Working to Improve Youth-Police Interactions: A Pilot Evaluation of a Program for Young People

In addition to training law enforcement personnel in strategies to promote positive youth-police interactions, equipping youth with similar knowledge is critical in ensuring safe and effective youth-police encounters. The classroom-based Juvenile Justice Curriculum was designed to equip young people with knowledge about the law and their rights and to empower them to have safer interactions with police. In the current study, we conducted the first evaluation of Strategies for Youth's nationally recognized classroom-based intervention. Cross-sectional data were collected from 155 youth (M age = 15.3; 43% White, 23% Black; 61% boys) after they completed the Juvenile Justice Curriculum. Results from our study indicated young people learned new information regarding what leads to arrest and multiple ways they might consider changing their behaviors when interacting with police. Young people's negative experiences with police officers were significantly associated with reduced views that police respect them and reports that they respect police, and with increased views of police as ethnoracially biased after completing the program. Altogether, our pilot program evaluation of this program demonstrated increased awareness of what constitutes illegal behavior, program engagement, and learned strategies to improve future interactions with police. Findings highlight the importance of policy makers supporting programming like the Juvenile Justice Curriculum as one means of preventing juvenile legal system involvement. While the onus to ensure safe and effective interactions with police should not be on young people, empowering young people to understand the law and their rights may help improve the social climate surrounding community responses to police and police interactions.

Did George Floyd's murder shape the public's felt obligation to obey the police?

OBJECTIVE

Our goal in the present study was to use longitudinal data to assess how normative (i.e., consensually motivated) and instrumental (i.e., coercively motivated) obligation to obey police changed after police murdered George Floyd and whether these changes differed by political ideology.

HYPOTHESES

Using procedural justice theory, we hypothesized that after Floyd's murder, participants would feel less normatively obligated and more instrumentally obligated to obey police. We also hypothesized that these trends would be stronger for liberal-leaning than conservative-leaning participants.

METHOD

Adults (N = 645) were recruited through Prolific from four politically diverse U.S. states. Participants reported their normative and instrumental obligation across three waves of data collection, each separated by 3 weeks. The first two waves were collected prior to the Floyd's murder, and the third was collected after.

RESULTS

Hierarchical linear models indicated that although normative obligation remained stable before Floyd's murder, it declined after Floyd's murder (b = -0.19, 95% CI [-0.24, -0.14], p < .001). In contrast, coercive obligation to obey increased consistently across all three waves. Liberal-leaning participants drove most of the effects.

CONCLUSIONS

For researchers, these findings help strengthen our understanding of procedural justice theory by differentiating normative and instrumental obligation and by distinguishing differences by political ideology within the context of a historic police-brutality event. For policymakers and law enforcement, our research suggests that police brutality may undermine the public's normative felt obligation to obey the police, which would be problematic for police reformation efforts grounded in governing by mutual consent versus by fear and coercion. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prognostic value of plasma circulating tumor DNA fraction across four common cancer types: a real-world outcomes study

BACKGROUND

Genomic analysis of circulating tumor DNA (ctDNA) is increasingly incorporated into the clinical management of patients with advanced cancer. Beyond tumor profiling, ctDNA analysis also can enable calculation of circulating tumor fraction (TF), which has previously been found to be prognostic. While most prognostic models in metastatic cancer are tumor type specific and require significant patient-level data, quantification of TF in ctDNA has the potential to serve as a pragmatic, tumor-agnostic prognostic tool.

PATIENTS AND METHODS

This study utilized a cohort of patients in a nationwide de-identified clinico-genomic database with metastatic castration-resistant prostate cancer (mCRPC), metastatic breast cancer (mBC), advanced non-small-cell lung cancer (aNSCLC), or metastatic colorectal cancer (mCRC) undergoing liquid biopsy testing as part of routine care. TF was calculated based on single-nucleotide polymorphism aneuploidy across the genome. Clinical, disease, laboratory, and treatment data were captured from the electronic health record. Overall survival (OS) was evaluated by TF level while controlling for relevant covariables.

RESULTS

A total of 1725 patients were included: 198 mCRPC, 402 mBC, 902 aNSCLC, and 223 mCRC. TF ≥10% was highly correlated with OS in univariable analyses for all cancer types: mCRPC [hazard ratio (HR) 3.3, 95% confidence interval (CI) 2.04-5.34, P < 0.001], mBC (HR 2.4, 95% CI 1.71-3.37, P < 0.001), aNSCLC (HR 1.68, 95% CI 1.34-2.1, P < 0.001), and mCRC (HR 2.11, 95% CI 1.39-3.2, P < 0.001). Multivariable assessments of TF had similar point estimates and CIs, suggesting a consistent and independent association with survival. Exploratory analysis showed that TF remained consistently prognostic across a wide range of cutpoints.

CONCLUSIONS

Plasma ctDNA TF is a pragmatic, independent prognostic biomarker across four advanced cancers with potential to guide clinical conversations around expected treatment outcomes. With further prospective validation, ctDNA TF could be incorporated into care paradigms to enable precision escalation and de-escalation of cancer therapy based on patient-level tumor biology.

Adolescents' views of defunding the police, abolishing the police, and "The Talk"

INTRODUCTION

Definitions regarding defunding or abolishing the police are highly contested in the United States. Moreover, adolescents' definitions and how socialization processes shape their definitions are unclear.

METHODS

Within a national sample of 822 adolescents ages 13-17 (49.69% female; 63.22% White, 16.93% Black/African American, 11.01% Hispanic/Latinx) surveyed in July 2020, this study examined how youth define defunding versus abolishing the police, how much parents talk to youth about the police (i.e., "the Talk"), and whether relations emerged between defunding/abolishing the police and "the Talk."

RESULTS

Youth supported defunding more than abolishing (d = 0.57). Support for abolishing was higher for youth who frequently received "the Talk" (b = 0.25). Differences by race and gender were uncovered in how frequently youth received "the Talk."

CONCLUSIONS

Police must recognize that coercion, fear, and biased policing breed discontent and promote families to engage in protective parenting strategies including engaging in "the Talk."

Perceptions of Legal Authorities in a Longitudinal Study of Adjudicated Youth

While perceptions of the legitimacy of formal authority have been found to influence offending, little is known about the extent to which such perceptions influence the related outcome of victimization. This study addressed this gap by examining how changes in legitimacy affected victimization both within- and between-individuals. This study used 7 waves of the Pathways to Desistance data (n = 1310; 13.85% female; age range 14-22). Youth who have committed serious offenses were surveyed at 6-month intervals during the transition from adolescence to young adulthood. In the full sample, the effects of legitimacy on both victimization and offending remained largely stable over time within individuals. Sensitivity analyses revealed that more positive perceptions of legitimacy significantly reduce offending for boys and reduce victimization for girls during the developmental period under study. Consistent with prior research, between-individual differences appear to be more important than within-individual change for explaining both offending and victimization. The implications of the results for theory, future research, and early intervention for high-risk youth are discussed.

Social distancing in America: Understanding long-term adherence to COVID-19 mitigation recommendations

A crucial question in the governance of infectious disease outbreaks is how to ensure that people continue to adhere to mitigation measures for the longer duration. The present paper examines this question by means of a set of cross-sectional studies conducted in the United States during the COVID-19 pandemic, in May, June, and July of 2020. Using stratified samples that mimic the demographic characteristics of the U.S. population, it seeks to understand to what extent Americans continued to adhere to social distancing measures in the period after the first lockdown ended. Moreover, it seeks to uncover which variables sustained (or undermined) adherence across this period. For this purpose, we examined a broad range of factors, relating to people’s (1) knowledge and understanding of the mitigation measures, (2) perceptions of their costs and benefits, (3) perceptions of legitimacy and procedural justice, (4) personal factors, (5) social environment, and (6) practical circumstances. Our findings reveal that adherence was chiefly shaped by three major factors: respondents adhered more when they (a) had greater practical capacity to adhere, (b) morally agreed more with the measures, and (c) perceived the virus as a more severe health threat. Adherence was shaped to a lesser extent by impulsivity, knowledge of social distancing measures, opportunities for violating, personal costs, and descriptive social norms. The results also reveal, however, that adherence declined across this period, which was partly explained by changes in people’s moral alignment, threat perceptions, knowledge, and perceived social norms. These findings show that adherence originates from a broad range of factors that develop dynamically across time. Practically these insights help to improve pandemic governance, as well as contributing theoretically to the study of compliance and the way that rules come to shape behavior.

Perceptions of police legitimacy and bias from ages 13 to 22 among Black, Latino, and White justice-involved males

OBJECTIVE

Although researchers, policymakers, and practitioners recognize the importance of the public's perceptions of police, few studies have examined developmental trends in adolescents and young adults' views of police.

HYPOTHESES

Hypothesis 1: Perceptions of police legitimacy would exhibit a U-shaped curve, declining in adolescence before improving in young adulthood. Hypothesis 2: At all ages, Black youth would report more negative perceptions of police legitimacy than Latino youth, who would report more negative perceptions than White youth. Hypothesis 3: Perceptions of police bias would be consistently associated with worse perceptions of police legitimacy.

METHOD

Utilizing longitudinal data from the Crossroads Study, this study examined within-person trends in males' perceptions of police legitimacy from ages 13 to 22, as well as whether perceptions of police bias were associated with perceptions of police legitimacy.

RESULTS

Perceptions of police legitimacy followed a U-shaped curve that declined during adolescence, reached its lowest point around age 18, and improved during the transition to young adulthood. Compared with White youth, Latino and Black youth had shallower curves in perceptions of police legitimacy that exhibited less improvement during the transition to adulthood. Further, perceptions of police bias were consistently associated with more negative perceptions of police legitimacy across races and ages.

CONCLUSIONS

While perceptions of police legitimacy may decline during adolescence before improving during the transition to adulthood, perceptions of police bias are consistently negatively related to youth and young adults' perceptions of police legitimacy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Social distancing in America: Understanding long-term adherence to COVID-19 mitigation recommendations

A crucial question in the governance of infectious disease outbreaks is how to ensure that people continue to adhere to mitigation measures for the longer duration. The present paper examines this question by means of a set of cross-sectional studies conducted in the United States during the COVID-19 pandemic, in May, June, and July of 2020. Using stratified samples that mimic the demographic characteristics of the U.S. population, it seeks to understand to what extent Americans continued to adhere to social distancing measures in the period after the first lockdown ended. Moreover, it seeks to uncover which variables sustained (or undermined) adherence across this period. For this purpose, we examined a broad range of factors, relating to people's (1) knowledge and understanding of the mitigation measures, (2) perceptions of their costs and benefits, (3) perceptions of legitimacy and procedural justice, (4) personal factors, (5) social environment, and (6) practical circumstances. Our findings reveal that adherence was chiefly shaped by three major factors: respondents adhered more when they (a) had greater practical capacity to adhere, (b) morally agreed more with the measures, and (c) perceived the virus as a more severe health threat. Adherence was shaped to a lesser extent by impulsivity, knowledge of social distancing measures, opportunities for violating, personal costs, and descriptive social norms. The results also reveal, however, that adherence declined across this period, which was partly explained by changes in people's moral alignment, threat perceptions, knowledge, and perceived social norms. These findings show that adherence originates from a broad range of factors that develop dynamically across time. Practically these insights help to improve pandemic governance, as well as contributing theoretically to the study of compliance and the way that rules come to shape behavior.

Partners or adversaries? The relation between juvenile diversion supervision and parenting practices

OBJECTIVE

Based on guiding principles such as parens patriae, juvenile probation officers (JPOs) not only supervise youth, but in certain jurisdictions they also decide how control-oriented their conditions will be. JPOs' perceptions of parenting could be related to their decision making. This study examined: (a) whether JPOs' perceptions of the home were associated with the conditions they placed on youth; (b) if JPOs' perceptions of the home aligned with the youths' perceptions; and (c) if JPOs' control-oriented conditions were associated with changes in parenting practices.

HYPOTHESES

(H1) JPOs' perceptions of the home should be positively related to youths' perceptions of parenting practices. (H2) JPOs' perceptions of the home should be positively associated with the conditions imposed. (H3) JPOs' control-oriented conditions may be positively associated with increased parental supervision, yet they may also be associated with lessened parental supervision.

METHOD

The sample consisted of 265 male youth (mean age = 15.41; 76.6% Latino, 19.25% White, 0.75% Black) who were arrested for the first time and placed on supervised diversion.

RESULTS

Latent class analyses indicated that there were three supervision conditions classes: standard, moderate, and high control. JPOs' perceptions of the home did not align with youths' perceptions of parenting practices (e.g., rule setting, curfew setting, and monitoring) yet they were the strongest predictor of receiving the most control-oriented conditions. Surprisingly, parental rule setting, curfew setting, and monitoring declined once youth were placed under supervision, and declines did not differ based on how control-oriented their official conditions were.

CONCLUSIONS

Parents are thought to be vital in justice-involved youths' success. Yet within this sample, officers' perceptions of the family did not align with youths' perceptions. Further, parental supervision declined equally regardless of how control-oriented youths' supervision conditions were. Parents must be better integrated into the process to enhance the success of youth on community supervision. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Dynamic Risk Factors for Handgun Carrying: Are There Developmental or Sex Differences?

Objective: This study examines the effects of dynamic risk factors on handgun carrying from adolescence into young adulthood.Method: A nationally representative sample of 8,679 individuals (ages 12-26; 51.1% male; 58% White, 26.8% African American; 21.2% Hispanic ethnicity) from the National Longitudinal Survey of Youth (1997 cohort) interviewed at least three times across nine annual waves is used to estimate effects on handgun carrying. Key predictors include gang membership, selling and using drugs, violent crime, and arrest. Using mixed effects models, we focus on within-individual effects across three timeframes from ages 12 to 26: 1) predictors and handgun carrying measured concurrently, 2) predictors measured across one year and handgun carrying measured in the final month of the same year, and 3) predictors measured in the wave before handgun carrying. We also contrast estimates by sex and age.Results: All theoretically relevant predictors statistically significantly predict handgun carrying across the first two timeframes. However, none are statistically significant predictors of handgun carrying in the following year. Few significant sex and age differences emerge.Conclusions: Handgun carrying is an ephemeral behavior particularly during adolescence. The predictors of handgun carrying, which are grounded in gangs, drug use/sale, and crime involvement, appear to have short-term impacts that are consistent across age as well as across sex. Consequently, future work should focus on shorter-term changes in models and there is no evidence that intervention efforts must take fundamentally different approaches to reduce handgun use among males versus females or adolescents versus adults.

Adolescents' confidence in institutions: Do America's youth differentiate between legal and social institutions?

It is widely believed that there is a crisis of confidence in law enforcement in the United States. What remains to be seen, however, is whether adolescents actually differentiate between legal authorities and other types of authorities. Leveraging cross-sectional, nationally representative data of 12th graders from every year from 2006 to 2017 from Monitoring the Future (N = 10,941), the results indicate that adolescents distinguish between legal authorities (e.g., law enforcement, justice system) and social authorities (e.g., schools, religious institutions). Youth report more confidence in social authorities than in legal authorities. Furthermore, whereas confidence in social authorities remained largely stable between the cohorts over the last decade, confidence in legal authorities, and in law enforcement in particular, has declined markedly. Although there may be an era of mistrust in legal authorities, it cannot be attributed to a ubiquitous anti-authority attitude among modern adolescents in the United States. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Epidemic West Nile encephalitis, New York, 1999: results of a household-based seroepidemiological survey

BACKGROUND

In the summer of 1999, West Nile virus was recognised in the western hemisphere for the first time when it caused an epidemic of encephalitis and meningitis in the metropolitan area of New York City, NY, USA. Intensive hospital-based surveillance identified 59 cases, including seven deaths in the region. We did a household-based seroepidemiological survey to assess more clearly the public-health impact of the epidemic, its range of illness, and risk factors associated with infection.

METHODS

We used cluster sampling to select a representative sample of households in an area of about 7.3 km(2) at the outbreak epicentre. All individuals aged 5 years or older were eligible for interviews and phlebotomy. Serum samples were tested for IgM and IgG antibodies specific for West Nile virus.

FINDINGS

677 individuals from 459 households participated. 19 were seropositive (weighted seroprevalence 2.6% [95% CI 1.2-4.1). Six (32%) of the seropositive individuals reported a recent febrile illness compared with 70 of 648 (11%) seronegative participants (difference 21% [0-47]). A febrile syndrome with fatigue, headache, myalgia, and arthralgia was highly associated with seropositivity (prevalence ratio 7.4 [1.5-36.6]). By extrapolation from the 59 diagnosed meningoencephalitis cases, we conservatively estimated that the New York outbreak consisted of 8200 (range 3500-13000) West Nile viral infections, including about 1700 febrile infections.

INTERPRETATION

During the 1999 West Nile virus outbreak, thousands of symptomless and symptomatic West Nile viral infections probably occurred, with fewer than 1% resulting in severe neurological disease.

Tularemia as a biological weapon: medical and public health management

OBJECTIVE

The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if tularemia is used as a biological weapon against a civilian population.

PARTICIPANTS

The working group included 25 representatives from academic medical centers, civilian and military governmental agencies, and other public health and emergency management institutions and agencies.

EVIDENCE

MEDLINE databases were searched from January 1966 to October 2000, using the Medical Subject Headings Francisella tularensis, Pasteurella tularensis, biological weapon, biological terrorism, bioterrorism, biological warfare, and biowarfare. Review of these references led to identification of relevant materials published prior to 1966. In addition, participants identified other references and sources.

CONSENSUS PROCESS

Three formal drafts of the statement that synthesized information obtained in the formal evidence-gathering process were reviewed by members of the working group. Consensus was achieved on the final draft.

CONCLUSIONS

A weapon using airborne tularemia would likely result 3 to 5 days later in an outbreak of acute, undifferentiated febrile illness with incipient pneumonia, pleuritis, and hilar lymphadenopathy. Specific epidemiological, clinical, and microbiological findings should lead to early suspicion of intentional tularemia in an alert health system; laboratory confirmation of agent could be delayed. Without treatment, the clinical course could progress to respiratory failure, shock, and death. Prompt treatment with streptomycin, gentamicin, doxycycline, or ciprofloxacin is recommended. Prophylactic use of doxycycline or ciprofloxacin may be useful in the early postexposure period.

Influenza A among patients with human immunodeficiency virus: an outbreak of infection at a residential facility in New York City

Although annual influenza vaccination is recommended for persons who are infected with human immunodeficiency virus (HIV), data are limited regarding the epidemiology of influenza or the effectiveness of influenza vaccination in this population. We investigated a 1996 outbreak of infection with influenza A at a residential facility for persons with AIDS. We interviewed 118 residents and employees, reviewed 65 resident medical records, and collected serum samples for measurement of influenza antibody titers. After controlling for history of smoking, influenza vaccination, and resident or employee status, in a multivariate model, HIV infection was not statistically associated with influenza-like illness (ILI). Symptoms and duration of ILI were similar for most HIV-infected and HIV-uninfected persons. However, 8 (21.1%) of 38 HIV-infected persons with ILI (vs. none of 15 HIV-uninfected persons) were either hospitalized, evaluated in an emergency room, or had ILI lasting > or = 14 days (P=.06). Vaccination effectiveness (VE) was similar for HIV-infected and HIV-uninfected persons. Vaccination was most effective among HIV-infected persons with CD4 cell counts of >100 cells/microL (VE, 65%; 95% CI, 36%--81%) or HIV type 1 virus load of <30,000 copies/mL (VE, 52%; 95% CI, 11%--75%). Providers should continue to offer influenza vaccination to HIV-infected persons.

Botulinum toxin as a biological weapon: medical and public health management

OBJECTIVE

The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals if botulinum toxin is used as a biological weapon against a civilian population.

PARTICIPANTS

The working group included 23 representatives from academic, government, and private institutions with expertise in public health, emergency management, and clinical medicine.

EVIDENCE

The primary authors (S.S.A. and R.S.) searched OLDMEDLINE and MEDLINE (1960-March 1999) and their professional collections for literature concerning use of botulinum toxin as a bioweapon. The literature was reviewed, and opinions were sought from the working group and other experts on diagnosis and management of botulism. Additional MEDLINE searches were conducted through April 2000 during the review and revisions of the consensus statement.

CONSENSUS PROCESS

The first draft of the working group's consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group convened to review the first draft in May 1999. Working group members reviewed subsequent drafts and suggested additional revisions. The final statement incorporates all relevant evidence obtained in the literature search in conjunction with final consensus recommendations supported by all working group members.

CONCLUSIONS

An aerosolized or foodborne botulinum toxin weapon would cause acute symmetric, descending flaccid paralysis with prominent bulbar palsies such as diplopia, dysarthria, dysphonia, and dysphagia that would typically present 12 to 72 hours after exposure. Effective response to a deliberate release of botulinum toxin will depend on timely clinical diagnosis, case reporting, and epidemiological investigation. Persons potentially exposed to botulinum toxin should be closely observed, and those with signs of botulism require prompt treatment with antitoxin and supportive care that may include assisted ventilation for weeks or months. Treatment with antitoxin should not be delayed for microbiological testing.

Plague as a biological weapon: medical and public health management. Working Group on Civilian Biodefense

OBJECTIVE

The Working Group on Civilian Biodefense has developed consensus-based recommendations for measures to be taken by medical and public health professionals following the use of plague as a biological weapon against a civilian population.

PARTICIPANTS

The working group included 25 representatives from major academic medical centers and research, government, military, public health, and emergency management institutions and agencies.

EVIDENCE

MEDLINE databases were searched from January 1966 to June 1998 for the Medical Subject Headings plague, Yersinia pestis, biological weapon, biological terrorism, biological warfare, and biowarfare. Review of the bibliographies of the references identified by this search led to subsequent identification of relevant references published prior to 1966. In addition, participants identified other unpublished references and sources. Additional MEDLINE searches were conducted through January 2000.

CONSENSUS PROCESS

The first draft of the consensus statement was a synthesis of information obtained in the formal evidence-gathering process. The working group was convened to review drafts of the document in October 1998 and May 1999. The final statement incorporates all relevant evidence obtained by the literature search in conjunction with final consensus recommendations supported by all working group members.

CONCLUSIONS

An aerosolized plague weapon could cause fever, cough, chest pain, and hemoptysis with signs consistent with severe pneumonia 1 to 6 days after exposure. Rapid evolution of disease would occur in the 2 to 4 days after symptom onset and would lead to septic shock with high mortality without early treatment. Early treatment and prophylaxis with streptomycin or gentamicin or the tetracycline or fluoroquinolone classes of antimicrobials would be advised.

Microsurgical anatomy of the extracranial-extradural origin of the posterior inferior cerebellar artery

OBJECT

The authors describe the microsurgical anatomy of the posterior inferior cerebellar artery (PICA) with an extradural origin and discuss its importance as a common variation.

METHODS

The microsurgical anatomy of paired PICAs with an extradural origin were examined.

CONCLUSIONS

Five to 20% of PICAs have an extradural origin. In the case described, both PICAs arose extradurally from the third segment of the vertebral artery (VA). Both origins were less than 1 cm proximal to the site at which the VA penetrated the dura, and neither PICA gave rise to extradural branches. Extradurally, the PICAs coursed parallel to the VA and the C-1 nerve and the three structures penetrated the dura together. Intradurally, the PICAs remained lateral and posterior to the brainstem, whereas, in the common PICA configuration, the first segment of the PICA courses anterior to the medulla. Neither PICA sent branches to the anterior brainstem, which is commonly found in PICAs with an intradural origin. There were no soft-tissue or bone anomalies.

Physiological and immunocytochemical evidence for a putative H-K-ATPase in elasmobranch renal acid secretion

The mechanism of renal acid secretion in marine fish is largely unknown. We explored whether H(+)-K(+)-adenosinetriphosphatase (H(+)-K(+)-ATPase) is present and functional in acid secretion in the kidney of the elasmobranch spiny dogfish shark, Squalus acanthias. In whole animal studies, a specific inhibitor of mammalian H(+)-K(+)-ATPase, Sch-28080, abolished greater than 87% of basal (62 mg/kg) and 75% of imidazole-stimulated titratable acid excretion (5 and 62 mg/kg). Antibodies directed against the COOH-terminus hog gastric H(+)-K(+)-ATPase alpha-subunit stained specific subdivisions of the neck, early and late proximal tubule, late intermediate tubule, both segments of the distal tubule, and the early collecting duct of the renal tubule of these fish. These findings are consistent with a major role for a protein similar to the mammalian gastric H(+)-K(+)-ATPase in elasmobranch renal acid secretion.