractory and additional therapies are needed. Patients treated with CAR‐T can also develop neurotoxicity and, as the biology is poorly understood, current therapeutic interventions are limited to supportive care. Nevertheless, a number of recent studies have shed new light on the pathophysiology of CAR‐T‐related neurotoxicity, which will hopefully lead to effective treatments. In this review we discuss some of the mechanistic contributions intrinsic to the CAR‐T construct, the tumor being treated, and the individual patient that impact the development and severity of CRS and neurotoxicity. As CAR‐T and cellular therapy have redefined the concept of personalized medicine, so too will personalization be necessary in managing the unique side effects of these therapies. [ABSTRACT FROM AUTHOR]

The Equality and Human Rights Commission was created in 2006 with wide-ranging powers to protect human rights, promote equal opportunities and encourage mutual respect between different groups. Alongside the Commission, individuals through the courts, and sector-specific enforcers (such as ombudsmen and regulators) have also been given equality and human rights enforcement powers. Within this enforcement landscape, the Commission has struggled to craft an enforcement role for itself. For the first time, this paper, through the mapping of these different actors in their shared regulatory space, outlines a role for the Commission in equality and human rights enforcement. This role consists of three primary tasks: (i) taking action that courts and sector-specific enforcers are unable to perform; (ii) overcoming some of the limitations of private enforcement in the courts; and (iii) coordinating and supporting sector-specific enforcers. The paper concludes by exploring how the Equality and Human Rights Commission (EHRC) can effectively fulfil this role. [ABSTRACT FROM AUTHOR]

After the failure of the April 1961 Bay of Pigs intervention in Cuba, senior officials from the Kennedy administration, including the president, devoted two days to off-the-record briefings for more than 200 journalists. Although President John F. Kennedy refused to assign blame, other officials were less circumspect, disagreeing about whether the Central Intelligence Agency or another part of the government was responsible for the failure. The most notable aspect of this episode is not that senior administration personnel discussed a covert action in the presence of journalists but that the briefings subsequently remained unknown. Some newspapers briefly mentioned them, but no book on the Bay of Pigs—from the 1960s through today—has mentioned that such briefings happened or described their content. Using primary-source materials (including fragments of the briefings' transcript) plus some newspaper accounts, this article describes the conflicting opinions voiced at the briefings and explores why and how the Kennedy administration succeeded in keeping the encounters mostly unknown. [ABSTRACT FROM AUTHOR]

• Artificial and biological neural networks can be analyzed using similar methods. • Neural analysis has revealed similarities between the representations in artificial and biological networks. • Challenges: Even with full access and control, interpreting neural networks can be difficult. • Opportunities: DNNs can provide hypotheses about computation in the brain. • Opportunities: DNNs can be used to prototype new neural analysis techniques. Deep neural networks (DNNs) transform stimuli across multiple processing stages to produce representations that can be used to solve complex tasks, such as object recognition in images. However, a full understanding of how they achieve this remains elusive. The complexity of biological neural networks substantially exceeds the complexity of DNNs, making it even more challenging to understand the representations they learn. Thus, both machine learning and computational neuroscience are faced with a shared challenge: how can we analyze their representations in order to understand how they solve complex tasks? We review how data-analysis concepts and techniques developed by computational neuroscientists can be useful for analyzing representations in DNNs, and in turn, how recently developed techniques for analysis of DNNs can be useful for understanding representations in biological neural networks. We explore opportunities for synergy between the two fields, such as the use of DNNs as in silico model systems for neuroscience, and how this synergy can lead to new hypotheses about the operating principles of biological neural networks. [ABSTRACT FROM AUTHOR]

Though multiple realization has been an important concept in the philosophy of mind and philosophy of psychology for more than fifty years, it has not been until quite recently that anyone proposed an actual theory of what multiple realization is. This paper argues that the most dominant current theories of multiple realization are unacceptable. It does so by mainly arguing for a particular methodology for theorizing about multiple realization. Rather than being mostly constrained by intuitions, as theorizing about folk notions usually is, theorizing about multiple realization is, it argues, constrained by the theoretical context in which the concept was born. By the lights of this method for constructing theories of multiple realization, these current theories are unacceptable. [ABSTRACT FROM AUTHOR]

The UK has extremely high levels of socio-economic inequality, which are predicted to rise over the next five years. Traditionally, equality law was seen as inappropriate to address socio-economic inequality but in the last decade, a growing number of equality duties have been introduced to address this persistent form of inequality. There is, however, little research on the principles that underpin these duties. This article seeks to address this gap through the use of data from interviews conducted with primary school personnel implementing the pupil premium. The article explores understandings of socio-economic inequality by individuals in schools; policy conflicts; the wider context of action to address socio-economic inequality; different decision-making processes; and accountability mechanisms. On the basis of the findings of this study, broad principles are outlined to inform the design, implementation and enforcement of socio-economic equality duties in the future. [ABSTRACT FROM AUTHOR]

This article notes that it was a student who suggested to me that I teach a course on intelligence. After some thought, I acted on his idea. Selecting books for the course was a significant task. One ‘lesson learned’ in doing so was that, while some books on intelligence can be great reading for those already knowledgeable on the basics, they can be too sophisticated for undergraduates who (like most Americans) are ignorant about U.S. intelligence agencies and their place in the larger government. Other books have been nearly perfect for such students. Since Villanova University is a few hours from Washington, D.C., students have rarely encountered anyone who actually works in intelligence. Therefore, bringing alumni of our school who do just that work back to campus helps the course seem less ‘ivory tower’ to students. As I am a historian, as much as a political scientist, I find that certain documents I have found in archives can be fascinating reading for students in the course. [ABSTRACT FROM AUTHOR]

Aims and objectives To develop a theory that offered an evidence-based insight into the use of teleconsultation by nurses. Background Teleconsultation is the use of video to facilitate real-time, remote interaction between healthcare practitioners and patients. Although its popularity is growing, there is little understanding of how teleconsultation impacts on the role of nurses. Design The study adopted a constructivist grounded theory method, supplemented by the use of Straussian analytical approaches. Methods Using selective and theoretical approaches, registered nurses with experience of using video in health care were sampled. Data were collected using semi-structured interviews exploring experiences, knowledge and feelings surrounding teleconsultation. Interviews were recorded, transcribed and subjected to three-stage, nonlinear manual analysis (open, axial and selective coding). Results Theoretical saturation occurred after 17 interviews. The core category identified from the data was 'nursing presence' Four subcategories of nursing presence were identified: operational, clinical, therapeutic and social. The degree to which presence could be achieved was dependent upon three influencing factors - enablers, constraints and compensation. Conclusions Nurses provide different types of presence during teleconsultation, with the degree of presence dependent on specific characteristics of video-mediated communication. Where the use of video constrains the delivery of presence, nurses use a range of compensatory mechanisms to enhance patient care. Relevance to clinical practice Teleconsultation provides an innovative approach to enhancing the delivery of health care. This study provides nurses with insight into the impact of teleconsultation on their professional role, and an understanding of how best to use video-mediated communication to support patient care. [ABSTRACT FROM AUTHOR]

Clemson University researchers have conducted a multi-agency, multi-cohort study on juvenile offending and recidivism. Important features of the study are a sample size of approximately 100,000 delinquents and 100,000 non-delinquents; the merging of data sets from a state department of juvenile justice with those of departments of mental health, social services, education, and (adult) law enforcement; and statistical analyses focusing on the role of age, race, gender, child maltreatment, mental health disorders and school-related disabilities on juvenile referrals, prosecutions, re-offending and incarceration. Published findings strongly support earlier empirical and clinical work on influences on juvenile delinquency. The present article emphasizes our findings related to five important issues: the impact of prosecution on repeat offending, the effects of the juvenile's race on solicitor recommendations, the significance of one-time juvenile offending, the empirical support for the concept of "resilience," and the magnitude of associations between childhood history and later criminal offending. [ABSTRACT FROM AUTHOR]

In an earlier paper, we appealed to various empirical studies to make the case that the unconscious mind is capable of robust self-deception. Paul Doody has challenged our interpretations of that empirical evidence. In this reply we defend our interpretations, arguing that the unconscious is engaged in strategic and flexible goal pursuit. [ABSTRACT FROM AUTHOR]

On 26 July 1962, the New York Times published a front-page story by reporter Hanson Baldwin which, among many things, showed the vulnerability of Soviet land-based missiles, in the event of a first strike by the US. Drawing at least indirectly from a National Intelligence Estimate, it also showed how US intelligence had obtained that information. The story infuriated President John F. Kennedy, who believed it harmed the security of the United States. This article details an aggressive FBI investigation of who had leaked to Baldwin, as well as an initiative at the Central Intelligence Agency to conduct its own future leak investigations inside the US, both authorized by President Kennedy. [ABSTRACT FROM AUTHOR]

Bovine respiratory disease (BRD) remains an important condition of calves that leads to reduced weight gain and productivity as well as incurring significant cost in terms of management, treatment and prevention. The disease is multi-factorial with numerous viruses (bovine herpesvirus 1 (BoHV1); bovine respiratory syncytial virus (BRSV); parainfluenza 3 virus (PI3); and bovine virus diarrhoea virus (BVDV)) and bacteria (Mycoplasma bovis, Pasteurella multocida, Mannheimia haemolytica, Histophilus somni) being implicated in its aetiology. While the economic impact is well documented, and despite in excess of 2900 research publications related to the disease in the last 30 years, BRD continues to be a major concern clinically. [ABSTRACT FROM AUTHOR]

The brain has an impressive ability to withstand neural damage. Diseases that kill neurons can go unnoticed for years, and incomplete brain lesions or silencing of neurons often fail to produce any behavioral effect. How does the brain compensate for such damage, and what are the limits of this compensation? We propose that neural circuits immediately com pensate for neuron loss, thereby preserving their function as much as possible. We show that this compensation can explain changes in tuning curves induced by neuron silencing across a variety of systems, including the primary visual cortex. We find that compensatory mechanisms can be implemented through the dynamics of networks with a tight balance of excitation and inhibition, without requiring synaptic plasticity. The limits of this compen satory mechanism are reached when excitation and inhibition become unbalanced, thereby demarcating a recovery boundary, where signal representation fails and where diseases may become symptomatic. [ABSTRACT FROM AUTHOR]

Potent CD19-directed immunotherapies, such as chimeric antigen receptor T cells (CART) and blinatumomab, have drastically changed the outcome of patients with relapsed/refractory B cell acute lymphoblastic leukemia (B-ALL). However, CD19-negative relapses have emerged as a major problem that is observed in approximately 30% of treated patients. Developing approaches to preventing and treating antigen-loss escapes would therefore represent a vertical advance in the field. Here, we found that in primary patient samples, the IL-3 receptor α chain CD123 was highly expressed on leukemia-initiating cells and CD19-negative blasts in bulk B-ALL at baseline and at relapse after CART19 administration. Using intravital imaging in an antigen-loss CD19-negative relapse xenograft model, we determined that CART123, but not CART19, recognized leukemic blasts, established protracted synapses, and eradicated CD19-negative leukemia, leading to prolonged survival. Furthermore, combining CART19 and CART123 prevented antigen-loss relapses in xenograft models. Finally, we devised a dual CAR-expressing construct that combined CD19- and CD123-mediated T cell activation and demonstrated that it provides superior in vivo activity against B-ALL compared with single-expressing CART or pooled combination CART. In conclusion, these findings indicate that targeting CD19 and CD123 on leukemic blasts represents an effective strategy for treating and preventing antigen-loss relapses occurring after CD19-directed therapies. [ABSTRACT FROM AUTHOR]

The Irish General Election, held on 26 February, was eagerly anticipated for several reasons. It was the first contest since the ‘Earthquake’ election of 2011, which saw a historic change in the Irish party system, with the near total demolition of Fianna Fáil and the first and second place finishes of Fine Gael and the Labour Party. It would be the first test of the permanency of this shift. It was also the first contest following the serious economic adjustments pursued since then, as well as the first since the introduction of the Gender Quota in 2012, a measure expected to change the kind of candidate selected – and thus elected – for the Dáil. Ultimately, the election returned a defeat for the government, and a fragmented new Dáil, but at the time of writing, it is unclear what, if any, government will be formed. [ABSTRACT FROM PUBLISHER]

Chimeric antigen receptor (CAR) T cells are an effective therapy for relapsed or refractory pediatric B cell leukemia. Analysis of the starting material, the T cells collected from the patient prior to CAR manufacture, reveals possible biomarkers of cells destined to perform poorly in patients. Long-term follow-up shows that long periods of B cell aplasia, a marker of in vivo CAR activity, are associated with longer remission but also a higher chance of antigen-negative relapse. The role of transplantation as consolidative therapy is unclear in this nonrandomized data, but clearly warrants further study. [ABSTRACT FROM AUTHOR]

The article discusses some of the innovations in education which support student learning and development. Topics include the spectrum of care within the veterinary teaching hospitals along with the experienced primary care practitioners with expertise in teaching; practical teaching innovations, and the comprehensive veterinary public health experience.

In recent years deflationary accounts of self-deception, under the banner of motivationalism, have proven popular. On these views the deception at work is simply a motivated bias. In contrast, we argue for an account of self-deception that involves more robustly deceptive unconscious processes. These processes are strategic, flexible, and demand some retention of the truth. We offer substantial empirical support for unconscious deceptive processes that run counter to certain philosophical and psychological claims that the unconscious is rigid, ballistic, and of limited cognitive sophistication. [ABSTRACT FROM AUTHOR]

Sub-optimal heifer growth is associated with higher disease rates and reduced future performance and longevity in the dairy herd. This report describes a system for measuring heifer growth from birth to first calving that was used on commercial dairy farms in South West England, in order to gather benchmarking data to feed back to farmers. Weights ( n  = 8443) were collected from 20 farms. There was a marked variation in individual and herd mean growth rates. Overall, calves gained no weight in the first 8 days after birth and had a very low growth rate (median 0.12 kg/day) up to 30 days, a period when feed conversion efficiency is high and calves are vulnerable to disease. Heifers whose growth rate up to 180 days was low were significantly less likely to achieve target service weight (374 kg) by 420 days. Monitoring heifer growth during the rearing period enables farmers to improve heifer growth rates and so impact both the efficiency of heifer rearing and, potentially, the productivity and performance of the adult herd. [ABSTRACT FROM AUTHOR]

Using large sample archival data from the state of South Carolina's juvenile justice agency and other state agencies, we examined the background, early experiential and delinquency-related variables predicting young adult (ages 17-30 years) offending among juvenile offenders. We also examined characteristics of juvenile offenders who committed only a single misdemeanor offense, compared to non-juvenile offenders. Finally, we examined the variables that accounted for group differences in persistence of juvenile offending. Early adverse experiences including family-related adversities, mental health problems, identification as having school-related disabilities and juvenile recidivism accounted for more than 20 % of the variance in adult offending. Cox proportional hazards analysis revealed several time-dependent covariates including gender, age at first offense and repeat versus one time offending. Contrary to the view that the one time, misdemeanor level juvenile offending represents only minor departure from normative adolescent behavior, we found that this group of offenders differed significantly from non-delinquents on every category of risk for adult offending and also were more likely than non-delinquents to commit felonies as adults. Finally, in comparing adolescence-limited offenders with life-course persistent offenders, we accounted for more than 50 % of the variance in criminal outcomes on the basis of measures of background, early adversity, psychological characteristics and age of first juvenile arrest or referral. [ABSTRACT FROM AUTHOR]

Aims and objectives To evaluate and critique current knowledge regarding the role of animals in palliative care. To explore the impact that animals may have on the well-being of individuals and to identify gaps in the evidence base. Background There is recognition that having a companion animal will affect patient experience. Similarly, there has been some previous exploration on the use of specific animal assisted therapies for patients with different healthcare needs. Design A literature review was conducted to identify published and unpublished research about companion animals or animal-assisted therapy in palliative and/or end-of-life care. The primary objective was to explore the impact of animals on well-being at the end of life. Methods A search for literature was carried out using a variety of databases and different combinations of search terms linked to animals in palliative care. Included works were critically appraised and thematically analysed. Results A limited range of literature was identified. From the small number of studies included in the review ( n = 4), it appears that there is some evidence of animals (either companion animals or those used specifically to enhance care) having a positive impact on the patient experience. Conclusion This study suggests that animals play a large part in the lives of people receiving palliative care. Using animals to support care may also offer some benefits to the patient experience. However, there appears to be a dearth of high-quality literature in this area. More research is therefore required. Relevance to clinical practice Nurses providing palliative care need to be aware of the part that a companion animal may play in the life of patients. There may also be the opportunity for nurses in some settings to integrate animal therapy into their provision of palliative care. [ABSTRACT FROM AUTHOR]

We show that the efficiency of a natural pairing between certain projectively invariant Hardy spaces on dual strongly ℂ-convex real hypersurfaces in complex projective space is measured by the norm of the corresponding Leray transform. [ABSTRACT FROM AUTHOR]

The US developed the capability to see and reproduce photo imagery taken by Soviet satellites crossing the American landmass, according to notes of a conversation between DCI John McCone and Secretary of State Dean Rusk in 1963. We analyze the implications of this conversation, and report results of a literature search to explore how the US might have developed such a capability, and whether it lasted. [ABSTRACT FROM AUTHOR]

This article explores the first nomination for Director of Central Intelligence (DCI) that was seriously contested in the US Senate. Unlike three previous DCIs who headed the Central Intelligence Agency, John A. McCone faced harsh criticism from some in the news media and 12 negative votes in the US Senate after he was nominated for the position by President John F. Kennedy. The article considers factors, including McCone's personal attributes and recent years' controversies about the CIA, as reasons that provoked some opposition to his confirmation as DCI. [ABSTRACT FROM AUTHOR]

The field of adoptive cell transfer includes chimeric antigen receptor (CAR) engineered T cells, constructs that emerged from basic research into principles of immunology and have transformed into clinically effective therapies for haematological malignancies. T cells engineered to express these artificial receptors hold great promise, but also carry significant risk. While permanent genetic modification of mature T cells appears safe, modulating their in vivo function is difficult, partly because the robust response can trigger other arms of the immune system. Suicide systems and toxicity management with cytokine blockade or signal transduction modulators have emerged as a new frontier in this field, a far cry from early problems getting CAR T cells to work at all. Currently, clinical trials in patients with relapsed or refractory B cell malignancies treated with CD19-specific CAR T cells have induced durable remissions in adults and children. Results from these trials indicate that more work needs to be done to understand biomarkers of efficacy, the role of T cell persistence and how to integrate this care into standard practice. Cell therapy will not be a 'one size fits all' class of medicine, and here we will discuss the development of this therapy and important questions for its future. [ABSTRACT FROM AUTHOR]

The field of adoptive cell transfer (ACT) is currently comprised of chimeric Ag receptor (CAR)- and TCRengineered T cells and has emerged from principles of basic immunology to paradigm-shifting clinical immunotherapy. ACT of T cells engineered to express artificial receptors that target cells of choice is an exciting new approach for cancer, and it holds equal promise for chronic infection and autoimmunity. Using principles of synthetic biology, advances in immunology, and genetic engineering have made it possible to generate human T cells that display desired specificities and enhanced functionalities. Clinical trials in patients with advanced B cell leukemias and lymphomas treated with CD 19-specific CAR T cells have induced durable remissions in adults and children. The prospects for the widespread availability of engineered T cells have changed dramatically given the recent entry of the pharmaceutical industry to this arena. In this overview, we discuss some of the challenges and opportunities that face the field of ACT. [ABSTRACT FROM AUTHOR]

Using large-sample, archival data from the state of South Carolina's juvenile justice agency, we examine the question of race differences in predictors of repeat offending for a sample of approximately 100,000 youth who had been referred for criminal offenses. Independent variables relating to background, adverse parenting, mental health, school-related disabilities, and features of first offenses contributed to more than 25% of the variance in recidivism for both Black and White youth. Male gender, eligibility for free or reduced school lunch, diagnoses based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; text rev.; American Psychiatric Association, 2000), placement in Child Protective Services, and school identification as having a classification of emotional or behavioral disorders or learning disabilities were all predictive of juvenile recidivism. In addition, early age of first offense, status offenses, and being prosecuted for a first offense were significant predictors. Magnitudes of prediction were similar across racial groups, suggesting similar vulnerability of both Black and White youth to these early adversities. Interactions between race and other independent variables accounted for only .001 of the variance in recidivism. However, there were several significant interactions. Mental health history and characteristics of the first offense were stronger predictors for White youth than for Black youth. Gender, poverty (free or reduced lunch), and school identification of having a classification of emotional or behavioral disorders were stronger predictors for Blacks than for Whites. Implications for prevention are addressed. [ABSTRACT FROM AUTHOR]

Antimicrobial treatments are regularly used in the management of lameness in dairy cattle at both individual and herd levels. However, individual treatments may be prescribed and administered without specific indication and the examination and corrective trimming of the affected digit. Effective non-antibiotic alternatives are also available for use in foot baths as a component of herd level control programmes for infectious lameness. The focus of any control strategy must be on lameness prevention and prompt diagnosis and appropriate treatment of any cases. This article explores how antimicrobial use in the treatment and control of bovine lameness can be made more responsible and sustainable. [ABSTRACT FROM AUTHOR]

We examined the role of childhood behavioral and mental health problems in the prediction of adolescent childbearing. Using large sample archival data from multiple state agencies, we examined the relationships between early adverse experiences and adolescent childbearing in a sample of 70,200 females, one half of whom had juvenile delinquency histories. Females who had been committed to Child Protective Services, had received a DSM-IV diagnosis for a mental health disorder from the State Department of Mental Health, had been classified in school as having a school-related disability such as a learning disability, or who were eligible for free or reduced lunch were significantly more likely than other females to bear a child during the teen years. The strongest association between childhood risk and teen childbearing involved juvenile delinquency; girls who had been referred to the state juvenile justice department were 3 ½ times more likely to have a child while still a teenager than girls who had not been arrested. Race and income (free/reduced lunch) were also associated with teen childbearing. Associations between teen childbearing and mental health problems/risk indicators remained strong even for teens who had not been involved in the juvenile justice system. Implications for prevention/reduction of adolescent childbearing were examined. [ABSTRACT FROM AUTHOR]

The role of mental health history and family dysfunction or disruption on female juvenile delinquency was examined. Using large sample archival data from a state juvenile justice agency, we examined the behavioral and demographic predictors of repeat offending for a sample of approximately 34,000 females who had been referred for criminal offenses. Then, after merging these data with those from multiple state agencies, we compared the family and mental health histories of the delinquent females with those of females from a matched control group of the same number, constructed from the records of the state department of education. Drug use, family delinquency, severity of first offenses, and age of first offending were predictors of repeat offending for the females in the delinquent sample. Compared with non-delinquent females, delinquent females were more likely to be eligible for free or reduced lunch, and were more likely to have been in foster care or child protective services. The strongest predictor of membership in the delinquent sample was a DSM-IV diagnosis of a mental health disorder related to aggression or impulse control. All variables associated with delinquency remained significant when other predictors were statistically controlled. Implications for prevention of female juvenile delinquency were addressed. [ABSTRACT FROM AUTHOR]

A popular issue in mind is to explain why conscious mental states are conscious. Prinz (2012) defends three claims in an effort to make such an explanation: (i) mental states become conscious when and only when we attend to them; (ii) attention is a process by which mental states become available to working memory; so (iii) mental states are conscious when and only when they become available to working memory. Here I attack Prinz's theory, made explicit in (iii), by showing that there is strong empirical reason to doubt each o f the foregoing claims. I rehearse defences o f the claims Prinz has made, as well as possible replies he does not explicitly employ, and show how they are inadequate to save his view. [ABSTRACT FROM AUTHOR]

Background: Delay in seeking care increases the morbidity and mortality in tuberculosis (TB) patients and leads to increased likelihood of transmission within the community. Stigmatisation is one of the influencing factors causing delay in accessing healthcare when experiencing symptoms of TB. Objective: This study aimed to explore the relationship between TB stigmatisation and patient delay among pulmonary tuberculosis (PTB) patients. Methods: A mixed methods study was undertaken among 300 randomly sampled participants who completed questionnaire surveys, supplemented by 25 in-depth interviews with purposively-sampled participants identified as delaying access to healthcare. Results: Participants reporting higher perceived levels of TB stigmatisation demonstrated a longer duration of patient delay (p < 0.001). Qualitative data reinforced the view that perceptions of TB as being a disease carrying with it a stigma contributed to a delay in seeking healthcare. This was also exacerbated in patients with HIV-positive. Given that HIV-positive status is still subject to stigma in some parts of society, patients demonstrated additional reluctance to seek out healthcare if they were known to be HIV-positive whilst also experiencing symptoms of TB. Discussion: The study highlights that accurate and objective information about TB is required to reduce societal stigmatisation related to the disease, thereby reducing the reluctance of patients to access healthcare. [ABSTRACT FROM AUTHOR]

Cattle practitioners are responsible for the health and welfare of their patients, including minimising pain and discomfort. Surveys of practitioners have shown wide variation in the recognition of painful processes in cattle, and in the use of analgesic agents. Here we investigate assessment of pain in cattle, analgesic options available, and some of the barriers to analgesic use. In this clinical forum the panel members consider what the gold standards in pain relief are, and what is being done in the field. [ABSTRACT FROM AUTHOR]

This study examined influences on delinquency and recidivism using structural equation modeling. The sample comprised 199,204 individuals: 99,602 youth whose cases had been processed by the South Carolina Department of Juvenile Justice and a matched control group of 99,602 youth without juvenile records. Structural equation modeling for the outcome of delinquent versus nondelinquent status showed direct paths of two latent constructs, developmental exceptionalities and early parenting problems, to delinquent outcome, with developmental problems also mediating the relationship between adverse parenting and delinquency. Separate analysis of the delinquent group indicated gender differences in the predictors of more serious offending (early arrests and recidivism), with adverse parenting a significant influence for girls only. Implications for prevention of juvenile delinquency were addressed. [ABSTRACT FROM AUTHOR]

Background aims. Cytotoxic T lymphocytes modified with chimeric antigen receptors (CARs) for adoptive immunotherapy of hematologic malignancies are effective in pre-clinical models, and this efficacy has translated to success in several clinical trials. Many early trials were disappointing in large part because of the lack of proliferation and subsequent persistence of transferred cells. Recent investigations have pointed to the importance of delivering highly proliferative cells, whether of naive or early memory phenotypes. Methods. We investigated the influence of two common cell culturing methods used in early trials and their relationship to T-cell phenotype and pre-clinical efficacy. Results. We observed that stimulation with soluble anti-CD3 antibody OKT-3 and high-dose interleukin-2 produces more effector memory-type T cells with shorter average telomeres when compared with cells generated with the use of CD3/CD28 beads. When used in xenograft models of leukemia, bead-stimulated cells proliferated earlier and to a higher degree than those generated with the use of OKT-3/IL2 and resulted in better disease control despite no difference in distribution or migration throughout the mouse. Inclusion of the known successful clinical 4-1BB endodomain in the CAR could not rescue the function of OKT-3/IL-2-cultured cells. T cells isolated from animals that survived long-term (>120 days) retained a central memory-like phenotype and demonstrated a memory response to a large re-challenge of CD 19-positive leukemia. Conclusions. In summary, we confirm that cells with a younger phenotype or higher proliferative capacity perform better in pre-clinical models and that cell culturing influences cell phenotype seemingly independent of the 4-1BB endodomain in the CAR structure. [ABSTRACT FROM AUTHOR]

The authors examined the role of early adverse experiences, mental health problems, and disabilities in the prediction of juvenile delinquency and recidivism, using a matched-control group design. The delinquent group comprised 99,602 youth, born between 1981 and 1988, whose cases had been processed by the South Carolina Department of Juvenile Justice. Records of 99,602 controls, matched by age, race, and gender were drawn from the records of the South Carolina Department of Education. Data on Child Protective Services, foster care, mental health referrals, and diagnoses as well as information about eligibility for free/reduced-price lunch were obtained from the South Carolina Budget and Control Board, Office of Research and Statistics. Logistic regression analyses showed that parental maltreatment and foster care made unique contributions to the prediction of membership in a delinquent sample. Presence of a public school classification of learning disability or emotional/behavioral disorder was also predictive of delinquent outcomes. A prearrest Diagnostic and Statistical Manual of Mental Disorders (4th ed.) diagnosis relating to aggressive behavior (e.g., conduct disorder) was the strongest predictor of delinquency. Analyses conducted on the delinquent sample to predict recidivism showed a similar pattern, with an early mental health diagnosis of an aggressive disorder the strongest predictor of recidivism. [ABSTRACT FROM AUTHOR]