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The study of temporal trends in altmetrics is under-developed, and this multi-year observation study addresses some of the deficits in our understanding of altmetric behaviour over time. The attention surrounding research outputs, as partially captured by altmetrics, or alternative metrics, constitutes many varied forms of data. Over the years 2008-2013, a set of 7739 papers were sampled on six occasions. Five altmetric data sources were recorded (Twitter, Mendeley, News, Blogs and Policy) and analysed for temporal trends, with particular attention being paid to their Open Access status and discipline. Twitter attention both starts and ends quickly. Mendeley readers accumulate quickly, and continue to grow over the following years. News and blog attention is quick to start, although news attention persists over a longer timeframe. Citations in policy documents are slow to start, and are observed to be growing over a decade after publication. Over time, growth in Twitter activity is confirmed, alongside an apparent decline in blogging attention. Mendeley usage is observed to grow, but shows signs of recent decline. Policy attention is identified as the slowest form of impact studied by altmetrics, and one that strongly favours the Humanities and Social Sciences. The Open Access Altmetrics Advantage is seen to emerge and evolve over time, with each attention source showing different trends. The existence of late-emergent attention in all attention sources is confirmed.

PURPOSE: More than 50,000 children are hospitalized yearly in the U.S. for acquired brain injury (ABI) with no established standards or protocols for school re-entry and limited resources for hospital-school communication. While ultimately the school has autonomy over curricula and services, specialty physicians were asked about their participation and perception of barriers in the school re-entry process. METHODS: Approximately 545 specialty physicians were sent an electronic survey. RESULTS: 84 responses (43% neurologists and 37% physiatrists) were obtained with a response rate of ∼15%. Thirty-five percent reported that specialty clinicians currently make the plan for school re-entry. The biggest challenge for school re-entry noted by physicians was cognitive difficulties (63%). The biggest gaps perceived by physicians were a lack of hospital-school liaisons to help design and implement a school re-entry plan (27%), schools’ inability to implement a school re-entry plan (26%), and an evidence-based cognitive rehab curriculum (26%). Forty-seven percent of physicians reported that they did not have adequate medical personnel to support school re-entry. The most commonly used outcome measure was family satisfaction. Ideal outcome measures included satisfaction (33%) and formal assessment of quality of life (26%). CONCLUSION: These data suggest that specialty physicians identify a lack of school liaisons in the medical setting as an important gap in hospital-school communication. Satisfaction and formal assessment of quality of life are meaningful outcomes for this provider group.

Donor-to-recipient size matching for heart transplantation typically involves comparing donor and recipient body weight; however, weight is not linearly related to cardiac size. Attention has shifted toward the use of computed tomography- (CT-) derived total cardiac volume (TCV), that is, CT-TCV, to compare donor and recipient heart organ size. At this time, TCV size matching is near impossible for most centers due to logistical limitations. To overcome this impediment, echocardiogram-derived TCV (ECHO-TCV) is an attractive, alternative option to estimate CT-TCV. The goal of this study is to test whether ECHO-TCV is an accurate and reliable surrogate for TCV measurement compared with the gold standard CT-TCV.ECHO-TCV and CT-TCV were measured in a cohort spanning the neonatal to young adult age range with the intention to simulate the pediatric heart transplant donor pool. ECHO-TCV was measured using a modified Simpson's summation-of-discs method from the apical 4-chamber (A4C) view. The gold standard of CT-TCV was measured from CT scans using three-dimensional reconstruction software. The relationship between ECHO-TCV and CT-TCV was evaluated and compared with other anthropometric and image-based markers that may predict CT-TCV. Inter-rater reliability of ECHO-TCV was tested among 4 independent observers. Subanalyses were performed to identify imaging views and timing that enable greater accuracy of ECHO-TCV.Banked imaging data of 136 subjects with both echocardiogram and CT were identified. ECHO-TCV demonstrated a linear relationship to CT-TCV with a Pearson correlation coefficient of r = 0.96 (95% CI, 0.95-0.97; P .0001) and mean absolute percent error of 8.6%. ECHO-TCV correlated most strongly with CT-TCV in the subset of subjects4 years of age (n = 33; r = 0.98; 95% CI, 0.96-0.99; P .0001). The single-score intraclass correlation coefficient across all 4 raters is 0.96 (interquartile range, 0.93-0.98). ECHO-TCV measured from a standard A4C view at end diastole with the atria in the plane of view had the strongest correlation to CT-TCV.ECHO-TCV by the A4C view was found to be both an accurate and reliable alternative measurement of CT-TCV and is derived from readily available donor ECHO images. The ECHO-TCV findings in this study make the ECHO method an attractive means of direct donor-to-recipient TCV size matching in pediatric heart transplantation.

Background & aims: Long term outcomes have been reported in home parenteral nutrition (HPN)-dependent patients with type 3 intestinal failure (IF), but there are limited survival data standardised to the general population that would help provide a meaningful prognosis for patients and clinicians. The primary aim of this study was therefore to investigate the survival of HPN-dependent patients and to evaluate the specific impact of type 3 IF on their life expectancy standardised to that of the general population. Methods: This was a cohort study of adult patients initiated on HPN between 1978 and 2018 at a national UK IF reference centre and followed up until death or censoring date of 31st December 2020. The standardised mortality ratio (SMR) was calculated as observed deaths divided by expected deaths using UK Office for National Statistics database. Excess Life Years Lost (LYL) were calculated separately for each sex as the differences in average life expectancy between patients with type 3 IF and the general population. Survival data were evaluated using cox regression models adjusting for confounding. Results: In total, 1046 patients were identified, with a total observation time of 7344.1 patient-years. Patients with malignancy (n = 206) were excluded from the survival analysis. Of the remaining 840 patients, 398 were alive by the end of follow-up. The probability of survival was 91.8% at 1 year, 69.3% at 5 years, 54.3% at 10 years, 29.8% at 20 years and 16.7% at 30 years. Patients who did not achieve nutritional autonomy had an increased likelihood of death compared to patients who ceased HPN. In total, 40 (9.0%) deaths were HPN or IF-related, while underlying disease leading to IF accounted for 98 (22.2%) deaths. There were 270 (61.1%) deaths not related to IF, with the majority of these patients dying from infections unrelated to HPN. Overall mortality rates were higher among patients with a diagnosis of type 3 IF compared with the general UK population with a SMR of 7.48 (95% CI 6.80 to 8.21) and an excess mortality rate of 54.0 per 1000 person-years. All mechanisms of IF were associated with excess mortality, with SMR ranging from 6.82 (95% CI 5.98 to 7.72) for short bowel syndrome to 15.51 (95% CI 11.73 to 20.03) for dysmotility. On average, the excess LYL was 17.45 years for males and 17.39 years for females compared with the general population of the same age. Conclusion: This the largest single-centre series reporting survival outcomes in patients with type 3 IF over more than a four-decade period and the first to report LYL in this patient cohort. Type 3 IF was associated with more than seven-fold higher mortality rates than for the general UK population and shorter life expectancies of more than 17 years. Survival, however, was better in those able to achieve nutritional autonomy. Since the majority of deaths were due to non-HPN or non-IF causes, there is clearly a need now to further explore these causes of death in order to improve our understanding of excessive mortality in type 3 IF and develop ways to prevent it.

Introduction: Children with craniopharyngiomas (CP) can experience significant morbidities caused by extensive surgery and/or radiation. Ommaya reservoir insertion (ORI) into cystic CP represents a minimally invasive approach allowing immediate decompression and aims to avoid additional injuries. The purpose of this study was to determine the surgical outcome and relevance of upfront ORI (+/- intracystic treatment) for preservation of endocrine function. Methods: We performed a retrospective chart review of children with CP treated at the Hospital for Sick Children between 01/01/2000 and 15/01/2020. Endocrine function was reviewed at the time of initial surgery and throughout follow-up. New endocrinological deficits related to the index procedure were defined as immediate failure (IF), whereas postoperative duration of endocrinological stability was defined as event-free survival. The rate of IF and EFS were compared between the treatment groups. Results: Seventy-nine patients were included and had a median age of 8.3 years (range 2.1–18.0 years); 31 were males. Fifty-three patients with upfront surgical treatment, including 29 ORI and 24 gross total or partial resections had sufficient endocrinological follow up data. Endocrine dysfunction occurring immediately after the index procedure was observed in 15 patients (62.5%) in the resection group compared to 2 patients (6.8%) in the ORI group, odds ratio: 0.05 (CI: 0.01–0.26, p

Background Radiogenomics of pediatric medulloblastoma (MB) offers an opportunity for MB risk stratification, which may aid therapeutic decision making, family counseling, and selection of patient groups suitable for targeted genetic analysis. Purpose To develop machine learning strategies that identify the four clinically significant MB molecular subgroups. Materials and Methods In this retrospective study, consecutive pediatric patients with newly diagnosed MB at MRI at 12 international pediatric sites between July 1997 and May 2020 were identified. There were 1800 features extracted from T2- and contrast-enhanced T1-weighted preoperative MRI scans. A two-stage sequential classifier was designed-one that first identifies non-wingless (

Future CPU-manycore heterogeneous systems can provide high peak throughput by integrating thousands of simple, independent, energy-efficient cores in a single die. However, there are two key challenges to translating this high peak throughput into improved end-to-end workload performance: (1) manycore co-processors rely on simple hardware putting significant demands on the software programmer; and (2) manycore co-processors use in-order cores that struggle to tolerate long memory latencies. To address the manycore programmability challenge, this paper presents a dense and sparse tensor processing framework based on PyTorch that enables domain experts to easily accelerate off-the-shelf workloads on CPUmanycore heterogeneous systems. To address the manycore memory latency challenge, we use our extended PyTorch framework to explore the potential for decoupled access/execute (DAE) software and hardware mechanisms. More specifically, we propose two software-only techniques, naive-software DAE and systolic-software DAE, along with a lightweight hardware access accelerator to further improve area-normalized throughput. We evaluate our techniques using a combination of PyTorch operator microbenchmarking and real-world PyTorch workloads running on a detailed register-transfer-level model of a 128-core manycore architecture. Our evaluation on three real-world dense and sparse tensor workloads suggest these workloads can achieve approximately 2-6× performance improvement when scaled to a future 2,000-core CPU-manycore heterogeneous system compared to an 18-core out-of-order CPU baseline, while potentially achieving higher area-normalized throughput and improved energyefficiency compared to general-purpose graphics processing units.

We present a new data set of air temperature change across land and ocean extending back to the late-18th century. This new data set uses marine air temperature observations rather than the sea surface temperature measurements typically used by pre-existing data sets. This allows the new data set to extend further into the past than existing instrumental temperature records, which typically have start dates in the mid-to-late 19th century. The new data set brings together advances in understanding of measurement biases affecting all-day marine air temperature observations with a new assessment of the effects of non-standard thermometer enclosures used at land meteorological stations in the early instrumental record. A further innovation is the use of kriging to obtain localised temperature estimates that allow land air temperature records to be converted into anomalies even for stations without observations during the baseline period. Global and hemispheric series show close agreement with those based on sea-surface temperature for much of the overlapping period of their records, some of the interesting differences will be presented. This data set has been developed under the GloSAT project (https://www.glosat.org/).

Exposure biases are non-climatic changes in the surface air temperature record which were introduced due to changes in the way thermometers were protected from solar radiation. The possible presence of the exposure bias in early instrumental temperature datasets is a well-known issue, and the impact of changing thermometer exposures, particularly the transition between historic exposures and the Stevenson screen, has been explored by previous studies. However, despite this, very few adjustments have been made to account for the bias, with the exception of a handful of localised studies. As a result, the exposure bias still accounts for significant uncertainty in global surface air temperature compilations, such as HadCRUT5.In this work we report an attempt to address the exposure bias for extratropical weather stations in a version of CRUTEM5 that has been extended back in time to 1781 (CRUTEM5_ext). We developed statistical models to predict the bias introduced by transitions from four main categories of historic exposure – open, wall-mounted, intermediate and closed – to the Stevenson screen. The models are based on an empirical analysis of the characteristics of the exposure bias observed in 20 parallel measurement studies, together with the temperature and radiation variables that were a priori expected to influence the magnitude of the bias in mean temperatures on a monthly timescale. Separately, we have compiled a database detailing the historic exposures in use at stations and the timing (or approximate timing when a precise time is not known) of the transition to the Stevenson screen. The statistical models, where robust, are then applied to the individual stations within CRUTEM5_ext to make adjustments for the exposure changes according to the database of historic exposures.This presentation will outline the model development, give a brief overview of the evolution of thermometer exposures in use in the early instrumental period for extratropical stations, and will illustrate the impact the exposure bias adjustments have on the CRUTEM5_ext data. This work forms part of the NERC-funded GloSAT project (https://www.glosat.org/) which is developing a global surface air temperature dataset starting in 1781. Where appropriate, stations used to create the GloSAT dataset will be adjusted for the exposure bias using the models presented here.

Spin crossover (SCO) complexes, which exhibit changes in spin state in response to external stimuli, have applications in molecular electronics and are challenging materials for computational design. We curate a data set of 95 Fe(II) SCO complexes (SCO-95) from the Cambridge Structural Database that have available low- and high-temperature crystal structures and, in most cases, confirmed experimental spin transition temperatures (T1/2). We study these complexes using density functional theory (DFT) with thirty functionals spanning across multiple rungs of “Jacob’s ladder” to understand the effect of exchange-correlation functional on electronic and Gibbs free energies associated with spin crossover. We specifically assess the effect of varying the Hartree–Fock exchange fraction (aHF) in structures and properties within the B3LYP family of functionals. We identify three best-performing functionals, a modified version of B3LYP (aHF = 0.10), M06-L, and TPSSh, that accurately predict SCO behavior for the majority of the complexes. Contrary to observations from prior studies, double-hybrids with higher aHF values are found to strongly stabilize high-spin states and therefore exhibit poor performance in predicting SCO behavior. Computationally predicted T1/2 values are consistent among the three functionals but show limited correlation to experimentally reported T1/2 values. These failures are attributed to the lack of crystal packing effects and counter-anions in the DFT calculations that would be needed to account for phenomena like hysteresis and two-step SCO behavior. The SCO-95 set thus presents opportunities for method development, both in terms of increasing model complexity and method fidelity.

We survey over 230,000 crystallized mononuclear transition metal complexes (TMCs) to identify trends in preferred geometric structure and metal coordination. While we observe d-filling to influence coordination preference, with late TMCs preferring lower coordination number, we also note exceptions. We also observe that 4d and 5d transition metals and 3p-coordinating ligands are systematically undersampled. For the roughly one third of the set of mononuclear TMCs that are octahedral, analysis of the 67 symmetry classes of their ligand environments reveals that complexes most commonly contain monodentate ligands that may likely be removable to leave an open site amenable to catalysis. Due to their frequent use in transition metal catalysts, we analyze trends in coordination by tetradentate ligands in terms of the capacity to support multiple metals and the variability of coordination geometry. We identify promising tetradentate ligands that co-occur in crystallized complexes with labile monodentate ligands, indicating their ability to generate reactive sites. Literature mining suggests that many of these tetradentate ligands are untapped as ligands in catalytic complexes, motivating proposal of a promising octa-functionalized porphyrin in this set as a candidate ligand for catalysis.

Supplementary Figure S4. EphA2 inhibitors suppressed the viability of VEM sensitive and resistant BRAF mutant cell lines and NRAS mutant cell lines.

Supplementary Table S2. Combination indices per method of Chou and Talalay.

Supplementary Figure S3. Fig. S3. Validation of EphA2 as the target of EphA2 inhibitors.

Supplementary Figure S5. ALW-II-41-27 suppresses in vivo tumor growth of both VEM sensitive and resistant melanomas.

Supplementary Figure S2. EphA2 inhibitor-kinase interaction maps.

Supplementary Figure S1. Survival Curves for VEM resistant lines.

Supplementary Figure Legends

Supplementary Table S1. The information of the melanoma patients for EphA2 analysis.

PDF file, 88K, Nutlin-3 induces p53 and Hdm2 but not Mdm4 even though the basal levels of Mdm4 is higher than Hdm2.

PDF file, 86K, Overexpression of survivin leads to a decrease in percentage of FITC-annexin V positive cells.

PDF file, 74K, Mean survival fraction upon exposure to 10uM vemurafenib among p53 mutated and p53WT cell lines.

PDF file, 89K, These are molecules that respond to vemurafenib.

Purpose: For patients with advanced melanoma, primary and secondary resistance to selective BRAF inhibition remains one of the most critically compelling challenges. One rationale argues that novel biologically informed strategies are needed to maximally cripple melanoma cells up front before compensatory mechanisms emerge. As p53 is uncommonly mutated in melanoma, restoration of its function represents an attractive adjunct to selective BRAF inhibition.Experimental Design: Thirty-seven BRAF(V600E)-mutated melanoma lines were subjected to synergy studies in vitro using a combination of vemurafenib and nutlin-3 (Nt-3). In addition, cellular responses and in vivo efficacy were also determined. We also analyzed changes in the levels of canonical apoptotic/survival factors in response to vemurafenib.Results: Dual targeting of BRAF(V600E) and Hdm2 with vemurafenib and Nt-3, respectively, synergistically induced apoptosis and suppressed melanoma viability in vitro and tumor growth in vivo. Suppression of p53 in melanoma cells abrogated Nt-3′s effects fully and vemurafenib's effects partially. A survey of canonical survival factors revealed that both vemurafenib and Nt-3 independently attenuated levels of the antiapoptotic protein, survivin. Genetic depletion of survivin reproduces the cytotoxic effects of the combination strategy.Conclusion: These results show preclinical feasibility for overcoming primary vemurafenib resistance by restoring p53 function. Moreover, it identifies survivin as one downstream mediator of the observed synergism and a potential secondary target. Clin Cancer Res; 19(16); 4383–91. ©2013 AACR.

PDF file, 136K, Synergistic cytotoxicity between vemurafenib and Nt3. Green cells are live while dead cells are red in this assay.

PDF file, 57K, Suppression of survivin levels by Nt3 (6 uM) in 4 melanoma lines.

PDF file, 75K, Survival curves for A375 and A375(PLX-R) which have been induced into resistance.

We provide a simple and intuitive theory to explain how coupling a molecule to an optical cavity can modify ground-state chemical reactivity by exploiting intrinsic quantum behaviors of light-matter interactions. Using the recently developed Polarized Fock States representation, we demonstrate that the change of the ground-state potential is achieved due to the scaling of diabatic electronic couplings with the overlap of the polarized Fock states. Our theory predicts that for a proton-transfer model system, the ground state barrier height can be modified through light-matter interactions when the cavity frequency is in the electronic excitation range. Our simple theory explains several recent computational investigations that discovered the same effect. We further demonstrate that under the deep strong coupling limit of the light and matter, the polaritonic ground and first excited eigenstates become the Mulliken-Hush diabatic states, which are the eigenstates of the dipole operator. This work provides a simple but powerful theoretical framework to understand how strong coupling between molecule and cavity can modify ground state reactivities.

Background The Long-ter M O U tcomes after the Multisystem Inflammatory S yndrome I n C hildren (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood. Methods This multicenter observational cohort study will enroll at least 600 patients Conclusion The MUSIC study, with the largest cohort of MIS-C patients and the longest follow-up period to date, will make an important contribution to our understanding of the acute cardiac and non-cardiac manifestations of MIS-C and the long-term effects of this public health emergency.

The military punishment of decimatio, the cudgelling by lot of one in ten men in a disgraced unit, often described as a cornerstone of Roman military discipline, was never practised during the third and second centuries BC. The punishment was possibly used as an extraordinary measure a couple of times in the fifth and fourth centuries BC. It soon fell into total desuetude but was cultivated as a rhetorical construct that proclaimed theoretical powers commanders no longer dared effect. It was only revived, or rather reinvented, during the Late Republic, a violent moment that saw the confluence of antiquarian enthusiasm with military dynasts whose unrestrained powers allowed them to manifest what had previously been an aristocratic talking point.

Despite the modern celebrity of the fossil collector Mary Anning (1799–1847) of Lyme Regis and her frequent use as an icon in scientific education and popularization, there are few accounts of her life by her contemporaries. We report here a previously unpublished anonymous manuscript memoir of Anning's life, in the Special Collections of the University of Bristol Library. Evidence from textual analysis and handwriting corroborates its attribution to George Roberts (bap. 1804–60) of Lyme Regis, schoolmaster and historian. He wrote it at some time during 1837–47, perhaps 1839–47, by adapting a passage in his 1834 history of Lyme Regis. It was apparently intended for a new book, but was altered into an obituary after Anning's death. Evidence is presented that Roberts wrote the obituary of Anning in the Athenæum , which was widely republished in newspapers. Henry De la Beche (1796–1855) published another obituary in the Proceedings of the Geological Society . Roberts helped him to obtain information from Anning's family, but did not use this new information in his manuscript. Benjamin J.M. Donne (1831–1928), a former pupil of Roberts, painted the Society's portrait of Anning. A claim that it was commissioned by a group, mostly Fellows of the Society, remains unconfirmed.

This study reports a content analysis of the first 10 years of the Journal of Nonprofit Education and Leadership (JNEL). A team of 10 researchers spent two years piloting, and comprehensively reading and coding 97 theoretical articles published between 2010-2020. This analysis found the journal published education and leadership-focused articles with an emerging area of democracy-focused articles. The journal produced a mix of quantitative, qualitative, and mixed-methods articles, which differ from previous content analysis studies conducted in other nonprofit and philanthropic studies journals. The keywords were separated into the 16 categories of the NACC curricular guidelines, which demonstrated the variety of education and leadership-focused topics covered in the first 10 years of the journal. This study has implications for nonprofit and philanthropic studies as JNEL is a lesser-known emerging journal that caters to practitioners and scholars.

Objectives The inclusion of musculoskeletal conditions within multimorbidity research is inconsistent, and working-age populations are largely ignored. We aimed to: (1) estimate multimorbidity prevalence among working-age individuals with a range of musculoskeletal conditions; and (2) better understand the implications of decisions about the number and range of conditions constituting multimorbidity on the strength of associations between multimorbidity and burden (e.g., health status and health care utilization). Study Design and Setting Using data from the Australian National Health Survey 2007–08, the associations between burden measures and three ways of operationalizing multimorbidity (survey, policy, and research based) within the working-age (18–64 years) musculoskeletal population were estimated using multiple logistic regression (age and gender adjusted). Results Depending on definition, from 20.2% to 75.4% of working-age individuals with musculoskeletal conditions have multimorbidity. Irrespective of definition, multimorbidity was associated with increased likelihood of subjective health burden, pain or musculoskeletal medicines use, nonmusculoskeletal specialist and pharmacist (advice only) consultations, and reduced likelihood of not consulting health professionals. A group with intermediate health outcomes was considered multimorbid by some, but not all definitions. With the restrictive policy and research multimorbidity definitions, this intermediate group is included within the reference population (i.e., are considered nonmultimorbid). This worsens the reference group's apparent health status thereby leveling the comparative burden between those with and without multimorbidity. Consequently, dichotomous cut points lead to similar associations with burden measures despite the increasingly restrictive multimorbidity definitions used. Conclusions All multimorbidity definitions were associated with burden among the working-age musculoskeletal population. However, dichotomous cut points obscure the gradient of increased burden associated with restrictive definitions.

Background Health systems globally promote appropriate prescribing by healthcare providers and safe and effective medicine use by consumers. Rx for Change, a publicly available database, provides access to systematic reviews regarding best practices for prescribing and using medicines. Despite the value of the database for improving prescribing and medicine use, its use remains suboptimal. This study aimed to develop a training program for five medicine-focused organisations in Canada and Australia to facilitate the use and understanding of the Rx for Change database. Methods Four steps were undertaken: 1) key informant interviews were completed across all organisations to understand the knowledge user perspective; 2) a directed content analysis was completed of the interview transcripts and proposed training was developed; 3) a second round of feedback on the proposed training by knowledge users was gathered; and 4) feedback was integrated to develop the final training. Results Sixteen key informant interviews with knowledge users were conducted. Themes for training content included the scope of, navigation and strategies for using Rx for Change (generic content) and practical examples on incorporating evidence within their workplace context (tailored content). The final training consisted of an informational video, a 60-minute face-to-face workshop and two post-training reminders. Conclusions A method of engaging knowledge users in the development of a training program to improve the use of an on-line database of systematic reviews was established and used to design training. Next steps include the delivery and evaluation of the training.

This article develops economic models for a cow-calf ranching operation and an alfalfa hay operation in the Humboldt River Region (HRR) that use surface water for irrigation. The models were built and parameterized through consultation with ranchers and farmers in the HRR in order to represent typical agricultural operations in the region. The models were used to calculate the economic value to an operation of an acre-foot of water not received due to an unanticipated supply reduction. This analysis was conducted to support the conjunctive management of surface and groundwater in the HRR by providing estimates of the economic value of the water that surface water users expect but do not receive due to interference from upstream groundwater pumping. For the cow-calf ranch model, reduced water deliveries impact ranch profits by reducing the amount of low-cost feed grown on the ranch. The increase in average feed costs forces the ranch to reduce its herd size, which lowers the number of new calf births and, as a result, lowers future profits from livestock sales. The cow-calf ranching model predicts an economic value of an acre-foot of water for the cow-calf ranch in the range of $215 per acre-foot for unanticipated supply interruptions that occur in normal water years, and upwards of $290 per acre-foot for supply interruptions that occur during drought. Model results do not provide evidence that the economic value of an acre-foot of water increases with the length of the unanticipated supply reduction. For the alfalfa hay farm model, results indicate that unanticipated reduced water deliveries impact farm profits by first preventing the farm from planting a cover crop during fallow years and then, for more significant interruptions, reducing its acreage of alfalfa hay. The alfalfa hay model predicts that the economic value of an acre-foot of water increases with both the volume of water not received and the length of the unanticipated supply reduction. The economic value of water per-acre-foot predicted by the alfalfa hay model ranges from less than $10 per acre-foot for unanticipated supply interruptions that occur in normal water years, in the range of $100-$200 per acre-foot for single-year supply interruptions that occur during a below average water year, and over $300 per-acre-foot for supply interruptions that occur in successive below average water years.

BACKGROUND In an era of pay for performance metrics, we sought to increase understanding of factors driving high resource utilization (HRU) in emergent (EGS) versus same-day elective (SDGS) general surgery patients. METHODS General surgery procedures from the 2016 ACS-NSQIP public use file were grouped according to the first four digits of the primary procedure CPT code. Groups having at least 100 of both elective and emergent cases were included (22 groups; 83,872 cases). HRU patients were defined as those in-hospital >7D, returned to the OR, readmitted, and/or had morbidity likely requiring an intensive care unit (ICU)stay. Independent NSQIP predictors of HRU were identified through forward regression; P for entry 0.10. RESULTS Of all patients, 33% were HRU. The three highest HRU procedures (total colectomy, enterolysis, and ileostomy) comprised a higher proportion of EGS than SDGS cases (10.3 versus 2.6%, P < 0.001). The duration of operation was 40 Min lower in EGS after adjustment. Thirty-nine of the remaining 40 HRU predictors were higher in EGS including preoperative SIRS/Sepsis (50 versus 2%), ASA classification IV-V (31 versus 5%), albumin

When molecules are coupled to an optical cavity, new light-matter hybrid states, so-called polaritons, are formed due to quantum light-matter interactions. With the experimental demonstrations of modifying chemical reactivities by forming polaritons under strong light-matter interactions, theorists have been encouraged to develop new methods to simulate these systems and discover new strategies to tune and control reactions. This review summarizes some of these exciting theoretical advances in polariton chemistry, in methods ranging from the fundamental framework to computational techniques and applications spanning from photochemistry to vibrational strong coupling. Even though the theory of quantum light-matter interactions goes back to the mid-twentieth century, the gaps in the knowledge of molecular quantum electrodynamics (QED) have only recently been filled. We review recent advances made in resolving gauge ambiguities, the correct form of different QED Hamiltonians under different gauges, and their connections to various quantum optics models. Then, we review recently developed {\it ab-initio} QED approaches which can accurately describe polariton states in a realistic molecule-cavity hybrid system. We then discuss applications using these method advancements. We review advancements in polariton photochemistry where the cavity is made resonant to electronic transitions to control molecular non-adiabatic excited state dynamics and enable new photochemical reactivities. When the cavity resonance is tuned to the molecular vibrations instead, ground-state chemical reaction modifications have been demonstrated experimentally, though its mechanistic principle remains unclear. We present some recent theoretical progress in resolving this mystery. Finally, we review the recent advances in understanding the collective coupling regime between light and matter, where many molecules can collectively couple to a single cavity mode or many cavity modes. We also lay out the current challenges in theory to explain the observed experimental results. We hope that this review will serve as a useful document for anyone who wants to become familiar with the context of polariton chemistry and molecular cavity QED and thus significantly benefit the entire community.

Chronic analgesic use is described in home parenteral nutrition (HPN)-dependent patients, but there are limited data on factors associated with opioid use for noncancerous pain.Patients attending a national UK intestinal failure reference center were divided in two groups according to strong opioid (SO) usage; risk factors for SO usage were analyzed using logistic regression.A total of 168 HPN-dependent patients were included. During the study period, 73 patients (43.5%) had documented SO usage (SO group), whereas the remainder did not (No-SO group). The prevalence of Crohn's disease among the No-SO group was twofold higher than among the SO group (43.2% vs 24.7%; P = 0.013), whereas those with surgical complications were twice as prevalent among the SO group (19.2% vs 8.4%, respectively; P = 0.04). The rate of working-age unemployment was significantly higher in the SO group (90.6%) than the No-SO group (55.6%; P = 0.001). Multivariate regression showed unemployment as an independent risk factor for SO usage (OR, 6.005; 95% CI, 1.435-25.134), whereas Crohn's disease (OR, 0.284; 95% CI, 0.09-0.898) and4 intravenous support (IVS) nights per week (OR, 0.113; 95% CI, 0.012-1.009) were protective factors. The life-long incidence of catheter-related bloodstream infection (CRBSI) was comparable between groups (34.2% SO vs 27.4% No-SO; P = 0.336).SO use is frequent among HPN-dependent patients and associated with high rates of unemployment and ≥4 IVS nights per week, but not with increased rate of CRBSI. The reduced usage among patients with Crohn's disease warrants further evaluation but might be due to the chronicity as compared with other IF etiologies.

John Johnstone was an Edinburgh printer and publisher, from 1849 in partnership with Robert Hunter. In 1839, Johnstone and the printer Robert Fairly established a separate firm, Johnstone & Fairly, to publish the Witness, a newspaper edited by the geologist Hugh Miller. The firm became Miller & Fairly in 1844 when Miller bought out Johnstone's share. The editorial office was in the High Street. The steam-powered printing office was in Horse Wynd, in the former gatehouse of Minto House and later also in the former house of the physician Dr John Clerk of Listonshiels. Johnstone's own publishing business specialized in religious and ecclesiastical works. Nevertheless, Miller chose that firm to publish The Old Red Sandstone (1841), and later books, until the firm ran into financial trouble in the mid-1850s, and Miller placed The testimony of the rocks (1857) with Shepherd & Elliot of Edinburgh. Miller's original choice of Johnstone was perhaps to protect the reputation of Miller and the Witness when geology was often regarded with suspicion on religious grounds. It may also have given Miller more creative freedom. Miller & Fairly printed many, but not all, impressions of Miller's books for Johnstone and other publishers. This was to Miller's, and Miller's heirs', presumed double profit as copyright holder and printer, with implications for his relationships with publishers. Miller's dual role may help explain his reluctance to resign the newspaper's editorship even at the cost of his health and life.