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This is the first report describing detailed T cell responses to viral-like proteins contained in an HPV specific vaccine given in combination with Imiquimod for treatment of persistent VAIN2/3. We postulate that stimulation of the innate immune system with Imiquimod and the specific CD4 and CD8T cell responses following HPV vaccination with Gardasil9@ combined to induce clinical remission in a woman with treatment-refractory disease.

Glaciers expel sediment as they melt, in addition to ice and water. As a result, changing glacier dynamics and melt produce changes to glacier erosion and sediment discharge, which can impact the landscape surrounding retreating glaciers, as well as communities and ecosystems downstream. Currently, numerical models that transport subglacial sediment on sub-hourly to decadal scales are one-dimensional, usually along a glacier's flow line. Such models have proven useful in describing the formation of glacial landforms, the impact of sediment transport on glacier dynamics, and the interactions among climate, glacier dynamics, and erosion. However, these models omit the two-dimensional spatial distribution of sediment and its impact on sediment connectivity – the movement of sediment between its detachment in source areas and its deposition in sinks. Here, we present a numerical model that fulfills a need for predictive frameworks that describe subglacial sediment discharge in two spatial dimensions (x and y) over time. SUGSET_2D evolves a two-dimensional subglacial till layer in response to bedrock erosion and changing sediment transport conditions. Numerical experiments performed using an idealized alpine glacier illustrate the heterogeneity in sediment transport and bedrock erosion below the glacier. An increase in sediment discharge follows increased glacier melt, as has been documented in field observations and other numerical experiments. We also apply the model to a real alpine glacier, Griesgletscher in the Swiss Alps, where we compare outputs with annual measurements of sediment discharge. SUGSET_2D accurately reproduces the general quantities of sediment discharge and the year-to-year sediment discharge pattern measured at the glacier terminus. The model's ability to match the measured data depends on the tunable sediment grain size parameter, which controls subglacial sediment transport capacity. Smaller grain sizes allow sediment transport to occur in regions of the bed with reduced water flow and channel size, effectively increasing sediment connectivity into the main channels. The model provides the essential components of modeling subglacial sediment discharge on seasonal to decadal timescales and reveals the importance of including spatial heterogeneities in water discharge and sediment transport in both the x and y dimensions in evaluating sediment discharge.

Abstract Background Preoperative education and breathing exercise training by a physiotherapist minimises pulmonary complications after abdominal surgery. Effects on specific clinical outcomes such as antibiotic prescriptions, chest imaging, sputum cultures, oxygen requirements, and diagnostic coding are unknown. Methods This post hoc analysis of prospectively collected data within a double-blinded, multicentre, randomised controlled trial involving 432 participants having major abdominal surgery explored effects of preoperative education and breathing exercise training with a physiotherapist on postoperative antibiotic prescriptions, hypoxemia, sputum cultures, chest imaging, auscultation, leukocytosis, pyrexia, oxygen therapy, and diagnostic coding, compared to a control group who received a booklet alone. All participants received standardised postoperative early ambulation. Outcomes were assessed daily for 14 postoperative days. Analyses were intention-to-treat using adjusted generalised multivariate linear regression. Results Preoperative physiotherapy was associated with fewer antibiotic prescriptions specific for a respiratory infection (RR 0.52; 95% CI 0.31 to 0.85, p = 0.01), less purulent sputum on the third and fourth postoperative days (RR 0.50; 95% CI 0.34 to 0.73, p = 0.01), fewer positive sputum cultures from the third to fifth postoperative day (RR 0.17; 95% CI 0.04 to 0.77, p = 0.01), and less oxygen therapy requirements (RR 0.49; 95% CI 0.31 to 0.78, p = 0.002). Treatment effects were specific to respiratory clinical coding domains. Conclusions Preoperative physiotherapy prevents postoperative pulmonary complications and is associated with the minimisation of signs and symptoms of pulmonary collapse/consolidation and airway infection and specifically results in reduced oxygen therapy requirements and antibiotic prescriptions. Trial registration ANZCTR 12613000664741 ; 19/06/2013.

Childhood trauma can result in developmental and psychosocial problems leaving teachers struggling to manage the effects of students' trauma and potentially leading to increased burnout. The present study investigated whether teachers' attitudes towards teaching trauma-affected students and prior experience with trauma predicted teacher burnout. Five types of prior experience were informed by the multidimensional model of attitude strength: the extent and valence (i.e., how favourable or unfavourable the experience was) of direct teaching experience, the extent and valence of personal experience, and the extent of indirect experience (trauma-training). The study investigated whether the relationships between prior experiences and burnout were mediated by teachers' attitudes, controlling for teacher age. Australian mainstream teachers (N = 536) were recruited to an online survey through snowball sampling on social media. Results showed that attitudes significantly mediated the relationships between all experience variables with burnout, except for the extent of personal experience. More favourable attitudes were predicted by more direct experience (contrary to the hypothesised direction) and indirect experience (as hypothesised). Regarding valence of experience, exploratory analyses found more favourable direct and personal experiences predicted more favourable attitudes. Supporting the hypotheses, all mediations found more favourable attitudes predicted less burnout, while more personal experience predicted greater burnout. These cross-sectional findings suggest that greater experience teaching trauma-affected students, trauma-training, and fostering favourable perceptions of teachers' personal trauma may protect teachers from burnout. Future research using longitudinal designs is needed to support causal effects between teachers' experiences, attitudes, and burnout.

Having a common framework for early action to cope with complex disasters can make it easier for authorities and other stakeholders, including populations at risk, to understand the full spectrum of secondary and tertiary effects and thus where to focus preparedness efforts, and how best to provide more targeted warnings and response services. Meteorological and hydrological services world-wide have developed and implemented Multi-Hazard Early Warning Systems (MHEWS) for weather and climate related hazards that are now being expanded and transitioned towards Multi-Hazard Impact-based Early Warning Systems (MHIEWS). While it is still early days it is becoming clear that there are useful lessons from this approach in the COVID-19 global pandemic, and some valuable insight to be gained in risk communication, risk analysis and monitoring methodologies and approaches. The ability to understand and respond effectively to warnings through appropriate behaviours and actions is central to resilient societies and communities. By avoiding physical, societal and economic harm to the greatest extent possible, recovery from a hazard is likely to be faster, less costly and more complete. MHIEWS can be a common approach for all hazards and therefore more likely to become a trusted tool that everyone can understand and use as a basic element of their national disaster risk management system. The interconnectedness of hazards and their impacts is a strong motivator for a common approach. One of the lessons from the COVID-19 pandemic and extreme weather events is the need to understand the vulnerability of individuals, communities and societies so as to provide reliable, targeted guidance and warnings and the willingness and capacity to prepare for a reasonable worst-case scenario based on informed long-term planning. Meteorology and hydrology are making good progress in this direction and the process can be readily applied to health and other sectors.

While a strong literature base exists around undergraduate experiences in Science, Technology, Engineering, and Math (STEM), few studies examine how students approach the question of "what's next" after graduation. This study examines the impact of social ties on STEM college seniors' plans to enter the STEM workforce, and how race/ethnicity and gender impact postgraduation planning in STEM. We interviewed a racially diverse sample of 39 STEM college seniors at a predominantly White research institution. Analysis showed that students relied on weak and strong social ties in obtaining job leads and valued diversity in the workplace. Some students of color and women experienced negative social ties (via racism and sexism) during internship experiences, which shaped their thinking around postgraduate opportunities. We discuss implications for equity, as well as recommendations for research and practice.

Drawing on interviews with 70 college peer socialization agents (PSAs) across 42 U.S.-based institutions of higher education, this study explores how PSAs create "underlives" (Goffman, 1961) in response to their roles and expectations for communicating institutional messages about diversity. Findings from this study illuminate the ways in which institutional scripts produce tension for the PSAs who enact them and the symbolic, behavioral, and discursive ways in which PSAs use distancing strategies to resist. Most of these public-facing students employed "contained" strategies to preserve an underlife away from the surveillance and pressures of the institution. However, some students - especially Students of Color and those from other marginalized groups - also sometimes utilized more "disruptive" forms of underlife, using resistance to attempt systemic change. We illustrate these strategies by presenting two narrative vignettes of participants' experiences that explore and develop the roles of identity, relationships, environment, and expectations in influencing PSAs strategic decisions.

A rigorous exploration of the sea ice data assimilation (DA) problem using a framework specifically developed for rapid, interpretable hypothesis testing is presented. In many applications, DA is implemented to constrain a modeled estimate of a state with observations. The sea ice DA application is complicated by the wide range of spatiotemporal scales over which key sea ice variables evolve, a variety of physical bounds on those variables, and the particular construction of modern complex sea ice models. By coupling a single-column sea ice model (Icepack) to the Data Assimilation Research Testbed (DART) in a series of observing system simulation experiments (OSSEs), the grid-cell-level response of a complex sea ice model to a range of ensemble Kalman DA methods designed to address the aforementioned complications is explored. The impact on the modeled ice thickness distribution and the bounded nature of both state and prognostic variables in the sea ice model are of particular interest, as these problems are under-examined. Explicitly respecting boundedness has little effect in the winter months, but it correctly accounts for the bounded nature of the observations, particularly in the summer months when the prescribed sea ice concentration (SIC) error is large. Assimilating observations representing each of the individual modeled sea ice thickness categories consistently improves the analyses across multiple diagnostic variables and sea ice mean states. These results elucidate many of the positive and negative results of previous sea ice DA studies, highlight the many counterintuitive aspects of this particular DA application, and motivate better future sea ice analysis products.

Intrinsic inequity in assessment refers to sources of harmful discrimination inherent in the design of assessment tools and systems. This study seeks to understand intrinsic inequity in assessment systems by studying assessment policies and associated procedures in residency training, using general pediatrics as a discourse case study. Foucauldian discourse analysis (FDA) was conducted on assessment policy and procedure documents. Two authors independently prepared structured analytic notes using guiding questions. Documents and respective analytic notes were subsequently reviewed independently by all authors. Each author prepared further unstructured analytic notes on the documents' discourse. The authors then compared notes and constructed truth statements (i.e., interpretations of what the discourse establishes as true about the construct under study) and sub-strands (i.e., themes) that were repeated and legitimized across the documents via iterative discussion. Based on analysis, the authors constructed two truth statements. These truth statements, "good assessment is equitable assessment," and "everyone is responsible for inequity," conceptualized inequity in assessment as an isolated or individual-level aberration in an otherwise effective or neutral system. Closer examination of the truth statements and sub-strands in the discourse presented an alternative view, suggesting that inequity may in fact not be an aberration but rather an inherent feature of assessment systems.

Carbon dioxide (CO2) is, next to water vapour, considered to be the most important natural greenhouse gas on Earth. Rapidly rising atmospheric CO2 concentrations caused by human actions such as fossil fuel burning, land-use change or cement production over the past 250 years have given cause for concern that changes in Earth's climate system may progress at a much faster pace and larger extent than during the past 20 000 years. Investigating global carbon cycle pathways and finding suitable adaptation and mitigation strategies has, therefore, become of major concern in many research fields. The oceans have a key role in regulating atmospheric CO2 concentrations and currently take up about 25% of annual anthropogenic carbon emissions to the atmosphere. Questions that yet need to be answered are what the carbon uptake kinetics of the oceans will be in the future and how the increase in oceanic carbon inventory will affect its ecosystems and their services. This requires comprehensive investigations, including high-quality ocean carbon measurements on different spatial and temporal scales, the management of data in sophisticated databases, the application of Earth system models to provide future projections for given emission scenarios as well as a global synthesis and outreach to policy makers. In this paper, the current understanding of the ocean as an important carbon sink is reviewed with respect to these topics. Emphasis is placed on the complex interplay of different physical, chemical and biological processes that yield both positive and negative air–sea flux values for natural and anthropogenic CO2 as well as on increased CO2 (uptake) as the regulating force of the radiative warming of the atmosphere and the gradual acidification of the oceans. Major future ocean carbon challenges in the fields of ocean observations, modelling and process research as well as the relevance of other biogeochemical cycles and greenhouse gases are discussed.

No abstract available. doi:10.2204/iodp.sd.15.08.2013

We used 5-yr concomitant data of tracer distribution from the BATS (Bermuda Time-series Study) and ESTOC (European Station for Time-Series in the Ocean, Canary Islands) sites to build a 1-D tracer model conservation including horizontal advection, and then compute net production and shallow remineralization rates for both sites. Our main goal was to verify if differences in these rates are consistent with the lower export rates of particulate organic carbon observed at ESTOC. Net production rates computed below the mixed layer to 110 m from April to December for oxygen, dissolved inorganic carbon and nitrate at BATS (1.34±0.79 mol O2 m−2, −1.73±0.52 mol C m−2 and −125±36 mmol N m−2) were slightly higher for oxygen and carbon compared to ESTOC (1.03±0.62 mol O2 m−2, −1.42±0.30 mol C m−2 and −213±56 mmol N m−2), although the differences were not statistically significant. Shallow remineralization rates between 110 and 250 m computed at ESTOC (−3.9±1.0 mol O2 m−2, 1.53±0.43 mol C m−2 and 38±155 mmol N m−2) were statistically higher for oxygen compared to BATS (−1.81±0.37 mol O2 m−2, 1.52±0.30 mol C m−2 and 147±43 mmol N m−2). The lateral advective flux divergence of tracers, which was more significant at ESTOC, was responsible for the differences in estimated oxygen remineralization rates between both stations. According to these results, the differences in net production and shallow remineralization cannot fully explain the differences in the flux of sinking organic matter observed between both stations, suggesting an additional consumption of non-sinking organic matter at ESTOC.

Even though scientific communication and collaboration play critical roles in academic success, they often come in second to teaching laboratory fundamentals. COVID-19 associated capacity constraints forced our program to reexamine the traditional laboratory instruction paradigm by limiting physical attendance, as well as laboratory duration. Instead, we opted to turn these restrictions into opportunities to study peer-to-peer communication as a means to enhance in-person experimentation. Here, a two-week high performance liquid and gas chromatography (HPLC and GC) module uses centralized student communication between peer groups to not only maintain but increase quality laboratory experiences. Students rotate between two chromatography experiments to ensure each person gains exposure to foundational separations techniques. The module's first week focuses on method development, while the second week highlights method validation. Since HPLC and GC can accommodate similar experimental objectives, students receive comparable method development and validation experiences no matter which specific instrument they are assigned to that week. By integrating communication into the experimental process and adding peer accountability to the laboratory's design, the authors observed an increase in laboratory report words and figures when compared to the prior years' reports. Student questionnaires also indicated structured rotation and group communication increased student interest and investment in obtaining and reporting quality data.

This study investigated how 15 kindergarten teachers from one school district implemented small-group Guided Reading (GR). Analysis of video recordings indicates substantial differences in how GR was conducted, with none of the teachers fully implementing GR as conceptualized by Fountas and Pinnell (2012). Consistency across teachers was limited to reading a new book and using a picture walk as part of the book introduction. Differences were observed in how the books were read (choral, round robin, or independent reading) and in instructional activities before and after reading the new book, with word solving being the most prevalent focus of instruction. Findings suggest that while districts may promote a GR approach, teachers may be doing very different things. These findings are considered in light of current debates around early reading instruction and the importance of evidence-based decision making with regard to instructional improvements.