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G351.16+0.70 is a relatively well-studied high-mass star-forming region with at least two main bipolar outflow structures originating from an OB-embedded star and multiple IR sources. Using high-resolution and large-bandwidth SMA observations, we studied its molecular content to probe the emission of iCOMs, which could be related to the bipolar outflows or their jets. We analysed the emission spectra in the 1 mm band within 8 GHz bandwidth coverage, finding that the observed emission spectra could be explained by 11 iCOMs and 5 molecular isotopologues. Additionally, we analysed the unusually broad iCOM emission lines by using integrated and velocity field maps, searching for extended emission and velocity gradients related to molecular outflows. Ro-vibrational transitions of CH3OH and CH3OCHO present evidence of extended emission that does not fit with spherical morphology and that follows the extension of the low-velocity 13CO outflow. The multiple outflows in the system are revealed also by the CO (2–1) and SiO (5–4) emission, but in particular we have discovered an extremely high-velocity outflow (| V Max − V LSR| ∼ 60 km s−1). Finally, we provide the complete catalogue of iCOMs produced by the protostellar core within the 8 GHz bandwidth of our observations, along with a compilation of iCOM abundances studied in interferometric works from the literature and a comparison with single-dish results. [ABSTRACT FROM AUTHOR]

We present line and continuum observations (resolution ∼0.″3â€"3.″5) made with the Atacama Large Millimeter/submillimeter Array (ALMA), Submillimeter Array, and Very Large Array of a young O-type protostar W42-MME (mass: 19 ± 4 M ⊙). The ALMA 1.35 mm continuum map (resolution ∼1″) shows that W42-MME is embedded in one of the cores (i.e., MM1) located within a thermally supercritical filament-like feature (extent ∼0.15 pc) containing three cores (mass ∼1â€"4.4 M ⊙). Several dense/hot gas tracers are detected toward MM1, suggesting the presence of a hot molecular core with a gas temperature of ∼38â€"220 K. The ALMA 865 ÎĽ m continuum map (resolution ∼0.″3) reveals at least five continuum sources/peaks (Aâ€"E) within a dusty envelope (extent ∼9000 au) toward MM1, where shocks are traced in the SiO (8â€"7) emission. Source A associated with W42-MME is seen almost at the center of the dusty envelope and is surrounded by other continuum peaks. The ALMA CO (3â€"2) and SiO (8â€"7) line observations show the bipolar outflow extended below 10,000 au, which is driven by source A. The ALMA data hint at the episodic ejections from W42-MME. A disk-like feature (extent ∼2000 au, mass ∼1 M ⊙) with velocity gradients is investigated in source A (dynamical mass ∼9 M ⊙) using the ALMA H13CO+ emission, and it is perpendicular to the CO outflow. A small-scale feature (below 3000 au), probably heated by UV radiation from the O-type star, is also investigated toward source A. Overall, W42-MME appears to gain mass from its disk and the dusty envelope. [ABSTRACT FROM AUTHOR]

Mesocosm systems simulating floodplain areas are essential for the understanding of the environmental fate and effects of engineered nanoparticles (ENPs). In such mesocosm studies, the quantification of different types of nanoparticles coexisting in natural systems and containing the same element is often challenging. Such coexistence is expected e.g., for ENPs simultaneously released into the environmental systems. Despite the relevance of the coexistence, little is known about combined behavior and effects of ENPs in the environment. In this study, we developed a method for the quantification and differentiation of silver nanoparticles enriched by 109 Ag isotope ( 109 Ag-NPs) and sulfidized silver nanoparticles with natural isotopic distribution (S-Ag-NPs) in water, soil, and sediment and applied it to evaluate the environmental fate of these nanoparticles introduced simultaneously together with gold (Au-NPs) and titanium dioxide (TiO 2 -NPs) nanoparticles into mesocosms simulating an aquatic-terrestrial transition zone. High nanoparticle recoveries determined in water, sand, and soil spiked with nanoparticle mixtures indicate that the application of isotopically enriched ENPs will allow their differentiation from other nanoparticles containing the same element in environmental compartments even at the concentrations in the range of natural background. The co-accumulation of 109 Ag-NPs, S-Ag-NPs, and Au-NPs in the top layer of sediment and soil and in biofilms observed in mesocosm studies suggests that these compartments can act as effective sinks for these ENPs. We suggest that the hetero-aggregation between different co-occurring ENPs and their high affinity to biota are major mechanisms controlling their fate in the aquatic-terrestrial transition zone. A high co-enrichment of 109 Ag-NPs, S-Ag-NPs, Au-NPs, and TiO 2 -NPs in/on algae, biofilms, leaves, and amphipods suggests an enhanced risk of biomagnification. The findings of this study will contribute to a better understanding of the fate of ENPs and their combined effects in environmental compartments, where the simultaneous presence of diverse nanoparticles is expected., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Long-duration energy storage (LDES) is a key resource in enabling zero-emissions electricity grids but its role within different types of grids is not well understood. Using the Switch capacity expansion model, we model a zero-emissions Western Interconnect with high geographical resolution to understand the value of LDES under 39 scenarios with different generation mixes, transmission expansion, storage costs, and storage mandates. We find that a) LDES is particularly valuable in majority wind-powered regions and regions with diminishing hydropower generation, b) seasonal operation of storage becomes cost-effective if storage capital costs fall below US$5 kWh -1 , and c) mandating the installation of enough LDES to enable year-long storage cycles would reduce electricity prices during times of high demand by over 70%. Given the asset and resource diversity of the Western Interconnect, our results can provide grid planners in many regions with guidance on how LDES impacts and is impacted by energy storage mandates, investments in LDES research and development, and generation mix and transmission expansion decisions., (© 2024. The Author(s).)

We analyzed variations in the epidermal growth factor receptor (EGFR) gene and 5'-upstream region to identify potential molecular predictors of treatment response in primary epithelial ovarian cancer. Tumor tissues collected during debulking surgery from the prospective multicenter OVCAD study were investigated. Copy number variations in the human endogenous retrovirus sequence human endogenous retrovirus K9 (HERVK9) and EGFR Exons 7 and 9, as well as repeat length and loss of heterozygosity of polymorphic CA-SSR I and relative EGFR mRNA expression were determined quantitatively. At least one EGFR variation was observed in 94% of the patients. Among the 30 combinations of variations discovered, enhanced platinum sensitivity (n = 151) was found dominantly with HERVK9 haploidy and Exon 7 tetraploidy, overrepresented among patients with survival ≥120 months (24/29, p = .0212). EGFR overexpression (≥80 percentile) was significantly less likely in the responders (17% vs. 32%, p = .044). Multivariate Cox regression analysis, including age, FIGO stage, and grade, indicated that the patients' subgroup was prognostically significant for CA-SSR I repeat length <18 CA for both alleles (HR 0.276, 95% confidence interval 0.109-0.655, p = .001). Although EGFR variations occur in ovarian cancer, the mRNA levels remain low compared to other EGFR-mutated cancers. Notably, the inherited length of the CA-SSR I repeat, HERVK9 haploidy, and Exon 7 tetraploidy conferred three times higher odds ratio to survive for more than 10 years under therapy. This may add value in guiding therapies if determined during follow-up in circulating tumor cells or circulating tumor DNA and offers HERVK9 as a potential therapeutic target., (© 2024 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Background: To evaluate real-world utilization of gonioscopy for diagnosing glaucoma among ophthalmologists with diverse subspecialties, and understand current perceptions of teaching, training, and confidence in gonioscopy., Methods: A nationwide anonymous online survey was conducted among practicing ophthalmologists, querying about demographics, professional experience, practice of routine ocular examination for glaucoma and perceptions of confidence in performing them., Results: 136 ophthalmologists participated in the survey, with various levels of experience from residency to over twenty years of ophthalmology practice. Glaucoma specialists comprised 23 (16.9%) of the participants. Of the non-glaucoma-specialist respondents, only 33 (29.2%) expressed being highly confident in interpreting gonioscopic findings, which correlated significantly with their self-reported inadequate level of training in gonioscopy during residency (p < 0.001) and even more so with their low frequency of implementing gonioscopy in routine examinations (p < 0.001). The commonly cited reasons for the low practice of gonioscopy were insufficient time allotted to examinations and lack of experience, knowledge or equipment., Conclusions: Gonioscopy is fundamental to the detection of glaucoma. This study reveals underutilization of gonioscopy in the practice of ophthalmology and its association with lower training opportunities, calling for expedited changes in the residency's curriculum, alongside measures to promote its use in clinical practice., (© 2024. The Author(s).)

The inverse problem that underlies Magnetic Resonance Elastography (MRE) is sensitive to the measurement data and the quality of the results of this tissue elasticity imaging process can be influenced both directly and indirectly by measurement noise. In this work, we apply a coupled adjoint field formulation of the viscoelastic constitutive parameter identification problem, where the indirect influence of noise through applied boundary conditions is avoided. A well-posed formulation of the coupled field problem is obtained through conditions applied to the adjoint field, relieving the computed displacement field from kinematic errors on the boundary. The theoretical framework for this formulation via a nearly incompressible, parallel subdomain-decomposition approach is presented, along with verification and a detailed exploration of the performance of the methods via a numerical simulation study. In addition, the advantages of this novel approach are demonstrated in-vivo in the human brain, showing the ability of the method to obtain viable tissue property maps in difficult configurations, enhancing the accuracy of the method.

Background: Fetal alcohol spectrum disorders (FASD), a group of prevalent conditions resulting from prenatal alcohol exposure, affect the maturation of cerebral white matter as first identified with neuroimaging. However, traditional methods are unable to track subtle microstructural alterations to white matter. This preliminary study uses a highly sensitive and clinically translatable magnetic resonance elastography (MRE) protocol to assess brain tissue microstructure through its mechanical properties following an exercise intervention in a rat model of FASD., Methods: Female rat pups were either alcohol-exposed (AE) via intragastric intubation of alcohol in milk substitute (5.25 g/kg/day) or sham-intubated (SI) on postnatal days (PD) four through nine to model alcohol exposure during the brain growth spurt. On PD 30, half of AE and SI rats were randomly assigned to either a wheel-running or standard cage for 12 days. Magnetic resonance elastography was used to measure whole brain and callosal mechanical properties at the end of the intervention (around PD 42) and at 1 month post-intervention, and findings were validated with histological quantification of oligoglia., Results: Alcohol exposure reduced forebrain stiffness (p = 0.02) in standard-housed rats. The adolescent exercise intervention mitigated this effect, confirming that increased aerobic activity supports proper neurodevelopmental trajectories. Forebrain damping ratio was lowest in standard-housed AE rats (p < 0.01), but this effect was not mitigated by intervention exposure. At 1 month post-intervention, all rats exhibited comparable forebrain stiffness and damping ratio (p > 0.05). Callosal stiffness and damping ratio increased with age. With cessation of exercise, there was a negative rebound effect on the quantity of callosal oligodendrocytes, irrespective of treatment group, which diverged from our MRE results., Conclusions: This is the first application of MRE to measure the brain's mechanical properties in a rodent model of FASD. MRE successfully captured alcohol-related changes in forebrain stiffness and damping ratio. Additionally, MRE identified an exercise-related increase to forebrain stiffness in AE rats., (© 2024 Research Society on Alcohol.)

After noting an elevated surgical site infection rate in 2019 associated with colorectal surgeries, leaders at two Central Virginia health system hospitals convened an interdisciplinary team to audit current practices and research infection prevention strategies. After identifying a lack of standardization in care processes for colorectal surgery patients and reviewing the literature on colorectal bundles, the team created a bundle focusing on the use of antibiotics, chlorhexidine gluconate wipes or baths, separate closing instrument trays, nasal decolonization, bowel preparation, and maintaining patient normothermia. After synthesis and stakeholder input, the team implemented the colorectal bundle along with a checklist for all users to complete to ensure compliance and standardization of practice and for auditing purposes. Implementation results were positive: the total number of colorectal infections decreased from nine in 2020 to three in 2021. Education was critical to securing staff member engagement for successful implementation of and compliance with the bundle., (© AORN, Inc, 2023.)

Proximal femoral fractures are a serious complication, especially for elderly patients. Therefore, we have aimed to answer the following research question: What is the postfracture mortality rate in the elderly population and what are associated risk factors? For this, proximal femoral fractures that occurred between 1 January 2009 and 31 December 2019 were identified from the Medicare Physician Service Records database. The Kaplan-Meier (KM) method with the Fine and Gray subdistribution adaptation was used to determine rates of mortality. A semiparametric Cox regression model was applied, incorporating 23 measures as covariates to identify risk factors. The estimated 1 year mortality rate was 26.8% after head/neck fracture, 28.2% after intertrochanteric fracture, and 24.2% after subtrochanteric fracture. Male sex, age over 70 years, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, chronic kidney disease, a concomitant fracture, congestive heart failure, diabetes mellitus, hypertension, insulin use, ischemic heart disease, morbid obesity, osteoporosis, tobacco dependence, and median household income were determined as risk factors for increased mortality. An early assessment of individual risk factors accessible for therapeutic treatment is crucial in the management of proximal femur fractures to aid in attempts at reducing the high mortality apparent in the elderly US population., (© 2023. The Author(s).)

Purpose: To investigate the effect of change in body mass index (BMI) on intraocular pressure (IOP) in a large cohort of apparently healthy volunteers who underwent an annual comprehensive screening examinations., Methods: This study included individuals who were enrolled in the Tel Aviv Medical Center Inflammation Survey (TAMCIS) and had IOP and BMI measurements at their baseline and follow up visits. Relationships between BMI and IOP and the effect of change in BMI on IOP were investigated., Results: A total of 7,782 individuals had at least one IOP measurement at their baseline visit, and 2,985 individuals had ≥2 visits recorded. The mean (SD) IOP (right eye) was 14.6 (2.5) mm Hg and mean (SD) BMI was 26.4 (4.1) kg/m2. IOP positively correlated with BMI levels (r = 0.16, p<0.0001). For individuals with morbid obesity (BMI≥35 kg/m2) and ≥2 visits, a change in BMI between the baseline and first follow-up visits correlated positively with a change in the IOP (r = 0.23, p = 0.029). Subgroup analysis of subjects who had a reduction of at least 2 BMI units showed a stronger positive correlation between change in BMI and change in IOP (r = 0.29, p<0.0001). For this subgroup, a reduction of 2.86 kg/m2 of BMI was associated with a reduction of 1 mm Hg in IOP., Conclusions: BMI loss correlated with reduction in IOP, and this correlation was more pronounced among morbidly obese individuals., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Coster et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

25% annual PV growth is possible over the next decade.

Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to evaluate the role of anamnestic information in predicting possible SB in children aged 4-12 years. In a cross-sectional retrospective exploratory study, the dental files of 521 children were examined with regard to the following anamnestic information: gender, age, medical conditions associated with ear, nose, and throat (ENT), respiratory disorders, use of methylphenidate (Ritalin), oral habits, and bruxing during sleep. A child was defined as presenting possible SB when a positive report was received from parents regarding such behavior (SB positive, No. = 84). There were no age- and/or gender-wise differences between SB-positive children and children whose parents did not report SB behavior (SB negative). SB-positive children suffered more from ENT and respiratory disorders than children without SB. Additionally, the use of pacifiers/finger sucking, as well as snoring, were more common among SB-positive children as compared to their SB-negative counterparts (Chi-square). The variables which were found to significantly increase the odds of possible SB in children were mouth breathing, ENT problems, and use of a pacifier or finger sucking (forward stepwise logistic regression). Clinicians should look for clinical signs of possible SB in children whose anamnesis reveals one or more of these anamnestic signals.

To report clinical outcomes following ocular injury from foam dart (nerf) blasters - a spring-loaded toy guns that fire foam-coated darts or bullets at a relatively low velocity. These guns gained popularity in recent years among children and adolescents. Eleven patients with ocular injuries from foam dart blasters were included in this retrospective, single-center study. Visual acuity (VA), intraocular pressure (IOP), and anterior segment, glaucoma-related, and vitreoretinal complications were recorded at each visit. The average age at presentation was 13.4 years and 82% were male. Mean initial VA was 6/12 (range 6/6 - 1/18); On initial examination, nine patients (82%) had hyphema, three (27%) had corneal abrasions, three (27%) had vitreous hemorrhage, and two (18%) had traumatic mydriasis. Four patients (36%) experienced glaucoma-related complications, including three (27%) with angle recession and three (27%) with increased IOP. Three patients (27%) were diagnosed with posterior segment injuries, including three (27%) with commotio retinae and one (9%) with severe retinal photoreceptor damage. No patients required surgical intervention., Conclusion: Foam dart blasters can cause severe blunt ocular trauma and permanent visual loss, illustrating the need for eye protection when handling these toys., What Is Known: • Foam dart blasters, a blanket term for spring-loaded toy guns that fire foam-coated darts or bullets at a relatively low velocity, have gained popularity in recent years among pediatric populations, with an increase in associated ocular injuries. • To date, scattered case reporting provides insufficient insight into the full clinical spectrum of injury and prognosis of foam dart blasters related ocular injury., What Is New: • This case series characterizes the myriad foam dart blasters injuries that may afflict the eye, most of which are self-limiting, but some of which may result in poor visual outcomes and lifelong disability in pediatric patients. • We strongly recommend that all users wear eye protection while using foam dart blasters., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objectives: In recent years, we have witnessed a growing interest in pediatric sleep-related breathing disorders (SRBD). Although a Pediatric Sleep Questionnaire (PSQ) exists and was found reliable in screening SRBD in children, many of the children remain underdiagnosed. The aim of the present study was to define anamnestic and clinical findings that can serve as red flags indicating the presence of SRBD in children., Methods: 227 children aged 4-12 years old were evaluated with regard to the following parameters: (i) anamnestic variables (e.g., general state of health, oral habits, bruxism, esophageal reflux, sleep continuity, snoring); (ii) clinical parameters (e.g., oral mucosa, palate, tonsils, tongue, floor of the mouth, angle classification, gingival health, caries risk) and (iii) presence of SRBD (through the PSQ)., Results: Significant differences between children with and without SRBD were observed regarding continuous sleep, developmental delay, mouth breathing, and snoring. Taking medications for ADHD increased the odds of SRBD in children by over seven times, non-continuous sleep increased the odds of SRBD by six times, mouth breathing increased the odds by almost five times, and snoring increased the odds by over three times., Conclusions: Child caregivers from various fields (dentists, orthodontists, pediatric physicians, school nurses) should actively inquire about disturbed sleep, medications for ADHD, snoring, and mouth breathing among their young patients. Initial screening through a few simple questions may help raise red flags that can assist in the early detection of SRBD in children and lead to proper diagnosis and treatment.

Aim: To report short-term outcomes of mitomycin C-augmented excisional bleb revision with capsulectomy (ERC) after Ahmed glaucoma valve (AGV) failure., Methods: Patients who underwent ERC procedures between January 2017 and December 2019 with a minimum follow-up of 6mo were evaluated retrospectively for indications of AGV and AGV implantation to ERC interval. The number of anti-glaucoma medications (AGMs), intraocular pressure (IOP) and best corrected visual acuity (BCVA) were recorded at baseline, 1, 7, 30, 90, and 180d. Intra- and postoperative complications were also recorded. Positive outcome was defined as IOP≤21 mm Hg with or without AGMs., Results: Fourteen eyes [14 patients, median age 69.5y, interquartile range (IQR) 61.3-80] were included. Pseudoexfoliative glaucoma ( n =5, 36%) was the most common form of glaucoma. The median AGV implantation to ERC interval was 8.8mo (IQR 3.91-43.67). At 6mo, the median number of AGMs decreased from 3.0 (IQR 3.0-4.0) to 2.0 (IQR 1.5-3), the median IOP decreased from 26 mm Hg (IQR 22-29) to 16.5 mm Hg (IQR 13.75-20) and there was no significant change in BCVA. The success rate at 6mo was 92.9%. The Kaplan-Meier cumulative probability of survival was 93%, 79%, 64%, and 64% at 1wk, and 1, 3, and 6mo, respectively. No intraoperative complications were identified. Postoperative complications were identified in 5 eyes (36%), which were resolved spontaneously during the first week following ERC., Conclusion: ERC has a high success rate for short-term management of AGV failure. A longer follow-up study is required to determine long-term cumulative failure rates., (International Journal of Ophthalmology Press.)

Despite high initial response rates, acute myeloid leukemia (AML) treated with the BCL-2-selective inhibitor venetoclax (VEN) alone or in combinations commonly acquires resistance. We performed gene/protein expression, metabolomic and methylation analyses of isogenic AML cell lines sensitive or resistant to VEN, and identified the activation of RAS/MAPK pathway, leading to increased stability and higher levels of MCL-1 protein, as a major acquired mechanism of VEN resistance. MCL-1 sustained survival and maintained mitochondrial respiration in VEN-RE cells, which had impaired electron transport chain (ETC) complex II activity, and MCL-1 silencing or pharmacologic inhibition restored VEN sensitivity. In support of the importance of RAS/MAPK activation, we found by single-cell DNA sequencing rapid clonal selection of RAS-mutated clones in AML patients treated with VEN-containing regimens. In summary, these findings establish RAS/MAPK/MCL-1 and mitochondrial fitness as key survival mechanisms of VEN-RE AML and provide the rationale for combinatorial strategies effectively targeting these pathways., (© 2022. The Author(s).)

Introduction: The purpose of this study was to investigate the feasibility and effectiveness of an innovative telemedicine community-based intervention to increase detection of previously undiagnosed ocular diseases in high-risk populations in Israel. Methods: A team comprising an ocular technician, a project manager, and a driver was sent to underserved areas in Israel. Patient demographics, ocular, and medical information were recorded. Visual acuity (VA), intraocular pressure and fundus photographs were obtained. The data were transferred to the Ophthalmology Reading Center in Tel-Aviv Medical Center, where it was interpreted by an ophthalmologist. A letter was sent to the patients indicating examination results. It instructed them to return for a follow-up examination if indicated. Results: A total of 124 individuals underwent telemedicine remote screening examinations in 10 locations. The mean age was 79.9 ± 7.2 years, with female predominance of 67%. The major pathologies detected were (1) reduction in VA >6/12 in at least one eye ( n  = 48, 38.7%); (2) glaucoma suspicion in the optic disk ( n  = 18, 14.5%); (3) ocular hypertension >21 mmHg ( n  = 15, 12.1%); (4) age-related macular degeneration (AMD; n  = 15, 12.1%); (5) diabetic retinopathy ( n  = 6, 4.8%); (6) visually significant cataract ( n  = 6, 4.8%); and (7) other pathologies ( n  = 11, 8.9%); 97.7% of the patients reported high satisfaction rates (they were satisfied or very satisfied from the project model). Conclusions: Our pilot telemedicine screening project effectively detected ocular diseases in underserved areas in Israel and helped improve access to eye care. This project has the potential of reaching a national level, allow for early diagnosis, and prevent vision loss and blindness in underserved areas.