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Non-pharmacologic adjuncts to opioid analgesics for burn wound debridement enhance safety and cost effectiveness in care. The current study explored the feasibility of using a custom portable water-friendly immersive VR hardware during burn debridement in adults, and tested whether interactive VR would reduce pain more effectively than nature stimuli viewed in the same VR goggles.Forty-eight patients with severe burn injuries (44 adults and 4 children) had their burn injuries debrided and dressed in a wet wound care environment on Study Day 1, and 13 also participated in Study Day 2.The study used a within-subject design to test two hypotheses (one hypothesis per study day) with the condition order randomized. On Study Day 1, each individual (n = 44 participants) spent 5 min of wound care in an interactive immersive VR environment designed for burn care, and 5 min looking at still nature photos and sounds of nature in the same VR goggles. On Study Day 2 (n = 12 adult participants and one adolescent from Day 1), each participant spent 5 min of burn wound care with no distraction and 5 min of wound care in VR, using a new water-friendly VR system. On both days, during a post-wound care assessment, participants rated and compared the pain they had experienced in each condition. OUTCOME MEASURES ON STUDY DAYS 1 AND 2: Worst pain during burn wound care was the primary dependent variable. Secondary measures were ratings of time spent thinking about pain during wound care, pain unpleasantness, and positive affect during wound care.On Study Day 1, no significant differences in worst pain ratings during wound care were found between the computer-generated world (Mean = 71.06, SD = 26.86) vs. Nature pictures conditions (Mean = 68.19, SD = 29.26; t 1, NS). On secondary measures, positive affect (fun) was higher, and realism was lower during computer-generated VR. No significant differences in pain unpleasantness or "presence in VR" between the two conditions were found, however. VR VS. NO VR. (STUDY DAY 2): Participants reported significantly less worst pain when distracted with adjunctive computer generated VR than during standard wound care without distraction (Mean = 54.23, SD = 26.13 vs 63.85, SD = 31.50, t(11) = 1.91, p .05, SD = 17.38). In addition, on Study Day 2, "time spent thinking about pain during wound care" was significantly less during the VR condition, and positive affect was significantly greater during VR, compared to the No VR condition.The current study is innovative in that it is the first to show the feasibility of using a custom portable water-friendly immersive VR hardware during burn debridement in adults. However, contrary to predictions, interactive VR did not reduce pain more effectively than nature stimuli viewed in the same VR goggles.

Although strong evidence exists for using individual hypnosis to treat pain, evidence regarding group applications is limited. This project evaluated changes in multiple outcome measures in persons with chronic pain treated with 8 weeks of group hypnosis. Eighty-five adults with diverse chronic pain etiologies completed an 8-session, structured group hypnosis treatment. Pain intensity, pain interference, and global health were evaluated at baseline, posttreatment, and 3- and 6-months posttreatment. Linear mixed effects models assessed changes in outcomes over time. In a model testing, all three outcome measures simultaneously, participants improved substantially from pre- to posttreatment and maintained improvement across follow-up. Analyses of individual outcomes showed significant pre- to posttreatment reductions in pain intensity and interference, which were maintained for pain intensity and continued to improve for pain interference across follow-up. The findings provide compelling preliminary evidence that a group format is an effective delivery system for teaching individual skills in using hypnosis for chronic pain management. Larger randomized controlled trials are warranted to demonstrate equivalence of outcomes between treatment modes.

Wildlife conservation in the Anthropocene requires bold conservation solutions including restoration of ecosystems and species. The recovery of large carnivore populations is a conservation goal which can generate significant benefits in terms of ecosystem services, ecological functionality, and human well-being. Tigers Panthera tigris, Asia’s most iconic species, are currently restricted to less than 10% of their historic range with recent national extinctions from a number of countries in mainland Southeast Asia. Tiger recovery through range expansion requires suitable habitat, a robust prey base, and high levels of institutional support for conservation. We explored government support for conservation to produce a ranking of the political opportunities for tiger restoration across current and former tiger range countries. We used this analysis, in combination with globally remotely sensed data-sets on human impact, to show that there is potential for significant tiger range expansion. We identified large expanses of currently unoccupied, but potentially suitable, habitat in at least 14 countries including all extant tiger range countries and four countries with extirpated tiger populations – Cambodia, Lao PDR, Viet Nam, and Kazakhstan. Thirty-two percent of expansion areas were within 50-km, and 50% within 100-km, of current tiger populations highlighting that in many landscapes range expansion could be driven by the natural dispersal of tigers provided connectivity is maintained or enhanced. The proportion of potential range within existing protected areas varied between 60% in Thailand and Cambodia. As such socially appropriate conservation approaches, in collaboration with local communities, will be necessary to support tiger recovery in many areas. We recommend that some of the areas which we have identified should be highlighted as significant for future tiger conservation by tiger range country governments. Whilst the landscapes and sites which we identify will require detailed ground-truthing, and all tiger reintroductions need extensive planning and feasibility assessments, safeguarding these areas for human-carnivore coexistence could provide significant planetary benefits and support both tiger recovery and Global Sustainable Development Goals.

Although infectious agents can act as strong population regulators, knowledge of their spatial distributions in wild Pacific salmon is limited, especially in the marine environment. Characterizing pathogen distributions during early marine residence, a period considered a survival bottleneck for Pacific salmon, may reveal where salmon populations are exposed to potentially detrimental pathogens. Using high-throughput qPCR, we determined the prevalence of 56 infectious agents in 5719 Chinook, 2032 Coho and 4062 Sockeye salmon, sampled between 2008 and 2018, in their first year of marine residence along coastal Western Canada. We identified high prevalence clusters, which often shifted geographically with season, for most of the 41 detected agents. A high density of infection clusters was found in the Salish Sea along the east coast of Vancouver Island, an important migration route and residence area for many salmon populations, some experiencing chronically poor marine survival. Maps for each infectious agent taxa showing clusters across all host species are provided. Our novel documentation of salmon pathogen distributions in the marine environment contributes to the ecological knowledge regarding some lesser known pathogens, identifies salmon populations potentially impacted by specific pathogens, and pinpoints priority locations for future research and remediation.

Recent decades have seen an increased appreciation for the role infectious diseases can play in mass mortality events across a diversity of marine taxa. At the same time many Pacific salmon populations have declined in abundance as a result of reduced marine survival. However, few studies have explicitly considered the potential role pathogens could play in these declines. Using a multi-year dataset spanning 59 pathogen taxa in Chinook and Coho salmon sampled along the British Columbia coast, we carried out an exploratory analysis to quantify evidence for associations between pathogen prevalence and cohort survival and between pathogen load and body condition. While a variety of pathogens had moderate to strong negative correlations with body condition or survival for one host species in one season, we found that Tenacibaculum maritimum and Piscine orthoreovirus had consistently negative associations with body condition in both host species and seasons and were negatively associated with survival for Chinook salmon collected in the fall and winter. Our analyses, which offer the most comprehensive examination of associations between pathogen prevalence and Pacific salmon survival to date, suggest that pathogens in Pacific salmon warrant further attention, especially those whose distribution and abundance may be influenced by anthropogenic stressors.

Nearly one-fourth of all undergraduate degrees received by Black students are from historically Black colleges and universities (HBCUs). HBCUs have both historical significance and present-day relevance in the promotion of Black excellence in higher education, especially in the consideration of behavioral health. The purpose of this work is to examine the present state of research surrounding behavioral health within HBCUs. A scoping review was conducted of the EbscoHost database, yielding a total of 252 articles. A total of 39 articles met the inclusion criteria and were examined within this work. Six studies informed the prevalence of behavioral health issues on campus, while the remaining articles covered a broad range of research from psychological and physical wellbeing, sexual health, violence, identity, and ideology, and finally programs and policies. Gaps and future recommendations for research and practice are discussed.

Several species of Pacific Salmon migrate upstream every year in the Fraser River (British Columbia, Canada) to reach their spawning grounds. A large portion of the fish get delayed in specific sections of the river, where the morphology and the flow create sections with high flow velocity, high turbulence and jumps in bed elevation that constitute hydraulic barriers. Several fish populations migrate along the Fraser River and any barrier for their passage (created by the river morphology, the flow structure or a localized landslide) can severely endanger the survival of such species, while also impacting indigenous communities for which fish is a fundamental element. In the Fraser River those hydraulic barriers have been identified but not yet thoroughly studied. Here we present results from an extensive monitoring campaign conducted in the last 3 years to measure surface flow velocities in previously identified hydraulic barriers. We selected segments of the Fraser Canyon where distributions of surface flow velocities due to specific river morphologies are potentially impacting fish passage. These include areas where series of constriction-pool-widenings create plunging flows, bedrock step rapids and overfalls. In such areas we collected video of surface flows (with fixed field cameras and drones) at high frequency during the freshet season and obtained surface flow velocity maps using Large Scale Particle Image Velocimetry (LSPIV) for different values of flow discharge. Using this extensive dataset, we can detect how stable coherent flow structures are for different flow depths and flow discharges and we are also able to identify which areas are most problematic for fish passage (and for which values of flow), helping fish management agencies and public authorities to better protect the survival of vital species in British Columbia.

The early marine life of Pacific salmon is believed to be a critical period limiting population-level survival. Recent evidence suggests that some infectious agents are associated with survival but linkages with underlying physiological mechanisms are lacking. While challenge studies can demonstrate cause and effect relationships between infection and pathological change or mortality, in some cases pathological change may only manifest in the presence of environmental stressors; thus, it is important to gain context from field observations. Herein, we examined physiological correlates with infectious agent loads in Chinook salmon during their first ocean year. We measured physiology at the molecular (gene expression), metabolic (plasma chemistry) and cellular (histopathology) levels. Of 46 assayed infectious agents, 27 were detected, including viruses, bacteria and parasites. This exploratory study identified: Importantly, our study provides the first evidence that the molecular activation of viral disease response and the lesions observed during the development of the PRV-related disease jaundice/anemia in farmed Chinook salmon are also observed in wild juvenile Chinook salmon.

Climate change is causing large declines in many Pacific salmon populations. In particular, warm rivers are associated with high levels of premature mortality in migrating adults. The Fraser River watershed in British Columbia, Canada, supports some of the largest Chinook salmon (Oncorhynchus tshawytscha) runs in the world. However, the Fraser River is warming at a rate that threatens these populations at critical freshwater life stages. A growing body of literature suggests salmonids are locally adapted to their thermal migratory experience, and thus, population-specific thermal performance information can aid in management decisions. We compared the thermal performance of pre-spawning adult Chinook salmon from two populations, a coastal fall-run from the Chilliwack River (125 km cooler migration) and an interior summer-run from the Shuswap River (565 km warmer migration). We acutely exposed fish to temperatures reflecting current (12°C, 18°C) and future projected temperatures (21°C, 24°C) in the Fraser River and assessed survival, aerobic capacity (resting and maximum metabolic rates, absolute aerobic scope (AAS), muscle and ventricle citrate synthase), anaerobic capacity (muscle and ventricle lactate dehydrogenase) and recovery capacity (post-exercise metabolism, blood physiology, tissue lactate). Chilliwack Chinook salmon performed worse at high temperatures, indicated by elevated mortality, reduced breadth in AAS, enhanced plasma lactate and potassium levels and elevated tissue lactate concentrations compared with Shuswap Chinook salmon. At water temperatures exceeding the upper pejus temperatures (Tpejus, defined here as 80% of maximum AAS) of Chilliwack (18.7°C) and Shuswap (20.2°C) Chinook salmon populations, physiological performance will decline and affect migration and survival to spawn. Our results reveal population differences in pre-spawning Chinook salmon performance across scales of biological organization at ecologically relevant temperatures. Given the rapid warming of rivers, we show that it is critical to consider the intra-specific variation in thermal physiology to assist in the conservation and management of Pacific salmon.

Incorporating host-pathogen(s)-environment axes into management and conservation planning is critical to preserving species in a warming climate. However, the role pathogens play in host stress resilience remains largely unexplored in wild animal populations. We experimentally characterized how independent and cumulative stressors (fisheries handling, high water temperature) and natural infections affected the health and longevity of released wild adult sockeye salmon (Oncorhynchus nerka) in British Columbia, Canada. Returning adults were collected before and after entering the Fraser River, yielding marine- and river-collected groups, respectively (N = 185). Fish were exposed to a mild (seine) or severe (gill net) fishery treatment at collection, and then held in flow-through freshwater tanks for up to four weeks at historical (14°C) or projected migration temperatures (18°C). Using weekly nonlethal gill biopsies and high-throughput qPCR, we quantified loads of up to 46 pathogens with host stress and immune gene expression. Marine-collected fish had less severe infections than river-collected fish, a short migration distance (100 km, 5-7 days) that produced profound infection differences. At 14°C, river-collected fish survived 1-2 weeks less than marine-collected fish. All fish held at 18°C died within 4 weeks unless they experienced minimal handling. Gene expression correlated with infections in river-collected fish, while marine-collected fish were more stressor-responsive. Cumulative stressors were detrimental regardless of infections or collection location, probably due to extreme physiological disturbance. Because river-derived infections correlated with single stressor responses, river entry probably decreases stressor resilience of adult salmon by altering both physiology and pathogen burdens, which redirect host responses toward disease resistance.

Dead animals may be an important or the only source of tissues to analyze for stable isotopes, with the goal of making inferences about an animal’s past ecological history. However, in nature, stable isotope values may be affected by myriad decomposition processes, such as abiotic environmental conditions and bacterial and fungal decay, potentially reducing the accuracy of derived ecological conclusions. We used Pacific salmon carcasses left in air or submerged under water to test whether stable isotope values of metabolically active (skin, muscle, and adipose fin) and inactive (scale) tissues changed over time. We found that the δ13C values of active tissues were all affected by decomposition but not in a predictable direction, and hard scale tissue was not. In contrast, there was no effect on δ15N values for any tissue up to 4 days under water or 8 days in air. This suggests that tissues can be analyzed for nitrogen stable isotope values even after several days in water and even if covered in fungus on the surface. For populations within which dead animals are frequently encountered, e.g., salmonid carcass surveys, hard tissues of fish (scales, otoliths) and other animals (baleen, bone, hair, feathers) will likely yield relevant biological information even if soft tissue is rotting, providing another avenue to collect important data about the life history of those animals.

A central goal of paleoanthropology is understanding the role of ecological change in hominin evolution. Over the past several decades researchers have expanded the hominin fossil record and assembled detailed late Cenozoic paleoclimatic, paleoenvironmental, and paleoecological archives. However, effective use of these data is precluded by the limitations of pattern-matching strategies for inferring causal relationships between ecological and evolutionary change. We examine several obstacles that have hindered progress, and highlight recent research that is addressing them by (i) confronting an incomplete fossil record, (ii) contending with datasets spanning varied spatiotemporal scales, and (iii) using theoretical frameworks to build stronger inferences. Expanding on this work promises to transform challenges into opportunities and set the stage for a new phase of paleoanthropological research.

The large-scale culture of low-cost algal biomass can be significantly affected by microbial grazing on the algae. To minimize the impact, it is necessary to manage the predators. In this study, we describe a new genus and species of vampyrellid amoeba, Kinopus chlorellivorus, which caused the loss of Chlorella sorokiniana in large-scale cultures. We assigned it to the family Leptophryidae (Vampyrellida) based on morphology and small-subunit (SSU) rRNA gene sequence comparisons. Using transmission electron microscopy, we found spherical lucent inclusions, which have not been reported for any leptophryids or other vampyrellids. The gene sequence of SSU rRNA did not match any recognized genera or species and contained four characteristic regions. K. chlorellivorus preys on algae by engulfment. Laboratory feeding experiments confirmed that its grazing rate was as high as 131 Chlorella cells day(−1) individual(−1). Results of prey-range experiments demonstrated that it could consume other chlorophyte microalgae (e.g., Scenedesmus, Coelastrella, and Haematococcus) but with a strong feeding ability on Chlorella spp., with ingestion rates ranging from 2.67 to 3.15 prey predator(−1) h(−1) and growth rates of the amoeba ranging from 0.039 to 0.045 h(−1). On the basis of its high grazing ability on Chlorella, capacity to form large populations in a short period of time, and capacity to form resistant resting stages, this contaminant has the potential to cause serious problems in large-scale Chlorella culture and should be of concern to operators of algal production facilities. IMPORTANCE The vampyrellids (Vampyrellida, Rhizaria) are a major group of predatory amoebae that have attracted significant attention because of their diversity of feeding strategies. The crucial roles they play in important processes such as suppressing soil disease and controlling aquatic algae, and as microbial contaminants in outdoor large-scale algal cultures, have also received increasing attention. In this study, a new genus and species of algivorous vampyrellid amoeba, Kinopus chlorellivorus, is described as a significant grazer responsible for losses in outdoor industrial Chlorella cultures. We found that the amoeba’s detrimental effects on Chlorella cultures may be related to its specific feeding characteristics. This study provides phenotypic and genetic information on a previously unknown vampyrellid, emphasizes the impact of contaminating vampyrellids in commercial microalgal cultures, and will contribute to the development of management strategies for predicting this kind of contaminant in large-scale microalgal cultivation.

The extension of biology with a more data-centric component offers new opportunities for discovery. To enable investigations that rely on third-party data, the infrastructure that retains data and allows their re-use should, arguably, enable transactions that relate to any and all biological processes. The assembly of such a service-oriented and enabling infrastructure is challenging. Part of the challenge is to factor in the scope and scale of biological processes. From this foundation can emerge an estimate of the number of discipline-specific centres which will gather data in their given area of interest and prepare them for a path that will lead to trusted, persistent data repositories which will make fit-for-purpose data available for re-use. A simple model is presented for the scope and scale of life sciences. It can accommodate all known processes conducted by or caused by any and all organisms. It is depicted on a grid, the axes of which are (x) the durations of the processes and (y) the sizes of participants involved. Both axes are presented in log10 scales, and the grid is divided into decadal blocks with ten fold increments of time and size. Processes range in duration from 10-17 seconds to 3.5 billion years or more, and the sizes of participants range from 10-15 to 1.3 107 metres. Examples are given to illustrate the diversity of biological processes and their often inexact character. About half of the blocks within the grid do not contain known processes. The blocks that include biological processes amount to ‘Nature’s envelope’, a valuable rhetorical device onto which subdisciplines and existing initiatives may be mapped, and from which can be derived some key requirements for a comprehensive data infrastructure.

In recent decades, the relative proportion of female sockeye salmon (Oncorhynchus nerka) on spawning grounds of several British Columbia populations has declined. Coincident with the decline has been large changes to oceanic, estuarine, and river migration environments. Over the past 30 years, numerous telemetry tracking and laboratory studies have examined mortality of adult Fraser River sockeye salmon during ocean and freshwater migrations. We reviewed 19 studies that provided 40 situations where male and female mortality could be directly compared. Female mortality averaged 2.1 times greater than that of males and up to eightfold higher. High female mortality was also evident in migrating coho salmon (Oncorhynchus kisutch) and Chinook salmon (Oncorhynchus tshawytscha) and for sockeye salmon in other systems. Female mortality was highest when migration conditions were challenging (e.g., high or turbulent flows, high temperatures, confinement, or handling) and towards end of river migration. We review mechanisms for differential mortality, including energy exhaustion, cardiac performance, physiological stress, and immune factors. Female-specific mortality will become even more pronounced in coming years as ocean and riverine conditions continue to change.

The evolution that serverless computing represents, the economic forces that shape it, why it could fail, and how it might fulfill its potential.

Excessive pain during medical procedures is a pervasive health challenge. This study tested the (additive) analgesic efficacy of combining hypnotic analgesia and virtual reality (VR) pain distraction. A single blind, randomized, and controlled trial was used to study 205 undergraduate volunteers aged 18 to 20. The individual and combined effects of hypnotic analgesia (H) and VR distraction on experimentally induced acute thermal pain were examined using a 2 X 2, between-groups parallel design (4 groups total). Participants in groups that received hypnosis remained hypnotized during the test phase pain stimulus. The main outcome measure was “worst pain” ratings. Hypnosis reduced acute pain even for people who scored low on hypnotizability. As predicted, H+ VR was significantly more effective than VR distraction alone. However, H+ VR was not significantly more effective than hypnotic analgesia alone. Being hypnotized during thermal pain enhanced VR distraction analgesia.

Though behavioral interventions and medications have shown efficacy for individuals suffering from an opioid use disorder (OUD), there is a substantial sub-population that does not respond to curre...

Five years ago, few would have predicted that a software company like Google would build its own computers. Nevertheless, Google has been deploying computers for machine learning (ML) training since 2017, powering key Google services. These Tensor Processing Units (TPUs) are composed of chips, systems, and software, all co-designed in-house. In this paper, we detail the circumstances that led to this outcome, the challenges and opportunities observed, the approach taken for the chips, a quick review of performance, and finally a retrospective on the results. A companion paper describes the supercomputers built from these chips, the compiler, and a detailed performance analysis [Jou20].

Under the United Nations Framework Convention on Climate Change and its protocols, states have legal obligations to address the climate crisis. The principle of participation is increasingly acknowledged as central to the protection and promotion of human rights, including the right to health. This paper explores states’ obligations to address the climate crisis—and concomitant health crises—from a right to health perspective. The right to health lens provides a valuable opportunity for engaging diverse civil society constituencies in the response to the climate crisis. However, civic space must be protected if these actors are to participate meaningfully. The climate crisis discourse has lacked an explicit recognition of the interconnected nature of the right to health, environmental degradation and climate change, and civic space. There is also concern that restrictions on civic space will continue after the COVID-19 pandemic. While the public health community is an important constituency in the design and implementation of laws, policies, and programs to address climate change, the human rights literacy of this community remains to be strengthened. This paper addresses these lacunae within the context of the right to health as enshrined in United Nations human rights treaties and related international law.

Numerous laboratory and field studies have found that female Pacific salmon have higher mortality than males during their once-in-a-lifetime upriver spawning migration. However, the proximate cause(s) of this increased mortality are poorly understood. This study exposed sockeye salmon (Oncorhynchus nerka) to a mild capture and tagging stressor and evaluated physiological recovery and movement behaviour at 1 and 4 h postrelease. Female sockeye salmon did not expend more anaerobic energy in response to the stressor but did have higher plasma lactate levels 4 h after the stressor, indicating that females took longer to physiologically recover compared with males. In addition, female salmon had lower plasma glucose but higher plasma cortisol, plasma K+, and cardiac lactate levels compared with males. Male and female salmon had markedly different postrelease behaviours within the first hour of release; males were more likely to hold position within the staging area. Two potential mechanisms leading to increased mortality in female salmon were identified in this study: (a) prolonged recovery duration (possibly mediated by elevated plasma cortisol levels) and (b) insufficient oxygen delivery to the heart.

Many of the world’s rivers are dammed, altering the physiology, behaviour, ecology and survival of fish. Integrative research has the potential to improve our understanding of these impacts and could enable environmental managers to develop effective solutions for population conservation. Such approaches, however, are not yet prevalent. We use a case study on Pacific salmon (Oncorhynchus spp.) in British Columbia, Canada, to demonstrate how regulated rivers may be used as experimental systems, allowing for applied research that can advance our understanding of the biology of migratory fish as well as our ability to manage them. Through the integration of multiple research approaches (i.e. biotelemetry, behavioural tests, physiological and molecular analyses, and hydraulic monitoring), we characterized the effects of natal water dilution and dam flow releases on upstream navigation, passage success and post-passage survival of returning adult salmon. Our findings confirmed previously established operational guidelines for natal water dilution and informed the adoption of new operational conditions for dam flow releases, providing an example of the successful application of integrative research to the management of a fisheries resource in a regulated river. We encourage researchers to consider using an experimental approach that integrates multiple research disciplines to inform science-based management action.

Adolescent substance use is a growing problem that causes a myriad of negative outcomes. Using substances during adolescence can lead to decreased executive functioning and is correlated with the top three causes of deaths for adolescents. Treatment options vary and the impact on outcomes are mixed, with engagement being of the most important indicators. Gaming is a popular activity among adolescents, and yet smartphone applications are relatively unexplored within substance use disorder treatment programs. This paper explores the feasibility and acceptability of implementing a mobile application as a supplement to existing adolescent substance use disorder treatment in a behavioral health agency in eastern Missouri. Feedback was received from staff and clients to assess feasibility and acceptability of implementation with barriers discussed. Results indicate there is promise with incorporation of smartphone-based applications into existing interventions and act as recommendations for other providers.

Google's TPU supercomputers train deep neural networks 50x faster than general-purpose supercomputers running a high-performance computing benchmark.

Scientific analyses commonly compose multiple single-process programs into a dataflow. An end-to-end dataflow of single-process programs is known as a many-task application. Typically, HPC tools are used to parallelize these analyses. In this work, we investigate an alternate approach that uses Apache Spark—a modern platform for data intensive computing—to parallelize many-task applications. We implement Kira, a flexible and distributed astronomy image processing toolkit, and its Source Extractor (Kira SE) application. Using Kira SE as a case study, we examine the programming flexibility, dataflow richness, scheduling capacity and performance of Apache Spark running on the Amazon EC2 cloud. By exploiting data locality, Kira SE achieves a 4.1× speedup over an equivalent C program when analyzing a 1TB dataset using 512 cores on the Amazon EC2 cloud. Furthermore, Kira SE on the Amazon EC2 cloud achieves a 1.8× speedup over the C program on the NERSC Edison supercomputer. A 128-core Amazon EC2 cloud deployment of Kira SE using Spark Streaming can achieve a second-scale latency with a sustained throughput of $\sim$ ∼ 800 MB/s. Our experience with Kira demonstrates that data intensive computing platforms like Apache Spark are a performant alternative for many-task scientific applications.

Chronic pain is a significant health problem worldwide with limited pharmacological treatment options. This study evaluated the relative efficacy of 4 treatment sessions each of 4 nonpharmacological treatments: (1) hypnotic cognitive therapy (using hypnosis to alter the meaning of pain); (2) standard cognitive therapy; (3) hypnosis focused on pain reduction, and (4) pain education. One hundred seventy-three individuals with chronic pain were randomly assigned to receive 4 sessions of 1 of the 4 treatments. Primary (pain intensity) and secondary outcome measures were administered by assessors unaware of treatment allocation at pretreatment, posttreatment, and 3-, 6-, and 12-month follow-up. Treatment effects were evaluated using analysis of variance, a generalized estimating equation approach, or a Fisher exact test, depending on the outcome domain examined. All 4 treatments were associated with medium to large effect size improvements in pain intensity that maintained up to 12 months posttreatment. Pretreatment to posttreatment improvements were observed across the 4 treatment conditions on the secondary outcomes of pain interference and depressive symptoms, with some return towards pretreatment levels at 12-month follow-up. No significant between-group differences emerged in omnibus analyses, and few statistically significant between-group differences emerged in the planned pairwise analyses, although the 2 significant effects that did emerge favored hypnotic cognitive therapy. Future research is needed to determine whether the significant differences that emerged are reliable.

Background College dropout has been described as an epidemic, with underrepresented minority (URM) students having the highest dropout rates at colleges and universities. This study examines interpersonal violence and substance use as potential threats to the academic success of URM students. Methods This study is a secondary data analysis of the National College Health Assessment. Results Significant decreases for grade point average (GPA) in African American students were associated with physical violence and marijuana use. For Hispanic/Latinx students, physical violence, marijuana use, and methamphetamine use were significantly associated with decreases in GPA. American Indian, Alaska Native, or Native Hawaiian students’ decreases in GPA were significantly associated with marijuana use. Conclusions Results of the study indicated that substance use and interpersonal violence are associated with decreases in GPA for various groups of URM. These findings are disconcerting and relay the importance for colleges and universities to undertake strategies to increase the retention of URM students.

In this article, we describe the design choices behind MLPerf, a machine learning performance benchmark that has become an industry standard. The first two rounds of the MLPerf Training benchmark helped drive improvements to software-stack performance and scalability, showing a 1.3× speedup in the top 16-chip results despite higher quality targets and a 5.5× increase in system scale. The first round of MLPerf Inference received over 500 benchmark results from 14 different organizations, showing growing adoption.

Background: Using alternating orthogonal suture throws with the looped whipstitch technique may allow enhanced suture fixation. Hypothesis: It was hypothesized that this novel multiplanar, perpendicular looped whipstitch (MP) technique would have improved biomechanical properties compared with the standard looped whipstitch (WS) and Krackow stitch (KS). Study Design: Controlled laboratory study. Methods: A total of 30 cadaveric tibialis anterior tendons were randomly assigned into 3 groups of 10. Tendons were secured to a custom clamp, and the other end was sutured using 1 of 3 techniques: the KS, WS, or novel MP. The MP was performed with alternating orthogonal throws starting right to left, then front to back, left to right, and back to front. Each technique used 4 passes of No. 2 FiberWire spaced 5 mm apart and ending 10 mm from the tendon end. Tendons were preloaded to 5 N, pretensioned to 50 N at 100 mm/min for 3 cycles, returned to 5 N for 1 minute, cycled from 5 to 100 N at 200 mm/min for 100 cycles, and then loaded to failure at 20 mm/min. Elongation was recorded after pretensioning and cycling and was measured both across the suture-tendon interface and from the base of the suture-tendon interface to markings on the suture limbs (construct elongation). One-way analyses of variance were performed, with Bonferroni post hoc analysis when appropriate. Results: There were no differences in cross-sectional area or stiffness among the 3 techniques. The ultimate load for WS (183.33 ± 57.44 N) was less compared with both MP (270.76 ± 39.36 N) and KS (298.90 ± 25.94 N) ( P ≤ .001 for both). There was less construct elongation for KS compared with WS and MP for total displacement, measured from pretensioning to the end of cycling ( P < .001). All 3 techniques saw a decrease in length (shortening) at the suture-tendon interface during testing. There was more shortening at the suture-tendon interface for WS compared with KS ( P = .006). Conclusion: The KS appears superior, as it maximized strength while minimizing construct elongation or graft shortening. The ultimate load of the MP technique was greater than that of the standard technique but not significantly different from that of the KS technique. Clinical Relevance: The KS is preferred. If using a WS, multiplanar, perpendicular passes should be considered.

A unique viewpoint on risks to senior citizens from academia.

ACM luminaries describe how their experiences with DEI issues vary between the different continents where they have lived.

PicoRio™ is an open-source project stewarded by the RISC-V International Open Source (RIOS) laboratory—rioslab.org—a nonprofit research lab at Tsinghua-Berkeley Shenzhen Institute (TBSI). The RIOS Lab uses collaborative engineering from both academia and industry to elevate the RISC-V software and hardware ecosystem. In PicoRio, we create an open, affordable, Linux-capable RISC-V hardware platform to aid software developers in porting many modern programs that require Javascript or GPUs. PicoRio will build upon high-quality IPs and software components from expert industry engineers and academic researchers. PicoRio is not proprietary to any specific vendor and platform, and will have complete documentation that can help people to build quality products in a short amount of time. Our plan is to ship PicoRio 1.0 in 1H2021.

Much genomic data comes in the form of paired-end reads: two reads that represent genetic material with a small gap between. We present a new algorithm for aligning both reads in a pair simultaneously by fuzzily intersecting the sets of candidate alignment locations for each read. This algorithm is often much faster and produces alignments that result in variant calls having roughly the same concordance as the best competing aligners.

SUMMARYTumor evolution is driven by the progressive acquisition of genetic and epigenetic alterations that enable uncontrolled growth, expansion to neighboring and distal tissues, and therapeutic resistance. The study of phylogenetic relationships between cancer cells provides key insights into these processes. Here, we introduced an evolving lineage-tracing system with a single-cell RNA-seq readout into a mouse model of Kras;Trp53(KP)-driven lung adenocarcinoma which enabled us to track tumor evolution from single transformed cells to metastatic tumors at unprecedented resolution. We found that loss of the initial, stable alveolar-type2-like state was accompanied by transient increase in plasticity. This was followed by adoption of distinct fitness-associated transcriptional programs which enable rapid expansion and ultimately clonal sweep of rare, stable subclones capable of metastasizing to distant sites. Finally, we showed that tumors develop through stereotypical evolutionary trajectories, and perturbing additional tumor suppressors accelerates tumor progression by creating novel evolutionary paths. Overall, our study elucidates the hierarchical nature of tumor evolution, and more broadly enables the in-depth study of tumor progression.

Decades of research have identified three effective treatments for substance use disorders. This chapter explores the three most studied and proven evidence-based interventions: Motivational Interviewing, Cognitive Behavioral Therapy, and Twelve-Step Facilitation. The inconsistency or infrequency with which evidence-based interventions are used in the treatment of addictions is finally getting some attention at the national level, and there are new recommendations regarding the deployment of treatment approaches. It is important for the reader to understand the roots of these three interventions and why, despite being easy to learn and likely to work, they are not regularly being deployed inside of treatment centers.

One of the most effective and proven ingredients of successful addiction treatment is the relationship between the therapist and patient. Known as a therapeutic alliance, the strong professional relationship is the most important piece of treatment and, unfortunately, one of the first things damaged when a patient enters a standard treatment facility. This chapter discusses the importance of the therapeutic relationships and how our system of care must change in order to build strong alliances. Touched on are the skills therapists should have and the most effective interventions therapists should know how to efficiently deploy in practice. Addressed are certain principles that should be continually monitored during a counseling session.

The introduction begins with the story of a fatal airline flight and how commercial airlines—unlike addiction treatment professionals—learn from their mistakes. This chapter sets the stage for a discussion of how the addiction treatment industry regularly fails to safely transport patients to their final destination: sustained long-term recovery. The addiction treatment industry operates without performance measures to evaluate the effectiveness of therapists or how well their patients are progressing. While there are many treatment system failures, all the blame is placed on the patient, none on the provider of care. This book is an attempt to initiate a shift to heightened accountability and measured performance.

It is important to understand how the addiction treatment industry began and how its beliefs and practices gradually evolved into today’s standards of care. The problems associated with alcohol and drug use have been around for millennia, but the notion of addiction as a chronic medical illness is a relatively new (twentieth-century) concept. Stigma and misunderstanding abound, and antiquated attitudes about addiction as a moral failing continue to marginalize and shame the people we are tasked with helping. The chapter addresses how current addiction treatment is designed and its involvement with both medical and physical elements.

This chapter argues for a robust prevention effort for substance use disorders. It briefly explains how the 1971 war on drugs began and guided (or misguided) our nation’s efforts to combat this illness. It laments how the potentially monumental 2016 surgeon general’s report on substance use in America was drowned out by the presidential election and how its call for empirically supported prevention strategies was ignored.