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Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations
- Sarah E. Paul, David A.A. Baranger, Emma C. Johnson, Joshua J. Jackson, Aaron J. Gorelik, Alex P. Miller, Alexander S. Hatoum, Wesley K. Thompson, Michael Strube, Danielle M. Dick, Chella Kamarajan, John R. Kramer, Martin H. Plawecki, Grace Chan, Andrey P. Anokhin, David B. Chorlian, Sivan Kinreich, Jacquelyn L. Meyers, Bernice Porjesz, Howard J. Edenberg, Arpana Agrawal, Kathleen K. Bucholz, Ryan Bogdan
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- Journal:
- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 09 May 2024, pp. 1-14
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Background
Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.
MethodsData came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.
ResultsExternalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).
ConclusionsBehavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.
Socio-ecological factors linked with changes in adults’ dietary intake in Los Angeles County during the peak of the coronavirus 2019 pandemic
- Sydney Miller, Trevor A Pickering, Wändi Bruine de Bruin, Thomas W. Valente, John P Wilson, Kayla de la Haye
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- Journal:
- Public Health Nutrition / Volume 27 / Issue 1 / 2024
- Published online by Cambridge University Press:
- 07 May 2024, e133
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Objective:
Comprehensive studies examining longitudinal predictors of dietary change during the coronavirus disease 2019 pandemic are lacking. Based on an ecological framework, this study used longitudinal data to test if individual, social and environmental factors predicted change in dietary intake during the peak of the coronavirus 2019 pandemic in Los Angeles County and examined interactions among the multilevel predictors.
Design:We analysed two survey waves (e.g. baseline and follow-up) of the Understanding America Study, administered online to the same participants 3 months apart. The surveys assessed dietary intake and individual, social, and neighbourhood factors potentially associated with diet. Lagged multilevel regression models were used to predict change from baseline to follow-up in daily servings of fruits, vegetables and sugar-sweetened beverages.
Setting:Data were collected in October 2020 and January 2021, during the peak of the coronavirus disease 2019 pandemic in Los Angeles County.
Participants:903 adults representative of Los Angeles County households.
Results:Individuals who had depression and less education or who identified as non-Hispanic Black or Hispanic reported unhealthy dietary changes over the study period. Individuals with smaller social networks, especially low-income individuals with smaller networks, also reported unhealthy dietary changes. After accounting for individual and social factors, neighbourhood factors were generally not associated with dietary change.
Conclusions:Given poor diets are a leading cause of death in the USA, addressing ecological risk factors that put some segments of the community at risk for unhealthy dietary changes during a crisis should be a priority for health interventions and policy.
Ecological risk and protective factors for food insufficiency in Los Angeles County during the COVID-19 pandemic
- Kayla de la Haye, Htay-Wah Saw, Sydney Miller, Wändi Bruine de Bruin, John P Wilson, Kate Weber, Alison Frazzini, Michelle Livings, Marianna Babboni, Arie Kapteyn
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- Journal:
- Public Health Nutrition / Volume 26 / Issue 10 / October 2023
- Published online by Cambridge University Press:
- 05 July 2023, pp. 1944-1955
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Objective:
The COVID-19 pandemic increased food insufficiency: a severe form of food insecurity. Drawing on an ecological framework, we aimed to understand factors that contributed to changes in food insufficiency from April to December 2020, in a large urban population hard hit by the pandemic.
Design:We conducted internet surveys every 2 weeks in April–December 2020, including a subset of items from the Food Insecurity Experience Scale. Longitudinal analysis identified predictors of food insufficiency, using fixed effects models.
Setting:Los Angeles County, which has a diverse population of 10 million residents.
Participants:A representative sample of 1535 adults in Los Angeles County who are participants in the Understanding Coronavirus in America tracking survey.
Results:Rates of food insufficiency spiked in the first year of the pandemic, especially among participants living in poverty, in middle adulthood and with larger households. Government food assistance from the Supplemental Nutrition Assistance Program was significantly associated with reduced food insufficiency over time, while other forms of assistance such as help from family and friends or stimulus funds were not.
Conclusions:The findings highlight that during a crisis, there is value in rapidly monitoring food insufficiency and investing in government food benefits.
Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals
- Cecilia A. Hinojosa, Amanda Liew, Xinming An, Jennifer S. Stevens, Archana Basu, Sanne J. H. van Rooij, Stacey L. House, Francesca L. Beaudoin, Donglin Zeng, Thomas C. Neylan, Gari D. Clifford, Tanja Jovanovic, Sarah D. Linnstaedt, Laura T. Germine, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Michael C. Kurz, Robert A. Swor, Lauren A. Hudak, Jose L. Pascual, Mark J. Seamon, Elizabeth M. Datner, Anna M. Chang, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Paulina Sergot, Leon D. Sanchez, Steven E. Bruce, Mark W. Miller, Robert H. Pietrzak, Jutta Joormann, Diego A. Pizzagalli, John F. Sheridan, Steven E. Harte, James M. Elliott, Ronald C. Kessler, Karestan C. Koenen, Samuel A. McLean, Kerry J. Ressler, Negar Fani
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- Journal:
- Psychological Medicine / Volume 54 / Issue 2 / January 2024
- Published online by Cambridge University Press:
- 13 June 2023, pp. 338-349
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Background
Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians.
MethodsIn total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance.
ResultsThree trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12.
ConclusionsOur findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
361 WDR5 represents a therapeutically exploitable target for cancer stem cells in glioblastoma
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- Christopher Hubert, Kelly Mitchell, Samuel Sprowls, Sajina Shakya, Sonali Arora, Daniel J. Silver, Christopher M. Goins, Lisa Wallace, Gustavo Roversi, Rachel Schafer, Kristen Kay, Tyler E. Miller, Adam Lauko, John Bassett, Anjali Kashyap, J. D’Amato Kass, Erin E. Mulkearns-Hubert, Sadie Johnson, Joseph Alvarado, Jeremy N. Rich, Patrick J. Paddison, Anoop P. Patel, Shaun R. Stauffer, Christopher G. Hubert, Justin D. Lathia
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- Journal:
- Journal of Clinical and Translational Science / Volume 7 / Issue s1 / April 2023
- Published online by Cambridge University Press:
- 24 April 2023, p. 107
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OBJECTIVES/GOALS: Glioblastomas (GBMs) are heterogeneous, treatment-resistant tumors that are driven by populations of cancer stem cells (CSCs). In this study, we perform an epigenetic-focused functional genomics screen in GBM organoids and identify WDR5 as an essential epigenetic regulator in the SOX2-enriched, therapy resistant cancer stem cell niche. METHODS/STUDY POPULATION: Despite their importance for tumor growth, few molecular mechanisms critical for CSC population maintenance have been exploited for therapeutic development. We developed a spatially resolved loss-of-function screen in GBM patient-derived organoids to identify essential epigenetic regulators in the SOX2-enriched, therapy resistant niche. Our niche-specific screens identified WDR5, an H3K4 histone methyltransferase responsible for activating specific gene expression, as indispensable for GBM CSC growth and survival. RESULTS/ANTICIPATED RESULTS: In GBM CSC models, WDR5 inhibitors blocked WRAD complex assembly and reduced H3K4 trimethylation and expression of genes involved in CSC-relevant oncogenic pathways. H3K4me3 peaks lost with WDR5 inhibitor treatment occurred disproportionally on POU transcription factor motifs, required for stem cell maintenance and including the POU5F1(OCT4)::SOX2 motif. We incorporated a SOX2/OCT4 motif driven GFP reporter system into our CSC cell models and found that WDR5 inhibitor treatment resulted in dose-dependent silencing of stem cell reporter activity. Further, WDR5 inhibitor treatment altered the stem cell state, disrupting CSC in vitro growth and self-renewal as well as in vivo tumor growth. DISCUSSION/SIGNIFICANCE: Our results unveiled the role of WDR5 in maintaining the CSC state in GBM and provide a rationale for therapeutic development of WDR5 inhibitors for GBM and other advanced cancers. This conceptual and experimental framework can be applied to many cancers, and can unmask unique microenvironmental biology and rationally designed combination therapies.
Reintervention and mortality risk after total anomalous pulmonary venous connection repair
- Kevin M. Beers, Christian P. Jacobsen, Stewart R. Miller, David G. Lehenbauer, Elaine Maldonado, S. Adil Husain, John H. Calhoon
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 11 / November 2023
- Published online by Cambridge University Press:
- 13 January 2023, pp. 2228-2235
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Background:
Management of total anomalous pulmonary venous connections has been extensively studied to further improve outcomes. Our institution previously reported factors associated with mortality, recurrent obstruction, and reintervention. The study purpose was to revisit the cohort of patients and evaluate factors associated with reintervention, and mortality in early and late follow-up.
Methods:A retrospective review at our institution identified 81 patients undergoing total anomalous pulmonary venous connection repair from January 2002 to January 2018. Demographic and operative variables were evaluated. Anastomotic reintervention (interventional or surgical) and/or mortality were primary endpoints.
Results:Eighty-one patients met the study criteria. Follow-up ranged from 0 to 6,291 days (17.2 years), a mean of 1263 days (3.5 years). Surgical mortality was 16.1% and reintervention rates were 19.8%. In re-interventions performed, 80% occurred within 1.2 years, while 94% of mortalities were within 4.1 months. Increasing cardiopulmonary bypass times (p = 0.0001) and the presence of obstruction at the time of surgery (p = 0.025) were predictors of mortality, while intracardiac total anomalous pulmonary venous connection type (p = 0.033) was protective. Risk of reintervention was higher with increasing cardiopulmonary bypass times (p = 0.015), single ventricle anatomy (p = 0.02), and a post-repair gradient >2 mmHg on transesophageal echocardiogram (p = 0.009).
Conclusions:Evaluation of a larger cohort with longer follow-up demonstrated the relationship of anatomic complexity and symptoms at presentation to increased mortality risk after total anomalous pulmonary venous connection repair. The presence of a single ventricle or a post-operative confluence gradient >2 mmHg were risk factors for reintervention. These findings support those found in our initial study.
Deep ancestry of collapsing networks of nomadic hunter–gatherers in Borneo
- J. Stephen Lansing, Guy S. Jacobs, Sean S. Downey, Peter K. Norquest, Murray P. Cox, Steven L. Kuhn, John H. Miller, Safarina G. Malik, Herawati Sudoyo, Pradiptajati Kusuma
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- Journal:
- Evolutionary Human Sciences / Volume 4 / 2022
- Published online by Cambridge University Press:
- 21 February 2022, e9
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Theories of early cooperation in human society often draw from a small sample of ethnographic studies of surviving populations of hunter–gatherers, most of which are now sedentary. Borneo hunter–gatherers (Punan, Penan) have seldom figured in comparative research because of a decades-old controversy about whether they are the descendants of farmers who adopted a hunting and gathering way of life. In 2018 we began an ethnographic study of a group of still-nomadic hunter–gatherers who call themselves Punan Batu (Cave Punan). Our genetic analysis clearly indicates that they are very unlikely to be the descendants of neighbouring agriculturalists. They also preserve a song language that is unrelated to other languages of Borneo. Dispersed travelling groups of Punan Batu with fluid membership use message sticks to stay in contact, co-operate and share resources as they journey between rock shelters and forest camps. Message sticks were once widespread among nomadic Punan in Borneo, but have largely disappeared in sedentary Punan villages. Thus the small community of Punan Batu offers a rare glimpse of a hunting and gathering way of life that was once widespread in the forests of Borneo, where prosocial behaviour extended beyond the face-to-face community, facilitating successful collective adaptation to the diverse resources of Borneo's forests.
Self-Affirmation and Identity-Driven Political Behavior
- Benjamin A. Lyons, Christina E. Farhart, Michael P. Hall, John Kotcher, Matthew Levendusky, Joanne M. Miller, Brendan Nyhan, Kaitlin T. Raimi, Jason Reifler, Kyle L. Saunders, Rasmus Skytte, Xiaoquan Zhao
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- Journal of Experimental Political Science / Volume 9 / Issue 2 / Summer 2022
- Published online by Cambridge University Press:
- 08 February 2021, pp. 225-240
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Psychological attachment to political parties can bias people’s attitudes, beliefs, and group evaluations. Studies from psychology suggest that self-affirmation theory may ameliorate this problem in the domain of politics on a variety of outcome measures. We report a series of studies conducted by separate research teams that examine whether a self-affirmation intervention affects a variety of outcomes, including political or policy attitudes, factual beliefs, conspiracy beliefs, affective polarization, and evaluations of news sources. The different research teams use a variety of self-affirmation interventions, research designs, and outcomes. Despite these differences, the research teams consistently find that self-affirmation treatments have little effect. These findings suggest considerable caution is warranted for researchers who wish to apply the self-affirmation framework to studies that investigate political attitudes and beliefs. By presenting the “null results” of separate research teams, we hope to spark a discussion about whether and how the self-affirmation paradigm should be applied to political topics.
Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral therapy - CORRIGENDUM
- Spiro P. Pantazatos, Ashley Yttredahl, Harry Rubin-Falcone, Ronit Kishon, Maria A. Oquendo, J. John Mann, Jeffrey M. Miller
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- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 17 July 2020, e66
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Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral therapy
- Spiro P. Pantazatos, Ashley Yttredahl, Harry Rubin-Falcone, Ronit Kishon, Maria A. Oquendo, J. John Mann, Jeffrey M. Miller
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- European Psychiatry / Volume 63 / Issue 1 / 2020
- Published online by Cambridge University Press:
- 14 April 2020, e37
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Background.
Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients with major depressive disorder (MDD), using seeds from three SCC subdivisions.
Methods.Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann’s area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity.
Results.Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement.
Conclusions.rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses.
Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE)
- C. Norman Coleman, Judith L. Bader, John F. Koerner, Chad Hrdina, Kenneth D. Cliffer, John L. Hick, James J. James, Monique K. Mansoura, Alicia A. Livinski, Scott V. Nystrom, Andrea DiCarlo-Cohen, Maria Julia Marinissen, Lynne Wathen, Jessica M. Appler, Brooke Buddemeier, Rocco Casagrande, Derek Estes, Patrick Byrne, Edward M. Kennedy, Ann A. Jakubowski, Cullen Case, Jr, David M. Weinstock, Nicholas Dainiak, Dan Hanfling, Andrew L. Garrett, Natalie N. Grant, Daniel Dodgen, Irwin Redlener, Thomas F. MacKAY, Meghan Treber, Mary J. Homer, Tammy P. Taylor, Aubrey Miller, George Korch, Richard Hatchett
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- Disaster Medicine and Public Health Preparedness / Volume 13 / Issue 5-6 / December 2019
- Published online by Cambridge University Press:
- 17 June 2019, pp. 995-1010
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A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Pioneering the Use of Neural Network Architectures and Feature Engineering for Real-Time Augmented Microscopy and Analysis
- Matthew L. Gong, Su Jong Yoon, Raymond R. Unocic, Hope Ishii, John P. Bradley, Brandon D. Miller, Daniel Masiel, Bryan Reed, Tolga Tasdizen, Jeffery A. Aguiar
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- Microscopy and Microanalysis / Volume 24 / Issue S1 / August 2018
- Published online by Cambridge University Press:
- 01 August 2018, pp. 514-515
- Print publication:
- August 2018
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2385: An education program for engineering students collaborating with clinician scientists to address priority hospital patient safety problems using an ethnographic research approach
- Laura Camarata, Stephen P. Juraschek, Pamela Sheff, Peter A. Doyle, Robert M. Graham, John M. Adamovich, Lori A. Paine, Edgar R. Miller III
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- Journal of Clinical and Translational Science / Volume 1 / Issue S1 / September 2017
- Published online by Cambridge University Press:
- 10 May 2018, pp. 49-50
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OBJECTIVES/SPECIFIC AIMS: Enhancing Patient Safety for hospitalized patients is a priority for healthcare facilities, providers, and federal funding agencies. Multidisciplinary partnerships in clinical and translational research better defines the scope of complex patient-safety issues, and is part of more effectively developing interventions. The discipline represented by engineering-trained partners brings valuable perspective to patient safety problems through their training background in human factors and systems analysis. The objective of this education program was to create and implement a collaboration between engineering students and clinical providers. Through the Johns Hopkins Institute for Clinical and Translational Research, a multidisciplinary partnership was created, to identify contributing factors, and suggest novel solutions, to key patient safety problems using an ethnographic research approach. METHODS/STUDY POPULATION: The collaboration was formed between the following Johns Hopkins (JH) groups: (1) The Institute for Clinical and Translational Research (ICTR), (2) The Armstrong Institute for Patient Safety, (3) The JH Hospital Clinical Engineering Services, (4) The Homecare Group, (5) The Masters of Science in Engineering Management Program at the Whiting School of Engineering, and (6) The JH Hospital Risk Management. All 6 provided representation to contribute to the planning, structure, and implementation of the project. The initial cohort was 24 masters students enrolled in the JHU Whiting School of engineering, and included 46% men, 54% women, and 75% international students. Students were placed in teams of 2–3 to work on 9 distinct patient safety concerns, as provided by the Armstrong Institute as priority. Potential clinical hosts from the appropriate clinical departments were vetted for feasibility and scope before students were assigned to them. Students and clinical hosts were oriented to the process. The students then spent 3–6 hours a week, for 7 weeks, observing and interacting with patients and health professionals at their specific clinical sites, conducting ethnographic research under the guidance of their hosts. Ethnographic research is the systematic investigation of a culture or system; in our application, teams were looking at the environment, culture, and its contributing factors, with respect to patient safety issues. Teams made observations, then formulated hypothesis and collected data relevant to what systems factors may be contributing to the patient safety issue. Following data collection and analyses, teams made recommendations for culture and/or systems shifts that could impact change and improve patient safety. Ethnography research process training is a tenet of the training undertaken by all Masters of Science in Engineering Management Students. RESULTS/ANTICIPATED RESULTS: At the end of the 7-week project, each team generated a comprehensive report suggesting potential solutions for each problem, and gave presentations on their findings to their peers, clinical hosts, and JHU steering committee representatives. Requirements on the student side included a midterm, final presentation, and report. Both students and site leaders submitted mid- and final program evaluations. Based on follow-up survey data, 71% of students said that the course may impact their career choice, 57% said the collaboration changed the way they viewed themselves, and 28% elected to continue working or were planning to work with their site in some fashion after the course ended. Nearly 60% of students believed additional funding or resources would benefit the course and 71% thought they would benefit from more or similar experiences with their clinical partners. Furthermore, 85% wanted to see the course expanded. Of the clinical hosts, 71% said that students added value, 86% believed students changed their perspective on their problem, unveiled new areas of investigation, and improved or likely would improve patient safety in their department. Seventy-one percent of hosts were actively acting on the students’ findings, and over 86% shared findings with their colleagues. Following the 7-week program, 2 teams also presented their findings to committees within the hospital departments, 2 patient-safety projects are being continued with engineering teams, and 2 new collaborative projects have been initiated. Based on the popularity of this program with the students, hosts, and teaching faculty, this will be implemented within the engineering curriculum for a second time next year. Additional outcomes data collection are currently ongoing, and we plan to continue to monitor and analyze results. DISCUSSION/SIGNIFICANCE OF IMPACT: In its first year our engineering collaboration exceeded expectations. Engineering students and clinical providers successfully worked toward tangible solutions that were directly applicable to patient care. Furthermore, interactions were both personally and professionally beneficial for students while simultaneously adding value to clinical hosts. Beyond the collaboration, this initiative allowed for secondary connections between engineers and clinicians that are also have great potential for resulting in translational innovation. Despite the overwhelming success of this project, it highlighted the need for increased resources for sustainability. Our pilot highlighted a role for funding with regards to: (1) students in the execution of their projects (eg, transportation to sites, prototype materials); (2) clinical hosts, particularly protecting time to interact with and lead student teams; (3) the Armstrong Institute—to aid the identification and prioritization of high impact, patient safety projects; and (4) the ICTR for staff to facilitate placements, student orientation to the hospital setting, and program execution and maintenance. Ultimately, this collaboration addressed an unmet need for the clinical providers as well as the engineering students: thus, all partners agree that (1) the impact of this pilot would be greatly magnified by more time, longer duration, and additional resources; and (2) this collaboration could provide a useful model for approaching other complex health care problems. In terms of larger and longer-term impact, engaging engineers at the training level together with clinicians provides early exposure, and could potentially prime them to continue collaborations with clinical and translational science, across their careers.
Student Research Assistant Acknowledgements: The authors thank Manik Arora, Alexandra Morani, and Thomas Cornish -- Johns Hopkins University.
Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants
- Bradley C. Johnston, Lyubov Lytvyn, Calvin Ka-Fung Lo, Stephen J. Allen, Duolao Wang, Hania Szajewska, Mark Miller, Stephan Ehrhardt, John Sampalis, Deniz G. Duman, Pietro Pozzoni, Agostino Colli, Elisabet Lönnermark, Christian P. Selinger, Samford Wong, Susan Plummer, Mary Hickson, Ruzha Pancheva, Sandra Hirsch, Bengt Klarin, Joshua Z Goldenberg, Li Wang, Lawrence Mbuagbaw, Gary Foster, Anna Maw, Behnam Sadeghirad, Lehana Thabane, Dominik Mertz
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 39 / Issue 7 / July 2018
- Published online by Cambridge University Press:
- 26 April 2018, pp. 771-781
- Print publication:
- July 2018
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OBJECTIVE
To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.
DESIGNIndividual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.
METHODSWe searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality.
RESULTSProbiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25–0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23–0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11–4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is ≥5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89–1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89–1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness.
CONCLUSIONSModerate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is ≥5%.
TRIAL REGISTRATIONPROSPERO 2015 identifier: CRD42015015701
Infect Control Hosp Epidemiol 2018;771–781
A Prospective, Holistic, Multicenter Approach to Tracking and Understanding Bloodstream Infections in Pediatric Hematology-Oncology Patients
- Aditya H. Gaur, David G. Bundy, Eric J. Werner, Jeffrey D. Hord, Marlene R. Miller, Li Tang, John P. Lawlor, Amy L. Billett, Children’s Hospital Association Childhood Cancer & Blood Disorders Network (CCBDN)
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 38 / Issue 6 / June 2017
- Published online by Cambridge University Press:
- 12 April 2017, pp. 690-696
- Print publication:
- June 2017
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OBJECTIVE
To assess the burden of bloodstream infections (BSIs) among pediatric hematology-oncology (PHO) inpatients, to propose a comprehensive, all-BSI tracking approach, and to discuss how such an approach helps better inform within-center and across-center differences in CLABSI rate
DESIGNProspective cohort study
SETTINGUS multicenter, quality-improvement, BSI prevention network
PARTICIPANTSPHO centers across the United States who agreed to follow a standardized central-line–maintenance care bundle and track all BSI events and central-line days every month.
METHODSInfections were categorized as CLABSI (stratified by mucosal barrier injury–related, laboratory-confirmed BSI [MBI-LCBI] versus non–MBI-LCBI) and secondary BSI, using National Healthcare Safety Network (NHSN) definitions. Single positive blood cultures (SPBCs) with NHSN defined common commensals were also tracked.
RESULTSBetween 2013 and 2015, 34 PHO centers reported 1,110 BSIs. Among them, 708 (63.8%) were CLABSIs, 170 (15.3%) were secondary BSIs, and 232 (20.9%) were SPBCs. Most SPBCs (75%) occurred in patients with profound neutropenia; 22% of SPBCs were viridans group streptococci. Among the CLABSIs, 51% were MBI-LCBI. Excluding SPBCs, CLABSI rates were higher (88% vs 77%) and secondary BSI rates were lower (12% vs 23%) after the NHSN updated the definition of secondary BSI (P<.001). Preliminary analyses showed across-center differences in CLABSI versus secondary BSI and between SPBC and CLABSI versus non-CLABSI rates.
CONCLUSIONSTracking all BSIs, not just CLABSIs in PHO patients, is a patient-centered, clinically relevant approach that could help better assess across-center and within-center differences in infection rates, including CLABSI. This approach enables informed decision making by healthcare providers, payors, and the public.
Infect Control Hosp Epidemiol 2017;38:690–696
Directly dated MIS 3 Lake-Level Record from Lake Manix, Mojave Desert, California, USA
- Marith C. Reheis, David M. Miller, John P. McGeehin, Joanna R. Redwine, Charles G. Oviatt, Jordon Bright
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- Journal:
- Quaternary Research / Volume 83 / Issue 1 / January 2015
- Published online by Cambridge University Press:
- 20 January 2017, pp. 187-203
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An outcrop-based lake-level curve, constrained by ~ 70 calibrated 14C ages on Anodonta shells, indicates at least 8 highstands between 45 and 25 cal ka BP within 10 m of the 543-m upper threshold of Lake Manix in the Mojave Desert of southern California. Correlations of Manix highstands with ice, marine, and speleothem records suggest that at least the youngest three highstands coincide with Dansgaard–Oeschger (D–O) stadials and Heinrich events 3 and 4. The lake-level record is consistent with results from speleothem studies in the Southwest that indicate cool wet conditions during D–O stadials. Notably, highstands between 43 and 25 ka apparently occurred at times of generally low levels of pluvial lakes farther north as interpreted from core-based proxies. Mojave lakes may have been supported by tropical moisture sources during oxygen-isotope stage 3, perhaps controlled by southerly deflection of Pacific storm tracks due to weakening of the sea-surface temperature gradient in response to North Atlantic climate perturbations.
Effectiveness of Preemergence Herbicide and Postemergence Glyphosate Programs in Second-Generation Glyphosate-Resistant Cotton
- Derek M. Scroggs, Donnie K. Miller, James L. Griffin, John W. Wilcut, David C. Blouin, Alexander M. Stewart, P. Roy Vidrine
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- Journal:
- Weed Technology / Volume 21 / Issue 4 / December 2007
- Published online by Cambridge University Press:
- 20 January 2017, pp. 877-881
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A study was conducted in 2004 and 2005 to evaluate the benefit of applying fluometuron PRE versus glyphosate-only POST programs in second-generation GR cotton (Roundup Ready Flex®). Fluometuron was either included or excluded with POST application timings of glyphosate at the following cotton growth stages: (1) 3 leaf (lf) followed by (fb) 7 lf fb 14 lf (over the top) OT (2) 3 fb 7 lf OT (3) 7 lf OT fb 14 lf postemergence directed (PD), and (4) 7 fb 14 lf OT. Control of goosegrass, Palmer amaranth, pitted morningglory, sicklepod, and smellmelon was increased 2 to 8 percentage points with the addition of fluometuron PRE. The inclusion of fluometuron PRE did not improve control of barnyardgrass, browntop millet, hemp sesbania, johnsongrass, or redroot pigweed and control ranged from 81% to 84%, 69% to 75%, 94% to 94%, 87% to 89%, and 92% to 93%, respectively. By 56 d after the last POST application, control of johnsongrass, Palmer amaranth, pitted morningglory, and smellmelon was at least 83%, 93%, 92%, and 86%, respectively, with only slight differences noted among POST glyphosate programs. Control of barnyardgrass, browntop millet, and redroot pigweed was 68%, 47%, 86%, respectively, with the POST glyphosate program of 3 fb 7 lf OT, which was significantly less than all other glyphosate POST programs. Cotton yield increased 32% and 36% with the addition of fluometuron PRE to glyphosate POST programs consisting of 7 lf OT fb 14 lf PD and 7 lf fb 14 lf OT, respectively. Cotton yield for other glyphosate POST programs including an earlier 3 lf application was not improved when fluometuron was applied PRE. Without inclusion of fluometuron PRE, yield was maximized with the glyphosate POST program that included three applications of glyphosate (2,510 kg/ha). Overall, this research emphasizes the fact that weed control is important in the early season as well as in the late season in second-generation GR cotton.
Early Holocene Great Salt Lake, USA
- Charles G. Oviatt, David B. Madsen, David M. Miller, Robert S. Thompson, John P. McGeehin
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- Journal:
- Quaternary Research / Volume 84 / Issue 1 / July 2015
- Published online by Cambridge University Press:
- 20 January 2017, pp. 57-68
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Shorelines and surficial deposits (including buried forest-floor mats and organic-rich wetland sediments) show that Great Salt Lake did not rise higher than modern lake levels during the earliest Holocene (11.5–10.2 cal ka BP; 10–9 14C ka BP). During that period, finely laminated, organic-rich muds (sapropel) containing brine-shrimp cysts and pellets and interbedded sodium-sulfate salts were deposited on the lake floor. Sapropel deposition was probably caused by stratification of the water column — a freshwater cap possibly was formed by groundwater, which had been stored in upland aquifers during the immediately preceding late-Pleistocene deep-lake cycle (Lake Bonneville), and was actively discharging on the basin floor. A climate characterized by low precipitation and runoff, combined with local areas of groundwater discharge in piedmont settings, could explain the apparent conflict between evidence for a shallow lake (a dry climate) and previously published interpretations for a moist climate in the Great Salt Lake basin of the eastern Great Basin.
Personality Polygenes, Positive Affect, and Life Satisfaction
- Alexander Weiss, Bart M. L. Baselmans, Edith Hofer, Jingyun Yang, Aysu Okbay, Penelope A. Lind, Mike B. Miller, Ilja M. Nolte, Wei Zhao, Saskia P. Hagenaars, Jouke-Jan Hottenga, Lindsay K. Matteson, Harold Snieder, Jessica D. Faul, Catharina A. Hartman, Patricia A. Boyle, Henning Tiemeier, Miriam A. Mosing, Alison Pattie, Gail Davies, David C. Liewald, Reinhold Schmidt, Philip L. De Jager, Andrew C. Heath, Markus Jokela, John M. Starr, Albertine J. Oldehinkel, Magnus Johannesson, David Cesarini, Albert Hofman, Sarah E. Harris, Jennifer A. Smith, Liisa Keltikangas-Järvinen, Laura Pulkki-Råback, Helena Schmidt, Jacqui Smith, William G. Iacono, Matt McGue, David A. Bennett, Nancy L. Pedersen, Patrik K. E. Magnusson, Ian J. Deary, Nicholas G. Martin, Dorret I. Boomsma, Meike Bartels, Michelle Luciano
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- Journal:
- Twin Research and Human Genetics / Volume 19 / Issue 5 / October 2016
- Published online by Cambridge University Press:
- 22 August 2016, pp. 407-417
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Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
- Print publication:
- 27 April 2015, pp ix-xxx
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