Active Travel Co-Benefits of Travel Demand Management Policies that Reduce Greenhouse Gas Emissions, MTI Report 12-12

There is increasing evidence that improved health outcomes may be significant co-benefits of land use plans and transport policies that increase active transport (or walking and biking for purposeful travel) and reduce greenhouse gas emissions (GHGs) from vehicle miles traveled (VMT). A greater understanding of these benefits may broaden the constituency for regional planning that supports local and national GHG reduction goals. In this study, California’s activity-based travel demand model (ABM) is applied to (1) demonstrate how this new generation of travel models can be used to produce the active travel data (age and sex distributions) required by comparative risk assessment models to estimate health outcomes for alternative land use and transport plans and to (2) identify the magnitude of change in active travel that may be possible from land use, transit, and vehicle pricing policies for California and its five major regions for a future 2035 time horizon. The results of this study suggest that distance-based vehicle pricing may increase walking by about 10% and biking by about 17%, and concurrently GHG from VMT may be reduced by about 16%. Transit expansion and supportive development patterns may increase active travel by about 2% to 3% for both walk and bike modes while also reducing VMT by about 4% on average. The combination of all three policies may increase time spent walking by about 13% and biking by about 19%, and reduce VMT by about 19%

Provider Perspectives on the Influence of Family on Nursing Home Resident Transfers to the Emergency Department: Crises at the End of Life.

Background. Nursing home (NH) residents often experience burdensome and unnecessary care transitions, especially towards the end of life. This paper explores provider perspectives on the role that families play in the decision to transfer NH residents to the emergency department (ED). Methods. Multiple stakeholder focus groups (n = 35 participants) were conducted with NH nurses, NH physicians, nurse practitioners, physician assistants, NH administrators, ED nurses, ED physicians, and a hospitalist. Stakeholders described experiences and challenges with NH resident transfers to the ED. Focus group interviews were recorded and transcribed verbatim. Transcripts and field notes were analyzed using a Grounded Theory approach. Findings. Providers perceive that families often play a significant role in ED transfer decisions as they frequently react to a resident change of condition as a crisis. This sense of crisis is driven by 4 main influences: insecurities with NH care; families being unprepared for end of life; absent/inadequate advance care planning; and lack of communication and agreement within families regarding goals of care. Conclusions. Suboptimal communication and lack of access to appropriate and timely palliative care support and expertise in the NH setting may contribute to frequent ED transfers

Time for change: a new training programme for morpho-molecular pathologists?

The evolution of cellular pathology as a specialty has always been driven by technological developments and the clinical relevance of incorporating novel investigations into diagnostic practice. In recent years, the molecular characterisation of cancer has become of crucial relevance in patient treatment both for predictive testing and subclassification of certain tumours. Much of this has become possible due to the availability of next-generation sequencing technologies and the whole-genome sequencing of tumours is now being rolled out into clinical practice in England via the 100 000 Genome Project. The effective integration of cellular pathology reporting and genomic characterisation is crucial to ensure the morphological and genomic data are interpreted in the relevant context, though despite this, in many UK centres molecular testing is entirely detached from cellular pathology departments. The CM-Path initiative recognises there is a genomics knowledge and skills gap within cellular pathology that needs to be bridged through an upskilling of the current workforce and a redesign of pathology training. Bridging this gap will allow the development of an integrated 'morphomolecular pathology' specialty, which can maintain the relevance of cellular pathology at the centre of cancer patient management and allow the pathology community to continue to be a major influence in cancer discovery as well as playing a driving role in the delivery of precision medicine approaches. Here, several alternative models of pathology training, designed to address this challenge, are presented and appraised

Emergency department visits and hospitalizations by tube-fed nursing home residents with varying degrees of cognitive impairment: a national study

BACKGROUND: Numerous studies indicate that the use of feeding tubes (FT) in persons with advanced cognitive impairment (CI) does not improve clinical outcomes or survival, and results in higher rates of hospitalization and emergency department (ED) visits. It is not clear, however, whether such risk varies by resident level of CI and whether these ED visits and hospitalizations are potentially preventable. The objective of this study was to determine the rates of ED visits, hospitalizations and potentially preventable ambulatory care sensitive (ACS) ED visits and ACS hospitalizations for long-stay NH residents with FTs at differing levels of CI. METHODS: We linked Centers for Medicare and Medicaid Services inpatient & outpatient administrative claims and beneficiary eligibility data with Minimum Data Set (MDS) resident assessment data for nursing home residents with feeding tubes in a 5% random sample of Medicare beneficiaries residing in US nursing facilities in 2006 (n = 3479). Severity of CI was measured using the Cognitive Performance Scale (CPS) and categorized into 4 groups: None/Mild (CPS = 0-1, MMSE = 22-25), Moderate (CPS = 2-3, MMSE = 15-19), Severe (CPS = 4-5, MMSE = 5-7) and Very Severe (CPS = 6, MMSE = 0-4). ED visits, hospitalizations, ACS ED visits and ACS hospitalizations were ascertained from inpatient and outpatient administrative claims. We estimated the risk ratio of each outcome by CI level using over-dispersed Poisson models accounting for potential confounding factors. RESULTS: Twenty-nine percent of our cohort was considered “comatose” and “without any discernible consciousness”, suggesting that over 20,000 NH residents in the US with feeding tubes are non-interactive. Approximately 25% of NH residents with FTs required an ED visit or hospitalization, with 44% of hospitalizations and 24% of ED visits being potentially preventable or for an ACS condition. Severity of CI had a significant effect on rates of ACS ED visits, but little effect on ACS hospitalizations. CONCLUSIONS: ED visits and hospitalizations are common in cognitively impaired tube-fed nursing home residents and a substantial proportion of ED visits and hospitalizations are potentially preventable due to ACS conditions

Who Are Social Entrepreneurs? Connecting the Stories of Women in the Global Textile and Apparel Industry

Current definitions of social entrepreneurs appear limited in view, delineating social-entrepreneurs as outside elites with special qualities and their work to be complex and lavish. Definitions of social entrepreneurs fail to capture and illustrate the multitudes and diversity of social entrepreneurship. Thus, social entrepreneurship needs refashioning to address the multiple types of intentions (feasibility and desirability) to act, opportunities, and capacities. The present interpretation lacks a holistic standpoint. Using a scenario of analysis of the textile and apparel industry, it becomes evident that micro-entrepreneurs engage daily in solving the complex problem of poverty, unemployment, exploitation, and other social issues through self-employment. They are by their very nature practicing social entrepreneurship. The purpose of this concept paper is not to dispute current definitions of social entrepreneurs but to help make definitions more holistic, by recognizing the contributions of the multiple types of people and organization who attempt to solve societal concerns

Z-FIRE: ISM properties of the z = 2.095 COSMOS Cluster

We investigate the ISM properties of 13 star-forming galaxies within the z~2 COSMOS cluster. We show that the cluster members have [NII]/Ha and [OIII]/Hb emission-line ratios similar to z~2 field galaxies, yet systematically different emission-line ratios (by ~0.17 dex) from the majority of local star-forming galaxies. We find no statistically significant difference in the [NII]/Ha and [OIII]/Hb line ratios or ISM pressures among the z~2 cluster galaxies and field galaxies at the same redshift. We show that our cluster galaxies have significantly larger ionization parameters (by up to an order of magnitude) than local star-forming galaxies. We hypothesize that these high ionization parameters may be associated with large specific star formation rates (i.e. a large star formation rate per unit stellar mass). If this hypothesis is correct, then this relationship would have important implications for the geometry and/or the mass of stars contained within individual star clusters as a function of redshift.Comment: 11 pages, 5 figures, accepted for publication in Ap

ZFIRE: The Evolution of the Stellar Mass Tully-Fisher Relation to Redshift 2.0 < Z < 2.5 with MOSFIRE

Using observations made with MOSFIRE on Keck I as part of the ZFIRE survey, we present the stellar mass Tully-Fisher relation at 2.0 < z < 2.5. The sample was drawn from a stellar mass limited, Ks-band selected catalog from ZFOURGE over the CANDELS area in the COSMOS field. We model the shear of the Halpha emission line to derive rotational velocities at 2.2X the scale radius of an exponential disk (V2.2). We correct for the blurring effect of a two-dimensional PSF and the fact that the MOSFIRE PSF is better approximated by a Moffat than a Gaussian, which is more typically assumed for natural seeing. We find for the Tully-Fisher relation at 2.0 < z < 2.5 that logV2.2 =(2.18 +/- 0.051)+(0.193 +/- 0.108)(logM/Msun - 10) and infer an evolution of the zeropoint of Delta M/Msun = -0.25 +/- 0.16 dex or Delta M/Msun = -0.39 +/- 0.21 dex compared to z = 0 when adopting a fixed slope of 0.29 or 1/4.5, respectively. We also derive the alternative kinematic estimator S0.5, with a best-fit relation logS0.5 =(2.06 +/- 0.032)+(0.211 +/- 0.086)(logM/Msun - 10), and infer an evolution of Delta M/Msun= -0.45 +/- 0.13 dex compared to z < 1.2 if we adopt a fixed slope. We investigate and review various systematics, ranging from PSF effects, projection effects, systematics related to stellar mass derivation, selection biases and slope. We find that discrepancies between the various literature values are reduced when taking these into account. Our observations correspond well with the gradual evolution predicted by semi-analytic models.Comment: 21 pages, 14 figures, 1 appendix. Accepted for publication by Apj, February 28, 201

Planets in Mean-Motion Resonances and the System Around HD45364

In some planetary systems, the orbital periods of two of its members present a commensurability, usually known by mean-motion resonance. These resonances greatly enhance the mutual gravitational influence of the planets. As a consequence, these systems present uncommon behaviors, and their motions need to be studied with specific methods. Some features are unique and allow us a better understanding and characterization of these systems. Moreover, mean-motion resonances are a result of an early migration of the orbits in an accretion disk, so it is possible to derive constraints on their formation. Here we review the dynamics of a pair of resonant planets and explain how their orbits evolve in time. We apply our results to the HD 45365 planetary system.Comment: invited review, 17 pages, 6 figure

Human Tra2 proteins jointly control a CHEK1 splicing switch among alternative and constitutive target exons

Alternative splicing—the production of multiple messenger RNA isoforms from a single gene—is regulated in part by RNA binding proteins. While the RBPs transformer2 alpha (Tra2α) and Tra2β have both been implicated in the regulation of alternative splicing, their relative contributions to this process are not well understood. Here we find simultaneous—but not individual—depletion of Tra2α and Tra2β induces substantial shifts in splicing of endogenous Tra2β target exons, and that both constitutive and alternative target exons are under dual Tra2α–Tra2β control. Target exons are enriched in genes associated with chromosome biology including CHEK1, which encodes a key DNA damage response protein. Dual Tra2 protein depletion reduces expression of full-length CHK1 protein, results in the accumulation of the DNA damage marker γH2AX and decreased cell viability. We conclude Tra2 proteins jointly control constitutive and alternative splicing patterns via paralog compensation to control pathways essential to the maintenance of cell viability