Early Separation Research Articles

Investigation of Gene Sequence Divergence, Expression Dynamics, and Endocrine Regulation of the Vitellogenin Gene Family in the Whiteleg Shrimp Litopenaeus vannamei.

In this report, we studied the vitellogenin gene family in the whiteleg shrimp Litopenaeus vannamei by transcriptomics, bioinformatics, and molecular biology methods. At least three moderately homologous vitellogenin (Vg) genes (i.e. LvVg1, LvVg2, and LvVg3) were identified in the genome. The deduced LvVg proteins consisted of a vitellogenin_N domain, a DUF1943 domain, and a VWD domain typical of most vitellogenins from oviparous animals. LvVg1 was the most abundant Vg expressed in the hepatopancreas and ovary of maturing females. Furthermore, multiple isoforms of LvVg1 were evolved presumably due to the need for rapid Vg production during the rapid phase of vitellogenesis. LvVg transcripts were detected in different larval stages, juveniles, and subadults. During the non-reproductive cycle, LvVg expression in the hepatopancreas peaked at the intermolt stages. During the female vitellogenesis cycle, a two-phase expression pattern of LvVg1 gene was observed in the hepatopancreas and ovary. Moreover, the eyestalk optic nerve, brain, and thoracic ganglion consisted of factors that differentially regulated the expression of the three Vg genes. In addition to their reproduction-related roles, Vg may also be involved in growth and molt-related processes. Phylogenetic analysis revealed the early expansion and separation of these Vg genes, and it is most likely correlated with the expansion of Vg’s function. In conclusion, the evolution of multiple LvVg1 isoforms and the acquisition of different Vg genes (i.e. LvVg2 and LvVg3) may occur universally in most decapods. Full information on the total number of Vg genes and precise knowledge on the expression pattern and endocrine regulation of each Vg during all life cycle stages are crucial for us to understand the roles of this emerging gene family in the control of shrimp reproduction and other non-reproductive processes.

Effect of aspect ratio on the recirculation region of 35° Ahmed body

ABSTRACT This paper reports a numerical investigation of the effect of aspect ratio (AR) on the flow structure around the 35° Ahmed body. The AR is defined as the ratio of length to the height of the model. A total of five ARs are considered at a Reynolds number based on the height of the Ahmed body of 7.8 105. The flow governing equations are solved in the FLUENT solver using the SST K-Omega turbulence model. It is found that the drag coefficient (Cd) slightly increases at the AR1 4.2%. As the aspect ratio increases, the drag coefficient decreases. The analysis reveals that early flow separation in the AR1 causes a reattachment at the rear slant end, which leads to an increase in drag. It also highlights that there exists a minimum aspect ratio beyond which the drag increases. and there is a limit in the increasing order beyond which the drag will begin to reduce. Further, it demonstrates that there is no change in the recirculation region and consequently drag coefficient is not a function of the recirculation region. Thence, a clear understanding of the effect of the length-based aspect ratio can help to optimize the length during design.

Ivosidenib Improves Overall Survival Relative to Standard Therapies in Relapsed or Refractory Mutant IDH1 AML: Results from Matched Comparisons to Historical Controls

Ivosidenib Improves Overall Survival Relative to Standard Therapies in Relapsed or Refractory Mutant IDH1 AML: Results from Matched Comparisons to Historical Controls

Delays in Time to Deterioration of Health-Related Quality of Life Were Observed in Patients with Acute Myeloid Leukemia Receiving Venetoclax in Combination with Azacitidine or in Combination with Low-Dose Cytarabine

Delays in Time to Deterioration of Health-Related Quality of Life Were Observed in Patients with Acute Myeloid Leukemia Receiving Venetoclax in Combination with Azacitidine or in Combination with Low-Dose Cytarabine

Role of the Pubic Symphysis in Osseous Pelvic Development: A Novel Model of Bladder Exstrophy in Rabbits.

It has been posited that the osseous pelvic anomalies seen in patients with classic bladder exstrophy (CBE) result from disruption of the pubic symphysis. This hypothesis, however, has not been tested. In the present animal study, our objective was to determine whether the tension of the pubic symphysis helps maintain the shape of the pelvic ring, or whether the growing bones maintain a ring shape even without the tension of the symphysis. In total, 12 neonatal New Zealand White rabbits underwent pubic symphysiotomy (experimental group, n=9) or sham surgery (control group, n=3) on days 3 or 4 of life. Rabbits were scanned with cone-beam computed tomography at 1, 4, 12, and 20 weeks postoperatively to monitor changes in the following pelvic parameters, which are known to be altered in CBE: anterior segment angle, anterior segment length, intertriradiate distance, interpubic distance, and posterior segment angle. Changes within the experimental and control groups were evaluated using repeated-measures analysis of variance and post hoc Tukey honest significant difference testing. Two-tailed t tests were used to compare treatment groups at each time point. Both groups showed increases in anterior segment length and intertriradiate distance during the study period; rabbits in the experimental group also showed a steady increase in interpubic distance (F=43.9; P<0.001). Experimental rabbits had significantly larger mean values for anterior segment angle, intertriradiate distance, interpubic distance, and posterior segment angle than did control rabbits at all time points. We found no difference in mean anterior segment length between control and experimental groups at any time point. The difference in interpubic distance was particularly pronounced by 20 weeks (experimental group, 13±2.7 mm; control group, 1.1±0.1 mm; P<0.001). The pubic symphysis is essential for normal pelvic development. Its absence led to early pelvic angulation and progressive pubic separation in a rabbit model. However, we found no significant difference in the mean anterior segment length, and it is likely that other factors are also implicated in the growth disturbance seen in CBE. Level V.

The Mechanical Harvesting of Hemp Using In-Field Stand-Retting: A Simpler Approach Converted to the Production of Fibers for Industrial Use

The mechanical harvesting of hemp is a key step toward a profitable use of the product. Various fractions (fiber, seeds, residual biomass) may be recovered, and their correct management is fundamental for complying with the requirements of processors/end users. In the light of the renewed interest for its industrial use (panels and insulators), this work proposes the use of modified commercial machines to implement a field separation of the fibrous fraction of stand-retted hemp, a practice that would be profitable if realized with the systems adopted for textile use. The present work was conducted to test the efficiency of harvesting partially macerated plants by using a modified self-propelled forage harvester (SPFH). In Northern Italy, a hemp crop was stand-retted for four months. Then, an SPFH—with rotor knives reduced in number from 24 to 12—was used. Stand-retting made it possible to separate cortical fibers from the inner stem cylinder during harvesting; 53.3% of the material (fibers and shives) was separated automatically by the SPFH together with the chopped bast fiber, while the remaining 46.7% was separated on exiting the launch tube. More than 50% of the fibers were shorter than 5 cm in length, while almost 15% were longer than 10 cm. The SPFH had an effective operating speed of 3.48 km h−1, and no clogging occurred during the test. Therefore, the combination of stand-retting with harvesting using a modified SPFH could be helpful in obtaining an early separation of fibers from shives, thus facilitating the product treatment during its subsequent processing, e.g., by enhancing the defibration.

Cognitive impact of early separation from migrant parents: A spectrum of risk and key mechanisms in child development contexts. A commentary on Hou et al., (2020).

Prolonged separation from migrant parents may lead to child development risks, despite the potential benefits from improved financial circumstances. Within the substantial literature on the health and well-being of the so-called left-behind children, the cognitive impact of parental migration has been inconclusive across different settings globally. In this issue, Hou et al.'s study in rural China focused on school-age children who experience persistent absence of both migrant parents since infancy, and revealed disadvantages in language comprehension outcomes among these children, despite the mitigating effect of higher household income. While results from this study are limited to the ongoing parent-child separation, previous absence of migrant parents has been suggested to have long-lasting negative effects in studies of adolescents in reunited families. Findings from Hou and colleagues' study highlight the needs to better understand migration-related parent-child separation during sensitive developmental periods in infancy and early childhood. A spectrum of risk due to parental migration should be established, accounting for the timing and duration of migration and care arrangements, in order to better identify the at-risk children in communities affected by out-migration. Future research should further explore the mediating and moderating factors in child's environments, and evaluate post-separation adjustment among reunited families after parents' return migration. Research evidence on these aspects will inform the development of tailored intervention programs for left-behind children, and strengthen the abilities of families and communities in best serving the needs of children affected by prolonged parental absence.

Effects of Early-Life Stress on the Brain and Behaviors: Implications of Early Maternal Separation in Rodents.

Early-life stress during the prenatal and postnatal periods affects the formation of neural networks that influence brain function throughout life. Previous studies have indicated that maternal separation (MS), a typical rodent model equivalent to early-life stress and, more specifically, to child abuse and/or neglect in humans, can modulate the hypothalamic–pituitary–adrenal (HPA) axis, affecting subsequent neuronal function and emotional behavior. However, the neural basis of the long-lasting effects of early-life stress on brain function has not been clarified. In the present review, we describe the alterations in the HPA-axis activity—focusing on serum corticosterone (CORT)—and in the end products of the HPA axis as well as on the CORT receptor in rodents. We then introduce the brain regions activated during various patterns of MS, including repeated MS and single exposure to MS at various stages before weaning, via an investigation of c-Fos expression, which is a biological marker of neuronal activity. Furthermore, we discuss the alterations in behavior and gene expression in the brains of adult mice exposed to MS. Finally, we ask whether MS repeats itself and whether intergenerational transmission of child abuse and neglect is possible.

The effect of premature maternal separation on distress vocalizations and activity in kittens (Felis catus) during a brief nest separation

It is unknown how premature maternal separation affects the responses of kittens to potentially stressful events. In the United States, thousands of kittens are orphaned each year due to death of the queen, neglect, or accidental separation by humans. Neonatal mammals emit distress calls and increase locomotion when socially isolated, suggesting that being separated from the nest is a stressful event. Increased vocalization and activity of isolated neonates may aid maternal retrieval or relocation of the nest. In the current study, we assessed the effects of early maternal separation on later vocalizations and activity of 49 kittens (28 orphaned, 21 mother-reared; 23 female, 26 male) from 11 litters (5 mothered, 6 orphaned) during an open field test when the kittens were one and three weeks of age. We conducted a total of 79 trials.Each kitten was placed individually in a 1-meter diameter pen away from the rest of the litter and/or mother for two minutes. The number of calls emitted and total activity (in seconds) were recorded for each kitten on every trial. We assessed the effects of age, sex, orphan status, and interactions between orphan status with sex and age on activity and vocalizations. Orphaned kittens were more active than mother-reared kittens at both times (t(46) = 4.62, p < 0.001), with an interaction between age and orphan status (t(28) = -2.84, p = 0.008). Orphaned kittens emitted more vocalizations at both times (Z = 2.38, p = 0.018), with an interaction between age and orphan status (Z = -3.18, p = 0.001).Orphaned kittens showed increased activity and vocalizations in response to a brief nest separation compared to mother-reared kittens. This effect was still present after over two weeks of maternal separation, suggesting that maternal separation may lead to long-term changes in stress responses. Future research should explore if such effects of maternal separation are present in older kittens or adult cats.

Pubertal recalibration of cortisol reactivity following early life parent-child separation

BackgroundThe hypothalamic–pituitary–adrenocortical (HPA) axis had been proved to calibrate to early-life adversity and puberty may reverse the calibration. This study examines the consequences of prolonged parent-child separation on HPA axis reactivity and the pubertal recalibration hypothesis. MethodsTotally of 144 participants aged 8.75 to 15.25 (mean age 12.50 years, SD: 1.32) were enrolled from rural areas of Chizhou city, Anhui Province of China in 2019. Data on parent-child separation was collected from parents. Self-reported Peterson Pubertal Development Scale was used to assess pubertal maturation and HPA axis stress reactivity was measured using the Trier Social Stress Test for Children. ResultsFor children at early stage of puberty, childhood parent-child separation experiences were associated with blunted HPA axis reactivity (B = -1.888, p = 0.034); while for those at later stage of puberty, HPA axis reactivity was similar between children experienced early childhood separation and those without separation (AUCi: B = -0.426, p = 0.878). In contrast, for children experienced persistent parent-child separation, blunted HPA axis reactivity was observed (all p < 0.05). LimitationsDue to the cross-sectional nature of this study, conclusions about causality remain speculative. ConclusionsThe effect of parent-child separation on dysregulation of HPA axis acts in a time-dependent manner. This finding provides support for the pubertal recalibration hypothesis suggesting that a focus of improving environment in adolescence would help those individuals reared initially in non-supportive conditions.

Extinct and extant Pacific Trogossitidae and the evolution of Cleroidea (Coleoptera) after the Late Triassic biotic crisis

AbstractA new subgenus of Tenebroides, Polynesibroides subgen. nov., is established for six potentially extinct beetles, Tenebroides atiu, T. moorea, T. raivavae, T. rimatara, T. tubuai and T. mihiura spp. nov., described from the Cook, Austral and Society Islands based on subfossil fragments, and the extant T. tahiti sp. nov. from the island of Tahiti, Society Islands. Here we present the first detailed time-scaled phylogeny of the superfamily Cleroidea inferred from our four-gene dataset, including T. tahiti. Bayesian tip-dating, incorporating 17 fossils, estimated that Cleroidea appeared at the end of the Triassic (~210 Mya). The split of Biphyllidae + Byturidae + Phloiophilidae was reconstructed at ~204 Mya, followed by Early Jurassic separation of Trogossitidae (~200 Mya), Acanthocnemidae (~197 Mya), stem Cleridae–Thanerocleridae–Chaetosomatidae (~194 Mya), Peltidae, Lophocateridae, Decamerinae and the melyrid lineage (~191 Mya). Trogossitidae diversified by separation of Kolibacia (~136 Mya) in the Cretaceous, followed by parting Temnoscheila + Nemozoma and Airora + Tenebroides lineages (~113 Mya). Tenebroides radiated ~75 Mya and T. tahiti diverged from Panamanian taxa in the Middle Eocene (~40 Mya). Fourteen morphological characters of Pacific trogossitids were analysed. Parallelodera, including the Panamanian species, is nested within Tenebroides being sister to Polynesibroides. Therefore, Parallelodera is classified as a subgenus of Tenebroides. Tenebroides fairmairei is placed in the subgenus Parallelodera. A Neotropical origin for Parallelodera and Polynesibroides is inferred.

Effect of cow-calf contact on cow motivation to reunite with their calf

Early cow-calf separation prevents much of cows’ natural maternal behaviour. Early separation is thought to prevent the development of a cow-calf bond. To assess this bond, we measured motivation of dairy cows to reunite with their calf. To vary the degree of bonding, some cows were allowed continued contact with their calf and others were separated from their calf soon after birth, following standard practice on most farms. Among cows allowed continued contact, some were able to suckle their calf and others were prevented from suckling (by covering the cow’s udder with an udder net). Cows were habituated to the weighted-gate apparatus before calving by daily training with the (un-weighted) gate. After calving, cow willingness to use the gate was assessed by determining if she would push open the gate to access to her own calf. Testing occurred once daily, with weight on the gate gradually increased. After passing through the gate, the dam’s calf-directed behaviour was recorded. Suckled cows pushed a greater maximum weight (45.8 ± 7.8 kg) than separated cows (21.6 ± 6.7 kg) and non-suckled cows (24.3 ± 4.5 kg), with no differences between separated and non-suckled cows. Once reunited, latency to make nose contact and duration of licking did not differ between treatments. We conclude that motivation for calf contact is greater for cows that are suckled.

Diversification of epizoic freshwater limpets in ancient lakes on Sulawesi, Indonesia: Coincidence or coevolution?

The set of ancient lakes on Sulawesi, Indonesia, represents a unique global hotspot of aquatic biodiversity. These lakes have been recognized widely because of their high number of endemic species with specialized and distinctive morphological characters, life history and ecological adaptations. An interesting case of unusual life history involving brood care exists in the planorbid limpets of the genus Protancylus, which live exclusively as epizoans on the endemic pachychilid gastropod Tylomelania. We aimed to unravel the evolutionary and phylogeographical patterns of Protancylus from the Malili lakes and Lake Poso using two mitochondrial markers in an integrated framework that includes morphological, life-history and ecological data. At least three species of Protancylus evolved allopatrically, with a newly recognized species occurring in lakes Matano and Mahalona. All species are characterized by low morphological variation, shared life-history traits including a unique reproduction strategy. Our genetic data indicates that a drift-based geographic speciation mode correlates with the present distribution pattern. The initial diversification significantly predates the ages of the respective lakes and the lineages of Protancylus are significantly older than their corresponding Tylomelania ‘hosts’. The deep split between P. pileolus of Lake Poso and the populations in the Malili lakes is remarkable and hints to a very early separation in a time frame when Sulawesi reached its current composition. As colonization and onset of diversification is strikingly different in Tylomelania and the epizoic Protancylus, co-evolutionary components in this association can be excluded and both evolved largely independently. We discuss and compare our findings to other invertebrate assemblages in the ancient lakes of Sulawesi.

The importance of educating prospective dog owners on best practice for acquiring a puppy

The urgent need to reduce the number of dogs that are abandoned or relinquished to shelters is now widely recognised by the scientific community, veterinarians, dog trainers and breeders. The...

Neurophysiologic evidence for increased retrieval suppression among negative ruminators.

IntroductionEvents (e.g., seeing a familiar face) may initiate retrieval of associated information (e.g., person's name), but not all cue‐initiated memory retrieval is welcome (e.g., trauma). Retrieval suppression refers to the ability to halt unwanted retrieval, and any erosion of memory associations in response to repeatedly excluding a memory from consciousness. The current study sought to examine event‐related potential (ERP, averaged scalp electrical recordings) correlates of inhibitory cognitive control of memory retrieval and any linkage of such control to ruminative memory styles.MethodsParticipants (N = 23) first learned face‐picture pairings. ERPs were then recorded as they viewed face cues while either bringing the associated picture to mind (think trial), or not allowing the associated picture to come to mind (no‐think trial).ResultsEmotional valence of learned pictures (negative versus neutral) modulated a posterior (P1, 100–150 ms) ERP associated with attention to the face cue. Memory strategy (think versus no‐think) modulated a frontal (P3, 350–450 ms) associated with alerting of the need to control retrieval. Both valence and strategy worked in combination to modulate a late posterior (LC, 450–550 ms) ERP associated with successful memory retrieval. Brooding, a negative form of rumination, was found to be positively correlated with the LC ERP.ConclusionThe results suggest early separation of emotional and strategic control of retrieval, but later combined control over access to working memory. Moreover, the positive correlation of brooding and the LC suggest that individuals who are high in application of perseverative strategies to memory retrieval will show greater modulation of the retrieval‐related LC ERP.

Early weaning: new insights on an ever-persistent problem in the dairy industry.

It is common practice in the dairy industry to separate the calf from the cow immediately after parturition, and in most parts of the world calves are housed individually during the milk-feeding period. Early and abrupt separation has major implications for the calf's physical and psychological development. In this Research Reflection short review we present and discuss the main housing systems and management practices regarding early weaning in today's dairy industry. Main benefits and disadvantages are critically addressed, and possible future research suggested. Furthermore, major policy issues related to consumers, scientific recommendations and economic performance of farms have been identified, as well as future drivers for more viable housing solutions for neonatal calves. This review serves as an introduction and preamble to the second section of this Special Issue, which is dedicated to cow-calf contact management systems.

COVID 19 Vertical Transmission: A Growing Concern

Context: COVID 19 vertical transmission is a great concern in different aspects of mother, child, healthcare staff and community safety and protection. There is lack of definitive evidence confirming or declining mother to child COVID 19 transmission. This article is an update on this challenging issue. Evidence Acquisition: This article is a comprehensive search in scientific major database from 1 January 2020 up to 25 April 2020 with the key words of “COVID 19” and “vertical transmission” or “neonatal”. Two researchers reviewed all selected articles to extract data about neonatal COVID 19 and vertical transmission. Those reports that provided the results of PCR on fetus or neonate blood, amniotic fluid or pharyngeal secretion samples or elevated COVID 19 specific IgM were included. Those reports based on clinical COVID 19 characteristics or radiological findings were not included in data extraction. Thirty six articles have been reviewed and evidence supporting or against COVID 19 Vertical transmission have been extracted and discussed. Results: Most previous studies on vertical COVID 19 transmission have been tested placenta, amniotic fluid, cord blood and newborn blood or pharyngeal swab sample using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) that may show false negative results due to suboptimal sampling or inefficient viral load. Increased COVID 19 specific IgG/IgM antibodies have been reported in newborns from COVID 19 mothers; however, data is limited and longitudinal follow up is needed. Evidence supporting COVID 19 vertical transmission: Recent reports indicated that pharyngeal PCR test turned positive in first few hours of life in several neonates. Also increased level of COVID 19 specific IgM and IgG antibodies in newborns to COVID 19 positive mothers were observed. Rate of perinatal complications were higher among newborns of COVID 19 mothers. Evidence against COVID 19 vertical transmission: All tissue or blood specimens and pharyngeal swab qRT-PCR tests among neonates born from COVID 19 mothers were negative. Rate of cross reactivity and false positive results are high in serologic studies. Conclusions: COVID 19 vertical transmission is a growing health care concern that needs further investigation; however, it is suggested to be equipped with PPE on contacts with both COVID 19 pregnant woman and her newborn baby and apply early separation, isolation, testing and close follow up for both mother and child.

Laminar-Turbulent Transition on a Cambered NACA 16-009 Airfoil at Low Speed

Infrared thermography, force measurements, and oil flow visualizations are used to investigate the flow patterns around a cambered NACA16-409 airfoil at low Mach number. This cambered profile is widely used for propellers despite the lack of knowledge concerning its flow characteristics. The post-processing of thermograms relies on the analysis of the surface temperature gradient and identification of inflexion points in the temperature distribution. The observations made on the thermograms, based on the distribution of the temperature and Stanton number, are substantiated by the oil flow visualizations. RANS simulations with a transitional SST k-ω & γ turbulence model corroborate the analysis and deliver detailed insight in the flow around the airfoil. Depending on the angle of attack, three distinct flow patterns have been identified: laminar flow with early separation, laminar separation bubble with trailing edge separation, and turbulent flow with trailing edge separation. The shift between the last two regimes occurs sharply. The prediction capability of the transitional RANS simulations and XFOIL in terms of separation as well as reattachment location are compared with the experimental results. The force-coefficients dependency on the angle-of-attack, obtained by experiments, XFOIL, and RANS simulations, bear the traces from these flow patterns.

Early maternal separation accelerates the progression of endometriosis in adult mice

BackgroundA large body of research highlights the importance of early-life environmental impact on the health outcome in adulthood. However, whether early-life adversity (ELA) has any impact on the development of endometriosis is completely unclear. In this study, we tested the hypothesis that ELA, as manifested by neonatal separation, can accelerate the progression of endometriosis in mouse through activation of the adrenergic receptor β2 (ADRB2) signaling pathway, leading to increased angiogenesis and progression of endometriotic lesions.MethodsEight female Balb/C mice, in late pregnancy, were used used for this study, which later gave birth to 22 female newborn pubs. Eleven additional female Balb/C mice were also used as donors of uterine tissues. The 22 newborn pubs were randomly divided into 2 equal-sized groups, maternal separation (MS) and no separation (NS). Pubs in the MS group were separated from their dams for 3 h/day from postnatal day (PND) 1 to 21, while those in the NS control remained in the home cage with their dams. In adulthood (8-week old), 3 mice in each group were randomly selected to undergo a battery of behavior tests. The remaining 8 mice in each group were induced with endometriosis by intraperitoneal injection of uterine fragments from donor mice. Four weeks after the induction, all mice were sacrificed and their endometriotic lesions were excised for quantification and then prepared for immunohistochemistry analysis.ResultsWe confirmed that MS during infancy resulted in anxiety and depression-like behaviors as previously reported. We also found that in MS mice the lesion weight was increased by over 2 folds and generalized hyperalgesia was also significantly increased as compared with NS mice. Immunostaining analysis demonstrated that MS accelerated the development of endometriosis likely through decreased dopamine receptor D2 (DRD2) expression and activation of the ADRB2/cAMP-response element binding protein (CREB) signaling pathway, leading to increased angiogenesis and progression of endometriotic lesions.ConclusionsExposure of female mouse pups to ELA such as MS during their infancy period accelerates the progression of endometriosis, possibly through altered neuronal wiring and hyperactivity of the hypothalamic-pituitary-adrenal axis.

Predictors of Annual and Early Separations Among Direct Support Professionals: National Core Indicators Staff Stability Survey.

Direct support professionals (DSPs) provide a broad range of supports in a variety of settings to people with intellectual and developmental disabilities (IDD) that enables people to live, work, and participate in their communities. Despite the crucial importance in ensuring supports for community participation of people with IDD, high rates of annual turnover among DSPs in organizations that employ them have been documented for decades. This study utilizes National Core Indicators Staff Stability data from 2016 to examine the impact of organizational- and state-level factors related to DSP turnover, including annual DSP turnover and the percentage of DSPs who left their positions after less than 6 months. At the organizational level, a higher turnover rate in the last 12 months was significantly related to lower DSP wages and to not offering health insurance. At the state level, a higher turnover rate in the last 12 months was significantly related to a lower percentage of people living in individualized settings and lower per capita Medicaid spending. For early turnover at the organizational level, a higher percent of leavers within 6 months of tenure was significantly related to not offering paid time off and health insurance, higher vacancy rates, higher proportion of part-time DSPs, and lower overall staff sizes.