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Background Popliteal artery aneurysms (PAAs) are relatively rare but are one of the most common peripheral arterial aneurysms. Open popliteal artery aneurysm repair (OPAR) has been the standard, but technological advancements have made endovascular popliteal artery aneurysm repair (EPAR) a promising alternative. The aim of this study is to compare EPAR and OPAR efficacy and outcomes over a 10-year period.Methods This study retrospectively reviewed 72 patient charts who were diagnosed with PAA or popliteal artery pseudoaneurysm and underwent EPAR or OPAR from 1 January 2010 to 31 December 2019. Endovascular popliteal artery aneurysm repair was used in 37 cases and OPAR in 35 cases.Results Graft patency <30 days postoperative was 100% in both EPAR and OPAR groups. Graft patency >90 days postoperative was 72.73% in the EPAR group and 82.35% in the OPAR group (p= 0.477). Graft patency >2 years postoperative was 81.25% in the EPAR group and 86.67% in the OPAR group (p= 0.682). Freedom from reoperation 30-day postoperative was 78.38% in the EPAR group and 80% in the OPAR group (p= 0.865). Freedom from amputation 30-day postoperative was 91.43% in the EPAR group and 94.29% in the OPAR group (p= 0.263). The 30-day survival rate was 94.59% in the EPAR group and 100% in the OPAR group.Conclusions Endovascular repair represents a promising alternative for PAA repair. Our results demonstrate that EPAR has similar outcomes for asymptomatic, acutely symptomatic, and chronic symptomatic patients. Technological advancements of stent properties and refinement of surgical techniques may further improve endovascular techniques.

IMPORTANCE: Intensive interventions are provided to young children with unilateral cerebral palsy (UCP), classically focused on the upper extremity despite the frequent impairment of gross motor function. Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) effectively improves manual dexterity and gross motor function in school-aged children. OBJECTIVE: To verify if HABIT-ILE would improve manual abilities in young children with UCP more than usual motor activity. DESIGN, SETTING, AND PARTICIPANTS: This prospective randomized clinical trial (November 2018 to December 2021), including 2 parallel groups and a 1:1 allocation, recruitment took place at European university hospitals, cerebral palsy specialized centers, and spontaneous applications at 3 sites: Brussels, Belgium; Brest, France; and Pisa, Italy. Matched (age at inclusion, lesion type, cause of cerebral palsy, and affected side) pairs randomization was performed. Young children were assessed at baseline (T0), 2 weeks after baseline (T1), and 3 months after baseline (T2). Health care professionals and assessors of main outcomes were blinded to group allocation. At least 23 young children (in each group) aged 12 to 59 months with spastic/dyskinetic UCP and able to follow instructions were needed. Exclusion criteria included uncontrolled seizures, scheduled botulinum toxin injections, orthopedic surgery scheduled during the 6 months before or during the study period, severe visual/cognitive impairments, or contraindications to magnetic resonance imaging. INTERVENTIONS: Two weeks of usual motor activity including usual rehabilitation (control group) vs 2 weeks (50 hours) of HABIT-ILE (HABIT-ILE group). MAIN OUTCOMES AND MEASURES: Primary outcome: Assisting Hand Assessment (AHA); secondary outcomes: Gross Motor Function Measure-66 (GMFM-66), Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT), and Canadian Occupational Performance Measure (COPM). RESULTS: Of 50 recruited young children (26 girls [52%], median age; 35.3 months for HABIT-ILE group; median age, 32.8 months for control group), 49 were included in the final analyses. Change in AHA score from T0 to T2 was significantly greater in the HABIT-ILE group (adjusted mean score difference [MD], 5.19; 95% CI, 2.84-7.55; P &lt; .001). Changes in GMFM-66 (MD, 4.72; 95% CI, 2.66-6.78), PEDI-CAT daily activities (MD, 1.40; 95% CI, 0.29-2.51), COPM performance (MD, 3.62; 95% CI, 2.91-4.32), and satisfaction (MD, 3.53; 95% CI, 2.70-4.36) scores were greater in the HABIT ILE group. CONCLUSIONS AND RELEVANCE: In this clinical trial, early HABIT-ILE was shown to be an effective treatment to improve motor performance in young children with UCP. Moreover, the improvements had an impact on daily life activities of these children. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04020354

Explaining how international institutions develop is the significant contribution of historical institutionalism (HI) to the study of contemporary world politics. HI offers two important concepts, critical juncture and path dependence, demonstrating dynamics within the institution, leading towards continuity and change. The case of the Association of Southeast Asian Nations (ASEAN) during the COVID-19 pandemic and the Myanmar democratic crisis tells us about the impact of the crucial moments on the regional organisation and its responses. Yet, ASEAN is resistant to change. What makes it possible is the question that cannot be answered by using the HI approach. Hence, we explain by employing a theoretical framework founded upon the link between diplomatic culture and institutional legitimacy, adopted from the English School (ES) theory of International Relations (IR). This article argues that ASEAN's diplomatic culture ensures member countrie’s compliance with the Association's code of conduct and prevents external power intrusion into Southeast Asian affairs and interests. Therefore, ASEAN's institutional legitimacy can be maintained. The Association deals with the critical juncture without undertaking any fundamental change.

L’édition des Recommandations de Bonnes Pratiques (RBP) fait suite à une demande réalisée auprès de la HAS par les personnes concernées par la paralysie cérébrale (PC). Les RBP soulignent la nécessité de mettre en œuvre un partenariat, mais en pratique il n’est pas toujours simple d’aboutir à une relation équilibrée entre personnes avec PC, leurs proches/aidants et les professionnels de rééducation. La co-détermination récurrente d’objectifs de qualité est cruciale afin de faciliter la mise en place des thérapies et d’assurer le maintien de la motivation et de l’engagement tout au long de la prise en charge. Dans cette perspective, les RBP apportent un éclairage pour sélectionner les moyens réadaptatifs constituant le plan d’action individualisé co-déterminé. Ainsi, en cas d’identification de facteurs de risque de troubles musculo-squelettiques secondaires, il est recommandé de proposer des postures passives nocturnes dans le but de prévenir et/ou retarder l’apparition de rétractions musculaires et de ne pas proposer d’étirements passifs chez les enfants et adolescents avec PC. Afin d’améliorer l’activité des membres supérieurs des personnes présentant une PC unilatérale ou bilatérale, les programmes de rééducation intensive, incluant les principes de l’apprentissage moteur et intégrant des interventions ciblant spécifiquement des objectifs fonctionnels de la vie quotidienne sont priorisés. Afin d’améliorer la fonction motrice globale des enfants avec PC, l’entraînement à la marche est préconisé. Enfin, il est recommandé de proposer des activités physiques et des activités sportives afin de prévenir la désadaptation à l’effort des enfants, adolescents et adultes avec PC. Les RBP de la HAS sont construites à partir des études issues de la littérature scientifique internationale. Ces études s’intéressent particulièrement aux enfants et adolescents ayant des atteintes motrices légères à modérées. La proposition de recommandations sur une population plus large n’est pour l’instant pas possible.

Chlorhexidine skin antisepsis is frequently recommended for most surgical procedures; however, it is unclear if these recommendations should apply to surgery involving traumatic contaminated wounds where povidone-iodine has previously been preferred. We aimed to compare the effect of aqueous 10% povidone-iodine versus aqueous 4% chlorhexidine gluconate on the risk of surgical site infection in patients who required surgery for an open fracture.

One of the key challenges for the development of perovskite solar cells lies in the approach toward large-scale fabrication of the active materials that allows for good photovoltaic performance, as well as facile handling. The electrodeposition technique can potentially address such requirements. However, the technique has yet to be investigated in detail and still suffers from low efficiency of the device. In this study, we sought to significantly upgrade the electrodeposition approach by coupling the technique with an external magnetic field in the preparation of high-quality PbI2 precursor layer and using Li-doped SnO2 electron transport layer. Our results showed that the magnetic field-assisted electrodeposition yielded good crystallinity of PbI2 and perovskite. Introducing the Li-doped mesoporous SnO2 into the device structure resulted in a higher current density of 18.50–18.80 mA cm-2, which can be attributed to, based on the linear sweep voltammetry, reduced resistance of the electron transport layer from 32.27 to 22.11 Ω cm-2. Moreover, the carbon-based device prepared using this simple procedure also yielded 5.20% in photoconversion efficiency for 1-cm2 active area and 0.45% for 25-cm2 active area, all without any significant hysteresis.

ObjectiveNutrition societies recommend using standardised parenteral nutrition (SPN) solutions. We designed evidence-based SPN formulations for neonates admitted to our neonatal intensive care unit (NICU) and evaluated their outcomes.DesignThis was a quality improvement initiative. Data were collected retrospectively before and after the intervention.SettingA tertiary-care level 3 NICU at the Aga Khan University in Karachi, Pakistan.PatientsAll NICU patients who received individualised PN (IPN) from December 2016 to August 2017 and SPN from October 2017 to June 2018.InterventionsA team of neonatologists and nutrition pharmacists collaborated to design two evidence-based SPN solutions for preterm neonates admitted to the NICU.Main outcome measuresWe recorded mean weight gain velocity from days 7 to 14 of life. The other outcomes were change in weight expressed as z-scores, metabolic abnormalities, PN-associated liver disease (PNALD), length of NICU stay and episodes of sepsis during hospital stay.ResultsNeonates on SPN had greater rate of change in weight compared with IPN (β=13.40, 95% CI: 12.02 to 14.79) and a smaller decrease in z-scores (p<0.001). Neonates in the SPN group had fewer hyperglycemic episodes (IPN: 37.5%, SPN: 6.2%) (p<0.001), electrolyte abnormalities (IPN: 56.3%, SPN: 21%) (p<0.001), PNALD (IPN: 52.5%, SPN: 18.5%) (p<0.001) and sepsis (IPN: 26%, SPN: 20%) (p<0.05). The median length of stay in NICU was 14.0 (IQR 12.0–21.0) for the IPN and 8.0 (IQR 5.0–13.0) days for the SPN group.ConclusionsWe found that SPN was associated with shorter NICU stay and greater weight gain. In-house preparation of SPN can be used to address the nutritional needs in resource-limited settings where commercially prepared SPN is not available.

Two-photon microscopy has enabled high-resolution imaging of neuroactivity at depth within scattering brain tissue. However, its various realizations have not overcome the tradeoffs between speed and spatiotemporal sampling that would be necessary to enable mesoscale volumetric recording of neuroactivity at cellular resolution and speed compatible with resolving calcium transients. Here, we introduce light beads microscopy (LBM), a scalable and spatiotemporally optimal acquisition approach limited only by fluorescence lifetime, where a set of axially separated and temporally distinct foci record the entire axial imaging range near-simultaneously, enabling volumetric recording at 1.41 × 108voxels per second. Using LBM, we demonstrate mesoscopic and volumetric imaging at multiple scales in the mouse cortex, including cellular-resolution recordings within ~3 × 5 × 0.5 mm volumes containing >200,000 neurons at ~5 Hz and recordings of populations of ~1 million neurons within ~5.4 × 6 × 0.5 mm volumes at ~2 Hz, as well as higher speed (9.6 Hz) subcellular-resolution volumetric recordings. LBM provides an opportunity for discovering the neurocomputations underlying cortex-wide encoding and processing of information in the mammalian brain.

ObjectiveCentral line associated bloodstream infection (CLABSI) is an important cause of morbidity and mortality in the neonatal intensive care unit (NICU). We designed a CLABSI Prevention Package (CPP) to decrease NICU CLABSI rates, using evidence-proven interventions.DesignThis was a quality improvement (QI) project. Data collection was divided into three phases (pre-implementation, implementation and post implementation). SQUIRE2.0 guidelines were used to design, implement and report this QI initiative.SettingA tertiary care level 3 NICU at the Aga Khan University Hospital (AKUH), Karachi, Pakistan.PatientsAll patients admitted to the AKUH NICU from 1 January 2016 to 31 March 2018 who had a central line in place during their NICU admission.InterventionsCPP used evidence-based interventions focusing on hand hygiene, aseptic central line insertion techniques and central line care, prevention of fungal infections and nurse empowerment.Main outcome measuresCLABSI rates pre and post intervention were recorded. Secondary outcomes were risk factors for CLABSI, device (central line) utilisation ratio, CLABSI related mortality and micro-organism profile.ResultsCLABSI rates decreased from 17.1/1000 device days to 5.0/1000 device days (relative risk (RR)=0.36, CI=0.17–0.74). Device (central line) utilisation ratio declined from 0.30 to 0.25. Out of 613 patients enrolled in our study, 139 (22.7%) died. Mortality was higher in CLABSI group (n=20, 44%) as compared with non CLABSI group (n=119, 21.1%) (p<0.001). Gestational age of <27 weeks was an independent risk factor for CLABSI (RR=4.45, CI=1.10–18.25, p=0.03). A total of 158 pathogens were isolated among which 68 were associated with CLABSI. Gram-negative bacteria 31 (47.7%) were the most common cause of CLABSI. Ninety-seven (61%) micro-organisms were multi-drug resistant.ConclusionsCPP was effective in decreasing NICU CLABSI rates and can be used as a model to decrease NICU CLABSI rates in low or middle-income countries.

In the psychological thriller film Joker,released in 2019 and starring Joaquin Phoenix in the first role, another possible origin story for this iconic character is reported. Above all, it brings us medical elements for the understanding of the development of this complex character. Contrary to other interpretations, we discover a lonely, timid and uncharismatic man (Arthur Fleck). He seems to be suffering from psychobehavioral disorders and seems depressed. There is a strangeness in his behavior along with social withdrawal. He suffers from fits of laughter that occur at socially inappropriate times. He also suffers from psychotic symptoms with visual delusions. We learn through the film that he was a beaten child, psychologically and physically abused with severe traumatic brain injury (TBI). The uncontrollable outbursts of laughter, behavioral and psychotic disorders followed these elements. As a neurologist, I was intrigued by these symptoms. I have explored the neuropsychiatric symptoms complicating TBI from which he seems to suffer and which have been reported in the literature. We can assume that the Joker is suffering from neuropsychiatric sequelae related to childhood TBI involving the frontotemporal regions and, in particular, the lateral aspect of the left frontal lobe. The movie Jokerhas medical significance and covers social aspects of medicine and health care. First, it allows us to discuss whether psychotic disorder due to TBI should be considered a neurobiological syndrome. More broadly, albeit fictitious, it asks us about the management of patients with neuropsychiatric illness, which is a public health problem. It also reminds us that semiological descriptions of patients with neuropsychiatric disorders have served as inspiration for many authors.

As companies increase their environmental, social, governance (ESG) reporting and statements in response to market and shareholder demands, plaintiffs have pursued with growing success legal challenges to company claims and disclosures related to ESG performance. Similarly, inventive theories are being put forward to directly attack companies for alleged ESG-related performance and operational deficiencies. In both arenas, there has been a recent growth in efforts to hold companies accountable for supplier misconduct. The expanding growing misstatement and performance litigation signals a rising need to carefully manage ESG programs, performance, and statements. [ABSTRACT FROM AUTHOR]

Objective:To determine whether use of absorbable antibiotic-imbued beads in chronic soft tissue wounds presents a viable therapeutic modality.Approach:Retrospective analysis of all cases utilizing calcium sulfate antibiotic beads was conducted. Cases comprised complex wound and breast reconstruction performed by the senior author (C.P.D.) over 4 years at the University of New Mexico Hospital. All-cause need for reoperation and reoperation for infection in the 90 days following bead-assisted surgery were compared to traditional surgical intervention in the 90-day period preceding bead-assisted surgery. Paired-samples t-test and corrected Cohen's dwere calculated for outcome significance and effect size.Results:A total of 60 patients underwent 84 bead-assisted surgeries. There was a significant decrease in rate of reoperation following bead surgery (M = 0.32) compared with prebead surgery (M = 2.2), p< 0.001. Rate of reoperation for infection significantly decreased from 1.7 before bead surgery to 0.05 following bead surgery, p< 0.001. Results remained significant when stratified by complex wound or breast reconstruction, p< 0.01. Cohen's dranged from 1.25 to 2.13, with probability of superiority between 80% and 93%.Innovation:Use of antibiotic-laden materials is well established in the orthopedic literature, but poorly characterized in soft tissue applications. Biofilms are increasingly implicated as a unifying pathologic foe underlying chronic wound infection and nonhealing. Antibiotic beads have demonstrated activity against biofilm in vitro. This study demonstrates diminished reoperative burden for these wounds following antibiotic bead surgery, possibly as a result of in vivobiofilm antagonism.Conclusion:Antibiotic bead-assisted surgery was associated with significantly decreased infectious and all-cause reoperations for chronic and infected wounds.

Supplemental digital content is available in the text.

Although research has shown interactions between the reproductive system and energy homeostasis, it is not clear how environmental or behavioral factors may factor into these associations. Here we aimed to determine how changes in reproductive state (i.e., phase of the menstrual cycle) and other behavioral and physiological factors may influence leptin levels in healthy women, as well as how sexual activity may play a role in leptin modulation. We collected serum and saliva from 32 healthy women and measured leptin, estradiol, and progesterone. Participants also completed surveys of demographics, health and sexual behaviors, and physical activity. Leptin was predicted by meals per day and missed meals at both menses and ovulation. However, estradiol and physical activity were stronger predictors of leptin at menses, while sexual activity was a stronger predictor of leptin at ovulation. These findings suggest that predictors of serum leptin, and possibly energy storage and expenditure, vary across the menstrual cycle.

Nitrogen- and oxygen-containing compounds were designed empirically and subsequently synthesized, and their rheology, friction, and wear performance as multifunctional base oils (MFBOs) were evaluated. Two of the compounds displayed good viscosity/rheology profiles without the addition of polymeric viscosity modifiers, displaying high viscosity indexes (VIs) above 200. Furthermore, all three MFBOs had lower coefficients of friction compared to well-established and accepted benchmarks. The most significant advancement is their impressive wear improvement by a factor of 5.5 to 70 compared to either of the benchmarks, which is attributed to the polar nature of the base oil which promotes boundary lubrication with metal surfaces. Moreover, these compounds were easily synthesized in one step from commercial starting materials. This work demonstrates that a careful design could provide the features/performance/functions of base oil, rheology modifiers (or VI improvers), and antiwear and friction-reducing additives, all-in one molecule.

Dispersion control is a critical functionality required in systems involving ultra-short (∼100  fs) pulses, and we demonstrate the use of chirped long-period fiber gratings for this purpose. The operation principles of this device share many attributes with the more established fiber Bragg grating technology for dispersion compensation, but with the added benefit of record low loss (0.2 dB) and the potential of being free from group-delay ripple distortions. The bandwidth of the transmissive grating device we demonstrate exceeds 12 nm, and it provides +52  fs/nm of dispersion in the 1 μm wavelength range. This corresponds to the capability of compensating the dispersion of ∼100  fs pulses in approximately meter-long single mode fibers.

Historically, the fields of ecoimmunology, psychoneuroimmunology and disease ecology have taken complementary yet disparate theoretical and experimental approaches, despite sharing critical common themes. Researchers in these areas have largely worked independently of one another to understand mechanistic immunological responses, organismal level immune performance, behavioral changes, and host and parasite/disease population dynamics, with few bridges across disciplines. Although efforts to strengthen and expand these bridges have been called for (and occasionally heeded) over the last decade, more integrative studies are only now beginning to emerge, with critical gaps remaining. Here, we briefly discuss the origins of these key fields, and their current state of integration, while highlighting several critical directions that we suggest will strengthen their connections into the future. Specifically, we highlight three key research areas that provide collaborative opportunities for integrative investigation across multiple levels of biological organization, from mechanisms to ecosystems: (1) parental effects of immunity, (2) microbiome and immune function and (3) sickness behaviors. By building new bridges among these fields, and strengthening existing ones, a truly integrative approach to understanding the role of host immunity on individual and community fitness is within our grasp.

Au cours des dernières décennies, les thérapies intensives se sont révélées efficaces pour améliorer la fonction motrice chez les enfants atteints de paralysie cérébrale (PC) en âge scolaire. Les évidences de l’efficacité de ces thérapies chez les jeunes enfants sont rares. Cette étude vise à déterminer si une intervention intensive axée sur les objectifs fonctionnels telle que la thérapie HABIT-ILE est efficace chez les enfants d’âge préscolaire (1 à 4 ans) atteints de PC unilatérale.

The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.

Compact and cost-effective systems for in vivofluorescence and near-infrared imaging in combination with activatable reporters embedded inside the skin to sample interstitial fluid or blood can enable a variety of biomedical applications. However, the strong autofluorescence of human skin creates an obstacle for fluorescence-based sensing. Here we introduce a method for quantitative fluorescence sensing through highly autofluorescent, scattering, and absorbing media. For this, we created a compact and cost-effective fluorescence microscope weighing <40 g and used it to measure various concentrations of a fluorescent dye embedded inside a tissue phantom, which was designed to mimic the optical characteristics of human skin. We used an elliptical Gaussian beam excitation to digitally separate tissue autofluorescence from target fluorescence, although they severely overlap in both space and optical spectrum. Using ∼10-fold less excitation intensity than the safety limit for skin radiation exposure, we successfully quantified the density of the embedded fluorophores by imaging the skin phantom surface and achieved a detection limit of ∼5 × 105and ∼2.5 × 107fluorophores within ∼0.01 μL sample volume that is positioned 0.5 and 2 mm below the phantom surface, corresponding to a concentration of 105.9 pg/mL and 5.3 ng/mL, respectively. We also confirmed that this approach can track the spatial misalignments of the mobile microscope with respect to the embedded target fluorescent volume. This wearable microscopy platform might be useful for designing implantable biochemical sensors with the capability of spatial multiplexing to continuously monitor a panel of biomarkers and chronic conditions even at patients’ home.

We demonstrate higher-order-mode (A_eff up to ∼2000  μm^2) propagation in a 100 μm outer diameter pure-silica fiber with a low-index polymer jacket commonly used for fiber laser pump guidance. This simple structure obviates the need for complex designs deemed necessary for realizing large-mode-area fibers. Modes ranging from HE_1,12 to HE_1,22 were found to propagate stably over 15 m in this fiber. The index step is approximately 4 times larger than that obtained with fluorine down doping; thus the fiber supports even higher-order modes, which may have implications for building rare-earth-doped fiber lasers or achieving enhanced dispersion tunability for high-energy fiber nonlinear phenomena.

Little is known about water movement, volume, or residence time (RT), and how those characteristics affect sediment trapping efficiency (TE) and dissolved oxygen concentrations (DO) in the United States' largest remaining bottomland hardwood swamp, the Atchafalaya River Basin. To better understand these dynamics, this study used bathymetry, lidar, and stage records to determine volumes in the Basin's hydrologically distinct water management units (WMUs). Discharge measurements determined flow distribution and RT. Residence time was compared with DO to identify conditions that coincided with DO increases or decreases. Suspended sediment concentrations (SSC) were used to determine TE relative to calculated and measured discharge and RT. Discharge through units (85–2,200 m3/s) and RT (0.37–231 d) depended on connectivity and river stage. At high stages, with water temperatures >20°C, DO in the largest WMU declined by −0.21 mg/l/day. DO trends indicated less well‐connected areas of the WMU contributed hypoxic waters as the flood wave lengthened and stages fell. In the two WMUs examined for TE, TE (−266% to 99% and up to 38 Gg/day) correlated with hydrologic connectivity, SSC, RT, water volume, and, in one WMU, discharge losses. Long RT and high TE indicated a high potential to process nutrients. These relationships varied among WMUs. Large volumes of sediment‐laden water moving over the floodplain combined with long RT, high TE, and hypoxia indicate that this ecosystem has continental‐scale importance in reducing nutrient loads to the northern Gulf of Mexico. Reports from other systems suggest similar processes may be operating on other large river floodplains globally. The Atchafalaya Basin is the largest floodplain wetland in the lower United States and the last floodplain interaction of the Mississippi/Atchafalaya River (AR) system before entering the estuaries of the Gulf of Mexico. This study examined the distribution and duration of water on the floodplain of the AR Basin over a range of discharges from normal low water to a normal flood. Large volumes of water moved across the floodplain, carrying and depositing large masses of sediment and nutrients at high flows but exported sediment during low flows. Small inputs of water relative to floodplain volume indicated a high potential to reduce nutrient delivery to the Gulf of Mexico. Oxygen data indicated pockets of poorly connected water were present across the floodplain and contributed to low water oxygen. High water levels on the floodplain could not maintain oxygen levels during the late spring through summer when water temperatures were high. Because of the large amount of flow, sediment, and associated nutrients, the AR Basin is likely important at the continental scale for the reduction of nutrients delivered to the Gulf of Mexico. Reports from other large systems suggest that similar processes are likely occurring on large coastal floodplains around the world. Residence times calculated from previous studies of the Atchafalaya River are accurate but do not reflect the conditions on the floodplain of the Atchafalaya River BasinFloodplain interactions in the Atchafalaya River Basin are not well represented by main stem river channel samplingThe Atchafalaya River Basin is likely of continental‐scale importance for nutrient trapping Residence times calculated from previous studies of the Atchafalaya River are accurate but do not reflect the conditions on the floodplain of the Atchafalaya River Basin Floodplain interactions in the Atchafalaya River Basin are not well represented by main stem river channel sampling The Atchafalaya River Basin is likely of continental‐scale importance for nutrient trapping

Lifetime-based oxygen imaging is useful in many biological applications but instrumentation can be stationary, expensive, and complex. Herein, we present a portable, cost effective, simple alternative with high spatiotemporal resolution that uses a complementary metal oxide silicon (CMOS) camera to measure oxygen sensitive lifetimes on the millisecond scale. We demonstrate its compatibility with difluoroboron β-diketonate poly(lactic acid) (BF2bdkPLA) polymers which are nontoxic and exhibit long-lived oxygen sensitive phosphorescence. Spatially resolved lifetimes of four BF2bdkPLA variants are measured using nonlinear least squares (NLS) and rapid lifetime determination (RLD) both of which are shown to be accurate and precise. Real-time imaging in a dynamic environment is demonstrated by determining lifetime pixel-wise. The setup costs less than $5000, easily fits into a backpack, and can operate on battery power alone. This versatility combined with the inherent utility of lifetime measurements make this system a useful tool for a wide variety of oxygen sensing applications. This study serves as an important foundation for the development of dual mode real time lifetime plus ratiometric imaging with bright, long lifetime difluoroboron β-diketonate probes.

I read the article by Coolen et al.1with interest. The wide range of manifestations of the coronavirus disease 2019 (COVID-19) pandemic is not yet known. In their article, Coolen et al. reported 2 patients presenting with subcortical micro- and macrobleeds, 1 patient with cortico-subcortical edematous changes evocative of PRES, and the last patient presenting with nonspecific deep white matter changes. Multiple neuroradiologic patterns attributable to the coronavirus have been reported.2,3Recently, various cerebral hemorrhagic disorders have been reported, including both intraparenchymal hemorrhages and diffuse microhemorrhages of the white matter. Extensive and isolated white matter microhemorrhages are found in patients hospitalized in intensive care units for various causes.4Regarding PRES, it has been suggested that SARS-CoV-2 could act as a triggering factor for the development of rapid autoimmune and/or autoinflammatory dysregulation and lead to the endothelial dysfunction. The neuropathologic findings from the autopsies of 18 patients with COVID-19 infection from a recent article showed only hypoxic changes and did not show encephalitis or other specific brain changes referable to the virus.5Considering this, the radiologic abnormalities reported by the authors do not appear to be related to encephalitis or vasculitis due to coronavirus but appear to be related to hypoxemia or autoinflammatory dysregulation.

At the initiation of the COVID-19 pandemic, restrictions forced researchers to decide whether to continue their ongoing clinical trials. The PREPARE (Pragmatic Randomized Trial Evaluating Pre-Operative Alcohol Skin Solutions in Fractured Extremities) trial is a pragmatic cluster-randomized crossover trial in patients with open and closed fractures. PREPARE was enrolling over 200 participants per month at the initiation of the pandemic. We aim to describe how the COVID-19 research restrictions affected participant enrollment.

Burn injuries are thought to be preventable but are still a prevalent global health problem, especially in low- and middle-income countries. It continues to remain a leading cause of morbidity and mortality in Ethiopia. Proper knowledge about burn first aid minimizes the overall impact of the injury.

Nonlinear frequency mixing as a means to coherently convert light to new frequencies is widely used in many branches of optics. This process requires momentum conservation through phase matching (PM). In free-space optics, PM is achieved through angle tuning the medium with respect to the incoming light—here we explore an in-fiber analogue: PM using spatial modes of the fiber. We demonstrate over two octaves (400–1700 nm) of coherent spectral translation generated by intermodal four-wave mixing between subsets of 11 different Bessel-like fiber modes. These interactions are facilitated by the unique mode-coupling resistance of this subset of azimuthally symmetric, zero orbital angular momentum fiber modes. Their stability allows overcoming previous limitations of multimode nonlinear-optical systems imposed by mode coupling, hence enabling long interaction lengths, large effective mode areas, and a highly multimode basis set with which a new degree of freedom for versatile PM can be obtained.

The Railton Community Assessment Project constituted a community-based, participatory form of research that sought to identify community needs and assets for the purposes of prioritising actions to support community development planning and funding allocation in a local community in a South African rural context. The research design, which included 11 research phases, each including a number of research activities, was collaboratively developed and implemented collectively. The design included the establishment of a collaborative planning and accountability forum; interviews with key informants; a stratified household survey; community asset-mapping workshops with youth, adults, elders, and services providers; and community feedback processes. The findings of the research highlighted a number of community assets and needs which were directly linked to the identification of priority actions and recommendations by the community. The major strength of this study was its successful application of a Community-Based Participatory Research approach, which constitutes a particular focus for this article. Furthermore, this case study provides a useful example of how psychologists can contribute their knowledge and skills to promote general community well-being.

Fiber-optic parametric wavelength conversion (PWC) below the zero-dispersion wavelength of silica is typically constrained by the requirement of a small, tightly confined mode with anomalous dispersion to achieve phase matching. This limits the ability to power scale PWC at arbitrary wavelengths. However, the constraint is lifted for higher-order modes. We demonstrate PWC in the 1 μm band via degenerate four-wave mixing pumped in a large effective area (>600  μm^2) LP_0,7 mode of a double-clad fiber. We obtain up to 25% conversion in to the Stokes line with 0.5 ns pump pulses, corresponding to ∼20  kW peak power at the converted wavelength.

The World Heritage site of the Mogao Grottoes near Dunhuang is China's preeminent ancient Buddhist site on the Silk Road. It flourished between the fourth and the fourteenth centuries and comprises some 492 cave temples with wall paintings and sculpture. The Getty Conservation Institute has been working with the Dunhuang Academy since 1989 on site conservation and management using guidelines, the Principles for the Conservation of Heritage Sites in China, that were developed at the national level. Elements of the successful twenty-year collaboration are discussed in the context of the conservation and management challenges faced at the site and the projects developed to address them, including conservation of the wall paintings in Cave 85, a late Tang dynasty cave with extensive deterioration induced by salts derived from the underlying rock; and visitors to the site, who have increased rapidly since the site was opened in 1979.

The article presents an update to the California's Mechanic's Lien Law, a law which provides priority of rights under the California Constitution and the California Civil Code for those who improve real property. It analyzes the effect of new changes on contractors, laborers and suppliers. It discusses the anticipated effect of new changes on the treatment of liens in the bankruptcy courts. It informs about the amendments to the California's Bankruptcy Code, Sections 362(b) and 546(b).

ABSTRACTAccurate and rapid diagnosis of malaria infections is crucial for implementing species-appropriate treatment and saving lives. Molecular diagnostic tools are the most accurate and sensitive method of detecting Plasmodium, differentiating between Plasmodiumspecies, and detecting subclinical infections. Despite available whole-genome sequence data for Plasmodium falciparumand P. vivax, the majority of PCR-based methods still rely on the 18S rRNA gene targets. Historically, this gene has served as the best target for diagnostic assays. However, it is limited in its ability to detect mixed infections in multiplex assay platforms without the use of nested PCR. New diagnostic targets are needed. Ideal targets will be species specific, highly sensitive, and amenable to both single-step and multiplex PCRs. We have mined the genomes of P. falciparumand P. vivaxto identify species-specific, repetitive sequences that serve as new PCR targets for the detection of malaria. We show that these targets (Pvr47 and Pfr364) exist in 14 to 41 copies and are more sensitive than 18S rRNA when utilized in a single-step PCR. Parasites are routinely detected at levels of 1 to 10 parasites/µl. The reaction can be multiplexed to detect both species in a single reaction. We have examined 7 P. falciparumstrains and 91 P. falciparumclinical isolates from Tanzania and 10 P. vivaxstrains and 96 P. vivaxclinical isolates from Venezuela, and we have verified a sensitivity and specificity of ~100% for both targets compared with a nested 18S rRNA approach. We show that bioinformatics approaches can be successfully applied to identify novel diagnostic targets and improve molecular methods for pathogen detection. These novel targets provide a powerful alternative molecular diagnostic method for the detection of P. falciparumand P. vivaxin conventional or multiplex PCR platforms.

Systemic lupus erythematosus (SLE), an inflammatory rheumatic disease characterized by autoantibody production and diverse clinical manifestations, disproportionately affects vulnerable groups women, racial and ethnic minorities, the poor and those lacking medical insurance and education. We summarize the current knowledge of the disparities observed in SLE and highlight recent research that aims to dissect the causes of these disparities and identify the potentially modifiable factors contributing to them.

This article provides an introduction to magnetic material properties and an overview of compact permanent magnet designs. The descriptions are focused on portable magnetic resonance instruments, including inmagnet and open configurations. A few examples are presented for spectroscopy as well as for spaceresolved and relaxation measurements. © 2009 Wiley Periodicals, Inc. Concepts Magn Reson Part A 34A: 48–59, 2009.

Spectroscopic imaging of a sample placed outside of both the radio frequency and the imaging gradient coils is presented. The sample is placed in a field with a permanent one‐dimensional inhomogeneity. The imaging gradients used for phase encoding are designed to produce a static field that depends only on the transverse direction, uncoupling the effects associated with the single‐sided nature of these coils. Two‐dimensional imaging coupled with chemical shift information is obtained via the ex situ matching technique. Open‐saddle geometry is used to match the static field profile for chemical shift information recovery. © 2006 Wiley Periodicals, Inc. Concepts Magn Reson Part B (Magn Reson Engineering) 29B:137–144, 2006