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Concept: Kentucky


EuroAmerican land-use and its legacies have transformed forest structure and composition across the United States (US). More accurate reconstructions of historical states are critical to understanding the processes governing past, current, and future forest dynamics. Here we present new gridded (8x8km) reconstructions of pre-settlement (1800s) forest composition and structure from the upper Midwestern US (Minnesota, Wisconsin, and most of Michigan), using 19th Century Public Land Survey System (PLSS), with estimates of relative composition, above-ground biomass, stem density, and basal area for 28 tree types. This mapping is more robust than past efforts, using spatially varying correction factors to accommodate sampling design, azimuthal censoring, and biases in tree selection.

Concepts: United States, Minnesota, Michigan, Kentucky, Midwestern United States, Wisconsin, Public Land Survey System, Great Lakes region


A review of the neuroscientific, clinical medicine, culinary, and food technology and agriculture presentations and demonstrations that were featured at the inaugural symposium of the International Society of Neurogastronomy, held at the University of Kentucky on November 7, 2015.

Concepts: Kentucky, Steve Davis, Oak Ridge Associated Universities, Lexington, Kentucky


A heated purge-and-trap gas chromatography/mass spectrometry method was used to determine the cis- and trans-isomers of (4-methylcyclohexyl)methanol (4-MCHM), the reported major component of the Crude MCHM/Dowanol™ PPh glycol ether material spilled into the Elk River upriver from Charleston, West Virginia, on January 9, 2014. The trans-isomer eluted first and method detection limits were 0.16-μgL(-1)trans-, 0.28-μgL(-1)cis-, and 0.4-μgL(-1) Total (total response of isomers) 4-MCHM. Estimated concentrations in the spill source material were 491-gL(-1)trans- and 277-gL(-1)cis-4-MCHM, the sum constituting 84% of the source material assuming its density equaled 4-MCHM. Elk River samples collected⩽3.2km downriver from the spill on January 15 had low (⩽2.9μgL(-1) Total) 4-MCHM concentrations, whereas the isomers were not detected in samples collected 2 d earlier at the same sites. Similar 4-MCHM concentrations (range 4.2-5.5μgL(-1) Total) occurred for samples of the Ohio River at Louisville, Kentucky, on January 17, ∼630km downriver from the spill. Total 4-MCHM concentrations in Charleston, WV, office tap water decreased from 129μgL(-1) on January 27 to 2.2μgL(-1) on February 3, but remained detectable in tap samples through final collection on February 25 indicating some persistence of 4-MCHM within the water distribution system. One isomer of methyl 4-methylcyclohexanecarboxylate was detected in all Ohio River and tap water samples, and both isomers were detected in the source material spilled.

Concepts: Ohio River, Ohio, Kentucky, Virginia, West Virginia, Louisville, Kentucky, Huntington, West Virginia, Kanawha River


There are ∼380 000 tobacco retailers in the USA, where the largest tobacco companies spend almost $9 billion a year to promote their products. No systematic survey has been conducted of state-level activities to regulate the retail environment, thus little is known about what policies are being planned, proposed or implemented.

Concepts: United States, U.S. state, Policy, Implementation, Massachusetts, Public policy, Kentucky, Tobacco industry


The second international consensus conference on the scapula was held in Lexington Kentucky. The purpose of the conference was to update, present and discuss the accumulated knowledge regarding scapular involvement in various shoulder injuries and highlight the clinical implications for the evaluation and treatment of shoulder injuries. The areas covered included the scapula and shoulder injury, the scapula and sports participation, clinical evaluation and interventions and known outcomes. Major conclusions were (1) scapular dyskinesis is present in a high percentage of most shoulder injuries; (2) the exact role of the dyskinesis in creating or exacerbating shoulder dysfunction is not clearly defined; (3) shoulder impingement symptoms are particularly affected by scapular dyskinesis; (4) scapular dyskinesis is most aptly viewed as a potential impairment to shoulder function; (5) treatment strategies for shoulder injury can be more effectively implemented by evaluation of the dyskinesis; (6) a reliable observational clinical evaluation method for dyskinesis is available and (7) rehabilitation programmes to restore scapular position and motion can be effective within a more comprehensive shoulder rehabilitation programme.

Concepts: Injury, Knowledge, Shoulder, Program, Scapular, Kentucky, Scapula, Lexington, Kentucky


Chemical analyses of organic residues in fragments of pottery from the large site of Cahokia and surrounding smaller sites in Illinois reveal theobromine, caffeine, and ursolic acid, biomarkers for species of Ilex (holly) used to prepare the ritually important Black Drink. As recorded during the historic period, men consumed Black Drink in portions of the American Southeast for ritual purification. This first demonstrated discovery of biomarkers for Ilex occurs in beaker vessels dating between A.D. 1050 and 1250 from Cahokia, located far north of the known range of the holly species used to prepare Black Drink during historic times. The association of Ilex and beaker vessels indicates a sustained ritual consumption of a caffeine-laced drink made from the leaves of plants grown in the southern United States.

Concepts: Florida, North Carolina, Southern United States, Kentucky, Tennessee, Southeastern United States, Ilex vomitoria, Ritual


Both the Affordable Care Act (ACA) and attempts to repeal and replace it have been criticized for their highly partisan passage. Many argue that only bipartisan reform can be sustained over time regardless of which party is in power. Bipartisan reforms require that at least some specific, articulated, health policy goals from each party are met.(1,2) A new survey of state legislators' goals for US health policy provides crucial insights into the challenges and opportunities for future bipartisan reform. (Am J Public Health. Published online ahead of print August 17, 2017: e1-e3. doi:10.2105/AJPH.2017.304023).

Concepts: Health care, Health economics, Universal health care, Barack Obama, Kentucky, Democratic Party, United States House of Representatives, Legislature


Coal combustion residuals (CCRs), the largest industrial waste in the United States, are mainly stored in surface impoundments and landfills. Here, we examine the geochemistry of seeps and surface water from seven sites and shallow groundwater from 15 sites in five states (Tennessee, Kentucky, Georgia, Virginia, and North Carolina) to evaluate possible leaking from coal ash ponds. The assessment for groundwater impacts at the 14 sites in North Carolina was based on state-archived monitoring well data. Boron and strontium exceeded background values of 100 and 150 μg/L, respectively, at all sites, and the high concentrations were associated with low δ(11)B (-9‰ to +8‰) and radiogenic (87)Sr/(86)Sr (0.7070 to 0.7120) isotopic fingerprints that are characteristic of coal ash at all but one site. Concentrations of CCR contaminants, including SO4, Ca, Mn, Fe, Se, As, Mo, and V above background levels, were also identified at all sites, but contamination levels above drinking water and ecological standards were observed in 10 out of 24 samples of impacted surface water. Out of 165 monitoring wells, 65 were impacted with high B levels and 49 had high CCR-contaminant levels. Distinct isotope fingerprints, combined with elevated levels of CCR tracers, provide strong evidence for the leaking of coal ash ponds to adjacent surface water and shallow groundwater. Given the large number of coal ash impoundments throughout the United States, the systematic evidence for leaking of coal ash ponds shown in this study highlights potential environmental risks from unlined coal ash ponds.

Concepts: Water, United States, Groundwater, North Carolina, Water well, Georgia, Kentucky, Tennessee


School-based compulsory vaccination laws have provoked debates over the legitimacy of government coercion versus the scope of parental rights. A key point of contention in these school vaccination laws are provisions known as exemption clauses that allow some parents to enroll their children in school unimmunized for reasons other than medical conditions. For more than three decades Mississippi and West Virginia stood apart as the only two US states that did not offer nonmedical exemptions to school vaccination laws. But other states seem to be moving in this direction, such as California, which in 2015 eliminated nonmedical exemptions following the Disneyland measles outbreak. The apparent shift creates an opportune moment to look at the experiences of Mississippi and West Virginia. Through a review of legislative histories, legal rulings, media accounts, and interviews with health officials in the two states, we consider the reasons for and consequences of their allowing only medical exemptions and the prospects their approach holds out for other states that may wish to emulate it. The experiences of these two states suggest that contrary to conventional wisdom, it may be politically tenable to limit exemptions to only medical reasons without damaging either the stature of public health or the immunization system.

Concepts: Epidemiology, Infectious disease, Vaccination, United States, U.S. state, Law, Kentucky, Nevada