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Background: Red blood cell exchange is often used prophylactically in patients with sickle cell disease, with the goal to maintain hemoglobin S (HbS) below a target threshold level. We reviewed whether the daily "rate of rise" (RoR) in HbS that occurs between procedures can be used for patient management. For some patients not achieving their HbS goals despite efficient exchanges, the post‐procedure hematocrit (Hct) target is increased to potentially suppress HbS production. This case series explores the utility of this approach, other clinical uses of the daily RoR in HbS, and the factors that influence it. Study Design and Methods: A total of 660 procedures from 24 patients undergoing prophylactic RBC depletion/exchange procedures were included. Laboratory values and clinical parameters were collected and used to calculate the daily RoR in HbS. Factors such as Hct or medications that might influence the RoR in HbS were evaluated. Results: The RoR in HbS varied widely between patients but remained relatively stable within individuals. Surprisingly, this value was not significantly influenced by changes in post‐procedure Hct or concurrent hydroxyurea use. A patient's average RoR in HbS effectively predicted the pre‐procedure HbS at the following visit (R2 = 0.65). Discussion: The RoR in HbS is a relatively consistent parameter for individual patients that is unaffected by medication use or procedural Hct targets and may be useful in determining intervals between procedures. [ABSTRACT FROM AUTHOR]

Background: The Mirasol® Pathogen Reduction Technology System was developed to reduce transfusion‐transmitted diseases in platelet (PLT) products. Study Design and Methods: MiPLATE trial was a prospective, multicenter, controlled, randomized, non‐inferiority (NI) study of the clinical effectiveness of conventional versus Mirasol‐treated Apheresis PLTs in participants with hypoproliferative thrombocytopenia. The novel primary endpoint was days of ≥Grade 2 bleeding with an NI margin of 1.6. Results: After 330 participants were randomized, a planned interim analysis of 297 participants (145 MIRASOL, 152 CONTROL) receiving ≥1 study transfusion found a 2.79‐relative rate (RR) in the MIRASOL compared to the CONTROL in number of days with ≥Grade 2 bleeding (95% confidence interval [CI] 1.67–4.67). The proportion of subjects with ≥Grade 2 bleeding was 40.0% (n = 58) in MIRASOL and 30.3% (n = 46) in CONTROL (RR = 1.32, 95% CI 0.97–1.81, p =.08). Corrected count increments were lower (p <.01) and the number of PLT transfusion episodes per participant was higher (RR = 1.22, 95% CI 1.05–1.41) in MIRASOL. There was no difference in the days of PLT support (hazard ratio = 0.86, 95% CI 0.68–1.08) or total number of red blood cell transfusions (RR = 1.12, 95% CI 0.91–1.37) between MIRASOL versus CONTROL. Transfusion emergent adverse events were reported in 119 MIRASOL participants (84.4%) compared to 133 (82.6%) participants in CONTROL (p = NS). Discussion: This study did not support that MIRASOL was non‐inferior compared to conventional platelets using the novel endpoint number of days with ≥Grade 2 bleeding in MIRASOL when compared to CONTROL. [ABSTRACT FROM AUTHOR]

Kemeny's constant for a connected graph G$$ G $$ is the expected time for a random walk to reach a randomly chosen vertex u$$ u $$, regardless of the choice of the initial vertex. We extend the definition of Kemeny's constant to nonbacktracking random walks and compare it to Kemeny's constant for simple random walks. We explore the relationship between these two parameters for several families of graphs and provide closed‐form expressions for regular and biregular graphs. In nearly all cases, the nonbacktracking variant yields the smaller Kemeny's constant. [ABSTRACT FROM AUTHOR]

The article addresses the urgent need for rural reinvestment to combat geographic health inequities in the U.S. Topics discussed include the persistent disparities in preventable deaths between rural and urban areas, the detrimental impact of economic stagnation and underinvestment in rural communities, and the importance of leveraging local strengths and partnerships to improve health outcomes.

Copyright of Canadian Review of Sociology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lava tubes are key targets in the search for life on Mars. Their basaltic walls provide protection from radiation and changing environmental conditions, which could enable life or preservation of previous life in an otherwise harsh environment. We can understand the potential for Martian life in lava tubes by studying the habitability of analog environments on Earth. In this study, we present the first characterization of the microbial life inside a pristine Mauna Loa lava tube. This study is the first to combine 16S SSU rRNA sequencing and whole genome shotgun sequencing to map the taxonomic makeup and functional potential of any lava tube community in Hawaii, enabling a deep understanding of the types of microbes that thrive in this unique environment and the metabolisms they use. We find a surprisingly high degree of niche partitioning over small spatial scales and discuss implications for life detection strategies. Based on recent bioinformatic advancements in metagenomics, we also assemble dozens of high‐quality metagenome assembled genomes from the microbes living in the lava tubes, including several novel species. Plain Language Summary: In the search for life on Mars, lava tubes are targets for astrobiology. Lava tubes provide an underground shelter, protected from radiation and the harsh climate. Analog studies here on Earth can help us understand what types of microbes live in these terrains and how best to find them. In this study, we investigate the microbial communities in a previously unexplored lava tube on the Mauna Loa volcano in Hawaii. We set out to characterize the microbes that live there and what capabilities enable them to survive, such as how they acquire nutrients from their environment to produce energy. We collected mineral samples in the lava tube and sequenced the DNA that we found in the minerals. We used DNA sequences to identify which microbes are present as well as which metabolisms they can use. We found that there are significant differences in the microbial make‐up of each of the samples, even though some are taken within several centimeters of each other, with implications for how to assay a region of interest on Mars. We also found several novel species. Key Points: In this undisturbed environment, communities were characterized by multiple microniches, varying widely over the scale of metersThe lava tube contained high amounts of "microbial dark matter" or uncultivated microbes that remain unclassified in taxonomic databasesAlthough the mineralogy of many of the samples we studied was sulfate‐rich, metabolisms unrelated to sulfur dominated the metagenome [ABSTRACT FROM AUTHOR]

Objective: To present an updated version of the Utah Photophobia Symptom Impact Scale version 2 (UPSIS2), providing robust clinical and psychometric validation, to improve headache‐specific evaluation of light sensitivity and headache‐related photophobia. Background: The original UPSIS filled a gap in available tools for assessment of headache‐associated light sensitivity by providing patient‐reported evaluation of the impact of light sensitivity on activities of daily living (ADLs). We have since revised the original questionnaire to provide a more robust item construct and refined validation approach. Methods: We conducted a psychometric validation of the UPSIS2 through a primary analysis of an online survey of volunteers with recurrent headaches recruited from the University of Utah clinics and surrounding community. Volunteers completed the original UPSIS and UPSIS2 questionnaire versions in addition to measures of headache impact, disability, and frequency. The UPSIS2 now includes a pre‐defined recall period and a 1–4 Likert scale with standardized response anchors to improve clarity. Internal construct validity, external construct validity, and test–retest reliability, were evaluated. Results: Responses were obtained from 163 volunteers, with UPSIS2 scores ranging from 15 to 57 (out of a possible 15–60) with a mean (standard deviation) of 32.4 (8.80). Construct validity was satisfactory, as evidenced by sufficient unidimensionality, monotonicity, and local independence. Reliability was excellent, with Rasch test reliability = 0.90 and Cronbach's alpha = 0.92, and an intraclass correlation of 0.79 (95% confidence interval 0.65–0.88) for participants who took the test twice. UPSIS2 correlates well with other headache measures (Spearman's correlations >0.50), as well as the original UPSIS (Spearman's correlation = 0.87), indicating good convergent validity. UPSIS2 scores differ significantly across International Classification of Headache Disorders (third edition) groups, indicating good known group validity. Conclusion: The UPSIS2 provides a well‐validated headache‐specific outcome measure for the assessment of photophobia impact on ADLs. [ABSTRACT FROM AUTHOR]

The article discusses the need to modernize the payment system for Critical Access Hospitals (CAHs) under the Medicare Rural Hospital Flexibility Program (Flex). Topics highlights the challenges with the current cost-based reimbursement (CBR) system, which is becoming problematic for CAHs, and proposes a tripartite CAH payment system that incentivizes accountability, equity, and value-based care while ensuring access to rural health services.

Objectives: Intentional cranial modification and diet serve as markers of identity. Here, we explore the intersection between the body and social persona in the San Pedro oases through the complex relationship(s) between these markers and other aspects of society and the individual. Methods: Skeletal remains of 1190 individuals were analyzed for evidence of intentional head shaping and classed as unmodified, tabular, or annular. Stable carbon and nitrogen isotope analyses of bone (n = 203) focused on the contribution of C3 plants, C4/CAM plants, beans, and terrestrial animal meat per the Bayesian model, FRUITS. Strontium isotope data from dental enamel was considered for more detailed analyses. Results: Cranial modification was present in 520 individuals (43.7%; N = 1190). Modification was significantly more common among females (χ2 = 7.403, p = 0.007). There was no significant difference in presence or type between periods. Average values for the four modeled food groupings differ significantly. There is a significant difference in consumption of C4/CAM plants by those individuals with modified heads consuming more (26.5 ± 9.9% vs. 23.6 ± 9.4%, Wilcoxon signed‐rank test, p < 0.05). In the Middle Period sample, males consume significantly more C4/CAM plants (p < 0.05) and females more C3 plants (p < 0.01). Four of those with outlier C4 values were analyzed for strontium, yielding values outside the "local" range. Conclusions: As head shaping is permanently imposed in infancy while dietary patterns are the consequence of ongoing choices and constraints in the social and ecological environment, these markers of identity are not parallel. The numerous points of intersection between these markers and other aspects of identity are highlighted. [ABSTRACT FROM AUTHOR]

Craters of the Moon National Monument and Preserve (CotM) is a strong terrestrial analog for lava tube formations on Mars. The commonality of its basalt composition to Martian lava tubes makes it especially useful for probing how interactions between water, rock, and life have developed over time, and what traces of these microbial communities may be detectable by current flight‐capable instrumentation. Our investigations found that secondary mineral deposits within these caves contain a range of underlying compositions that support diverse and active microbial communities. Examining the taxonomy, activity, and metabolic potential of these communities revealed largely heterotrophic life strategies supported by contributions from chemolithoautotrophs that facilitate key elemental cycles. Finally, traces of these microbial communities were detectable by flight‐capable pyrolysis and wet chemistry gas chromatography‐mass spectrometry methods comparable to those employed by the Sample Analysis at Mars (SAM) instrument aboard the Curiosity rover and the Mars Organic Molecule Analyzer (MOMA) on the upcoming Rosalind Franklin rover. Using a suite of methods for chemical derivatization of organic compounds is beneficial for resolving the greatest variety of biosignatures. Tetramethylammonium hydroxide (TMAH), for example, allowed for optimal resolution of long chain fatty acids. Taken together, these results have implications for the direction of mass spectrometry as a tool for biosignature detection on Mars, as well as informing the selection of sampling sites that could potentially host biosignatures. Plain Language Summary: We investigated lava tubes at Craters of the Moon National Monument and Preserve for their potential to host and preserve evidence of life. Lava tubes are found on both Earth and Mars, and can shield life from extreme environmental conditions such as radiation and temperature fluctuation. We found a variety of mineral deposits on the walls of lava tube caves formed by water‐rock interactions throughout time, which hosted diverse microbial communities. These communities contained the ability to generate energy from both inorganic and organic carbon sources, as well as cycle important nutrients such as nitrogen and sulfur. In addition, we used techniques comparable to those employed aboard the Sample Analysis at Mars instrument on the Curiosity rover to understand whether this life could hypothetically be detected by exploratory missions. Many organic molecules were detected using our techniques, demonstrating that these habitats have the potential to preserve life and its traces on other worlds. Key Points: Genomic results reveal a diverse microbial ecosystem in the lava tubes at Craters of the MoonThere are multiple ways for chemolithotrophic life to harvest energy in this basaltic Mars analog environmentBiosignatures, or traces of life, can be detected in secondary mineral deposits using flight‐like techniques [ABSTRACT FROM AUTHOR]

Evolved gas analysis (EGA) data from the Sample Analysis at Mars (SAM) instrument suite indicated Fe‐rich smectite, carbonate, oxidized organics, Fe/Mg sulfate, and chloride in sedimentary rocks from the Glen Torridon (GT) region of Gale crater that displayed phyllosilicate spectral signatures from orbit. SAM evolved H2O data indicated that the primary phyllosilicate in all GT samples was an Fe‐rich dioctahedral smectite (e.g., nontronite) with lesser amounts of a phyllosilicate such as mixed layer talc‐serpentine or greenalite‐minnesotaite. CO2 data supported the identification of siderite in several samples, and CO2 and CO data was also consistent with trace oxidized organic compounds such as oxalate salts. SO2 data indicated trace and/or amorphous Fe sulfates in all samples and one sample may contain Fe sulfides. SO2 data points to significant Mg sulfates in two samples, and lesser amounts in several other samples. A lack of evolved O2 indicated the absence of oxychlorine salts and Mn3+/Mn4+ oxides. The lack of, or very minor, evolved NO revealed absent or very trace nitrate/nitrite salts. HCl data suggested chloride salts in GT samples. Constraints from EGA data on mineralogy and chemistry indicated that the environmental history of GT involved alteration with fluids of variable redox potential, chemistry and pH under a range of fluid‐to‐rock ratio conditions. Several of the fluid episodes could have provided habitable environmental conditions and carbon would have been available to any past microbes though the lack of significant N could have been a limiting factor for microbial habitability in the GT region. Plain Language Summary: The Mars Science Laboratory Curiosity rover carried out a comprehensive investigation of the sedimentary rocks in the Glen Torridon (GT) region in Gale crater, Mars, to better understand Martian geologic history. The rover's Sample Analysis at Mars instrument suite was used to heat samples from GT and detect gases that were evolved to help identify the volatile‐bearing mineralogy of the samples. Results indicated the presence of Fe‐rich smectite, carbonate, oxidized organics, Fe and Mg sulfate, and chloride while oxychlorine salts, Mn3+/Mn4+ oxides, and nitrate/nitrite salts were either not detected or occurred in trace amounts. This mineralogy data implied that geochemical conditions and fluid‐to‐rock ratios varied over time and that the conditions of GT depositional and diagenetic environments would have been amenable to microbial life with sufficient carbon but nitrogen abundances could have been limiting. Key Points: Sample Analysis at Mars data indicated Fe‐smectite, carbonate, oxidized organics, Fe/Mg sulfates, and chlorides in Glen Torridon (GT) rocksGT's environmental history involved fluids of variable redox potential and chemistry under a range of fluid‐to‐rock ratiosFluid episodes could have provided habitable environments and carbon was present, but nitrogen could have been a limiting factor [ABSTRACT FROM AUTHOR]

Background: A direct antiglobulin test (DAT) checks for antibody or complement on the surface of RBCs and is often done following a transfusion reaction. While passive anti-A and anti-B antibodies are known to cause positive DATs, the extent this occurs following transfusion is unknown.Study Design and Methods: DAT results, ABO type, eluate information, and blood product information were recorded on 1097 transfusion reactions at a large academic hospital over 8 years. The effect of patient blood type, product type, and plasma compatibility of blood product transfused on DAT results were determined. Statistical significance was determined using Chi-squared testing.Results: Patient ABO blood type was a strong predictor of a positive DAT, with type O patients having 6.7% positive rate and non-O patients having a positive rate of 20.6% (p < .0001). Plasma compatibility of the product was a strong predictor of a positive DAT, with plasma compatible transfusions having a 9.4% positive rate while plasma incompatible transfusions were positive 44% of the time (p < .0001). Elution studies found that anti-A/B antibodies were the most common antibody identified. Platelets were more likely to be associated with a positive DAT when compared with RBC transfusions (p < .05).Conclusions: These results demonstrate the patient ABO type and plasma incompatibility are strong predictors of positive DAT results following a transfusion reaction. Anti-A and anti-B antibodies are estimated to account for about 50% of positive DATs in this study. [ABSTRACT FROM AUTHOR]

Objective: Intestinal parasitic infections (IPIs) are a public health challenge in developing countries such as Colombia, causing anaemia and delayed growth and development in children. We aimed to estimate the geographical and prevalence trend of IPIs in the last 30 years in school and preschool children in Colombia.Methods: We conducted a systematic review and meta-analysis. We identified potential manuscripts through PubMed, EMBASE, Web of Science, LILACS, Scielo and Google Scholar on the IPIs prevalence in school and preschool children in Colombia. Articles included in the qualitative analysis were published between 1990 and 2020 in English or Spanish and met the inclusion criteria. Subsequently, a random-effects meta-analysis, a meta-regression and a trend analysis were performed.Results: We identified 2292 articles; 109 were included in the qualitative review, and 79 articles were included in the meta-analysis. The estimated IPI prevalence was 55% (95% CI: 48-63). By age group, the prevalence in preschool children was 37% (95% CI: 26-49) and 66% (95% CI: 52-78) in schoolchildren. The prevalence by region was heterogeneous, with the Amazon being the highest (69%) and the Santanderes the lowest (28%). In the last 20 years, the prevalence of helminthiasis has decreased (from 64.66% in 1990-1995 to 22.09% in 2016-2020).Conclusion: The prevalence of IPIs is high (>30%) in three of the seven regions in Colombia. Biannual administration of mass deworming in schoolchildren is recommended in the Amazon region. Public policies aiming to control IPIs should be reinforced. Further prevalence studies should include Cesar, Guaviare, Vichada and Vaupés, where the epidemiology of IPIs is unknown.Sustainable Development Goals: Good health and wellbeing, clean water and sanitation, sustainable cities and communities. [ABSTRACT FROM AUTHOR]

Objective: Poor hearing outcomes often persist following total drum replacement tympanoplasty. To understand the mechanics of the reconstructed eardrum, we measured wideband acoustic immittance and compared the mechanical characteristics of fascia-grafted ears with the normal tympanic membrane. Study Design: Prospective comparison study. Setting: Tertiary care center. Methods: Patients who underwent uncomplicated total drum replacement with temporalis fascia grafts were identified. Ears with healed grafts, an aerated middle ear, and no other conductive abnormalities were included. All patients underwent pre- and postoperative audiometry. Wideband acoustic immittance was measured with absorbance and impedance computed. Fascia-grafted ears were compared with normal unoperated ears. Results: Eleven fascia-grafted ears without complications were included. Postoperatively, the median air-bone gap was 15 dB (250-4000 Hz), with variation across frequency and between ears. Fifty-six control ears were included. Absorbance of fascia-grafted ears was significantly lower than that of normal ears at 1 to 4 kHz (P <.05) but similar below 1 kHz. Impedance magnitude demonstrated deeper and sharper resonant notches in fascia-grafted ears than normal ears (P <.05), suggesting lower mechanical resistance of the fascia graft. Conclusion: The mechanics of fascia-grafted ears differ from the normal tympanic membrane by having lower absorbance at mid- to high frequencies and thus poor sound transmission. The lower resistance in fascia-grafted ears may be due to poor coupling of the graft to the malleus. To improve sound transmission, grafts for tympanic membrane reconstructions would benefit from refined mechanical properties. [ABSTRACT FROM AUTHOR]

Using in vitro models, we previously reported that 4‐methylumbelliferone (4‐MU) blocked many of the pro‐catabolic features of activated chondrocytes. 4‐MU also blocked safranin O loss from human cartilage explants exposed to interleukin 1β (IL1β) in vitro. However, the mechanism for this chondroprotective effect was independent of the action of 4‐MU as a hyaluronan (HA) inhibitor. Interestingly, overexpression of HA synthase 2 (HAS2) also blocked the same pro‐catabolic features of activated chondrocytes as 4‐MU via a mechanism independent of extracellular HA accumulation. Data suggest that altering UDP‐sugars may be behind these changes in chondrocyte metabolism. However, all of our previous experiments with 4‐MU or HAS2 overexpression were performed in vitro. The purpose of this study was to confirm whether 4‐MU was effective at limiting the effects of osteoarthritis (OA) on articular cartilage in vivo. The progression of OA was evaluated after destabilization of the medial meniscus (DMM) surgery on C57BL/6 mice in the presence or absence of 4‐MU‐containing chow. Mice fed 4‐MU after DMM surgery exhibited significant suppression of OA starting from an early stage in vivo. Mice fed 4‐MU exhibited lower OARSI scores after DMM; reduced osteophyte formation and reduced MMP3 and MMP13 immunostaining. 4‐MU also exerted pronounced chondroprotective effects on murine joint cartilage exposed to IL1β in vitro and, blocked IL1β‐enhanced lactate production in cartilage explants. Therefore, 4‐MU is effective at significantly reducing the loss of proteoglycan and reducing MMP production both in vitro and in vivo as well as cartilage damage and osteophyte formation in vivo after DMM. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. 38:1122‐1131, 2020 [ABSTRACT FROM AUTHOR]

The R package glmm enables likelihood‐based inference for generalized linear mixed models with a canonical link. No other publicly available software accurately conducts likelihood‐based inference for generalized linear mixed models with crossed random effects. glmm is able to do so by approximating the likelihood function and two derivatives using importance sampling. The importance sampling distribution is an essential piece of Monte Carlo likelihood approximation, and developing a good one is the main challenge in implementing it. The package glmm uses the data to tailor the importance sampling distribution and is constructed to ensure finite Monte Carlo standard errors. In the context of the generalized linear mixed model, the salamander model with crossed random effects has become a benchmark example. We use this model to illustrate the complexities of the likelihood function and to demonstrate the use of the R package glmm. [ABSTRACT FROM AUTHOR]

Increasingly, couple therapists are called to promote equity in their clinical practice, yet little research illuminates the intricacy of doing this work. The purpose of this study was to clarify the clinical processes involved when therapists facilitate a more equitable balance of power in couple relationships while utilizing a sociocontextual frame of reference. It is part of larger research explicating Socio‐Emotional Relationship Therapy (SERT), an approach that places equity and social justice at the core. The sample included 72 SERT sessions with nine heterosoexual couples in which there was an observable power difference between partners. Using Charmaz's (2014, Constructinggroundedtheory:Apracticalguidethroughqualitativeanalysis, Sage) grounded theory coding, theoretical sampling, and interpretive methods, we examined therapist/client responses over multiple sessions to explain shifts in the couples' power balance. Analysis identified sociocultural attunement to vulnerability as the core clinical process and detailed five sociocultural expressions: socialized vulnerability, socialized invulnerability, reactive (in)vulnerability, reactive vulnerability, and shared vulnerability. Shifts in power involved each of three therapist stances: (a) identification of the societal power context of vulnerability, (b) therapist leadership and responsive persistence, and (c) facilitating mutual sociocultural attunement to vulnerability to promote shared relational responsibility and influence. Implications address the connections between power and vulnerability in couples work and what therapists can do to more effectively facilitate relational equity. [ABSTRACT FROM AUTHOR]

Background: With the recent approval of COVID‐19 vaccines, recovered COVID‐19 subjects who are vaccinated may be ideal candidates to donate COVID‐19 convalescent plasma (CCP). Case Series: Eleven recovered COVID‐19 patients were screened to donate CCP. All had molecularly confirmed COVID‐19, and all but one were antibody positive by chemiluminescence immunoassay (DiaSorin) prior to vaccination. All were tested again for antibodies 11–21 days after they were vaccinated (Pfizer/Moderna). All showed dramatic increases (~50‐fold) in spike‐specific antibody levels and had at least a 20‐fold increase in the IC50 neutralizing antibody titer based on plaque reduction neutralization testing (PRNT). The spike‐specific antibody levels following vaccination were significantly higher than those seen in any non‐vaccinated COVID‐19 subjects tested to date at our facility. Conclusion: Spike‐specific and neutralizing antibodies demonstrated dramatic increases following a single vaccination after COVID‐19 infection, which significantly exceeded values seen with COVID‐19 infection alone. Recovered COVID‐19 subjects who are vaccinated may make ideal candidates for CCP donation. [ABSTRACT FROM AUTHOR]

Purpose: In 2018, the Centers for Disease Control and Prevention (CDC) released an evidence‐based guideline on pediatric mild traumatic brain injury (mTBI) to educate health care providers on best practices of mTBI diagnosis, prognosis, and management/treatment. As residents living in rural areas have higher rates of mTBI, and may have limited access to care, it is particularly important to disseminate the CDC guideline to rural health care providers. The purpose of this paper is to describe rural health care providers' experience with pediatric mTBI patients and their perceptions on incorporating the guideline recommendations into their practice. Method: Interviews with 9 pediatric rural health care providers from all US regions were conducted. Interview transcripts were coded and analyzed for themes for each of the main topic areas covered in the interview guide. Findings: Common causes of mTBI reported by health care providers included sports and all‐terrain vehicles. While health care providers found the guideline recommendations to be helpful and feasible, they reported barriers to implementation, such as lack of access to specialists. To help with uptake of the CDC guideline, they suggested the development of concise implementation tools that can be referenced quickly, integrated into electronic health record‐based systems, and that are customized by visit type and health care setting (eg, initial vs follow‐up visits and emergency department vs primary care visits). Conclusion: Length, accessibility, and usability are important considerations when designing clinical tools for busy rural health care providers caring for pediatric patients with mTBI. Customized information, in both print and digital formats, may help with uptake of best practices. [ABSTRACT FROM AUTHOR]

Family therapists know that clinical concerns are not separate from larger sociopolitical contexts. Attunement to clients' sociocultural experience is foundational to good practice, yet few guidelines integrate attention to the larger societal processes or address social equity. The purpose of this article is to help therapists move from knowing about sociocontextual issues to doing socioculturally attuned practice. We offer an overarching framework that returns to Bateson and the roots of family therapy through a call for third order transformation. The approach is responsive to societal context and an analysis of power while working through enduring concepts of major family therapy models. Transtheoretical guidelines that can be integrated across practice models to promote third order change are illustrated with case examples. [ABSTRACT FROM AUTHOR]

Investigational therapies such as CCP should focus on patients most likely to benefit from the therapy and in our view seronegative patients are most likely to benefit from this therapy. In the field of transfusion medicine, laboratory results are commonly used to identify patients most likely to benefit from transfusion. However, CCP is not a proven therapy in any patients and under the EUA, the FDA requires all patients be informed that this is an investigational therapy. [Extracted from the article]

The database on ocean primary productivity comprises over two decades (1985–2008) of data that the authors have participated in collecting, using the assimilation of inorganic 14C through photosynthesis, in incubations carried out in situ. The dataset is perhaps unique in that it uses, overwhelmingly, consistent methodology while covering a wide geographic range. Ancillary data are included. Using the database, it is hoped that investigators can test for the relationships among the environmental drivers for ocean productivity, the meaning of the 14C method in terms of phytoplankton physiology and the dynamics in the water column, and as a resource for further development of productivity algorithms using satellite ocean color imagery. [ABSTRACT FROM AUTHOR]

Organic salts, such as Fe, Ca, and Mg oxalates and acetates, may be widespread radiolysis and oxidation products of organic matter in Martian surface sediments. Such organic salts are challenging to identify by evolved gas analysis but the ubiquitous CO2 and CO in pyrolysis data from the Sample Analysis at Mars (SAM) instrument suite on the Curiosity rover indirectly points to their presence. Here, we examined laboratory results from SAM‐like analyses of organic salts as pure phases, as trace phases mixed with silica, and in mixtures with Ca and Mg perchlorates. Pure oxalates evolved CO2 and CO, while pure acetates evolved CO2 and a diverse range of organic products dominated by acetone and acetic acid. Dispersal within silica caused minor peak shifting, decreased the amounts of CO2 evolved by the acetate standards, and altered the relative abundances of the organic products of acetate pyrolysis. The perchlorate salts scrubbed Fe oxalate CO releases and shifted the CO2 peaks to lower temperatures, whereas with Ca and Mg oxalate, a weaker CO release was observed but the initial CO2 evolutions were largely unchanged. The perchlorates induced a stronger CO2 release from acetates at the expense of other products. Oxalates evolved ∼47% more CO2 and acetates yielded ∼69% more CO2 when the perchlorates were abundant. The most compelling fits between our organic salt data and SAM CO2 and CO data included Martian samples acquired from modern eolian deposits and sedimentary rocks with evidence for low‐temperature alteration. Plain Language Summary: In our efforts to characterize indigenous Martian organic matter, we must contend with a near‐surface record that has been substantially altered by radiation and oxidation. Under such conditions, much of the surficial organic record on Mars may have decomposed into organic salts, which are challenging for flight instruments to conclusively identify. If organic salts are widespread on the Martian surface, their composition and distribution could offer insight into the less‐altered organic record at depth and they may play an important role in near‐surface carbon cycling and habitability. The organic detection techniques employed by the Mars Science Laboratory Curiosity rover include thermal extraction in combination with mass spectrometry. In this work, we used laboratory thermal extraction techniques analogous to those of the rover to examine organic salts as pure standards, as minor phases in a silica matrix, and in mixtures with O2‐evolving perchlorate salts. When we compared our results with flight data, we found that many of the CO2 profiles produced by our organic salt samples were similar to the CO2 evolutions observed by the rover. The best fits with our laboratory data included Martian materials acquired from modern eolian deposits and sedimentary rocks that had evidence for low‐temperature alteration. Key Points: Flight‐like thermal analyses of organic salts suggest such phases may have been present in many of the samples analyzed by Mars missionsPerchlorates greatly impacted the thermal decomposition of organic salts and enhanced CO2 production at the expense of other productsThe most compelling hints of organic salts occurred in pyrolysis data from altered Martian sedimentary rocks and modern eolian deposits [ABSTRACT FROM AUTHOR]

We have previously demonstrated that Fanconi anemia (FA) proteins work in concert with other FA and non‐FA proteins to mediate stalled replication fork restart. Previous studies suggest a connection between the FA protein FANCD2 and the non‐FA protein mechanistic target of rapamycin (mTOR). A recent study showed that mTOR is involved in actin‐dependent DNA replication fork restart, suggesting possible roles in the FA DNA repair pathway. In this study, we demonstrate that during replication stress mTOR interacts and cooperates with FANCD2 to provide cellular stability, mediate stalled replication fork restart, and prevent nucleolytic degradation of the nascent DNA strands. Taken together, this study unravels a novel functional cross‐talk between two important mechanisms: mTOR and FA DNA repair pathways that ensure genomic stability. [ABSTRACT FROM AUTHOR]

The global thermohaline circulation plays a major role in regulating global climate, driven by the formation of North Atlantic Deep Water (NADW). ODP Site 1063 on the Bermuda Rise, at the interface of NADW and Southern Ocean‐sourced water, appears an ideal location to study the relationships between ocean circulation and climate. This study reports Nd isotope ratios at Site 1063 that extend to ~1 Ma. The data show Nd isotope values during portions of interglacials that are much lower than modern NADW. However, interglacial Nd isotope values at Site 607, located within the core of NADW, off the abyssal seafloor in the North Atlantic, are consistently similar to modern NADW. In contrast to glacial values, we infer that interglacial Nd isotopes at Site 1063 are not representative of NADW and do not solely record water mass mixing. We conclude that the low Ndisotope ratios reflect regional particle‐seawater exchange as a consequence of input of freshly ground bedrock from the Canadian shield, which is eroded into the North Atlantic during major ice sheet retreats. The result is a deep, thin, and regionally constrained layer of seawater tagged with this anomalous low Nd isotope signature that is unrepresentative of the Atlantic Meridional Overturning Circulation (AMOC). We suggest that a benthic nepheloid layer, whose development is linked to the behavior of a deep‐recirculating gyre system, regulated by the interaction between the Gulf Stream and the deep western boundary current, facilitates the periodic masking of the Nd isotope signature of the North Atlantic AMOC end‐member in this region at these depths. Key Points: Glacial‐interglacial changes at the deep Bermuda Rise during the Middle and early Lower Pleistocene were recorded with εNdGlacial εNd values in the deep Bermuda Rise record the AMOC, interglacial εNd values do notDynamic benthic nepheloid layers temporally mask εNd at the deep Bermuda Rise during parts of interglacials [ABSTRACT FROM AUTHOR]

Copyright of Family Process is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Vera Rubin ridge (VRR) is a topographic high within the layers of Mount Sharp, Gale crater, that exhibits a strong hematite spectral signature from orbit. The Mars Science Laboratory Curiosity rover carried out a comprehensive investigation to understand the depositional and diagenetic processes recorded in the rocks of VRR. Sample Analysis at Mars (SAM) evolved gas analyses (EGA) were performed on three samples from the ridge and one from directly beneath the ridge. SAM evolved H2O data suggested the presence of an Fe‐rich dioctahedral smectite, such as nontronite, in the sample from beneath the ridge. H2O data are also consistent with ferripyrophyllite in VRR samples. SAM SO2 data indicated that all samples contained Mg sulfates and some Fe sulfate. Several volatile detections suggested trace reduced sulfur sources, such as Fe sulfides and/or S‐bearing organic compounds, in two samples while significant O2 and NO evolved from one sample indicated the presence of oxychlorine and nitrate/nitrite salts, respectively. The O2 evolution was the second highest to date and the first observed in ~1,200 sols. HCl released from all samples likely resulted, in part, from trace chloride salts. All samples evolved CO2 and CO consistent with oxidized carbon compounds (e.g., oxalates), while some CO2 may result from carbonate. SAM‐derived constraints on the mineralogy and chemistry of VRR materials, in the context of additional mineralogy, geochemistry, and sedimentology information obtained by Curiosity, support a complex diagenetic history that involved fluids of a range of possible salinities, redox characteristics, pHs, and temperatures. Plain Language Summary: The Mars Science Laboratory Curiosity rover conducted a detailed study of the rocks that make up the Vera Rubin ridge (VRR) feature in Gale crater, Mars, to better understand Martian geologic history. The Curiosity rover's Sample Analysis at Mars (SAM), a suite of scientific instruments on the rover, measured several diagnostic gases when it was used to heat samples from on and beneath VRR. These gases provided information about the mineralogy and chemistry of VRR samples that, together with additional information from other instruments on the rover, indicated that several different types of fluids affected the rocks in the ridge over geologic time. These fluids varied in temperature, salt content, and acidity. Key Points: Vera Rubin ridge experienced a complicated diagenetic history involving alteration by fluids with a variety of chemistries and temperaturesSample Analysis at Mars instrument suite data support an Fe‐rich composition for phyllosilicates detected on and near Vera Rubin ridgeSeveral salts were detected, including sulfate, chloride, nitrate, and oxychlorine salts, enabling constraints on diagenetic fluid chemistry [ABSTRACT FROM AUTHOR]

Most seabird species nest colonially on cliffs or islands with limited terrestrial predation, so that oceanic effects on the quality or quantity of prey fed to chicks more often determine nest success. However, when predator access increases, impacts can be dramatic, especially when exposure to predators is extended due to slow growth from inadequate food. Kittlitz's Murrelet (Brachyramphus brevirostris), a rare seabird having experienced serious declines, nests solitarily on the ground in barren, often alpine areas where exposure to predators is generally low. Nestling growth rates are exceptionally high and nestling periods very short relative to other Alcidae. This strategy reduces duration of exposure to predators, but demands adequate deliveries of high‐energy prey. In an area where foxes can access nests, we investigated whether varying energy content of prey fed to chicks could alter growth rates and resulting duration of predator exposure, and whether prolonged exposure appreciably reduced nest success. From 2009 to 2016, we monitored 139 nests; 49% were depredated (almost all by foxes) and 25% fledged. Prey fed to nestlings were 80% Pacific sand lance (Ammodytes personatus) and 19% capelin (Mallotus villosus), with capelin having 2.3× higher energy content per fish. In a year of slow chick growth, increased sand lance energy density of 31% (4.29–5.64 kJ/g, within published values), or increased proportion of capelin in the diet from 5.6% to 27.2%, would have allowed maximum chick growth. Maximum growth rates were attainable by delivering only 1.9 capelin/d versus 5.5 sand lance/d. Slow growth increased time to fledging by up to 5 d, decreasing survival by 7.7% (0.142–0.131). Breeding propensity of Kittlitz's Murrelet averages only 20%, so even small changes in nest success could affect populations. Although nest success was limited mainly by predation, oceanic effects on prey quantity and quality had overriding impacts in one year (2015 heat wave), and small but substantive effects in other years by mediating exposure to predation. Climate warming that decreases availability of high‐energy forage fish, or increases expansion of predators into nesting habitats, may disproportionately affect this sensitive species and others with predator‐accessible nests and demands for energy‐rich prey. [ABSTRACT FROM AUTHOR]

The Mars Science Laboratory mission investigated Vera Rubin ridge, which bears spectral indications of elevated amounts of hematite and has been hypothesized as having a complex diagenetic history. Martian samples, including three drilled samples from the ridge, were analyzed by the Sample Analysis at Mars instrument suite via evolved gas analysis‐mass spectrometry (EGA‐MS). Here, we report new EGA‐MS data from Martian samples and describe laboratory analogue experiments. Analyses of laboratory analogues help determine the presence of reduced sulfur in Martian solid samples, which could have supported potential microbial life. We used evolved carbonyl sulfide (COS) and carbon disulfide (CS2) to identify Martian samples likely to contain reduced sulfur by applying a quadratic discriminant analysis. While we report results for 24 Martian samples, we focus on Vera Rubin ridge samples and select others for comparison. Our results suggest the presence of reduced sulfur in the Jura member of Vera Rubin ridge, which can support various diagenetic history models, including, as discussed in this work, diagenetic alteration initiated by a mildly reducing, sulfite‐containing groundwater. Plain Language Summary: The Mars Science Laboratory studied the chemical composition of Vera Rubin ridge in Gale crater, Mars. The Sample Analysis at Mars, a set of scientific instruments designed to study rock chemistry, observed a number of gases released during the heating of Martian drilled samples. The same gases were observed when Mars‐relevant minerals were analyzed with similar instruments on Earth. From these two sets of data, we applied statistical analyses to determine which Mars samples on Vera Rubin ridge contained important sulfur compounds. Two samples on the ridge showed evidence for these compounds, which could have supported the energetic requirements for life. The results presented here improve both the understanding of the history of Gale crater and the potential for ancient life to have existed. Key Points: The Sample Analysis at Mars instrument suite studied carbon‐sulfur gases released during evolved gas analysis of Vera Rubin ridge samplesQuadratic discriminant analysis compared laboratory and flight data to identify Martian samples that contain reduced sulfurTwo Vera Rubin ridge samples from the Jura member were identified as likely to include reduced sulfur [ABSTRACT FROM AUTHOR]

Background: The in vivo recovery of transfused platelets is variable and often unpredictable. Although many recipient-dependent factors are well described, donor-dependent variables remain poorly understood.Study Design and Methods: To explore donor-dependent variables we conducted 2 retrospective studies of platelet transfusion outcomes in repeat donors. One study analyzed multiple autologous, radiolabeled platelet transfusions, and a second study analyzed multiple clinical platelet transfusions from a small cohort of repeat donors.Results: In 36 subjects, multiple within-subject determinations of recovery and survival of radiolabeled autologous platelets revealed a relative consistency in platelet recoveries within donors compared to the range of recoveries among donors. Intraclass correlation coefficients for platelet recovery were 43% to 93%. In 524 ABO-compatible clinical platelet transfusions derived from seven donors, a linear mixed-effects model revealed significant donor-dependent differences in corrected count increments for units stored for 4 or 5 days.Conclusions: These two studies indicate reproducible donor-dependent differences in transfused platelet recovery, suggesting a possible heritable influence on the quality of transfused platelets. [ABSTRACT FROM AUTHOR]

It is known that aging decreases natural resistance to viral diseases due to dysfunctional innate and adaptive immune responses, but the nature of these dysfunctions, particularly in regard to innate immunity, is not well understood. We have previously shown that C57BL/6J (B6) mice lose their natural resistance to footpad infection with ectromelia virus (ECTV) due to impaired maturation and recruitment of natural killer (NK) cells to the draining popliteal lymph node (dLN). More recently, we have also shown that in young B6 mice infected with ECTV, the recruitment of NK cells is dependent on a complex cascade whereby migratory dendritic cells (mDCs) traffic from the skin to the dLN, where they produce CCL2 and CCL7 to recruit inflammatory monocytes (iMOs). In the dLN, mDCs also upregulate NKG2D ligands to induce interferon gamma (IFN‐γ) expression by group 1 innate lymphoid cells (G1‐ILCs), mostly NK in cells but also some ILC1. In response to the IFN‐γ, the incoming uninfected iMOs secret CXCL9 to recruit the critical NK cells. Here, we show that in aged B6 mice, the trafficking of mDCs to the dLN in response to ECTV is decreased, resulting in impaired IFN‐γ expression by G1‐ILCs, reduced accumulation of iMOs, and attenuated CXCL9 production by iMOs, which likely contributes to decrease in NK cell recruitment. Together, these data indicate that defects in the mDC response to viral infection during aging result in a reduced innate immune response in the dLN and contribute to increased susceptibility to viral disease in the aged. [ABSTRACT FROM AUTHOR]

Objectives: Written accounts, as well as a previous craniometric study, indicate that migrations of non‐Europeans and conversions of Europeans to Islam define Ottoman communities in Early Modern Europe. What is less clear are the roles of migration and admixture in generating intra‐communal variation. This study combines craniometric with strontium isotope data to compare the cranial affinities of locally born and immigrant individuals. We predict that locally born individuals are more likely than non‐locals to show evidence of admixture. Materials and Methods: Radiogenic strontium isotope data for 21 Ottomans were compared against archaeological faunal values. Sixteen individuals with intact crania were also measured and compared against two comparative source populations from Anatolia and Europe. Discriminant function analysis assigned unclassified Ottoans to either comparative group based on typicality probabilities, with potential admixture established via intermediate morphology between the two source populations. Results: Strontium isotope values revealed relatively high proportions of non‐locals, consistent with high mobility documented historically. The sexes differed, with more males classifying as "typically Anatolian" than females. Locals and non‐locals also had different cranial affinity patterns, with most classifying either as "typically Anatolian" or "typically European." Contrary to expectation, none of the locals were identified as intermediate, suggesting admixture rates were relatively low. Conclusions: Consistent with historical records, the results revealed high levels of extra‐regional migration, with most individuals identifiable as either typically Anatolian or European. Moreover, locals and non‐locals differed craniometrically, with no signs of admixture between Anatolian migrants and European converts in locals. This suggests intra‐communal divisions were maintained. [ABSTRACT FROM AUTHOR]

Background: ABO compatibility can affect platelet transfusion safety and efficacy, and ABO-incompatible (ABOi) platelets likely increases the risks of transfusion reactions though the magnitude of this risk is unclear.Study Design and Methods: Data collected on all platelet transfusions administered over 36+ months were classified based on patient and product ABO blood group type and merged with a data set that included all transfusion reactions reported during that period. The transfusion reaction rates among various subsets was calculated.Results: In patients greater than 1 year of age, the transfusion reaction rate in the ABO-compatible (ABO-identical) platelet group was 1.0%, while the ABOi platelet group had an elevated reaction rate of 1.7%. The increased reaction rate for ABOi platelets held true even if the analysis were limited to Centers for Disease Control and Prevention/National Healthcare Safety Network qualifying reactions or just allergic or febrile nonhemolytic reactions. The increased reaction rate with ABOi platelets was independent of unit age. Surprisingly, major-incompatible transfusions (A/B antigen incompatible) had the highest rate of reactions, at 2.0%. During the study period, three acute hemolytic reactions were reported out of 2522 plasma-incompatible platelet transfusions (0.12%).Conclusions: Our results find that compatible platelet transfusions have the lowest rate of transfusion reactions. While hemolytic reactions were observed with plasma-incompatible transfusions, the rate was low. Transfusion of ABO antigen-incompatible platelets had the highest rate of transfusion reactions and resulted in a transfusion reaction rate 1.5 to 2 times that of ABO compatible transfusions. [ABSTRACT FROM AUTHOR]

Objective: To examine how older, heterosexual couples negotiate gendered power when both partners are retired. Background: After retirement, changes frequently prompt couples to renegotiate traditional, gender‐informed ways of relating. Although a shift toward less gender‐specific division of tasks has been identified in previous studies, it is unclear how underlying gendered power structures may also be transformed. Method: A constructivist grounded theory analysis was conducted of 18 interviews with a convenience sample of retired older couples (69–91 years of age) in Southern California. Results: Three patterns were identified that kept couples engaged in stereotypic gendered processes: (a) women's relational responsibility, (b) masked inequality, and (c) men's marketing of traditional gender‐specific processes. In addition, four patterns were identified that moved couples closer to mutuality: (a) equal attunement to one another, (b) mutual decision‐making, (c) connecting with socioemotional context, and (d) recognition of inequality. Conclusion: Retired couples seeking relational help may be experiencing a gap between ideals of mutuality and the persistence of gendered power. Implications: This study shows that gendered power dynamics may be somewhat masked among older couples. Practitioners are advised to address the subtle ways that relational dynamics may remain gendered and the extent to which that limits closeness and connection within the relationship. Specific areas therapists should explore with clients are provided. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to review our 5‐year experience with clinical FISH testing for TP63 rearrangements using both TP63 break‐apart (BAP) and TBL1XR1/TP63 dual‐fusion (D‐FISH) probes to evaluate the frequency of TP63 rearrangements and the distribution of TBL1XR1 vs. alternate partner loci, and to assess whether both probe sets are necessary in all cases undergoing FISH testing. Methods and results: A retrospective review of the Mayo Clinic cytogenetic database identified 470 patients evaluated by FISH testing for TP63 rearrangements in formalin‐fixed paraffin‐embedded (FFPE) tissue using both BAP and D‐FISH probes. Of these, 25 (5.3%) had TP63 rearrangements. All samples were being investigated for anaplastic large‐cell lymphoma or other T cell lymphoma subtypes. A TBL1XR1 partner was identified by D‐FISH in 12 (48%) of 25 cases. All cases positive by TBL1XR1/TP63 D‐FISH were also positive by TP63 BAP FISH. Conclusion: This is the largest series of TP63 rearrangements to date. The frequency of positive results among cases referred to a large reference laboratory for TP63 FISH testing was 5.3%. Approximately half of TP63 rearrangements have a TBL1XR1 partner. TP63 BAP FISH testing is sufficient for up‐front testing of FFPE tissue samples. However, because of the genomic proximity of the TP63 and TBL1XR1 loci, we recommend reflex TBL1XR1/TP63 D‐FISH testing in positive and equivocal cases. [ABSTRACT FROM AUTHOR]

In this article, we present an isotopic perspective of key research questions in Andean bioarchaeology, focusing on the ways in which stable and radiogenic isotope analyses have contributed to our understanding of the past. Andean archaeology offers a window into long‐term processes of economic, socioecological and political change since the mid‐Holocene, thus providing historical trajectories of socio‐ecological change relevant for global comparison. The spatial scale of this review includes the areas traditionally identified as the south‐central Andes and the southern Andes. These ecological scenarios are characterised by marked topographic, climatic and ecological variations that are fruitful for the application of isotopes to understand diet, mobility, migration and ritual in past human societies. Within the broader Andean context, here we focus on the growth of bioarchaeological applications of isotopic data. We discuss some major themes of economic production, mobility and exploitation of environmental diversity, maize agriculture, migrations in small‐ and large‐scale societies and ritual practices related to human sacrifices and body modifications. Building on this, we discuss theoretical and methodological trends and directions for future research combining bioarchaeology and isotopes in the Andes. [ABSTRACT FROM AUTHOR]

The article comments on the National Action Plan for chronic obstructive pulmonary disease (COPD) and rural health. Topics include that the COPD is a complex lung disease characterized by airways inflammation and lung tissue remodeling that leads to loss of small airways and emphysema; and its tag as the fourth leading cause of death in the United States.

Objectives: Patients with dementia are at high risk for hip fractures and often have poor outcomes when a fracture is sustained. Despite this poor prognosis, little data are available on what factors should be prioritized to guide surgical decision making in these cases. We aimed to understand the decision‐making process for older dementia patients hospitalized after hip fractures. Design: We performed a qualitative analysis of in‐depth elite interviews conducted with a clinical care team involved in management of patients with dementia after hospitalization for hip fractures. Setting: Interviews were conducted with an interprofessional team involved in the care of patients with dementia after being hospitalized for hip fractures. Participants: Interviewees included nine orthopaedic surgeons, three hospitalists, three geriatricians, five nurses, three occupational therapists, three physical therapists, and two clinical ethicists. Measurements: Verbatim transcripts of the interviews were analyzed and coded using QSR International's NVivo 10 qualitative database management software. Results: The three main themes that most interviewees discussed were pain control, functional status, and medical comorbidities. Interviewees brought up many factors related to restoring functional status including baseline functional status, rehabilitation potential, social support, and the importance of mobility. Dementia and its impact on rehabilitation potential were mentioned by all geriatricians. Conclusion: Although frailty, prognosis, and life expectancy were largely absent from the responses, the emphasis on dementia, advanced directives, and involving family or caregivers by the three geriatricians indicates the importance of including geriatricians in the decision‐making team for these patients. [ABSTRACT FROM AUTHOR]

We contend that the field of family therapy is undergoing a notable shift from second‐ to third‐order thinking. We offer theoretical support and examples to demonstrate how third‐order thinking provides a framework for integrating heightened sociocultural attunement into family therapy practice. We discuss the importance of third‐order thinking relative to being prepared to invite families into third‐order change. Finally, we offer a case example to show specific guidelines for third‐order practice. Translation into Spanish [ABSTRACT FROM AUTHOR]

Five other Type O patients (Table 2 #3-7) were found that had allergic reactions to all B antigen positive units they received but these patients received fewer platelet transfusions, and all had just a single allergic reaction making the possibility that this occurred by chance much higher. While likely under-powered, this does not support the possibility that psoralen treated platelets increase allergic reaction rates as suggested previously.[1] In our data set there were 10 type O patients and 4 type A patients who had allergic reactions to B or AB platelets. We read the recent letter by Joubeh and Singh discussing allergic reactions to psoralen-treated platelets (PI-Platelets) and found their data intriguing.[1] These authors describe two cases of O+ male patients developing allergic reactions after psoralen-treated platelet transfusions, and they wonder whether PI-Platelets may cause allergic transfusion reactions. [Extracted from the article]

Field portable instrumentation, such as in situ geochemical analyzers or broader field of view instruments like multispectral imagers or other imaging capabilities, has the potential to dramatically increase the science return of a planetary surface exploration mission. However, more work is needed to determine how emerging portable technologies should be designed and implemented into evolving mission architectures. This work summarizes the efforts of the RIS4E (Remote, In Situ and Synchrotron Studies for Science and Exploration) SSERVI (Solar System Exploration Research Virtual Institute) team in investigating how field portable instruments should be including into planning for future exploration EVAs (extravehicular activities). EVA crews of geologists and astronauts tested a variety of portable and handheld technologies at both the December 1974 lava flow, Kilauea Volcano, Hawai'i, and Kilbourne Hole, New Mexico, both of which are planetary analog sites. The timeline data gathered during instrument deployment were then mapped onto EVA timelines used in large‐scale NASA planetary surface exploration analog missions. Results and recommendations for future instrument hardware and software development are discussed, as is the operational framework necessary for incorporating in situ analytical capabilities into future planetary surface exploration. Key Points: Advancements in field portable technologies have the capability to increase the science return from crewed planetary surface missionsSimulated extravehicular activities were conducted in planetary analog sites to investigate the utility of portable instrumentsMore integrated testing is needed to evaluate varying modes of integrating field portable instruments beyond a handheld capacity [ABSTRACT FROM AUTHOR]

Objectives Stable carbon and nitrogen isotope analysis is used to reconstruct diet among a pre-Hispanic population from the Peruvian Andes to evaluate whether local foodways changed with Wari imperial influence in the region. This study also compares local diet to other Wari-era sites. Materials and methods Samples derive from the site of Beringa in Peru and correspond primarily to pre-Wari (200-600 CE) and Wari (600-1,000 CE). We examine stable carbon isotopes from enamel ( n = 29) and bone apatite ( n = 22), and stable carbon and nitrogen isotopes from bone collagen ( n = 29), and we present stable carbon and nitrogen isotope data on archaeological and modern fauna ( n = 37) and plants ( n = 19) from the region. Results There were no significant differences in either δ13C or δ15N from the pre-Wari to Wari era, indicating that those measurable aspects of diet did not change with Wari influence. There were no sex-based differences among juveniles (as inferred from δ13C from enamel carbonates) nor among adults (based on δ13C and δ15N from adult bone collagen). Comparisons to other Wari era sites show that Beringa individuals exhibited significantly lower δ13C values, suggesting that they consumed significantly less maize, a socially valued food. Further, the Froehle et al. (2012) stable isotope model suggests that the majority of the Beringa individuals consumed more C3 than C4 plants, and dietary protein was derived primarily from terrestrial animals and some marine resources. Conclusions The similar diets from pre-Wari to Wari times hint at strong local dietary traditions and durable food trade networks during the period of Wari imperial influence. The presence of limited marine foods in the diet suggests a trade network with coastal groups or sojourns to the coast to gather marine resources. [ABSTRACT FROM AUTHOR]

One way to facilitate Multilingual Information Access (MLIA) for digital libraries is to generate multilingual metadata records by applying Machine Translation (MT) techniques. Current online MT services are available and affordable, but are not always effective for creating multilingual metadata records. In this study, we implemented 3 different MT strategies and evaluated their performance when translating English metadata records to Chinese and Spanish. These strategies included combining MT results from 3 online MT systems (Google, Bing, and Yahoo!) with and without additional linguistic resources, such as manually-generated parallel corpora, and metadata records in the two target languages obtained from international partners. The opensource statistical MT platform Moses was applied to design and implement the three translation strategies. Human evaluation of the MT results using adequacy and fluency demonstrated that two of the strategies produced higher quality translations than individual online MT systems for both languages. Especially, adding small, manuallygenerated parallel corpora of metadata records significantly improved translation performance. Our study suggested an effective and efficient MT approach for providing multilingual services for digital collections. [ABSTRACT FROM AUTHOR]

Background: Hemoglobin S percentages are used in the management of patients who have sickle cell disease. However, hemoglobin S measurements often are not routinely or rapidly performed. Rapid and accurate methods to estimate hemoglobin S levels after simple transfusion may improve the care of patients with sickle cell disease.Study Design and Methods: A comprehensive review of the electronic medical record identified 24 stable patients with sickle cell disease who received simple red blood cell transfusions and had hemoglobin S measurements before and after the transfusion that were less than 72 hours apart. Examination of these patients identified 62 separate transfusions that met our criteria. Three simple equations that utilized complete blood count values and readily available information from the medical record were used to predict the post-transfusion hemoglobin S level after transfusion (Equation 1: predicted post-transfusion hemoglobin = pre-transfusion hemoglobin S × [pre-transfusion hemoglobin/post-transfusion hemoglobin]; Equation 2: predicted post-transfusion hemoglobin S = pre-transfusion hemoglobin S × [pre-transfusion hematocrit/post-transfusion hematocrit]; and Equation 3: predicted post-transfusion hemoglobin S = pre-transfusion hemoglobin S × total pre-transfusion hemoglobin/[total pre-transfusion hemoglobin + (red blood cell volume × 20)]).Results: The predicted hemoglobin S values for all three equations showed a highly significant correlation with the measured post-hemoglobin S value. The coefficient of determination (R2 ) for Equations 1, 2, and 3 was 0.95, 0.92, and 0.97, respectively. Predicting the post-transfusion hemoglobin S value using estimates of the patient's total hemoglobin and the transfused hemoglobin (Equation 3) was the most precise.Conclusion: Reductions in hemoglobin S values in patients with sickle cell disease who receive simple red blood cell transfusions can be reliably predicted using complete blood cell measurements and simple arithmetic equations. [ABSTRACT FROM AUTHOR]