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Jeffrey Abramowitz spent 20 years as an attorney in Philadelphia, working his way up to senior partner at a law firm in the heart of the city. Then, a series [...]

Logan Mcintosh, a communications specialist at T-Mobile, and her husband, a Green Beret in the U.S. Army, were given about three weeks to relocate from the Seattle area to State [...]

Over the last several years, I have been asked by various audiences--basic course students, graduate course students, fellow faculty at The Judge Advocate General's Legal Center and School (TJAGLCS)--for advice [...]

JP Morgan Chase & Company, Boston Scientific Corp., T-Mobile, and two Ben & Jerry's shops in Nashville, Tenn. These businesses may seem to be an unlikely grouping, but they share [...]

Leaders in the public library field encounter myriad intricate challenges that demand skillful navigation. Librarians in leadership roles often face a diverse range of difficulties, from grappling with limited resources [...]

About 27% of U.S. workers quit their jobs in 2023, costing employers nearly a trillion dollars to replace them, according to Work Institute, a research and consulting firm in Franklin, [...]

INTRODUCTION 129 I. A "TOTALLY DIFFERENT SYSTEM OF JURISPRUDENCE"? 132 II. RISING CONTRADICTIONS 137 III. JUDICIAL DEFERENCE TO MILITARY DISTINCTIVENESS: PLACING THE EMPHASIS ON "MILITARY" IN MILITARY JUSTICE 142 A. [...], The Supreme Court's 2020 landmark decision in Ramos v. Louisiana finally confirmed that the Fourteenth Amendment incorporates the Sixth Amendment's guarantee of unanimous verdicts in criminal jury trials against States, ending the last vestiges of Jim Crow-era juror racial disenfranchisement remaining in two States' criminal procedures. It was not a shocking decision, and it was well past due: 400 years of common law practice reflected in the laws of forty-eight States and the Federal Rules of Criminal Procedure already required unanimous guilty verdicts, along with thirteen prior Court decisions validating this fundamental attribute of jury fact-finding. Nevertheless, one holdout remains: it is a niche federal jurisdiction that tries cases nationwide and in foreign countries, makes no distinction between misdemeanor and felony offenses, and invests many prosecutorial and some judicial powers in lay officials by virtue of their relative employment seniority and positional authority. Our lone holdout is the military justice system--erected under federal law and managed byboth civilian and uniformed elements of the Executive Branch. Ramos did not--indeed, no Supreme Court decision has--determined the constitutionality of this court-martial procedural rule. No matter one's understanding of military justice's purpose, this procedural rule stands out. But depending on that understanding, it stands out as either a necessary idiosyncrasy of a necessarily idiosyncratic system or as an unnecessary anachronism of an increasingly civilian due-process-driven system. The dominate reason for this single outlier is best understood as a combination of long-entrenched theories. First, that military courts-martial are implicitly excepted from the demands of the Sixth Amendment's jury requirement because they are explicitly excepted from the grand jury requirement of the Fifth Amendment and, in general, from Article III. Second, that Congressional determinations of what "military necessity " requires, even in its justice system and over questions of due process, should be given strong deference by the courts. This Article suggests that Congress can and should amend the Uniform Code of Military Justice ("UCMJ") to conform how its jury-like "panels" determine guilt of an accused with every other American jurisdiction. Squaring a circle this is not. No drastic reinterpretation of the Court's Sixth Amendment-as-applied-in-the-military need take place, and the argument that follows assumes that current doctrine regarding the military's carve-out from the jury requirement remains static. Instead, Ramos provides the Court's latest validation of this protection s worth, and it should be read in light of the 2018 decision in Ortiz v. United States, in which the Court articulated a new "civilianized" vision of what military justice's primary purpose actually is. While departing from its previous descriptions of the character of military law, the Court nonetheless is now consistent with the overall arc of due process evolution required by Congress in the last seventy years of amendments to the UCMJ. Congress can now turn to Ramos and Ortiz as principled justifications for a belief that any distinction made between the Sixth Amendment right to an impartial jury (which service members do not have) and the statutory right to an impartial panel (which service members do have) is a distinction without a difference when it comes to unanimity of guilty verdicts.

I'm going to tell them that I'm gay, thought Jeff Nally, SHRM-SCP, as he neared the final step in the hiring process for a job he really wanted. It was [...]

Objective: To advance equity by developing stakeholder-driven principles of shared measurement, which is using a common set of measurable goals that reflect shared priorities across communities and systems, such as health care, public health, and human and social services. Data Sources: From October 2019 to July 2021, we collected primary data from leaders in cross-systems alignment, measurement, and community engagement-including community members and community-based organization leaders-across the United States. Study Design: In partnership with equity and community engagement experts, we conducted a mixed-methods study that included multiple formative research activities and culminated in a six-week, stakeholder-engaged modified-Delphi process. Data Collection: Formative data collection occurred through an environmental scan, interviews, focus groups, and an online survey. Principles were developed using a virtual modified Delphi with iterative rapid-analysis. Feedback on the final principles was collected through virtual focus groups, an online feedback form, and during virtual presentations. Principal Findings: We developed a set of five guiding principles. Measurement that aligns systems with communities toward equitable outcomes: (1) Requires upfront investment in communities; (2) Is co-created by communities; (3) Creates accountability to communities for addressing root causes of inequities and repairing harm; (4) Focuses on a holistic and comprehensive view of communities that highlights assets and historical context; and (5) Reflects long-term efforts to build trust. Using an equity-focused process resulted in principles with broad applicability. Conclusions: Leaders across systems and communities can use these shared measurement principles to reimagine and transform how systems create equitable health by centering the needs and priorities of the communities they serve, particularly communities that historically have been harmed the most by inequities. Intentionally centering equity across all project activities was essential to producing principles that could guide others in advancing equity. KEYWORDS community health, community participation, Delphi technique, health equity, intersectoral collaboration, measurement, social determinants of health What is known on this topic * Achieving health equity requires creating aligned systems that work together with communities to meet their goals and needs. * A shared measurement system is essential to align efforts around outcomes, evaluate collective progress, improve the quality and credibility of data, and reduce costs associated with collecting and reporting data. What this study adds * Building shared measurement into systems' structure enables sustained progress toward equitable outcomes through redistribution of power, building partnerships, creating accountability to communities, and facilitating co-learning. * Five guiding principles show how community members, community-based organizations, system leaders, service providers, and policy makers can use shared measurement to align decisions, policies, and practices toward equitable health and well-being. * We found that how we approached the work--with the intention of centering equity across all project activities--was essential to producing principles that could themselves guide others in advancing equity., 1 | INTRODUCTION Achieving lasting and meaningful improvements in individual and population health requires aligning efforts across various systems--organizations, programs, and activities--within communities that directly influence the health and well-being [...]

Technology has been the main catalyst of change for the recruiting profession in recent decades, elevating talent acquisition practitioners from transactional order fillers to strategic business partners. And while talent [...]

HANAN SCHLESINGER, an Orthodox rabbi who lives on the West Bank, is director of international relations for Roots/Shorashim/Judur, which he cofounded with Ali Abu Awwad and Shaul Judelman. Since 2014, [...]

The remote-work revolution dramatically altered many aspects of the employment experience, but onboarding is not one of them. The fundamentals and objectives of onboarding remain crucial to successfully integrating new [...]

Recent introduction of 2 different lymphoma classifications has raised concerns about consistency in diagnosis, management, and clinical trial enrollment. Data from a large cohort reflecting real-world clinical practice suggest that differences between the classifications will affect <1% of non-Hodgkin lymphomas.

A subunit of factor XIII (FXIII-A) contains a unique activation peptide (AP) that protects the catalytic triad and prevents degradation. In plasma, FXIII is activated proteolytically (FXIII-A*) by thrombin and Ca2+cleaving AP, while in cytoplasm, it is activated nonproteolytically (FXIII-A°) with increased Ca2+concentrations. This study aimed to elucidate the role of individual parts of the FXIII-A AP in protein stability, thrombin activation, and transglutaminase activity. Recombinant FXIII-A AP variants were expressed, and SDS-PAGE was used to monitor thrombin hydrolysis at the AP cleavage sites R37–G38. Transglutaminase activities were assessed by cross-linking lysine mimics to Fbg αC (233–425, glutamine–substrate) and monitoring reactions by mass spectrometry and in-gel fluorescence assays. FXIII-A AP variants, S19P, E23K, and D24V, degraded during purification, indicating their vital role in FXIII-A2stability. Mutation of P36 to L36/F36 abolished the proteolytic cleavage of AP and thus prevented activation. FXIII-A N20S and P27L exhibited slower thrombin activation, likely due to the loss of key interdomain H-bonding interactions. Except N20S and P15L/P16L, all activatable FXIII-A* variants (P15L, P16L, S19A, and P27L) showed similar cross-linking activity to WT. By contrast, FXIII-A° P15L, P16L, and P15L/P16L had significantly lower cross-linking activity than FXIII-A° WT, suggesting that loss of these prolines had a greater structural impact. In conclusion, FXIII-A AP residues that play crucial roles in FXIII-A stability, activation, and activity were identified. The interactions between these AP amino acid residues and other domains control the stability and activity of FXIII.

Patients with chronic critical illness (CCI) represent a particularly vulnerable patient population with significant quality-of-life consequences and a need for follow-up care. Existing research on their quality-of-life trajectory and outpatient follow-up care is limited.

The research borehole Schneidlingen 1/2018 was drilled in the southern Egeln Syncline at the end of August to the beginning of September 2018. It was terminated at 70 m final depth and provided a complete core of the marine stratigraphic sequence from the Silberberg Formation over the Rupelian Basal Sand to the lower 15 m of the Rupelton Formation. The borehole was geophysically logged. This paper deals with the lithological profile documentation, the sampling, the geophysics and the results of the biostratigraphical investigations. The investigations confirm the presence of two parasequences in the Silberberg Formation (Latdorfian) as well as the transition from the nannoplankton zone NP21 into NP22 at the top of the Silberberg Formation. For the first time, a complete profile of the Silberberg Formation could be examined for pteropods by high resolution sampling. Especially the Creseis mass occurrences allow a very precise basin-wide correlation. The extraordinarily glauconite-rich, often intensely green Rupelian Basal Sand is completely decalcified and did not yield any biostratigraphically relevant fossils. Nannoplankton of zone NP23 was found in the Rupelian Clay Formation. The mollusc and fish fauna is characteristic for the early Rupelian reg.

The article explores the distinctions between mental health and wellbeing, emphasizing that good mental health involves more than just the absence of mental illness. Topics include performance anxiety, perfectionism, and impostor syndrome, along with their triggers and glimmers, which represent coping strategies. By addressing these issues openly, it advocates for creating a supportive community for musicians to enhance their mental health and overall wellbeing.

The article focuses on how Maker Education can be effectively integrated into inclusive schooling, emphasizing the design principles that enable students to thrive in Makerspaces. Topics include the four principles of inclusion (availability, accessibility, acceptability, adaptability), the significance of fostering diverse learning styles and perspectives, and creation of a supportive environment where all students feel valued and can express their needs without fear of discrimination.

The article focuses on the principles of a making-oriented teaching approach that promotes learner autonomy and emphasizes creating supportive learning environments without overwhelming structure. Topics include the importance of diverse learning spaces for problem-solving, the Mindset-Skillset-Toolset model that enhances creative and technical skills in making processes, and various types of making activities that foster innovation and student engagement in project-based learning.

Rare donor programs are critically important for those patients with rare phenotypes who have produced the associated alloantibodies that necessitate the provision of rare blood components. We describe the American Rare Donor Program (ARDP) and its establishment, members, and policies. The specific phenotypes meeting the ARDP criteria for inclusion are described. Data on the number of rare donors registered by year, and the number of requests for rare blood components received and fulfilled over the 25 years of the program (1998–2023) are provided, along with a description of some notable cases and discussion of how the program supports patients with sickle cell disease.

IMPORTANCE: Treating patients with chronic urticaria using omalizumab has been shown to be safe and effective in randomized clinical trials. Multinational studies on long-term omalizumab performance in chronic urticaria in clinical practice settings are lacking, especially on drug survival. Drug survival, which refers to the length of time that patients are treated with a specific drug, is a comprehensive outcome covering effectiveness, safety, and patient and physician preferences. Furthermore, little is known about the reasons and potential predictors for omalizumab discontinuation. OBJECTIVE: To investigate omalizumab drug survival as well as reasons and potential predictors for discontinuation in a large, diverse population. DESIGN, SETTING, AND PARTICIPANTS: This international multicenter cohort study was conducted at 14 Urticaria Centers of Reference and Excellence in 10 countries, including all patients with chronic urticaria from these centers who were ever treated with omalizumab. MAIN OUTCOMES AND MEASURES: Drug survival analysis was performed to assess time to discontinuation. Patient characteristics and treatment protocols were investigated by Cox regression analysis to identify potential predictors for omalizumab discontinuation. RESULTS: In 2325 patients with chronic urticaria who started omalizumab between June 2009 and July 2022, the mean (SD) age of the cohort was 42 (6) years, and 1650 participants (71%) were female. Overall omalizumab survival rates decreased from 76% to 39% after 1 to 7 years, respectively (median survival time, 3.3 [95 % CI, 2.9-4.0] years), primarily due to discontinuation from well-controlled disease in 576 patients (65%). Ineffectiveness and adverse effects were reasons for discontinuation in a far smaller proportion of patients, totaling 164 patients (18%) and 31 patients (4%), respectively. Fast treatment response was associated with higher rates of omalizumab discontinuation due to well-controlled disease (hazard ratio, 1.45 [95% CI, 1.20-1.75]), and disease duration of more than 2 years was associated with lower rates of discontinuation due to well-controlled disease (HR, 0.81 [95% CI, 0.67-0.98]). Immunosuppressive cotreatment at the start of omalizumab and autoimmune disease was associated with a higher risk for discontinuation due to ineffectiveness (HR, 1.65 [95% CI, 1.12-2.42]). The presence of spontaneous wheals (HR, 0.62 [95% CI, 0.41-0.93]) and access to higher dosages (HR, 0.40 [95% CI, 0.27-0.58) were both associated with a lower risk for discontinuation of omalizumab due to ineffectiveness. CONCLUSION AND RELEVANCE: This multinational omalizumab drug survival cohort study demonstrated that treatment of chronic urticaria with omalizumab in a clinical setting is effective and safe, and well-controlled disease is the main reason for treatment discontinuation. These findings on omalizumab drug survival rates and reasons and potential predictors for discontinuation may guide patients and physicians in clinical decision-making and expectation management. These results may call for the identification of biomarkers for chronic urticaria remission in complete responders to omalizumab treatment.

Transthyretin cardiac amyloidosis (ATTR-CA) is associated with an increased incidence of arrhythmias. We hypothesized that 2-week noninvasive ambulatory cardiac rhythm monitoring of patients with ATTR-CA would detect high rates of atrial fibrillation/atrial flutter (AF/AFL) and nonsustained ventricular tachycardia (NSVT).

Purpose: AI-assisted techniques for lesion registration and segmentation have the potential to make CT-based tumor follow-up assessment faster and less reader-dependent. However, empirical evidence on the advantages of AI-assisted volumetric segmentation for lymph node and soft tissue metastases in follow-up CT scans is lacking. The aim of this study was to assess the efficiency, quality, and inter-reader variability of an AI-assisted workflow for volumetric segmentation of lymph node and soft tissue metastases in follow-up CT scans. Three hypotheses were tested: (H1) Assessment time for follow-up lesion segmentation is reduced using an AI-assisted workflow. (H2) The quality of the AI-assisted segmentation is non-inferior to the quality of fully manual segmentation. (H3) The inter-reader variability of the resulting segmentations is reduced with AI assistance. Materials and methods: The study retrospectively analyzed 126 lymph nodes and 135 soft tissue metastases from 55 patients with stage IV melanoma. Three radiologists from two institutions performed both AI-assisted and manual segmentation, and the results were statistically analyzed and compared to a manual segmentation reference standard. Results: AI-assisted segmentation reduced user interaction time significantly by 33% (222 s vs. 336 s), achieved similar Dice scores (0.80–0.84 vs. 0.81–0.82) and decreased inter-reader variability (median Dice 0.85–1.0 vs. 0.80–0.82; ICC 0.84 vs. 0.80), compared to manual segmentation. Conclusion: The findings of this study support the use of AI-assisted registration and volumetric segmentation for lymph node and soft tissue metastases in follow-up CT scans. The AI-assisted workflow achieved significant time savings, similar segmentation quality, and reduced inter-reader variability compared to manual segmentation.

INTRODUCTION Sleep is vital for health and healing, yet it may not be getting the attention it deserves as a requirement for physical as well as mental and emotional health. [...]

THE CASE Paul F* is a 16-year-old White boy who lives with his mother and spends some weekends with his father who has shared custody. He recently presented to the [...]

Emboldened by a pandemic-fueled talent shortage, job candidates are asking for the moon--and often getting it. How will recruiters respond? Veteran talent acquisition specialists are worried. Many say they can't [...]

This article is intended to do one thing: encourage the military justice community of practice to grapple with the arguments typically made when justifying the value and utility of commanders [...]

Since the pandemic, online education and the use of technology have increased. Many music educators have embraced technology to ensure they continue to adapt their techniques, curriculums, and lessons to [...]

Objective: To evaluate the comparability of commercially available practice site data from SK&A with survey data to understand the implications of using SK&A data for health services research. Data sources: Responses to the Comprehensive Primary Care Plus (CP[C.sub.+]) Practice Survey and SK&A data. Study design: Comparison of CPC + Practice Survey responses to SK&A information for 2698 primary care practice sites. Data collection: CPC + Practice Survey data collected through a web-only survey from April through September 2017, and SK&A data purchased in November 2016. Principal findings: Information was similar across data sources, although some discrepancies were common. For example, 56% of practice sites had differences in the reported number of practitioners, and larger sites tended to have larger differences. Among practice sites with 1 practitioner in the survey, only 1.3% had a difference of 3 or more practitioners between the data sources, whereas 63% of practice sites with 11 or more practitioners had a difference of 3 or more practitioners. Conclusions: Discrepancies between data sources could reflect differences of interpretation when defining practice site characteristics, changes over time in those characteristics, or data errors in either SK&A or the survey. Researchers using SK&A data should consider possible ramifications for their studies. KEYWORDS data accuracy, data collection, primary health care, research design, surveys and questionnaires, 1 | INTRODUCTION SK&A databases, which are managed by IQVIA--a health care data vendor--contain data on health care providers, including practitioners, hospitals, and accountable care organizations, and their relationships. The [...]

In recent years, the use of diagnostic imaging in physical therapist practice in the United States has gained considerable interest. In several countries around the world and in the US military, patient direct referral for diagnostic imaging has been considered normative practice for decades. US physical therapy program accreditation standards now stipulate that diagnostic imaging content must be included in physical therapist educational curricula. The American Physical Therapy Association has made efforts to pursue practice authority for imaging referral. A recent review of state practice acts and other statutory language concluded that many states have no prohibitions against physical therapists referring for imaging studies. Additionally, physical therapists can now pursue certification as musculoskeletal sonographers. In light of these advances, and with a growing number of physical therapists serving patients who have not yet seen another health care provider, it may be helpful for those who have been actively involved in the use of imaging in physical therapist practice to provide their collective recommendations to serve as a guideline to those interested in incorporating this practice privilege. The purpose of this perspective article is to provide an overview of the key elements necessary for effective implementation of referral for imaging in physical therapist practice while emphasizing the cornerstone of effective communication. Keywords: Imaging, Referral, Autonomous Practice, Introduction As physical therapists in the United States seek to become the preferred primary care providers for those individuals with neuromusculoskeletal conditions, diagnostic imaging has emerged as an area of [...]

Getting a candidate to accept a job offer is only half the battle. The other half is getting that candidate to show up for their first day of work. A [...]

Global jobs board Indeed has reported that 50 percent of the U.S.-based job listings on its site now include some employer-provided salary information, the highest share yet recorded. The percentage [...]

•Patients excluded from clinical trials of DLBCL are at a higher risk of dying from lymphoma when treated with standard-of-care therapy.•Minorities, in particular Black patients, are at a greater risk of being left behind on clinical trials of DLBCL.

Objective: To assess the effectiveness of a kindergarten vision screening program by randomly assigning schools to receive or not receive vision screening, then following up 1.5 years later. Methods: Fifty high-needs elementary schools were randomly assigned to participate or not in a vision screening program for children in senior kindergarten (SK; age 5‒6 years). When the children were in Grade 2 (age 6‒7 years), vision screening was conducted at all 50 schools. Results: Contrary to expectations, screened and non-screened schools did not differ in the prevalence of suspected amblyopia in Grade 2 (8.6% vs. 7.5%, p= 0.10), nor prevalence of other visual problems such as astigmatism (45.1% vs. 47.1%, p= 0.51). There was also no difference between screened and non-screened schools in academic outcomes such as the proportion of children below grade level in reading (33% vs. 29%) or math (44% vs. 38%) (p= 0.86). However, more children were wearing glasses in screened than in non-screened schools (10.2% vs. 7.8%, p= 0.05), and more children reported their glasses as missing or broken (8.3% vs. 4.7%, p= 0.01), suggesting that SK screening had identified successfully those in need of glasses. Examination of individual results revealed that 72% of children diagnosed and treated for amblyopia in SK no longer had amblyopia in Grade 2. Conclusion: The prevalence of amblyopia and other visual problems was not reduced in Grade 2 by our SK vision screening program, perhaps because of poor treatment compliance and high attrition. The results suggest that a single screening intervention is insufficient to reduce visual problems among young children. However, the data from individuals with amblyopia suggest that continuing vision care and access to glasses benefits children, especially children from lower socioeconomic class.

Chronic urticaria is a common and debilitating mast cell-driven skin disease presenting with itchy wheals, angio-oedema, or both. Chronic urticaria is classified as spontaneous (without definite triggers) and inducible (with definite and subtype-specific triggers; eg, cold or pressure). Current management guidelines recommend step-up administration of second-generation H1-antihistamines to four-fold the approved dose, followed by omalizumab and ciclosporin. However, in many patients, chronic urticaria does not respond to this linear approach due to heterogeneous underlying mechanisms. A personalised endotype-based approach is emerging based on the identification of autoantibodies and other drivers of urticaria pathogenesis. Over the past decade, clinical trials have presented promising options for targeted treatment of chronic urticaria with the potential for disease modification, including Bruton's tyrosine kinase inhibitors, anti-cytokine therapies, and mast cell depletion. This Therapeutics article focuses on the evidence for these novel drugs and their role in addressing an unmet need for personalised management of patients with chronic urticaria.

Use of surrogates as primary end points is commonplace in hematology/oncology clinical trials. As opposed to prognostic markers, surrogates are end points that can be measured early and yet can still capture the full effect of treatment, because it would be captured by the true outcome (eg, overall survival). We discuss the level of evidence of the most commonly used end points in hematology and share recommendations on how to apply and evaluate surrogate end points in research and clinical practice. Based on the statistical literature, this clinician-friendly review intends to build a bridge between clinicians and surrogacy specialists.

Interventricular interactions may be responsible for the decline in ventricular performance observed in various disease states that primarily affect the contralateral ventricle.

The pathophysiology of mast cell (MC)-driven disorders is diverse, ranging from localized reactions to systemic disorders caused by abnormal accumulation and activation in multiorgan systems. Prompt and accurate diagnosis is critically important, both for informing treatment and objective assessment of treatment outcomes. As new therapeutics are being developed to deplete MCs or silence them (eg, by engaging inhibitory receptors that block activation), new biomarkers are needed that can distinguish between MC activation versus burden. Serum tryptase is the gold standard for assessing both MC burden and activation; however, commercial tryptase assays have limitations related to timing of release, lack of discernment between inactive (α) and active (β) forms of tryptase, and interpatient variability of baseline levels. Alternative approaches to measuring MC activation include urinary MC mediators, flow cytometry–based assays or gene expression profiling. Additional markers of MC activation are needed for use in clinical diagnostics, to help selection of treatment of MC diseases, and for assessing outcomes of therapy. We review the spectrum of disorders with known or suspected MC contribution, describe the utility and limitations of current MC markers and assays, and discuss the need for new markers that can differentiate between MC activation and burden.

Predicting the degradation processes of molecules over long time scales is a key aspect of industrial materials design. However, it is made computationally challenging by the need to construct large networks of chemical reactions that are relevant to the experimental conditions that kinetic models must mirror, with every reaction requiring accurate kinetic data. Here, we showcase Kinetica.jl, a new software package for constructing large-scale chemical reaction networks in a fully automated fashion by exploring chemical reaction space with a kinetics-driven algorithm; coupled to efficient machine-learning models of activation energies for sampled elementary reactions, we show how this approach readily enables generation and kinetic characterization of networks containing ∼103chemical species and ≃104–105reactions. Symbolic-numeric modeling of the generated reaction networks is used to allow for flexible, efficient computation of kinetic profiles under experimentally realizable conditions such as continuously variable temperature regimes, enabling direct connection between bottom-up reaction networks and experimental observations. Highly efficient propagation of long-time-scale kinetic profiles is required for automated reaction network refinement and is enabled here by a new discrete kinetic approximation. The resulting Kinetica.jlsimulation package therefore enables automated generation, characterization, and long-time-scale modeling of complex chemical reaction systems. We demonstrate this for hydrocarbon pyrolysis simulated over time scales of seconds, using transient temperature profiles representing those of tubular flow reactor experiments.

This case report showcases an extraordinary collaboration to support the transfusion needs of a patient with a rare phenotype and long-standing anemia due to gastrointestinal bleeding. This report describes the Immunohematology Reference Laboratory testing and logistics of rare blood provision over an 11-year period, as well as a summary of the hematologic, gastroenterologic, and surgical interventions. This case illustrates how a strong collaboration among the clinical team, laboratory, blood center, and the rare donor community facilitated successful management of this patient’s anemia until the patient could receive life-changing treatment.

AbstractHigh-energy photon interrogation is a nondestructive technique that is used to detect special nuclear materials and characterize nuclear waste. The development of such systems is complex and requires Monte Carlo simulations to optimize system performance. Monte Carlo simulations rely on various scattering, absorption, and photonuclear cross-section data. While the scattering and absorption cross-section data have been extensively studied and validated with experiments, the results obtained from photonuclear simulations are often found to underpredict measured results, indicating uncertainties in the photonuclear cross sections themselves. Thus, there is a need for new measured results that can be used to quantify underpredictions in simulations using photonuclear cross-section data. In the present work, we interrogated depleted uranium with a 9-MV electron linac and detected photoneutrons with trans-stilbene organic scintillators. The measurement of photoneutrons with organic scintillators is challenging due to the presence of the intense photon flux, which causes issues such as pulse pile-up, detector saturation, and poor signal-to-background ratio. To mitigate these challenges, we used iron and polyethylene shielding of varying thicknesses around the depleted uranium target and a neural network–based digital pulse processing algorithm to recover neutron and photon information from piled-up events. Our goal was to compare the measured photoneutron count rate with the simulated rate obtained using the MCNPX-PoliMi transport code. For a light output window of 0.28 to 2.67 MeVee (1.66- to 6.85-MeV proton recoil energy), we found that the simulated count rate obtained using the ENDF/B-VII photonuclear cross-section library underpredicts the measured rate by 32.8% $$ \pm $$±3.2%. Additionally, we compared the simulated and measured photoneutron light output distributions. For the least thicknesses of shielding, the simulation was found to underpredict measurements in the 0.70- to 2.67-MeVee light output window. For the greatest thicknesses of shielding, the simulation was found to underpredict the measurement across the entire light output window of 0.28 to 2.67 MeVee.

Persons with HIV-associated Kaposi’s sarcoma (KS) experience three co-existing stigmatizing health conditions: skin disease, HIV, and cancer, which contribute to a complex experience of stigmatization and to delays in diagnosis and treatment. Despite the importance of stigma among these patients, there are few proven stigma-reduction strategies for HIV-associated malignancies. Using qualitative methods, we explore how people with HIV-associated KS in western Kenya between August 2022 and 2023 describe changes in their stigma experience after participation in a multicomponent navigation strategy, which included 1) physical navigation and care coordination, 2) video-based education with motivational survivor stories, 3) travel stipend, 4) health insurance enrollment assistance, 5) health insurance stipend, and 6) peer mentorship. A purposive sample of persons at different stages of chemotherapy treatment were invited to participate. Participants described how a multicomponent navigation strategy contributed to increased knowledge and awareness, a sense of belonging, hope to survive, encouragement, and social support, which served as stigma mitigators, likely counteracting the major drivers of intersectional stigma in HIV-associated KS.