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Background: Prolonged intubation following lung transplantation is thought to delay recovery, yet a paucity of data exists regarding risk factors and outcomes related to extubation failure. Methods: We performed a single-center, retrospective analysis of 238 lung transplant recipients between January 1, 2018, and December 31, 2022, to identify risk factors for extubation failure (intubation greater than 3 days, reintubation, and/or need for tracheostomy). We also assessed short-term outcomes relative to extubation success. Results: In this cohort, 144 patients (60%) were extubated successfully while 94 patients experienced extubation failure; 10 (11%) were intubated greater than 3 days, 9 (9%) were reintubated, 34 (36%) required tracheostomy after reintubation, and 41 (44%) underwent empiric tracheostomy. Recipient height and female sex, lung allocation score, 6-minute walk distance, donor ischemic time, ex-vivo perfusion, donor smoking history, intraoperative transfused red blood cells (packed red blood cells (PRBCs)), primary graft dysfunction at time zero, and comatose sedation state at day 2 were associated with extubation failure on univariate analysis (all p

Goal: The American Association of Colleges of Pharmacy (AACP) Leadership Development Special Interest Group (LD SIG) held a one-hour “Virtual Think Tank” (VTT) interactive session in 2020 for pharmacy educators interested in leadership development. The purpose of this study was to evaluate the quantitative and qualitative outcomes of this VTT. Methods: VTT attendees worked together in small groups created based on pre-selected common interest areas related to leadership development to create collaborative leadership initiative plans (CLIPs), which were ideas for new collaborative scholarly or programmatic initiatives. Principal findings: Quantitative outcomes of this VTT included statistically significant increases in positive perceptions toward the organization hosting the VTT regarding networking, scholarly collaboration, educational collaboration, and professional service opportunities, as well as significant improvements in attitudes regarding engagement with the sponsoring organization. Additionally, 18.4% of VTT attendees continued communicating with CLIP groups post-VTT and 13.2% of respondents indicated that they successfully implemented the CLIP ideas that were generated during the VTT. Qualitative outcomes included findings that the two most commonly encountered barriers were insufficient traction of the initial idea and lack of time (41.9% (n = 13) for both). Other barriers included lack of alignment with priorities at 12.9% (n = 4). Practical applications: This leadership VTT for pharmacy academicians led to development and implementation of important scholarly and programmatic outcomes, and fostered cross-institutional partnerships. Findings from this study evaluating a VTT provide a framework of expectations for other organizations seeking to implement a similar initiative.

OBJECTIVES:. For patients with acute respiratory distress syndrome (ARDS) receiving venovenous extracorporeal membrane oxygenation (ECMO) who develop acute kidney injury (AKI) requiring kidney replacement therapy (KRT), the inability to renally compensate for respiratory acidosis could result in increased sweep gas flow to normalize arterial pH. Our objective was to examine the relationship of serum bicarbonate levels, arterial pH, sweep gas flow, and Paco2. DESIGN:. This is a retrospective cohort study. We compared patients who received KRT while undergoing venovenous ECMO to patients who did not. SETTING:. Vanderbilt University Medical Center, February 2019 to February 2022. PATIENTS:. We examined data from adult patients receiving venovenous ECMO for ARDS. INTERVENTIONS:. Values for serum bicarbonate, arterial pH, Paco2, and sweep gas flow were collected daily from time of cannulation until the earlier of decannulation, 30 days, or death. MEASUREMENTS AND MAIN RESULTS:. Of the 126 patients included, 53 (42.1%) received KRT and 73 (57.9%) did not. In patients who received KRT, mean serum bicarbonate levels remained between 22 and 28 mmol/L throughout the study period. Patients who did not receive KRT experienced an increase in mean serum bicarbonate levels over time up to 40 mmol/L (mean difference = –4.4 mmol/L [95% CI, –6.3 to –2.5 mmol/L]; p < 0.0001). Mean values for Paco2 (–5.2 [95% CI, –8.8 to –1.7]; p = 0.004) and pH (–0.03 [95% CI, –0.03 to –0.02]; p < 0.0001) were lower in patients who received KRT than in patients who did not, despite higher sweep gas flow rates in patients who received KRT than in patients who did not (mean difference = 1.5 [95% CI, 0.8–2.3]; p < 0.001). CONCLUSIONS:. ARDS patients on venovenous ECMO with preserved kidney function experience an increase in bicarbonate concentration over time, compared to patients with AKI on KRT. Whether this increase in bicarbonate concentration increases pH, decreases sweep gas flow requirements, and facilitate weaning from venovenous ECMO requires examination in future research.

Background In March 2021, the United States Food and Drug Administration (FDA) safety communication cautioned against the use of acellular dermal matrix (ADM) products in breast reconstruction and reiterated that the FDA does not approve ADM use in breast surgery. This study aims to assess the safety of ADM use in breast reconstruction. Methods Women who underwent ADM and non-ADM assisted tissue expander (TE)-based breast reconstruction were identified using the National Surgical Quality Improvement Program database (2012–2019). Trends of ADM use over time, and 30-day outcomes of surgical site infection (SSI), dehiscence, and unplanned reoperation were assessed. Results Of the 49,049 TE-based breast reconstructive cases, 42.4% were ADM assisted and 57.6% non-ADM assisted. From 2012 to 2019, the use of ADM increased from 26.1 to 55.6% (relative risk [RR] =1.10; p

Background and aim: Epidemiological studies conducted mostly in low- and middle-income countries have found a positive association between household combustion of wood and lung cancer. However, most studies have been retrospective, and few have been conducted in the United States where indoor wood-burning usage patterns differ. We examined the association of exposure to indoor wood smoke from fireplaces and stoves with incident lung cancer in a U.S.-wide cohort of women. Methods: We included 50,226 women without prior lung cancer participating in the U.S.-based prospective Sister Study. At enrollment (2003–2009), women reported frequency of use of wood-burning stoves and/or fireplaces in their longest-lived adult residence. Cox regression was used to estimate adjusted hazard ratios (HRadj) and 95 % confidence intervals (CI) for the association between indoor wood-burning fireplace/stove use and incident lung cancer. Lung cancer was self-reported and confirmed with medical records. Results: During an average 11.3 years of follow-up, 347 medically confirmed lung cancer cases accrued. Overall, 62.3 % of the study population reported the presence of an indoor wood-burning fireplace/stove at their longest-lived adult residence and 20.6 % reported annual usage of ≥30 days/year. Compared to those without a wood-burning fireplace/stove, women who used their wood-burning fireplace/stove ≥30 days/year had an elevated rate of lung cancer (HRadj = 1.68; 95 % CI = 1.27, 2.20). In never smokers, positive associations were seen for use 1–29 days/year (HRadj = 1.64; 95 % CI = 0.87, 3.10) and ≥30 days/year (HRadj = 1.99; 95 % CI = 1.02, 3.89). Associations were also elevated across all income groups, in Northeastern, Western or Midwestern U.S. regions, and among those who lived in urban or rural/small town settings. Conclusions: Our prospective analysis of a cohort of U.S. women found that increasing frequency of wood-burning indoor fireplace/stove usage was associated with incident lung cancer, even among never smokers.

Background The coronavirus disease 2019 (COVID-19) global pandemic prompted an unprecedented contraction in surgical volume. This utilizes the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) database to assess the impact of COVID-19 on breast reconstruction surgery volume and quality throughout 2020. Methods The NSQIP database was utilized to gather data from 2015 to 2020. We provide descriptive statistics in the form of mean (standard deviation), median (interquartile range), and range for continuous variables and counts (%) for categorical variables. A Kruskal–Wallis test was used to compare average age and a chi-squared test was used to compare other demographic categorical variables from 2019 to 2020. Results Breast reconstruction procedures decreased by 27% in Q2 2020 compared to Q2 of 2019. Immediate tissue-expander-based reconstruction was the only type of reconstruction that increased in comparison to Q2 2019 values (53.5 vs. 41.1%, p

Seed dormancy often hinders direct seeding efforts that are attempting to restore degraded landscapes. Gibberellic acid (GA3) can be applied to physiologically dormant seeds to induce germination, but this hormone is rarely effective, as it can degrade or be leached from the seed. We tested different polymer matrixes (polylactic acid, polyvinylpyrrolidone, and ethylcellulose) to apply and slowly release GA3 to the seed. These polymers were tested as seed coatings in either a powder, liquid, or a combination of powder and liquid forms. We found that a liquid ethylcellulose/GA3 coating generally outperformed the other polymers and applications methods using our test species Penstemon palmeri. With this top-performing treatment, seed germination was 3.0- and 3.9-fold higher at 15 °C and 25 °C, respectively. We also evaluated the liquid ethylcellulose/GA3 coating on P. comharrenus, P. strictus, P. pachyphyllus, and P. eatonii. Again, the coating had a strong treatment response, with the degree of difference related to the relative level of dormancy of the species. Growth studies were also performed in pots to ensure that the side effects of GA3 overdosing were not present. Here, we found minimal differences in root length, shoot length, or biomass between plants grown from untreated and GA3-coated seeds.

Introduction and objectiveSystematic review tools that provide guidance on evaluating epidemiology studies are receiving increasing attention and support because their application facilitates improved quality of the review, consistency across reviewers, and transparency for readers. The U.S. Environmental Protection Agency's Integrated Risk Information System (IRIS) Program has developed an approach for systematic review of evidence of health effects from chemical exposures that includes structured approaches for literature search and screening, study evaluation, data extraction, and evidence synthesis and integration. This approach recognizes the need for developing outcome-specific criteria for study evaluation. Because studies are assessed at the outcome level, a study could be considered high quality for one investigated outcome, and low quality for another, due to differences in the outcome measures, analytic strategies, how relevant a certain bias is to the outcome, and how the exposure measure relates to the outcome. The objective of this paper is to illustrate the need for outcome-specific criteria in study evaluation or risk of bias evaluation, describe the process we used to develop the criteria, and summarize the resulting criteria.MethodsWe used a process of expert consultation to develop several sets of outcome-specific criteria to guide study reviewers, improve consistency, and ensure consideration of critical issues specific to the outcomes. The criteria were developed using the following domains: outcome assessment, exposure measurement (specifically timing of exposure in relation to outcome; other exposure measurement issues would be addressed in exposure-specific criteria), participant selection, confounding, analysis, and sensitivity (the study's ability to detect a true effect or hazard).ResultsWe discuss the application of this process to pregnancy-related outcomes (preterm birth, spontaneous abortion), other reproductive-related outcomes (male reproductive hormones, sperm parameters, time to pregnancy, pubertal development), chronic disease (diabetes, insulin resistance), and acute or episodic conditions (asthma, allergies), and provide examples of the criteria developed. For each outcome the most influential methodological considerations are highlighted including biological sample collection and quality control, sensitivity and specificity of ascertainment tools, optimal timing for recruitment into the study (e.g., preconception, specific trimesters), the etiologically relevant window for exposure assessments, and important potential confounders.ConclusionsOutcome-specific criteria are an important part of a systematic review and will facilitate study evaluations by epidemiologists with experience in evaluating studies using systematic review methods who may not have extensive discipline-specific experience in the outcomes being reviewed.

Robust driver attention prediction for critical situations is a challenging computer vision problem, yet essential for autonomous driving. Because critical driving moments are so rare, collecting enough data for these situations is difficult with the conventional in-car data collection protocol—tracking eye movements during driving. Here, we first propose a new in-lab driver attention collection protocol and introduce a new driver attention dataset, Berkeley DeepDrive Attention (BDD-A) dataset, which is built upon braking event videos selected from a large-scale, crowd-sourced driving video dataset. We further propose Human Weighted Sampling (HWS) method, which uses human gaze behavior to identify crucial frames of a driving dataset and weights them heavily during model training. With our dataset and HWS, we built a driver attention prediction model that outperforms the state-of-the-art and demonstrates sophisticated behaviors, like attending to crossing pedestrians but not giving false alarms to pedestrians safely walking on the sidewalk. Its prediction results are nearly indistinguishable from ground-truth to humans. Although only being trained with our in-lab attention data, the model also predicts in-car driver attention data of routine driving with state-of-the-art accuracy. This result not only demonstrates the performance of our model but also proves the validity and usefulness of our dataset and data collection protocol.

IntroductionConcussion in children and adolescents is a public health concern with higher concussion incidence than adults and increased susceptibility to axonal injury. The corpus callosum is a vulnerable location of concussion-related white matter damage that can be associated with short- and long-term effects of concussion. Interhemispheric transfer time (IHTT) of visual information across the corpus callosum can be used as a direct measure of corpus callosum functioning that may be impacted by adolescent concussion with slower IHTT relative to matched controls. Longitudinal studies and studies testing physiological measures of IHTT following concussion in adolescents are lacking.MethodsWe used the N1 and P1 components of the scalp-recorded brain event-related potential (ERP) to measure IHTT in 20 adolescents (ages 12–19 years old) with confirmed concussion and 16 neurologically-healthy control participants within 3 weeks of concussion (subacute stage) and approximately 10 months after injury (longitudinal).ResultsSeparate two-group (concussion, control) by two-time (3 weeks, 10 months) repeated measures ANOVAs on difference response times and IHTT latencies of the P1 and N1 components showed no significant differences by group (ps ≥ 0.25) nor by time (ps ≥ 0.64), with no significant interactions (ps ≥ 0.15).DiscussionResults from the current sample suggest that measures of IHTT may not be strongly influenced at 3 weeks or longitudinally following adolescent concussion using the current IHTT paradigm.

The American Association of Colleges of Pharmacy (AACP) Leadership Development Special Interest Group (LD SIG) created a Virtual Social Networking Hour (VSNH). The VSNH explored pharmacy leadership educators' connections through discussing topics of interest that influence current teaching and scholarship practices. The VSNH also served to connect members in the LD SIG through informal networking, which was vital during a time when in-person connection was heavily restricted due to the COVID-19 global pandemic. The VSNH functioned as both a space for members to connect with LD SIG leadership and other members of the LD SIG and a tool to areas of leadership development the SIG should explore in future programming. Each of the four sessions included a skeleton structure that grew organically based on the conversations of the attendees. Common themes of scholarship, adaptation to a virtual landscape, leadership, and student-focused endeavors were interwoven across all four sessions. The VSNHs have since become an integral component in LD SIG Programming.

BackgroundGlycolysis breakdowns glucose into essential building blocks and ATP/NAD(P)H for the cell, occupying a central role in its growth and bio-production. Among glycolytic pathways, the Entner Doudoroff pathway (EDP) is a more thermodynamically favorable pathway with fewer enzymatic steps than either the Embden-Meyerhof-Parnas pathway (EMPP) or the oxidative pentose phosphate pathway (OPPP). However, Escherichia coli do not use their native EDP for glucose metabolism.ResultsOverexpression of edd and eda in E. coli to enhance EDP activity resulted in only a small shift in the flux directed through the EDP (~20 % of glycolysis flux). Disrupting the EMPP by phosphofructokinase I (pfkA) knockout increased flux through OPPP (~60 % of glycolysis flux) and the native EDP (~14 % of glycolysis flux), while overexpressing edd and eda in this ΔpfkA mutant directed ~70 % of glycolytic flux through the EDP. The downregulation of EMPP via the pfkA deletion significantly decreased the growth rate, while EDP overexpression in the ΔpfkA mutant failed to improve its growth rates due to metabolic burden. However, the reorganization of E. coli glycolytic strategies did reduce glucose catabolite repression. The ΔpfkA mutant in glucose medium was able to cometabolize acetate via the citric acid cycle and gluconeogenesis, while EDP overexpression in the ΔpfkA mutant repressed acetate flux toward gluconeogenesis. Moreover, 13C-pulse experiments in the ΔpfkA mutants showed unsequential labeling dynamics in glycolysis intermediates, possibly suggesting metabolite channeling (metabolites in glycolysis are pass from enzyme to enzyme without fully equilibrating within the cytosol medium).ConclusionsWe engineered E. coli to redistribute its native glycolytic flux. The replacement of EMPP by EDP did not improve E. coli glucose utilization or biomass growth, but alleviated catabolite repression. More importantly, our results supported the hypothesis of channeling in the glycolytic pathways, a potentially overlooked mechanism for regulating glucose catabolism and coutilization of other substrates. The presence of channeling in native pathways, if proven true, would affect synthetic biology applications and metabolic modeling.

The AACP Leadership Development Special Interest Group (LD SIG) held a one-hour Virtual Networking Session during the American Association of Colleges of Pharmacy (AACP) 2020 Annual Meeting. The purpose of the session was to connect attendees with colleagues from other institutions sharing similar interests related to leadership development through an engaging “Virtual Think Tank” (VTT). The VTT included facilitated collaboration which enabled small groups to develop “Collaborative Leadership Initiative Plans” (CLIPs) based on shared leadership interest areas. A CLIP is an idea for a multi-institutional programmatic or scholarly initiative that is expected to lead to deliverables or outcomes mutually beneficial for all collaborators. Facilitators then assisted the CLIP groups with identifying specific deliverables and potential outcomes of successful implementation, as well as a plan for group follow-up. Seventy-two attendees from 55 unique institutions participated to form seven CLIP groups consisting of an average of ten individuals each. CLIP ideas generated included an initiative to align faculty tenure and promotion criteria to incentivize entrepreneurship and innovation among faculty, incorporation of a leadership project into Advanced Pharmacy Practice Experiences in the experiential pharmacy curriculum, and creation of a cross-institutional co-curricular program for students. An important legacy of the session was a leadership networking contact list, called the Leadership Networking Database, which will serve as an enduring leadership networking tool. This session offered an innovative solution to a canceled in-person professional meeting and replaced missed networking and collaboration opportunities resulting from cancellation of the in-person meeting.

Abstract Background Nonpharmacologic interventions for asthma management rely on identification and mitigation of important asthma triggers. Cockroach exposure is strongly associated with asthma morbidity. It is also associated with stress, another risk factor for asthma. Despite high prevalence of both in vulnerable populations, the impact of joint exposure has not been examined. Methods Participants included 173 children with asthma in New Orleans, Louisiana. Cockroach exposure was based on visual inspection using standard protocols. Caregiver stress was measured using Cohen’s 4-item Perceived Stress Scale. Outcomes included unscheduled clinic or emergency department (ED) visits, hospitalization, and pulmonary function. Multivariable logistic regression was performed to assess independent effects of the exposure on the outcome and effect modification was examined in stratified analysis based on stress. Path analysis to explore the mediation effect by stress was performed using a probit link with parameters based on Bayes’ method with non-informative priors. Results Adjusting for stress and other covariates, cockroach exposure was associated with unscheduled clinic/ED visits (aOR = 6.2; 95% CI 1.8, 21.7). Positive associations were also found for hospitalization and FEV1

Abstract Background Radiation-induced brain injury is a common concern for survivors of adult and pediatric brain cancer. Pre-clinically, rodent models are the standard approach to evaluate mechanisms of injury and test new therapeutics for this condition. However, these rodent models fail to recapitulate the radiological and histological characteristics of the clinical disease. Methods Here we describe a hemispheric mini-pig model of radiation-induced brain injury generated with a clinical 6 MV photon irradiator and evaluated with a clinical 3T MRI. Two pairs of Yucatan mini-pigs each received either 15 Gy or 25 Gy to the left brain hemisphere. Quality of intensity modulated radiation therapy treatment plans was evaluated retrospectively with parameters reported according to ICRU guidelines. The pigs were observed weekly to check for any outright signs of neurological impairment. The pigs underwent anatomical MRI examination before irradiation and up to 6 months post-irradiation. Immediately after the last imaging time point, the pigs were euthanized and their brains were collected for histopathological assessment. Results Analysis of the dose volume histograms showed that 93% of the prescribed dose was delivered to at least 93% of the target volume in the left hemisphere. Organs at risk excluded from the target volume received doses below clinical safety thresholds. For the pigs that received a 25 Gy dose, progressive neurological impairment was observed starting at 2 months post-irradiation leading to the need for euthanasia by 3–4 months. On MRI, these two animals presented with diffuse white matter pathology consistent with the human disease that progressed to outright radiation necrosis and severe brain swelling. Histology was consistent with the final MRI evaluation. The pigs that received a 15 Gy dose appeared normal all the way to 6 months post-irradiation with no obvious neurological impairment or lesions on MRI or histopathology. Conclusion Based on our results, a mini-pig model of radiation-induced brain injury is feasible though some optimization is still needed. The mini-pig model produced lesions on MRI that are consistent with the human disease and which are not seen in rodent models. Our data shows that the ideal radiation dose for this model likely lies between 15 and 25 Gy.

This article provides an extensive review of the literature on the use of repeated reading to improve the reading fluency and comprehension skills of elementary-age students with learning disabilities. A systematic review of the published literature from 2001 to 2011 was conducted and nineteen (N = 19) research-based repeated reading studies were identified. Based on the criteria for inclusion, repeated reading research has been conducted using four main approaches: (a) repeated reading as the primary intervention, (b) repeated reading compared to other reading interventions, (c) repeated reading in combination with other reading interventions, and (d) repeated reading as part of a reading program. Overall, the results suggest that repeated reading is an effective strategy to increase students' reading fluency and comprehension skills. Findings indicated moderate to large gains in reading fluency and comprehension on practiced passages. However, these gains showed only minor to moderate transfer to novel passages. Implications for classroom practice, limitations, and future research directions are presented. (Contains 4 tables and 1 footnote.)

Fothergilla is a small genus of deciduous shrubs native to the southeastern United States that depending on circumscription comprises two to four species. Recent treatments recognized only two species in the genus: F. gardenii (tetraploid) and F. major (hexaploid). Until recently, no diploid taxon of Fothergilla was known. However, recent investigations identified a number of diploid populations in Alabama, Florida, Georgia, and South Carolina. A subsequent phylogenomic analysis showed that the diploids segregated into two, well-supported lineages, corresponding to largely allopatric populations. A re-examination of the morphology of diploid plants, in combination with the genetic evidence, has led us to the recognition of two species of diploids in the genus – a resurrected F. parvifolia and a new species (F. milleri W.D. Phillips & J.E. Haynes, sp. nov.) – bringing the total number of recognized species in Fothergilla to four. A revised taxonomic treatment of the genus is provided.

Summary:. Cleft repair has been in constant evolution since its inception. Conventional repair of the cleft hard palate involves closure of nasal and oral mucosa without bony reconstitution. In many instances, this approach is adequate, but, particularly in complete clefts, the lack of bony support can lead to collapse of the maxillary arch, dental crowding, and posterior cross-bite. To address these shortcomings, our institution performs a two-staged palatoplasty with concomitant bone grafting of the alveolus and hard palate in the second stage. A retrospective review of children who underwent a two-staged palatoplasty at our institution was performed. These patients’ records and images were reviewed for complications and changes in maxillary morphology. Fourteen patients with complete clefts had a two-staged palatoplasty with bone grafting in the second stage. The mean age at surgery was 37.5 months, and the mean follow-up was 16 months. One patient had resorption of the alveolar bone graft requiring additional bone grafting. The remaining patients were without complications and had good consolidation of the bone graft on follow-up imaging. Our early results support that there is a low complication rate (7% regrafting) in those patients who underwent bone grafting at the time of cleft palate repair with early evidence of bony consolidation on imaging and clinical examination. Wide exposure during the repair allows complete grafting of the maxillary bony deficit, which is not possible with traditional alveolar cleft repair and may alleviate the shortcoming of soft-tissue closure only. Future study is necessary to determine long-term outcomes.

Background. Due to extended life expectancy and recent improvements in surgical techniques, limb salvage has replaced amputation as the gold standard and is now performed in 90–95% of upper extremity malignancies. However, many of these salvage procedures are associated with significant postsurgical complications. In particular, the clavicula pro humero (CPH) procedure is associated with high rates of nonunion. We present our experience with upper extremity salvage using the free vascularized fibular flap (VFF) after failure or nonunion of the original CPH procedure in the pediatric population. Methods. Five patients under the age of 18 diagnosed with upper extremity sarcoma who underwent tumor resection with immediate CPH reconstruction complicated with nonunion, and subsequent revision with free VFF were included. Data on patient demographics, oncologic characteristics, surgical procedures, intraoperative details, postoperative complications, and time to graft union were recorded. Results. Five patients (average age = 8.4 years; range = 5–10 years at surgery date) underwent secondary limb salvage procedure with free VFF reconstruction following failed CPH reconstruction for proximal humeral osteosarcoma (n = 4) or Ewing sarcoma (n = 1). The mean follow-up was 3.7 years. Complications occurred in five patients (100%), with three patients requiring reoperation (60%). Four patients achieved graft union (average union time = 3.7 months) and successful limb reconstruction. Four patients were alive with no local recurrence of the disease. One patient did not achieve union and was lost to follow-up. Conclusion. Primary bone tumors in the pediatric population require wide surgical resection, and reconstruction often has high complication rates that can warrant further procedures. A free VFF is a viable option for upper extremity salvage after previously failed reconstructions because it provides vascularized tissue to a scarred tissue bed and allows for the replacement or augmentation of large bony defects.

Studies were conducted in 2020 and 2021 at the Delta Research and Extension Center in Stoneville, MS, to determine the residual concentrations of chlorantraniliprole in cotton (Gossypium hirsutum, L.) leaves, as well as the concentrations in petals and anthers that developed after the time of application. Foliar applications of chlorantraniliprole were applied at four rates for leaves and two rates for petals and anthers at the second week of bloom. Additional bioassays were conducted to determine mortality of corn earworm (Helicoverpa zea, Boddie) in anthers. For the leaf study, plants were partitioned into three zones consisting of top, middle, and bottom zones. Leaf samples from each zone were analyzed for chemical concentrations at 1, 7, 14, 21, and 28 days after treatment (DAT). Residual concentrations, although variable, persisted through all sampling dates, rates, and zones tested. In this study, chlorantraniliprole remained detectable up to 28 DAT. Results from the cotton flower petal and anther studies detected concentrations of chlorantraniliprole in petals at 4, 7, 10, and 14 DAT, but no concentrations were detected in anthers. Therefore, no mortality of corn earworm was recorded in the anther bioassays. A series of diet-incorporated bioassays were conducted using concentrations previously found in the petal study to determine baseline susceptibilities of corn earworms and predicted mortality. Results from the diet-incorporated bioassays showed similar susceptibility in field and lab colony corn earworms. Concentrations of chlorantraniliprole could provide up to 64% control of corn earworm when feeding occurs on the petals.

Summary:. Absence of the proximal upper limb, whether congenital or acquired, has a profound impact on quality of life. Targeted muscle reinnervation (TMR) was originally developed to improve functional control over myoelectric prostheses; however, it has also been shown to decrease phantom limb pain and neuroma pain as well as prevent neuroma formation. In children, whose rates of prosthetic use are considerably lower than adults, the effects of amputation on limb function can be devastating. To date, there is very little literature regarding the use of TMR in children. In this case report, we review the current literature and present the case of a 9-year-old boy with a transhumeral amputation secondary to a traumatic injury who underwent acute TMR at the time of wound closure. At 22 months follow-up, the patient is doing well with minimal pain, no evidence of neuroma formation, and signs of muscle reinnervation.

The American Association of Colleges of Pharmacy (AACP) Leadership Development Special Interest Group (LD SIG) embarked upon a one-week virtual symposium (VS) across three years. The purpose of the VS was to disseminate leadership content, case studies, and various topics of interest utilizing technology. This electronic format provided a new communication approach to facilitate content and discussion of leadership materials amongst faculty colleagues nationally. The VS allowed participants to gain knowledge and skills to address leadership development in a timely, flexible manner that can be challenging during in-person professional meetings and conferences due to conflicting programming and travel limitations. Evaluators across each of the VS (100%) indicated that they either agreed or strongly agreed with the scaled evaluative statements that the video presentations met their educational needs.

Individuals can rapidly and precisely judge the average of a set of similar items, including both low-level (Ariely, 2001) and high-level objects (Haberman & Whitney, 2007). However, to date, it is unclear whether ensemble perception is based on viewpoint-invariant object representations. Here, we tested this question by presenting participants with crowds of sequentially presented faces. The number of faces in each crowd and the viewpoint of each face varied from trial to trial. This design required participants to integrate information from multiple viewpoints into one ensemble percept. Participants reported the mean identity of crowds (e.g., family resemblance) using an adjustable, forwardoriented test face. Our results showed that participants accurately perceived the mean crowd identity even when required to incorporate information across multiple face orientations. Control experiments showed that the precision of ensemble coding was not solely dependent on the length of time participants viewed the crowd. Moreover, control analyses demonstrated that observers did not simply sample a subset of faces in the crowd but rather integrated many faces into their estimates of average crowd identity. These results demonstrate that ensemble perception can operate at the highest levels of object recognition after 3-D viewpoint-invariant faces are represented. © 2014 ARVO.

BackgroundPolycyclic aromatic hydrocarbons (PAHs) are ubiquitous organic compounds associated with chronic disease in epidemiologic studies, though the contribution of PAH exposure on fatal outcomes in the U.S. is largely unknown.ObjectivesWe investigated urinary hydroxylated PAH metabolites (OH-PAHs) with all-cause and cause-specific mortality in a representative sample of the U.S. population.MethodsStudy participants were ≥20 years old from the National Health and Nutrition Examination Survey 2001-2014. Concentrations (nmol/L) of eight OH-PAHs from four parent PAHs (naphthalene, fluorene, phenanthrene, pyrene) were measured in spot urine samples at examination. We identified all-cause, cancer-specific, and cardiovascular-specific deaths through 2015 using the National Death Index. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between ΣOH-PAHs and mortality endpoints. We assessed potential heterogeneity by age, gender, smoking status, poverty, and race/ethnicity. Additionally, we examined the overall mixture effect using quantile g-computation.ResultsIn 9,739 eligible participants, there were 934 all-cause deaths, 159 cancer-specific deaths, and 108 cardiovascular-specific deaths (median 6.75 years follow-up). A log10 increase in ΣOH-PAHs was associated with higher all-cause mortality (HRadj = 1.39 [95%CI: 1.21, 1.61]), and possibly cancer-specific mortality (HRadj = 1.15 [95%CI: 0.79, 1.69]), and cardiovascular-specific mortality (HRadj = 1.49 [95%CI: 0.94, 2.33]). We observed substantial effect modification by age, smoking status, gender, and race/ethnicity across mortality endpoints. Risk of cardiovascular mortality was higher for non-Hispanic blacks and those in poverty, indicating potential disparities. Quantile g-computation joint associations for a simultaneous quartile increase in OH-PAHs were HRadj = 1.15 [95%CI: 1.02, 1.31], HRadj = 1.41 [95%CI: 1.05, 1.90], and HRadj = 0.98 [95%CI: 0.66, 1.47] for all-cause, cancer-specific, and cardiovascular-specific mortalities, respectively.DiscussionOur results support a role for total PAH exposure in all-cause and cause-specific mortality in the U.S. population.