Feeding infants: choice-specific considerations, parental obligation, and pragmatic satisficing

Health institutions recommend that young infants be exclusively breastfed on demand, and it is widely held that parents who can breastfeed have an obligation to do so. This has been challenged in recent philosophical work, especially by Fiona Woollard. Woollard’s work critically engages with two distinct views of parental obligation that might ground such an obligation—based on maximal benefit and avoidance of significant harm—to reject an obligation to breastfeed. While agreeing with Woollard’s substantive conclusion, this paper (drawing on philosophical discussion of the ‘right to rear’) argues that there are several more moderate views of parental obligation which might also be thought to ground parental obligation. We first show that an obligation to breastfeed might result not from a general obligation to maximally benefit one’s child, but from what we call ‘choice-specific’ obligations to maximise benefit within particular activities. We then develop this idea through two views of parental obligation—the Dual Interest view, and the Best Custodian view—to ground an obligation to exclusively breastfeed on demand, before showing how both these more moderate views fail. Finally, we argue that not only is there no general obligation to breastfeed children, but that it is often morally right not to do so. Since much advice from health institutions on this issue implies that exclusive breastfeeding on demand is the best option for all families, our argument drives the feeding debate forward by showing that this advice often misrepresents parents’ moral obligations in potentially harmful ways

The Impact of Racial Disparities and Outcomes on Urinary Anastomotic Leak in Radical Prostatectomy

Prostate cancer is the leading malignancy and third most common cause of cancer death among men. In the United States, racial disparities exist in prostate cancer incidence and mortality rates. According to the National Cancer Institute, African American (AA) men have a significantly increased incidence of prostate cancer compared to Caucasians or Asians. Urinary leak at the urethrovesical anastomosis has been cited as a complication of radical prostatectomy (RP), with incidence rates as high as 23%. Urinary anastomotic leak is associated with increased rates of ileus, prolonged hospitalization rates, and longer time to achieve continence. The etiology of risk factors in urinary anastomotic leak post RP is most likely multifactorial; however, the impact of racial disparities on incidence of urinary anastomotic leak has not been studied. The objective of this study was to determine the impact of racial group on rates of urinary anastomotic leak in patients who have undergone RP for malignant neoplasm of the prostate. We predict that higher pathological staging and comorbid conditions contribute to urinary anastomotic leak in AAs. Secondary factors including postoperative complications were also examined to analyze their impact on urinary anastomotic leaks between racial groups

Closing the Coverage Gaps: Reducing Health Insurance Disparities in Massachusetts

Massachusetts has been exemplary in developing health insurance coverage policies to cover its residents. By 2019, the state's uninsurance rate was 3.0 percent, the lowest rate in the nation, representing about 204,000 uninsured residents. While the state's overall uninsured rate at a given point in time is low, more than twice as many people - 503,000, or 7.3 percent of the population - experienced a gap in coverage over the previous twelve months. And importantly, not all groups benefit equally. People who are Black or Hispanic, or who have lower incomes, experience significantly higher rates of uninsurance than the state population overall. As a result, these groups are more likely to face access barriers and financial insecurity associated with being uninsured.The purpose of this report is to begin charting a course toward closing the coverage gaps in Massachusetts, with a particular focus on creating a more racially and ethnically equitable system of coverage. The report and accompanying infographics describe the people in Massachusetts without health insurance and the barriers to coverage they face, including affordability, administrative complexity, and immigration, language, and cultural barriers. It then proposes a menu of policy options that address the specific circumstances in Massachusetts. The proposed options are meant to inform a statewide conversation about the best approaches to closing the remaining coverage gaps in Massachusetts and removing structural barriers that result in racial and ethnic disparities in health insurance coverage

Pyroclastic Deposits in Floor-Fractured Craters: A Unique Style or Lunar Basaltic Volcanism?

The lunar maria were formed by effusive fissure flows of low-viscosity basalt. Regional pyroclastic deposits were formed by deep-sourced fire-fountain eruptions dominated by basaltic glass. Basaltic material is also erupted from small vents within floor-fractured impact craters. These craters are characterized by shallow, flat floors cut by radial, concentric and/or polygonal fractures. Schultz [1] identified and classified over 200 examples. Low albedo pyroclastic deposits originate from depressions along the fractures in many of these craters

Pyroclastic Deposits in the Floor-fractured Crater Alphonsus

Alphonsus, the 118 km diameter floor-fractured crater, is located immediately east of Mare Nubium. Eleven pyroclastic deposits have been identified on the crater's floor. Early telescopic spectra suggest that the floor of Alphonsus is noritic, and that the pyroclastic deposits contain mixtures of floor material and a juvenile component including basaltic glass. Head and Wilson contend that Nubium lavas intruded the breccia zone beneath Alphonsus, forming dikes and fractures on the crater floor. In this model, the magma ascended to the level of the mare but cooled underground, and a portion broke thru to the surface in vulcanian (explosive) eruptions. Alternatively, the erupted material could be from a source unrelated to the mare, in the style of regional pyroclastic deposits. High-resolution images and spectroscopy from the Moon Mineralogy Mapper (M3), Diviner Lunar Radiometer, and Lunar Reconnaissance Orbiter Camera Narrow Angle Camera (NAC) provide data to test these formation models. Spectra from M3 confirm that the crater floor is primarily composed of noritic material, and that the Nubium lavas are basaltic. Spectra from the three largest pyroclastic deposits in Alphonsus are consistent with a minor low- Ca pyroxene component in a glass-rich matrix. The centers of the 2 micron absorption bands have wavelengths too short to be of the same origin as the Nubium basalts. Diviner Christiansen feature (CF) values were used to estimate FeO abundances for the crater floor, Nubium soil, and pyroclastic deposits. The estimated abundance for the crater floor (7.5 +/- 1.4 wt.%) is within the range of FeO values for Apollo norite samples. However, the estimated FeO abundance for Nubium soil (13.4 +/- 1.4 wt.%) is lower than those measured in most mare samples. The difference may reflect contamination of the mare soil by highland ejecta. The Diviner-derived FeO abundance for the western pyroclastic deposit is 13.8 +/- 3.3 wt.%. This is lower than the values for mare soil samples, but within the range of analyzed pyroclastic glasses. The NAC images of the pyroclastic vents highlight their bright wall materials. The M3 spectra of the southeastern vent indicate that this bright material is noritic, likely crater floor material exposed by explosive eruption. These observations address the hypothesis that Nubium lavas intruded the fracture network beneath Alphonsus, leading to localized vulcanian-style eruptions. This model implies that the eruption products should be dominated by crystalline basalt fragments similar in elemental composition and mineralogy to mare lavas. The bright noritic material exposed in the vent walls is consistent with explosive eruptions. The estimated FeO abundances for the pyroclastic deposits are too low to be consistent with FeO abundances measured in mare basalts, but are within the range of pyroclastic glass samples. The visible- to near-infrared (VIS-NIR) spectra of the pyroclastic deposits and Nubium soils are significantly different, suggesting that the pyroclastics are unrelated to the mare basalts. The pyroclastic spectra are consistent with Fe-bearing glass plus small amounts of noritic wall rock. Similar glassy materials dominate regional pyroclastic deposits, suggesting a deep source for the pyroclastics observed in Alphonsus

Age Moderates the Effect of Injury Severity on Functional Trajectories in Traumatic Brain Injury: A Study Using the NIDILRR Traumatic Brain Injury Model Systems National Dataset.

Age is a risk factor for a host of poor outcomes following traumatic brain injury (TBI), with some evidence suggesting that age is also a source of excess disability. We tested the extent to which age moderates the effect of injury severity on functional trajectories over 15 years post injury. Data from 11,442 participants from the 2020 National Institute of Disability and Independent Living Rehabiitation Research (NIDILRR) Traumatic Brain Injury Model Systems (TBIMS) National Dataset were analyzed using linear mixed effects models. Injury severity was operationally defined using a composite of Glasgow Coma Scale scores, structural imaging findings, and the number of days with post-trauma amnesia. Functioning was measured using the Glasgow Outcomes Scale-Extended. Age at injury was the hypothesized moderator. Race, ethnicity, sex, education, and marital status served as covariates. The results showed a significant confounder-adjusted effect of injury severity and age of injury on the linear slope in functioning. The age effect was strongest for those with mild TBI. Thus, the effects of injury severity on functional trajectory were found to be moderated by age. To optimize outcomes, TBI rehabilitation should be developed specifically for older patients. Age should also be a major focus in TBI research

Are 100 enough? Inferring acanthomorph teleost phylogeny using Anchored Hybrid Enrichment

BACKGROUND: The past decade has witnessed remarkable progress towards resolution of the Tree of Life. However, despite the increased use of genomic scale datasets, some phylogenetic relationships remain difficult to resolve. Here we employ anchored phylogenomics to capture 107 nuclear loci in 29 species of acanthomorph teleost fishes, with 25 of these species sampled from the recently delimited clade Ovalentaria. Previous studies employing multilocus nuclear exon datasets have not been able to resolve the nodes at the base of the Ovalentaria tree with confidence. Here we test whether a phylogenomic approach will provide better support for these nodes, and if not, why this may be. RESULTS: After using a novel method to account for paralogous loci, we estimated phylogenies with maximum likelihood and species tree methods using DNA sequence alignments of over 80,000 base pairs. Several key relationships within Ovalentaria are well resolved, including 1) the sister taxon relationship between Cichlidae and Pholidichthys, 2) a clade containing blennies, grammas, clingfishes, and jawfishes, and 3) monophyly of Atherinomorpha (topminnows, flyingfishes, and silversides). However, many nodes in the phylogeny associated with the early diversification of Ovalentaria are poorly resolved in several analyses. Through the use of rarefaction curves we show that limited phylogenetic resolution among the earliest nodes in the Ovalentaria phylogeny does not appear to be due to a deficiency of data, as average global node support ceases to increase when only 1/3rd of the sampled loci are used in analyses. Instead this lack of resolution may be driven by model misspecification as a Bayesian mixed model analysis of the amino acid dataset provided good support for parts of the base of the Ovalentaria tree. CONCLUSIONS: Although it does not appear that the limited phylogenetic resolution among the earliest nodes in the Ovalentaria phylogeny is due to a deficiency of data, it may be that both stochastic and systematic error resulting from model misspecification play a role in the poor resolution at the base of the Ovalentaria tree as a Bayesian approach was able to resolve some of the deeper nodes, where the other methods failed. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12862-015-0415-0) contains supplementary material, which is available to authorized users

Bacteriocin as Weapons in the Marine Animal-Associated Bacteria Warfare: Inventory and Potential Applications as an Aquaculture Probiotic

As the association of marine animals with bacteria has become more commonly recognized, researchers have increasingly questioned whether these animals actually produce many of the bioactive compounds originally isolated from them. Bacteriocins, ribosomally synthesized antibiotic peptides, constitute one of the most potent weapons to fight against pathogen infections. Indeed, bacteriocinogenic bacteria may prevent pathogen dissemination by occupying the same ecological niche. Bacteriocinogenic strains associated with marine animals are a relevant source for isolation of probiotics. This review draws up an inventory of the marine bacteriocinogenic strains isolated from animal-associated microbial communities, known to date. Bacteriocin-like inhibitory substances (BLIS) and fully-characterized bacteriocins are described. Finally, their applications as probiotics in aquaculture are discussed