Original Recipients Research Articles

Optimizing an mHealth Program to Promote Type 2 Diabetes Prevention in High-Risk Individuals: Cross-Sectional Questionnaire Study.

We evaluated the outcomes of a pilot SMS text messaging-based public health campaign that identified social networking nodes and variations of response rates to develop a list of variables that could be used to analyze and develop an outreach strategy that would maximize the impact of future public health campaigns planned for Kuwait. Computational analysis of connections has been used to analyze the spread of infectious diseases, dissemination of new thoughts and ideas, efficiency of logistics networks, and even public health care campaigns. Percolation theory network analysis provides a mathematical alternative to more established heuristic approaches that have been used to optimize network development. We report on a pilot study designed to identify and treat subjects at high risk of developing type 2 diabetes mellitus in Kuwait. The aim of this study was to identify ways to optimize efficient deployment of resources and improve response rates in a public health campaign by using variables identified in this secondary analysis of our previously published data (Alqabandi et al, 2020). This analysis identified key variables that could be used in a computational analysis to plan for future public health campaigns. SMS text message screening posts were sent inviting recipients to answer 6 questions to determine their risk of developing type 2 diabetes mellitus. If subjects agreed to participate, a link to the Centers for Disease Control and Prevention prediabetes screening test was automatically transmitted to their mobile devices. The phone numbers used in this campaign were recorded and compared to the responses received through SMS text messaging and social media forwarding. A total of 180,000 SMS text messages through 5 different campaigns were sent to 6% of the adult population in Kuwait. A total of 260 individuals agreed to participate, of which 153 (58.8%) completed the screening. Remarkably, 367 additional surveys were received from individuals who were not invited by the original circulated SMS text messages. These individuals were invited through forwarded surveys from the original recipients after authentication with the study center. The original SMS text messages were found to successfully identify influencers in existing social networks to improve the efficacy of the public health campaign. SMS text messaging-based health care screening campaigns were found to have limited effectiveness alone; however, the increased reach through shared second-party forwarding suggests the potential of exponentially expanding the reach of the study and identifying a higher percentage of eligible candidates through the use of percolation theory. Future research should be directed toward designing SMS text messaging campaigns that support a combination of SMS text message invitations and social networks along with identification of influential nodes and key variables, which are likely unique to the environment and cultural background of the population, using percolation theory modeling and chatbots.

The First Christian Slave: Onesimus in Context by Mary Ann Beavis

Reviewed by: The First Christian Slave: Onesimus in Context by Mary Ann Beavis Sung Uk Lim mary ann beavis, The First Christian Slave: Onesimus in Context (Eugene, OR: Cascade, 2021). Pp. xii + 136. $21. In stark contrast to the traditional interpretation deeply entrenched in the dominant perspective of Paul or Philemon, Mary Ann Beavis takes a doulocentric, or slave-centered, perspective in analyzing Philemon in order to recover the silenced voice and repressed [End Page 351] agency of Onesimus in the dominant societies, both ancient and modern. B.'s awareness of and sensitivity to the long-lasting legacy of the slave trade even in modern history stimulates her to use a cross-cultural reading strategy across spatial and temporal constraints. Reading Philemon with Onesimus in the foreground triggers a liberationist hermeneutics for those enslaved people throughout history. In chap. 1, B. starts with a deepened understanding of the notion of "social death" coined by Orlando Patterson in his work Slavery and Social Death (Cambridge, MA: Harvard University Press, 1982). Social death can be defined simply as "a way of describing a set of dehumanizing conditions imposed by slaveholders on slaves" (p. 16). B. emphasizes, however, that enslaved people, including Onesimus, have the agency to resist the oppressive system forcibly imposing social death upon them in the day-to-day tactics, most of which are not recorded in the extant documents. At the same time, B. pays due attention to the notion of "soul value" termed by Daina Ramey Berry (The Price for Their Pound of Flesh [Boston: Beacon, 2017]). Soul value is referred to as the intrinsically felt self-worth of enslaved people in marked opposition to their monetary worth estimated by the slaveholders. Even if it still remains a puzzle how Onesimus responded to Paul's perception of his soul value, B. is assured that Onesimus embraced the gospel as beneficial to the improvement of his life at the material and spiritual levels. Interestingly, B. strenuously points out that enslaved people can variously express their soul values, regardless of their situation between accommodation and recalcitrance. In contrast to the widely accepted hypothesis of white slaveholders that Onesimus was a runaway slave sent back by the apostle to his master Philemon, B. in chap. 2 assumes that Philemon sent or left Onesimus behind to provide Paul with assistance in multiple ways. To sustain a doulocentric perspective in the process of exegesis, B. leans toward the interpretations of Philemon by the (formerly) enslaved in American nineteenth-century history. Along this line of reasoning, she surmises that the letter's original recipients consisted of mixed groups of free, freed, and enslaved people as members of the so-called ecclesia. Certainly, Onesimus the slave as part of the oikos of Philemon had no choice but to participate in the cultic ceremonies practiced in the master's household. According to B., Onesimus, nevertheless, was likely to have more agency in the religious realm in his relationships with Paul than has traditionally been imagined. For instance, she concurs that Onesimus, albeit enslaved, took on diakonia ("diaconal service"). Furthermore, beyond the realm of religion, B. goes so far as to suppose that Onesimus, closely acquainted with Paul, was able to manipulate the apostle into interceding in the strained relationship between a master and a slave. In chap. 3, B. compares Paul's letter to Philemon with the letter of Pliny the Elder to Sabianus, the purpose of which was to request that Sabianus pardon an unnamed freedman for his offensive action. In spite of manifold differences between the two letters, B. demonstrates a similarity between them in that both were composed at the request of a supplicant. In cross-cultural perspective, B. goes on to juxtapose Paul's letter to Philemon with the letters written by enslaved people in antebellum American culture. Surprisingly, despite their great historical and cultural separation, such letters have much in common in that all of them have a person of higher status who asks a slaveholder to grant a favor for an enslaved person. These intercultural observations lead to the conviction that Onesimus directed Paul to contrive the letter in Onesimus's favor. [End Page 352] In chap. 4, B. discusses...

Jesus in Context: Making Sense of the Historical Figure by David Wenham

Reviewed by: Jesus in Context: Making Sense of the Historical Figure by David Wenham Glenn B. Siniscalchi david wenham, Jesus in Context: Making Sense of the Historical Figure (Cambridge Studies in Religion, Philosophy, and Society; Cambridge: Cambridge University Press, 2021). Pp. xii + 249. Paper $29.99. David Wenham’s evenhanded, concise, and accessible book is dedicated to the basic themes of contemporary research on the historical Jesus. It is strongly recommended for introductory-level college courses that are related to historical approaches to the NT writings. One of the best aspects of Jesus in Context is the comprehensive coverage of most of the pertinent subjects in the current state of historical Jesus research. Whether it is the broad contours of the Roman Empire or the Jewish matrix from which Jesus and his first followers emerged in ancient Israel, there is plenty of informative and digestible material in this book. Wenham’s impartial coverage of the current findings of Jesus research is both ecumenically sensitive and consistent with the presuppositions of Christian theology. In this way, W.’s text subtly reports that christological orthodoxy and many well-established conclusions about the historical figure of Jesus can now be seen as comrades-in-arms. W. is keen on informing the reader where the consensus of NT scholars stand with respect to Jesus and his self-understanding; his teachings, actions, and miracles; and the immediate impact that he made on his followers. One might profit from understanding the political and socioreligious contexts in which Jesus lived (part 1) and some of the major themes that characterized his sayings and ministry (part 2). Toward the beginning of Jesus in Context, W. discusses the literary sources that ancient historians commonly use to study Jesus, the geographical and archaeological discoveries that seem pertinent for the relevant contemporary studies, and the history of ancient Israel and the Roman Empire up to and including the first century of the Common Era. [End Page 168] Wenham’s text is also excellent with regard to the fundamental reliability of the canonical Gospels. He rightly reports that form criticism, redaction criticism, the fascination with the second-century apocryphal Gospels, and the notion of oral traditions in ancient Palestine are not relevant enough concerns to lead one to conclude that the Christian Gospels are unreliable. Moreover, the current state of NT scholarship is not on the side of the revision-ist views of Rudolf Bultmann (who was known for separating the theology of the canonical Gospels from whatever history might lie behind them) or the older nineteenth-century scholars who saw the Gospels as fabricated myths. In the words of W., “The skepticism that ends up with scholars concluding or implying that much gospel tradition is the creation of the early Christian church rather than Jesus is curious, to say the least. It is much more likely that the main creative genius reflected in the gospel stories and teaching was the person who inspired the Christian movement, rather than . . . his followers” (p. 76). Rather, most of the newest questers in the guild endorse the historicity of Jesus and his various teachings about the reign of God, his baptism by John the Baptist, his wondrous miracles, and his resurrection from the dead. Recognizing that Paul’s letters were not understood as inspired texts by the original recipients, W. pointedly brings home the relevance of the apostle Paul for Jesus studies: “Both these early letters and others that followed, . . . give a lot of evidence about what the first Christians said and believed about Jesus. The letters are not telling the stories of Jesus, but are dealing with issues that had arisen in the churches; their references to Jesus are all the more revealing for being incidental” (p. 47). One of W.’s areas of special interest is that the apostle Paul and the four Gospel writers were not literarily dependent on one another. Despite that barrage of technical publications on early christology and historical criticism, W.’s book should be warmly welcomed as one of the best introductory texts on the current state of the basic questions on the historical Jesus and the reliability of the NT. In terms of accessibility and depth of...

The Relevance of Textual Criticism in Biblical Interpretation

Textual criticism refers to the techniques used by biblical scholars in interpreting a given text of the Bible to ascertain its original wording, the nature of its composition, sources, date, and authorship. Textual criticism is an essential aspect of biblical interpretation, which some interpreters technically dodged from it thinking that the word “criticism” is negative. Far be it from this assertion, biblical criticism is relevant, and it remains relevant. Textual criticism is significant; it helps us understand that Scripture cannot be overestimated. It is vital to the understanding of Scripture as the Word of God. It seeks to investigate and understand the situation of the original recipients of the word to discover precisely what the original writers of the scriptures meant by their words. From this Spirit, the writer would shed light on the importance and relevance of biblical criticism, especially to the interpretation of the Bible. To achieve the aim of the writing, the writer uses the narrative-critical analysis method to present the paper’s idea.

The impact of the Hebrew Scriptures, and especially the Torah, on James’s thought, terminology and teaching

While James is a Christian document, it is also undeniably Jewish. This article investigated the degree to which James is rooted in the Hebrew Scriptures (i.e. Old Testament [OT]), especially the Torah, and how that gives meaning to what he says and teaches. The study was undertaken by establishing the likely relevance and role of the Hebrew Scriptures and particularly the Torah for James’s first readers, and the manner and extent of James’s use of these Scriptures in his Letter. The study was concluded by outlining the findings of the impact of these Scriptures on the Letter. The Greek translation of the Hebrews Scriptures was most likely the Bible of James’s original recipients. As with the rest of the New Testament (NT), James shows remarkable dependence upon and ascribes unqualified authority to the Hebrew Scriptures. James draws substance from, applies, and never nullifies anything from the OT. Referring to an OT Scripture, on average, every 1.86 verses, James’s thought is clearly shaped by the OT. He grounds his fundamental teachings in the Torah – notably in the Shema, Decalogue, and ‘Holiness Code’. While James is silent on the ritual commandments, he focusses on the moral commandments and ‘weightier matters’ of the Torah, so much so that his entire contents may fall under ‘faith/faithfulness’ (or loving God, 1st Table of the Decalogue) or ‘justice’/’mercy’ (or loving neighbour, 2nd Table of the Decalogue). With the core of the Torah evidently being foundational in James, it seems appropriate to interpret James’s terms and teaching in the light of and in line with the Torah, and especially the Torah’s weightier matters and moral instructions.Contribution: This key finding may contribute to the debate about what James’s means and teaches concerning ‘law’ (νόμος) his Letter.

A Small Multihost Plasmid Carrying erm(T) Identified in Enterococcus faecalis

The aim of this study was to determine the mobile genetic elements involved in the horizontal transfer of erm(T) in Enterococcus faecalis, and its transmission ability in heterologous hosts. A total of 159 erythromycin-resistant enterococci isolates were screened for the presence of macrolide resistance genes by PCR. Whole genome sequencing for erm(T)-carrying E. faecalis E165 was performed. The transmission ability in heterologous hosts was explored by conjugation, transformation, and fitness cost. The erm(T) gene was detected only in an E. faecalis isolate E165 (1/159), which was located on a 4,244-bp small plasmid, designed pE165. Using E. faecalis OG1RF as the recipient strain, pE165 is transferable. Natural transformation experiments using Streptococcus suis P1/7 and Streptococcus mutans UA159 as the recipients indicated it is transmissible, which was also observed by electrotransformation using Staphylococcus aureus RN4220 as a recipient. The erm(T)-carrying pE165 can replicate in the heterologous host including E. faecalis OG1RF, S. suis P1/7, S. mutans UA159, and S. aureus RN4220 and conferred resistance to erythromycin and clindamycin to all hosts. Although there is no disadvantage of pE165 in the recipient strains in growth curve experiments, all the pE165-carrying recipients had a fitness cost compared to the corresponding original recipients in growth competition experiments. In brief, an erm(T)-carrying plasmid was for the first time described in E. faecalis and as transmissible to heterologous hosts.

The Letter to the Ephesians

Lynn Cohick’s anticipated NICNT commentary on Ephesians deservedly takes its place in what is widely regarded as one of the most rigorous, thorough, historically and socio-culturally informed, and theologically insightful and balanced series available. Overall, the commentary reflects the scholarship and style we have come to expect from Cohick: well- researched, judicious, expert, and pastorally sensitive and wise.Especially valuable are the fifteen excursuses scattered throughout the work, covering topics from (for example) “The Meaning of Kephalē” (pp. 130–34) and “Supersessionism” (pp. 189–95) to “Household Codes in the Ancient World” (pp. 342–48) and “Slavery in the Ancient World” (pp. 391–407). Throughout, Cohick shows herself to be not only a sharp historical critic but also a sensitive expositor of these volatile issues for our troubled times.Any commentary on Ephesians, of course, must start with the contested question of authorship (pp. 3–25). Particularly valuable in this connection is the discussion of the role of an amanuensis and of the potential role of the co-senders of Paul’s letters (pp. 23–24). After a careful discussion, Cohick concludes that Ephesians is Pauline. She then turns her attention to the question of the letter’s original recipients, a question complicated by the fact that “in Ephesus” (1:1) is missed out in some early and important witnesses. In any event, Cohick decides on an Ephesian address (pp. 25–30). This decision then prompts a helpful, concise survey of the Artemis and imperial cults (pp. 34–40). From here, Cohick turns to the contested question of the letter’s provenance, some scholars advocating an Ephesian provenance and others a Roman one. Having carefully weighed the evidence, she concludes that Paul wrote Ephesians from Rome (pp. 45–47). Moreover, beyond these fundamental matters of the text’s historical exigencies, Cohick also provides valuable introductory material on a number of topics, prominent among which is a lengthy discussion of the text’s Christology and proto-trinitarianism (pp. 57–70).All relevant matters text-critical, linguistic, rhetorical, historical, socio-cultural, and theological are handled with thoroughness and care. But a few features of the volume deserve special mention.A thorough and yet succinct discussion of the so-called Haustafeln (“household codes”) can be found on pp. 342–48. A couple of Cohick’s summary remarks with respect to Ephesians 5:21–6:9 are worth quoting at length.Cohick then helpfully locates Paul’s vision of the household, and of its constituent members and relationships, in relation to the visions of the ancient philosophical tradition (pp. 342–50, 385–401).For Paul, she argues, unlike (for example) for Plato, “there is no ontological difference between the slave and the master.” And Paul, moreover, unlike (for example) Aristotle, shows no strong interest in “maintaining class distinctions or [in] isolating virtues to specific groups on a sliding scale of social worth” (345). Finally, Paul, unlike (for example) Plutarch, “seems unconcerned about the wife working to make her husband happy. Instead, Paul emphasizes a husband’s sacrificial, self-giving love that is more in keeping with Plutarch’s description of a wife” (p. 347).Moreover, although she acknowledges, here quoting Margaret Y. MacDonald, Colossians and Ephesians, Sacra Pagina 17 (Collegeville: Liturgical Press, 2000), 341, that “it is important to acknowledge that the text presents a vision of household relationships, rooted in an ancient setting, that is considered unjust today (and, in the case of slavery, completely immoral),” she also concludes the following: “Paul eliminates the power of the superordinate—husband and (male or female) slave master—and elevates the importance and worth of the subordinate. By so doing, he effectively cuts the bottom out of the institutions of patriarchy and slavery” (p. 388).Cohick also appreciates throughout that—though I am putting this in my words and not hers—unless we are to have a docetic bibliology and consequently a docetic view of scriptural inspiration, we ought to expect the authors of scripture to be, as we often wrongly say with no small amount of chronological snobbery, “people of their time.” The point of inspiration is not that the authors of scripture attained to a point of view that was timeless, somehow completely detached from the (broken) context within which alone they understood God, themselves, and everything else. Rather, the point is that they said precisely what God wanted them to say from within and in relation to this broken context.We owe Cohick a debt: this is now one of the best Ephesians commentaries we have.

Post-Crisis Assurance and the ‘Tests of Life’ Reading of 1 John

1 John has often been read as advocating a series of personal ‘tests of life’, by which individuals can evaluate the genuineness of their conversion. This article argues that framing 1 John’s teaching on assurance in this way distorts its teaching by failing to recognise the epistle’s rhetorical strategy. It argues that this epistle was intended to positively cultivate assurance in its original recipients by highlighting that they had already proven their possession of salvation by their perseverance in their confession, whereas others had recently abandoned it. This invites reflection on the role of pastoral evaluation and exhortation in cultivating assurance rather than on individualistic strategies alone.

Fecal Microbial Transplant in Individuals With Immune-Mediated Dry Eye

To evaluate the safety of the Fecal Microbial Transplant for Sjogren Syndrome (FMT) trial in individuals with immune-mediated dry eye (DE). Open-label, nonrandomized clinical trial. The study population included 10 individuals with DE symptoms and signs meeting criteria for Sjögren or positive early Sjögren markers. Procedures were 2 FMTs from a single healthy donor delivered via enema, 1 week apart. The primary outcome measure was safety. In addition, gut microbiome profiles, DE metrics, and T-cell profiles in blood were examined at baseline before FMT, and at 1 week, 1 month, and 3 months after FMT. The mean age of the population was 60.4 years; 30% were male; 50% were white; and 50% were Hispanic. At baseline, all subjects had significantly different gut microbiome profiles from the donor, including higher mean diversity indices. Subjects had a decreased abundance of genera Faecalibacterium, Prevotella, and Ruminococcus and an increased abundance of genera Alistipes, Streptococcus, and Blautia compared to the donor. Effector and regulatory T-cell profiles were positively correlated with each other and with DE symptom severity (T helper 1 cells [Th1]; r=.76; P=.01; Th17: r=0.83; P=.003; CD25: r=0.66; P=.04; FoxP3: r=0.68; P=.03). No adverse events were noted with FMT. After FMT, gut microbiome profiles in 8 subjects moved closer to the donor's profile. As a group, gut microbiome profiles at all follow-up time points were more similar to the original recipients' than the donor's microbiome; however, certain phyla, classes, and genera operational taxonomic unit (OTU) numbers remained closer to the donor vs recipients' baseline profiles out to 3 months. Five individuals subjectively reported improved dry eye symptoms 3 months after FMT. FMT was safely performed in individuals with immune-mediated DE, with certain bacterial profiles resembling the donor out to 3 months after FMT. One-half the subjects reported improved DE symptoms. The most effective FMT administration method has yet to be determined.

Decisional authority of gamete donors over embryos created with their gametes

In the ongoing discussion on the rights and obligations of gamete donors, scant attention has been paid to the decisional authority of gamete donors over the disposition of the embryos created with their gametes. This paper analyses four different positions: three cases relate to the disposition options for surplus or unused embryos by the first recipients, and one case relates to the use of the embryos stored by the first recipients for procreation.We conclude that the gamete donor causally contributes to the creation of the embryos and thus becomes indirectly responsible. To avoid that donors would become accomplices to an activity to which they morally object, a qualified generic consent mentioning types of research should be obtained. No consent from the donor is required for the destruction of the embryos.The cancellation of the agreement by anonymous or identifiable gamete donors should not be possible for embryos in storage for reproduction by the recipients. The interests in not becoming a genetic parent against one's wishes do not outweigh the damage done to recipients who would no longer be able to use their embryos. Known donors, on the contrary, should be able to withdraw their consent up to the moment of transfer of the embryos based on the greater harm caused to them as a consequence of attributional parenthood. They should also be able to veto transfer of the embryos to other people than the original recipients.

Colossians: Background and contexts

This article explores various facets of the historical background that assist in illuminating passages within Colossians, including the hymn to Christ (Col 1:15–20), the conflict that seems to have prompted the letter (Col 2:8–19), and the household code (Col 3:18–25). This exploration relies on archaeological evidence as well as texts from extra-biblical sources to project what the original recipients of this letter might have heard and understood when they received it.

A Study on Change in the Subae nongga at the Time of the South Korean Land Reform: The Case of Namjong-myeon, Gwangju City

Though strictly forbidden by the South Korean Land Reform Act (1950), the resale of lands distributed by that land reform was widespread. In Namjong-myeon, 38.3 percent of the recipient households (the so-called subae nongga , those households that originally received land under the land reform) resold their distributed lands in de facto land sales. As a result of such sales, while the recipient households in Namjong-myeon had numbered 371, the actual number of recipient households-those who ultimately gained possession of the distributed lands-increased to 393. Among these 371 subae nongga households, 77 abandoned their distributed lands. Those who did so were economically disadvantaged relative to their peers in both the size of their landholdings as well as land distributions. Yet, despite the widespread de facto buying and selling of land at the time of the land reform, ultimately there was little difference between the original recipients and final recipients of distributed land in terms of land size and ownership. This means that the equalitarianism of the South Korean land reform, which is regarded as one of the key factors behind the successful growth of the South Korean economy, was steadfastly maintained even through the turmoil of the Korean War.

Random transposon vectors pUTTns for the markerless integration of exogenous genes into gram-negative eubacteria chromosomes

A set of random transposon vectors pUTTns that facilitates the markerless integration of new functions into the chromosome of gram-negative bacteria has been developed. The vectors, which are derived from mini-Tn5 transposons, are located on a R6K-based suicide delivery plasmid that provides the IS 50 R transposase tnp gene in cis, but they are external to the mobile element. The vectors' conjugal transfer to recipients is mediated by RP4 mobilization functions in the donor. Internal to the mini-Tn5 element is a cassette that contains a selectable antibiotic resistance marker (kanamycin, chloramphenicol, or tetracycline resistance gene), a counter-selectable marker ( sacB), a 430-bp repeat of the sacB gene 3′ end acted as the directly-repeated (DR) sequence, and modified multiple cloning sites (MCS). After two total rounds of transposon integration and recombination between the two DRs, only the exogenous DNA inserted into the MCS (passenger genes) and a single 430-bp scar sacBDR fragment remained in the chromosome after excision. The utility of these vectors was demonstrated by integrating the organophosphorus insecticide hydrolase gene ( mpd) into the chromosome of Escherichia, Pseudomonas, Sphingomonas, and Paracoccus species. Sequential integration of another organophosphorus insecticide hydrolase gene ( oph) into the previously engineered bacteria, without bringing any selectable markers, was also successful. These engineered bacteria were relatively stable. Cell viability and original degrading characteristics were not affected compared with the original recipients. This shows that the developed system is very useful for the markerless integration of exogenous genes into the chromosome of gram-negative eubacteria.

From Agraristas to Guerrilleros: The Jaramillista Movement in Morelos

From Agraristas to Guerrilleros: The Jaramillista Movement in Morelos

Identification of putative ancestors of the multidrug-resistant Salmonella enterica serovar typhimurium DT104 clone harboring the Salmonella genomic island 1

The origin of multidrug-resistant Salmonella enterica serovar typhimurium (S. typhimurium) harboring the Salmonella Genomic Island 1 (SGI1), which was detected for the first time in the mid-1980s is unknown. In this study, we performed microarray genomotyping of four multidrug-resistant SGI1 positive strains and found that unlike the S. typhimurium LT2 strain, the multidrug-resistant strains lacked genes STM0517-0529 allowing the utilization of allantoin as a sole nitrogen source. We extended this observation by PCR screening of additional 120 S. typhimurium field strains and found that this locus was absent in all SGI1 positive and also in 24% of SGI1 negative strains, which were proposed to be the original recipients of SGI1. To prove this hypothesis, we compared the STM0517-0529 negative strains (with or without the SGI1) by PFGE and PCR prophage typing and found that 8 out of 11 of the SGI1 negative strains and 17 out of 22 SGI1 positive strains were of identical PFGE pattern and PCR prophage pattern, while this specific pattern was never observed among STM0517-0529 positive strains. We therefore propose that a lineage of the S. typhimurium DT104 sensitive strain first lost the ability to metabolize allantoin and then acquired SGI1.

Comparison of perceived payer status and referring hospital dwell time for trauma air transports

Introduction: On a regular basis, trauma centers are requested to accept referrals from smaller facilities that have been the original recipients of traumatic injury victims. Time to a properly equipped trauma center is generally understood to be a key factor in trauma patient outcomes. While studies by Nathans, et al., and Niegleberg, et al., have investigated the relationship between insurance coverage and frequency of transfer, there have been no studies to determine if a relationship exists between perceived insurance coverage and how quickly a request is made for air transport to a trauma center. The researchers hypothesized that commercially insured patients are held at referral centers longer than uninsured or Medicaid patients, enabling further testing to take place prior to transfer.

The Undying Novena

At first, I was highly suspicious of the stated birthdate of this letter and its claimed continuity. If no one ever broke the chain, I naively reasoned, then the exponential growth of mail would have overwhelmed the earth and stripped the world's forests for paper. (Today's electronic novena would similarly swamp the Internet with e-mail.) However, I soon realized that it is possible that the chain has never completely died out, although many individuals have broken their part of it. Despite its claim, the letter is a type of chain letter, whose life can be modeled as a branching process [2]. In this stochastic process, each parent may give birth to four offspring creating four branches. Of course, some of the branches may die out as individuals break the chain. As long as one branch survives, however, the chain survives another generation. Since a novena requires nine consecutive days of prayer, we assume that a new generation occurs after every nine days-time sufficient for both the post office and the recipient to handle the letter before sending it onward. To investigate the purported lifetime of the novena, let's assume that a person either breaks the chain, with probability p, or continues it as instructed, with probability 1 p. Then the mean number of offspring from each person is m = 4(1 p). Thus, each recipient of the novena sends out, on average, m novenas. Each of these m recipients sends out, on average, m novenas, and so on. Thus, in the nth generation there are, on average, 4mn novena recipients stemming from the four original recipients in generation zero.

INCISIONAL HERNIA AND ITS REPAIR WITH POLYPROPYLENE MESH IN RENAL TRANSPLANT RECIPIENTS

We evaluate the incidence of incisional hernia after kidney transplantation, predisposing factors and the results of surgical repair with polypropylene mesh. We reviewed the records of 371 consecutive kidney transplants performed between April 1995 and February 2000. Patients with clinical signs of hernia at the transplant incision site were included in the study. Predisposing factors for incisional hernia were also reviewed. A prospective protocol of surgical correction was established using polypropylene mesh and patient outcome was studied. We identified 14 patients (3.8%) with an incisional hernia at the transplant incision site. Hernias developed 3 to 840 days after transplant surgery and were significantly more common in white (p = 0.019) and cadaveric graft (p = 0.02) recipients. Predisposing factors in 11 cases included complications of transplant surgery in 7, bladder obstruction in 2, large polycystic kidneys in 1 and chronic pulmonary disease in 1. Surgical repair was performed by primary fascial approximation and polypropylene mesh reinforcement in 13 cases and by pre-peritoneal mesh placement in 1. Minor subcutaneous wound infection developed in 1 patient. No relapses were noted at a mean followup of 17.8 months. In the majority of cases incisional hernia develops in the first 3 months after transplant surgery. The incidence is significantly higher in white patients and after cadaveric donor transplantation. Surgical complications of transplant surgery are important predisposing factors for incisional hernia after kidney transplantation. Surgical repair using polypropylene mesh is safe and effective in this group of patients.

Exposure of hepatitis C virus (HCV) RNA-positive recipients to HCV RNA-positive blood donors results in rapid predominance of a single donor strain and exclusion and/or suppression of the recipient strain.

We have analyzed three cases of hepatitis C virus (HCV)-infected recipients who received blood from HCV-infected donors. Two recipients were exposed to two different HCV RNA-positive donors, and one was exposed to a single donor. All parental genomes from the actual infecting units of blood and the recipients were defined, and their presence in the follow-up serum samples was determined using sensitive strain-specific assays. The strain from one of the donors was found to predominate in all recipients' serum samples collected throughout the follow-up period of 10 to 30 months. In two recipients exposed to two infected donors, the strain from the second donor was occasionally found at very low level. However, the original recipients' strains were not detected. Our observations show that HCV-infected individuals can be superinfected with different strains, and this event may lead to eradication or suppression of the original infecting strain. Furthermore, our findings demonstrate that simultaneous exposure to multiple HCV strains may result in concomitant infection by more than one strain, although a single strain could rapidly establish its dominance. The results of the present study suggest the existence of competition among infecting HCV strains which determines the ultimate outcome of multiple HCV exposure.

Changes in land tenure and use during thirty years of small irrigation system operation

This article provides a detailed case study of land tenure and use during 30 years of small irrigation system operation in Niger Republic. In contrast to larger systems in the region, the state-sponsored system that was studied has developed certain management polices which accommodate farmer preferences and increase farmers' sense of control over the lands they cultivate. The initial process of land expropriation and redistribution, subsequent changes in parcel tenure and land use practices, and concessionary changes in system management by state authorities are reviewed in detail. A long-term policy of parcel inheritance and subdivision within households has resulted in a 37% reduction in mean holding size, a 54% increase in parcel holder population, and greater equity of parcel distribution among beneficiaries. Most parcels have remained within the extended families of the original parcel recipients during the life of the system. Characteristics of land tenure and use policy that have enhanced beneficiary incentives and project sustainability are summarized and a closer examination of the applicability of similar policies and practices among other systems in the region is suggested. Specific areas for future, related research are also proposed.