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Approximately two-thirds of patients discharged from an emergency department (ED) are prescribed at least one medication. Prescription clarification by outpatient pharmacies for ED patients can lead to delays for patients and added workload.This study aims to describe prescriptions requiring clarification prior to being dispensed by an outpatient pharmacy for patients recently discharged from an ED.This study was conducted at an urban, 61-bed academic ED. Prescription clarification forms were used to identify common causes for outpatient pharmacies to contact the ED to clarify prescriptions prior to dispensation. Clarification types were reviewed and classified. Descriptive statistics were used to present the classification types.There were 1278 documented calls to the ED for prescription clarification that were classified as clarification of directions for use (611, 47.7%), insurance or affordability issues (182, 14.2%), dose (172, 13.4%), medication availability (126, 9.8%), lost or missing prescription (93, 7.3%), patient allergy or adverse event (62, 4.8%), duplication in therapy (17, 1.3%), and clarification of medication ordered (17, 1.3%). When grouped into provider, system, or patient-related issues, provider issues were noted to be most frequent clarifications (862 clarifications, 67.3%), followed by system issues (325 clarifications, 25.4%), and finally, patient-related issues (93 clarifications, 7.3%).Clarification of directions for use, insurance or affordability issues, and clarification of the dose were the most common reasons that outpatient pharmacies contacted an ED regarding a prescription for a recently discharged patient.

The purpose of this study is to investigate the effectiveness of a genetics educational module created to improve understanding about the genetics of diabetes, assess motivation to engage in healthy lifestyle behaviors, and gauge interest in genetic testing for diabetes.Participants were recruited from the Multidisciplinary Comprehensive Diabetes Clinic at the University of Alabama at Birmingham. Participants completed a pre-survey to assess three domains: (1) knowledge about diabetes etiology and testing, (2) healthy lifestyle behaviors, and (3) interest in genetic testing. Participants viewed a short, recorded educational module, then completed a post-survey to re-assess the domains.Participants increased knowledge about genetics of diabetes (p0.0001) and genetic testing (p = 0.0184), demonstrated motivation to adopt healthy behaviors (p0.0001), and decreased interest in genetic testing (p = 0.0833) after viewing the module.The educational module increased understanding of diabetes and increased motivation to adopt healthy behaviors. The need for patient-friendly educational modules explaining the genetics of diabetes will likely increase with continued discoveries of how genetics contributes to diabetes risk and outcomes. This short, educational module has the potential to provide genetic information in an effective way that is easily adapted in a routine clinic setting.

The U.S. National Library of Medicine and Department of Homeland Security assembled subject matter experts (SMEs) for the Toxic Chemical Syndrome Definitions and Nomenclature Workshop. The SMEs at this meeting identified a lack of research evaluating the effectiveness of field recognition of toxidromes to guide treatment. They suggested that mnemonics may be helpful for remembering and recognizing toxidromes and further, that rapid toxidrome recognition, through use of a mnemonic or otherwise, leads to rapid action and urgent intervention.(1) Determine if published studies demonstrate HPs can learn and recall hazardous materials (hazmat) toxidromes. (2) Determine if Healthcare Professionals (HPs) can learn mnemonics for muscarinic and nicotinic toxidromes during the Advanced Hazmat Life Support (AHLS) Provider Course (PC) and recall these cholinergic mnemonics when retested years later. Our hypothesis is HPs can learn these mnemonics and recall them up to four years later.We analyzed results of HPs who completed AHLS PC pre-tests and post-tests during their initial AHLS PC between March 1, 2007 and March 1, 2010, and then, within four years, took either an online retest or a pre-test for a second AHLS PC. We compared pre- and post-test answers for questions regarding muscarinic and nicotinic mnemonics to assess if HPs can learn these mnemonics during an initial AHLS PC and then recall these mnemonics later, during retesting. We compared the percentage of HPs who correctly identified each cholinergic mnemonic on the pre-test, post-test, and retest using McNemar's test for paired, nominal data. We searched six literature databases to see if there were any previous similar studies.Our literature search found no similar published studies. The mean time to re-testing was 3.6 years (SD 0.8 year). The percentage of respondents correctly answering the question for the muscarinic toxidrome was 53% on the pre-test, 100% on the post-test, and 75% on the retest. The percentage of respondents correctly answering the nicotinic toxidrome question was 52% on the pre-test, 100% on the post-test, and 77% on the retest.All studied healthcare professionals learned the cholinergic toxidrome mnemonics during their initial AHLS PC. Mnemonic recall declined somewhat on retesting; however, recall was evident in 75-77% of retest takers compared to their pre-test results up to four years earlier, a statistically significant difference (

Pediatric emergency intubation is a high-acuity, low-occurrence procedure. Despite advances in technology, the success of this procedure remains low and adverse events are very high. Prospective observational studies in children have demonstrated improved success with the use of video laryngoscopy (VL) compared with direct laryngoscopy, although reported first-pass success (FPS) rates are lower than that reported for adults. This may in part be due to difficulty directing the tracheal tube to the laryngeal inlet considering the cephalad position of the larynx in infants. Using airway adjuncts such as the pediatric rigid stylet (PRS) or a tracheal tube introducer (TTI) may aid with intubation to the cephalad positioned airway when performing VL. The objectives of this study were to assess the FPS and time to intubation when intubating an infant manikin with a standard malleable stylet (SMS) compared with a PRS and TTI.This was a randomized cross-over study performed at an academic institution both with emergency medicine (EM) and combined pediatric and EM (EMPEDS) residency programs. Emergency medicine and EMPEDS residents were recruited to participate. Each resident performed intubations on a 6-month-old infant simulator using a standard geometry C-MAC Miller 1 video laryngoscope and 3 different intubation adjuncts (SMS, PRS, TTI) in a randomized fashion. All sessions were video recorded for data analysis. The primary outcome was FPS using the 3 different intubation adjuncts. The secondary outcome was the mean time to intubation (in seconds) for each adjunct.Fifty-one participants performed 227 intubations. First-pass success for the SMS was 73% (37/51), FPS was 94% (48/51) with the PRS, and 29% (15/51) with the TTI. First-pass success was lower with the SMS (-43%; 95% confidence interval [CI], -63% to -23%; P0.01) and significantly lower with the TTI compared with PRS (difference -65%; 95% CI, -81% to -49%; P0.01). First-pass success while using the PRS was higher than SMS (difference 22%, 7% to 36%; P0.01). The mean time to intubation using the SMS was 44 ± 13 seconds, the PRS was 38 ± 11 seconds, and TTI was 59 ± 15 seconds. The mean time to intubation was higher with SMS (difference 15 seconds; 95% CI, 10 to 20 seconds; P0.01) and significantly higher with the TTI compared with PRS (difference 21 seconds; 95% CI, 17 to 26 seconds; P0.01). Time to intubation while using the PRS was lower than SMS (difference -7 seconds; 95% CI, -11 to -2 seconds; P0.01). The ease of use was significantly higher for the PRS compared with the TTI when operators rated them on a visual analog scale (91 vs 20 mm).Use of the PRS by EM and EMPEDS residents on an infant simulator was associated with increased FPS and shorter time to intubation. Clinical studies are warranted comparing these intubation aids in children.

Airway compromise and respiratory failure are leading causes of pediatric cardiac arrest making advanced airway management central to pediatric resuscitation. Previous literature has demonstrated that achieving first-pass success (FPS) is associated with fewer adverse events. In cardiac arrest for adult patients, increasing number of intubation attempts is associated with lower likelihood of return of spontaneous circulation (ROSC) and favorable neurologic outcome. There is limited evidence regarding advanced airway management for pediatric out-of-hospital cardiac arrest (OHCA) in the emergency department (ED). The purpose of this study was to compare FPS in pediatric OHCA and non-cardiac arrest patients in the ED.This is an analysis of pediatric intubations prospectively recorded into a continuous quality improvement database in an academic pediatric ED over a 12-year period. Between July 1, 2007, and June 30, 2019, physicians recorded all intubations performed in the pediatric ED. The database included patient demographics and detailed information about each intubation such as age of the patient, reason for intubation, number of intubation attempts, and outcome of each attempt. All patients younger than 18 years who underwent intubation in the ED were eligible for inclusion in the study. The primary outcome was FPS for pediatric patients in cardiac arrest compared with those not in cardiac arrest. A logistic regressions analysis was performed to identify characteristics associated with FPS in OHCA patients.Six hundred eight pediatric patients were intubated during the study period. One hundred three pediatric patients had OHCA compared with 459 non-cardiac arrest patients who underwent rapid sequence intubation. In patients with OHCA, 47.6% had FPS (95% confidence interval [CI], 38.2%-57.1%), 33% required 2 attempts (95% CI, 24.7%-42.6%), and 19.4% required 3 or more attempts (95% CI, 12.9%-28.2%). In patients without OHCA, 75.4% had FPS (95% CI, 75.4%-79.1%), 15% required 2 attempts (95% CI, 12.0%-18.6%), and 9.6% required 3 or more attempts (95% CI, 7.2%-12.6%). Cardiac arrest was associated with a reduction in FPS adjusted odds ratio 0.44 (95% CI, 0.26-0.77).In this study, we found that pediatric OHCA is associated with reduced FPS in the ED. Although additional studies are needed, rescuers should prioritize restoring effective oxygenation and ventilation and optimizing intubation conditions before an advanced airway attempt.

Silicon carbide nanotube/nanowires (SiCNT/NWs) exhibit excellent mechanical properties in extreme thermal and oxidative environments. Here, we demonstrate an easily scalable process to synthesize millimeter-sized three-dimensional architectures using SiCNT/NW building blocks to create materials with excellent mechanical strength, stiffness, and resiliency with ultra-low density. The structure of these macro-materials is initially synthesized using carbon nanotubes, then utilizing the shape memory synthesis (SMS) method are converted to nano-silicon carbide. It is proposed that using this technique, any micro-structure can initially be created with nano-carbon building blocks, optimized for the necessary morphological features of a specific application. Here, the synthesis and subsequent SiCNT/NW conversion of carbon nanotube spheres and graphene foam, demonstrates the ability to use a simple, cost-effective conversion method to create a material that can mechanically perform in extreme environments.

Studies published over 15 years ago surveyed genetic counselors (GC) and medical geneticists (MG) to examine their clinical experiences with the conflict of "duty to warn" versus patient confidentiality. Federal and state laws pertaining to medical professionals' duty to warn have since been implemented following the publications of these studies. Using a merged version of surveys employed in the prior studies, this study seeks to understand clinicians' current decision-making process when faced with patient refusal to inform at-risk relatives, as well as their familiarity with and opinions of laws and guidelines covering this issue. Consistent with the previous studies, the majority of MG and almost half of GC experience patient refusal. Significantly, fewer MG and GC believe they had a duty to warn their patients' relatives of genetic risk. Only 8% of participants believe current guidelines effectively address the issue of duty to warn. Participant awareness of federal or state laws regulating the disclosure of genetic information remains low. The conflict of duty to warn remains a shared experience among genetics professionals, and resources are needed to facilitate informed decision-making. Participants' opinions of current policies and clinical decisions may guide professional actions regarding duty to warn.

Introduction: The goal of emergency airway management is first pass success without adverse events (FPS-AE). Anatomically difficult airways are well appreciated to be an obstacle to this goal. However, little is known about the effect of the physiologically difficult airway with regard to FPS-AE. This study evaluates the effects of both anatomically and physiologically difficult airways on FPS-AE in patients undergoing rapid sequence intubation (RSI) in the emergency department (ED).Methods: We analyzed prospectively recorded intubations in a continuous quality improvement database between July 1, 2014–June 30, 2018. Emergency medicine (EM) or emergency medicine/pediatric (EM-PEDS) residents recorded patient, operator, and procedural characteristics on all consecutive adult RSIs performed using a direct or video laryngoscope. The presence of specific anatomically and physiologically difficult airway characteristics were also documented by the operator. Patients were analyzed in four cohorts: 1) no anatomically or physiologically difficult airway characteristics; 2) one or more anatomically difficult airway characteristics; 3) one or more physiologically difficult airway characteristics; and 4) both anatomically and physiologically difficult airway characteristics. The primary outcome was FPS-AE. We performed a multivariable logistic regression analysis to determine the association between anatomically difficult airways or physiologically difficult airways and FPS-AE.Results: A total of 1513 intubations met inclusion criteria and were analyzed. FPS-AE for patients without any difficult airway characteristics was 92.4%, but reduced to 82.1% (difference = - 10.3%, 95% confidence interval (CI), - 14.8% to - 5.6%) with the presence of one or more anatomically difficult airway characteristics, and 81.7% (difference = - 10.7%, 95% CI, - 17.3% to - 4.0%) with the presence of one or more physiologically difficult airway characteristics. FPS-AE was further reduced to 70.9% (difference = - 21.4%, 95% CI, - 27.0% to - 16.0%) with the presence of both anatomically and physiologically difficult airway characteristics. The adjusted odds ratio (aOR) of FPS-AE was 0.37 [95% CI, 0.21 - 0.66] in patients with anatomically difficult airway characteristics and 0.36 [95% CI, 0.19 - 0.67] for patients with physiologically difficult airway characteristics, compared to patients with no difficult airway characteristics. Patients who had both anatomically and physiologically difficult airway characteristics had a further decreased aOR of FPS-AE of 0.19 [95% CI, 0.11 - 0.33].Conclusion: FPS-AE is reduced to a similar degree in patients with anatomically and physiologically difficult airways. Operators should assess and plan for potential physiologic difficulty as is routinely done for anatomically difficulty airways. Optimization strategies to improve FPS-AE for patients with physiologically difficult airways should be studied in randomized controlled trials.

Membrane organization plays an important role in signaling, transport, and defense. In eukaryotes, the stability, organization, and function of membrane proteins are influenced by certain lipids and sterols, such as cholesterol. Bacteria lack cholesterol, but carotenoids and hopanoids are predicted to play a similar role in modulating membrane properties. We have previously shown that the loss of carotenoids in the plant-associated bacteria Pantoea sp. YR343 results in changes to membrane biophysical properties and leads to physiological changes, including increased sensitivity to reactive oxygen species, reduced indole-3-acetic acid secretion, reduced biofilm and pellicle formation, and reduced plant colonization. Here, using whole cell and membrane proteomics, we show that the deletion of carotenoid production in Pantoea sp. YR343 results in altered membrane protein distribution and abundance. Moreover, we observe significant differences in the protein composition of detergent-resistant membrane fractions from wildtype and mutant cells, consistent with the prediction that carotenoids play a role in organizing membrane microdomains. These data provide new insights into the function of carotenoids in bacterial membrane organization and identify cellular functions that are affected by the loss of carotenoids.

Antibiotics are sometimes administered to victims of rattlesnake bites in the hope of preventing infections. Experts in the field recommend that prophylactic antibiotics not be used because secondary infections are rare. Current recommendations are based on a small number of studies conducted in the United States. We decided to reexamine the issue by taking advantage of a large database on snakebites in Arizona. This allowed us to determine how often prophylactic antibiotics were used and whether or not they were effective.We obtained data from the Arizona Poison and Drug Information Center electronic medical record, Toxicall. Rattlesnake bites occurring over 18 years (1999-2016) were analyzed according to the descriptors: infection, pus, isolation of bacteria, and antibiotic use.There were 2748 evaluable patients identified as having rattlesnake bites. The mean number of bite victims was 153 per year. Most (72%) were male. Their ages ranged from 8 months to 91 years. Prophylactic antibiotics were administered to 120 of 2748 (4.4%) victims. There were 27 postbite infections (0.98%) but no deaths. Victims sometimes manipulated the wound sites. Microorganisms were isolated from only 9 patients. Only a Salmonella sp. was of certain reptilian origin; the others were likely of human origin.This large study supports recommendations that prophylactic antibiotics not be used following rattlesnake bites in the United States. The incidence of postbite infections was low,1%. All but 1 of the bacteria isolated from the wounds were common inhabitants of human skin and not found in oral secretions of rattlesnakes.

Cell-free protein synthesis (CFPS) has the potential to produce enzymes, therapeutic agents, and other proteins, while circumventing difficulties associated with in vivo heterologous expression. However, the contents of the cell-free extracts used to carry out synthesis are generally not characterized, which hampers progress toward enhancing yield or functional activity of the target protein. We explored the utility of mass spectrometry (MS)-based proteomics for characterizing the bacterial extracts used for transcribing and translating gene sequences into proteins as well as the products of CFPS reactions. Full proteome experiments identified over 1000 proteins per reaction. The complete set of proteins necessary for transcription and translation were found, demonstrating the ability to define potential metabolic capabilities of the extract. Further, MS-based techniques allowed characterization of the CFPS product and provided insight into the synthesis reaction and potential functional activity of the product. These capabilities were demonstrated using two different CFPS products, the commonly used standard green fluorescent protein (GFP, 27 kDa) and the polyketide synthase DEBS1 (394 kDa). For the large, multidomain DEBS1, substantial premature termination of protein translation was observed. Additionally, MS/MS analysis, as part of a conventional full proteomics workflow, identified post-translational modifications, including the chromophore in GFP, as well as the three phosphopantetheinylation sites in DEBS1. A hypothesis-driven approach focused on these three sites identified that all were correctly modified for DEBS1 expressed in vivo but with less complete coverage for protein expressed in CFPS reactions. These post-translational modifications are essential for functional activity, and the ability to identify them with mass spectrometry is valuable for judging the success of the CFPS reaction. Collectively, the use of MS-based proteomics will prove advantageous for advancing the application of CFPS and related techniques.

Selectively labeled GroEL protein was produced in living deuterated bacterial cells to enhance its neutron scattering signal above that of the intracellular milieu. Quasi-elastic neutron scattering shows that the in-cell diffusion coefficient of GroEL was (4.7 ± 0.3) × 10–12 m2/s, a factor of 4 slower than its diffusion coefficient in buffer solution. Internal protein dynamics showed a relaxation time of (65 ± 6) ps, a factor of 2 slower compared to the protein in solution. Comparison to the literature suggests that the effective diffusivity of proteins depends on the length and time scale being probed. Retardation of in-cell diffusion compared to the buffer becomes more significant with the increasing probe length scale, suggesting that intracellular diffusion of biomolecules is nonuniform over the cellular volume. The approach outlined here enables investigation of protein dynamics within living cells to open up new lines of research using “in-cell neutron scattering” to study the dynamics of complex bi...

Many plant-associated fungi host endosymbiotic endobacteria with reduced genomes. While endobacteria play important roles in these tri-partite plant-fungal-endobacterial systems, the active physiology of fungal endobacteria has not been characterized extensively by systems biology approaches. Here, we use integrated proteomics and metabolomics to characterize the relationship between the endobacterium Mycoavidus sp. and the root-associated fungus Mortierella elongata. In nitrogen-poor media, M. elongata had decreased growth but hosted a large and growing endobacterial population. The active endobacterium likely extracted malate from the fungal host as the primary carbon substrate for energy production and biosynthesis of phospho-sugars, nucleobases, peptidoglycan and some amino acids. The endobacterium obtained nitrogen by importing a variety of nitrogen-containing compounds. Further, nitrogen limitation significantly perturbed the carbon and nitrogen flows in the fungal metabolic network. M. elongata regulated many pathways by concordant changes on enzyme abundances, post-translational modifications, reactant concentrations and allosteric effectors. Such multimodal regulations may be a general mechanism for metabolic modulation.

The ability of bacteria to monitor their metabolism and adjust their behavior accordingly is critical to maintain competitiveness in the environment. The motile microaerophilic bacterium Azospirillum brasilense navigates oxygen gradients by aerotaxis in order to locate low oxygen concentrations that can support metabolism. When cells are exposed to elevated levels of oxygen in their surroundings, motile A. brasilense cells implement an alternative response to aerotaxis and form transient clumps by cell-to-cell interactions. Clumping was suggested to represent a behavior protecting motile cells from transiently elevated levels of aeration. Using the proteomics of wild-type and mutant strains affected in the extent of their clumping abilities, we show that cell-to-cell clumping represents a metabolic scavenging strategy that likely prepares the cells for further metabolic stresses. Analysis of mutants affected in carbon or nitrogen metabolism confirmed this assumption. The metabolic changes experienced as clumping progresses prime cells for flocculation, a morphological and metabolic shift of cells triggered under elevated-aeration conditions and nitrogen limitation. The analysis of various mutants during clumping and flocculation characterized an ordered set of changes in cell envelope properties accompanying the metabolic changes. These data also identify clumping and early flocculation to be behaviors compatible with the expression of nitrogen fixation genes, despite the elevated-aeration conditions. Cell-to-cell clumping may thus license diazotrophy to microaerophilic A. brasilense cells under elevated oxygen conditions and prime them for long-term survival via flocculation if metabolic stress persists.

Advanced gas turbine engine designs continue to push into regimes of higher operating temperatures and increased pressures. Materials capable of functioning under these extreme conditions have been sought by both government and industry. As part of its mission, the NASA Transformational Tools and Technologies (TTT) Project, under the auspices of NASA’s Aeronautics Research Mission Directorate (ARMD), has been pursuing high temperature materials development with the performance goal of 2700°F (1482°C) operation. This goal has evolved into a focused three year Technology Challenge which is nearing its conclusion. This challenge problem has sought to develop high temperature materials for turbine engines which will enable a 6% reduction in fuel burn for commercial aircraft as compared to the current generation. This ambitious effort has included ceramic matrix composite (CMC) compositions, architectures and processing as well as environmental barrier coating compositions (EBC) and processing routes. It has included collaborators and materials suppliers from both industry and academia. The development and validation of thermomechanical models and computational tools for design, analysis, and life prediction have been an important part of this effort. Evaluation of CMC/EBCs included various aspects of thermomechanical testing from coupon testing for strength and creep resistance, to materials evaluation under conditions similar to aspects of engine operation. Simulated engine testing of airfoil subcomponents in a P&W test rig is the final evaluation step following years of materials development. As this three year Technical Challenge concludes, plans are under development for continued environmental durability investigation of CMC/EBC systems accompanied by validated durability modeling.

Indole-3-acetic acid (IAA) plays a central role in plant growth and development, and many plant-associated microbes produce IAA using tryptophan as the precursor. Using genomic analyses, we predicted that Pantoea sp. YR343, a microbe isolated from Populus deltoides, synthesizes IAA using the indole-3-pyruvate (IPA) pathway. To better understand IAA biosynthesis and the effects of IAA exposure on cell physiology, we characterized proteomes of Pantoea sp. YR343 grown in the presence of tryptophan or IAA. Exposure to IAA resulted in upregulation of proteins predicted to function in carbohydrate and amino acid transport and exopolysaccharide (EPS) biosynthesis. Metabolite profiles of wild-type cells showed the production of IPA, IAA, and tryptophol, consistent with an active IPA pathway. Finally, we constructed an Δ ipdC mutant that showed the elimination of tryptophol, consistent with a loss of IpdC activity, but was still able to produce IAA (20% of wild-type levels). Although we failed to detect intermediates from other known IAA biosynthetic pathways, this result suggests the possibility of an alternate pathway or the production of IAA by a nonenzymatic route in Pantoea sp. YR343. The Δ ipdC mutant was able to efficiently colonize poplar, suggesting that an active IPA pathway is not required for plant association.

Living systems possess a rich biochemistry that can be harnessed through metabolic engineering to produce valuable therapeutics, fuels and fine chemicals. In spite of the tools created for this purpose, many organisms tend to be recalcitrant to modification or difficult to optimize. Crude cellular extracts, made by lysis of cells, possess much of the same biochemical capability, but in an easier to manipulate context. Metabolic engineering in crude extracts, or cell-free metabolic engineering, can harness these capabilities to feed heterologous pathways for metabolite production and serve as a platform for pathway optimization. However, the inherent biochemical potential of a crude extract remains ill-defined, and consequently, the use of such extracts can result in inefficient processes and unintended side products. Herein, we show that changes in cell growth conditions lead to changes in the enzymatic activity of crude cell extracts and result in different abilities to produce the central biochemical precursor pyruvate when fed glucose. Proteomic analyses coupled with metabolite measurements uncover the diverse biochemical capabilities of these different crude extract preparations and provide a framework for how analytical measurements can be used to inform and improve crude extract performance. Such informed developments can allow enrichment of crude extracts with pathways that promote or deplete particular metabolic processes and aid in the metabolic engineering of defined products.

Boron nitride nanotubes (BNNTs), an analogue of carbon nanotube (CNT) is one of the most used non-metallic materials in high technology applications related to thin film fabrications. Taking advantage of their unique properties such as electrically non-conductive, thermally conductive, and high hardness, it has been used in high-temperature electronic devices, multifunctional aerospace materials, and structures and electric and aerospace systems. The main goal of this project was to use BNNTs in the fabrication of nano epoxycomposites to enhance their thermal and mechanical properties to use it for applications in aerospace constituents. In order to accomplish this goal, BNNTs were functionalized with isopherone diisocyante (IPDC). Surface analysis techniques were employed to ensure the modification BNNTs and study the interface of the reinforced composites before and after the modification. Mechanical and thermal conductivity testing was performed in order to understand the quality of the composites. Three different nanocomposites were accomplished with hBN and BNNTs using two different epoxy polymers and three curing agents. The systems EPON 862/Curing Agent W/ (hBN or BNNTs) have Tgs and tan deltas higher compared with those fabricated at the same conditions without nanoparticles. The fabricated BN composites showed improved physical properties due to their particle dispersion and boron nitrite intermolecular interactions with the epoxy polymer.

The investigation of non-reciprocal behavior of optical beams in a rotating reference frame was the main motivation of the historic tabletop experiment of George Sagnac. His ground-breaking experiment was extended to a very large installation more than a decade later, which was sensitive enough to allow Michelson, Pearson and Gale to resolve the rotation rate of the Earth by an optical interferometer. With the advent of lasers in the early sixties of the last century, rotating laser cavities with a ring structure demonstrated superior performance and very soon matured to a point where mechanical gyroscopes were quickly superseded by laser gyroscopes in aircraft navigation. When vastly upscaled ring lasers were taken back to the laboratory at the end of the 20th century, the goal of applying the Sagnac effect to geodesy for the monitoring of tiny variations of Earth's rotation was the main motivation. The large-ring laser G, which is the most stable instrument out of a series of instruments built by the New Zealand–German collaboration, routinely resolves the rotation rate of the Earth to better than eight orders of magnitude. Since G is directly referenced to the Earth rotation axis, the effect of diurnal polar motion, the Chandler and the Annual wobbles as well as tilts from the solid Earth tides can be found in the interferogram obtained from the ring laser. G has also demonstrated high sensitivity to rotations associated with seismic events. The toroidal eigenmodes of the Earth when they are excited by large earthquakes have been resolved. A surprisingly large amplitude has been measured for Love wave signals contained in the microseismic background signal. This paper summarizes the recent development of highly sensitive large Sagnac gyroscopes, and presents unique results from the measurements of rotations of the earth.

Envenomation by Centruroides sculpturatus can manifest with cranial nerve dysfunction and neuromuscular hyperactivity. While these symptoms are most commonly seen in young children, they may also be seen in adults.Three cases of adult patients are presented with grades IIIIV scorpion envenomation. They reported symptoms including disconjugate, roving eye movements, and motor involvement. Also reported were hyposmia, difficulty with fine motor movements, and dysgeusia. All were first treated with benzodiazepines with little to no effect. They then received a three vial antivenom bolus with resolution of severe symptoms within 30-60 min.Severe Centruroides envenomation can occur in adults as well as children. These three cases demonstrate the usefulness, safety, and effectiveness of antivenom therapy to quickly relieve symptoms in adult patients with grades IIIIV envenomations.

Genetic counseling is a rapidly expanding field, and the supply of certified genetic counselors is currently unable to keep up with job demand. Research is fairly limited regarding the awareness and perceptions that prospective genetic counseling students have on the field and what factors most influence their interest. The current study includes data collected from 1389 undergraduate students in the sciences at 23 universities across the United States who were surveyed regarding information related to their awareness, perceptions, knowledge, and interest in genetic counseling. The majority of participants had heard of genetic counseling (78.0%), many from a high school course (37.3%), college course (28.1%), or online (11.5%). Familiarity was associated with factors such as female gender (p = 0.003) and length of time in school (p

The most recent and innovative silicon carbide (SiC) fiber ceramic matrix composites, used for lightweight high-heat engine parts in aerospace applications, are woven, layered, and then surrounded by a SiC ceramic matrix composite (CMC). To further improve both the mechanical properties and thermal and oxidative resistance abilities of this material, SiC nanotubes and nanowires (SiCNT/NWs) are grown on the surface of the SiC fiber via carbon nanotube conversion. This conversion utilizes the shape memory synthesis (SMS) method, starting with carbon nanotube (CNT) growth on the SiC fiber surface, to capitalize on the ease of dense surface morphology optimization and the ability to effectively engineer the CNT-SiC fiber interface to create a secure nanotube-fiber attachment. Then, by converting the CNTs to SiCNT/NWs, the relative morphology, advantageous mechanical properties, and secure connection of the initial CNT-SiC fiber architecture are retained, with the addition of high temperature and oxidation resistance. The resultant SiCNT/NW-SiC fiber can be used inside the SiC ceramic matrix composite for a high-heat turbo engine part with longer fatigue life and higher temperature resistance. The differing sides of the woven SiCNT/NWs act as the "hook and loop" mechanism of Velcro but in much smaller scale.

Large ring lasers have exceeded the performance of navigational gyroscopes by several orders of magnitude and have become useful tools for geodesy. In order to apply them to tests in fundamental physics, remaining systematic errors have to be significantly reduced. We derive a modified expression for the Sagnac frequency of a square ring laser gyro under Earth rotation. The modifications include corrections for dispersion (of both the gain medium and the mirrors), for the Goos-Hänchen effect in the mirrors, and for refractive index of the gas filling the cavity. The corrections were measured and calculated for the 16 msup2/supGrossring laser located at the Geodetic Observatory Wettzell. The optical frequency and the free spectral range of this laser were measured, allowing unique determination of the longitudinal mode number, and measurement of the dispersion. Ultimately we find that the absolute scale factor of the gyroscope can be estimated to an accuracy of approximately 1 part in 10sup8/sup.

This study uses a unique data set derived from parcel data and aerial photographs to estimate the effect of the introduction of light rail transit (LRT) on land use in Minneapolis, Minnesota. We measure detailed changes in land use before and after construction of the METRO Blue Line and exploit heterogeneity in starting land use type and neighborhood characteristics to examine the differential effects of proximity to light rail across space. Results show that properties within ½ mile of operational LRT stations experience a small increase in the likelihood of land use change relative to when the LRT is under construction, but neither construction nor operation of the line appears to affect land use change relative to the time before construction. Within the corridor, proximity to LRT increases the likelihood of land use change on single-family and industrial properties, but appears to have no effect on vacant land, commercial properties, and multi-family properties.

This paper reports on the development of a hybrid atmospheric pressure atomic force microscopy/mass spectrometry imaging system utilizing nanothermal analysis probes for thermal desorption surface sampling with subsequent atmospheric pressure chemical ionization and mass analysis. The basic instrumental setup and the general operation of the system were discussed, and optimized performance metrics were presented. The ability to correlate topographic images of a surface with atomic force microscopy and a mass spectral chemical image of the same surface, utilizing the same probe without moving the sample from the system, was demonstrated. Co-registered mass spectral chemical images and atomic force microscopy topographical images were obtained from inked patterns on paper as well as from a living bacterial colony on an agar gel. Spatial resolution of the topography images based on pixel size (0.2 μm × 0.8 μm) was better than the resolution of the mass spectral images (2.5 μm × 2.0 μm), which were limited by current mass spectral data acquisition rate and system detection levels.

We study the anisotropy effects measured with INDRA at GSI in central collisions of Xe+Sn at 50 A.MeV and Au+Au at 60, 80, 100 A.MeV incident energy. The microcanonical multifragmentation model with non-spherical sources is used to simulate an incomplete shape relaxation of the multifragmenting system. This model is employed to interpret observed anisotropic distributions in the fragment size and mean kinetic energy. The data can be well reproduced if an expanding prolate source aligned along the beam direction is assumed. An either non-Hubblean or non-isotropic radial expansion is required to describe the fragment kinetic energies and their anisotropy. The qualitative similarity of the results for the studied reactions suggests that the concept of a longitudinally elongated freeze-out configuration is generally applicable for central collisions of heavy systems. The deformation decreases slightly with increasing beam energy., Comment: 35 pages, 19 figures, submitted to Nuclear Physics A

“Massacre” was the accepted interpretation for a prehistoric skeletal assemblage of around 90 individuals from Cave 7 in the SE Utah of the North American Southwest since the 1890s. Coltrain and others (Journal of Archaeological Science 39, 2220–2230) rejected this account based on a dispersed suite of AMS radiocarbon dates on purified bone collagen from the interred individuals. Since dates from skeletons exhibiting perimortem damage were scattered across some 400 radiocarbon years, Coltrain et al. argued for multiple interments of victims of violence and related kin spread across several centuries. The temporal placement of interment events in Cave 7 clearly cannot be known independent of radiocarbon assays but such assays should not be privileged above contextual information about which individuals were interred together unless verified by an independent dating laboratory. Only by ignoring important information about burial context in the 1893 field record can the dates of Coltrain et al. be accepted as accurate estimates of time of death. We redated residual collagen from 11 of the Cave 7 individuals because of significant contextual anomalies with some of the prior results. The new assays combined with contextual evidence demonstrate that some of Coltrain et al.’s dates are either too old or too young; the dates are neither sufficiently accurate (true estimates of sample age) nor sufficiently precise (small confidence intervals) to refute a single-event massacre or to confirm multiple interment events in Cave 7. Nonetheless, dates that meet these criteria disclose at least two interment events, a large one of mostly adult males, many exhibiting perimortem damage (a massacre assemblage), and a small one consisting of an adult female with three children. A third interment event of a few adult females and child is possible based primarily on context since the date distribution in this case overlaps substantially with that of the massacre victims; context also hints at other interment events. Aside from chronology we clarify the number of Basketmaker individuals interred at the site and the incidence of perimortem violence. A single-event mass killing continues to be the most likely interpretation for around 58 individuals, mostly adult males (at least 35) but also adult females and children. This incident occurred between cal. AD 20–80 and doubtless had a significant social impact at the time because of its scale, reverberating throughout the early farming communities of the Southwest.

Development of the Europium-doped Strontium Iodide scintillator, SrI2(Eu), involves advances in crystal growth, optics and readout methodology for prototype detectors. We have demonstrated energy resolution of 3% at 662 keV for a 26 cm3 SrI2(Eu) crystal, which is equivalent to the performance obtained with Cerium-doped Lanthanum Bromide of equivalent size. Compared to standard analog readout, use of a digital readout method allows improved energy resolution to be obtained with large volume SrI2(Eu) crystals. Comparative gamma spectra acquired with LaBr3(Ce) and NaI(Tl) quantitatively depict the value of the high resolution of SrI2(Eu) in discriminating closely spaced gamma lines for radioisotope identification applications.