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Summertime brings warm weather, making it a great time for a trip. Accessibility is critical when finding vacation destinations for individuals with disabilities. Consider these five tips to find accessible [...]

As dawn breaks, I stare at my Class A uniform and get ready to put it on once again to head to a funeral for a firefighter who I never [...]

Danobat presents its range of LG external grinders. The family of solutions is intended to perform the toughest production work while still maintaining flexibility and obtaining optimal precision results. It [...]

About 90% of the Texas High Plains area depends on the water supply from the Ogallala aquifer. The decline of the Ogallala water table raises a concern for the sustainability of producing the traditional irrigated field crops due to their high water demand. Thus, diversifying cropping systems may be a solution. However, about 70% of the irrigated cropland uses center pivots that may negatively impact specialty crop quality. Thus, a 3‐year experiment was conducted to assess the potential of using mobile drip irrigation (MDI) to produce fresh watermelon compared to center pivot sprinkler irrigation using low‐elevation spray application (LESA), and surface drip irrigation with plastic mulch (DI). The study evaluated the effects of irrigation systems on crop yield, fruit quality, physiological responses, water use efficiency (WUE), and irrigation use efficiency (IUE). On average, plants under MDI had higher yields (106 Mg ha−1) than those under DI (70 Mg ha−1) and LESA (68 Mg ha−1). Plants under MDI and DI also had more fruits per plant (1.9) than those under LESA (1.4). The higher yield was associated with higher biomass and photosynthetic function. In general, fruit quality was not affected by irrigation system. In addition, plants under MDI system showed a higher WUE and IUE, and less water stress than those under LESA and DI systems. Results of this study suggest that irrigating under an MDI system is a good alternative for growers in the Texas High Plains that aim to diversify their cropping system with high‐value vegetable crops such as watermelon (Citrullus lanatus). The decline of the Ogallala water table is a concern for growing traditional field crops with high water demand.Irrigated land in the Texas High Plains is mainly under center pivots. Watermelons use surface drip irrigation.The use of mobile drip irrigation (MDI) to grow watermelons was as effective as using surface drip irrigation (DI).Plants under the MDI system had higher yields and higher water use efficiency (WUE) than those under the LESA system.The MDI system is a good option for growers who aim to diversify their cropping systems in the Texas High Plains.

This paper presents a nonlinear control design technique that capitalizes on an hour glass (HG) variable geometry wave energy converter (WEC). The HG buoy is assumed to operate in the heave motion of the wave. The unique interaction between the HG buoy and the wave creates a nonlinear cubic storage effect that produces actual energy storage or reactive power during operation. A multi-frequency Bretschneider spectrum wave excitation input is reviewed for the varying steepness angle profile for refinements to the respective sea state. As part of our feasibility study, the numerical simulations showed further increase in power generation over the constant steepness angle baseline. As a result this will increase efficiency of operation and power generation by reducing conventional buoy size and weight, respectively.

Femoral catheters are commonly viewed as a barrier to Burn ICU mobility progression due to anatomical location and potential risk of complications. The purpose of this review was to examine outcomes and complication rates following implementation of femoral catheter mobilization guidelines, as well as determine safety and feasibility of mobilization with femoral catheters in place within the burn population. A retrospective review was completed on 17 patients prior to and following the implementation of new femoral catheter mobility guidelines, 34 patients total. Burn therapy notes were reviewed for burn admissions with at least 1 femoral catheter in place, including arterial, central, and dialysis catheters. Demographic data, admission statistics, line placement timelines, and active mobility achieved during therapy sessions were recorded for both the nonmobilization group (NMG) and mobilization group (MG). The 34 patients reviewed had 99 total lines placed (30 NMG, 69 MG). Change in mobility protocols for the MG resulted in more therapy sessions (n= 516 vs 281) and a significant increase in active mobility sessions (n= 83 vs 5, P< .001), including 146 total mobility activities such as transitions to chairs, tilt table, sitting edge of bed, standing, active chair transfers, ambulation, and cycle ergometry. No catheter-associated adverse events occurred during active mobility sessions and no complications were associated with participation in mobility. This review supports that the presence of femoral catheters alone should not limit the progression of mobility interventions with the use of clinical judgment in specialty-trained burn therapists.

ABSTRACTThis paper seeks to provide clarity on the link between Black people’s perceptions of racism in American institutions and society and voter engagement. We hypothesize that Black people with high feelings of racial efficacy, or the belief that government and society operate in a racially equitable manner, the more likely they will be to vote. Conversely, Black people with low racial efficacy are discouraged from voting. However, confidence in in-group leaders and movements can counteract the demobilizing risk of low racial efficacy. Our analysis uses data from an African American Research Collaborative national survey of 1200 Black voters. Analysis of turnout in 2016 finds that Black people with low racial efficacy were significantly less likely to vote, all else being equal. However, we find that having highly favorable attitudes toward Barack Obama, Black Elected Officials, and Black Lives Matter recovers the propensity to vote for low racial efficacy Blacks back to levels comparable with their racially optimistic peers. Finally, we conclude with a survey experiment which demonstrates that priming Black people with a low racial efficacy environment results in reduced faith in government, in part corroborating the causal direction theorized in our study.

Approximate Message Passing (AMP) algorithms are a class of iterative procedures for computationally-efficient estimation in high-dimensional inference and estimation tasks. Due to the presence of an ‘Onsager’ correction term in its iterates, for $N \times M$ design matrices A with i.i.d. Gaussian entries, the asymptotic distribution of the estimate at any iteration of the algorithm can be exactly characterized in the large system limit as $M/N\to \delta \in (0,\infty)$ via a scalar recursion referred to as state evolution. In this paper, we show that appropriate functionals of the iterates, in fact, concentrate around their limiting values predicted by these asymptotic distributions with rates exponentially fast in N for a large class of AMP-style algorithms, including those that are used when high-dimensional generalized linear regression models are assumed to be the data-generating process, like the generalized AMP algorithm, or those that are used when the measurement matrix is assumed to be rotationally invariant instead of i.i.d. Gaussian, like vector AMP and generalized vector AMP. In practice, these more general AMP algorithms have many applications, for example in communications or imaging, and this work provides the first study of finite sample behavior of such algorithms.

Cooperative adaptive cruise control (CACC) is one of the many advanced driver assistance systems (ADAS) that leverage communication between nearby vehicles to maintain speed while ensuring safe following distances. The current CACC algorithms are designed with the assumption that the communication channel is secure. However, the use of communication channels makes CACC susceptible to attacks, such as False data injection (FDI). This paper develops a novel secure nonlinear controller and a nonlinear observer which can estimate FDI attacks in real-time. Furthermore, this paper shows that the developed controller and FDI attack estimation techniques ensure semi-globally uniformly bounded tracking under FDI attacks, noise, and disturbances. The efficaciousness of the proposed CACC algorithm was demonstrated in simulation and through experimental implementation. During testing using both methodologies, the controller was able to maintain a safe following distance and estimate FDI attacks and noise in real-time.

The article discusses the Biden administration's approach to China and critiques a different perspective presented by Matt Pottinger and Mike Gallagher. The authors argue that the Biden administration's strategy is based on realistic assumptions about shaping China's political system and focuses on maintaining American objectives. They emphasize the importance of managing the competition with China and highlight the need for diplomacy and communication to avoid escalation. The authors also acknowledge areas of overlap between their perspective and the Biden administration's approach. [Extracted from the article]

Interventional therapies (ITs) are an emerging treatment modality for pulmonary embolism (PE); however, the degree of racial, sex-based, and sociodemographic disparities in access and timing is unknown.

We present a case series of 5 patients diagnosed with schwannoma and 1 patient diagnosed with astrocytoma who underwent PSMA PET imaging for tumor detection. We retrospectively analyzed the records of 4 male and 2 female patients (mean age, 53.2 ± 13.2) who underwent PSMA PET imaging between March and September 2023. PET interpretation showed increased Ga-PSMA-11 accumulation in all patients with a mean SUVmaxof 3.11 ± 1.8. This series underscores PSMA PET’s potential for CNS neoplasm detection.

In today's rapidly changing business and social environment, the oil and gas industry must adapt to a new reality for hy-Given the importance of ESG issues, the emphasis is increasingly [...]

Enhancement of the participant experience in quality of life (QOL) research is imperative to improve recruitment and ongoing engagement in QOL studies. Implementation of recommendations made by the patient and public involvement representatives for STAMPEDE2 could optimise the impact of QOL studies, with a benefit for participants and collection of invaluable data for cancer care research.

Prior to March 2020, you may not have thought twice about grabbing a door handle at the store or touching a railing in the park. Now that our daily habits [...]

What does the rise of the primary service provider approach in early intervention mean for speech-language pathologists? Possibly a chance to enhance services--if implemented as intended. When I first heard [...]

Mike Griggs replies The team at Maxon have been hard at work ensuring that the content available with Cinema 4D is among the best in the industry. With a massive [...]

One overarching theme from InfoComm 2023 was that the industry is at, or near, the end of its collective supply challenges, and hopefully that's true. Many of us learned during [...]

Imagine being at a conference for music educators and running into one (or more!) of the teaching/conducting/composing icons of our day! What would you ask them if you had the [...]

Climate change is melting Antarctica's Thwaites Glacier. Should it collapse, it could single-handedly raise global sea levels half a meter or more. In January 2019, Rush joined a 57-person icebreaker [...]

The three 1993 issues of "Seasons" (the Spring/Summer issues are combined) address various aspects of dealing with Acquired Immune Deficiency Syndrome (AIDS) and Human Immunodeficiency Virus (HIV) among Native Americans. The Winter issue focuses on tuberculosis (TB) and its incidence and treatment among HIV-positive individuals. "Remembering Tuberculosis" (Ernie Turner) is a personal account by the executive director of the Alaska Native Alcohol Recovery Center of his battles with tuberculosis and alcoholism. "Tuberculosis in the 90's" is an interview with Dr. Eric Goosby, emphasizing the risk of TB to HIV positive people and treatment options. In the Spring-Summer issue, "HIV Prevention in Rural Alaska" (Joe Cantil) describes both a program using telecommunications for AIDS prevention education in rural Alaska, and the Youth Leadership Symposium for AIDS Prevention, involving youth from rural Alaskan villages. "The ART Education Model: An Approach to HIV and AIDS Education Developed" by the AIDS Resource Team (ART), Incorporated, describes ART's programs in rural communities in the Midwest. "HIV Prevention for a Lifetime: Educating Our Children" (Calvin E. Twoguns) stresses communication with Native American children about high-risk behaviors. In the Autumn issue, "A Journey to Life: Native People with HIV Disease and Traditional Healing" (Marcie R. Rendon) discusses traditional healing and ceremonies as part of AIDS treatment. "Increasing Access to Care: The Native Special Initiatives Program" (Jay Johnson) describes nine grant projects involving culturally appropriate HIV/AIDS services. "It's Up to Me" (David Andrews) is a personal account by a homosexual Native American infected with AIDS. Each issue highlights the work of a Native American artist and includes book and video reviews and announcements of special events. (KS)

Background: Hypophosphatasia (HPP) is an inborn error of metabolism with a variable presentation. We conducted a modified Delphi panel to obtain expert consensus on knowledge gaps regarding disease severity and progression in adult patients with HPP. Methods: Healthcare professionals (HCPs) with experience managing adult patients with HPP were recruited to participate in a 3-round Delphi panel (round 1: paper survey and 1:1 interview; rounds 2–3: email survey). Panelists rated the extent of their agreement with statements about disease severity and progression in adult patients with HPP. Consensus was defined as ≥ 80% agreement. Results: Ten HCPs completed round 1; nine completed rounds 2 and 3. Consensus was reached on 46/120 statements derived from steering committee input. Disease severity markers in adult patients with HPP can be bone-related (recurrent/poorly healing fractures, pseudo-fractures, metatarsal fractures, osteomalacia) or involve dentition or physiologic/functional manifestations (use of mobility devices/home modifications, abnormal gait, pain). Disease progression markers can include recurrent/poorly healing low-trauma fractures, development of ectopic calcifications, and/or impairment of functional activity. Panelists supported the development of a tool to help assess disease severity in the clinic and track changes in severity over time. Panelists also highlighted the role of a multidisciplinary team, centers with expertise, and the need to refer patients when disease severity is not clear. Conclusions: These statements regarding disease severity, progression, and assessment methods address some knowledge gaps in adult patients with HPP and may be helpful for treating HCPs, although the small sample size affects the ability to generalize the healthcare provider experience.

Plant-based or plant-forward? Vegan or vegetarian? No matter the label attached, produce- and plant-based proteins are proliferating on menus. And though different forces-including health, sustainability and animal welfare-may be driving [...]

In the 1980s and 90s, a message to reinvigorate reliance on state constitutions gathered momentum, (1) producing a now-familiar refrain: state constitutional law plays an important role in securing the [...]

THERE'S A LOT OF RESTAURANT ACTIVITY IN MAJOR URBAN MARKETS, and many operators are aware of the demographics and dynamics of those areas. But what about some of the secondary [...]

RENT IS HIGH. LABOR IS EXPENSIVE AND HARD TO COME BY. COMPETITION FOR TRAFFIC IS INCREASING. And as a result, many operators took the 'focus on what you've got' approach [...]

Which ingredients are poised to garner mainstream attention in 2019 and beyond? This third annual report provides a deep, data-driven dive into the under-the-radar ingredients emerging on menus now. Sriracha. [...]

Sriracha. Nashville hot chicken. Kale. While relatively mainstream now, these flavors were once uncommon. Because many of today's consumers are trend seekers, it can pay off to be on the [...]

There's a bit of a dichotomy between the wants and needs of the modern restaurant customer.At times, convenience is the top priority, giving rise to grab-and-go, delivery and other options [...]

This review of the 2017 hurricane season and the ongoing response and recovery efforts 1 year following the disasters in Puerto Rico and the U.S. Virgin Islands reveal the cascading effects of these events on the social determinants of health. Nurses are well positioned to participate as full partners with the medical, public health, and emergency management community in all aspects of disaster planning, mitigation, response, and recovery., Climate change-related disasters, including hurricanes, floods, and typhoons, directly impact community economies, force millions of people into poverty, and cost billions of dollars annually (Hallegatte, VogtSchilb, Bangalore, & Rozenberg, 2017; [...]

The article "What Solution for Haiti Under Siege?" by Cynthia R. Rush provides an overview of the current situation in Haiti, where violent gangs have been causing chaos in the capital city of Port-au-Prince. The de facto Prime Minister, Ariel Henry, recently resigned amid protests and accusations of inaction against the escalating gang violence and economic difficulties. The article highlights the ongoing violence, including attacks on government buildings, hospitals, and schools, as well as the severe humanitarian crisis with shortages of food and fuel. It also acknowledges the historical context of foreign interventions and economic exploitation that have contributed to Haiti's present challenges. The text explores issues such as gang proliferation, weapons trafficking, and drug trade in Haiti, suggesting that these problems are fueled by an international banking and drug money laundering network called Dope, Inc. The article argues that Haiti's economic and political devastation could be addressed through a new financial security and development framework, involving collaboration between China, Russia, the United States, and other nations. It criticizes the proposed transitional presidential council for Haiti, viewing it as a continuation of imperial policies, and calls for a new international financial architecture to counter unilateral coercive measures imposed by the United States and Europe. [Extracted from the article]

The article discusses a university initiative called the Wyoming Teacher Mentor Corps (WTMC) that trains experienced educators to serve as mentors for new teachers. The program focuses on four core competencies for mentors: assessing teaching and learning, assertive communication, meaningful feedback, and work-life balance. The article highlights recommendations from the mentor fellows for maintaining work-life balance, including setting boundaries for work, acknowledging one's own humanity, and prioritizing tasks. The article also provides recommendations for school systems and leaders, such as prioritizing carefully and improving communication. [Extracted from the article]

Children with medical complexity (CMC) are high health care utilizers prompting hospitals to implement care models focused on this population, yet practices have not been evaluated on a national level. Our objective with this study is to describe the presence and structure of care models and the use of discharge services for CMC admitted to freestanding children’s hospitals across the nation.We distributed an electronic survey to 48 hospitals within the Pediatric Health Information System exploring the availability of care models and discharge services for CMC. Care models were grouped by type and number present at each institution. Discharge services were grouped by low (never, rarely), medium (sometimes), and high (most of the time, always) frequency use.Of 48 eligible hospitals, 33 completed the survey (69%). There were no significant differences between responders and non-responders for both hospital and patient characteristics. Most participants identified an outpatient care model (67%), whereas 21% had no dedicated care model for CMC in the inpatient or outpatient setting. High-frequency discharge services included durable medical equipment delivery, medication delivery, and communication with outpatient provider before discharge. Low-frequency discharge services included the use of a structured handoff tool for outpatient communication, personalized access plans, inpatient team follow-up with family after discharge, and the use of discharge checklists.Children’s hospitals vary largely in care model structure and discharge services. Future work is needed to evaluate the associations between care models and discharge services for CMC with various health care outcomes.

BackgroundThe total artificial heart (TAH) is an implanted device approved as a modality to stabilize patients with severe biventricular heart failure or persistent ventricular arrhythmias for evaluation and bridge to transplantation. According to the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS), about 450 patients received a TAH between 2006 and 2018. Patients being evaluated for a TAH are often critically ill and a TAH offers the best chance at survival. Given the prognostic uncertainty of these patients, there is a crucial need for preparedness planning to help patients and their caregivers plan for living and supporting a loved one with a TAH.AimTo describe an approach to preparedness planning and highlight the importance of palliative care.MethodsWe reviewed the current needs and approaches to preparedness planning for a TAH. We categorized our findings and suggest a guide to maximize conversations with patients and their decision makers.ResultsWe identified four critical areas to address: the decision maker, minimal acceptable outcome/maximal acceptable burden, living with the device, and dying with the device. We suggest using a framework of mental and physical outcomes and locations of care as a way to identify minimal acceptable outcome and maximal acceptable burden.ConclusionDecision making for a TAH is complex. There is an urgency and patients do not always have capacity. Identifying legal decision makers and social support is critical. The surrogate decision makers should be included in preparedness planning including discussions about end-of-life care and treatment discontinuation. Having palliative care as members of the interdisciplinary mechanical circulatory support team can assist in these preparedness conversations.

BackgroundPatients with end-stage liver disease (ESLD) have a reduced life expectancy and a significant symptom burden. Our aim is to determine if inpatient palliative care (PC) referral for patients with ESLD is associated with decreased hospital readmission rates.MethodsThe 2013 US Nationwide Readmission Database (NRD) was used for the current analysis. The NRD allows for longitudinal analysis of all patient hospital admissions across 22 states. Patients ≥18 years of age with a diagnosis of ESLD with at least two decompensating events were included in the analysis. PC referral at the index hospitalisation divided the cohort into two groups, which were tracked for 9 months.ResultsA total of 14 325 172 hospital admissions from the 2013 NRD were examined. In the first 3 months of 2013, a total of 3647 patients with ESLD were admitted with 206 (5.6%) receiving PC referral during the index admission. After the index hospitalisation, patients referred to PC were more likely to be discharged to skilled nursing facilities (45.5% vs 14.7%; p<0.01) or hospice/home care (32.9% vs 15.3%; p<0.01). After propensity score matching, those patients referred to PC demonstrated a significantly lower rate of 1-year hospital readmission (11.0% vs 32.1%; p<0.01).ConclusionInpatient PC referral for patients with ESLD was associated with lower rates of hospital readmission. Early concurrent PC referral likely has added beneficial effects beyond quality of life issues and symptom management.

Major Depressive Disorder (MDD) is a common, frequently chronic condition characterized by substantial molecular alterations and pathway dysregulations. Single metabolite and targeted metabolomics platforms have revealed several metabolic alterations in depression, including energy metabolism, neurotransmission, and lipid metabolism. More comprehensive coverage of the metabolome is needed to further specify metabolic dysregulations in depression and reveal previously untargeted mechanisms. Here, we measured 820 metabolites using the metabolome-wide Metabolon platform in 2770 subjects from a large Dutch clinical cohort with extensive clinical phenotyping (1101 current MDD, 868 remitted MDD, 801 healthy controls) at baseline, which were repeated in 1805 subjects at 6-year follow up (327 current MDD, 1045 remitted MDD, 433 healthy controls). MDD diagnosis was based on DSM-IV psychiatric interviews. Depression severity was measured with the Inventory of Depressive Symptomatology Self-report. Associations between metabolites and MDD status and depression severity were assessed at baseline and at 6-year follow-up. At baseline, 139 and 126 metabolites were associated with current MDD status and depression severity, respectively, with 79 overlapping metabolites. Adding body mass index and lipid-lowering medication to the models changed results only marginally. Among the overlapping metabolites, 34 were confirmed in internal replication analyses using 6-year follow-up data. Downregulated metabolites were enriched with long-chain monounsaturated (P= 6.7e−07) and saturated (P= 3.2e−05) fatty acids; upregulated metabolites were enriched with lysophospholipids (P= 3.4e−4). Mendelian randomization analyses using genetic instruments for metabolites (N= 14,000) and MDD (N= 800,000) showed that genetically predicted higher levels of the lysophospholipid 1-linoleoyl-GPE (18:2) were associated with greater risk of depression. The identified metabolome-wide profile of depression indicated altered lipid metabolism with downregulation of long-chain fatty acids and upregulation of lysophospholipids, for which causal involvement was suggested using genetic tools. This metabolomics signature offers a window on depression pathophysiology and a potential access point for the development of novel therapeutic approaches.