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Due to the optimistic outcomes of the research on high-entropy alloys, new designs of these alloys are being encouraged. We studied the high-entropy CoCrFeMoNi alloy and the CoCrFeMoNi alloy doped with Zr. In order to choose the best electrical equivalent circuit for the prediction of the behavior of these high-entropy alloys at various potentials in artificial seawater, electrochemical impedance spectroscopy (EIS) measurements were conducted on samples with and without Zr-doped CoCrFeMoNi. At various potential levels, the impedance spectra were measured between −1.0 and +0.8 V vs. SCE. The study consists of a preliminary section with microstructure by metallography, open-circuit potential, and linear polarization curves by direct-current tests followed by visual analysis of the impedance spectra, and, finally, the selection of an equivalent electrical circuit model to fit the experimental data. By leveraging the advantages of EIS analysis, the information is essential for materials development, corrosion-mitigation strategies, and the successful implementation of these alloys in practical applications. It is important to note that selecting an equivalent circuit is often an iterative and subjective process, as it involves a balance between model complexity and the ability to accurately represent the system’s behavior.

Uno de los propósitos de la investigación geomorfológica es reconocer e interpretar los mecanismos que controlan la evolución de las distintas formas de relieve y sus procesos conexos, siendo suficientemente estudiado el rol geomorfológico en la formación de suelos, equiparable a la conformación de sustratos adecuados para la colonización de pasto marino, el cual modifica el sistema morfodinámico al incorporar un efecto estabilizador que coadyuva a la diversificación tanto de las formas arrecifales circunvecinas como de las cubiertas vegetales. Por tal razón la importancia de reconocer los atributos geomorfológicos que sirven para identificar la estabilidad de los ecosistemas bajo uso intensivo para así generar herramientas de planificación en áreas marinas protegidas. En este sentido, esta investigación tuvo como objetivo determinar la importancia de los atributos geomorfológicos como factor de reconocimiento y predicción de las alteraciones ambientales en el ambiente arrecifal, así como su utilidad en el cálculo de la capacidad de carga turística en áreas sometidas a presión antrópica. El desarrollo del objetivo principal amerito del empleo de técnicas de reconocimiento detallado en campo en combinación con las herramientas de teledetección y sistemas de información geográfica para la generación de indicadores para el cálculo de la capacidad de carga física para el uso turístico, los factores limitantes y finalmente la capacidad de carga real que resulto ser de 320 personas por día, en función tanto de la fragilidad de los bancos y fondos arenosos como también de la normativa venezolana de protección del manglar, lo que significaría una reducción en las afluencia actual del 88,7% que impactaría parte de la economía local con los consecuentes conflictos sociales.

RESUMEN El presente texto efectúa una problematización teórica del carácter conflictivo de la memoria colectiva desde la perspectiva de la teoría del antagonismo propuesta por Laclau, el cual constituye un aporte de este trabajo, dado que resulta una aproximación novedosa para la comprensión de los fenómenos de trauma histórico desde una perspectiva atenta a la dimensión política de la memoria. A partir de esta problematización se reflexiona acerca de la relevancia de los sitios de memoria como espacios de inscripción y tramitación simbólica de los traumas colectivos, los que dada su particular naturaleza material y ubicación en el espacio público pueden operar como hitos de referencia para la elaboración de las repercusiones transgeneracionales de los traumas colectivos. RESUMO O presente texto constitui uma problematização teórica do caráter conflituoso da memória coletiva, na perspectiva da teoria do antagonismo proposta por Laclau, que constitui uma contribuição deste trabalho, trata-se de uma abordagem inovadora para a compreensão dos fenômenos de trauma histórico, de uma perspectiva atenta à dimensão política da memória. A partir desta problematização se reflete sobre a relevância dos lugares da memória como espaços para inscrição e processamento simbólico dos traumas coletivos, aqueles que, dada a sua natureza material e localização particular no espaço público, podem operar como marcos de referência para a elaboração das repercussões transgeracionais dos traumas coletivos. ABSTRACT This article presents a theoretical problematization of the conflicting character of collective memory in the perspective of the theory of antagonism proposed by Laclau. It is an innovative approach to understanding the phenomena of historical trauma, from a point of view attentive to the political dimension of memory. From this, we reflect on the relevance of memory places as spaces for inscription and symbolic processing of collective traumas, those that, given their material nature and particular location in the public space, can operate as benchmarks for the elaboration of transgenerational repercussions of collective traumas. RÉSUMÉ Ce texte présente une problématisation théorique de la nature conflictuelle de la mémoire collective du point de vue de la théorie de l’antagonisme proposée par Laclau, qui constitue une contribution à ce travail, puisqu’elle aboutit à une approche inédite de la compréhension des phénomènes de traumatisme historique à partir de une perspective attentive à la dimension politique de la mémoire. A partir de cette problématisation, on réfléchit à la pertinence des lieux de mémoire en tant qu’espaces d’inscription et de traitement symbolique des traumatismes collectifs, qui, compte tenu de leur nature matérielle particulière et de leur localisation dans l’espace public, peuvent opérer comme des coups de référence pour l’élaboration des répercussions transgénérationnelles des traumatismes collectifs.

Resumen Este texto presenta los resultados y análisis de una investigación sobre transmisión transgeneracional del trauma colectivo, en la que participaron nietos(as) de víctimas de la dictadura chilena. Es una investigación de naturaleza cualitativa, que tuvo por objetivo aproximarse a los procesos de subjetivación de la memoria del trauma colectivo por parte de la tercera generación. El material textual obtenido por medio de entrevistas fue interpretado a través de un enfoque de análisis crítico del discurso. Se concluye que la subjetivación de la memoria del trauma colectivo por la tercera generación se da en el marco de una interpelación ideológica, en la que el sujeto adquiere una posición de responsabilidad ético-política respecto del sostén de la memoria de sus abuelos/as, proceso que comprende la organización de un recubrimiento representacional de los vacíos que implica la transmisión transgeneracional del trauma.

OBJECTIVES Studies have shown the advantages of carbon dioxide (CO2) over air insufflation in the adult population during colonoscopies. This study was designed to investigate the efficacy and safety of CO2 insufflation in deeply sedated children undergoing colonoscopy. METHODS This was a prospective, randomized, double-blind clinical trial. We recruited 100 consecutive pediatric patients who had colonoscopy under deep sedation for various indications. Patients were first randomized by history of abdominal pain and then randomly assigned to either CO2 or air insufflation. Postprocedural abdominal pain scores were registered on a 10-point visual analog rating scale and significant pain was defined as a score of 3 or higher. Abdominal circumferences and end tidal CO2 (ETCO2) levels were measured. Complications during and after the procedure were recorded. RESULTS We did not find statistically significant difference between CO2 and air insufflation on univariate analysis because of low number of children experiencing significant pain after colonoscopy. After adjusting for baseline pain, we found that pain was significantly lower in patients after CO2 versus air insufflation on multivariable analysis (P = 0.03). The significant factors related to pain were duration of the procedure (P = 0.006), history of abdominal pain (P = 0.002) and previous abdominal surgery (P = 0.02). CO2 insufflation was associated with decreased abdominal circumference after colonoscopy (P = 0.002). Girls were more likely to have pain regardless of intervention (P = .04). CONCLUSIONS Most children tolerate endoscopic procedures without significant pain. Our study was underpowered to show significant difference between air and CO2 on univariate analysis. CO2 insufflation during colonoscopy, however, may reduce postprocedural abdominal pain. Significant factors for increased pain on multivariate analysis included colonoscopy length over 30 minutes, history of abdominal pain, and previous abdominal surgery.

Background Inflammatory bowel diseases (IBD) often begins early in life. Adolescents and young adults (AYA) with IBD have to acquire behaviors that support self-care, effective healthcare decision-making, and self-advocacy to successfully transition from pediatric to adult health care. Despite the importance of this critical time period, limited empirical study of factors associated with transition readiness in AYA exists. This study aimed to describe transition readiness in a sample of AYA with IBD and identify associated modifiable and nonmodifiable factors. Methods Seventy-five AYA (ages 16-20) and their parents participated. AYA and parents reported on demographics, patient-provider transition-related communication, and transition readiness. AYA self-reported on disease self-efficacy. Disease information was abstracted from the medical record. Results Deficits in AYA responsibility were found in knowledge of insurance coverage, scheduling appointments, and ordering medication refills. Older AYA age, higher AYA disease-management self-efficacy, and increased patient-provider transition communication were each associated with higher overall transition readiness and AYA responsibility scores. Regression analyses revealed that older AYA age and increased patient-provider transition-related communication were the most salient predictors of AYA responsibility for disease management and overall transition readiness across parent and AYA reports. Conclusions AYA with IBD show deficits in responsibility for their disease management that have the potential to affect their self-management skills. Findings suggest provider communication is particularly important in promoting transition readiness. Additionally, it may be beneficial to wait to transition patients until they are older to allow them more time to master skills necessary to responsibly manage their own healthcare.

This study aims to carry out the implementation in FPGA (Field Programmable Gate Array) of a processing system capable of detecting and tracking moving vehicles without losing the system's reliability and efficiency of real-time application. Hence, for simple technique of tracking reach good results is proposed for removing shadows, an auxiliary processing based on insect vision system EMD (Elementary Motion Detector). The principle of this processing is based on cross-correlation and has been implemented in some work to get the direction of moving objects, however, this work is modified and implemented to auxiliary in removing shadows of objects detected using color, spatial and temporal information. The proposed auxiliary processing proves to be efficient in a video stream where the two most critical vehicles are selected with respect the cast shadow. The results of the implementation proposal are presented in terms of resource consumption and maximum operating frequency in a Spartan-6 FPGA-based development board. The experimental results are obtained in co-simulation system and show the effectiveness of the proposed system.

This paper shows the possibility to improve the accuracy of medical diagnosis on contaminated radiographic image with salt and pepper noise using FPGA-based filters. Investigation is carried out using filters described widely in the literature, such as Blur, Smooth and Gaussian linear filters and nonlinear median filter implemented on FPGA in an attempt to eliminate the noise. Implementations are checked on a development board with Spartan 6slx100fgg484-3 FPGA and a low-power optimized version Spartan 6slx100lfgg484-1l. The results are verified through the filtered images, resources consumption and the lowest response time. The implementation methodology uses model-based engineering involving MATLAB/Simulink and System Generator software using the XSGlmgLib library to perform co-simulation. The results show that the FPGA implementation of the median filter has a good tradeoff between resource consumption and noise removal efficiency.

Background This systematic review critically analyzes the current research on micronutrient deficiency in children with inflammatory bowel disease (IBD) and synthesizes these data to provide evidence-based guidelines for nutritional surveillance in this population. Methods We searched 5 databases (Ovid Medline, PubMed, Scopus, CINAHL, and Cochrane Library) for studies evaluating micronutrients in patients with IBD using the following inclusion criteria: 1) original research, 2) published 1996 or later; 3) published in English; 4) human subjects; and 5) containing pediatric data. Studies were reviewed and included based on the strength of research methods. Data on the prevalence of micronutrient deficiencies in pediatric patients with IBD and risk factors for micronutrient deficiency in these patients were extracted from included studies and compared and discussed in preparation of the proposed guidelines and manuscript. Results A total of 39 studies were included in the final review. The data presented in these studies show that iron deficiency and vitamin D deficiency are common in pediatric patients with IBD. Vitamin B12 and folate deficiency are rare. Zinc deficiency, while not common, occurs at a higher rate in patients with Crohn's disease than in healthy controls. There was limited data on vitamins A, E, and C, and selenium, but deficiency of these micronutrients seems rare. Conclusions We recommend annual surveillance of iron and vitamin D in pediatric patients with IBD regardless of disease activity or phenotype. Zinc should be monitored annually in patients with Crohn's disease. There is insufficient evidence to support routine screening for other micronutrient deficiencies.

Objective: To implement a quality improvement based system to measure and improve data quality in an observational clinical registry to support a Learning Healthcare System.Data Source: ImproveCareNow Network registry, which as of September 2019 contained data from 314,250 visits of 43,305 pediatric Inflammatory Bowel Disease (IBD) patients at 109 participating care centers.Study Design: The impact of data quality improvement support to care centers was evaluated using statistical process control methodology. Data quality measures were defined, performance feedback of those measures using statistical process control charts was implemented, and reports that identified data items not following data quality checks were developed to enable centers to monitor and improve the quality of their data.Principal Findings: There was a pattern of improvement across measures of data quality. The proportion of visits with complete critical data increased from 72 percent to 82 percent. The percent of registered patients improved from 59 percent to 83 percent. Of three additional measures of data consistency and timeliness, one improved performance from 42 percent to 63 percent. Performance declined on one measure due to changes in network documentation practices and maturation. There was variation among care centers in data quality.Conclusions: A quality improvement based approach to data quality monitoring and improvement is feasible and effective.

BACKGROUND. Paneth cell dysfunction has been implicated in a subset of Crohn’s disease (CD) patients. We previously stratified clinical outcomes of CD patients by using Paneth cell phenotypes, which we defined by the intracellular distribution of antimicrobial proteins. Animal studies suggest that Paneth cells shape the intestinal microbiome. However, it is unclear whether Paneth cell phenotypes alter the microbiome complexity in CD subjects. Therefore, we analyzed the correlation of Paneth cell phenotypes with mucosal microbiome composition and ileal RNA expression in pediatric CD and noninflammatory bowel disease (non-IBD) patients. METHODS. Pediatric CD (n = 44) and non-IBD (n = 62) patients aged 4 to 18 were recruited prior to routine endoscopic biopsy. Ileal mucosal samples were analyzed for Paneth cell phenotypes, mucosal microbiome composition, and RNA transcriptome. RESULTS. The prevalence of abnormal Paneth cells was higher in pediatric versus adult CD cohorts. For pediatric CD patients, those with abnormal Paneth cells showed significant changes in their ileal mucosal microbiome, highlighted by reduced protective microbes and enriched proinflammatory microbes. Ileal transcriptome profiles showed reduced transcripts for genes that control oxidative phosphorylation in CD patients with abnormal Paneth cells. These transcriptional changes in turn were correlated with specific microbiome alterations. In non-IBD patients, a subset contained abnormal Paneth cells. However, this subset was not associated with alterations in the microbiome or host transcriptome. CONCLUSION. Paneth cell abnormalities in human subjects are associated with mucosal dysbiosis in the context of CD, and these changes are associated with alterations in oxidative phosphorylation, potentially in a feedback loop. FUNDING. The research was funded by Helmsley Charitable Trust (to T.S. Stappenbeck, R.J. Xavier, and D.P.B. McGovern), Crohn’s and Colitis Foundation of America (to N.H. Salzman, T.S. Stappenbeck, R.J. Xavier, and C. Huttenhower), and Doris Duke Charitable Foundation grant 2014103 (to T.C. Liu).

This study provides specific evidence regarding the extent to which quantitative measures, common sense notional measures, and comprehensive measures adequately characterize spontaneous, although engaged, speech. As such, the study contributes to the growing body of literature describing the current limits of automatic systems for evaluating spoken proficiency, provides examples of the essential nature of various notional and comprehensive variables, supports continued development of hybrid systems, and includes suggestions for the possible utilization of additional variables for automatic analyses. Data for this study were gathered and analyzed as follows. After 4 weeks of activities related to career development, 20 native English speaking college freshmen made recordings in English explaining their career preferences. Three experiments were then conducted. Experiment 1 analyzed the recordings according to current quantitative analyses used in fully automatic evaluations of fluency. Experiment 2 examined the recordings through a perception study according to common everyday notions of fluency. Experiment 3 analyzed the recordings according to an adaptation of the comprehensive rubrics used by the Educational Testing Service (ETS) for evaluating oral proficiency. The comprehensive evaluation (Experiment 3) provided the most insight, and temporal quantitative measures (Experiment 1) provided the least insight concerning the proficiency of the 20 speakers.

It is important to determine the effects of immunomodulators on the ability of children to remain on infliximab therapy for Crohn's disease (durability of therapy), given the potential benefits and risks of concomitant therapy-especially with thiopurines in male patients. We investigated how immunomodulatory treatment affects the durability of infliximab therapy.We collected data from the Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry, from January 2002 through August 2014, on 502 children with Crohn's disease who participated in a prospective multicenter study. Data were collected from patients who received at least a 3-dose induction regimen of infliximab, and their concomitant use of immunomodulators: no thiopurine or methotrexate treatment, treatment for 6 months or less during infliximab therapy, or treatment for more than 6 months during infliximab therapy.The probabilities (± standard error) that children remained on infliximab therapy for 1 year, 3 years, and 5 years after the treatment began were 0.84 ± 0.02, 0.69 ± 0.03, and 0.60 ± 0.03, respectively. Age, sex, and disease extent or location did not affect the durability of infliximab therapy. Greater length of concomitant use of immunomodulators was associated with increased time of infliximab therapy. The probability that patients with more than 6 months of immunomodulator use remained on infliximab therapy for 5 years was 0.70 ± 0.04, compared with 0.48 ± 0.08 for patients who did not receive immunomodulators and 0.55 ± 0.06 for patients who received immunomodulators for 6 months or less (P.001). In boys who received immunomodulators for 6 months or more after starting infliximab, the overall durability of infliximab therapy was greater among patients receiving methotrexate than thiopurine (P.01); the probabilities that they remained on infliximab therapy for 5 years were 0.97 ± 0.03 vs 0.58 ± 0.08, respectively.In children with Crohn's disease, concomitant treatment with an immunomodulator for more than 6 months after starting infliximab therapy increases the chances that patients will remain on infliximab. In boys, methotrexate appears to increase the durability of infliximab therapy compared with thiopurine.

The mid-IR spectrum of gas-phase C2H5OO has been measured over the spectral range of 800−4000 cm-1. The employed experimental technique was long-path-length absorption in which a White cell was coupled to an FTIR spectrometer. Radicals were generated in a mixing manifold prior to the absorption cell by passing an F2/He mixture through a microwave discharge to create fluorine atoms followed by the reaction of atomic fluorine with an ethane/oxygen mixture. A number of absorption bands were observed to increase in intensity with increasing atomic fluorine concentration. Verification that the observed bands originated from the ethyl peroxy radical was done first by comparing measured band frequencies with the spectra of possible secondary reaction products and second by titrating C2H5OO• with excess nitric oxide and observing the nitrogen dioxide and ethyl nitrite products that ultimately result from the titration reaction. Bands were assigned to normal modes of C2H5OO• through comparing the observed band pos...

BACKGROUND Methotrexate (MTX) use as an alternative to thiopurines in the treatment of Crohn's disease (CD) in children is increasing. This study was undertaken to assess safety and efficacy of MTX in children with CD. METHODS Patients treated with MTX with a minimum of 1-year follow-up were identified in the Pediatric IBD Collaborative Research Group Registry, a prospective inception cohort study started in 2002. The clinical efficacy and safety of MTX were analyzed retrospectively. RESULTS Two hundred ninety patients treated with MTX were identified. One hundred seventy-two patients received at least 3 months of MTX without thiopurine or biologicals and had ≥1 year of follow-up. Eighty-one of 172 patients (47%) received MTX as first immunomodulator (IMM), of which 22 (27%) achieved ≥12 months of sustained clinical remission without surgery, thiopurine, biologicals, or corticosteroids. Those receiving MTX as second IMM achieved similar remission rate (35%, P = not significant). Fourteen percent received MTX as first IMM in 2002 and 60% in 2010 (P = 0.005). Disease location did not affect outcomes. MTX doses were equivalent in both groups. Fifteen percent of patients developed an alanine aminotransferase >60 international units/liter and 12% developed a white blood cell

Inflammatory bowel disease-associated liver diseases (IBD-LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD-LD in patients with pediatric inflammatory bowel disease (IBD) are lacking. We examined early alanine aminotransferase (ALT) and γ-glutamyl transpeptidase (GGT) elevations in children diagnosed as having IBD and assessed the likelihood of IBD-LD.Data collected from the prospective observational Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry enrolling children of age16 years within 30 days of diagnosis. AIH, PSC, and overlap syndrome were diagnosed using local institutional criteria.A total of 1569 subjects had liver enzymes available. Of the total, 757 had both ALT and GGT, 800 had ALT only (no GGT), and 12 had GGT only (no ALT). Overall, 29 of 1569 patients (1.8%) had IBD-LD. IBD-LD was diagnosed in 1 of 661 (0.15%) of patients with both ALT and GGT ≤ 50 IU/L compared with 21 of 42 (50%) of patients with both ALT and GGT 50 (odds ratio 660, P 0.0001). Of the 29 patients with IBD-LD, 21 had PSC, 2 had AIH, and 6 had overlap syndrome. IBD-LD was more common in patients with ulcerative colitis and IBD-unclassified (indeterminate colitis) than in those with Crohn disease (4% vs 0.8%, respectively, P 0.001).Elevation of both ALT and GGT within 90 days after the diagnosis of IBD is associated with a markedly increased likelihood of IBD-LD. Both ALT and GGT levels should be measured in all of the pediatric patients newly diagnosed as having IBD.

To identify and develop novel targeted therapies for complex diseases such as Crohn's disease (CD), functional subtypes rooted in pathogenesis must be defined. One candidate method to subtype CD is to define the small intestinal Paneth cell phenotypes based on the intracellular distribution of antimicrobial proteins. We have previously shown that in CD patients, Paneth cell phenotype correlates with the patients' genotype, distinct gene expression signature, presence of granuloma (pathologic hallmark), and time to recurrence after surgery. However, the mechanism by which abnormal Paneth cells contribute to pathogenesis and sub-classify disease in the context of host-microbial interaction is unclear. We analyzed Paneth cell phenotype and its correlation with mucosal microbiome and transcriptome in a cohort of pediatric CD and non-inflammatory bowel disease (IBD) patients.We first retrospectively analyzed Paneth cell phenotypes using archived resection specimens from adult (n = 531) and pediatric (n = 73) CD patients. We next analyzed a prospectively recruited pediatric cohort, including CD (n = 44) and non-IBD (n = 62) patients aged 4 to 18. These patients were recruited at the time of routine endoscopy. Ileal mucosal biopsy samples were collected and analyzed for Paneth cell phenotype (lysozyme/defensin 5 immunofluorescence), mucosal microbiome (16S rRNA sequencing), and transcriptome (RNA-sequencing). Paneth cell phenotype was determined by the percentage of normal Paneth cells in each sample. Type I Paneth cell phenotype was defined as

AIM The aim of the present study was to report the global experience with placement, complication rate, and recording of esophageal pH using the BRAVO capsule at our institution. PATIENTS AND METHODS We recorded the rate of any technical problems and complications during placement in all of the patients (ages 4-22 years) who received this device during a 2-year period. All of the patients undergoing esophagogastroduodenoscopy with the placement of BRAVO pH capsule were included in this analysis. We also examined the pH data recorded on days 1 and 2 for significant day-to-day variability during 2 days of pH monitoring. RESULTS Two hundred eighty-nine BRAVO pH probes were placed from January 1, 2006 to December 31, 2008. At least 1 day of data was obtained in 278 patients (96.2%). Two days of data were obtained in 274 patients (94.8%). Of all of the reported complications, 1% occurred before deployment of the capsule, 4% occurred during deployment of the capsule, and 9% occurred after successful deployment of the capsule. One patient experienced a superficial esophageal tear that was associated with failure of the capsule to release from the delivery system. No patient requested removal of the capsule and all of the capsules detached within 14 days. In 9.12% of our patients, reflux index was normal on day 1 and abnormal on day 2. There was no statistically significant difference between reflux index recorded on day 1 versus day 2 (P = 0.686). CONCLUSIONS The BRAVO pH capsule is easy to place, safe, and well tolerated by children. Performing a 48-hour study detected abnormal reflux in an additional 9% of our patients.