Search

The amount of time it takes for bone allograft particles to be replaced with new vital bone during ridge preservation is unclear. The purpose of this article was to compare the wound healing and vital bone formation following ridge preservation using a combination allograft of 70% mineralized and 30% demineralized freeze-dried bone allograft (FDBA/DFDBA) at 4 months (short-term, ST) versus 12 months (long-term, LT).Fifty-seven patients were enrolled in the study who required extraction of a single tooth (excluding second and third molars) and were planned for replacement with a dental implant. After tooth extraction, all sites were grafted with a combination allograft procured from a single donor, and patients were randomized into the ST or LT healing groups. Patients returned for implant placement and an 8mm bone core biopsy was harvested using a trephine drill during initial implant osteotomy preparation. The cores were then analyzed histologically to determine the percentages of vital bone formation, residual graft particles, and connective tissue (CT)/other.There was significantly greater vital bone formation in the LT group (51.38%) compared to the ST group (31.39%) (p = 0.0025) and significantly fewer residual graft particles in the LT group (18.04%) compared to the ST group (40.38%).A longer healing time following ridge preservation results in more vital bone formation and less residual graft particles at the time of implant placement. However, residual allograft material still remains at 12 months after ridge preservation. This article is protected by copyright. All rights reserved.

This study aims to examine the duration and rate of delayed diagnosis in Charcot foot. We systematically reviewed articles published in Medline, SCOPUS, and Cumulative Index of Nursing and Allied Health Literature to identify articles discussing delayed or misdiagnosis of Charcot foot. Random-effects models were generated to determine the average time from symptom onset to correct diagnosis (diagnostic delay duration) and proportion of patients misdiagnosed prior to being correctly diagnosed (delayed diagnosis rate). Our search identified 142 articles, 7 of which are included in this review. The review found that 53.2% of cases of Charcot osteoarthropathy experienced a delay in diagnosis (95% CI: 28.9%-77.4%). Overall, the duration of diagnostic delay was determined to be 86.9 days (95% CI: 10.5-162.1). We found that patients with Charcot foot experienced prolonged delays from symptom onset to correct diagnosis, and a majority of patients are misdiagnosed. These delays in diagnosis contribute to worse patient outcomes.

Acute perioperative changes in arterial pressure occur frequently, particularly in patients with cardiovascular disease or those receiving vasoactive medications, or in relation to certain cardiovascular surgical procedures. Hemodynamic Instability (HI) is common in patients undergoing carotid revascularization because of unique patho-physiological and surgical factors. The operation, by necessity, disrupts the afferent pathway of the baroreflex, which can lead to postendarterectomy HI. Poor arterial pressure control is associated with increased morbidity and mortality after carotid revascularization, but good control of arterial pressure is often difficult to achieve in practice. The incidence, implications, and etiology of HI associated with carotid surgery are reviewed, and some recommendations made for its management. Close monitoring and titration of therapy are probably the most important considerations rather than specific choice of agents.

Background Performing an episiotomy where clinically indicated is a key intervention in the Obstetric Anal Sphincter Injury Care Bundle (OASI-CB) implemented across England and Wales to reduce the risk and increase the detection of severe perineal trauma after birth. Standards of consent provided to people in maternity care generally and for episiotomy specifically have been reported as suboptimal. Compromising birthing people's personal autonomy or sense of control has been linked to a dissatisfying birth experience, negative psychological sequelae, and litigation. Methods This study explored experienced midwives' practice of informed consent for episiotomy during a midwife-led birth. We sampled 43 midwives across eight NHS Trusts in England and Wales using online focus groups and telephone interviews about their experience of consent in episiotomy. Using qualitative content analysis and art-based co-analysis methods with eight midwives from across the research sites, we co-analyzed and co-constructed three themes and four practice recommendations from the data. Results Three themes were constructed from the data: Assent rather than consent, Change in culture to support best practice, and Standardized information. These themes informed the shaping of four recommendations for best practice in episiotomy informed consent. Conclusion This study has shown how variations in midwifery practice and culture may impact birthing people's experience of informed consent in episiotomy. Midwives may not have the knowledge or skills to conduct a detailed consent conversation, leading to variation in practice and messages for birthing people. The use of antenatal discussion aids can offer women the opportunity to become informed and fully participate in the decision-making process.

Coumarins are bioactive molecules that often serve as defenses in plant and animal systems, and understanding their fundamental behavior is essential for understanding their bioactivity. Aesculetin (6,7-dihydroxycoumarin) has recently attracted attention due to its ability to act as an antioxidant, but little is known about its photophysical properties. The fluorescence lifetimes of its neutral and anion form in water are 19 ± 2 ps and 2.3 ± 0.1 ns, respectively. Assuming the short lifetime of the neutral is determined by ESPT, we estimate kPT ~ 5 × 1010 s–1. Using steady-state and time-resolved fluorescence spectroscopy, we determine its ground and excited-state $${\text{p}}{K}_{a1}$$ to be 7.3 and –1, respectively, making it one of the strongest photoacids of the natural coumarins. Aesculetin exhibits a strong pH dependence of the relative fluorescence quantum yield becoming much more fluorescent above $${\text{p}}{K}_{a1}$$ . The aesculetin anion $${\text{has}}$$ slightly photobasic character. We also report that aesculetin forms a fluorescent catechol-like complex with boric acid, and this complex has a $${\text{p}}{K}_{c}$$ of 5.6.

Fishers reporting all of their catch is key to estimating population viabilities of vulnerable, highly migratory fish stocks. However, fishery managers find it difficult to ensure that this reporting behavior takes place consistently. Wild Atlantic salmon (Salmo salar) are a highly migratory and internationally contested species with a threatened conservation status. Greenland manages a fishery for Atlantic salmon, and its coastline serves as a key feeding ground in the life history of Atlantic salmon. However, salmon catch is underreported by fishers, even though they are required to report. Deterring noncompliant behavior with penalties and sending short message service (SMS) messages have been shown to increase compliance, but no known studies test their effect on compliance with catch reporting requirements. We evaluated two interventions for their effect on salmon catch reporting behavior among Greenland's salmon fishers. Salmon fishers were 41% more likely to report (p

SummaryIn mammals, inflammatory responses to infections trigger adaptive behavioral changes collectively known as ‘sickness behavior’. Among these, lethargy protects the sick individual by conserving energy, and increased anxiety is believed to prevent exposure to threats. However, the characterization of these conflicting behavioral states in sickness could be an artifact of behavioral assessment, particularly in rodents. We adjusted existing behavioral testing and designed a new paradigm to disambiguate between increased lethargy versus increased anxiety. Our data indicate that in mice sickness induces a significant increase in lethargy but not in anxiety. Further supporting our behavioral results, at the neuronal level we found evidence that sickness activates anxiolytic rather than anxiogenic regions of the amygdala, including oxytocin receptor expressing neurons. Putative mechanisms by which sickness could activate CeA-OTR+ neurons were investigated.

Community-based public health advocacy efforts are crucial to sustaining the low-cost/free breast cancer services that support underserved populations.We introduce two ways in which narrative theory may be a useful tool for developing advocacy materials and provide an example, using a community-academic partnership to promote Latina breast health in Chicago, Illinois.Community and academic partners 1) engaged 25 Spanish-speaking Latinas in an advocacy workshop, 2) leveraged narrative theory to develop multi-media advocacy materials, and 3) disseminated materials to policymakers.Our project highlights 1) that narrative theory may be useful to describe how Latinas engage policy-makers in relation to their needs and cultural norms, 2) the importance of flexibility and offering community members multiple options to engage policymakers, and 3) the importance of leveraging partners' complementary strengths.Narrative theory may be a useful tool for developing advocacy materials in community-academic partnerships.

Trauma mortality disproportionately affects populations farther from potentially lifesaving trauma care, and traumatic brain injury (TBI) is no exception. Previous examinations have examined proximity to trauma centers as an explanation for trauma mortality, but little is known about the relationship between proximity to neurosurgeons specifically in TBI mortality.In this cross-sectional study, county-level TBI mortality rates from 2008 to 2014 were examined in relation to the distance to the nearest neurosurgeon and trauma facility. The locations of practicing neurosurgeons and trauma facilities in the United States were determined by geocoding data from the 2017 Medicare Physician and Other Supplier and Provider of Services files (respectively). The association between TBI mortality and the distance from the population-weighted centroid of the county to a closest neurosurgeon and trauma facility was examined using multivariate negative binomial regression.A total of 761 of the 3108 counties (24.5%) in the continental United States were excluded from the analysis because they had 20 or fewer TBI deaths during this time, producing unstable estimates. Excluded counties accounted for 1.67% of the US population. Multivariate analysis revealed a county's mortality increased 10% for every 25 miles from the nearest neurosurgeon (adjusted incident rate ratio: 1.10 [95% confidence interval: 1.08-1.12]; P 0.001). The distance to the nearest trauma facility was not found to be significantly associated with mortality (adjusted incident rate ratio: 1.01 [95% confidence interval: 0.99-1.03]; P = 0.36).These findings suggest that proximity to neurosurgeons may influence county-level TBI mortality. Further research into this topic with more granular data may help to allocate scarce public health resources.

A framework for the generalization of pairs of cuboid magnets embedded in origami-based hinges is presented. Various design variables for the framework are defined. Two novel self-actuation and self-stabilizing hinges (the MaLO hinge and the MaLDO hinge) are presented. The characterization of these hinges is defined, and the hinges are shown in application. The presented applications are the VEMO reflect array antenna design and a deployable truss.

Novel metal oxide nanoparticle (NP) contrast agents may offer safety and functionality advantages over conventional gadolinium-based contrast agents (GBCAs) for cancer diagnosis by magnetic resonance imaging. However, little is known about the behavior of metal oxide NPs, or of their effect, upon coming into contact with the innate immune system. As neutrophils are the body’s first line of defense, we sought to understand how manganese oxide and iron oxide NPs impact leukocyte functionality. Specifically, we evaluated whether contrast agents caused neutrophils to release web-like fibers of DNA known as neutrophil extracellular traps (NETs), which are known to enhance metastasis and thrombosis in cancer patients. Murine neutrophils were treated with GBCA, bare manganese oxide or iron oxide NPs, or poly(lactic-co-glycolic acid) (PLGA)-coated metal oxide NPs with different incorporated levels of poly(ethylene glycol) (PEG). Manganese oxide NPs elicited the highest NETosis rates and had enhanced neutrophil uptake properties compared to iron oxide NPs. Interestingly, NPs with low levels of PEGylation produced more NETs than those with higher PEGylation. Despite generating a low rate of NETosis, GBCA altered neutrophil cytokine expression more than NP treatments. This study is the first to investigate whether manganese oxide NPs and GBCAs modulate NETosis and reveals that contrast agents may have unintended off-target effects which warrant further investigation.

BACKGROUND AND AIMS: Observational studies have demonstrated that the pneumococcal polysaccharide vaccine (PPV) is associated with reduced risk of cardiovascular events. This may be mediated through IgM antibodies to OxLDL, which have previously been associated with cardioprotective effects. The Australian Study for the Prevention through Immunisation of Cardiovascular Events (AUSPICE) is a double-blind, randomised controlled trial (RCT) of PPV in preventing ischaemic events. Participants received PPV or placebo once at baseline and are being followed-up for incident fatal and non-fatal myocardial infarction or stroke over 6 years. METHODS: A subgroup of participants at one centre (Canberra; n = 1,001) were evaluated at 1 month and 2 years post immunisation for changes in surrogate markers of atherosclerosis, as pre-specified secondary outcomes: high-sensitive C-reactive protein (CRP), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT). In addition, 100 participants were randomly selected in each of the intervention and control groups for measurement of anti-pneumococcal antibodies (IgG, IgG2, IgM) as well as anti-OxLDL antibodies (IgG and IgM to CuOxLDL, MDA-LDL, and PC-KLH). RESULTS: Concentrations of anti-pneumococcal IgG and IgG2 increased and remained high at 2 years in the PPV group compared to the placebo group, while IgM increased and then declined, but remained detectable, at 2 years. There were statistically significant increases in all anti-OxLDL IgM antibodies at 1 month, which were no longer detectable at 2 years; there was no increase in anti-OxLDL IgG antibodies. There were no significant changes in CRP, PWV or CIMT between the treatment groups at the 2-year follow-up. CONCLUSIONS: PPV engenders a long-lasting increase in anti-pneumococcal IgG, and to a lesser extent, IgM titres, as well as a transient increase in anti-OxLDL IgM antibodies. However, there were no detectable changes in surrogate markers of atherosclerosis at the 2-year follow-up. Long-term, prospective follow-up of clinical outcomes is continuing to assess if PPV reduces CVD events.

To date, the efficacy of ridge preservation in the maintenance of the residual alveolar ridge dimension beyond 6 months after treatment is unknown. The purpose of this study was to compare the differences in alveolar ridge dimensional change following ridge preservation between 4- and 12-month healing time points using cone-beam computed tomography (CBCT).Fifty seven patients planned for tooth extraction and implant placement were enrolled. Following extraction, ridge preservation was performed. CBCT scans were taken within 72 hours following extraction with a customized resin stent containing a fixed radiographic marker. At either 4 months (short-term, ST group) or 12 months (long-term, LT group) after ridge preservation, patients had a second CBCT taken and an implant placed. Changes in ridge height and width were measured using the standardized radiographic marker.No significant differences were detected between the ST and LT groups in loss of buccal and lingual ridge height. Similarly, when adjusted for baseline ridge width, no significant differences were detected in ridge width loss at 3, 5, and 7 mm apical to the crest between the ST and LT groups.The efficacy of ridge preservation in the maintenance of ridge width and height at the 12-month time point is similar to that of the 4-month time point. Clinicians may feel confident that a delay in implant placement for up to a year has no significant negative impact on the height and width of the healed ridge.

Noise-induced gate errors remain one of the main obstacles to realizing a broad range of quantum information technologies. Dynamical error suppression using carefully designed control schemes is critical for overcoming this challenge. Such schemes must be able to correct against multiple noise sources simultaneously afflicting a qubit in order to reach error correction thresholds. Here, we present a general framework for designing control fields that simultaneous suppress both noise in the fields themselves as well as transverse dephasing noise. Using the recently developed Space Curve Quantum Control formalism, in which robust quantum evolution is mapped to closed geometric curves in a multidimensional Euclidean space, we derive necessary and sufficient conditions that guarantee the cancellation of both types of noise to leading order. We present several techniques for solving these conditions and provide explicit examples of error-resistant control fields. Our work also sheds light on the relation between holonomic evolution and the suppression of control field errors., Comment: 12 pages, 4 figures

Background: The association between long-term exposure to air pollution and mortality from cardiorespiratory diseases is well established, yet the evidence for other diseases remains limited. Objectives: To examine the associations of long-term exposure to air pollution with mortality from diabetes, dementia, psychiatric disorders, chronic kidney disease (CKD), asthma, acute lower respiratory infection (ALRI), as well as mortality from all-natural and cardiorespiratory causes in the Danish nationwide administrative cohort. Methods: We followed all residents aged ≥ 30 years (3,083,227) in Denmark from 1 January 2000 until 31 December 2017. Annual mean concentrations of fine particulate matter (PM2.5), nitrogen dioxide (NO2), black carbon (BC), and ozone (warm season) were estimated using European-wide hybrid land-use regression models (100 m × 100 m) and assigned to baseline residential addresses. We used Cox proportional hazard models to evaluate the association between air pollution and mortality, accounting for demographic and socioeconomic factors. We additionally applied indirect adjustment for smoking and body mass index (BMI). Results: During 47,023,454 person-years of follow-up, 803,881 people died from natural causes. Long-term exposure to PM2.5 (mean: 12.4 µg/m3), NO2 (20.3 µg/m3), and/or BC (1.0 × 10-5/m) was statistically significantly associated with all studied mortality outcomes except CKD. A 5 µg/m3 increase in PM2.5 was associated with higher mortality from all-natural causes (hazard ratio 1.11; 95% confidence interval 1.09–1.13), cardiovascular disease (1.09; 1.07–1.12), respiratory disease (1.11; 1.07–1.15), lung cancer (1.19; 1.15–1.24), diabetes (1.10; 1.04–1.16), dementia (1.05; 1.00–1.10), psychiatric disorders (1.38; 1.27–1.50), asthma (1.13; 0.94–1.36), and ALRI (1.14; 1.09–1.20). Associations with long-term exposure to ozone (mean: 80.2 µg/m3) were generally negative but became significantly positive for several endpoints in two-pollutant models. Generally, associations were attenuated but remained significant after indirect adjustment for smoking and BMI. Conclusion: Long-term exposure to PM2.5, NO2, and/or BC in Denmark were associated with mortality beyond cardiorespiratory diseases, including diabetes, dementia, psychiatric disorders, asthma, and ALRI. © 2022 The Authors

This paper proposes a novel origami-inspired adult diaper design that improves discretion by reducing sag and increasing wicking across the entire diaper pad. While other diapers rely on supporting elastics to reduce the sag of the diaper as a whole, this paper proposes an absorbent core that uses liquid activated shaping to take a specified shape. Origami-based folds are also incorporated into the diaper design to increase wicking performance. The paper introduces a disposable compliant mechanism waistband used to deploy the diaper, making it easier to put onto one’s body.

The formation of neutrophil extracellular traps (NETs), known as NETosis, was first observed as a novel immune response to bacterial infection, but has since been found to occur abnormally in a variety of other inflammatory disease states including cancer. Breast cancer is the most commonly diagnosed malignancy in women. In breast cancer, NETosis has been linked to increased disease progression, metastasis, and complications such as venous thromboembolism. NET-targeted therapies have shown success in preclinical cancer models and may prove valuable clinical targets in slowing or halting tumor progression in breast cancer patients. We will briefly outline the mechanisms by which NETs may form in the tumor microenvironment and circulation, including the crosstalk between neutrophils, tumor cells, endothelial cells, and platelets as well as the role of cancer-associated extracellular vesicles in modulating neutrophil behavior and NET extrusion. The prognostic implications of cancer-associated NETosis will be explored in addition to development of novel therapeutics aimed at targeting NET interactions to improve outcomes in patients with breast cancer.

Electronic cigarettes are frequently viewed as a safer alternative to conventional cigarettes; however, evidence to support this perspective has not materialized. Indeed, the current literature reports that electronic cigarette use is associated with both acute lung injury and subclinical dysfunction to the lung and vasculature that may result in pathology following chronic use. E-cigarettes can alter vascular dynamics, polarize innate immune populations towards a proinflammatory state, compromise barrier function in the pulmonary endothelium and epithelium, and promote pre-oncogenic phenomena. This review will summarize the variety of e-cigarette products available to users, discuss current challenges in e-cigarette study design, outline the range of pathologies occurring in cases of e-cigarette associated acute lung injury, highlight disease supporting tissue- and cellular-level changes resulting from e-cigarette exposure, and briefly examine how these changes may promote tumorigenesis. Continued research of the mechanisms by which e-cigarettes induce pathology benefit users and clinicians by resulting in increased regulation of vaping devices, informing treatments for emerging diseases e-cigarettes produce, and increasing public awareness to reduce e-cigarette use and the onset of preventable disease.

We have observed a sample of 9 Extended Green Objects (EGOs) at 1.3 and 5 cm with the VLA with sub-arcsecond resolution and ~7-14 uJy/beam sensitivities in order to characterize centimeter continuum emission as it first appears in these massive protoclusters. We find EGO-associated continuum emission - within 1 arcsec of the extended 4.5 um emission - in every field, which is typically faint (order 10^1-10^2 uJy) and compact (unresolved at 0.3-0.5 arcsec). The derived spectral indices of our 36 total detections are consistent with a wide array of physical processes, including both non-thermal (19% of detections) and thermal free-free processes (e.g. ionized jets and compact HII regions, 78% of sample), and warm dust (1 source). We also find EGO-associated 6.7 GHz CH$_3$OH and 22 GHz H$_2$O maser emission in 100% of the sample, and NH$_3$ (3,3) masers in ~45%; we do not detect any NH$_3$ (6,6) masers at ~5.6 mJy/beam sensitivity. We find statistically-significant correlations between radio-distance and bolometric luminosities at two physical scales and three frequencies, consistent with thermal emission from ionized jets, but no correlation between water-maser and radio-distance luminosities for our sample. From these data, we conclude that EGOs likely host multiple different centimeter continuum-producing processes simultaneously. Additionally, at our ~1000 au resolution, we find that all EGOs except G18.89$-$0.47 contain 1 to 2 massive sources based on the presence of methanol maser groups, which is consistent with our previous work suggesting that these are typical massive protoclusters in which only one to a few of the YSOs are massive., 37 pages, 13 figures (incl. 2 figure sets), 8 tables (incl. 4 MRTs)

Coumarins are bioactive molecules that often serve as defenses in plant and animal systems, and understanding their fundamental behavior is essential for understanding their bioactivity. Aesculetin (6,7-dihydroxycoumarin) has recently attracted attention due to its ability to act as an antioxidant, but little is known about its photophysical properties. The fluorescence lifetimes of its neutral and anion form in water are 19 ± 2 ps and 2.3 ± 0.1 ns, respectively. Assuming the short lifetime of the neutral is determined by ESPT, we estimate k

Inter-organizational collaboration is often considered essential to transboundary fishery governance, due, in part, to the high levels of task interdependence, the remote and often treacherous conditions, and the limited levels of information available to any policy actor on resource status. In the high seas, Regional Fisheries Management Organizations (RFMOs) are responsible for sustainably managing highly migratory and straddling fish stocks through the implementation of ecosystem-based approaches and ensuring adequate inter-jurisdictional cooperation. A central question facing RFMO governance is therefore how to structure and sustain inter-organizational transboundary collaboration under high uncertainty? This paper presents the case of the North Atlantic Salmon Conservation Organization (NASCO), conceptualized as a strategic alliance between the bureaucratic organizations responsible for north Atlantic salmon fishery management in the member countries. We identify and explain how dimensions of trust, control, and perceived risk have structured the collaborative performance of the alliance. The application of an integrated trust-control-risk framework increases conceptual clarity for how, when and why alliance managers might seek to develop different forms of trust through different management control systems in ways that further multi-actor collaborative network performance. Future research needs are identified, including better understanding how managerial strategies and control mechanisms facilitate inter-organizational trust in transboundary governance settings and mitigate the perceived risks of working together.

The objective of this study was comparing medium-term outcomes between comparable minor and major amputations in adults with diabetes.We used data from the 2016-2017 National Readmissions Database to construct a representative cohort of 15,581 adults with diabetes with lower extremity amputations. Patients were categorized by level of index amputation (major/minor), and propensity score matched to compare outcomes in candidates for either level of amputation. Readmission and reamputations were assessed at 1, 3, and 6 months following index amputation.In the 6 months following index amputation, large proportions of patients were readmitted (n = 7597, 48.8%) or had reamputations (n = 1990, 12.8%). Patients with minor amputations had greater odds of readmission (OR = 1.25; 95% CI 1.18-1.31), reamputation (OR = 3.71; 95% CI 3.34-4.12), and more proximal reamputation (OR = 2.61; 95% 2.33-2.93) (all P 0.001). Further, minor amputation patients had higher and lower odds of readmission for postoperative infection (OR = 4.45; 95% CI 3.27-6.05), or sepsis (OR = 0.79; 95% CI 0.68-0.93), respectively.Patients desire to save as much limb as possible and should be counseled on higher risk for reamputation, readmission, and infection with minor amputations.

Targeted memory reactivation (TMR) is a technique by which sounds paired with learned information can be used to cue neural reactivation of that information during sleep. While TMR in slow-wave sleep (SWS) has been shown to strengthen procedural memories, it is unclear whether TMR in rapid eye movement (REM) sleep, a state strongly associated with motor consolidation, provides equivalent benefit. Furthermore, it is unclear whether this technique influences dominant and non-dominant hands equally. We applied TMR of a two-handed serial reaction time task (SRTT) during either SWS or REM in thirty-two human right handed adults (sixteen female) to examine the impact of stimulation in each sleep stage on right (dominant) and left hands. While TMR in SWS led to strong benefits in reaction times and sequence-specific skill, equivalent cueing in REM led to no benefit at all, suggesting that reactivation in this sleep stage is not important for the SRTT. Event-related potentials elicited by TMR cues for left and right hand movements differed significantly in REM, but not SWS, showing that these cues are at least processed in REM. Interestingly, TMR benefits were apparent only in the non-dominant hand, potentially due to the weaker performance measured in this hand at the outset. Overall, these findings suggest that memory replay in SWS, but not REM, is important for consolidation of the SRTT, and TMR-cued consolidation is stronger in the non-dominant hand.Significance statementTargeted memory reactivation (TMR) in sleep leads to memory consolidation, but many aspects of this process remain to be understood. We used TMR of a bimanual serial reaction time task to show that behavioural benefit is only observed after stimulation in SWS, even though electrophysiology shows that the TMR cues are processed in REM. Importantly, TMR selectively benefitted the non-dominant hand. These findings suggest that TMR in REM does not benefit this serial reaction time task, and that TMR in SWS preferentially consolidates weaker memory traces relating to the non-dominant hand.

Data-driven models are rising as an auspicious method for the geometrical design of materials and structural systems. Nevertheless, existing data-driven models customarily address the optimization of structural designs rather than metamaterial designs. Metamaterials are emerging as promising materials exhibiting tailorable and unprecedented properties for a wide spectrum of applications. In this paper, we develop a deep learning (DL) model based on a convolutional neural network (CNN) that predicts optimal metamaterial designs. The developed DL model non-iteratively optimizes metamaterials for either maximizing the bulk modulus, maximizing the shear modulus, or minimizing the Poisson's ratio (including negative values). The data are generated by solving a large set of inverse homogenization boundary values problems, with randomly generated geometrical features from a specific distribution. Such s data-driven model can play a vital role in accelerating more computationally expensive design problems, such as multiscale metamaterial systems.

Traumatic brain injury (TBI) prognostic prediction models offer value to individualized treatment planning, systematic outcome assessments and clinical research design but require continuous external validation to ensure generalizability to different settings. The Corticosteroid Randomization After Significant Head Injury (CRASH) and International Mission on Prognosis and Analysis on Clinical Trials in TBI (IMPACT) models are widely available but lack robust assessments of performance in a current national sample of patients. The purpose of this study is to assess the performance of the CRASH-Basic and IMPACT-Core models in predicting in-hospital mortality using a nationwide retrospective cohort from the National Trauma Data Bank (NTDB).The 2016 NTDB was used to analyze an adult cohort with moderate-severe TBI (Glasgow Coma Scale [GCS] ≤ 12, head Abbreviated Injury Scale of 2-6). Observed in-hospital mortality or discharge to hospice was compared to the CRASH-Basic and IMPACT-Core models' predicted probability of 14-day or 6-month mortality, respectively. Performance measures included discrimination (area under the receiver operating characteristic curve [AUC]) and calibration (calibration plots and Brier scores). Further sensitivity analysis included patients with GCS ≤ 14 and considered patients discharged to hospice to be alive at 14-days.A total of 26,228 patients were included in this study. Both models demonstrated good ability in differentiating between patients who died and those who survived, with IMPACT demonstrating a marginally greater AUC (0.863; 95% CI: 0.858 - 0.867) than CRASH (0.858; 0.854 - 0.863); p0.001. On calibration, IMPACT overpredicted at lower scores and underpredicted at higher scores but had good calibration-in-the-large (indicating no systemic over/underprediction), while CRASH consistently underpredicted mortality. Brier scores were similar (0.152 for IMPACT, 0.162 for CRASH; p0.001). Both models showed slight improvement in performance when including patients with GCS ≤ 14.Both CRASH-Basic and IMPACT-Core accurately predict in-hospital mortality following moderate-severe TBI, and IMPACT-Core performs well beyond its original GCS cut-off of 12, indicating potential utility for mild TBI (GCS 13-15). By demonstrating validity in the NTDB, these models appear generalizable to new data and offer value to current practice in diverse settings as well as to large-scale research design.

Background The management of febrile infants under the age of 3 months has long been a controversial topic, often requiring them to be subject to a battery of tests, antibiotics, and hospitalization. Multiplex polymerase chain reaction (PCR) panels can provide a rapid diagnosis, but their role in managing these patients is still unknown. Our objective was to determine if multiplex respiratory and meningitis/encephalitis PCR panels decreased antibiotic duration of therapy (DOT) and hospital length of stay (LOS) when used in sepsis evaluations of febrile infants less than 90 days of age. Methods We performed a retrospective chart review of infants younger than 90 days old who were admitted to the pediatric ward for concerns of fever or sepsis from 1/1/2016 to 9/30/2019. Subjects with documented bacterial infections were excluded. Our primary outcomes were differences in DOT and LOS between patients admitted before and after PCR panels became available (Pre-PCR era and PCR era). Results 118 subjects were included in our analysis, with 52 (44.1%) coming from the Pre-PCR group. Descriptive statistics, stratified by era, are available in Table 1. The unadjusted mean LOS and DOT decreased by 8.4 (P = .003) and 32.8 (P < .001) hours, respectively. Multivariate regression demonstrated that LOS was 1.16 times longer in the Pre-PCR era (95% CI: 1.10 - 1.22; P < .001). Similarly, patients in the Pre-PCR era had DOT that was 1.95 times longer (95% CI: 1.55 - 2.46; P < .001) when adjusting for covariates. Adjusted LOS and DOT by Era and Diagnosis PCR panel results by pathogen Conclusion We conclude that multiplex PCR panels can potentially influence the management of young febrile infants admitted for sepsis evaluations by rapidly diagnosing viral infections and thus decreasing DOT and LOS. In turn, that may improve patient outcomes and satisfaction, as well as possibly decrease costs. Multiplex PCR panels should be considered as part of routine sepsis evaluations in young febrile infants. Larger studies are needed, including in depth cost analysis. Table 1: Demographics Table 2: Results between Eras Disclosures All Authors: No reported disclosures

Photoswitches capable of accessing two geometric states are highly desirable, especially if their design is modular and incorporates a pharmacophore tethering site. We describe a redox isomerization strategy for synthesizing p-formylazobenzenes from p-nitrobenzyl alcohol. The resulting azo-aldehydes can be readily converted to photoswitchable compounds with excellent photophysical properties using simple hydrazide click chemistry. As a proof of principle, we synthesized a photoswitchable surfactant enabling the photocontrol of an emulsion with exceptionally high spatiotemporal precision.

Scopoletin is highly fluorescent in water and acts as a photoacid exhibiting excited-state proton transfer, ESPT, competitive with fluorescence. Its absorbance and emission spectral characteristics yield ground-state and excited-state pKa values of 7.4 ± 0.1 and 1.4 ± 0.1, respectively. The pKa* implies an ESPT rate constant an order of magnitude smaller than that for umbelliferone. This report provides quantum yield measurements in water that are comparable to quinine sulfate, and fluorescence lifetime values that are on a par with other similar coumarins yet provide insight into the ESPT process. The scopoletin anion is observed in tetrahydrofuran by reaction with a strong base. The Stokes shift of aqueous scopoletin is >100 nm in the pH range 3 to 7 due in part to its action as a photoacid. Modeling by density functional theory methods provides reasonable support for the experimental results.

The novel N-acyldehydrotyrosine analogues known as thalassotalic acids A–C were isolated from a marine bacterium by Deering et al. in 2016. These molecules were shown to have tyrosinase inhibition activity and thus are an attractive set of molecules for further study and optimization. To this end, a concise and modular synthesis has been devised and executed to produce thalassotalic acids A–C and two unnatural analogues. This synthesis has confirmed the identity and inhibitory data of thalassotalic acids A–C, more potent synthetic analogues (IC50 = 65 μM), and provides a route for further structure–activity relationship studies to optimize these molecules.

The Pr-rich end of the alloy series Pr$_{1-x}$Nd$_x$Os$_4$Sb$_{12}$ has been studied using muon spin rotation and relaxation. The end compound PrOs$_4$Sb$_{12}$ is an unconventional heavy-fermion superconductor, which exhibits a spontaneous magnetic field in the superconducting phase associated with broken time-reversal symmetry. No spontaneous field is observed in the Nd-doped alloys for x $>$ 0.05. The superfluid density is insensitive to Nd concentration, and no Nd$^{3+}$ static magnetism is found down to the lowest temperatures of measurement. Together with the slow suppression of the superconducting transition temperature with Nd doping, these results suggest anomalously weak coupling between Nd spins and conduction-band states., 17 pages, 6 figures

We present (sub)millimeter imaging at 0.″5 resolution of the massive star-forming region G358.93−0.03 acquired in multiple epochs at 2 and 3 months following the recent flaring of its 6.7 GHz CH3OH maser emission. Using the Submillimeter Array and Atacama Large Millimeter/submillimeter Array, we have discovered 14 new Class II CH3OH maser lines ranging in frequency from 199 to 361 GHz, which originate mostly from {v}t = 1 torsionally excited transitions and include one {v}t = 2 transition. The latter detection provides the first observational evidence that Class II maser pumping involves levels in the {v}t = 2 state. The masers are associated with the brightest continuum source (MM1), which hosts a line-rich hot core. The masers present a consistent curvilinear spatial velocity pattern that wraps around MM1, suggestive of a coherent physical structure 1200 au in extent. In contrast, the thermal lines exhibit a linear pattern that crosses MM1 but at progressive position angles that appear to be a function of either increasing temperature or decreasing optical depth. The maser spectral profiles evolved significantly over one month, and the intensities dropped by factors of 3.0-7.2, with the {v}t = 2 line showing the largest change. A small area of maser emission from only the highest excitation lines closest to MM1 has disappeared. There are seven additional dust continuum sources in the protocluster, including another hot core (MM3). We do not find evidence for a significant change in (sub)millimeter continuum emission from any of the sources during the one month interval, and the total protocluster emission remains comparable to prior single-dish measurements.

Background: Ulcerative colitis (UC) often first presents during adolescence and early adulthood. Primary symptoms of UC are well known, yet similarities and differences of disease experience in adults and adolescents are not well characterized. Methods: To understand the health-related quality of life (HRQoL) and symptomatic experience of UC, in-depth interviews were conducted in the US with 21 adults (20–70 years) and 14 adolescents (12–17 years). Eligibility and medical history were confirmed by clinician report. A previously conducted literature review and resultant conceptual model informed the discussion guide to explore symptoms and HRQoL. Age appropriate creative tasks (“animal” task and collage) were employed to facilitate discussion. Transcripts and collages were subjected to thematic analysis using ATLAS.ti software. Results: Clinician-reported UC severity included 24% mild, 38% moderate, 38% severe among adults; and 64% mild, 29% moderate, 7% severe among adolescents. Among adults, 52% were female, 67% were white. Among adolescents, 50% were female, 71% were white. During analysis it was noted that all participants reported stomach/abdominal pain. Other key symptoms identified were frequent bowel movements, diarrhea, blood in stools, sudden need for bowel movement, stomach cramping, bloating, and feeling gassy/passing gas (?75% of participants). Key impacts identified were embarrassment, dietary limitations, having to plan around UC, worry/fear, anger, low mood/depression, and relationship with others, (?75% of participants). In creative tasks, animals were chosen to represent their UC and content included in the collages reflected the most commonly discussed themes from the interviews. Only adults discussed feeling dehydrated, while only adolescents discussed the impact of UC on school life. Conclusions: Open-ended interviews highlighted the HRQoL and symptomatic experiences of UC from the patient’s perspective, which were similar between adult and adolescent UC patients.

Prenatal alcohol exposure (PAE) can induce physical malformations and behavioral abnormalities that depend in part on the developmental timing of alcohol exposure. The current studies employed a mouse FASD model to characterize the long-term behavioral and brain structural consequences of a binge-like alcohol exposure during neurulation; a first-trimester stage when women are typically unaware that they are pregnant. Time-mated C57BL/6J female mice were administered two alcohol doses (2.8 g/kg, four hours apart) or vehicle starting at gestational day 8.0. Male and female adolescent offspring (postnatal day28–45) were then examined for motor activity (open field and elevated plus maze), coordination (rotarod), spatial learning and memory (Morris water maze), sensory motor gating (acoustic startle and prepulse inhibition), sociability (three-chambered social test), and nociceptive responses (hot plate). Regional brain volumes and shapes were determined using magnetic resonance imaging. In males, PAE increased activity on the elevated plus maze and reduced social novelty preference, while in females PAE increased exploratory behavior in the open field and transiently impaired rotarod performance. In both males and females, PAE modestly impaired Morris water maze performance and decreased the latency to respond on the hot plate. There were no brain volume differences; however, significant shape differences were found in the cerebellum, hypothalamus, striatum, and corpus callosum. These results demonstrate that alcohol exposure during neurulation can have functional consequences into adolescence, even in the absence of significant brain regional volumetric changes. However, PAE-induced regional shape changes provide evidence for persistent brain alterations and suggest alternative clinical diagnostic markers.

Fishery observers are prevalent actors in the global effort to reduce discards in fisheries, but there remains considerable uncertainty about how effective they are. We analyzed high-resolution logbook records of individual hauls (n = 127 415) across five-and-a-half-years (2012–2018) for all of Greenland’s large-scale fisheries to determine if onboard fishery observers influence the mandatory reporting of discards. To do so, we used exact matching to compare reported discards for observed and unobserved hauls (each time a catch is recorded), thus controlling for systematic differences between monitored and unmonitored practices. After adjusting for variables that represent species caught, gear, vessel, owner, year, license, and location, we found that skippers systematically underreport discards when no observers are on board. Systematic underreporting was most pronounced in less valuable fisheries, in contrast to theoretical arguments in previous studies. The differences between reported discards from observed and unobserved fishing leads us to assume that onboard observers encourage more faithful logbook records. Thus, onboard observers play a vital role in improving information on the environmental impact of fishing and in turn, make a key contribution to sustainable fisheries management.