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The Rhode Island Department of Health (RIDOH) uses emergency department data to monitor nonfatal opioid overdoses in Rhode Island. In April 2019, RIDOH detected an increase in nonfatal opioid overdoses in Woonsocket, Rhode Island, and sent an alert to state and local partners (eg, fire departments, emergency departments, faith leaders) with guidance on how to respond. To guide community-level, strategic response efforts, RIDOH analyzed surveillance data to identify overdose patterns, populations, and geographic areas most affected. During April–June 2019, nonfatal opioid overdoses in Woonsocket increased 463% (from 13 to 73) when compared with the previous 3 months. Because of the sustained increase in nonfatal opioid overdoses, RIDOH brought together community partners at a meeting in June 2019 to discuss RIDOH opioid overdose data and coordinate next steps. Data analyses were essential to framing the discussion and allowed community partners at the event to identify an unexpected increase in cocaine-involved nonfatal opioid overdoses in Woonsocket. Many patients with cocaine-involved nonfatal overdoses also had fentanyl in their system, and input from community partners suggested that many patients were unaware of using fentanyl. Community response actions included targeting harm reduction services (eg, distribution of naloxone, mobile needle exchange); deploying peer recovery support specialists to overdose hotspots to connect people to treatment and recovery resources; placing harm reduction messaging in high-traffic areas; and targeted social media messaging. After the meeting, nonfatal opioid overdoses returned to pre-outbreak levels. This case study provides an example of how timely opioid overdose data can be effectively used to detect a spike in nonfatal opioid overdoses and inform a strategic, community-level response.

We explored the influence of sex and maturation on resting cervical artery hemodynamics (common carotid artery, CCA; internal carotid artery, ICA; and vertebral artery, VA), free-living physical activity, and sedentary behavior in children 6-17 yr of age. In addition, we investigated the relationship between physical activity, sedentary behavior, and cervical artery hemodynamics. Seventy-eight children and adolescents, girls (n = 42; mean age, 11.4 ± 2.5 yr) and boys (n = 36; mean age, 11.0 ± 2.6 yr), completed anthropometric measures, duplex ultrasound assessment of the cervical arteries, and wore an activPAL accelerometer to assess physical activity (indexed by steps/day) and sedentary behavior for 7 days. The ICA and VA diameters were similar between prepubertal and pubertal groups, as was volumetric blood flow (Q); however, the CCA diameter was significantly larger in the pubertal group (P < 0.05). Boys were found to have larger diameters in all cervical arteries than girls, as well as higher QCCA, QICA, and global cerebral blood flow (P < 0.05). The pubertal group was more sedentary (100 min/day more; P < 0.05) and took 3,500 fewer steps/day than the prepubertal group (P < 0.05). Shear rate (SR) and Q of the cervical arteries showed no relationship to physical activity or prolonged bouts of sedentary behavior; however, a significant negative relationship was apparent between total sedentary time and internal carotid artery shear rate (ICASR) after covarying for steps/day and maturation (P < 0.05). These findings provide novel insight into the potential influence sedentary behavior may have on cerebrovascular blood flow in healthy girls and boys.NEW & NOTEWORTHY Cerebral blood flow is known to change with age; however, assessing these age-related changes is complex and requires consideration of pubertal status. This, to our knowledge, is the first study to investigate the influence of sex and maturation on resting cervical artery hemodynamics and subsequently explore associations with physical activity and sedentary behavior in healthy children and adolescents. Our findings suggest that habitual sedentary behavior may influence cervical artery hemodynamics in youth, independent of physical activity, maturation, and sex.

Objectives There is a critical need to monitor the development of children around the world, and in Brazil, this need is substantial since there is a paucity of assessment tools. This study aimed to describe the design and provide evidence of reliability and validity for the short version of the Dimensional Inventory for Child Development Assessment (IDADI-short). Methods A sample of 1,865 biological mothers of children aged 4–72 months (M = 34.8, SD = 20.20) completed the IDADI to assess Cognitive, socio-emotional, Expressive, and Receptive Language and Communication, Fine and Gross Motor, and Adaptive Behavior development. The psychometric properties of a total of 118 subscales of IDADI were obtained and the IDADI-short age-specific scores were correlated with the original inventory, and criteria variables such as neurodevelopment diagnosis, socioeconomic status, and sex. Results Item Response Theory analysis, Cronbach's Alpha, and McDonald’s Omega indicated excellent internal consistency and optimal participant discrimination after minor alterations. IDADI-short scores were strongly associated with the original inventory, with high sensibility and specificity precision for developmental delays. Significant associations with relevant criteria variables were also observed. Conclusion Findings support the use of IDADI-short as a parental measure of young children’s development.

Background Intimate partner violence (IPV) is a major public health problem with harmful consequences. In Australia, there is no national standard screening tool and screening practice is variable across states. The objectives of this study were to assess in the antenatal healthcare setting: i) the validity of a new IPV brief screening tool and ii) women’s preference for screening response format, screening frequency and comfort level. Methods One thousand sixty-seven antenatal patients in a major metropolitan Victorian hospital in Australia completed a paper-based, self-administered survey. The survey included four screening items about whether they were Afraid/Controlled/Threatened/Slapped or physically hurt (ACTS) by a partner or ex-partner in the last 12 months; and the Composite Abuse Scale (reference standard). The ACTS screen was presented firstly with a binary yes/no response format and then with a five-point ordinal frequency format from ‘never’ (0) to ‘very frequently’ (4). The main outcome measures were test statistics of the four-item ACTS screening tool (sensitivity, specificity, predictive values, and area under the curve) against the reference standard and women’s screening preferences. Results Twelve-month IPV prevalence varied depending on the ACTS response format with 8% (83) positive on ACTS yes/no format, 12.8% (133) positive on ACTS ordinal frequency format and 10.5% (108) on the reference Composite Abuse Scale. Overall, the ACTS screening tool demonstrated clinical utility for the ordinal frequency format (AUC, 0.80; 95% CI = 0.76 to 0.85) and the binary yes/no format (AUC, 0.74, 95% CI = 0.69 to 0.79). The frequency scale (66%) had greater sensitivity than the yes/no scale (51%). The positive and negative predictive values were 56 and 96% for the frequency scale and 68 and 95% for the yes/no scale. Specificity was high regardless of screening question response options. Half (53%) of the women categorised as abused preferred the yes/no scale. Around half of the women (48%, 472) thought health care providers should ask pregnant women about IPV at every visit. Conclusions The four-item ACTS tool (using the frequency scale and a cut-off of one on any item) is recommended for written self-administered screening of women to identify those experiencing IPV to enable first-line response and follow-up.

When all is said and done, 5G will cost almost US $1 trillion to deploy over the next half decade. That enormous expense will be borne mostly by network operators, companies like AT&T, China Mobile, Deutsche Telekom, Vodafone, and dozens more around the world that provide cellular service to their customers. Facing such an immense cost, these operators asked a very reasonable question: How can we make this cheaper and more flexible?

Triple-negative breast cancer (TNBCs) display lung metastasis tropism. However, the mechanisms underlying this organ-specific pattern remains to be elucidated. We sought to evaluate the utility of blocking extravasation to prevent lung metastasis. To identify potential geminin overexpression-controlled genetic drivers that promote TNBC tumor homing to lungs, we used the differential/suppression subtractive chain (D/SSC) technique. A geminin overexpression-induced lung metastasis gene signature consists of 24 genes was discovered. We validated overexpression of five of these genes (LGR5, HAS2, CDH11, NCAM2, and DSC2) in worsening lung metastasis-free survival in TNBC patients. Our data demonstrate that LGR5-induced β-catenin signaling and stemness in TNBC cells are geminin-overexpression dependent. They also demonstrate for the first-time expression of RSPO2 in mouse lung tissue only and exacerbation of its secretion in the circulation of mice that develop geminin overexpressing/LGR5+-TNBC lung metastasis. We identified a novel extravasation receptor complex, consists of CDH11, CD44v6, c-Met, and AXL on geminin overexpressing/LGR5+-TNBC lung metastatic precursors, inhibition of any of its receptors prevented geminin overexpressing/LGR5+-TNBC lung metastasis. Overall, we propose that geminin overexpression in normal mammary epithelial (HME) cells promotes the generation of TNBC metastatic precursors that home specifically to lungs by upregulating LGR5 expression and promoting stemness, intravasation, and extravasation in these precursors. Circulating levels of RSPO2 and OPN can be diagnostic biomarkers to improve risk stratification of metastatic TNBC to lungs, as well as identifying patients who may benefit from therapy targeting geminin alone or in combination with any member of the newly discovered extravasation receptor complex to minimize TNBC lung metastasis.

When measuring academic skills among students whose primary language is not English, standardized assessments are often provided in languages other than English. The degree to which alternate-language test translations yield unbiased, equitable assessment must be evaluated; however, traditional methods of investigating measurement equivalence are susceptible to confounding group differences. The primary purposes of this study were to investigate differential item functioning (DIF) and item bias across Spanish and English forms of an assessment of early mathematics skills. Secondary purposes were to investigate the presence of selection bias and demonstrate a novel approach for investigating DIF that uses a regression discontinuity design framework to control for selection bias. Data were drawn from 1,750 Spanish-speaking Kindergarteners participating in the Early Childhood Longitudinal Study, Kindergarten Class of 1998–1999, who were administered either the Spanish or English version of the mathematics assessment based on their performance on an English language screening measure. Evidence of selection bias—differences between groups in SES, age, approaches to learning, self-control, social interaction, country of birth, childcare, household composition and number in the home, books in the home, and parent involvement—highlighted limitations of a traditional approach for investigating DIF that only controlled for ability. When controlling for selection bias, only 11% of items displayed DIF, and subsequent examination of item content did not suggest item bias. Results provide evidence that the Spanish translation of the ECLS-K mathematics assessment is an equitable and unbiased assessment accommodation for young dual language learners.

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. An important role of innate immune dysregulation in the pathogenesis of HS has been highlighted. S100A7 (psoriasin) is an innate, antimicrobial protein that exerts proinflammatory and chemotactic action. Objectives: The objective of the study was to investigate serum concentrations of S100A7 in individuals with HS as compared to healthy controls. Further, we evaluated the expression of S100A7 in lesional HS skin as compared to perilesional (clinically uninvolved) HS skin and normal skin. Methods: Serum concentrations of S100A7 were evaluated with a commercially available ELISA kit. The expression of S100A7 in the skin was assessed using qRT-PCR and immunofluorescence staining. Results: We found increased expression of S100A7 in lesional HS skin as compared to perilesional HS skin (p = 0.0017). The expression of S100A7 in lesional HS skin was positively associated with serum C-reactive protein concentration and the severity of disease according to Hurley staging. The serum concentration of S100A7 in individuals with HS was decreased as compared to healthy controls and patients with psoriasis. Conclusions: Upregulated in lesional HS skin, S100A7 may enhance the inflammatory process and contribute to the HS pathogenesis.

A significant number of people have been displaced from their country of origin and become refugees. Good health is essential for refugees to actively engage and take up opportunities within the society in their host countries. However, negotiating a new and unfamiliar health system hinders refugees’ ability to access and make use of the available health services. Communication difficulties due to language barriers are the most commonly cited challenges faced by refugees in accessing and utilizing health services post-resettlement. In this study, we aimed to examine effectiveness of interpreting services for refugee women in New Zealand. Data were collected through three sources: focus groups with Bhutanese women, focus group with Bhutanese men, and individual interviews with health professionals. The findings of this study reveal inadequacies and constraints in the provision of a socioculturally and linguistically effective interpreting service to Bhutanese women and provide evidence for recommendations to address these inadequacies.

BACKGROUND Uraemic pruritus is a common symptom in patients with chronic kidney disease undergoing haemodialysis (HD) treatment. Etiopathogenesis of uraemic pruritus is complex and not fully explained, but there are reports indicating a possible role of peripheral opioid system in its pathomechanism. OBJECTIVES This study was undertaken to analyse the expression of mu- and kappa-opioid receptors in the skin of HD patients with and without uraemic pruritus. METHODS Forty patients suffering from chronic kidney disease, treated with haemodialysis (21 pruritic and 19 non-pruritic), were included. The expression of mu- and kappa-opioid receptors in their skin was evaluated with immunohistochemistry. RESULTS The significant (P

The first phase of new radio (NR) standard, which was finalized in December 2017, is called a non‐standalone (NSA) NR as it is based on dual connectivity between an LTE radio access technology (RAT) and the NR RAT, known also as E‐UTRA – NR Dual Connectivity(EN‐DC). This chapter presents an overview of 5G core (5GC) network and functionalities by presenting the specified logical network nodes which are the standardized building blocks for the 5GC and by giving an example of a signaling flow between the nodes for connection establishment. It discusses the different dual connectivity options and related terminology. Two different protocol stacks exist in NR system: control plane protocol stack, carrying control information between user equipment (UE) and gNB or Core Network, and user plane protocol stack, carrying data between different applications in the UE and in the network.

The recent emergence of High Definition (HD) FT-IR and Quantum Cascade Laser (QCL) Microscopes elevated the IR imaging field very close to clinical timescales. However, the speed of acquisition and data quality are still the critical factors in reaching the clinic. Denoising offers aide in both aspects if performed properly. However, there is a lack of a direct comparison of the efficiency of denoising techniques in IR imaging in general. To achieve such comparison within a rigorous framework and obtaining the critical information about signal loss, a simulated dataset strongly bound by experimental parameters was created. Using experimental structural and spectral information and experimental noise levels data as an input for the simulation, a direct comparison of spatial (Fourier transform, Mean Filter, Weighted Mean Filter, Gauss Filter, Median Filter, spatial Wavelets and Deep Neural Networks) and spectral (Savitzky-Golay, Fourier transform, Principal Component Analysis, Minimum Noise Fraction and spectral Wavelets) denoising schemes was enabled. All of these techniques were compared on the simulated dataset, taking into account SNR gain, signal distortion and sensitivity to tuning parameters as comparison metrics. Later, the best techniques were applied to experimental data for validation. The results presented here clearly show the benefit of using hyperspectral denoising schemes such as PCA and MNF which outperform other methods.

Adenosine deaminase (ADA)-deficient mice and healthy rhesus monkeys were studied to determine the impact of age at treatment, vector dosage, dosing schedule, repeat administration, biodistribution, and immunogenicity after systemic delivery of lentiviral vectors (LVs). In Ada−/− mice, neonatal treatment resulted in broad vector marking across all tissues analyzed, whereas adult treatment resulted in marking restricted to the liver, spleen, and bone marrow. Intravenous administration to infant rhesus monkeys also resulted in dose-dependent marking in the liver, spleen, and bone marrow. Using an ELISA to monitor anti-vector antibody development, Ada−/− neonatal mice did not produce an antibody response, whereas Ada−/− adult mice produced a strong antibody response to vector administration. In mice and monkeys with repeat administration of LV, a strong anti-vector antibody response was shown in response to the second LV administration, which resulted in LV inactivation. Three separate doses administered to immune competent mice resulted in acute toxicity. Pegylation of the vesicular stomatitis virus G protein (VSV-G)-enveloped LVs showed a less robust anti-vector response but did not prevent the inactivation of the second LV administration. These studies identify important factors to consider related to age and timing of administration when implementing systemic delivery of LVs as a potential therapeutic agent. Keywords: lentiviral vector, gene therapy, rhesus monkeys, in vivo, immune response, ADA-deficiency, ERT, repeat administration

Miller, RM, Freitas, EDS, Heishman, AD, Koziol, KJ, Galletti, BAR, Kaur, J, and Bemben, MG. Test-retest reliability between free weight and machine-based movement velocities. J Strength Cond Res 34(2): 440-444, 2020-Several devices are available to measure muscular power through velocity measurement, including the Tendo FitroDyne. The ability for such devices to produce consistent results is still questioned, and the reproducibility of measurement between free weight and machine exercise has yet to be examined. Therefore, the aim of this investigation was to determine the test-retest reliability for barbell velocity during the bench press (BP) and weight velocity during the 2 leg press (2LP) for loads corresponding to 20-80% of 1 repetition maximum (1RM). Forty recreationally active individuals (22.6 ± 2.5 years; 175.9 ± 10.8 cm; and 76.2 ± 13.2 kg) with a 1RM BP and 2LP of 66.8 ± 32.4 kg and 189.5 ± 49 kg, respectively, volunteered for this study. Subjects completed 1 familiarization visit preceding 3 testing visits, which encompassed 1RM determination and 2 days of velocity testing. Forty-eight hours after 1RM testing, the subjects performed 1 repetition at 20, 30, 40, 50, 60, 70, and 80% of their 1RM for each exercise in randomized order. Subjects returned to the laboratory 1 week later to perform the velocity assessment again in randomized order. Intraclass correlation coefficient (ICC2,1) and relative SEM for the BP and 2LP ranged from 0.56 to 0.98 (3-18.1%) and 0.78 to 0.98 (2.8-7.2%), respectively, and no mean differences were observed between trials. The results suggest high reliability for BP velocity between 30 and 60% 1RM and moderate reliability at 20, 70, and 80% 1RM, while the 2LP displayed high to excellent reliability from 20 to 80% 1RM. Cumulatively, machine-based exercise displayed greater reproducibility; however, additional machine exercises need to be examined to bolster this conclusion.

The article presents the results of the analysis of the active control of Stodola-Green rotor, made of a cantilevered beam with a rigid disc attached to its free end. The rotor is of a smart type, ...

Background and purpose Unique work challenges of intensive care nurses can cause both stress and distress to nurses, evident in prevailing literature regarding burnout, compassion fatigue, and moral distress. Identifying factors contributing to intensive care nurses' well-being would complement this focus on nurse ill-being, supporting the development of workplace well-being initiatives. The review seeks to balance the existing negatively skewed evidence base by investigating intensive care nurses' well-being rather than ill-being. Objectives The objective of this review was to systematically identify, appraise, and synthesise primary research reporting intensive care nurses' well-being. Methods The electronic search strategy included (1) bibliographic databases for published work and (2) forward and backward citation searches. Key search terms included [critical OR intensive] AND [nurs*] AND [well*]. Inclusion criteria were as follows: (1) population: critical or intensive care nurses working with adult or mixed adult and paediatric patients, (2) study type: primary research studies, (3) outcome: intensive care unit nurses' well-being, and (4) publication available in the English language. Studies were excluded if the group of intensive care nurses was not independently reported. Included studies were critically appraised, and results were synthesised and presented descriptively. Semantics of the included studies were explored to identify frequently used terms. Results Four primary research studies met the inclusion criteria, focussing on spiritual well-being, team commitment, emotional well-being, and the effects of a mindfulness programme. The studies were heterogeneous in terms of study focus, definitions, and measures, with small sample sizes, and of variable quality and generalisability. Conclusions The well-being of intensive care nurses is currently understudied. Conceptualising intensive care nurses' well-being, understanding correlates of well-being, and testing workplace interventions to improve well-being remain significant opportunities for future research.

This paper presents a Multi-Objective path planning approach using reconfigurable Analog-Very-Large-Scale-Integrated (AVLSI) circuits. It is significant because it is the first example of floating-gate based analog resistive grid circuits used for Multi-Objective path planning. The two path planning objectives are 1) minimizing path length and 2) minimizing path cost. Three hardware experimental results are presented that implement the approach using a Field Programmable Analog Array (FPAA) circuit. First, an example demonstrates a simple proof-of-concept. Second, an example shows how the FPAA solution compares to an entire solution set for a specific Start and Goal path planning problem. Third, an example shows how the FPAA solution compares to two edge-cases. The edge-cases are the two ideals: ideal lowest cost path, and ideal shortest distance path. Based on these foundational proof-of-concept hardware results, larger environment grids than are currently implementable on the FPAA hardware were simulated to predict performance if a custom FPAA application specific integrated circuit (ASIC) was built for this Multi-Objective path planning purpose. Finally, analysis is presented to address this method's computational complexity.

This letter presents a single-electron injection device for position-based charge qubit structures implemented in 22-nm fully depleted silicon-on-insulator CMOS. Quantum dots are implemented in local well areas separated by tunnel barriers controlled by gate terminals overlapping with a thin 5-nm undoped silicon film. Interface of the quantum structure with classical electronic circuitry is provided with single-electron transistors that feature doped wells on the classic side. A small $0.7\times 0.4\,\,\mu \text{m}^{2}$ elementary quantum core is co-located with control circuitry inside the quantum operation cell which is operating at 3.5 K and a 2-GHz clock frequency. With this apparatus, we demonstrate a single-electron injection into a quantum dot.

This letter presents a fully integrated interface circuitry with a position-based charge qubit structure implemented in 22-nm FDSOI CMOS. The quantum structure is controlled by a tiny capacitive DAC (CDAC) that occupies $3.5\times 45\,\,\mu \text{m}^{2}$ and consumes 0.27mW running at a 2-GHz system clock. The state of the quantum structure is measured by a single-electron detector that consumes 1mW (including its output driver) with an area of $40\times 25\,\,\mu \text{m}^{2}$ . The low power and miniaturized layout of these circuits pave the way for integration in a large quantum core with thousands of qubits, which is a necessity for practical quantum computers. The CDAC output noise of 12 $\mu \text{V}$ -rms is estimated through mathematical analysis while the ≤ 0.225mV-rms input referred noise of the detector is verified by measurements at 3.4 K. The functionality of the system and performance of the CDAC are verified in a loopback mode with the detector sensing the CDAC-induced electron tunneling from the floating diffusion node into the quantum structure.

Atypical geostationary satellite is as big as a van, as heavy as a hippopotamus, and as long-lived as a horse. These parameters shorten the list of companies and countries that can afford to build and operate the things.

IntroductionThe impacts of violence have a significant effect on health and well-being, particularly for women and children. Violence within families is widely recognised as a complex problem constituted by constantly interacting and evolving social, economic, health and cultural elements. Calls for integrated services have arisen from growing understanding about the implications of this complexity, which suggest family violence and solutions to it are generated endogenously from the reflexive nonlinear interactions of system agents. Despite these calls for integration, services designed to support families impacted by violence and the systems that design and fund them are often responsive only to one part of the problem and might not pay attention to agent interactions and their adaptive reflexivity. This paper outlines a scoping protocol to explore how integrated approaches to family violence are conceptualised in current literature, with innovative use of a complexity theory lens.MethodOur scoping review protocol follows the framework outlined by Arksey and O’Malley and refined by Levac. It searches 6 databases, 3 journals and 10 websites using keywords to capture the notion of integration and a complex adaptive system, namely the participant (system agents), concept (system agent interaction) and the context (family violence). Selection criteria require the articles to be written in English, have full-text article available, and were published after 2010. Items selected also need to be evidence based showing interaction between system agents. Applying complexity theory, sensitises us to the reflexive patterns of interaction between system elements and routine ways of interacting.Ethics and disseminationThe nature of this review means that ethics approval is not required. Findings will be disseminated via academic publications, conferences and discussions with policy decision-makers. The findings will be used to develop a plan for stakeholder consultation to share and validate learnings and inform future research.

Recent progress in the study of infant motor development has been achieved by ground-breaking paradigm shifts combined with clever and innovative tasks that place the infant center stage as the acting subject. One of the challenges that developmental scientists are facing today is understanding the complexity of infants’ spontaneous movements. Novel methods such as wearables and computer vision methods have the potential to revolutionize the measurement of infants’ motor behavior in various situational and social contexts. However, a comparison between any computer method and wearables data has not been carried out so far in this age group for spontaneous behavior during social interactions with a caregiver. In this paper, we compare the results of Deeplabcut, an algorithm for tracking user-defined body parts, with simultaneously acquired wearable data and show that computer vision can be a good alternative to advanced wearable systems.

Ayat is a system of self-improvement of health and self-consciousness, which was proposed by Abdullayev Farkhat Muhamedovich more than 20 years ago and today, is used by many people all over the world. It helps thousands to regain health and live normal healthy and happy life.

Physical therapy interventions for children with severe motor impairments do not address the relationship between motor and cognitive development.Evaluate the potential of a physical therapy intervention focusing on enhancing cognitive and motor outcomes in a child with severe motor impairments.AB phase design without reversal.One child participated in 8 assessments from 4 to 29 months of age. The START-Play intervention was provided for 3 months following 4 baseline assessments over 12 months. Total Gross Motor Function Measure (GMFM), Sitting, Reaching, and Problem Solving assessments were completed. Visual inspection, 2 standard deviation (SD) Band Method, and percent of nonoverlapping data methods evaluated change.This child had improved GMFM total and sitting scores, increased frequency of toys contacts, and increased rate of problem-solving behaviors following intervention.START-Play shows promise for children with severe motor impairments. Additional research is needed to evaluate efficacy.

Purpose: To understand the extent different types of acute exercise influence cerebral blood flow during and following exercise in children. Methods: Eight children (7–11 y; 4 girls) completed 2 conditions: high-intensity interval exercise (HIIE; 6 × 1-min sprints at 90% watt maximum) and moderate-intensity steady-state exercise (MISS; 15 min at 44% watt maximum). Blood velocity in the middle cerebral artery (MCAV) and heart rate were assessed continuously. The partial pressure of end-tidal carbon dioxide and mean arterial pressure were assessed at baseline and following exercise. Results: Percentage of maximum heart rate during HIIE was 82% (4%), compared with 69% (4%) during MISS. MCAV was increased above baseline in MISS after 75 seconds (5.8% [3.9%], P × .004) but was unchanged during HIIE. MCAV was reduced below baseline (−10.7% [4.1%], P × .004) during the sixth sprint of HIIE. In both conditions, MCAV remained below baseline postexercise, but returned to baseline values 30-minute postexercise (P P Conclusion: These preliminary findings show HIIE and MISS elicit differing intracranial vascular responses; however, research is needed to elucidate the implications and underlying regulatory mechanisms of these responses.

WITH NASA MAKING serious moves toward a permanent return to the moon, it's natural to wonder whether human settlers-accustomed to high-speed, ubiquitous Internet access—will have to deal with mind-numbingly slow connections once they arrive on the lunar surface. The vast majority of today's satellites and spacecraft have data rates measured in kilobits per second. But long-term lunar residents might not be as satisfied with the skinny bandwidth that, say, the Apollo astronauts contended with. • To meet the demands of highdefinition video and data-intensive scientific research, NASA and other space agencies are pushing the radio bands traditionally allocated for space research to their limits. For example, the Orion spacecraft, which will carry astronauts around the moon during NASA's Artemis 2 mission in 2022, will transmit mission-critical information to Earth via an S-band radio at 50 megabits per second. "It's the most complex flight-management system ever flown on a spacecraft," says Jim Schier, the chief architect for NASA's Space Communications and Navigation program. Still, barely 1 Mb/s will be allocated for streaming video from the mission. That's about one-fifth the speed needed to stream a high-definition movie from Netflix. • To boost data rates even higher means moving beyond radio and developing optical communications systems that use lasers to beam data across space. In addition to its S-band radio, Orion will carry a laser communications system for sending ultrahigh-definition 4K video back to Earth. And further out, NASA's Gateway will create a long-term laser communications hub linking our planet and its satellite.

R Rwanda is known as the land of a thousand hills, and our car seems to go over every one of them as we drive from the small town of Muhanga to the even smaller town of Kinazi. The 50-kilometer I trip into western Rwanda will take us well over an hour. We're on our way to rendezvous with a blood-carrying drone that will make the trip in under 14 minutes. • The drone is operated by Zipline, a California-based company focused on delivering medical supplies in areas with poor infrastructure. And not long after we arrive at Kinazi's hospital, the fixed-wing drone materializes out of the blue. In a blink-and-you'll-miss-it moment, the drone descends, opens a set of doors in its belly, and drops a small package that parachutes to the ground. The drone immediately begins to climb and vanishes over the hills as a staff member crosses the hospital parking lot to pick up the package-a shipment of blood ordered by WhatsApp less than half an hour earlier. • We then climb back into our car to start our bone-jarring return drive to Muhanga, one of Zipline's launch sites, winding our way over dirt roads. By the time we make it back, the drone is flying smoothly toward another hospital elsewhere in Rwanda, with a fresh package of blood in its belly.

Abstract. Research, policy, and practice often target specific subpopulations. Large-scale survey studies are particularly useful for performing subpopulation analyses due to the large and representative nature of the samples. However, these studies utilize complex probability sampling designs, which complicate subpopulation analyses. This Monte-Carlo simulation study evaluated the interactive effect of subpopulation analysis method (multiple-group; zero-weight; subset) and cluster estimation method (multilevel modeling; robust single-level modeling) on the performance of fixed effect parameter, standard error, and interval estimators. Results should be used to inform statistical practice with the ultimate goal of achieving more valid inferences in subpopulation research.

Currently, there is great interest in bringing the application of IR spectroscopy into the clinic. This however will require a significant reduction in measurement time as Fourier Transform Infrared (FT-IR) imaging takes hours to days to scan a clinically relevant specimen. A potential remedy for this issue is the use of Quantum Cascade Laser Infrared (QCL IR) microscopy performed in Discrete Frequency (DF) mode for maximum speed gain. This gain could be furthermore improved by applying a proper denoising algorithm that takes into account the specific data structure. We have recently compared spectral and spatial denoising techniques in the context of Fourier Transform IR (FT-IR) imaging and showed that the optimal methods depend heavily on the exact data structure. In general multivariate denoising methods such as Principal Component Analysis (PCA) and Minimum Noise Fraction (MNF) are the most effective for a dataset containing multiple bands. Histologic classification of QCL IR images of pancreatic tissue using Random Forest was therefore performed to investigate which denoising schemes are the most optimal for such experimental data structure. This work is the first to show the effects of denoising on classification accuracy of QCL data and is likely to be transferable to other QCL microscopes and other modalities using DF imaging, e.g. AFM-IR or CARS/SRS imaging.

Airway smooth muscle is the primary cell mediating bronchomotor tone. The milieu created in the asthmatic lung modulates airway smooth muscle contractility and relaxation. Experimental findings suggest intrinsic abnormalities in airway smooth muscle derived from patients with asthma in comparison with airway smooth muscle from those without asthma. These changes to excitation-contraction pathways may underlie airway hyperresponsiveness and increased airway resistance associated with asthma.

OBJECTIVE To report surgical and long-term postoperative outcomes of bulls undergoing surgical occlusion of the corpus cavernosum penis (CCP) by acrylic injection and epididymectomy with or without penile fixation as preparation for use in estrus detection. DESIGN Retrospective case series. ANIMALS 18 client-owned bulls. PROCEDURES Medical records of bulls that underwent CCP occlusion between December 2002 and March 2016 were identified. Signalment, surgical data, and reported complications were recorded. Long-term (> 6 months after surgery) follow-up data were obtained from medical records or by telephone interview of bull owners with a questionnaire focused on postoperative outcome, use of the bull for estrus detection, and overall satisfaction with the procedure. RESULTS Intraoperative complications included difficulty isolating the penis, polymerization of the acrylic prior to injection, incomplete anesthesia of the surgical site, and fecal contamination of the site. Deposition of acrylic in an improper location led to urethral obstruction and euthanasia of 1 bull; another developed an abscess that was treated successfully. One bull was euthanized because of orchitis. Most (15/18) bulls were used for estrus detection (mean duration, 17.9 months). Libido was considered good or very good for 14 of 15 bulls; 1 was culled for loss of libido after 14 months. Ten of 12 bulls were reportedly unable to protrude the penis; 2 had or developed partial protrusion ability. Overall client satisfaction was high. CONCLUSIONS AND CLINICAL RELEVANCE In this population of healthy young bulls, CCP occlusion was generally well tolerated. Most bulls that underwent CCP occlusion (and epididymectomy with or without penile fixation) had adequate libido, and none were reported able to achieve intromission.

In March 2017, Rhode Island released treatment standards for care of adult patients with opioid use disorder. These standards prescribe three levels of hospital and emergency department treatment and prevention of opioid use disorder and opioid overdose and mechanisms for referral to treatment and epidemiological surveillance. By June 2018, all Rhode Island licensed acute care facilities had implemented policies meeting the standards’ requirements. This policy has standardized care for opioid use disorder, enhanced opioid overdose surveillance and response, and expanded linkage to peer recovery support, naloxone, and medication for opioid use disorder.

Aim of the publication was to show the process of designing, building, and programing an experimental portable charger for lithium-ion cells using a low-power photovoltaic panel, a microcontroller with dedicated modules for this microcontroller for educational applications. The publication shows the issue of engineering education, emphasizes the full integration of textbook learning methods, hardware, software, and methods of using them in the teaching of a modern engineer. During the analyse, the design of the device was made using CAD software, the elements were printed in 3D printing technology, electronic systems were created, components were assembled, the microcontroller was programmed, and the device was tested. The aim of the project was to show the possibility of using information technology in engineering education.

Coronavirus disease 2019 (COVID-19) is the latest respiratory pandemic caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2). Although infection initiates in the proximal airways, severe and sometimes fatal symptoms of the disease are caused by infection of the alveolar type 2 (AT2) cells of the distal lung and associated inflammation. In this study, we develop primary human lung epithelial infection models to understand initial responses of proximal and distal lung epithelium to SARS-CoV-2 infection. Differentiated air-liquid interface (ALI) cultures of proximal airway epithelium and alveosphere cultures of distal lung AT2 cells are readily infected by SARS-CoV-2, leading to an epithelial cell-autonomous proinflammatory response with increased expression of interferon signaling genes. Studies to validate the efficacy of selected candidate COVID-19 drugs confirm that remdesivir strongly suppresses viral infection/replication. We provide a relevant platform for study of COVID-19 pathobiology and for rapid drug screening against SARS-CoV-2 and emergent respiratory pathogens., Graphical abstract, In vitro models of human lung epithelium, including diverse cell types of the proximo-distal axis, are critical for modeling infection. Mulay et al. show that alveospheres, with epithelial type 2- and type 1-like cells, are infected by SARS-CoV-2, initiating an interferon response, and serve as a platform for screening antiviral drugs.

Fourier transform infrared spectroscopy (FT-IR) is widely used in the analysis of the chemical composition of biological materials and has the potential to reveal new aspects of the molecular basis of diseases, including different types of cancer. The potential of FT-IR in cancer research lies in its capability of monitoring the biochemical status of cells, which undergo malignant transformation and further examination of spectral features that differentiate normal and cancerous ones using proper mathematical approaches. Such examination can be performed with the use of chemometric tools, such as partial least squares discriminant analysis (PLS-DA) classification and partial least squares regression (PLSR), and proper application of preprocessing methods and their correct sequence is crucial for success. Here, we performed a comparison of several state-of-the-art methods commonly used in infrared biospectroscopy (denoising, baseline correction, and normalization) with the addition of methods not previously used in infrared biospectroscopy classification problems: Mie extinction extended multiplicative signal correction, Eiler’s smoothing, and probabilistic quotient normalization. We compared all of these approaches and their effect on the data structure, classification, and regression capability on experimental FT-IR spectra collected from five different prostate normal and cancerous cell lines. Additionally, we tested the influence of added spectral noise. Overall, we concluded that in the case of the data analyzed here, the biggest impact on data structure and performance of PLS-DA and PLSR was caused by the baseline correction, therefore, much attention should be given, especially to this step of data preprocessing.

Therapies for children with cerebral palsy (CP) often fail to address essential components of early rehabilitation: intensity, child initiation, and an embodied approach. Sitting Together And Reaching To Play (START-Play) addresses these issues while incorporating intensive family involvement to maximize therapeutic dosage. While START-Play was developed and tested on children aged 7–16 months with motor delays, the theoretical construct can be applied to intervention in children of broader ages and skills levels. This study quantifies the impact of a broader START-Play intervention combined with Botulinum toxin-A (BoNT-A) and phenol on the developmental trajectory of a 24 month-old child with bilateral spastic CP. In this AB +1 study, A consisted of multiple baseline assessments with the Gross Motor Function Measure-66 and the Assessment of Problem Solving in Play. The research participant demonstrated a stable baseline during A and changes in response to the combination of BoNT-A/phenol and 12 START-Play sessions during B, surpassing the minimal clinically important difference on the Gross Motor Function Measure-66. The follow-up data point (+1) was completed after a second round of BoNT-A/phenol injections. While the findings suggest the participant improved his gross motor skills with BoNT-A/phenol and START-Play, further research is needed to generalize these findings.

Airway smooth muscle plays a pivotal role in modulating bronchomotor tone. Modulation of contractile and relaxation signaling is critical to alleviate the airway hyperresponsiveness (AHR) associated with asthma. Emerging studies examining the phenotype of ASM in the context of asthma provide rich avenues to develop more effective therapeutics to attenuate the AHR associated with the disease.

This article describes a novel digital L-band EPR spectrometer. The spectrometer uses direct digital detection with time-locked subsampling (TLSS). The device consists of a microwave bridge equipped with a microwave source based on direct digital synthesis (DDS) and a digital receiver. DDS technology combined with an ultra-low noise 1 GHz master clock allowed the development of a digitally controlled microwave source with exceptionally good phase noise characteristics. The obtained level of phase noise is as low as −140 dBc/Hz at 30.5 kHz from the carrier frequency of 1.15 GHz, which is important when registering the EPR dispersion signal. The receiver is equipped with a high-speed A/D converter that enables direct digitalization of the L-band microwave signal. The obtained discrete data are then buffered and averaged in a programmable logic FPGA device. Data packets from FPGA are transferred to a DSP microcontroller that correlates them with the appropriate reference signals. This detection algorithm requires time locking of the generator and the receiver, which is ensured by clocking both devices from the same reference source. This procedure allows the simultaneous detection of the absorption and dispersion signals at the magnetic field modulation frequency and at any of its harmonics. The software to control the spectrometer was designed in the LabView programming environment. The program also allows further data processing. To the best of our knowledge, the described spectrometer is one of the first full implementation of the direct digital detection technique which could replace conventional analog CW spectrometers that utilize magnetic field modulation. For an 11 µm aqueous TEMPOL solution, the new spectrometer obtained a S/N ratio greater than 160 for an EPR spectrum registered in 69 s.

Background The COVID-19 epidemic has affected every area of life. The greatest challenge has been to adapt the functioning of the health service to prevent the spread of the epidemic and to help infected patients. This has required the involvement of not only doctors and nurses, but also pharmacists. In the face of this pandemic, governments in many countries have granted pharmacists greater authority. Objectives The purpose of this paper is to review the legal extension of the role of pharmacists in light of the COVID-19 pandemic. The review considers recent changes in European countries, Canada, and the United States. Methods A literature review was performed to summarise knowledge about the extension of the role of pharmacists during the pandemic period. Key articles were retrieved mainly from PubMed and Google Scholar, using the terms “COVID‐19”, “2019‐nCoV”, “coronavirus”, and “pandemic” in combination with “pharmacist” as keywords for our search. We included scientific publications from February 1, 2019 to May 15, 2020. Results Pharmacists have been given numerous opportunities so that they can actively join in the fight against the virus. Some of the novel legal extensions aimed at aiding overloaded healthcare systems are as follows: authorisation to prepare hand and surface disinfectants, eligibility to renew chronic treatment prescriptions, as well as filling pro auctore and pro familia prescriptions by pharmacists, performing COVID-19, influenza, and Group A Streptococcus screening tests, and vaccine administration. Moreover, many countries have facilitated Internet services, such as virtual medical consultations, e-prescriptions, and home drug delivery – to promote social distancing among patients. To mitigate drug shortages, the following strategies have been implemented: alternative sourcing, strength, generic, or therapeutic substitution, and preparing compounded formulations at the pharmacy. Conclusions Novel legal extensions have allowed exploitation of the full potential ofpharmacists worldwide, aiding the limited resources of overloaded healthcare systems.

We present a general-purpose numerical quantum mechanical solver using Schrodinger-Poisson equations called Aestimo 1D. The solver provides self-consistent solutions to the Schrodinger and Poisson equations for a given semiconductor heterostructure built with materials including elementary, binary, ternary, and quaternary semiconductors and their doped structures. The software can be used to calculate electronic band structures of heterostructures either using a single-band or multi-band k.p envelope function approximation. The software is fully open-source and it is released under the GNU general public license version 3 for full freedom of usage for applications in the fields of nano-electronics, optoelectronics, and solid-state device simulations.