The Emergency Room Admission: How Far Does the Open Door Go?

In recent years many private and some public hospitals have assumed a new proprietary persona, a business-like posture that clashes with the traditional hospital goals of charity and community service. This conflict may be most acute in the emergency room where the hospital may further its financial interests by quickly transferring or discharging undesirable emergency patients. This article explores the extent of a private hospital’s legal obligation to treat a patient once emergency care has begun. It begins by looking at hospital revolutions, emergency rooms, and the standards of emergency care. It then explores the common law and “no duty” rule, the open door policy, the duty to continue emergency care, and the standard of conduct

Water Quality Conditions and Restoration of Submerged Aquatic Vegetation (SAV) in the Tidal Freshwater James River: 2003-2004

In 2003-2004 wild celery (Vallisneria americana) whole shoots and seeds were transplanted into four sites in the Hopewell region of the tidal James River. The SAV transplants were sampled by the Virginia Institute of Marine Science (VIMS) for survivorship and growth at bi-weekly to monthly intervals throughout the growing season. Concurrently, water quality sampling was conducted at bi-weekly intervals throughout the year for water column nutrients, chlorophyll a, suspended solids, water transparency and other chemical and physical constituents important for SAV growth. Objectives of the study were to: 1) expand the SAV transplanted plots within the study sites previously transplanted; 2) conduct water quality sampling using both fixed station and continuous underway Dataflow sampling; 3) evaluate techniques for assessing visual surface water algal conditions and water color characteristics; 4) evaluate the relationships between SAV transplant performance and water quality. SAV growth and survival were evident at all sites when the plants were protected from herbivory. Seeds obtained from wild stock and planted within the exclosures germinated and produced adult plants at each of the sites. The transplanted beds demonstrated limited impacts from hurricane Isabel with losses only evident at one transplant site. Water quality conditions in 2003 and 2004 were characterized by relatively low chlorophyll concentrations in comparison to 2002. River flow appeared to be inversely related to chlorophyll levels with a precipitous drop in chlorophyll evident for 2003 and 2004 (higher flow years) in comparison to 2002 (low flow year). Chlorophyll concentrations in 2003 and 2004 were well below the SAV habitat criteria (15mg/l) that have been associated with SAV growth to 1m. Proposed seasonal numeric chlorophyll limits under consideration by the Va. DEQ for the tidal freshwater James River (10 to 20 mg/l) would have been met in most areas in 2003 and 2004, but not in 2002. Turbidity levels were comparable among both high flow and low flow years. Water column nutrient concentrations did not vary greatly as river flow increased in 2003 and 2004 from lower flows in 2002. High ammonium concentrations found throughout this region in 2002 have not been evident since. Algal condition assessments conducted in 2004 showed little visual algal impairment. Several visual water color assessment techniques using the Flore-Ule color systems and Munsell color charts were also investigated. None were very suitable for quantifying algal and phytoplankton concentrations in this environment. This was partly due to the relative low phytoplankton concentrations present during most of this study period, the confounding effects of the varying ambient conditions, and partly due to the subjective nature of the assessment techniques themselves

Rainbow Kaposi's Sarcoma-Associated Herpesvirus Revealed Heterogenic Replication with Dynamic Gene Expression.

Molecular mechanisms of Kaposi's sarcoma-associated herpesvirus (KSHV) reactivation have been studied primarily by measuring the total or average activity of an infected cell population, which often consists of a mixture of both nonresponding and reactivating cells that in turn contain KSHVs at various stages of replication. Studies on KSHV gene regulation at the individual cell level would allow us to better understand the basis for this heterogeneity, and new preventive measures could be developed based on findings from nonresponding cells exposed to reactivation stimuli. Here, we generated a recombinant reporter virus, which we named "Rainbow-KSHV," that encodes three fluorescence-tagged KSHV proteins (mBFP2-ORF6, mCardinal-ORF52, and mCherry-LANA). Rainbow-KSHV replicated similarly to a prototype reporter-KSHV, KSHVr.219, and wild-type BAC16 virus. Live imaging revealed unsynchronized initiation of reactivation and KSHV replication with diverse kinetics between individual cells. Cell fractionation revealed temporal gene regulation, in which early lytic gene expression was terminated in late protein-expressing cells. Finally, isolation of fluorescence-positive cells from nonresponders increased dynamic ranges of downstream experiments 10-fold. Thus, this study demonstrates a tool to examine heterogenic responses of KSHV reactivation for a deeper understanding of KSHV replication.IMPORTANCE Sensitivity and resolution of molecular analysis are often compromised by the use of techniques that measure the ensemble average of large cell populations. Having a research tool to nondestructively identify the KSHV replication stage in an infected cell would not only allow us to effectively isolate cells of interest from cell populations but also enable more precise sample selection for advanced single-cell analysis. We prepared a recombinant KSHV that can report on its replication stage in host cells by differential fluorescence emission. Consistent with previous host gene expression studies, our experiments reveal the highly heterogenic nature of KSHV replication/gene expression at individual cell levels. The utilization of a newly developed reporter-KSHV and initial characterization of KSHV replication in single cells are presented

Diclidophora merlangi (Kuhn, 1829) Krøyer, 1838 (Monogenea : Diclidophoridae) as an indicator of hydrocarbon pollution in the North Sea

Acknowledgements We thank the crews and scientific staff on the cruises of FRS Scotia during which these samples were collected. We are grateful to Dr Coby Needle of Marine Scotland for his helpful comments on an earlier draft of the manuscript, and to the anonymous reviewer for his constructive comments. We wish to dedicate this study to the memory of Dr H.H. Williams, whose original idea it was to investigate D. merlangi as an indicator of hydrocarbon pollution.Peer reviewedPostprin

Legislature’s Planning Committee 2015 Report

A message from Senator Tanya Cook, Chair of the Legislature’s Planning Committee 2015-2016 The Legislature’s Planning Committee serves a vital role in the Nebraska Unicameral. In an era of term limits, the Planning Committee provides future-focused, data-driven research for senators to use in crafting smart, effective policies. The 2015 Database Update continues to highlight nine key benchmarks – Economy, Agriculture, Natural Resources, State and Local Government, Education, Health and Human Services, Public Safety, Transportation, and Telecommunications – that give a well-rounded picture of the state’s strengths, struggles, and opportunities. The Planning Committee owes a debt of gratitude to Dr. John Bartle and Jerry Deichert, who have worked tirelessly since the Committee’s founding to ensure the best, most accurate data is provided to Nebraska’s policymakers. Thanks are also in order for the staffers and students at the University of Nebraska-Omaha’s College of Public Affairs and Community Service, as well as the other professors and researchers who have worked with the Committee over the years. I hope the data in this update will inform and inspire ever better policy decisions and discussions in Nebraska. The Planning Committee’s collection of studies and data resources will only continue to grow, and I trust that Nebraska’s policymakers will continue to utilize the information wisely. Sincerely,Senator Tanya CookLegislative District 1

A survey of carbon nanotube interconnects for energy efficient integrated circuits

This article is a review of the state-of-art carbon nanotube interconnects for Silicon application with respect to the recent literature. Amongst all the research on carbon nanotube interconnects, those discussed here cover 1) challenges with current copper interconnects, 2) process & growth of carbon nanotube interconnects compatible with back-end-of-line integration, and 3) modeling and simulation for circuit-level benchmarking and performance prediction. The focus is on the evolution of carbon nanotube interconnects from the process, theoretical modeling, and experimental characterization to on-chip interconnect applications. We provide an overview of the current advancements on carbon nanotube interconnects and also regarding the prospects for designing energy efficient integrated circuits. Each selected category is presented in an accessible manner aiming to serve as a survey and informative cornerstone on carbon nanotube interconnects relevant to students and scientists belonging to a range of fields from physics, processing to circuit design

Securitization and the construction of security

Those interested in the construction of security in contemporary international politics have increasingly turned to the conceptual framework of `securitization'. This article argues that while an important and innovative contribution, the securitization framework is problematically narrow in three senses. First, the form of act constructing security is defined narrowly, with the focus on the speech of dominant actors. Second, the context of the act is defined narrowly, with the focus only on the moment of intervention. Finally, the framework of securitization is narrow in the sense that the nature of the act is defined solely in terms of the designation of threats. In outlining this critique, the article points to possibilities for developing the framework further as well as for the need for those applying it to recognize both limits of their claims and the normative implications of their analysis. I conclude by pointing to how the framework might fit within a research agenda concerned with the broader construction of security

Aedes aegypti uses RNA interference in defense against Sindbis virus infection

<p>Abstract</p> <p>Background</p> <p>RNA interference (RNAi) is an important anti-viral defense mechanism. The <it>Aedes aegypti </it>genome encodes RNAi component orthologs, however, most populations of this mosquito are readily infected by, and subsequently transmit flaviviruses and alphaviruses. The goal of this study was to use <it>Ae. aegypti </it>as a model system to determine how the mosquito's anti-viral RNAi pathway interacts with recombinant Sindbis virus (SINV; family <it>Togaviridae</it>, genus <it>Alphavirus</it>).</p> <p>Results</p> <p>SINV (TR339-eGFP) (+) strand RNA, infectious virus titers and infection rates transiently increased in mosquitoes following dsRNA injection to cognate <it>Ago2</it>, <it>Dcr2</it>, or <it>TSN </it>mRNAs. Detection of SINV RNA-derived small RNAs at 2 and 7 days post-infection in non-silenced mosquitoes provided important confirmation of RNAi pathway activity. Two different recombinant SINV viruses (MRE16-eGFP and TR339-eGFP) with significant differences in infection kinetics were used to delineate vector/virus interactions in the midgut. We show virus-dependent effects on RNAi component transcript and protein levels during infection. Monitoring midgut <it>Ago2</it>, <it>Dcr2</it>, and <it>TSN </it>transcript levels during infection revealed that only <it>TSN </it>transcripts were significantly increased in midguts over blood-fed controls. Ago2 protein levels were depleted immediately following a non-infectious bloodmeal and varied during SINV infection in a virus-dependent manner.</p> <p>Conclusion</p> <p>We show that silencing RNAi components in <it>Ae. aegypti </it>results in transient increases in SINV replication. Furthermore, <it>Ae. aegypti </it>RNAi is active during SINV infection as indicated by production of virus-specific siRNAs. Lastly, the RNAi response varies in a virus-dependent manner. These data define important features of RNAi anti-viral defense in <it>Ae. aegypti</it>.</p

Small RNA profiling of Dengue virus-mosquito interactions implicates the PIWI RNA pathway in anti-viral defense

<p>Abstract</p> <p>Background</p> <p>Small RNA (sRNA) regulatory pathways (SRRPs) are important to anti-viral defence in mosquitoes. To identify critical features of the virus infection process in Dengue serotype 2 (DENV2)-infected <it>Ae. aegypti</it>, we deep-sequenced small non-coding RNAs. Triplicate biological replicates were used so that rigorous statistical metrics could be applied.</p> <p>Results</p> <p>In addition to virus-derived siRNAs (20-23 nts) previously reported for other arbovirus-infected mosquitoes, we show that PIWI pathway sRNAs (piRNAs) (24-30 nts) and unusually small RNAs (usRNAs) (13-19 nts) are produced in DENV-infected mosquitoes. We demonstrate that a major catalytic enzyme of the siRNA pathway, Argonaute 2 (Ago2), co-migrates with a ~1 megadalton complex in adults prior to bloodfeeding. sRNAs were cloned and sequenced from Ago2 immunoprecipitations. Viral sRNA patterns change over the course of infection. Host sRNAs were mapped to the published aedine transcriptome and subjected to analysis using edgeR (Bioconductor). We found that sRNA profiles are altered early in DENV2 infection, and mRNA targets from mitochondrial, transcription/translation, and transport functional categories are affected. Moreover, small non-coding RNAs (ncRNAs), such as tRNAs, spliceosomal U RNAs, and snoRNAs are highly enriched in DENV-infected samples at 2 and 4 dpi.</p> <p>Conclusions</p> <p>These data implicate the PIWI pathway in anti-viral defense. Changes to host sRNA profiles indicate that specific cellular processes are affected during DENV infection, such as mitochondrial function and ncRNA levels. Together, these data provide important progress in understanding the DENV2 infection process in <it>Ae. aegypti</it>.</p