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Societal Impact Statement: Intercropping techniques like the Three Sisters, where maize, beans, and squash are grown in an intermixed arrangement, have sustained communities in the Americas for thousands of years and continue to be practiced around the world. In collaboration with the Catawba Indian Nation, we assessed the yield and labor demands required when farming with Three Sisters versus monoculture arrangements. Our results illustrate how farmers could use different planting strategies depending on their priorities (e.g., maximizing yield) and available resources (e.g., conserving land, seeds, or labor). Studies like these can help inform food sovereignty programs and support cultural initiatives in Native communities. Summary: Many Native American communities have historically grown maize, beans, and squash in polyculture as the Three Sisters because of the reciprocal ecological benefits the species provide each other and the surrounding environment. For instance, archaeological remains indicate that the Catawba Indian Nation had grown the Three Sisters for hundreds of years before experiencing the expansion of the colonial market economy, a smallpox epidemic, and the drastic loss of land.To support the Catawba Indian Nation's food sovereignty and traditional ecological knowledge initiatives, we assess the yield and labor demands of growing their traditional variety of maize, beans, and squash plants in the Three Sisters planting design versus in monoculture conditions.While total maize yield was equivalent in monoculture and the Three Sisters, plants grew larger, had higher survival, and produced greater yield per plant and per unit area of land in the Three Sisters. [Correction added on 21 November 2024, after first online publication: The preceding sentence has been corrected.] Squash yield was highest in monoculture. Trellising bean plants in monoculture required the most labor, and altogether, yield per hour of labor was higher in monoculture than in the Three Sisters.Ultimately, the most appropriate farming strategy for the Catawba Indian Nation to use will depend on their priorities (e.g., maximizing the production of one species versus all species). We discuss the challenges managers of small farms face when considering traditional versus modern agricultural methods and describe how a respectful partnership between the Catawba Nation and Davidson College expanded and enhanced the outcomes of this study. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Conclusion For people diagnosed with ulcerative colitis (UC), racial disparities exist both in access to medications and clinical outcomes.We used the TriNetX database for two population‐based retrospective analyses with Black (n = 22,519) and Asian (n = 8,626) individuals with UC matched for age, sex, and ethnicity. Outcomes included mortality, medication prescriptions, and clinical encounters at 6 months and 10 years.At 6 months and 10 years after diagnosis, Black people had increased mortality (2.7% vs. 1.9% and 8.1% vs. 6.9%, p < 0.0001), were prescribed fewer UC‐specific therapies (21.3% vs. 26.4% and 30% vs. 36%, p < 0.0001), had higher rates of emergency department visits (22.3% vs. 13.6% and 41.2% vs. 31.5%, p < 0.0001), and higher hospitalisation rates (30.1% vs. 25.8% and 42.6% vs. 39.9%, p < 0.0001). At 6 months, they had more opioid prescriptions (18.5% vs. 15.7%, p < 0.0001). Asian people had lower mortality at 10 years (5.6% vs. 7.7%, p < 0.0001), higher rates of UC‐specific medications at 6 months (28.6% vs. 26.5%, p = 0.002), and more hospitalizations (38.8% vs. 27.7%, p < 0.0001 at 6 months and 50% vs. 42.2%, p < 0.0001 at 10 years).Black individuals with UC are prescribed fewer disease‐specific therapies compared to White individuals and have increased hospitalizations and mortality. Black individuals have higher rates of opioid prescriptions. Opioids have been associated with increased complication rates in inflammatory bowel disease. These trends are not seen in Asian individuals. This reveals critical disparities in the care of Black people with UC with opportunity for targeted interventions. [ABSTRACT FROM AUTHOR]

Background: The annual incidence of sudden cardiac death is over 300,000 in the United States (US). Historically, inpatient implantation of secondary prevention implantable cardioverter defibrillator (ICD) has been variable and subject to healthcare disparities. Objective: To evaluate contemporary practice trends of inpatient secondary prevention ICD implants within the US on the basis of race, sex, and socioeconomic status (SES). Methods: The study is a retrospective analysis of the National Inpatient Sample from 2016 to 2020 of adult discharges with a primary diagnosis of ventricular tachycardia (VT), ventricular flutter, and fibrillation (VF). Adjusted ICD implantation rates based on race, sex, and SES and associated temporal trends were calculated using multivariate regression. Results: A total of 193,600 primary VT/VF discharges in the NIS were included in the cohort, of which 57,895 (29.9%) had ICD placement. There was a significant racial and ethnic disparity in ICD placement for Black, Hispanic, Asian, and Native American patients as compared to White patients; adjusted odds ratio (aOR): 0.86 [p <.01], 0.90 [p =.03], 0.81[p <.01], 0.45 [p <.01], respectively. Female patients were also less likely to receive an ICD compared to male patients (aOR: 0.75, p <.01). Disparities in ICD placement remained stable over the study period (ptrend ≥.05 in all races, both sexes and income categories). Conclusion: Racial, sex, and SES disparities persisted for secondary prevention ICD implants in the US. An investigation into contributing factors and subsequent approaches are needed to address the modifiable causes of disparities in ICD implantation as these trends have not improved compared to historic data. [ABSTRACT FROM AUTHOR]

Background: Recent literature has identified students' academic well‐being as an indicator of their persistence in their current study and competence development. While prior literature has focused on measuring students' academic well‐being from psychological and mental health perspectives, limited studies have explored the ways in which the learning environment provides diverse sources (e.g., supervision and peer support) to support students' academic well‐being. Purpose: This study aims to explore sources that foster students' academic well‐being from the perspective of two different student groups, namely first‐year engineering students and senior engineering students, in a PBL (project‐based learning) environment. Method: The Q methodology was applied, connecting both qualitative and quantitative research characteristics. Two student groups, including 23 first‐year engineering students and 19 senior engineering students, participated in this study to illustrate various viewpoints of different student groups and offer prospects for analyzing data from a new comparative angle via second‐order factor analysis. Results: In the first‐year engineering student group, three viewpoints were identified, namely the emphasis on enjoyment through study–life balance, personal values and aspirations, and academic agency. The senior engineering student group focused on internal sources related to professional development, including two viewpoints pertaining to their goal‐oriented academic development and enactment of agency through self‐management. Practical suggestions are proposed to optimize engineering curriculum design to better support students' academic well‐being. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the risk of a new‐encounter diagnosis of unspecified chronic rhinosinusitis (CRS), CRS with nasal polyps (CRSwNP), and eosinophilic granulomatosis with polyangiitis (EGPA) 1 and 2 years following body mass index (BMI) classification of obesity utilizing a large‐population‐based analytics platform. Study Design: Retrospective cohort analysis Setting: The U.S. Collaborative Network within the TriNetX Analytics platform contains deidentified electronic health record (EHR) data of more than 100 million patients and was used to determine the association between obesity and a new encounter diagnosis of 3 CRS phenotypes in this study. Results: After 1:1 propensity score matching, patients with an overweight BMI and obesity were at a higher risk for a new‐encounter diagnosis of unspecified CRS and CRSwNP compared to healthy‐weight individuals. The obesity cohort had the greatest increased risk of new‐onset unspecified CRS with a relative risk of 1.23 (95% CI: 1.20‐1.25) and 1.26 (95% CI: 1.24‐1.28) 1 and 2 years following BMI classification, respectively. Conclusion: Our study indicates an association between obesity and new‐onset unspecified CRS and CRSwNP. With the increasing prevalence of obesity in the United States population, it will be important to understand how obesity‐associated CRS may affect treatment response. Future prospective studies are needed to assess causality and define a mechanistic link. [ABSTRACT FROM AUTHOR]

Background: No studies have investigated the systemic and local sinonasal profile of obesity‐related chronic rhinosinusitis (CRS), despite its observed association in recent retrospective studies. The objectives of our study were to assess the impact of obesity on the clinical and cytokine profile of patients with CRS and evaluate treatment response with functional endoscopic sinus surgery. Methods: This was a prospective observational study at the Cleveland Clinic that included patients with CRS (n = 54) between December 2021 and September 2022. Data collection included demographics, body mass index (BMI), comorbidities, baseline sinonasal outcome test scores, baseline radiologic scores (Lund–Mackay), postoperative sinonasal outcome test scores (at 3–4 months), and local and systemic alarmins/T‐helper cytokines. Results: Out of the 54 CRS patients, there were 20 CRS patients without nasal polyps (37%) and 34 with nasal polyps (63%). Patients were categorized based on obesity (BMI ≥ 30 kg/m2). Obese CRS patients had lower systemic alarmins (interleukin [IL]‐33 and Thymic stromal lymphopoietin (TSLP)) compared to non‐obese CRS patients (IL‐33: 744.2 ± 1164.6 pg/mL vs. 137.5 ± 320.0 pg/mL, p = 0.005; TSLP: 627.7 ± 1806.3 pg/mL vs. 28.1 ± 85.4 pg/mL, p = 0.017). CRS patients with nasal polyps with BMI ≥30 kg/m2 had higher postoperative sinonasal outcome test scores and lower levels of nasal eotaxin‐3 and IL‐33 compared to BMI <30 kg/m2 counterparts. Conclusions: In conclusion, patients with obese CRS and nasal polyps displayed diminished levels of intranasal alarmins and reduced intranasal eotaxin‐3. These results potentially imply the presence of a unique, obese type 2‐low CRS phenotype that warrants further exploration. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to investigate the utilization of artificial neural networks (ANNs) in learning models that address the nonlinear anisotropic flow and hysteresis retention behavior of deformable porous materials. Herein, the micro‐geometries of various networks of porous Bentheimer Sandstones subjected to several degrees of strain from the literature are considered. For the generation of the database required for the training, validation, and testing of the machine learning (ML) models, single‐phase and biphasic lattice Boltzmann (LB) simulations are performed. The anisotropic nature of the intrinsic permeability is investigated for the single‐phase LB simulations. Thereafter, the database contains the computed average fluid velocities versus the pressure gradients. In this database, the range of applied fluid pressure gradients includes Darcy as well as non‐Darcy flows. The generated output from the single‐phase flow simulations is implemented in a feed‐forward neural network, representing a path‐independent informed graph‐based model. Concerning the two‐phase LB simulations, the Shan‐Chen multiphase LB model is used to generate the retention curves of the cyclic drying/wetting processes in the deformed porous networks. Consequently, two different ML path‐dependent approaches, that is, 1D convolutional neural network and the recurrent neural network, are used to model the biphasic flow through the deformable porous materials. A comparison in terms of accuracy and speed of training between the two approaches is presented. Conclusively, the outcomes of the papers show the capability of the ML models in representing constitutive relations for permeability and hysteretic retention curves accurately and efficiently. [ABSTRACT FROM AUTHOR]

Objective: The aim of this Meta‐analysis and systematic review was to perform a comprehensive assessment of the association of chronic rhinosinusitis (CRS) with overweight/obesity, leptin hormone, and its associated metabolic dysregulation. Data Sources: Ovid MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, were searched for studies from 1946 to October 2022, using predefined syntax. Review Methods: Outcome data for the meta‐analysis were extracted on odds ratios (OR) of CRS prevalence based on the presence of overweight/obesity and mean serum leptin levels. A Meta‐analysis was performed using the DerSimonian‐Laird estimator to pool extracted data by the generalized inverse variance approach. Random effect models were utilized due to the small sample size. A qualitative synthesis was performed on articles that did not meet the inclusion criteria for the Meta‐analysis. Results: Thirty‐six studies met the systematic review inclusion criteria out of 1113 articles screened. A total of 6 studies were included in the pooled Meta‐analysis of the various outcome variables. Our pooled meta‐analysis observed a positive association between overweight/obesity and the prevalence of CRS (OR = 1.33, 95% confidence interval [CI]: 1.17‐1.51). The pooled ratio of the means analysis of the mean serum leptin levels between CRS with nasal polyposis and control patients was 2.21 (95% CI: 1.45; 3.36). Conclusion: Our pooled Meta‐analysis indicates a positive association between overweight/obesity and CRS. Future prospective studies are needed to explore the association between CRS and obesity with an understanding of potential confounding comorbidities, including studies focused on assessing the underlying immunologic mechanism of this association. [ABSTRACT FROM AUTHOR]

Metal halide perovskite nanocrystals (NCs) have emerged as highly promising light emitting materials for various applications, ranging from perovskite light‐emitting diodes (PeLEDs) to lasers and radiation detectors. While remarkable progress has been achieved in highly efficient and stable green, red, and infrared perovskite NCs, obtaining efficient and stable blue‐emitting perovskite NCs remains a great challenge. Here, a facile synthetic approach for the preparation of blue emitting CsPbBr3 nanoplatelets (NPLs) with treatment by an organic sulfate is reported, 2,2‐(ethylenedioxy) bis(ethylammonium) sulfate (EDBESO4), which exhibit remarkably enhanced photoluminescence quantum efficiency (PLQE) and stability as compared to pristine CsPbBr3 NPLs coated with oleylamines. The PLQE is improved from ≈28% for pristine CsPbBr3 NPLs to 85% for EDBESO4 treated CsPbBr3 NPLs. Detailed structural characterizations reveal that EDBESO4 treatment leads to surface passivation of CsPbBr3 NPLs by both EDBE2+ and SO42– ions, which helps to prevent the coalescence of NPLs and suppress the degradation of NPLs. A simple proof‐of‐concept device with emission peaked at 462 nm exhibits an external quantum efficiency of 1.77% with a luminance of 691 cd m−2 and a half‐lifetime of 20 min, which represents one of the brightest pure blue PeLEDs based on NPLs reported to date. [ABSTRACT FROM AUTHOR]

Purpose: To describe the characteristics and veterinary management of animal casualties after an ammonium nitrate explosion in the Port of Beirut. Methods: Retrospective evaluation of medical records from multiple veterinary organizations. Results: Veterinary care was administered to 298 cats and 103 dogs, with 101 animals (25%) undergoing surgical procedures under general anesthesia. Glass injuries prevailed, with suturing performed in 98 animals (24.4%). Surgery was used to treat 31 animals (7.7%) with extremity fractures and 52 animals with tendon injuries (13.3%). Bodily burns were encountered in 19 animals (4.7%). Six animals (1.5%) lost their hearing entirely, while another 6 (1.5%) lost an eye. Conclusion: The joint coordinated work of veterinary groups and nongovernmental animal organizations reduced the number of injured animal fatalities. Of animals documented as having undergone treatment, 355 (88.5%) survived their initial injury assessment, and 46 (11.5%) died. [ABSTRACT FROM AUTHOR]

The following proceeding presents a multiscale approach to investigate the hydraulic anisotropy and retention behavior in porous materials involving deformation effects. Concerning the former, single‐phasic fluid flow simulations using the lattice Boltzmann method (LBM) are initially accomplished at the pore‐level geometry of Bentheimer sandstones provided by X‐ray microscopy at several degrees of compression to compute the intrinsic permeability. Due to the anisotropic nature of the Bentheimer sandstones, favored pore channels for fluid flow are witnessed within the domain. Therefore, it is important to understand the alteration of the preferred flow paths at each degree of compression. In this regard, we propose a new upscaling approach between the LBM and the macroscopic Theory of Porous Media (TPM) to accurately compute the macroscopic hydraulic structural tensor, which plays a crucial role in the calculation of the deformation‐dependent anisotropic specific permeability. As for the latter, the Shan‐Chen (SC) model of the LBM is applied at each strain level to model biphasic fluid flow via the unsaturated porous domain. Herein, the retention curves of the drainage and imbibition processes of each deformed state are computed. In turn, the comparison among the results shows the effect of variation of the strain degree on the retention behavior. [ABSTRACT FROM AUTHOR]

In this paper, we present a reliable micro‐to‐macroscale framework to model multiphase fluid flow through fractured porous media. This is based on utilizing the capabilities of the lattice Boltzmann method (LBM) within the phase‐field modeling (PFM) of fractures in multiphase porous media. In this, we propose new physically motivated phase‐field‐dependent relationships for the residual saturation, the intrinsic as well as relative permeabilities. In addition, an anisotropic, phase‐field‐dependent intrinsic permeability tensor for the fractured porous domains is formulated, which relies on the single‐ and multiphasic LBM flow simulations. Based on these results, new relationships for the variation of the macroscopic theory of porous media (TPM)–PFM model parameters in the transition zone are proposed. Whereby, a multiscale concept for the coupling between the multiphasic flow through the crack on one hand and the porous ambient, on the other hand, is achieved. The hybrid model is numerically applied on a real microgeometry of fractured porous media, extracted via X‐ray microcomputed tomography data of fractured Berea Sandstone. Moreover, the model is utilized for the calculation of the fluid leak‐off from the crack to the intact zones. Additionally, the effects of the depth of the transition zone and the orientation of the crack channels on the amount of leakage flow rates are studied. The outcomes of the numerical model proved the reliability of the multiscale model to simulate multiphasic fluid flow through fractured porous media. [ABSTRACT FROM AUTHOR]

The presence of a "central vein sign" (CVS) has been introduced as a biomarker for the diagnosis of multiple sclerosis (MS) and shown to have the ability to accurately differentiate MS from other white matter diseases (MS mimics). Following the development of susceptibility‐based magnetic resonance venography that allowed the in vivo detection of CVS, a standard CVS definition was established by introducing the "40% rule" that assesses the number of MS lesions with CVS as a fraction of the total number of lesions to differentiate MS lesions from other types of lesions. The "50% rule," the "three‐lesion criteria," and the "six‐lesion criteria" were later introduced and defined. Each of these rules had high levels of sensitivity, specificity, and accuracy in differentiating MS from other diseases, which has been recognized by the Magnetic Resonance Imaging in MS (MAGNIMS) group and the Consortium of MS Centers task force. The North American Imaging in Multiple Sclerosis Cooperative even provided statements and recommendations aiming to refine, standardize and evaluate the CVS in MS. Herein, we review the existing literature on CVS and evaluate its added value in the diagnosis of MS and usefulness in differentiating it from other vasculopathies. We also review the histopathology of CVS and identify available automated CVS assessment methods as well as define the role of vascular comorbidities in the diagnosis of MS. [ABSTRACT FROM AUTHOR]

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease affecting primarily premature infants. The disease is characterized by intestinal inflammation and leucocyte infiltration, often progressing to necrosis, perforation, systemic inflammatory response and death. Neutrophil extracellular traps (NETs), denoting nuclear DNA, histone and antimicrobial protein release, have been suggested to play a role in NEC. This study aimed to determine the role of NETs in NEC and explore the effect of chloramidine, a NET inhibitor, on a murine NEC‐like intestinal injury model. Blood and intestinal tissues were collected from infants diagnosed with ≥ Stage II NEC, and levels of nucleosomes and NETs, respectively, were compared with those of case‐matched controls. In mice, NEC was induced with dithizone/Klebsiella, and mice in the treatment group received 40 mg/kg chloramidine. Bacterial load, intestinal histology, plasma myeloperoxidase and cytokine levels, and immunofluorescent staining were compared with controls. Nucleosomes were significantly elevated in both human and mouse NEC plasma, whereas NET staining was only present in NEC tissue in both species. Chloramidine treatment increased systemic inflammation, bacterial load, organ injury and mortality in murine NEC. Taken together, our findings suggest that NETs are critical in the innate immune defence during NEC in preventing systemic bacteraemia. [ABSTRACT FROM AUTHOR]

Perovskite light‐emitting diodes (PeLEDs) have received great attention for their potential as next‐generation display technology. While remarkable progress has been achieved in green, red, and near‐infrared PeLEDs with external quantum efficiencies (EQEs) exceeding 20%, obtaining high performance blue PeLEDs remains a challenge. Poor charge balance due to large charge injection barriers in blue PeLEDs has been identified as one of the major roadblocks to achieve high efficiency. Here band edge control of perovskite emitting layers for blue PeLEDs with enhanced charge balance and device performance is reported. By using organic spacer cations with different dipole moments, that is, phenethyl ammonium (PEA), methoxy phenethyl ammonium (MePEA), and 4‐fluoro phenethyl ammonium (4FPEA), the band edges of quasi‐2D perovskites are tuned without affecting their band gaps. Detailed characterization and computational studies have confirmed the effect of dipole moment modification to be mostly electrostatic, resulting in changes in the ionization energies of ≈0.45 eV for MePEA and ≈ −0.65 eV for 4FPEA based thin films relative to PEA‐based thin films. With improved charge balance, blue PeLEDs based on MePEA quasi‐2D perovskites show twofold increase of the EQE as compared to the control PEA based devices. [ABSTRACT FROM AUTHOR]

Mechanochemical synthesis has emerged as a facile method for the preparation of a wide range of organic, inorganic, and polymeric materials. Here, we report the use of mechanochemical synthesis for the preparation of ionically bonded organic metal halide hybrids with a zero‐dimensional (0D) structure at the molecular level. (Ph4P)2SbCl5 and (Ph4P)2MnCl4 were synthesized by grinding appropriate ratios of organic halide salt Ph4PCl with inorganic metal halide salts SbCl3 and MnCl2, respectively. The structural and photophysical properties of mechanochemically synthesized (Ph4P)2SbCl5 and (Ph4P)2MnCl4 were characterized, which are almost identical to those of single crystals prepared by slow solution growth. By reacting Ph4PCl with both SbCl3 and MnCl2, we have been able to produce a mixture of two 0D organic metal halide hybrids that exhibit a dual emission covering a wide range of the spectrum with Commission Internationale de l'Eclairage (CIE) coordinates of (0.4898, 0.4800). Our work has clearly established mechanochemical synthesis as an effective method to produce ionically bonded organic‐inorganic hybrids. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to explore the sinopulmonary outcomes of aspirin desensitization through a systematic review and meta-analysis. Data Sources: Embase and OVID Medline databases. Review Methods: A systematic review of published articles on outcomes following aspirin desensitization in any language for relevant articles was performed in February 2019. Outcomes included sinonasal quality-of-life assessment, sense-of-smell scores, FEV-1 (forced expiratory volume in 1 second), and medication/steroid use. Results: Thirteen studies met the inclusion criteria out of 6055 articles screened. Aspirin desensitization resulted in significant improvement in FEV-1 and reduction in asthma medication/steroid use (P <.05). There was no significant improvement in the sinonasal quality of life of patients who underwent aspirin desensitization (P =.098). Conclusion: Aspirin desensitization appears to be effective in improving pulmonary outcomes and should be considered in the treatment of patients with aspirin-exacerbated respiratory disease. However, good-quality studies are still needed to determine the ideal protocol tailored to individual patients. [ABSTRACT FROM AUTHOR]

The photophysical tuning is reported for a series of tetraphenylphosphonium (TPP) metal halide hybrids containing distinct metal halides, TPP2MXn (MXn=SbCl5, MnCl4, ZnCl4, ZnCl2Br2, ZnBr4), from efficient phosphorescence to ultralong afterglow. The afterglow properties of TPP+ cations could be suspended for the hybrids containing low band gap emissive metal halide species, such as SbCl52− and MnCl42−, but significantly enhanced for the hybrids containing wide band gap non‐emissive ZnCl42−. Structural and photophysical studies reveal that the enhanced afterglow is attributed to stronger π–π stacking and intermolecular electronic coupling between TPP+ cations in TPP2ZnCl4 than in the pristine organic ionic compound TPPCl. Moreover, the afterglow in TPP2ZnX4 can be tuned by controlling the halide composition, with the change from Cl to Br resulting in a shorter afterglow due to the heavy atom effect. [ABSTRACT FROM AUTHOR]

Background: Studies have not yet examined the trends and risk factors of biphasic and recurrent anaphylaxis in the United States using International Classification of Diseases, tenth revision (ICD‐10) CM codes. The goal of this study is to examine the trends of biphasic and recurrent anaphylaxis in all patient care settings (inpatient, outpatient, emergency department, and observation). Methods: We used the Clinformatics database from 2015 to 2017. Our main outcome measure was recurrent anaphylactic events occurring within 1 year after the initial event. We used Cox proportional hazards modeling to assess the factors associated with recurrent anaphylaxis and the Kaplan‐Meier method to estimate time to recurrence. Results: There were a total of 19,039 patients with incident anaphylaxis in 2016 and, of these, 2017 had a recurrent anaphylaxis event in the 12‐month period after the index date (10.6%). The most common trigger for recurrent anaphylaxis is venom followed by food allergens. Pediatric patients aged <18 years were more likely to develop recurrent anaphylaxis compared with patients aged 18 to 64 years (hazard ratio [HR], 1.53). Patients with allergic rhinitis and asthma were more likely to develop recurrent anaphylaxis compared to those without these comorbidities (HR, 1.15 and 1.27, respectively). Conclusion: This is the first national study using ICD‐10 CM codes looking at rates of biphasic and recurrent anaphylaxis in all patient care settings. Recurrent anaphylaxis is more common in the first 3 days after the initial event, in younger patients (<18 years), and in patients with allergic rhinitis and/or asthma. Physicians need to prescribe epinephrine auto‐injectors and educate their patients about the risk of recurrence. [ABSTRACT FROM AUTHOR]

Background: Malpractice litigation remains an important point of contention in the United States. Airway management often sees multidisciplinary teams of anesthesiologists and otolaryngologists. This report analyzes lawsuits affecting both teams in airway management. Methods: The Westlaw legal database (West Publishing Co., St. Paul, MN) was used to search for malpractice cases involving failed airway management, where both anesthesiology and otolaryngology were involved. Results: Among the 28 cases analyzed, otolaryngology and anesthesiology were most commonly sued together (46.4%). When sued together, defendants were less likely to win and average award amounts ($4, 558 716) were higher. These cases most commonly occurred in the operating room (78.6%), involved a difficult/improper intubation (39.3%), alleged a failure to follow standard of care (57%), and resulted in death (60.7%). Conclusion: These cases primarily cited failure to follow standard of care and communication failures. Efforts should be directed toward multidisciplinary airway management protocols and effective communication. [ABSTRACT FROM AUTHOR]

Aims: To assess tolerability and optimal time point for initiation of sacubitril/valsartan in patients stabilised after acute heart failure (AHF).Methods and Results: TRANSITION was a randomised, multicentre, open-label study comparing two treatment initiation modalities of sacubitril/valsartan. Patients aged ≥ 18 years, hospitalised for AHF were stratified according to pre-admission use of renin-angiotensin-aldosterone system inhibitors and randomised (n = 1002) after stabilisation to initiate sacubitril/valsartan either ≥ 12-h pre-discharge or between Days 1-14 post-discharge. Starting dose (as per label) was 24/26 mg or 49/51 mg bid with up- or down-titration based on tolerability. The primary endpoint was the proportion of patients attaining 97/103 mg bid target dose after 10 weeks. Median time of first dose of sacubitril/valsartan from the day of discharge was Day -1 and Day +1 in the pre-discharge group and the post-discharge group, respectively. Comparable proportions of patients in the pre- and post-discharge initiation groups met the primary endpoint [45.4% vs. 50.7%; risk ratio (RR) 0.90; 95% confidence interval (CI) 0.79-1.02]. The proportion of patients who achieved and maintained for ≥ 2 weeks leading to Week 10, either 49/51 or 97/103 mg bid was 62.1% vs. 68.5% (RR 0.91; 95% CI 0.83-0.99); or any dose was 86.0% vs. 89.6% (RR 0.96; 95% CI 0.92-1.01). Discontinuation due to adverse events occurred in 7.3% vs. 4.9% of patients (RR 1.49; 95% CI 0.90-2.46).Conclusions: Initiation of sacubitril/valsartan in a wide range of heart failure with reduced ejection fraction patients stabilised after an AHF event, either in hospital or shortly after discharge, is feasible with about half of the patients achieving target dose within 10 weeks.Clinical Trial Registration: ClinicalTrials.gov ID: NCT02661217. [ABSTRACT FROM AUTHOR]

Background: No national study has examined the epidemiology of anaphylaxis after introduction of the codes of the International Statistical Classification of Diseases and Health Related Problems, Tenth Revision, Clinical Modification (ICD‐10 CM). Our objective was to examine the trends in incidence and hospitalization rates in the United States utilizing ICD‐9 and ICD‐10 CM codes. Methods: We used the Clinformatics database from 2004 to 2016. Our outcome measures included incidence of anaphylaxis and hospitalization trends. Multivariable logistic regression was used to assess the predictors of anaphylaxis and hospitalization. Results: There were a total of 462,906 anaphylaxis cases. The incidence increased from 153 in 2004 to 218 in 2016 (per 100,000). Women were 1.19 (95% confidence interval, 1.18‐1.20) times more likely to present with anaphylaxis. Medication‐induced anaphylaxis increased 15‐fold. Conclusion: This is the first population‐based study that included ICD‐10 CM codes to describe the epidemiology of anaphylaxis in the United States. ICD‐10 codes improved the accuracy of medication‐induced anaphylaxis, the most likely etiology to result in hospitalization. [ABSTRACT FROM AUTHOR]

In this contribution, the Shan‐Chen (SC) two‐phase flow model of the lattice Boltzmann method (LBM) is numerically implemented to simulate multiphase fluid flow on microtomography (µ‐CT) data of a sphere packing. From the model, the saturation degrees of the fluid phases, i.e. invading and displaced fluids, are extracted from the computed lattice density distribution functions. Several simulations are run with different degrees of kinetic viscosity contrast between the fluid phases within increasing increments of capillary pressure. At each increment, the relative permeability regarding each fluid phase is computed as a function of the saturation degree. The motivation of this study is to (1) investigate the effect of the kinetic viscosity contrast between the fluid phases on the retention behavior, (2) analyze the range of validity of the van Genuchten relation according to the computed retention data and (3) propose an extension towards an upscaling micro‐to‐macroscopic hierarchic scheme for the simulation of multiphasic fluid flow in unsaturated porous media. [ABSTRACT FROM AUTHOR]

Summary: Citrus co‐products are rich in flavonones among them naringin. This compound exhibits several biological activities. These properties are mainly due to its antioxidant activity. The purpose of this work was in one hand to compare five technics of extraction conducted under different operating conditions and in the other hand, to analyse the effects of temperature, light and oxygen on naringin degradation and on the evolution of its antioxidant activity. The results obtained showed that the ultrasound assisted extraction leads to the highest naringin content and the thermal degradation of naringin occurs only for higher temperatures above 100 °C. Moreover, the naringin appears to be sensitive to an exposure to visible light (16.5 klux). The effect of the oxygen is less pronounced due to the lack of the enone structure and a hydroxyl group in position 3. The antioxidant activity of naringin is significantly affected by the light and high temperature. Effect of the extraction process and the temperature on the naringin content. [ABSTRACT FROM AUTHOR]

Background: Exercise stress echocardiography (SE) is commonly used for diagnosing coronary artery disease (CAD). The use of quantitative echocardiographic measures such as strain imaging is expected to improve the sensitivity of conventional SE which relies on the visual diagnosis of wall-motion abnormalities (WMAs). This study is set to demonstrate the added value of resting and exercise strain analysis to detect underlying microangiopathy and inducible myocardial ischemia during a resting and SE in comparison with the results of coronary computed tomographic angiogram (CCTA). Methods: A total of 103 consecutive outpatients from the executive screening program were identified and underwent resting and SE. Global longitudinal strain (GLS) and wall-motion changes at rest and peak exercise were analyzed and compared. Baseline demographics, heart rate, and blood pressure measurements were retrospectively extracted for analysis. CCTA was chosen as an alternative test to match with wall motion and strain imaging. Results: Patients who had abnormal CCTA had lower resting GLS (14.85% ± 3.05 vs 17.99% ± 2.88, P-value = .001) when compared to patients with normal CCTA. All patients who had abnormal CCTA had higher wall-motion score index (1.35 ± 0.2 vs 1.00, P-value < .0001) and lower and abnormal peak stress GLS (pGLS) as compared to patients with normal CCTA (14.89% ± 3.35 vs 18.44% ± 4.27, P-value = .007). However, all patients with pGLS ≥ 20% had normal/nonobstructive CCTA. Patients with multiple comorbidities showed reduced and lower values of resting and pGLS (P-value < .0001), suggesting associated subclinical left ventricular dysfunction. Conclusions: Global longitudinal strain offers quantitative interpretation of the resting and SE study, detects underlying subclinical left ventricular dysfunction and a peak stress value more than 20% excludes obstructive CAD on CCTA. [ABSTRACT FROM AUTHOR]

Two different two-dimensional thiostannates (SnS) were synthesized using tris(2-aminoethyl)amine (tren) or 1-(2-aminoethyl)piperidine (1AEP) as structure-directing agents. Both structures consist of negatively charged thiostannate layers with charge stabilizing cations sandwiched in-between. The fundamental building units are Sn3S4 broken-cube clusters connected by double sulfur bridges to form polymeric (Sn3S72−) n honeycomb hexagonal layers. The compounds are members of the R-SnS-1 family of structures, where R indicates the type of cation. Despite consisting of identical structural units, the band gaps of the two semiconducting compounds were found to differ substantially at 2.96 eV (violet-blue light) and 3.21 eV (UV light) for tren-SnS-1 and 1AEP-SnS-1, respectively. Aiming to explain the observed differences in optical properties, the structures of the two thiostannates were investigated in detail based on combined X-ray diffraction, solid-state 13C and 119Sn MAS NMR spectroscopy and scanning electron microscopy studies. The compound tren-SnS-1 has a hexagonal structure consisting of planar SnS layers with regular hexagonal pores and disordered cations, whereas 1AEP-SnS-1 has an orthorhombic unit cell with ordered cations, distorted hexagonal pores and non-planar SnS layers. In the formation of 1AEP-SnS-1, an intramolecular reaction of the structure-directing piperidine takes place to form an N-heterobicyclic cation through in situ C-H activation. Hirshfeld surface analysis was used to investigate the interaction between the SnS layers and cations in 1AEP-SnS-1 and revealed that the most nucleophilic part of the SnS sheets is one of the two crystallographically distinct double sulfur bridges. [ABSTRACT FROM AUTHOR]

The objective of this paper is on the one hand to study the effect of heat processing (30 to 130°C for 2 h) on the stability and antioxidant activity of six flavonoids (rutin, naringin, eriodictyol, mesquitol, luteolin, and luteolin 7-O glucoside), and on the other hand to establish the relation structure-activity-stability of these compounds. The dependency on temperature of the six kinetics was well described by the Arrhenius law and the main parameters provided by this model are determined and compared in this paper. Activation energies found were 107.3 kJ/mol for rutin, 100.6 for naringin, 33.3 for mesquitol, 68.2 for eriodictyol, 51.4 for luteolin, and 120 for luteolin 7-O-glucoside. The data collected showed that glycosylated flavonoids are more resistant than aglycon flavonoids to heat treatment. Moreover, it was also observed that despite the total degradation of some flavonoids, the treated solutions still have an antioxidant activity. Practical application Flavonoids are mainly consumed in processed foods. Thus, flavonoids often undergo heat processing. Knowing the thermal stability and the evolution of their antioxidant activity are particularly relevant in the field of food processing. The results of this study allow information to be collected on the relationship between heat stability-flavonoid structure and antioxidant activity. This information will be useful for the formulation of new food products or for the design of new food processes. [ABSTRACT FROM AUTHOR]

Background Over the past decade, the use of balloon sinuplasty has increased widely in the United States. Since its introduction, no nationally representative, population-based study has examined its use among chronic rhinosinusitis (CRS) patients. Methods We conducted a retrospective cohort study of patients diagnosed with CRS between 2011 and 2014, and compared the prevalence of conventional functional endoscopic sinus surgery (FESS), balloon sinuplasty, and hybrid sinus surgery according to surgical site and calendar year. Results Out of 11 million to 11.4 million enrollees per year, a total of 661,738 patients with the diagnosis of CRS were included in the analyses. There was an increase in the use of balloon sinuplasty as a stand-alone procedure from 5% in 2011 to 22.5% in 2014. Conventional FESS continued to be the most commonly performed sinus procedure over the study period. Multinomial logistic regression analyses showed a linear increase in balloon sinuplasty and hybrid procedures from 2011 to 2014. Compared to patients over 60 years, patients younger than 30 years had lower odds of having a balloon sinuplasty as a stand-alone procedure compared to FESS. Compared to patients in the West, patients in the South, Northeast, and Midwest were significantly more likely to have balloon sinuplasty as a stand-alone procedure. Assessment of the sinus surgery site showed that patients with additional frontal sinus surgery were more likely to have a balloon-only procedure (odds ratio [OR], 4.67; 95% confidence interval [CI], 4.21 to 5.17) or a hybrid procedure (OR, 8.69; 95% CI, 7.48 to 10.11) than conventional FESS when compared to patients with conventional maxillary surgery only. Conclusion From 2011 to 2014 there was an increase in the use of balloon sinuplasty and a modest decrease in the use of conventional FESS in the United States. Patients with frontal or sphenoid sinus surgical sites were more likely to have a balloon or hybrid procedure. [ABSTRACT FROM AUTHOR]

Objective To determine the demographics and seasonal and geographic variation of epistaxis in the United States. Study Design Retrospective cohort analysis based on data from Medicare claims. Setting Emergency department visits. Subjects and Methods We used a 5% sample of Medicare data from January 2012 to December 2012. Our cohort included patients with an incident diagnosis of epistaxis during a visit to the emergency department, excluding those with a diagnosis in the prior 12 months. Demographics included age, sex, race, and ethnicity. We compared the rate of emergency department visits for epistaxis by geographic division and individual states. Results In the 5% sample of Medicare data, 4120 emergency department visits for incident epistaxis were identified in 2012. Our results showed an increase in the emergency department visits for epistaxis with age. Compared with patients <65 years old, patients who were 66 to 76, 76 to 85, and >85 years old were 1.36 (95% confidence interval [95% CI], 1.23-1.50), 2.37 (95% CI, 2.14-2.62), and 3.24 (95% CI, 2.91-3.62) more likely to present with epistaxis, respectively. Men were 1.24 (95% CI, 1.17-1.32) times more likely to present with epistaxis than women. Blacks were 1.23 (95% CI, 1.10-1.36) times more likely to present with epistaxis when compared with non-Hispanic whites. Epistaxis emergency department visits were 40% lower in the summer months versus winter. The seasonal variation was more pronounced in the northern versus southern United States. Conclusion Emergency department visits for epistaxis increase with age and appear to be seasonal, with a more pronounced variation in the northern versus southern United States. [ABSTRACT FROM AUTHOR]

Shading in photovoltaic systems can cause many undesired effects. When shading occurs, the power generated from the PV system is much less than nominal power, increasing the electrical mismatching losses between PV system components. Active research to address this power loss focuses on static and adaptive systems. This paper addresses an adaptive system solution and proposes a new method to adaptively overcome losses due to shading during low radiation conditions. In addition, a statistical analysis for choosing the most feasible and efficient configuration for the system size is presented. The proposed system has been validated under shade conditions in a simulation and prototype experiment. The experiments are conducted using a PV system consisting of 10 PV modules located at the Petroleum Institute in the United Arab Emirates. The proposed system is shown to minimize the shading losses of the PV array in real time by an average of 100% under simulated conditions and 84% in practical experiments. [ABSTRACT FROM AUTHOR]

ABSTRACT The aim of this study was to evaluate the effectiveness of total contact casting ( TCC) in treating non-healing diabetic foot ulcers in Lebanese diabetic patients. Twenty-three diabetic patients were treated with TCC, and relevant data were collected retrospectively. Sixteen patients were analysed; the average duration of casting was 6 weeks, and 75% of the patients achieved complete ulcer closure without recurrence during one year of follow-up and without any complications. TCC appears to be an effective treatment of diabetic foot ulcers. [ABSTRACT FROM AUTHOR]

Disseminated Cryptococcus disease occurs in patients with defective T-cell immunity. Cryptococcal meningitis following autologous stem cell transplant (SCT) has been described previously in only 1 patient, 4 months post SCT and while off antifungal prophylaxis. We present a unique case of Cryptococcus meningitis pre-engraftment after autologous SCT, while the patient was receiving fluconazole prophylaxis. A 41-year-old man with non- Hodgkin's lymphoma underwent autologous SCT. Post-transplant prophylaxis consisted of fluconazole 400 mg daily, levofloxacin 500 mg daily, and acyclovir 800 mg twice daily. On day 9 post transplant, he developed fever and headache. Peripheral white blood cell count (WBC) was 700/µL. Magnetic resonance imaging of the brain showed lesions consistent with meningoencephalitis. Cerebrospinal fluid (CSF) analysis revealed a WBC of 39 with 77% lymphocytes, protein 63, glucose 38, CSF pressure 20.5 cmH2O, and a positive cryptococcal antigen. CSF culture confirmed Cryptococcus neoformans. The patient was treated with liposomal amphotericin B 5 mg/kg intravenously daily, and flucytosine 37.5 mg/kg orally every 6 h. He was switched to fluconazole 400 mg daily after 3 weeks of amphotericin therapy, with sterilization of the CSF with negative CSF Cryptococcus antigen and negative CSF culture. Review of the literature revealed 9 cases of cryptococcal disease in recipients of SCT. Median time of onset was 64 days post transplant. Only 3 meningitis cases were described; 2 of them after allogeneic SCT. Fungal prophylaxis with fluconazole post autologous SCT is recommended at least through engraftment, and for up to 100 days in high-risk patients. A high index of suspicion is needed to diagnose and treat opportunistic infections, especially in the face of immunosuppression and despite adequate prophylaxis. Infection is usually fatal without treatment, thus prompt diagnosis and therapy might be life saving. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis Mounting evidence indicates the majority of spontaneous cerebrospinal fluid (CSF) leaks are associated with intracranial hypertension. The objectives of the current study were to assess outcomes regarding spontaneous CSF leaks focusing on premorbid factors, surgical technique, and management of intracranial pressure. Study Design Prospective cohort. Methods Prospective evaluation of patients with spontaneous CSF leaks was performed. Data regarding demographics, nature of presentation, body mass index (BMI), location and size of defect, intracranial pressure, clinical follow-up, and complications were collected. Results Over 5 years, 46 patients (average age, 51 years) with 56 spontaneous CSF leaks were treated by a single otolaryngologist. Twenty-one subjects presented with recurrence of their CSF leak following previous endoscopic and/or open approaches by other physicians. Obesity was present in 78% of individuals (average BMI, 35.6). Fifty-two CSF leaks (93%) were successfully repaired at first attempt. With secondary repair, all CSF leaks were closed at last clinical follow-up (average, 93 weeks). Three patients developed late failures (>2 months), with one recurrence at a distinct location from the primary site at 8 months postprocedure (associated with ventriculoperitoneal shunt failure). Opening pressures via lumbar puncture averaged 24.3 ± 8.3 cm H20, which increased significantly to 32.3 ± 9.0 cm H20 ( P < .0001) following closure of the skull base defect(s). Management of intracranial hypertension included acetazolamide (n = 23) or permanent CSF diversion (n = 19, including five revisions of failed preexisting shunts). Conclusions Although spontaneous CSF leaks have the highest recurrence rate of any etiology, prospective evaluation demonstrates high success rates with control of intracranial hypertension. Level of Evidence 4. Laryngoscope, 124:70-75, 2014 [ABSTRACT FROM AUTHOR]

Background Skull base defects and encephaloceles of the sinus and nasal cavities are routinely repaired endoscopically using a variety of materials including bone, cartilage, fascia, acellular dermal allografts, and xenografts, with high success rates. However, there is a paucity of data regarding the use of porcine small intestine submucosal (SIS) grafts for endoscopic dural repair. The purpose of the current study was to review outcomes using SIS grafts in the endoscopic reconstruction of skull base defects. Methods Review of prospectively collected data regarding skull base defect repair using SIS was performed. Demographics, location, and size of skull base defect, method of repair, successful closure, and complications were recorded. Results Over 4.5 years, 155 patients (mean age 49 years) underwent 170 primary skull base repairs using porcine SIS. Etiologies included tumor (76), spontaneous (51), trauma (37), and congenital (5). The majority of repairs were in combination with a nasoseptal flap (n = 113). Average defect size (length vs width) was 13 × 10.5 mm. Success rate on first attempt was 94.7% (161/170), and all defects were effectively sealed on subsequent endoscopic revision. The average follow-up was 77 weeks. Major postoperative complications, including recurrent cerebrospinal fluid (CSF) leak (9), meningitis (1), periorbital cellulitis (1), and invasive fungal sinusitis (1), occurred in 6.4% of individuals with no long-term sequelae. Conclusion Use of porcine SIS dural graft was associated with excellent outcomes in this study and evidence presented here supports its routine use in the endoscopic closure of skull base defects. [ABSTRACT FROM AUTHOR]

The article discusses simultaneous pericranial (PCF) and nasoseptal flaps (NSF) reconstruction of anterior skull base defects after endoscopic-assisted craniofacial resection. The materials and methods used in the surgery are explained. The article concludes that The combined PCF and NSF is a valid option for defects extending to the planum sphenoidale and may provide additional support when iatrogenic tears are encountered.

Background Acetazolamide has become a standard treatment for cerebrospinal fluid (CSF) leaks associated with intracranial hypertension. The purpose of the current study was to evaluate the effectiveness of acetazolamide at decreasing elevated CSF pressure in this patient population. Methods Prospective evaluation and data collection of high intracranial pressure CSF leaks was performed. Subjects underwent CSF diversion and postoperative assessment of pressure changes via a standard protocol. Lumbar drains or ventriculostomies were clamped on postoperative day 2 for 4 hours prior to assessment with a manometer. Acetazolamide (500 mg) was administered orally immediately following the recording and CSF pressure was measured after 4 hours. Data regarding demographics, etiology of CSF leak, body mass index (BMI), location and size of defect, and clinical follow-up were also collected. Results Thirty-six patients (average age 50 years) with 42 CSF leaks (39 spontaneous, 3 traumatic) and an average BMI of 36.1 were evaluated. Success rate of primary repair was 94.4%, but all patients were effectively sealed with subsequent endoscopic reconstruction (average 80 weeks follow-up). Intracranial pressure (cm H2O) via lumbar puncture or ventriculostomy (n = 2) after clamping was 32.0 ± 7.4. Administration of acetazolamide significantly decreased intracranial pressure to 21.9 ± 7.5 in the 4-6 hour time frame studied ( p < 0.0001). Conclusion This study provides some of the first direct evidence of decreased intracranial pressure associated with the oral administration of acetazolamide. In combination with the excellent endoscopic repair outcomes noted in a high risk population, this evidence supports the routine use of acetazolamide in patients with high intracranial pressure CSF leaks. [ABSTRACT FROM AUTHOR]

The article presents a study on the use of endoscopic approaches to evaluate the frontal sinus fractures outcomes which involves the posterior table. The study made use of Draf llb front sinusotomies with I individual requiring a concomitant trephine to primarily manage the thirteen patients. The result of the study shows that excellent outcomes in selected cases were provided by managing frontal sinus posterior table fractures using minimally invasive endoscopic techniques.

This paper investigates empirically the determinants of agro-food firms’ adoption of the Protected Designation of Origin (PDO) label. A unique dataset containing firm-level cost and production information on the French Brie cheese is used, covering the period 1980–2000. The Brie cheese data are especially relevant as PDO Brie producers have coexisted with other non-PDO producers since 1981. To evaluate the producers’ incentive to opt for PDO certification, we use a structural switching regression model which incorporates cost and production structure variables. Results show that PDO certification is less attractive the higher the costs of raw materials and the greater the size of the company. PDO Brie cheese production costs are estimated to be on average 40% higher than those for non-PDO Brie. The PDO production process could be technically inefficient when compared with the unconstrained non-PDO manufacturing; yet, PDO producers benefit from a price premium on their product which offsets their higher production cost. [ABSTRACT FROM AUTHOR]

The article discusses a study which investigated the thermal, mechanical and structural effects of beam-irradiation in Bayfol nuclear track detector. The study showed that electron irradiation in 40-100 kGy can cause crosslinking that destroys the crystalline structure. It also discovered the influence of electron dose on tensile strength, elongation at break, yield strength and intrinsic viscosity.