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IMPORTANCE: Aggressive thyroid carcinoma, including radioiodine refractory (RAIR) differentiated thyroid carcinoma (DTC), medullary thyroid carcinoma (MTC), and anaplastic thyroid carcinoma (ATC), are associated with significant morbidity and mortality and have limited therapeutic options. Distinct immune profiles have been identified in thyroid cancer subtypes suggesting they may be susceptible to immune checkpoint inhibition. OBJECTIVE: To evaluate the efficacy of anti–programmed cell death 1 nivolumab and anti–cytotoxic lymphocyte–associated protein 4 ipilimumab in patients with aggressive thyroid carcinoma. DESIGN, SETTING, AND PARTICIPANTS: This phase 2 nonrandomized clinical trial enrolled patients with RAIR DTC in a single center from October 2017 to May 2019, with exploratory cohorts in MTC and ATC. The data were analyzed between June 2021 and September 2023. INTERVENTION: Intravenous nivolumab, 3 mg/kg, every 2 weeks and ipilimumab, 1 mg/kg, every 6 weeks until disease progression, intolerable adverse events, or a maximum duration of 2 years. MAIN OUTCOMES AND MEASURES: The primary end point of the study was objective response rate (ORR) in RAIR DTC, which was scored according to RECIST (Response Evaluation Criteria in Solid Tumours), version 1.1. Key secondary end points included safety, progression-free survival, overall survival, and biomarker analyses. RESULTS: A total of 51 patients were registered, and 49 patients were evaluable for analysis. The median (range) age was 65 years (30-88 years), and 25 participants (51%) were female. ORR in the DTC cohort was 9.4% (3/32 [95% CI, 2.8%-28.5%]), with all partial responses in either oncocytic carcinoma (2/6 [33.0%]) or poorly differentiated thyroid carcinoma (1/5 [20.0%]). Clinical benefit rates were 62.5% (20/32) in the overall DTC cohort, including 83.3% (5/6) in oncocytic carcinoma and 40% (2/5) in poorly differentiated thyroid carcinoma. ORR in the exploratory ATC cohort was 30.0% (3/10 [95% CI, 6.7%-65.2%]), with a clinical benefit rates of 50.0% (5/10). No responses were observed in the exploratory MTC cohort. The safety profile was similar to prior reports with dual immune checkpoint inhibition (pruritus, rash, diarrhea, fatigue, and elevation of lipase and liver enzymes). The presence of NRAS tumor genetic sequence variations, but not BRAF V600E, was associated with worse outcomes. CONCLUSIONS AND RELEVANCE: This phase 2 nonrandomized clinical trial reported clinical activity of dual immune checkpoint inhibition in aggressive thyroid cancer. The study did not meet its end point in the primary population of RAIR DTC and does not support further investigation in non–biomarker-selected DTC. However, the signal observed in ATC may merit further evaluation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03246958

Background: Data regarding North-American incidental (cT1a/b) prostate cancer (PCa) patients is scarce. To address this, incidental PCa characteristics (age, PSA values at diagnosis, Gleason score [GS]), subsequent treatment and cancer-specific survival (CSS) rates were explored. Methods: Incidental PCa patients were identified within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015). Descriptive statistics, annual percentage changes (EAPC), Kaplan-Meier estimates, as well as Cox regression models were used. Bootstrapping technique was used to generate 95% confidence intervals for CSS at 6 years. Results: Of all 344,031 newly diagnosed non metastatic PCa patients, 5155 harbored incidental PCa. Annual rates of incidental PCa increased from 1.9% (2004) to 2.5 % (2015; p= 0.02). PSA values at diagnosis were 0–4 ng/ml in 48% vs. 4–10 ng/ml in 31% vs. > 10 ng/ml in 21%. Of all incidental PCa patients, 64% harbored GS 6 vs. 25% GS 7 vs. 11% GS ≥ 8. Of all incidental PCa patients, 47% were aged < 70, 35% were between 70 and 79 and 18% were ≥ 80 years. Subsequently, 71% underwent no local treatment (NLT) vs. 16% radical prostatectomy (RP) vs. 14% radiotherapy (RT). Proportions of patients with NLT increased from 65 to 81% (p= 0.0001) over the study period (2004–2015). CSS at six years ranged from 58% in GS ≥ 8 patients with NLT to 100% in patients who harbored GS 6 and underwent either RP or RT. Conclusion: Incidental PCa in the United States is rare. Most incidental PCa patients are diagnosed in men aged less than 80 years of age. The majority of incidental PCa patients undergo NLT and enjoy excellent CSS.

Background:Disrupted 24-h sleep-wake and rest-activity cycles are known common features in Huntington's disease (HD) patients; however, critical periods during the 24-h cycle have been less studied. Objective:To analyze the differences between early-mid stage HD patients and healthy controls (HC) in sleep patterns and 24-h motor activity by using actigraphic monitoring. Methods:Twenty HD patients (13 females; mean age ± SD 56.45 ± 16.94) at early-mid stage of the disease and 20 HC were actigraphically monitored for a week. We applied the Functional Linear Modeling (FLM) to analyze motor activity from the actigraphic data. We analyzed parameters regarding both the time spent in bed and out of bed; get-up time (GUT); time in bed (TIB); midpoint of sleep (MS); sleep motor activity (SMA); sleep onset latency (SOL); total sleep time (TST); wake after sleep onset (WASO); sleep efficiency (SE); number and duration of awakenings (AWK); diurnal motor activity (DMA) and diurnal total sleep time (DTST). Results:Ten patients were in Stage I, 6 in Stage II and 4 in Stage III. HD patients presented lower SE and higher TIB, SOL, WASO, AWK and AWK > 5 min in comparison to HC. Moreover, higher motor activity was observed in patients with HD, in particular between 2:15 and 4:00 am, from around 40 min prior to bedtime until 20 min after bedtime, and from around 20 min prior to get-up time until 50 min after get-up time. Conclusions:Actigraphy documented a specific 24-h motor pattern in HD, potentially constituting a disease signature.

Venous access devices are used in health care. To prevent occlusions the evidence confirmed the need for routine catheter flushing before and after infusion as well as at the end of use. To date, the efficacy of heparin has not been demonstrated. The aim of this study was to evaluate the effectiveness of the locking of central venous catheters with heparin versus normal saline in adults to prevent occlusion, catheter-related infections and thrombosis in adults. A literature search using Medline, Embase, Cochrane Library and Cinahl was performed to identify all meta-analyses addressing the effectiveness of heparin versus normal saline in locking central venous catheters in adults. Four reviewers independently selected publications assessed quality and extracted data. Parameter estimates regarding occlusion, catheter- related infections and thrombosis were pooled using an umbrella review. We identified 6356 references. Seven systematic reviews were included in the study. Most of the studies included in the systematic reviews were conducted in oncohaematology departments, intensive care and cardiac surgery units among patients with multiple diseases and chronicity. Most studies report a heparin concentration of 10 to 5000 IU/ml versus normal saline and other solutions. There was no evidence that heparin was more effective than normal saline in reducing complications such as occlusion, catheter-related infections and thrombosis. No statistically significant difference was found between heparin and normal saline in reducing catheter occlusion. Heparin is not superior compared to normal saline.

A Discrete Element Method model, including interparticle cohesive forces, was calibrated and validated to develop a tool to predict the powder layer’s quality in the powder bed fusion process. An elastic contact model was used to describe cohesive interparticle interactions. The surface energy of the model particles was estimated by assuming that the pull-off force should provide the strength of the material evaluated at low consolidation with shear test experiments. The particle rolling friction was calibrated considering the bulk density of the layer produced by the spreading tool. The model was validated with the experiments by comparing the wavelet power spectra obtained with the simulations with those of the experimental layers illuminated by grazing light. The calibration proposed in this study demonstrated superior performance compared to our previous methods, which relied on measuring the angle of repose and unconfined yield strength.

Blends of bio‐polyesters cover a wide percentage of the market share and possess properties comparable to the ones of conventional polymers. Poly(butylene adipate‐co‐terephthalate) (PBAT) is a fossil‐based compostable bioplastic, which possess good mechanical properties and processability. Blending PBAT with thermoplastic starch (TPS) allows to lower the cost of the final products and to increase the amount of bioderived material. The influence of the processing parameters on the morphology and on the mechanical properties of PBAT/TPS blends is studied. The compounds were produced via twin‐screw extrusion and then films were produced via cast film extrusion. The quality of the dispersion is strongly related to the screw speed adopted during the compounding process. The quality of the film and their processability depend on the parameters adopted during the compounding process.

The effect of treatment intensification (systemic therapy [ST] + cytoreductive nephrectomy (CN) vs. ST alone) is unknown regarding rates of other-cause mortality (OCM) in clear-cell metastatic renal cell carcinoma (ccmRCC). We hypothesized that intensified treatment (ST + CN) may result in higher OCM, than when ST is used alone.

Increased prevalence of cardiovascular autonomic failure might play a key role on Parkinson’s disease (PD) progression of glucocerebrosidase gene (GBA)-mutated patients, determining a malignant phenotype of disease in these patients. To objectively characterize, for the first time, the cardiovascular autonomic profile of GBA-mutated patients compared to idiopathic PD patients by means of cardiovascular reflex tests (CRTs). This is a case-control (1 : 2) study on PD patients belonging to well-characterized prospective cohorts. For each PD patient carrying GBAvariants, two idiopathic PD patients, matched for sex and disease duration at CRTs, were selected. Patients recruited in these cohorts underwent a complete clinical and instrumental evaluation including specific autonomic questionnaires, CRTs and extensive genetic analysis. A total of 23 GBA-PD patients (19 males, disease duration 7.7 years) were included and matched with 46 non-mutated PD controls. GBA-mutated patients were younger than controls (59.9±8.1 vs. 64.3±7.2 years, p = 0.0257) and showed a more severe phenotype. Despite GBA-mutated patients reported more frequently symptoms suggestive of orthostatic hypotension (OH) than non-mutated patients (39.1% vs 6.5%, p = 0.001), the degree of cardiovascular autonomic dysfunction, when instrumentally assessed, did not differ between the two groups, showing the same prevalence of neurogenic OH, delayed OH and cardiovascular reflex impairment (pathological Valsalva maneuver). GBA-PD patients did not show different instrumental cardiovascular autonomic pattern than non-mutated PD. Our findings suggested that symptoms suggestive of OH should be promptly investigated by clinicians to confirm their nature and improve patient care and management.

Purpose: Demonstrate proof-of-concept for conducting NFL Draft trades on a blockchain network using smart contracts. Design/methodology/approach: Using Ethereum smart contracts, the authors model several types of draft trades between teams. An example scenario is used to demonstrate contract interaction and draft results. Findings: The authors show the feasibility of conducting draft-day trades using smart contracts. The entire negotiation process, including side deals, can be conducted digitally. Research limitations/implications: Further work is required to incorporate the full-scale depth required to integrate the draft trading process into a decentralized user platform and experience. Practical implications: Cutting time for the trade negotiation process buys decision time for team decision-makers. Gains are also made with accuracy and cost. Social implications: Full-scale adoption may find resistance due to the level of fan involvement; the draft has evolved into an interactive experience for both fans and teams. Originality/value: This research demonstrates the new application of smart contracts in the inter-section of sports management and blockchain technology.

Aim: When the pandemic was declared it was clear that healthcare workers were the category most at risk of infection. Our study aimed to identify factors influencing nasopharyngeal swab negativity and days to return to work after SARS-CoV-2 infection in a cohort of healthcare workers in the Teaching Hospital Umberto I in Rome, using a disability management approach. Subject and methods: A prospective cohort study was conducted on a sample of 481 healthcare workers from March 2020 to December 2021. The time to nasopharyngeal swab negativization by RT-PCR technique and the time to return to work were evaluated for the participants in our study, analysing factors that could have influenced the extension of these times. Univariate, bivariate and multivariate statistical analysis was performed. Results: Our analysis showed an association between severity of COVID-19 and prolongation of TNF-negative times, there was a strong association between the two dependent variables: TNF-negative times and days to return to work (β = 0.660; p< 0.001). Severity of illness and female sex are clear-cut determinants of prolongation of return to work and time to nasopharyngeal swab negativity. In the age group over 48 years, hypertension is positively associated with days of negativization, while BMI is positively associated with return to work days. Conclusion: It seems clear that in our age the workers’ health must be pointed out and stressed to improve the welfare of the worker environment. It would be desirable to increase that kind of study and apply the disability manager in other situations where the workers need to be protected.

Purpose: To investigate the detection and predictors of prostate cancer (PCA) and clinically significant prostate cancer (csPCA) in patients with positive multiparametric MRI (mpMRI) followed by a negative MRI – guided target biopsy (TB) and systematic biopsy (SB). Materials and methods: This retrospective multicenter study included 694 patients from 10 tertiary referral centers with an initial positive mpMRI (PI-RADS ≥ 3) and negative results on both MRI-TB and SB. Patients were classified into three groups based on follow-up: Group 1 (prostate re-biopsy without new mpMRI), Group 2 (standardized second prostate mpMRI and subsequent re-biopsy), and Group 3 (follow-up with mpMRIs and biopsy based on clinical and radiological triggers). The primary outcomes were the detection of any PCA and csPCA during follow up. Study groups were compared according to their probability of PCA and csPCA assessed with the ERSPC-MRI risk calculator. Statistical analysis included Kaplan – Meier analysis, Cox regression, and multivariable analysis for the detection of (cs)PCa. Results: The overall detection of PCA and csPCA was 26.8% and 19.3%, respectively, with varying rates in different PI-RADS groups. Group 3 had the highest 2-year and 5-year PCA–free survival (94 and 84%) and csPCA – free survival (96 and 86%). Multivariable analysis revealed a significantly higher risk of PCA and csPCA in Group 1 and 2 compared to Group 3 (p< 0.01). Clinical and radiological predictors for PCA and csPCA included higher age, prostate volume, PI-RADS score, the presence of atypical small acinar proliferation (ASAP), and a smaller number of TB and SB performed during the initial biopsy. Study limitations, include the retrospective design and reliance on clinical and radiological triggers for follow–up decisions. Conclusions: Patients with positive mpMRI but negative TB and SB results exhibit varying rates of PCA and csPCA depending on the follow up scheme. Tailored follow-up strategies are essential for optimal management in this clinical scenario.

We discuss single-shot decoding of quantum Calderbank-Shor-Steane codes with faulty syndrome measurements. We state the problem as a joint source-channel coding problem. By adding redundant rows to the code’s parity-check matrix, we obtain an additional syndrome error correcting code which addresses faulty syndrome measurements. Thereby, the redundant rows are chosen to obtain good syndrome error correction capabilities while keeping the stabilizer weights low. Optimal joint decoding rules are derived which, though too complex for general codes, can be evaluated for short quantum codes.

Objective: The objective of this review is to discuss acid-base physiology, describe the essential steps for interpreting an arterial blood gas and relevant laboratory tests, and review the 4 distinct types of acid-base disorders.Data Sources: A comprehensive literature search and resultant bibliography review of PubMed from inception through March 7, 2023.Study Selection and Data Extraction: Relevant English-language articles were extracted and evaluated.Data Synthesis: Critically ill patients are prone to significant acid-base disorders that can adversely affect clinical outcomes. Assessing these acid-base abnormalities can be complex because of dynamic aberrations in plasma proteins, electrolytes, extracellular volume, concomitant therapies, and use of mechanical ventilation. This article provides a systematic approach to acid-base abnormalities which is necessary to facilitate prompt identification of acid-base disturbances and prevent untoward morbidity and mortality.Relevance to Patient Care and Clinical Practice: Many acid-base disorders result from medication therapy or are treated with medications. Pharmacists are uniquely poised as the medication experts on the multidisciplinary team to assist with acid-base assessments in the context of pharmacotherapy.Conclusion: The use of a systematic approach to address acid-base disorders can be performed by all pharmacists to improve pharmacotherapy and optimize patient outcomes.

Aim: Extended reality (XR) provides technologies that can create engaging and interactive learning resources easily updatable in line with the learning needs. This systematic review aimed to investigate the academic performance (AP), level satisfaction (LS), and acceptability (Ac) of XRs in university education students of medicine and health sciences. Method: The Preferred Reporting Items for Systematic Reviews statement was applied. Results: Nineteen experimental studies were included, which examined AP, 15 LS and 4 AC. No study was found that applies the Metaverse, 15 considered virtual reality (VR), 3 Augmented Reality (AR), 1 Mixed Reality (MR). Ten studies showed a statistically significant increase in AP in students who adopted XRs compared to traditional teaching methodologies. Six 5 studies showed a significant increase in LS after VR use. Two studies reported a high percentage of significant acceptability of XR use. Conclusion: The review provides that Metaverse results still need to be implemented; VR was a valid tool to support the improvement of AP and LS of students; VR turns out to be more widespread than other XRs. There are several discrepancies in the studies that confirm the need to promote the understanding of VR simulation’s effects on the acquisition of skills.

Purpose: Immune checkpoint inhibitors (ICPIs) disrupting PD-1/PD-L1 axis have revolutionized the management of advanced non-small cell lung cancer (NSCLC). Some studies identified the development of endocrine toxicity as predictor of better survival in cancer patients treated with ICPIs. The aim of study was to evaluate survival and new onset of immune-related endocrine adverse events (irAEs) in patients treated with nivolumab for advanced NSCLC. Methods: In a prospective study, 73 patients with previously treated advanced NSCLC received nivolumab in monotherapy. Blood samples were collected at each cycle to monitor thyroid autoimmunity, thyroid, adrenal and somatotroph axes, while thyroid morphology was evaluated by ultrasonography. Results: An impaired thyroid function was recorded in 23.4% of patients (n= 15). Eight patients developed asymptomatic transient thyrotoxicosis (ATT) evolving to hypothyroidism in 50% of cases. In addition, seven patients developed overt hypothyroidism without ATT and with negative autoantibodies. Patients who developed hypothyroidism proved to have better overall survival (OS) as compared with non-developers at both univariate (p= 0.021) and multivariate analyses (p= 0.023). The survival curve of patients with reduced IGF-I at baseline, or displaying its reduction during the follow-up, showed significantly reduced median survival compared to patients with normal/high IGF-I levels (p= 0.031). Conclusions: Thyroid function abnormalities are the major irAEs in patients treated with nivolumab, and hypothyroidism onset is associated with prolonged survival. Our findings indicate that the development of hypothyroidism is a positive predictive biomarker of nivolumab antitumor efficacy in patients with NSCLC. Low IGF-I levels could represent a negative prognostic factor during nivolumab therapy.

In the current European regulatory environment, there is a growing emphasis on the need to develop fourth range and dairy packaging materials. which are more environmentally sustainable. In response to this need, a Life Cycle Analysis (LCA) was conducted to assess the suitability of replacing traditional polystyrene foam boxes and polypropylene (PP) and polyethylene terephthalate (PET) trays with packaging made of corrugated cardboard and coated with bioplastic. Life cycle analysis shows that bioplastic coated cardboard packaging has a lower environmental impact, despite the impact of corn and sugar cane bioplastic production. In the case of dairy packaging, an improved disposal scenario or scenario has been considered, in particular in terms of recycling. In the second case, raw materials that are totally or partially recyclable were considered. For the cardboard tray, recyclability is 100%, while for PET and PP respectively 50% and 4%, due to insufficient recycling and decontamination processes. In this scenario, the impact of fossil plastics decreases substantially, although corrugated and bioplastic packaging is again the best choice. To confirm these results, a multi-criteria decision analysis (multi-criteria Decision Analysis) was conducted, which corroborated the conclusions obtained through life cycle analysis.

Photoluminescent silicone epoxy resins were prepared by physical dispersion of SrAl2O4:Eu2+, Dy3+pigments. The resin was deposited on ceramic tiles for flooring by automatic drawdown and left to harden at ambient conditions. Morphology of the coated tiles was measured by contact gage profilometry and field emission gun scanning electron microscopy. Mechanical response was investigated by pencil and cross-hatch scratch tests; depth-sensing indentation measurements were performed using Vickers and flat punch indenters. Tribological response of the coated tiles was measured by progressive and constant load scratch tests and dry sliding linearly reciprocating ball-on-flat tests, respectively. Intensity of photoluminescent radiations and the corresponding decay time were estimated by digital imaging. The photoluminescent coatings feature high hardness, scratch and wear endurance as well as good clarity. Being the resin designed for spontaneous drying and suitable for easy-to-automate and versatile deposition processes, it is the ideal candidate for the decoration of a large variety of substrates as well as for the repowering and/or retrofitting of previous installations.

Current tools for predicting lymph node invasion (LNI) in prostate cancer have suboptimal performance in miN0M0 disease on prostate-specific membrane antigen positron emission tomography imaging and are associated with a high number of unnecessary extended pelvic lymph node dissection (ePLND) procedures. A novel model should be used to identify patients with miN0M0 disease who should be considered for ePLND to reduce the risk of unnecessary procedures without missing LNI cases.

Existing data on the impact of sex differences on transvenous lead extraction (TLE) outcomes in cardiac device patients are limited.

Tall fescue (TF) and tall wheatgrass (TW) are the main temperate perennial grasses used for livestock grazing in the Pampas region of Argentina. In this region, pastures based on these grasses show low tiller density and the presence of bare soil in winter. An experiment was performed in pots kept outdoors. Plants of TF and TW were cut every 550°C day and 700°C day, respectively. In each species, reproductive tillers were removed at different times: (i) at each cut, (ii) when they reached the flag leaf stage, or (iii) when they reached full bloom. Tiller appearance, tiller death, and type of bud (basal or axillary) of the tillers present were determined. Tiller appearance decreased from July to April. Minimum values were 0.2 and 1.1 tillers 100 tillers−1day−1in TF and TW, respectively. In TF, tiller death began in September–October and increased from 0.2 to 0.8 tillers 100 tillers−1day−1in March–April. In TW, tiller death began in October–November and increased from 0.6 to 0.8–1.0 tillers 100 tillers−1day−1from February to April. Defoliation of reproductive tillers affected the tiller density of TF plants in spring and in the following fall. In TW, the treatments did not modify the tiller density of the plants. The present work aimed to study the tiller demography of tall fescue (TF) and tall wheatgrass (TW) when reproductive tillers are removed at different stages of plant development. The results will help to improve management recommendations to obtain denser TF and TW swards.

Purpose: The purpose of this study was to create an air movement operations planning model to rapidly generate air mission request (AMR) assignment and routing courses of action (COA) in order to minimize unsupported AMRs, aircraft utilization and routing cost. Design/methodology/approach: In this paper, the US Army Aviation air movement operations planning problem is modeled as a mixed integer linear program (MILP) as an extension of the dial-a-ride problem (DARP). The paper also introduces a heuristic as an extension of a single-vehicle DARP demand insertion algorithm to generate feasible solutions in a tactically useful time period. Findings: The MILP model generates optimal solutions for small problems (low numbers of AMRs and small helicopter fleets). The heuristic generates near-optimal feasible solutions for problems of various sizes (up to 100 AMRs and 10 helicopter team fleet size) in near real time. Research limitations/implications: Due to the inability of the MILP to produce optimal solutions for mid- and large-sized problems, this research is limited in commenting on the heuristic solution quality beyond the numerical experimentation. Additionally, the authors make several simplifying assumptions to generalize the average performance and capabilities of aircraft throughout a flight. Originality/value: This research is the first to solve the US Army Aviation air movement operations planning problem via a single formulation that incorporates multiple refuel nodes, minimization of unsupported demand by priority level, demand time windows, aircraft team utilization penalties, aircraft team time windows and maximum duration and passenger ride time limits.

AbstractThe administration, uptake, and elimination of inhalant anesthetics is a challenging topic in the veterinary curriculum, and lecture-based learning is often insufficient to ensure that students understand these concepts. We hypothesized that the use of an interactive electronic book (e-book) would enhance student comprehension of the material. Two sequential Doctorate of Veterinary Medicine student cohorts participated in a prospective controlled study. The first cohort received traditional lecture-based learning while the second cohort was taught the topic using an interactive e-book. Student comprehension of the material was assessed twice during the course via multiple-choice questions: five questions in a midcourse quiz and seven within the final exam. At the end of the course, students also completed a Likert survey assessing their confidence regarding the topic. Averaged across assessment types, students taught using the interactive e-book scored higher than those taught via the traditional method (p< .001). Final exam scores were significantly higher in the e-book cohort compared with the lecture-based cohort (p< .001). However, there was no difference in quiz scores between groups (p= .109). No significant difference was found between groups in responses to the Likert survey. In conclusion, students using the interactive e-book had better comprehension of the material than students in the traditional lecture group as measured by their scores on multiple-choice question assessments. Future studies are needed to determine whether this advantage persists later in the curriculum when students apply these concepts in the clinical year.

The ozone air quality standard is regularly surpassed in the Los Angeles air basin, and efforts to mitigate ozone production have targeted emissions of precursor volatile organic compounds (VOCs), especially from mobile sources. In order to assess how VOC concentrations, emissions, and chemistry have changed over the past decade, VOCs were measured in this study using a Vocus‐2R proton‐transfer reaction time‐of‐flight mass spectrometer in Pasadena, California, downwind of Los Angeles, in summer 2022. Relative to 2010, ambient concentrations of aromatic hydrocarbons have declined at a similar rate as carbon monoxide, suggesting reduced overall emissions from mobile sources. However, the ambient concentrations of oxygenated VOCs have remained similar or increased, suggesting a greater relative importance of oxidation products and other emission sources, such as volatile chemical products whose emissions are largely unregulated. Relative to 2010, the range of measured VOCs was expanded, including higher aromatics and additional volatile chemical products, allowing a better understanding of a wider range of emission sources. Emission ratios relative to carbon monoxide were estimated and compared with 2010 emission ratios. Average measured ozone concentrations were generally comparable between 2022 and 2010; however, at the same temperature, daytime ozone concentrations were lower in 2022 than 2010. Faster photochemistry was observed in 2022, with average hydroxyl radical exposure being ∼68% higher during midday (statistically significant at 95% confidence), although this difference reduces to ∼35% when comparing observations at ambient temperatures of 25–30°C only. Future trends in temperature are important in predicting ozone production. Gas‐phase organic molecules are emitted from many sources including vegetation, cars, cooking, industries, and chemical products (paints, inks, pesticides, deodorant, shampoo, etc.), among others. These emissions oxidize in the atmosphere and contribute to the formation of particles and ozone, which are harmful to human health. To improve air quality, the behavior of these molecules in the atmosphere must be understood, and their sources must be identified, before effective emission reduction policies can be established. In summer 2022, we measured atmospheric concentrations of such molecules in Pasadena, California, downwind of Los Angeles, California, to investigate fresh, unreacted emissions as well as aged, oxidized emissions. Compared to similar measurements made in 2010, emissions from vehicle sources appear to have declined while chemical products have become relatively more important. Atmospheric oxidation of these emissions also appears to have increased relative to 2010, in part due to higher average temperatures and related meteorology. Despite reduced emissions from vehicles, unregulated emissions from chemical products and faster oxidation yielded similar concentrations of secondary products such as ozone. Future air quality improvements will likely require further emission reductions, particularly for chemical products, and such improvements may be offset by rising temperatures due to climate change. Concentrations of aromatic hydrocarbons in Los Angeles have declined since 2010 while those of oxygenated volatile organic compounds (VOCs) are similar or higherMidday photochemistry was ∼68% faster in 2022 than 2010 possibly due to higher average temperatures and changes in the NOx‐VOC regimeOzone concentrations were similar between 2010 and 2022 due to the combination of changes in emissions, photochemistry, and meteorology Concentrations of aromatic hydrocarbons in Los Angeles have declined since 2010 while those of oxygenated volatile organic compounds (VOCs) are similar or higher Midday photochemistry was ∼68% faster in 2022 than 2010 possibly due to higher average temperatures and changes in the NOx‐VOC regime Ozone concentrations were similar between 2010 and 2022 due to the combination of changes in emissions, photochemistry, and meteorology

The definitions of temporal instability and of spatial instability in a flow system are comparatively surveyed. The simple model of one-dimensional Burgers’ flow is taken as the scenario where such different conceptions of instability are described. The temporal analysis of instability stems from Lyapunov’s theory, while the spatial analysis of instability interchanges time and space in defining the evolution variable. Thus, the growth rate parameter for temporally unstable perturbations of a basic flow state is to be replaced by a spatial growth rate when a coordinate assumes the role of evolution variable. Finally, the idea of spatial instability is applied to a Rayleigh-Bénard system given by a fluid-saturated horizontal porous layer with an anisotropic permeability and impermeable boundaries kept at different uniform temperatures.

Host factors that mediate Leishmaniagenetic exchange are not well defined. Here we demonstrate that natural IgM (IgMn)1–4antibodies mediate parasite genetic exchange by inducing the transient formation of a spherical parasite clump that promotes parasite fusion and hybrid formation. We establish that IgMn from Leishmania-free animals binds to the surface of Leishmaniaparasites to induce significant changes in the expression of parasite transcripts and proteins. Leishmaniabinding to IgMn is partially lost after glycosidase treatment, although parasite surface phosphoglycans, including lipophosphoglycan, are not required for IgMn-induced parasite clumping. Notably, the transient formation of parasite clumps is essential for Leishmaniahybridization in vitro. In vivo, we observed a 12-fold increase in hybrid formation in sand flies provided a second blood meal containing IgMn compared with controls. Furthermore, the generation of recombinant progeny from mating hybrids and parental lines were only observed in sand flies provided with IgMn. Both in vitro and in vivo IgM-induced Leishmaniacrosses resulted in full genome hybrids that show equal patterns of biparental contribution. Leishmaniaco-option of a host natural antibody to facilitate mating in the insect vector establishes a new paradigm of parasite–host–vector interdependence that contributes to parasite diversity and fitness by promoting genetic exchange.

An upper bound on the capacity of multiple-input multiple-output (MIMO) Gaussian fading channels is derived under peak amplitude constraints. The upper bound is obtained borrowing concepts from convex geometry and it extends to MIMO channels notable results from the geometric analysis on the capacity of scalar Gaussian channels. Relying on a sphere packing argument and on the renowned Steiner’s formula, the proposed upper bound depends on the intrinsic volumes of the constraint region, i.e., functionals defining a measure of the geometric features of a convex body. The tightness of the bound is investigated at high signal-to-noise ratio (SNR) for any arbitrary convex amplitude constraint region, for any channel matrix realization, and any dimension of the MIMO system. In addition, two variants of the upper bound are proposed: one is useful to ensure the feasibility in the evaluation of the bound and the other to improve the bound’s performance in the low SNR regime. Finally, the upper bound is specialized for two practical transmitter configurations, either employing a single power amplifier for all transmitting antennas or a power amplifier for each antenna.

Abstract:In the present essay, I examine religious conversion as anthropophagic practice in the early modern Kingdom of Kongo. Through a close analysis of primary sources, I focus on King Nzinga a Nkuwu's conversion to Christianity in 1491 and the subsequent transformation of European religious beliefs and practice within the kingdom. Unlike converts in most other areas of Africa (and Brazil), Bakongo elites accepted Christianity largely on their own terms, and this allowed them to adapt their new faith to autochthonous tradition. In order to describe this process of adaptation, I link Bakongo conversion to Oswald de Andrade's call for 'blood transfusers' in his Manifesto Antropófago. In the end, my goal is to offer a more detailed account of Bakongo conversion while extending anthropophagic concepts to early modern contexts not primarily defined by coloniality.Resumo:O meu objetivo neste ensaio é examinar a conversão religiosa como prática antropofágica no Reino do Kongo dos séculos XV–XVIII. Através de uma análise de fontes primárias, concentro-me na conversão ao cristianismo de Nzinga a Nkuwu em 1491 e a transformação das crenças e práticas religiosas europeias dentro do reino desde então. Ao contrário dos convertidos em muitas outras regiões de África (e no Brasil), as elites Bakongo adotaram o cristianismo substancialmente nos seus próprios termos, o que as permitiu adaptar a sua nova fé à tradição autóctone. Para descrever este processo de adaptação, relaciono a conversão Bakongo com o apelo oswaldiano aos 'transfusores de sangue' no Manifesto Antropófago. No fim, espero estender os conceitos antropofágicos aos contextos modernos não definidos primariamente pelo colonialismo.

NUT carcinoma (NC) is a rare subtype of squamous cell carcinoma defined by NUTM1rearrangements encoding NUT fusion oncoproteins (the most frequent fusion partner being BRD4) that carries a very poor prognosis, with most patients dying in under 1 year. Only rare primary thyroid NCs have been reported. Here, we evaluated a series of 14 cases. The median patient age at diagnosis was 38 years (range: 17 to 72 y). Eight of 13 cases with slides available for review (62%) showed a morphology typical of NC, whereas 5 (38%) had a non–NC-like morphology, some of which had areas of cribriform or fused follicular architecture resembling a follicular cell–derived thyroid carcinoma. For cases with immunohistochemistry results, 85% (11/13) were positive for NUT on biopsy or resection, though staining was significantly decreased on resection specimens due to fixation; 55% (6/11) were positive for PAX8, and 54% (7/13) for TTF-1. Tumors with a non–NC-like morphology were all positive for PAX8 and TTF-1. The fusion partner was known in 12 cases: 9 (75%) cases had a NSD3-NUTM1fusion, and 3 (25%) had a BRD4-NUTM1fusion. For our cohort, the 2-year overall survival (OS) was 69%, and the 5-year OS was 58%. Patients with NC-like tumors had a significantly worse OS compared with that of patients with tumors with a non–NC-like morphology (P=0.0462). Our study shows that NC of the thyroid can mimic other thyroid primaries, has a high rate of NSD3-NUTM1fusions, and an overall more protracted clinical course compared with nonthyroid primary NC.