Saint Joseph's University

Between 2010 and 2019, international travel increased by approximately 52.2%, highlighting the world's dependence on transportation for global connectivity. Although travel enhances global interactions, it also poses risks to public health through the potential transmission of diseases. The rapid global transmission of infectious diseases, exemplified by the outbreaks of COVID-19 and Zika virus, underscores the critical need for in-depth research into travel-associated disease dissemination. When individuals travel, they are exposed to a variety of diverse microbial environments, which can affect their healthy microbiome. In this review, we introduce the concept of "travel microbiota" to encapsulate the dynamic shifts in human microbial communities induced by travel across different transportation modes. This disruption can affect metabolic and immune functions and potentially facilitate the spread of diseases. Given these implications, it is crucial to investigate how different modes of transportation affect the human microbiota. Our study reviews the impact of travel on the human microbiota, highlighting differences across transportation modes. The objective is to establish a framework for understanding travel health and the role of microbiota in managing travel-related health risks. A comprehensive understanding of this relationship is essential for developing preventive strategies to safeguard and restore the human microbiota. To provide the specific content, relevant publications were identified on Google Scholar, PubMed, and Science Direct using specific keywords such as dysbiosis, gut, health, microbiome, microbiota, pathogens, travel, and transportation. We did not add any limits to the publication date during the inclusion of papers. However, it is noteworthy that the initial reports, including the aforementioned keywords, have been published starting from 2015. Travel has a profound impact on the human microbiota, and it is essential to consider the implications associated with various modes of transportation. Traveling through various modes of transportation, such as roadways, airways, and maritime, has significantly influenced human microbiota. Moreover, it acts as a dynamic interface for microbial exchange driving rapid shift in microbial diversity, community convergence, and the diversification of resistant genes. However, the underlying mechanism of these changes remains elusive. By integrating evidence across multiple modes of transportation, this review highlights travel as an underrecognized determinant of microbiome variability and introduces the term "Travel microbiota". Moreover, this review is pivotal for understanding the ways in which travel alters microbial diversity and developing effective interventions. It is imperative to conduct future research that focuses on conducting large-scale longitudinal studies to assess the effects of traveling on microbial composition and to develop potential preventive measures.

The pediatric surgical workforce in the UnitedStates faces increasing strain due to a limited supply of specialists, geographic maldistribution, and rising complexity in pediatric cases. Rural and underserved communities experience the greatest gaps in access to timely, specialized care. Additionally, existing literature lacks integration of osteopathic perspectives in workforce development discussions, despite the holistic and preventive contributions of osteopathic medicine to patient care and physician well-being. This review analyzes current gaps in the pediatric surgical workforce and propose actionable solutions through an osteopathic lens, including the integration of osteopathic principles such as whole-person care, preventive health, and osteopathic manipulative treatment (OMT). A narrative literature review was conducted utilizing peer-reviewed publications, workforce data, policy reports, and the 2023 National Academies of Sciences, Engineering, and Medicine (NASEM) report on the pediatric subspecialty workforce. The review considered sources published between 2003 and 2024. Search terms included combinations of "pediatrics," "pediatric surgical workforce," "osteopathic medicine," "OMT," "healthcare disparities," and "surgical access," and they were applied to PubMed, Google Scholar, and gray literature databases. Inclusion criteria prioritized national US data on workforce distribution, diversity, burnout, and training. Then the studies were selected. No formal meta-analysis was conducted. Approximately 1,150board-certified pediatric surgeons practice in the UnitedStates, equating to approximately 18.2 surgeons per one million children. Access remains concentrated in urban academic centers, leaving rural regions dependent on general surgeons or patient transfers. Minority and uninsured children experience significantly lower rates of surgical intervention. Workforce burnout and limited training pipelines exacerbate shortages. Although no formal outcomes synthesis was performed, osteopathic contributions such as OMT for postoperative care and holistic, team-based education models were identified as underutilized assets in existing workforce strategies. The pediatric surgical workforce must be expanded and diversified to meet growing and unevenly distributed care needs. Integrating osteopathic principles-including whole-person care, OMT, and provider wellness-into training, recruitment, and care delivery offers a holistic framework for sustainable improvement. Future workforce strategies should incorporate these perspectives to enhance both patient outcomes and provider resilience.

In Undoing Slavery, historian Kathleen M. Brown offers a major revision of the prevailing emphasis in the literature on abolition by insisting that rather than being focused on human rights as an abstract principle, as many scholars have rendered them, abolitionists “gave human rights a pragmatic and domestic inflection” (p. 4) by emphasizing that the violation of the human body was the fundamental denial of the humanity of the enslaved, and thus their rights. She points to the ways abolitionists, Black and white, not only catalogued and condemned the many and horrific physical abuses of the enslaved with all manner of scourges but also gave equal emphasis to the wrongs of enslavers stealing Africans and carrying their bodies to labor in a new terrifying environment. She argues that the enslavers commodified the enslaved as chattel property that could be used, sold, and transported to the enslavers’ gain. They coerced unrequited labor from people's bodies, constraining the ability of the enslaved to move about at will, forcing or encouraging enslaved women to give up their bodies to bear children who by law would be enslaved at birth and to give their milk to sustain the lives of their enslavers’ children, and disrupting and separating families. Abolitionists used many means to relate such abuses and rally support for abolition by building empathic bonds between opponents of slavery and the enslaved. These tactics included publishing the personal accounts of formerly enslaved people that revealed the exploitations and expropriations of their bodies and photographs depicting the physical scars proving them. They also sought to strike at the enslavers’ profits and power by boycotting goods produced from the blood, sweat, and tears of the enslaved.According to Brown, central to the abolitionists’ focus was their belief in the unifying principle of “one blood”—that is, the common origin of all humans and with that the divinely sanctioned universality of rights as a birthright. With a daunting command of primary sources, Brown skillfully tracks the history of what she terms the “embodied nature of rights,” especially in the English-speaking world of the seventeenth through and nineteenth centuries, and she shows abolitionists’ expanding understanding of the implications and obligations of recognizing the right to the integrity and self-sovereignty of one's body.In so doing, Brown argues, abolitionists invariably addressed the issue of perceived racial differences that supposedly determined people's mental, physical, and moral capacities. Abolitionists dismissed arguments for innate racial characteristics and explained any seeming racial “difference” as a function of different environments. Thus, any seeming “backwardness” among enslaved people derived from the debilitating effects of their enslavement rather than innate traits. Emancipation from slavery would free Blacks to repair and realize their best selves. Defenders of slavery, however, asserted that Blacks were inherently inferior and incapable of responsible freedom. In the nineteenth century they turned to “science” to demonstrate that black bodies were deficient. Rather than focus on blood as the basis for shared humanity, they also looked at other parts of “the body” to discern people's true character and capacities. Using craniology, phrenology, and other “anthropological” methods and dissecting bodies to discover and document the measure of men, they made their case for racial difference as innate and immutable and supported the body politics of pro-slavery. Some among them even questioned the biblical account of monogenesis, postulating instead the idea of separate creations. As Brown ably shows, such “science” was premised on difference and biased toward it in perspective and methods, but it still gained racism a new authority that lasted well after slavery ended in the United States.Brown's argument that abolitionists presented “embodied self-sovereignty” as the essence of human rights, rather than only an aspect of it, is persuasive and pertinent. Readers of this journal will find much to consider in her focus on the body as the site of rights arguments and actions. To give one example: Although Brown misses the opportunity to reference parallel, and even intersecting, efforts by nativists and xenophobes in the nineteenth century to enlist “science” in defining the character and conduct of people as racially determined—witness the depictions of Irish, Chinese, Italians, and Eastern European Jews as innately deficient and dangerous—Brown's revelations about the place and methods of “scientists” and medical schools in race arguments are readily applicable and worth comparative treatment. So, too, might be an extrapolation of arguments about the meanings of “blood” to include the gestating ethnonationalism of the nineteenth century not only in Europe but in America as well. And, as Brown's brilliant book should lead us to realize, “embodied self-sovereignty” is not just a right asserted to end slavery yesterday, but a fundamental human right we need to understand and protect our own freedom today.

Caregiving is a demanding role that can result in significant psychological strain. Many caregivers experience increased stress, depression, and other negative psychological outcomes due to the intensity and duration of their caregiving responsibilities. Guided by social exchange theory (Thibaut & Kelley, 1959) and the stress process model (Pearlin et al., 1990), this study examines perceived appreciation role as a psychological resource that can impact caregivers’ well-being and work as a positive caregiving environment. Further, we aim to provide insights into gender differences by examining caregiving intensity and perceived appreciation from the caregivers’ perspective. Using data from 2015 and 2017 waves of the National Study of Caregiving (NSOC), we analyzed responses from 3,061 informal caregivers (Mean age = 61.96 years) through moderating regression analysis. Findings indicated that high levels of perceived appreciation mitigate the negative effects of caregiving intensity on role overload while promoting mental health and self-realization. Notably, perceived appreciation promoted self-realization in male caregivers, whereas it more strongly buffered the negative effects of caregiving intensity on mental health and role overload among female caregivers. These results highlight the importance of fostering environments where caregivers feel valued and recognized, with particular attention to gender differences in psychological well-being and caregiving experiences.

Purpose This study adopts the multinational operational flexibility perspective to examine how the characteristics of the existing subsidiary portfolio influence the subsequent investment attributes of its subsidiaries. Specifically, we explore how the switching needs and opportunities associated with cross-border labor cost conditions influence a new subsidiary's location, product and ownership. Design/methodology/approach We employed a panel data analysis of Korean overseas manufacturing subsidiaries. We adopt binomial logit regression for three dependent variables, the last two nested within the first regression. Findings We find that higher labor cost uncertainty interacts with higher labor cost correlation among countries of existing subsidiaries, leading to a new subsidiary in a country with a negatively correlated labor cost. We also find that the locational choice is synchronized with a less localized product and higher ownership for global switchability. We additionally observe that this synchronization of investment attributes is more pronounced when managers are highly aware of switching options embedded in their international investments. Originality/value We examine the nested relationships of key investment decisions (location, product, ownership) from the multinational operational flexibility, which provides different explanations from other perspectives.

Abstract The gap between the need for respite services and caregiver abilities to access them is well documented. (AARP, 2024). One reason for this gap is that many caregivers lack information regarding the cost and availability of respite services (Castro et al., 2023). Previous studies found that getting information on respite services can be cumbersome and the accessed information may be incomplete. (Leocadie et al., 2018). Drawing on institutional models of organizational behavior, we distinguish among three major types of information contexts: 1) Individualized, 2) Community-Level, and 3) Public-Level. The objective of our study is to examine the impact of information gathering on utilization of respite care among caregivers. Using data from the National Study of Caregivers (NSOC), we found that caregivers who seek information in the individual sphere have 16% higher odds (OR = 1.16) of using respite services whereas those who received information from community (OR = 0.82) or public (OR = 0.86) spheres have between 18% and 14% lower odds of using respite services. Rather, caregivers relying on community and public sphere for information had higher odds of receiving caregiving training and utilizing support group services. The results suggest that while individuals are more likely to seek functional, and costly, support via respite, public information sources are more likely to direct caregivers toward individualized self-help approaches via training to enhance caregiving activities or support group coping. These findings suggest that caregiver support policies should account for how informational disparities can create qualitative differences in formal support use.

Abstract Caregivers increasingly experience disruptions to their social activities due to their caregiving responsibilities. While previous studies have highlighted the negative impact of such disruptions on caregivers’ quality of life, the longitudinal relationship between disrupted activities and the values caregivers place on those activities remains underexplored. Using data from the National Study of Caregiving (NSOC) across three waves (N = 2328), this study examines how disrupted activities and their value change over time and their interaction with caregiver outcomes. Findings from multilevel modeling reveal that caregivers who experienced significant disruptions to their activities while attaching a high value to them reported a rapid increase in negative relationships and burnout over time. Conversely, caregivers who experienced high disruption but placed lower value on these activities showed a more moderate increase in both negative relationships and burnout. Caregivers with lower disruption and lower attachment to activities experienced only a slight increase in these outcomes. These findings underscore the critical role that the interruption of activities and the value placed on those activities play in shaping caregivers’ mental health outcomes. From a practical perspective, this study highlights the importance of considering the meaning caregivers attach to their activities when developing interventions to support their mental well-being. Practitioners should be aware that caregivers who find meaning in their social activities may be at greater risk for burnout and adverse relational outcomes when disrupted. Thus, strategies should focus on providing support for both activity continuity and emotional attachment to activities.

The use of 5-aminolevulinic acid (ALA)-induced protoporphyrin IX (PpIX) for tumor fluorescence imaging and photodynamic therapy (PDT) may be limited by intrinsic PpIX-reducing mechanisms including PpIX bioconversion and efflux transport. The effectiveness of targeting these PpIX-reducing mechanisms was evaluated in glioblastoma cell lines. Although either inhibiting PpIX bioconversion by an iron chelator deferoxamine (DFO) or suppressing PpIX efflux by an ABCG2 transporter inhibitor lapatinib (Lap) significantly increased ALA-PpIX and PDT effect in the A172 cell line with weak ABCG2 activity, DFO in combination with Lap led to significantly greater enhancement effects. However, DFO did not significantly enhance ALA in H4, U-87, and U-118 cell lines with robust ABCG2 activities, whereas Lap showed effective enhancement effects. The combination of DFO and Lap enhanced ALA-induced PpIX and PDT in these three cell lines. Not just increasing ALA-PpIX levels, Lap enhanced PpIX localization in the mitochondria and promoted mitochondria-mediated apoptosis after PDT in the H4 cell line with strong ABCG2 activities. Our results demonstrate that blocking ABCG2-mediated PpIX efflux is critical for the enhancement of ALA and, in tumor cells with ABCG2 activities, inhibiting PpIX bioconversion by DFO needs to be combined with PpIX efflux suppression for effective enhancement of ALA.

ABSTRACT Product photos are increasingly used by brands and consumers in eWOM. However, little research has investigated the basic visual cues’ impact on inducing product usage intentions. Drawing on the event coding theory, this study examines how perceived aesthetics, functionality, ergonomics and hedonics (the ‘golden 4’) underpin the first impression of a smartwatch photo image to entail intention to use it. Using 280 survey responses (U.S.A.), the results demonstrate (i) aesthetics and ergonomics elicit an intention to use the smartwatch; (ii) functionality impedes the intention to use the smartwatch; (iii) ergonomics enhance the influence of aesthetics and ‘transform’ the negative influence of functionality into a positive influence on the intention to use the smartwatch; and (iv) hedonics enhance the influence of ergonomics on the intention to use the smartwatch.