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Study objectiveMost long coronavirus disease (long COVID) studies rely on traditional surveillance methods that miss underserved populations who use emergency departments (EDs) as their primary health care source. In medically underserved ED populations, we sought to determine (1) whether there are gaps in awareness and self-declared understanding about long COVID illness, and (2) the prevalence, impact on school/work attendance, and receipt of care for long COVID symptoms.MethodsThis study was a cross-sectional, convenience sample survey study of adult patients at 11 geographically representative US EDs from December 2022 to October 2023. Awareness and self-declared understanding about long COVID illness were measured. Prevalence, impact on school/work attendance, and receipt of care for long COVID symptoms were also assessed.ResultsOf 1,618 eligible patients, 1455 (89.9%) agreed to participate, including 33.4% African Americans and 30.9% Latino/a. Of the patients, 17.1% lacked primary care. In total, 33.2% had persistent COVID-19 symptoms lasting >1 month, and 20.3% had symptoms >3 months. Moreover, 49.8% with long COVID symptoms missed work/school because of symptoms; 30.3% of all participants and 33.5% of participants who had long COVID symptoms had prior awareness and self-declared understanding of long COVID. Characteristics associated with poor understanding of long COVID were African American race (adjusted odds ratio [aOR] 3.68, 95% confidence interval [CI] 2.66 to 5.09) and Latino/a ethnicity (aOR 3.16, 95% CI 2.15 to 4.64). Participants lacking primary care were less likely to have received long COVID care (24.6% versus 51.2%; difference 26.6%; 95% CI 13.7% to 36.9%).ConclusionsDespite high prevalence and impact on school/work attendance of long COVID symptoms, most of this ED population had limited awareness and self-declared understanding of long COVID, and many had not received care. EDs should consider the development of protocols for diagnosis, education, and treatment of long COVID illness.

Although much evidence suggests that language influences perceptual discrimination, relatively little research has exploredfactors that might modulate such effects. Some have proposed that effects of language may be stronger for more difficultdiscriminations than for easier ones, yet previous studies have merely assumed this idea or tested it in a manner that treatslanguages influence as all-or-none rather than graded. Here we provide evidence for graded effects of language acrosssystematically varied levels of discrimination difficulty. Using color as a testbed, we show that categorical perceptionen-hanced discrimination at category boundariesincreases with difficulty, defined by the perceptual similarity between colors.Evidence for the modulatory role of difficulty was observed across two different linguistic category boundaries and twodifferent perceptual tasks. Our findings provide insight into the conditions under which language shapes perception andconverge with recent models that consider such effects in probabilistic terms.

Head computed tomography (CT) imaging is still a commonly obtained diagnostic test for patients with minor head injury despite availability of clinical decision rules to guide imaging use and recommendations to reduce radiation exposure resulting from unnecessary imaging. This prospective multicenter observational study of 251 patients with suspected mild to moderate traumatic brain injury (TBI) evaluated three serum biomarkers' (glial fibrillary acidic protein [GFAP], ubiquitin C-terminal hydrolase-L1 [UCH-L1] and S100B measured within 6 h of injury) ability to differentiate CT negative and CT positive findings. Of the 251 patients, 60.2% were male and 225 (89.6%) had a presenting Glasgow Coma Scale score of 15. A positive head CT (intracranial injury) was found in 36 (14.3%). UCH-L1 was 100% sensitive and 39% specific at a cutoff value >40 pg/mL. To retain 100% sensitivity, GFAP was 0% specific (cutoff value 0 pg/mL) and S100B had a specificity of only 2% (cutoff value 30 pg/mL). All three biomarkers had similar values for areas under the receiver operator characteristic curve: 0.79 (95% confidence interval; 0.70-0.88) for GFAP, 0.80 (0.71-0.89) for UCH-L1, and 0.75 (0.65-0.85) for S100B. Neither GFAP nor UCH-L1 curve values differed significantly from S100B (p = 0.21 and p = 0.77, respectively). In our patient cohort, UCH-L1 outperformed GFAP and S100B when the goal was to reduce CT use without sacrificing sensitivity. UCH-L1 values

ObjectiveTo examine the effectiveness of intramuscular (IM) midazolam versus intravenous (IV) lorazepam for the treatment of pediatric patients with status epilepticus (SE) in the prehospital care setting.MethodsThis multicenter clinical trial randomized patients diagnosed with SE to receive either IM midazolam or IV lorazepam administered by paramedics in the prehospital care setting. Included in this secondary analysis were only patients younger than 18 years of age. Evaluated were the associations of the treatment group (IM vs. IV) with the primary outcome, defined as seizure cessation prior to emergency department (ED) arrival, and with patient characteristics, time to important events, and adverse events. Descriptive statistics and 99% confidence intervals (CIs) were used for the analysis.ResultsOf 893 primary study subjects, 120 met criteria for this study (60 in each treatment group). There were no differences in important baseline characteristics or seizure etiologies between groups. The primary outcome was met in 41 (68.3%) and 43 (71.7%) of subjects in the IM and IV groups, respectively (risk difference [RD] -3.3%, 99% CI -24.9% to 18.2%). Similar results were noted for those younger than 11 years (RD -1.3%, 99% CI -25.7% to 23.1%). Time from initiating the treatment protocol was shorter for children who received IM midazolam, mainly due to the shorter time to administer the active treatment. Safety profiles were similar.SignificanceIM midazolam can be rapidly administered and appears to be safe and effective for the management of children with SE treated in the prehospital setting. The results must be interpreted in the context of the secondary analysis design and sample size of the study.

This paper will present information about the Web site--www.handsonmechanics.com, the process to develop the Web site, the vetting and management process for inclusion of physical models by the faculty at West Point, and how faculty at other institutions can add physical models and participate in the site as it grows. Each physical model has a description of the model, the theoretical background, pictures and/or video of the set-up and use of the demonstration, a parts list (or order location), and building plans, as well as that something extra about where else the physical model can be used, how to elicit greater student insight and bringing drama into the classroom using the model or demonstration. Course assessment data is provided to demonstrate the impact of physical models on student learning. A bibliography is included.

Significance: In the analysis of two-layered turbid dental tissues, the outer finitethickness layer is modeled by an optical transport coefficient distinct from its underlying semi-infinite substrate layer. The optical and thermophysical parameters of healthy and carious teeth across the various wavelengths were measured leading to the determination of the degree of reliability of each of the fitted parameters, with most reliable being thermal diffusivity and conductivity, enamel thickness, and optical transport coefficient of the enamel layer. Quantitative pixel-by-pixel images of the key reliable optical and thermophysical parameters were constructed. Aim: We introduced a theoretical model of pulsed photothermal radiometry based on conduction-radiation theory and applied to quantitative photothermal detection and imaging of biomaterials. The theoretical model integrates a combination of inverse Fourier transformation techniques, avoiding the conventional cumbersome analytical Laplace transform method. Approach: Two dental samples were selected for analysis: the first sample featured controlled, artificially induced early caries on a healthy tooth surface, while the second sample exhibited natural defects along with an internal filling. Using an Nd:YAG laser and specific optical parametric oscillator (OPO) wavelengths (675, 700, 750, and 808 nm), photothermal transient signals were captured from different points on these teeth and analyzed as a function of OPO wavelength. Measurements were also performed with an 808-nm laser diode for comparison with the same OPO wavelength excitation, particularly for the second sample with natural defects. Results: The findings demonstrated that the photothermal transient signals exhibit a fast-decaying pattern at shorter wavelengths due to their higher scattering nature, while increased scattering and absorption in the carious regions masked conductive and radiative contributions from the underlayer. These observations were crossvalidated using micro-computed tomography, which also enabled the examination of signal patterns at different tooth locations. Conclusions: The results of our study showed the impact of optical and thermal characteristics of two-layered turbid dental tissues via an inverse Fourier technique, as well as the interactions between these layers, on the patterns observed in depth profiles. [ABSTRACT FROM AUTHOR]

In the previous article, the authors described the 300 million gallon coal waste spill in Martin County, Kentucky and the interviews that they had with thirty-two area residents in the aftermath of the release (Scott, McSpirit, Hardesty, and Welch 2004 --this issue). Many of these interviewees charged MCCC-Massey and federal, state, and local government with incompetence, corruption, and an inability (or unwillingness) to clean up the spill, monitor the spill's impact on the local watershed and environment, and/or protect public health and safety. Yet as they acknowledged in the end, such semiprivate criticisms may indeed be important, but the political effects will remain relatively minimal unless they are also articulated publicly and directed toward some form of civic action. In this next piece, the authors focus instead on some of the more public forms of activism that occurred in Martin County after the coal waste release of October 2000. (Contains 40 notes.)

Abstract Probe and primer design for single nucleotide polymorphism (SNP) detection can be very challenging for A-T DNA-rich targets, requiring long sequences with lower specificity and stability, while G-C-rich DNA targets present limited design options to lower GC-content sequences only. We have developed the MGB Eclipsee™ Probe System, which is composed of the following elements: MGB Eclipse probes and primers, specially developed software for the design of probes and primers, a unique set of modified bases and a Microsoft Excel macro for automated genotyping, which ably solves, in large part, this challenge. Fluorogenic MGB Eclipse probes are modified oligo-nucleotides containing covalently attached duplex-stabilising dihydrocyclopyrroloindole tripeptide (DPI3), the MGB ligand (MGB™ is a trademark of Epoch Biosciences, Bothell, WA), which has the combined properties of allowing the use of short sequences and providing great mismatch discrimination. The MGB moiety prevents probe degradation during polymerase chain reaction (PCR), allowing the researcher to use real time data; alternatively, hybridisation can be accurately measured by a post-PCR two-colour melt curve analysis. Using MGB Eclipse probes and primers containing modified bases further enhances the analysis of difficult SNP targets. G- or C-rich sequences can be refractory to analysis due to Hoogsteen base pairing. Substitution of normal G with Epoch's modified G prevents Hoogsteen base pairing, allowing both superior PCR and probe-based analysis of GC-rich targets. The use of modified A and T bases allows better stabilisation by significantly increasing the Tm of the oligonucleotides. Modified A creates A-T base pairs that have a stability slightly lower than a G-C base pair, and modified T creates T-A base pairs that have a stability about 30 per cent higher than the unmodified base pair. Together, the modified bases permit the use of short probes, providing good mismatch discrimination and primers that allow PCR of refractory targets. The combination of MGB Eclipse probes and primers enriched with the MGB ligand and modified bases has allowed the analysis of refractory SNPs, where other methods have failed.

There is strong evidence that whole-grain foods protect against heart disease. Although underlying mechanisms and components are unclear, betaine, found at high levels in wheat aleurone, may play a role. We evaluated the effects of a diet high in wheat aleurone on plasma betaine and related measures. In a parallel, single-blinded intervention study, 79 healthy participants (aged 45-65 y, BMI [greater than or equal to] 25 kg/[m.sup.2] incorporated either aleurone-rich cereal products (27 g/d aleurone) or control products balanced for fiber and macronutrients into their habitual diets for 4 wk. Fasting blood samples were taken at baseline and postintervention (4 wk) from participants. Compared with the control, the aleurone products provided an additional 279 mg/d betaine and resulted in higher plasma betaine (P < 0.001 ; intervention effect size: 5.2 [micro]mol/L) and lower plasma total homocysteine (tHcy) (P = 0.010; -0.7 [micro]mol/L). Plasma dimethylglycine and methionine, which are products of betaine-mediated homocysteine remethylation, were also higher (P < 0.001 ; P = 0.027) relative to control. There were no significant effects on plasma choline or B vitamins (folate, riboflavin, and vitamin B-6). However, LDL cholesterol was lower than in the control group (P = 0.037). We conclude that incorporating aleurone-rich products into the habitual diet for 4 wk significantly increases plasma betaine concentrations and lowers tHcy, which is attributable to enhanced betaine-homocysteine methyltransferase-mediated remethylation of homocysteine. Although this supports a role for betaine in the protective effects of whole grains, concomitant decreases in LDL suggest more than one component or mechanism may be responsible. J. Nutr. 140:2153-2157, 2010. doi: 10.3945/jn.110.126961.