Effects of 2- vs 4- Week Attending Physician Inpatient Rotations on Unplanned Patient Revisits, Evaluations by Trainees, and Attending Physician Burnout: A Randomized Trial

Colin West and the Mayo team recently published a meta-analysis of Interventions to Prevent and Reduce Physician Burnout (Lancet 2016; 388: 2272-81) and found that only three randomized studies of structural or organizational interventions have been reported in the literature. Brian Lucas et al. examined the Effects of 2- vs 4- Week Attending Physician Inpatient Rotations on Unplanned Patient Revisits, Evaluations by Trainees, and Attending Physician Burnout (JAMA 2012). The second organizational intervention was the Healthy Work Place (HWP) study by Mark Linzer et al: Interventions to Improve Work Conditions and Clinician Burnout in Primary Care (J Gen Intern Med 2015). Third, Christopher Parshuram et al studied Patient Safety, Resident Well-Being and Continuity of Care with Different Residents Duty Schedules in the Intensive Care Unit (CMAJ 2015). The panel will discuss the findings of these four studies and what further research is needed to determine the most effective interventions for preventing and reducing physician burnout.https://openworks.mdanderson.org/hrc_burnout_presentations/1008/thumbnail.jp

Measuring the effect of farmland preservation on farm profitability

Purchase of development rights (PDR) programs have been created in 27 states to preserve farmland resources. These programs seek to advance several societal objectives, including the protection of farmland from development, retention of rural amenities, and promotion of the economic viability of farming. Using New Jersey farm-level data, this study evaluates whether participation in a state PDR program improves farm profitability. The propensity score matching method is used to correct for selection bias arising from the voluntary nature of these programs. No statistically significant profit differential is found between preserved and observationally equivalent unpreserved farms in our full sample of 4029 farms. When the analysis is replicated across different farm types, we find weak evidence that the profitability of preserved residential lifestyle/retirement farms is lower than that observed for their unpreserved equivalents. In contrast, we find that small farms (<$100,000 in annual sales) operated by individuals for whom farming is a principal occupation earn$414 to $436 more per acre in profit than their observationally equivalent unpreserved counterparts

Measuring the effect of farmland preservation on farm profitability

Purchase of development rights (PDR) programs have been created in 27 states to preserve farmland resources. These programs seek to advance several societal objectives, including the protection of farmland from development, retention of rural amenities, and promotion of the economic viability of farming. Using New Jersey farm-level data, this study evaluates whether participation in a state PDR program improves farm profitability. The propensity score matching method is used to correct for selection bias arising from the voluntary nature of these programs. No statistically significant profit differential is found between preserved and observationally equivalent unpreserved farms in our full sample of 4029 farms. When the analysis is replicated across different farm types, we find weak evidence that the profitability of preserved residential lifestyle/retirement farms is lower than that observed for their unpreserved equivalents. In contrast, we find that small farms (<$100,000 in annual sales) operated by individuals for whom farming is a principal occupation earn$414 to $436 more per acre in profit than their observationally equivalent unpreserved counterparts

Measurement of low-energy cosmic-ray electron and positron spectra at 1 AU with the AESOP-Lite spectrometer

We report on a new measurement of the cosmic ray (CR) electron and positron spectra in the energy range of 20 MeV -- 1 GeV. The data were taken during the first flight of the balloon-borne spectrometer AESOP-Lite (Anti Electron Sub Orbital Payload), which was flown from Esrange, Sweden, to Ellesmere Island, Canada, in May 2018. The instrument accumulated over 130 hours of exposure at an average altitude of 3 g.cm$^{-2}$ of residual atmosphere. The experiment uses a gas Cherenkov detector and a magnetic spectrometer, consisting of a permanent dipole magnet and silicon strip detectors (SSDs), to identify particle type and measure the rigidity. Electrons and positrons were detected against a background of protons and atmospheric secondary particles. The primary cosmic ray spectra of electrons and positrons, as well as the re-entrant albedo fluxes, were extracted between 20 MeV -- 1 GeV during a positive solar magnetic polarity epoch. The positron fraction below 100 MeV appears flat, suggesting diffusion dominated solar modulation at low rigidity. The all-electron spectrum is presented and compared with models from a heliospheric numerical transport code.Comment: 21 pages, 13 figure

Effects of increasing the affinity of CarD for RNA polymerase on Mycobacterium tuberculosis growth, rRNA transcription, and virulence

CarD is an essential RNA polymerase (RNAP) interacting protein in Mycobacterium tuberculosis that stimulates formation of RNAP-promoter open complexes. CarD plays a complex role in M. tuberculosis growth and virulence that is not fully understood. Therefore, to gain further insight into the role of CarD in M. tuberculosis growth and virulence, we determined the effect of increasing the affinity of CarD for RNAP. Using site-directed mutagenesis guided by crystal structures of CarD bound to RNAP, we identified amino acid substitutions that increase the affinity of CarD for RNAP. Using these substitutions, we show that increasing the affinity of CarD for RNAP increases the stability of the CarD protein in M. tuberculosis. In addition, we show that increasing the affinity of CarD for RNAP increases the growth rate in M. tuberculosis without affecting 16S rRNA levels. We further show that increasing the affinity of CarD for RNAP reduces M. tuberculosis virulence in a mouse model of infection despite the improved growth rate in vitro. Our findings suggest that the CarD-RNAP interaction protects CarD from proteolytic degradation in M. tuberculosis, establish that growth rate and rRNA levels can be uncoupled in M. tuberculosis and demonstrate that the strength of the CarD-RNAP interaction has been finely tuned to optimize virulence. IMPORTANCE Mycobacterium tuberculosis, the causative agent of tuberculosis, remains a major global health problem. In order to develop new strategies to battle this pathogen, we must gain a better understanding of the molecular processes involved in its survival and pathogenesis. We have previously identified CarD as an essential transcriptional regulator in mycobacteria. In this study, we detail the effects of increasing the affinity of CarD for RNAP on transcriptional regulation, CarD protein stability, and virulence. These studies expand our understanding of the global transcription regulator CarD, provide insight into how CarD activity is regulated, and broaden our understanding of prokaryotic transcription

Low 25-Hydroxyvitamin D Concentration Is Not Associated With Refractive Error in Middle-Aged and Older Western Australian Adults

Purpose: To investigate the association between serum 25-hydroxyvitamin D (25[OH]D) concentration and refractive error in a community-based cohort of adults aged 46 to 69 years. Methods: Residents of the City of Busselton in Western Australia born between 1946 and 1964 were invited to participate. Participants underwent cycloplegic autorefraction and completed questionnaires on education, occupational sun exposure, and physical activity. Blood samples were collected and serum frozen at −80°C. Serum 25[OH]D concentration was measured by immunoassay. Data on 25[OH]D were deseasonalized and multivariate models built to analyze the association between 25[OH]D concentration and spherical equivalent and myopia, defined as spherical equivalent <−0.50 D. Results: After exclusions, data were available for 4112 participants. Serum 25[OH]D concentration was not associated with spherical equivalent or myopia after adjustment for confounding factors (β = −0.01, 95% confidence interval [CI]: −0.03 to −0.008, P = 0.25, and odds ratio = 1.02, 95% CI: 0.99 to 1.05, P = 0.12, respectively). When participants were classified into 25[OH]D groups of lower (<50 nmol/L), medium (≥50 to <75 nmol/L), and upper (≥75 nmol/L), the upper group had slightly greater myopic refractive error than the medium group (P = 0.02) but not the lower group, after adjustment for confounders. Conclusions: There was no substantial association between 25[OH]D levels and spherical equivalent or odds of myopia in this study. The association previously noted between low serum 25[OH]D level and myopia in younger Western Australians is not evident in later adulthood. Translational Relevance: This study provides further evidence suggesting that vitamin D levels are unrelated to myopia risk in adults and thus not a suitable target for myopia intervention

Isolation, characterization, and genome sequence of the first representative of a novel class within the Chloroflexi that is abundant in some U.S. Great Basin hot springs and may play important roles in N and C cycling

A thermophilic, facultatively microaerophilic, heterotrophic bacterium, designated strain JAD2, was isolated from sediments of Great Boiling Spring (GBS), an ~80oC, circumneutral hot spring in the Great Basin GB). The strain grew anaerobically on yeast extract or peptone with an optimal growth temperature of 70-75oC. Growth was stimulated by addition of 0.01 atm O2 to the culture vessel headspace, but was inhibited by higher concentrations (0.2 atm). Cells of JAD2 formed non-motile filaments ranging from 10 to \u3e300 μm in length, which typically decreased in length during stationary phase. 16S rRNA gene-targeted pyrotag sequencing and clone library data suggest that close relatives of this isolate are prominent members of the sediment communities in GBS. Shotgun sequencing of the JAD2 genome produced an assembly consisting of ~3.2 Mbp with an average G+C content of 67.3%. Phylogenies inferred from the 16S rRNA gene and predicted amino acid sequences of various conserved proteins indicate that JAD2 is the first cultivated representative of the GAL35 group, a new class within the Chloroflexi. Predicted genes in the draft genome encoding a putative carbon monoxide dehydrogenase (coxMSL), nitrite reductase (nrfHA) and nitrous oxide reductase (nosZ) suggest that this isolate may play important roles in N and C cycling in GBS sediments

Space Use and Relative Habitat Selection for Immature Green Turtles Within a Caribbean Marine Protected Area

Background A better understanding of sea turtle spatial ecology is critical for the continued conservation of imperiled sea turtles and their habitats. For resource managers to develop the most effective conservation strategies, it is especially important to examine how turtles use and select for habitats within their developmental foraging grounds. Here, we examine the space use and relative habitat selection of immature green turtles (Chelonia mydas) using acoustic telemetry within the marine protected area, Buck Island Reef National Monument (BIRNM), St. Croix, United States Virgin Islands. Results Space use by turtles was concentrated on the southern side of Buck Island, but also extended to the northeast and northwest areas of the island, as indicated by minimum convex polygons (MCPs) and 99%, 95%, and 50% kernel density estimations (KDEs). On average space use for all categories was \u3c 3 km2 with mean KDE area overlap ranging from 41.9 to 67.7%. Cumulative monthly MCPs and their proportions to full MCPs began to stabilize 3 to 6 detection months after release, respectively. Resource selection functions (RSFs) were implemented using a generalized linear mixed effects model with turtle ID as the random effect. After model selection, the accuracy of the top model was 77.3% and showed relative habitat selection values were highest at shallow depths, for areas in close proximity to seagrass, and in reef zones for both day and night, and within lagoon zones at night. The top model was also extended to predict across BIRNM at both day and night. Conclusion More traditional acoustic telemetry analyses in combination with RSFs provide novel insights into animal space use and relative resource selection. Here, we demonstrated immature green turtles within the BIRNM have small, specific home ranges and core use areas with temporally varying relative selection strengths across habitat types. We conclude the BIRNM marine protected area is providing sufficient protection for immature green turtles, however, habitat protection could be focused in both areas of high space use and in locations where high relative selection values were determined. Ultimately, the methodologies and results presented here may help to design strategies to expand habitat protection for immature green turtles across their greater distribution

Liquid Tissue: Proteomic Profiling of Formalin-Fixed Tissues

Identification and quantitation of candidate biomarker proteins in large numbers of individual tissues is required to validate specific proteins, or panels of proteins, for clinical use as diagnostic, prognostic, toxicological, or therapeutic markers. Mass spectrometry (MS) provides an exciting analytical methodology for this purpose. Liquid Tissue MS protein preparation allows researchers to utilize the vast, already existing, collections offormalin-fixed paraffin-embedded (FFPE) tissues for the procurement of peptides and the analysis across a variety of MS platforms