Key Topics on End-of-Life Care for African Americans

Racial classifications of human populations are politically and socially determined. There is no biological or genetic basis for these racial classifications. Health behaviors may be influenced by culture and poverty. Disparities in health outcomes, sometimes resulting in higher mortality rates for African-Americans appear to influence end of life decision-making attitudes and behaviors. To improve the quality of end of life care in African-American communities, health care professionals must better understand and work to eliminate disparities in health care, increase their own skills, knowledge and confidence in palliative and hospice care, and improve awareness of the benefits and values of hospice and palliative care in their patients and families

Exile Vol. XX No. 1

ARTWORK by Sue Sartarelli cover, 24 by Chris Schulze 5, 24, 29 by Heather Richey 6 by Katheryn Riedl 7 by Jane Joldersma 10 by Jan Mosher 12 Pat Victory 15 Rona Rosen 20, 31 Arthur Ernst 21 Kim McMullen 24 FICTION First Time by Bud Foufos 3-4 Father\u27s Last Party by Vic Coccimiglio 11 untitled by Catherine Bader 16-17 God and Sergeant Mays by J. Frank Burkhard 22 Pages of a Story by Peter Porteous 27-31 POETRY The Rest by Ezra Pound (preface) In the Midst of an Echo by Phil Mercurio 4 Sierra Madre Prose by John Purcell 5 untitled by Sue Payne 6 untitled by Cathy Graff 6 untitled by Sharon Singleton 7 Big Al by Phil Mercurio 9-10 untitled by Sharon Singleton 12 Folksinger by Alison Orleans 13 Sweat Rebellion by S. Hunt 13 Blackgrey by Laurie Wharton 14 What is she to you? by Peter Porteous 18 Pojects by Mary Mueller 21 untitled by Dawn Patnode 25 The Barn by Mary Schloss 25 PHOTOGRAPHY by Bruce Andre 1, 18 by Jane Joldersma 4, 23, 26 by Breese Olander 8 by Pam Purcell 8 by Loree Ruman 13, 14 Foster Schmidt 19 Chip Andreae 19, 23 Nancy Pickenson 26 Nancy Chorpenning 32 Many thanks to the advertising agencie -2 Pgs. 25 and 26 are out of order in the published edition and can be found between pages 8 and 9

Maternal SARS-CoV-2 sero-surveillance using newborn dried blood spot (DBS) screening specimens highlights extent of low vaccine uptake in pregnant women

SARS-CoV-2 vaccine uptake in pregnant women is believed to be low and lags behind the general population contributing to increased hospital admissions, and poor maternal and fetal outcomes. However, there is a paucity of information on the SARS-CoV-2 serostatus of pregnant women to help inform policy planning and assess impact of interventions to improve vaccine uptake in this at-risk group. We analyzed 8,683 residual, anonymized newborn screening dried bloodspot (DBS) specimens during a 15-month period (October 2020 to December 2021) in Wales (UK) for SARS-CoV-2 IgG-antibodies. We compared newborn DBS antibody-positive rates to the percentage number of pregnant women vaccinated and the percentage number of antibody-positive adults. In December 2021, 47.8% of women in Wales had received two doses of the vaccine by their delivery date; however, only 41.1% of DBS specimens had high antibody concentrations. Results indicate that a proportion of pregnant women remain at higher-risk of COVID complications, particularly given the reduction in antibody neutralization of Omicron versus the Delta variant. Our study demonstrates the utility of newborn screening DBS specimens to monitor SARS-CoV-2 serostatus in pregnant women representing maternal vaccination and natural infection in almost real-time, defining the immunity gap and impact of any interventions

A Unique Resource Mutualism between the Giant Bornean Pitcher Plant, Nepenthes rajah, and Members of a Small Mammal Community

The carnivorous pitcher plant genus Nepenthes grows in nutrient-deficient substrates and produce jug-shaped leaf organs (pitchers) that trap arthropods as a source of N and P. A number of Bornean Nepenthes demonstrate novel nutrient acquisition strategies. Notably, three giant montane species are engaged in a mutualistic association with the mountain treeshrew, Tupaia montana, in which the treeshrew defecates into the pitchers while visiting them to feed on nectar secretions on the pitchers' lids

Invertebrate terrestrial consumer inventory in Cascade Douglas-fir - western hemlock forests

Insects represent the most diverse and abundant group of consumers know. The overall objective of this study was to obtain relative density estimates of the dominant taxa and identify their primary functions in order to assist consumer modelling efforts

Climatology of surface meteorology, surface fluxes, cloud fraction, and radiative forcing over the southeast Pacific from buoy observations

Author Posting. © American Meteorological Society, 2009. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Climate 22 (2009): 5527–5540, doi:10.1175/2009JCLI2961.1.A 5-yr climatology of the meteorology, including boundary layer cloudiness, for the southeast Pacific region is presented using observations from a buoy located at 20°S, 85°W. The sea surface temperature and surface air temperature exhibit a sinusoidal seasonal cycle that is negatively correlated with surface pressure. The relative humidity, wind speed, and wind direction show little seasonal variability. But the advection of cold and dry air from the southeast varies seasonally and is highly correlated with the latent heat flux variations. A simple model was used to estimate the monthly cloud fraction using the observed surface downwelling longwave radiative flux and surface meteorological parameters. The annual cycle of cloud fraction is highly correlated to that of S. A. Klein: lower-tropospheric stability parameter (0.87), latent heat flux (−0.59), and temperature and moisture advection (0.60). The derived cloud fraction compares poorly with the International Satellite Cloud Climatology Project (ISCCP)-derived low-cloud cover but compares well (0.86 correlation) with ISCCP low- plus middle-cloud cover. The monthly averaged diurnal variations in cloud fraction show marked seasonal variability in the amplitude and temporal structure. The mean annual cloud fraction is lower than the mean annual nighttime cloud fraction by about 9%. Annual and diurnal cycles of surface longwave and shortwave cloud radiative forcing were also estimated. The longwave cloud radiative forcing is about 45 W m−2 year-round, but, because of highly negative shortwave cloud radiative forcing, the net cloud radiative forcing is always negative with an annual mean of −50 W m−2.This research was supported by the Climate Prediction Program for the Americas (CPPA) of NOAA’s Climate Program Office. The Stratus Ocean Reference Station at 20°S, 85°W is supported by NOAA’s Climate Observation Program

Middle Neolithic pits and a burial at West Amesbury, Wiltshire

Excavations on the south-eastern slopes of King Barrow Ridge, 1.5 km east of Stonehenge, revealed five pits, a grave and other features of Middle Neolithic date. Analysis of the pit assemblages and the partial inhumation interred in the grave has provided insights into lifeways in this landscape in the late fourth millennium cal BC. Evidence suggests that the area was visited by a pastoralist, mobile community on a semi-regular basis for a significant period, in late autumn or winter. Selected remnants of craft-working and consumption were deposited in pits, before deliberate infilling. These depositions repeatedly memorialised activity on the hillside at a time of contemporary activity elsewhere on King Barrow Ridge and at the future site of Stonehenge. Middle Neolithic pits are present in significant numbers across King Barrow Ridge, and alongside pits in the Durrington area, form one of the densest concentrations of such activity in the region. Long distance mobility is suggested by the possible Irish origins of the inhumation, the first Middle Neolithic individual excavated in the environs of Stonehenge. Whilst of significance for understanding the Middle Neolithic in the WHS and the region, this research also hints at the roots of Late Neolithic monumentalisation of this landscape

Fish Oil Increases the Duodenal Flow of Long Chain Polyunsaturated Fatty Acids and trans-11 18:1 and Decreases 18:0 in Steers via Changes in the Rumen Bacterial Community

Ruminant fat is rich in SFA, partly due to the biohydrogenation of dietary PUFA to SFA in the rumen. This process can be inhibited by the dietary inclusion of fish oil. The only bacteria isolated from the rumen capable of converting PUFA to SFA are closely related to Clostridium proteoclasticum. The aim of this study was to investigate if a correlation could be found in vivo between dietary fish oil inclusions and the composition of the ruminal bacterial community and specifically of C. proteoclasticum. Six Hereford × Friesian steers, prepared with ruminal and duodenal cannulae, received grass silage plus 1 of 3 concentrates resulting in total dietary fish oil contents of 0, 1, or 3% of dry matter. A dual flow marker technique was employed to estimate the relative flow of fatty acids. Steers fed the 3% fish oil diet had 100% increases in trans 18:1 flow, whereas 18:0 flow declined to 39% of steers fed the control diet. 16S ribosomal RNA-based denaturing gradient gel electrophoresis profiles obtained from ruminal digesta showed major changes in the bacterial community within steers fed the 3% fish oil diet. Quantitative PCR indicated only a weak relation between numbers of C. proteoclasticum and 18:0 flow between treatments and in individual steers (P < 0.05, but the percentage variance accounted for only 22.8) and did not provide unambiguous evidence that numbers of C. proteoclasticum in the rumen dictate the ratios of SFA:PUFA available for absorption by the animal. Understanding which microbes biohydrogenate PUFA in the rumen is key to developing novel strategies to improve the quality of ruminant products

MARVELS-1: A face-on double-lined binary star masquerading as a resonant planetary system; and consideration of rare false positives in radial velocity planet searches

We have analyzed new and previously published radial velocity observations of MARVELS-1, known to have an ostensibly substellar companion in a ~6- day orbit. We find significant (~100 m/s) residuals to the best-fit model for the companion, and these residuals are naively consistent with an interior giant planet with a P = 1.965d in a nearly perfect 3:1 period commensuribility (|Pb/Pc - 3| < 10^{-4}). We have performed several tests for the reality of such a companion, including a dynamical analysis, a search for photometric variability, and a hunt for contaminating stellar spectra. We find many reasons to be critical of a planetary interpretation, including the fact that most of the three-body dynamical solutions are unstable. We find no evidence for transits, and no evidence of stellar photometric variability. We have discovered two apparent companions to MARVELS-1 with adaptive optics imaging at Keck; both are M dwarfs, one is likely bound, and the other is likely a foreground object. We explore false-alarm scenarios inspired by various curiosities in the data. Ultimately, a line profile and bisector analysis lead us to conclude that the ~100 m/s residuals are an artifact of spectral contamination from a stellar companion contributing ~15-30% of the optical light in the system. We conclude that origin of this contamination is the previously detected radial velocity companion to MARVELS-1, which is not, as previously reported, a brown dwarf, but in fact a G dwarf in a face-on orbit.Comment: ApJ 770, 119. 24 pp emulate ApJ style, 12 figures (One is very large). v2: corrects two (important!) errors: A priori chance of this alignment or worse is 0.1% (not 0.01%) and the primary has THREE total companions (not four

A Multi-Center, Qualitative Assessment of Pediatrician and Maternal Perspectives on Rotavirus Vaccines and the Detection of Porcine circovirus

<p>Abstract</p> <p>Background</p> <p>In 2010, researchers using novel laboratory techniques found that US-licensed rotavirus vaccines contain DNA or DNA fragments from <it>Porcine circovirus </it>(PCV), a virus common among pigs but not believed to cause illness in humans. We sought to understand pediatricians' and mothers' perspectives on this finding.</p> <p>Methods</p> <p>We conducted three iterations of focus groups for pediatricians and non-vaccine hesitant mothers in Seattle, WA, Cincinnati, OH, and Rochester, NY. Focus groups explored perceptions of rotavirus disease, rotavirus vaccination, and attitudes about the detection of PCV material in rotavirus vaccines.</p> <p>Results</p> <p>Pediatricians understood firsthand the success of rotavirus vaccines in preventing severe acute gastroenteritis among infants and young children. They measured this benefit against the theoretical risk of DNA material from PCV in rotavirus vaccines, determining overall that the PCV finding was of no clinical significance. Particularly influential was the realization that the large, randomized clinical trials that found both vaccines to be highly effective and safe were conducted with DNA material from PCV already in the vaccines.</p> <p>Most mothers supported the ideal of full disclosure regarding vaccination risks and benefits. However, with a scientific topic of this complexity, simplified information regarding PCV material in rotavirus vaccines seemed frightening and suspicious, and detailed information was frequently overwhelming. Mothers often remarked that if they did not understand a medical or technical topic regarding their child's health, they relied on their pediatrician's guidance.</p> <p>Many mothers and pediatricians were also concerned that persons who abstain from pork consumption for religious or personal reasons may have unsubstantiated fears of the PCV finding.</p> <p>Conclusions</p> <p>Pediatricians considered the detection of DNA material from PCV in rotavirus vaccines a "non-issue" and reported little hesitation in continuing to recommend the vaccines. Mothers desired transparency, but ultimately trusted their pediatrician's recommendation. Both vaccines are currently approved for their intended use, and no risk of human PCV illness has been reported. Communicating this topic to pediatricians and mothers requires sensitivity to a broad range of technical understanding and personal concerns.</p