There is a nationwide resurgence of tuberculosis in the country’s urban centers; New York City stands at the forefront of this resurgence. The root causes are increased homelessness, drug addiction and poverty, all symbols of deteriorating social and economic conditions in the city. The inadequate level of public health resources devoted to TB has also contributed to its spread. Still, even with these factors, it is questionable whether the escalating number of TB cases in this country would have occurred without (...) the reservoir of immunosuppressed persons, who are less resistant to the disease, created by the AIDS epidemic. The fear and urgency of this public health crisis, which has been emerging since the beginning of the last decade, are fueled by the rise of TB strains resistant to the first-line drugs and by the disease’s contagiousness. (shrink)

There is a nationwide resurgence of tuberculosis in the country’s urban centers; New York City stands at the forefront of this resurgence. The root causes are increased homelessness, drug addiction and poverty, all symbols of deteriorating social and economic conditions in the city. The inadequate level of public health resources devoted to TB has also contributed to its spread. Still, even with these factors, it is questionable whether the escalating number of TB cases in this country would have occurred without (...) the reservoir of immunosuppressed persons, who are less resistant to the disease, created by the AIDS epidemic. The fear and urgency of this public health crisis, which has been emerging since the beginning of the last decade, are fueled by the rise of TB strains resistant to the first-line drugs and by the disease’s contagiousness. (shrink)

This chapter suggests that descriptive epidemiological studies like the Global Burden of Disease Study can usefully be divided into four tasks: describing individuals’ health states over time, assessing their health states under a range of counterfactual scenarios, summarizing the information collected, and then packaging it for presentation. The authors show that each of these tasks raises important and challenging ethical questions. They comment on some of the philosophical issues involved in measuring health states, attributing causes to health outcomes, choosing the (...) counterfactual against which to assess causes, aggregating and summarizing complex information across multiple domains, discounting, age-weighting, handling fetal deaths, measuring health inequalities, representing uncertainty, and assessing personal responsibility for health outcomes. (shrink)

McCullough et al. propose an evolved cognitive revenge system which imposes retaliatory costs on aggressors. They distinguish between this and other forms of punishment (e.g., those administered by judges) which are not underpinned by a specifically designed evolutionary mechanism. Here we outline mechanisms and circumstances through which the revenge system might nonetheless infiltrate decision-making within the criminal justice system.

The essential nature of legislative power is to make the laws; that of executive power is to execute those law. The difference between the two is both substantial and significant; it is the difference between the rule of arbitrary power and the rule of law. This paper will seek to trace the genesis of an independent judicial power, in both theory and practice, through an examination of sections of The Constitutions of Clarendon, The Assize of Clarendon, Hobbes’ Leviathan, Locke’s Second (...) Treatise, Montesquieu’s Spirit of the Laws, as well as The Federalist Papers. Moreover, it will seek to establish its executive nature and to explain why it is so often (at least presently) misunderstood to be akin to the legislative power. (shrink)

In recent years, cognitive neuroscientists have began to explore the process of how sensory information gains access to awareness. To further probe this process, event-related functional magnetic resonance imaging was used while testing subjects with a paradigm known as the “attentional blink.” In this paradigm, visually presented information sporadically fails to reach awareness. It was found that the magnitude and time course of activation within the anterior cingulate , medial prefrontal cortex , and frontopolar cortex predicted whether or not information (...) was consciously perceived during the critical period for the attentional blink. These results are discussed in light of a neural framework for conscious processing. (shrink)

ObjectiveTo prospectively study the cingulate cortex for the localization and role of the grasping action in humans during electrical stimulation of depth electrodes.MethodsAll the patients with intractable focal epilepsy and a depth electrode stereotactically placed in the cingulate cortex, as part of their pre-surgical epilepsy evaluation from 2015 to 2017, were included. Cortical stimulation was performed and examined for grasping actions. Post-implantation volumetric T1 MRIs were co-registered to determine the exact electrode position.ResultsFive patients exhibited contralateral grasping actions during electrical stimulation. (...) All patients had electrodes implanted in the ventral bank of the right cingulate sulcus adjacent to the vertical anterior commissure line. Stimulation of other electrodes in adjacent regions did not elicit grasping.ConclusionGrasping action elicited from a localized region in the mid-cingulate cortex directly supports the concept of the cingulate cortex being crucially involved in the grasping network. This opens an opportunity to explore this region with deep brain stimulation as a motor neuromodulation target for treatment in specific movement disorders or neurorehabilitation. (shrink)

Multidrug resistant organisms are a public health threat that have reduced the effectiveness of many available antibiotics. Antimicrobial stewardship programs have been tasked with reducing antibiotic use and therefore the emergence of MDROs. While fecal microbiota transplant has been proposed as therapy to reduce patient colonization of MDROs, this will require additional evidence to support an expansion of the current clinical indication for FMT. This article discusses the evidence and ethics of the expanded utilization of FMT by ASPs for reasons (...) other than severe recurrent or refractory Clostridioides difficile infection. (shrink)

Tri‐methylation of lysine 4 on histone H3 (H3K4me3) is a near‐universal chromatin modification at the transcription start site of active genes in eukaryotes from yeast to man and its levels reflect the amount of transcription. Because of this association, H3K4me3 is often described as an ‘activating’ histone modification and assumed to have an instructive role in the transcription of genes, but the field is lacking a conserved mechanism to support this view. The overwhelming finding from genome‐wide studies is that actually (...) very little transcription changes upon removal of most H3K4me3 under steady‐state or dynamically changing conditions, including at mammalian CpG island promoters. Instead, rather than a major role in instructing transcription, time‐resolved experiments provide more evidence supporting the deposition of H3K4me3 into chromatin as a result of transcription, influencing processes such as memory of previous states, transcriptional consistency between cells in a population and transcription termination. -/- . (shrink)

Endothelial cells, when cultured on gelled basement membrane matrix exert forces of tension through which they deform the matrix and at the same time they aggregate into clusters. The cells eventually form a network of cord-like structures connecting cell aggregates. In this network, almost all of the matrix has been pulled underneath the cell cords and cell clusters. This phenomenon has been proposed as a possible model for the growth and development of planar vascular systems in vitro. Our hypothesis is (...) that the matrix is reorganized and the cellular networks form as a result of traction forces exerted by the cells on the matrix and the latter's elasticity. We construct and analyze a mathematical model based on this hypothesis and examine conditions necessary for the formation of the pattern. We show cell migration is not necessary for pattern formation and that isotropic, strain-stimulated traction is sufficient to form the observed patterns. (shrink)

Approaches to model evaluation in terms of Occam's razor or principles of parsimony cannot avoid judgements about the relative importance of aspects of the models. Assumptions about “core processing” are usually considered more important than those related to decision components, but when the decision is related to a central feature of the processing, it becomes extremely difficult to tease apart the influences of core and decision components and to draw sensible conclusions about underlying architecture. It is preferable, where possible, to (...) use experimental procedures that avoid the necessity for subject decisions related to critical aspects of the underlying process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Moral Distress: The Face of Workplace BullyingJohn S. MurrayAfter a 28–year long distinguished military career I accepted a research position in a tertiary academic health science center, which I considered to be my dream job following retirement. Initially I was to be responsible for one department. A second was added because of my expertise with disaster preparedness. Following my orientation, I immersed myself into my new roles recognizing that (...) there was much to be done to achieve the goal of getting both departmental research programs up to par with the rest of the organization. In a short time, I began to recognize one of my bosses was going to be challenging to work with.She expected that her name be included on all grant proposals and manuscripts despite making no substantial intellectual contributions to either. Additionally, she wanted unwarranted control over all research and scholarship activities I was engaged in with staff despite having no research experience. Even meeting with her to discuss my plans for the direction of research in this department, my efforts were met with argumentative and condescending behavior. She would agree to discuss my plans. When I showed up for meetings in her office she would get angry with me oftentimes for situations, which she herself created. I continued to move forward with my work feeling that how I had conducted research and scholarly work in the past, with integrity and uncompromising ethical standards, was going to be threatened. This created great moral stress for me. I felt overwhelmed, powerless and frustrated as a result of the uncertainty as to whether or not I could fulfill my responsibilities while still meeting moral obligations.Over time, my moral compass prevented me from deviating from the principles, which helped me to build a long–standing stellar reputation as a leader in the field of pediatric nursing. However, this came with a cost. Working for this particular boss was like being on an emotional rollercoaster. One day I would feel like she was pleased with my work, but the next day my efforts could be met with anger, demeaning and dismissive behaviors. Once she praised me in front of staff for the “great” work I was doing with the evidence–based practice initiative nurse leaders. The following day she reprimanded me for not working closely with this group. She was extremely well versed at singing my praises in front of staff. Behind her closed office door was a very different experience.I confided in some colleagues in this department how I was being treated. I quickly learned that all staff were treated in this manner by this one individual. They shared that condescending language and fear and intimidation were the norm. When [End Page 112] I asked them why no one had the awareness or courage to say this treatment was not right, they quickly shared with me that staff were deterred from speaking up for fear of greater bullying behaviors. Sadly, while everyone knew what was the right thing to do, institutional constraints made it nearly impossible to pursue the right course of action. It was readily apparent these nurses were missing advocacy. At that point, I decided it was important to seek a remedy to this problem recognizing it would be no easy task.Progressively, my work environment with this particular boss became intolerable. Despite working relentlessly to develop a research program, unwarranted criticism, unjustified blame, exclusion, isolation, unreasonable demands and denied opportunities persisted. By this time, I was suffering from nightmares, headaches, fear, anxiety, depression, difficulty concentrating, and problems with self–esteem. I felt like my professional competence and reputation was being unjustifiably denigrated by this one individual.In the past, I confided in trusted organizational leaders for guidance when faced with difficult situations. As such, I approached my other boss and shared what was happening. She was deeply concerned. She encouraged me to seek guidance from a safe and confidential environment where staff members can share concerns and receive assistance with how to handle these apprehensions. I had used a program like this in the past when dealing with moral distress. This experience was very helpful. In fact, I returned on multiple... (shrink)