BACKGROUND: Distracted driving has been linked to multiple driving decrements and is responsible for thousands of motor-vehicle fatalities annually. Most U.S. states have enacted restrictions on cellphone use while driving, the strictest of which prohibit any manual operation of a cellphone while driving. Illinois enacted such a law in 2014. To better understand how this law affected cellphone behaviors while driving, associations between Illinois\' handheld phone ban and self-reported talking on handheld, handsfree, and any cellphone (handheld or handsfree) while driving were estimated.
METHODS: Data from annual administrations of the Traffic Safety Culture Index from 2012-2017 in Illinois and a set of control states were leveraged. The data were cast into a difference-in-differences (DID) modeling framework, which compared Illinois to control states in terms of pre- to post-intervention changes in the proportion of drivers who self-reported the three outcomes. Separate models for each outcome were fit, and additional models were fit to the subset of drivers who talk on cellphones while driving.
RESULTS: In Illinois, the pre- to post-intervention decrease in the drivers\' probability of self-reporting talking on a handheld phone was significantly more extreme than that of drivers in control states (DID estimate -0.22; 95% CI -0.31, -0.13). Among drivers who talk on cellphones while driving, those in Illinois exhibited a more extreme increase in the probability of talking on a handsfree phone while driving than those control states (DID estimate 0.13; 95% CI 0.03, 0.23).
CONCLUSIONS: These results suggest that Illinois\' handheld phone ban reduced talking on handheld phones while driving among study participants. They also corroborate the hypothesis that the ban promoted substitution from handheld to handsfree phones among drivers who talk on the phone while driving.
CONCLUSIONS: These findings should encourage other states to enact comprehensive handheld phone bans to improve traffic safety.

In health care, licensing is pervasive. Restrictions on applicants with criminal records may have a disparate impact on historically marginalized groups. There is bipartisan interest in evaluating whether occupational licensing requirements are too strict.
The authors analyze how 12 representative states (California, Colorado, Connecticut, Delaware, Florida, Illinois, Missouri, New York, Ohio, Pennsylvania, South Dakota, and Texas) respond when people with criminal records apply for a license for five entry-level allied health professions (dental hygienist, occupational therapy assistant, physical therapy assistant, radiologic technologist, and respiratory therapist).
With one exception for one allied health profession, all states require their licensing boards to consider past serious criminal convictions. A majority of states require the conviction to be substantially related to the scope of professional duties for it to provide a basis for disqualification. Most states make it difficult for applicants with criminal records to determine whether they may obtain a license.
State licensing boards have considerable discretion in handling applicants with a criminal record. The trend is toward fewer restrictions, but more could be done to increase the transparency of state licensing board guidelines, practices, and procedures-particularly in the states that still rely on a \"good moral character\" test.

Guidelines recommend emergency medical services (EMS) patients to be transported to the nearest appropriate emergency department (ED). Our objective was to estimate the prevalence of EMS transport to an ED other than the nearest ED (\"potential bypassing\").
Illinois Prehospital Patient Care Report Data of EMS transports (July 2019 to December 2019).
We identified all EMS ground transports with an advanced life-support (ALS) paramedic to an ED for patients aged 21 years and older. Using street address of incident location, we performed geocoding and driving route analyses and obtained estimated driving distance and time to the destination ED and alternative EDs.
Our main outcomes were dichotomous indicators of potential bypassing of the nearest ED based on distance and time. As secondary outcomes we examined potential bypassing indicators based on excess driving distance and time.
We used Poisson regression models to obtain adjusted relative rates of potential bypassing indicators by acuity level, primary impression, patient demographics and geographic characteristics.
Our study cohort of 361,051 EMS transports consisted of 5.8% critical, 37.2% emergent and 57.0% low acuity cases transported to 222 EDs. The observed rate of potential bypassing was approximately 34% of cases for each acuity level. Treating the cardiovascular primary impression code group as the reference case, we found small to no differences in potential bypassing rates across other primary impression code groups of all acuity levels, with the exception of critical acuity trauma cases for which potential bypassing rate was 64% higher (incidence rate ratio = 1.64, 95% confidence interval, 1.54-1.74). Compared to zip codes with one ED within a 5-mile vicinity, potential bypassing was higher in areas with no ED or multiple EDs within a 5-mile vicinity.
Approximately one-third of EMS transports potentially bypassed the nearest ED. EMS transport destination may be motivated by factors other than proximity.

Despite the clear ecological significance of the microbiomes inhabiting groundwater and connected ecosystems, our current understanding of their habitats, functionality, and the ecological processes controlling their assembly have been limited. In this study, an efficient pipeline combining geochemistry, high-throughput FluidigmTM functional gene amplification and sequencing was developed to analyze the suspended and attached microbial communities inhabiting five groundwater monitoring wells in the Illinois Basin, USA. The dominant taxa in the suspended and the attached microbial communities exhibited significantly different spatial and temporal changes in both alpha- and beta-diversity. Further analyses of representative functional genes affiliated with N2 fixation (nifH), methane oxidation (pmoA), and sulfate reduction (dsrB, and aprA), suggested functional redundancy within the shallow aquifer microbiomes. While more diversified functional gene taxa were observed for the suspended microbial communities than the attached ones except for pmoA, different levels of changes over time and space were observed between these functional genes. Notably, deterministic and stochastic ecological processes shaped the assembly of microbial communities and functional gene reservoirs differently. While homogenous selection was the prevailing process controlling assembly of microbial communities, the neutral processes (e.g., dispersal limitation, drift and others) were more important for the functional genes. The results suggest complex and changing shallow aquifer microbiomes, whose functionality and assembly vary even between the spatially proximate habitats and fractions. This research underscored the importance to include all the interface components for a more holistic understanding of the biogeochemical processes in aquifer ecosystems, which is also instructive for practical applications.

Synthetic antioxidants represent a complex group of additive chemicals broadly used in consumer products. While traditional antioxidants such as 2,6-di-tert-butyl-4-methylphenol (BHT) have been well studied, a variety of \"novel\" antioxidants have emerged with extensive applications but received much less attention. Our study aimed to explore a suite of 34 emerging antioxidants in house dust from four different regions, including Guangzhou (China), Adelaide (Australia), Carbondale (Illinois), and Hanoi (Vietnam). The results revealed broad occurrence of several rarely investigated chemicals in house dust across regions, including triethylene glycol bis(3-tert-butyl-4-hydroxy-5-methylphenyl)propionate (AO245), 2,6-di-tert-butyl-4-(dimethylamino)methylphenol (AO4703), 2,2\'-thiene-2,5-diylbis(5-tert-butyl-1,3-benzoxazole) (BBOT), 1,3-diphenylguanidine (DPG), 2,4-bis(1,1-dimethylethyl)phenol (2,4DtBP), and 2,6-bis(1,1-dimethylethyl)phenol (2,6DtBP). In particular, DPG exhibited a median concentration of 5030-11 400 ng/g in house dust from the studied regions except for Hanoi (305 ng/g), generally 1 order of magnitude greater than that of BHT (890-1060 ng/g) and dominating the compositional profiles of antioxidants. Estimated intake of target antioxidants by toddlers via dust ingestion, even under the high exposure scenario, was determined to be 2-4 orders of magnitude lower than the reference doses of selected antioxidants. However, potential risks from long-term exposure to a cocktail of antioxidants under environmentally relevant concentrations merit further investigations due to insufficient knowledge on the sources, fate, and toxicokinetics of these chemicals to date.

Changing environments of temperature, precipitation and moisture availability can affect vegetation in ecosystems, by affecting regeneration from the seed bank. Our objective was to explore the responses of soil seed bank germination to climate-related environments along geographic gradients. We collected seed banks in baldcypress (Taxodium distichum) swamps along the Mississippi River and the Gulf of Mexico Coast in the United States, which have distinct temperature and/or precipitation gradients, and germinated them in a greenhouse. The frequency, richness and seed density of species germinated from the seed bank were compared between various geographic locations, experimental water regimes (saturated, flooded) and wetland types (tidal, non-tidal and inland swamps). We also analyzed the relationship of seed density to the environment by using a Non-metric Multi-dimensional Scaling (NMDS) model. Sixty-one species germinated from the seed bank, differing in pattern by geographic location, experimental water regime and wetland type. The foundation species (i.e., T. distichum and Cephalanthus occidentalis) germinated with a niche affinity for the northern part of the latitudinal gradient (Tennessee and Illinois) and these species may shift northward with climate change. Some species had higher seed density in the locations that were subject to more persistent drought conditions (e.g., Texas) including Cyperus rotundus and Gratiola virginiana, indicating that these species may be better adapted to sites with high temperature and low precipitation. In contrast, certain species including Saururus cernuus and Ludwigia palustris were present throughout the range of these gradients, and so may be more resilient to any future climate shifts. We found that the regeneration potential of baldcypress swamps might be altered by changes in local and climate environment because of nuances of responses of seed banks to climates along latitudinal and longitudinal gradients. Our study can help predict vegetation regeneration potential to climate change environments depending on the ability of these species to disperse and maintain seed banks.

Green space exposure is thought to have a positive influence on physical activity behavior and overall health. However, the literature remains equivocal, and green space measurement methods remain complicated. Using data from the Illinois Behavioral Risk Factor Surveillance System, this study examines the influence of green space on health-related factors, such as exercise, physical health, and mental health. Moreover, we explore the methods for measuring community green space via various spatial boundaries and green space resources. The results show that combining two contextually designated census boundaries and a measure of green space with seasonality were the best spatial conceptualizations for capturing community green space. Moreover, the findings showed a positive influence of green space exposure on health outcomes. These findings highlight the importance of considering geographic contexts of daily human behaviors and green space seasonality in providing a better understanding of the influence of community activity space on environmental exposure measurement. Further, this work contributes to community planning for encouraging health-promoting behaviors.

BACKGROUND: There are no guidelines on selecting alternating pressure (AP) configurations on increasing sacral skin blood flow (SBF).
OBJECTIVE: The specific aims were to compare different cycle periods and pressure amplitudes of AP on sacral SBF responses in healthy people to establish the efficacy and safety of the protocols.
METHODS: Two studies were tested, including the cycle period study (8 2.5-min vs 4 5-min protocols) and the pressure amplitude study (75/5 vs 65/15 mmHg protocols). Sacral SBF was measured using laser Doppler flowmetry (LDF) in 20 participants. AP loads were randomly applied using an indenter through the rigid LDF probe. Each protocol included a 10-min baseline, 20-min AP and 10-min recovery periods. A 30-min washout period was provided. The SBF response was normalized to the baseline SBF of each condition of each participant.
RESULTS: For the cycle period study, the 4 5-min cycle protocol partially restored more SBF than the 8 2.5-min cycle protocol at the low-pressure phase (0.87 ± 0.04 vs 0.71 ± 0.03, p < 0.05) and at the high-pressure phase (0.25 ± 0.03 vs 0.19 ± 0.03, p < 0.05). For the pressure amplitude study, the 75/5 mmHg protocol partially restored more sacral SBF than the 65/15 mmHg protocol at the low-pressure phase (0.87 ± 0.1 vs 0.25 ± 0.03, p < 0.05) but not at the high-pressure phase (0.23 ± 0.02 vs 0.21 ± 0.02, non-significant).
CONCLUSIONS: This study demonstrated that 1) a cycle period of 5 min was better than 2.5 min and 2) a pressure amplitude of 75/5 mmHg was better than 65/15 mmHg. The finding provides insights for selecting the AP configurations for increasing SBF.

This study draws the link between COVID-19 and air pollution (ground ozone O3) from February 29, 2020 to July 10, 2020 in the top 10 affected States of the US. Utilizing quantile-on-quantile (QQ) estimation technique, we examine in what manner the quantiles of COVID-19 affect the quantiles of air pollution and vice versa. The primary findings confirm overall dependence between COVID-19 and air pollution. Empirical results exhibit a strong negative effect of COVID-19 on air pollution in New York, Texas, Illinois, Massachusetts, and Pennsylvania; especially at medium to higher quantiles, while New Jersey, Illinois, Arizona, and Georgia show strong negative effect mainly at lower quantiles. Contrarily, COVID-19 positively affects air pollution in Pennsylvania at extreme lower quantiles. On the other side, air pollution predominantly caused to increase in the intensity of COVID-19 cases across all states except lower quantiles of Massachusetts, and extreme higher quantiles of Arizona and New Jersey, where this effect becomes less pronounced or negative. Concludingly, a rare positive fallout of COVID-19 is reducing environmental pressure, while higher environmental pollution causes to increase the vulnerability of COVID-19 cases. These findings imply that air pollution is at the heart of chronic diseases, therefore the state government should consider these asymmetric channels and introduce appropriate policy measures to reset and control atmospheric emissions.

Chronic wasting disease (CWD) is caused by prions, infectious proteinaceous particles, PrPCWD. We sequenced the PRNP gene of 2,899 white-tailed deer (WTD) from Illinois and southern Wisconsin, finding 38 haplotypes. Haplotypes A, B, D, E, G and 9 others encoded Q95G96S100N103A123Q226, designated \'PrP variant A.\' Haplotype C and 4 other haplotypes encoded PrP \'variant C\' (Q95S96S100N103A123Q226). Haplotype F and two other haplotypes encoded PrP \'variant F\' (H95G96S100N103A123Q226). The association of CWD with encoded PrP variants was examined in 2,537 tested WTD from counties with CWD. Relative to PrP variant A, CWD susceptibility was lower in deer with PrP variant C (OR = 0.26, p < 0.001), and even lower in deer with PrP variant F (OR = 0.10, p < 0.0001). Susceptibility to CWD was highest in deer with both chromosomes encoding PrP variant A, lower with one copy encoding PrP variant A (OR = 0.25, p < 0.0001) and lowest in deer without PrP variant A (OR = 0.07, p < 0.0001). There appeared to be incomplete dominance for haplotypes encoding PrP variant C in reducing CWD susceptibility. Deer with both chromosomes encoding PrP variant F (FF) or one encoding PrP variant C and the other F (CF) were all CWD negative. Our results suggest that an increased population frequency of PrP variants C or F and a reduced frequency of PrP variant A may reduce the risk of CWD infection. Understanding the population and geographic distribution of PRNP polymorphisms may be a useful tool in CWD management.