Conceptualizing Trust and Distrust as Alternative Stable States: Lessons from the Flint Water Crisis.

Despite the universally recognized importance of fostering trust and avoiding distrust in governance relationships, there remains considerable debate on core questions like the relation between (dis)trust and the evaluations of the characteristics that make a governance agent appear (un)worthy of trust. In particular, it remains unclear whether levels of (dis)trust simply follow levels of (dis)trustworthiness-such that building trust is primarily a question of increasing evidence of trustworthiness and avoiding evidence of distrustworthiness, or if their dynamics are more complicated. The current paper adds novel theory for thinking about the management of trust and distrust in the governance context through the application of principles borrowed from resilience theory. Specifically, we argue that trust and distrust exist as distinct, self-reinforcing (i.e., stable) states separated by a threshold. We then theorize as to the nature of the self-reinforcing processes and use qualitative data collected from and inductively coded in collaboration with Flint residents as part of a participatory process to look for evidence of our argument in a well-documented governance failure. We conclude by explaining how this novel perspective allows for clearer insight into the experience of this and other communities and speculate as to how it may help to better position governance actors to respond to future crises.

Melt-rich channel observed at the lithosphere-asthenosphere boundary.

The lithosphere-asthenosphere boundary (LAB) separates rigid oceanic plates from the underlying warm ductile asthenosphere. Although a viscosity decrease beneath this boundary is essential for plate tectonics, a consensus on its origin remains elusive. Seismic studies identify a prominent velocity discontinuity at depths thought to coincide with the LAB but disagree on its cause, generally invoking either partial melting or a mantle dehydration boundary as explanations. Here we use sea-floor magnetotelluric data to image the electrical conductivity of the LAB beneath the edge of the Cocos plate at the Middle America trench offshore of Nicaragua. Underneath the resistive oceanic lithosphere, the magnetotelluric data reveal a high-conductivity layer confined to depths of 45 to 70 kilometres. Because partial melts are stable at these depths in a warm damp mantle, we interpret the conductor to be a partially molten layer capped by an impermeable frozen lid that is the base of the lithosphere. A conductivity anisotropy parallel to plate motion indicates that this melt has been sheared into flow-aligned tube-like structures. We infer that the LAB beneath young plates consists of a thin, partially molten, channel of low viscosity that acts to decouple the overlying brittle lithosphere from the deeper convecting mantle. Because this boundary layer has the potential to behave as a lubricant to plate motion, its proximity to the trench may have implications for subduction dynamics.

Biochemical and immunohistochemical characterization of the isoforms of myosin and actin in human placenta.

Human placenta has long been known to contain large quantities of smooth muscle-type myosin and actin, while precise isoform compositions of its contractile proteins are not known. To determine the isoform compositions, myosin and actin were extracted from human term placentas and subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotting by using isoform-specific monoclonal anti-myosin and anti-actin antibodies. The placental myosin was found to be composed of about 65% of a nonmuscle-type heavy chain isoform (MIIA), each about 15% of two smooth muscle-type heavy chain isoforms (SM1 and SM2) and about 5% of a brain/fetus-type heavy chain isoform (MIIB2). Whereas the MIIA isoform was present in both vascular and extravascular tissues, the SM1 isoform was localized almost only in the vascular tissue. Similarly, human term placenta was found to contain approximately 60, 30, and 10% of ß-nonmuscle, α-smooth muscle, γ-smooth muscle actin isoforms, respectively. The ß-nonmuscle actin was located primarily in the extravascular tissue, while the α-smooth muscle actin was located mostly in the vascular tissue. The extravascular tissue of the human term placenta thus appears to be composed of almost only nonmuscle-type isoforms of contractile proteins. The vascular tissue appears to be composed of both smooth muscle-type and nonmuscle-type isoforms of contractile proteins.

Use of propofol and emergence agitation in children: a literature review.

Emergence agitation (EA) is an important issue in pediatric anesthesia. This phenomenon arises more frequently with the use of inhalational agents. Three commonly used general anesthesia techniques in children were evaluated as to the associated incidence of emergence reactions. An extensive literature review was performed to evaluate these anesthetic practices and the occurrence of EA in young children. Relevant literature was obtained from multiple sources, including professional journals, professional websites, and textbooks. Three categories of anesthesia techniques were reviewed: sevoflurane inhalational general anesthetic, Emerpropofol as an adjunct to sevoflurane general anesthetic, and propofol total intravenous anesthesia (TIVA) techniques. Several variables within each category were evaluated with respect to the outcome of EA: prevention, intraoperative adjuncts, type of surgery, and patient-related factors. According to the literature evidence base, there is an advantage to either propofol TIVA or adjunctive propofol with sevoflurane (compared with sevoflurane alone). We conclude, based on the current evidence, that the use of propofol is associated with a reduction in the incidence of emergence agitation.

A genetically engineered chimeric vaccine against porcine circovirus type 2 (PCV2) is genetically stable in vitro and in vivo.

A vaccine against porcine circovirus type 2 (PCV2), designated PCV1-2 chimera, was recently developed by replacing the capsid gene of the non-pathogenic PCV1 with that of PCV2. The PCV1-2 chimera virus is attenuated in pigs but induces protective immunity against PCV2. In this study, the genetic stability of the PCV1-2 chimera was evaluated for its potential use as a live vaccine. The PCV1-2 chimera virus was serially passaged 11 times in PK-15 cells and 3 times in pigs. The PCV1-2 chimera virus used in this study contained a tracking marker mutation in the capsid gene (F to V at amino acid position 79). Sequence analyses of the PCV1-2 chimera virus after 11 serial passages in PK-15 cells did not reveal any sequence change including the marker mutation. Similarly, there is no change in the genomic sequence of the PCV1-2 chimera virus recovered from pigs during 3 serial in vivo passages. Under in vivo selection pressure, however, the introduced tracking marker mutation in the PCV1-2 chimera quickly mutated (V79F) and restored to its original sequence after one passage in pigs, and remained stable in subsequent 2 passages in pigs. The results indicate that the PCV1-2 chimera virus is genetically stable, and thus should be a good vaccine candidate.

Direct inoculation of RNA transcripts from an infectious cDNA clone of porcine reproductive and respiratory syndrome virus (PRRSV) into the lymph nodes and tonsils of pigs initiates PRRSV infection in vivo.

The recent construction of PRRSV infectious cDNA clones affords the opportunity for structural and functional studies of PRRSV genes. However, the inherent instability of the PRRSV genome, the requirement of cell culture propagation, and poor virus recovery have limited the usefulness of the PRRSV reverse genetics system for in vivo studies. Here, we report a unique strategy of infecting pigs by bypassing the traditional in vitro cell culture step required for in vivo studies. We demonstrate that inoculation of RNA transcripts of a PRRSV infectious cDNA clone directly into the lymph nodes and tonsils of pigs produces active PRRSV infection. The information from this study will have significant implications for the study of the molecular mechanism of PRRSV pathogenesis using the reverse genetics system.

Development of a heteroduplex mobility assay to identify field isolates of porcine reproductive and respiratory syndrome virus with nucleotide sequences closely related to those of modified live-attenuated vaccines.

Porcine reproductive and respiratory syndrome has been devastating the swine industry since the late 1980s. The disease has been controlled, to some extent, through the use of modified live-attenuated (MLV) vaccines once available. However, such a practice periodically resulted in isolation or detection of vaccine-like viruses from pigs as determined by a partial genomic sequencing. In this study, we developed a heteroduplex mobility assay (HMA) for quickly identifying porcine reproductive and respiratory syndrome virus (PRRSV) isolates with significant nucleotide sequence identities (>/=98%) with the modified live-attenuated vaccines. The major envelope gene (ORF5) of 51 PRRSV field isolates recovered before and after the introduction of the vaccines was amplified, denatured, and reannealed with the HMA reference vaccine strains Ingelvac PRRS MLV and Ingelvac PRRS ATP, respectively. Nine of the 51 field isolates and the VR2332 parent virus of Ingelvac PRRS MLV, which were all highly related to Ingelvac PRRS MLV with

Comparison of molecular and biological characteristics of a modified live porcine reproductive and respiratory syndrome virus (PRRSV) vaccine (ingelvac PRRS MLV), the parent strain of the vaccine (ATCC VR2332), ATCC VR2385, and two recent field isolates of PRRSV.

The objectives of this study were to compare the molecular and biological characteristics of recent porcine reproductive and respiratory syndrome virus (PRRSV) field isolates to those of a modified live virus (MLV) PRRS vaccine and its parent strain. One hundred seventeen, 4-week-old pigs were randomly assigned to six groups. Group 1 (n = 20) served as sham-inoculated negative controls, group 2 (n = 19) was inoculated with Ingelvac PRRS MLV vaccine, group 3 (n = 20) was inoculated with the parent strain of the vaccine (ATCC VR2332), group 4 (n = 19) was inoculated with vaccine-like PRRSV field isolate 98-38803, group 5 (n = 19) was inoculated with PRRSV field isolate 98-37120, and group 6 (n = 20) was inoculated with known high-virulence PRRSV isolate ATCC VR2385. The levels of severity of gross lung lesions (0 to 100%) among the groups were significantly different at both 10 (P < 0.0001) and 28 days postinoculation (p.i.) (P = 0.002). At 10 days p.i., VR2332 (26.5% +/- 4.64%) and VR2385 (36.4% +/- 6.51%) induced gross lesions of significantly greater severity than 98-38803 (0.0% +/- 0.0%), 98-37120 (0.8% +/- 0.42%), Ingelvac PRRS MLV (0.9% +/- 0.46%), and negative controls (2.3% +/- 1.26%). At 28 days p.i., 98-37120 (17.2% +/- 6.51%) induced gross lesions of significantly greater severity than any of the other viruses. Analyses of the microscopic-interstitial-pneumonia-lesion scores (0 to 6) revealed that VR2332 (2.9 +/- 0.23) and VR2385 (3.1 +/- 0.35) induced significantly more severe lesions at 10 days p.i. At 28 days p.i., VR2385 (2.5 +/- 0.27), VR2332 (2.3 +/- 0.21), 98-38803 (2.6 +/- 0.29), and 98-37120 (3.0 +/- 0.41) induced significantly more severe lesions than Ingelvac PRRS MLV (0.7 +/- 0.17) and controls (0.7 +/- 0.15). The molecular analyses and biological characterizations suggest that the vaccine-like isolate 98-38803 (99.5% amino acid homology based on the ORF5 gene) induces microscopic pneumonia lesions similar in type to, but different in severity and time of onset from, those observed with virulent strains VR2385 and the parent strain of the vaccine. Our data strongly suggest that isolate 98-38803 is a derivative of Ingelvac PRRS MLV and that the isolate is pneumovirulent.

Genetic variation and phylogenetic analyses of the ORF5 gene of acute porcine reproductive and respiratory syndrome virus isolates.

Swine herds in the US have experienced recent outbreaks of a severe form of porcine reproductive and respiratory syndrome (designated acute or atypical PRRS) characterized by abortion and high mortality in pregnant sows. Most of the affected herds had been vaccinated with modified live-vaccines (MLVs) against PRRS. To explore the possible mechanism of the emergence of acute PRRS, the open reading frame 5 (ORF5) gene encoding the major envelope protein (GP5) of acute PRRSV isolates was characterized. The complete ORF5 gene of eight acute PRRSV isolates from herds experiencing acute PRRS outbreaks in Iowa and North Carolina was amplified and sequenced. Sequence analyses revealed that these acute PRRSV isolates shared 88-95% nucleotide and 88-96% amino acid sequence identities to each other, 87-97% nucleotide and 84-96% amino acid sequence identities with other North American PRRSV isolates and the MLVs. Most of the amino acid substitutions locate in the putative signal sequence and two short hypervariable regions at the amino terminus. The ORF5 gene sequence of the acute PRRSV isolate 98-37120-2 from a non-vaccinated swine herd in Iowa is very closely related to that of the RespPRRS MLV, with 97% nucleotide and 96% amino acid sequence identities. Phylogenetic analysis revealed that all eight acute PRRSV isolates are clustered within the North American genotype. Several minor branches that are not associated with geographic origins were also identified within the North American genotype. One acute PRRSV isolate (98-37120-2) is clustered with the RespPRRS MLV and several Danish isolates that were confirmed to be derived from the RespPRRS MLV. The ORF5 gene sequences of other seven acute isolates are more related to those of several earlier PRRSV isolates and the PrimePac MLV than to that of the RespPRRS MLV. Our results showed that the acute PRRSV isolates analyzed in this study differed from each other in ORF5 genes, although they all clustered within the North American genotype. The data from this study do not fully support the hypothesis that the emergence of acute PRRS is due to reversion of MLVs to a pathogenic phenotype, as only one of the eight acute isolates was shown to be very closely related to the RespPRRS MLV.

Your organization should consider a cash-balance pension plan.

In recent years, a growing number of healthcare organizations have dropped the traditional defined-benefit pension plan and adopted cash-balance pension plans. A cash-balance pension plan generally allows employers to pay less in overall pension benefits and administration costs. A cash-balance pension plan pays benefits according to a predetermined formula based on an average of the employee's annual salary over his or her length of service. This provides recognizable benefits to younger employees but lower overall benefits to employees who have a long length of service. To assuage employees who may feel cheated out of the pension benefits they expected, employers that change to a cash-balance pension plan should consider offering higher guaranteed growth rates, advanced notification of the change to the new plan, and generous early-retirement options for employees with longer lengths of service.

Marked hypochloremic metabolic alkalosis with severe compensatory hypoventilation.

In metabolic alkalosis, a compensatory decrease in alveolar ventilation with hypercapnia has been noted only rarely. We recently managed a patient with gastric outlet obstruction from a duodenal ulcer who survived after arriving in the emergency room comatose with severe hypochloremic metabolic alkalosis, compensatory hypoventilation, and hypercapnia. We know of no report in the English literature of a patient with gastric outlet obstruction having a respiratory acidosis or hypochloremia as severe as that in our patient. Proper understanding of the pathophysiology of primary metabolic alkalosis due to gastric losses is necessary to correct the acid-base abnormalities quickly and to restore normal alveolar ventilation.

Effects of noise frequency on performance and annoyance for women and men.

Effects of noise frequencies on both performance on a complex psychomotor task and annoyance were investigated for men (n = 30) and women (n = 30). Each subject performed a complex psychomotor task for 50 min. in the presence of low frequency noise, high frequency noise, or ambient noise. Women and men learned the task at different rates. Little effect of noise was shown. Annoyance ratings were subsequently obtained from each subject for noise of various frequencies by the method of magnitude estimation. High frequency noises were more annoying than low frequency noises regardless of sex and immediate prior exposure to noise. Sex differences in annoyance did not occur. Not direct relationship between learning to perform a complex task while exposed to noise and annoyance by that noise was demonstrated.