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Observations of near-Earth asteroid 1998 KY26 shortly after its discovery reveal a slightly elongated spheroid with a diameter of about 30 meters, a composition analogous to carbonaceous chondritic meteorites, and a rotation period of 10.7 minutes, which is an order of magnitude shorter than that measured for any other solar system object. The rotation is too rapid for 1998 KY26 to consist of multiple components bound together just by their mutual gravitational attraction. This monolithic object probably is a fragment derived from cratering or collisional destruction of a much larger asteroid.

Del sacro bronzo il rotto suono, o Morte, Dice di tua vittoria, E il ner vessillo a le affollatc porte Predica nuova gloria, E il nulla de le cose di quaggiu S' entri: ecco il vinto: ei giace innanzi sera, E a mezzo sua giornata; Fredda le gote tu gl' imbianchi austera...

Over the years, the overconsumption of natural resources has been an issue of concern. Companies have been inducing sustainable practices and approaches to help the environment. By specifically applying the sustainability theory of planned behavior, this study sought to extensively investigate behavioral preference and intention to buy green and sustainable products across name-brand businesses in a developing country. Utilizing Structural Equation Modeling, this study examined responses from 300 valid participants. The results revealed that consumers’ purchasing preferences and intentions are affected by customer expectation for the products, by the government, and by customer concern for the environment. It was seen that customers are prepared to pay extra for name-brand stores that sell eco-friendly or sustainable goods. In accordance, consumers’ purchase intentions are greatly affected by the customer preference or expectation for a product, as the findings indicate that customer-perceived value has the highest influential and consequential relationship to behavioral purposes. Customers are inclined to purchase eco-friendly goods if the sustainable product meets the requirements and expectations of the consumer. Furthermore, consumers’ purchasing intentions in buying green products from name-brand shops are also affected by the government, individuals’ environmental concerns and awareness, individuals’ personal needs and beliefs, society, and individual attitudes. For name-brand stores, consumers’ behavioral intentions to purchase environmentally friendly and sustainable goods are the most strongly associated with their perception of their own value, followed by perceived authority support and perceived environmental concern. The findings and results of this study can be relevant in understanding and exploring consumers’ behavioral intentions to purchase green products from name-brand shops.

Objective This study tested the efficacy of AFFIRM, a brief affirmative cognitive-behavioural group intervention tailored to reduce psychosocial distress and improve coping among sexual and gender minority adolescents and young adults (SGMY). Method SGMY ( n  = 138; M age = 22.44) were allocated to immediate 8-week AFFIRM intervention delivered at 12 community-based organisations or an 8-week waitlisted control. At baseline, post-intervention or post-waitlist, participants completed self-reported assessments of depression, hope, coping, and stress appraisal. Implementation outcomes of feasibility and acceptability were also assessed. Results Compared to waitlist, SGMY in the intervention condition significantly reduced their depressive symptoms ( b  = − 5.79, p  = .001) as well as increased reports of hope (agency: b  = 0.84, p  = .001; pathway: b  = 0.79, p  = .001), and coping by emotional support ( b  = 0.59, p  < .001), instrumental support ( b  = 0.67, p  < .001), positive framing ( b  = 0.59, p  < .001), humour ( b  = 0.36, p  = .014), planning ( b  = 0.49, p  < .001) as well as reflective coping ( b  = 0.27, p  = .009). Intervention participants were also less likely to perceive stress as a threat ( b  = − 0.43, p  = .001), and more likely to perceive stress as challenge ( b  = 0.67, p  < .001) and have the resources to deal with that stress ( b  = 0.38, p  = .016) in comparison to waitlisted control participants. All outcomes had medium to large effect sizes. AFFIRM participants reported low attrition (8.5%) and high levels of engagement and acceptability (e.g. 99% agreed intervention was relevant to their lives). Over 63% of the community organizations that participated in the training hosted AFFIRM at least once during the study. Conclusions Results demonstrate efficacy for the community-based implementation of an affirmative clinical intervention designed for SGMY to address depression and foster coping with universal and minority stressors.

Interleukin-13 receptor alpha 2 (IL13RA2), triggering receptor expressed on myeloid cells-1 (TREM-1), and oncostatin M (OSM) may be associated with response to tumor necrosis factor-α antagonists (TNFAs) in inflammatory bowel disease. We aimed to assess the direction of association between TNFA-induced clinical remission and IL13RA2 and TREM-1, respectively, and assess the value of combining biomarkers for identifying nonresponders. Plasma samples from a retrospective inflammatory bowel disease cohort were collected before TNFA start. Clinical remission at 1-year, surgery, hospitalization, adverse drug events, and TNFA discontinuation were assessed. IL13RA2 and TREM-1 concentrations were compared between those with and without 1-year clinical remission. OSM data were obtained from our previous cohort. Where significant, TREM-1 and IL23RA2 thresholds associated with clinical remission at 1-year were assessed using a receiver operating characteristic analysis. Significant biomarkers were combined using a linear discriminant analysis. The performance characteristics were assessed for individual biomarkers and biomarker combinations. In Crohn's disease (CD) (n = 95) and ulcerative colitis (UC) (n = 53), higher IL13RA2 concentrations, but not TREM-1, were found among those not achieving TNFA-associated clinical remission at 1-year (IL13RA2, CD, P < 0.0001; UC, P = 0.0003). IL13RA2 thresholds, 4.554 ng/mL (CD) and 6.117 ng/mL (UC) separated those with and without clinical remission at 1-year (CD, area under the receiver-operating characteristic curve = 0.80, 95% CI = 0.71-0.90, P < 0.0001; UC, area under the receiver-operating characteristic curve = 0.79, 95% CI = 0.66-0.91, P = 0.0005). In CD, combining IL13RA2 and OSM concentrations enhanced prediction accuracy compared with either biomarker alone and increased the identification of other important clinical outcomes. IL13RA2, but not TREM-1, was associated with TNFA response. In CD, its prediction accuracy improves when combined with OSM.

Outpatient total joint arthroplasty is becoming a more attractive option for hospitals, surgeons, and patients. In this study, the authors evaluated the safety of outpatient shoulder arthroplasty by comparing an outpatient cohort with an inpatient cohort. Ninety-day outcomes of consecutively performed elective shoulder arthroplasty cases from 2012 to 2016 were retrospectively reviewed. Patients were preoperatively assigned to outpatient or inpatient care. Primary outcomes were emergency department visits, readmissions, mortality, and surgical morbidity within 90 days of surgery. Two-tailed t tests were used to evaluate differences. Bivariate and multivariate logistic regressions were used to determine if the odds of emergency department visit, readmission, or complications were significantly different between the cohorts. There were 118 outpatient and 64 inpatient shoulder arthroplasty procedures. Mean age and American Society of Anesthesiologists score were lower in the outpatient group compared with the inpatient group—68.1 vs 72.4 years ( P =.01) and 2.3 vs 2.6 ( P <.01), respectively. In the multivariate logistic regression model including all arthroplasty cases, the odds of outpatient to inpatient readmission was significantly different (odds ratio, 0.181; P =.027). However, when only total shoulder arthroplasty cases were included, no difference was detected. No statistically significant difference was noted for number of emergency department visits, mortality, or surgical morbidity within 90 days of surgery in any of the models. There was 1 death in the ambulatory group at 28 days after surgery. On the basis of these findings, the authors believe that, for carefully selected patients, an outpatient shoulder arthroplasty protocol is safe when compared with inpatient protocols. [ Orthopedics . 2018; 41(4):e563–e568.]

A notable example is the 2007 MRSA directive that mandated that all acute-care units adopt a specific bundle of interventions to prevent the transmission of MRSA.2 The bundle consists of nasal surveillance testing for MRSA for all patients on admission, in-hospital transfer and discharge; contact precautions (CP) for MRSA colonized or infected patients; hand hygiene; and a change in the institutional culture that included institutional leadership with ground-level innovation along with hiring an MRSA coordinator at each facility. A summary of the existing knowledge base, research recommendations and how needs fit within the VA Quality Enhancement Research Initiative (QUERI) 6-step model are provided in Table 1.5TABLE 1 Proposed Veterans Healthcare Administration (VHA) Research Agenda for Transmission Prevention Research Topic Current Evidence Research Needs (QUERI Step Model) Hand hygiene surveillance All hand hygiene opportunities are considered equal risk. Develop, test, and validate sustainable interventions through cluster-randomized controlled trials, well-designed quasi-experimental studies; consider behavioral (eg, peer comparison) or behavioral economic interventions (steps 4, 5, and 6) Existing hand hygiene preparation are short acting and must be reapplied before and after each opportunity. Examine approaches for including active surveillance in the existing CDI bundle across care settings (eg, ICU); perform multicenter cohort or quasi-experimental studies to determine VHA-specific parameter estimates and inform power calculations prior to modeling or large-scale cluster-randomized trials (steps 4, 5, and 6) Active surveillance is pathogen specific and will identify many patients colonized with pathogens they are not likely to transmit.

Volcanic ash produced during explosive eruptions can have very severe impacts on modern technological societies. Here, we use reconstructed patterns of fine ash dispersal recorded in terrestrial and marine geological archives to assess volcanic ash hazards. The ash-dispersal maps from nine Holocene explosive eruptions of Italian volcanoes have been used to construct frequency maps of distal ash deposition over a wide area, which encompasses central and southern Italy, the Adriatic and Tyrrhenian seas and the Balkans. The maps are presented as two cumulative-thickness isopach maps, one for nine eruptions from different volcanoes and one for six eruptions from Somma-Vesuvius. These maps represent the first use of distal ash layers to construct volcanic hazard maps, and the proposed methodology is easily applicable to other volcanic areas worldwide.