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Alcohol use disorders (AUD) are commonly occurring, heritable and polygenic disorders with etiological origins in the brain and the environment. To outline the causes and consequences of alcohol-related milestones, including AUD, and their related psychiatric comorbidities, the Collaborative Study on the Genetics of Alcoholism (COGA) was launched in 1989 with a gene-brain-behavior framework. COGA is a family based, diverse (~25% self-identified African American, ~52% female) sample, including data on 17,878 individuals, ages 7-97 years, in 2246 families of which a proportion are densely affected for AUD. All participants responded to questionnaires (e.g., personality) and the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) which gathers information on psychiatric diagnoses, conditions and related behaviors (e.g., parental monitoring). In addition, 9871 individuals have brain function data from electroencephalogram (EEG) recordings while 12,009 individuals have been genotyped on genome-wide association study (GWAS) arrays. A series of functional genomics studies examine the specific cellular and molecular mechanisms underlying AUD. This overview provides the framework for the development of COGA as a scientific resource in the past three decades, with individual reviews providing in-depth descriptions of data on and discoveries from behavioral and clinical, brain function, genetic and functional genomics data. The value of COGA also resides in its data sharing policies, its efforts to communicate scientific findings to the broader community via a project website and its potential to nurture early career investigators and to generate independent research that has broadened the impact of gene-brain-behavior research into AUD.

BackgroundGenome-wide association studies have been conducted in alcohol use disorder (AUD), and they permit the use of polygenic risk scores (PRSs), in combination with clinical variables, to predict the onset of AUD in vulnerable populations.MethodsA total of 2794 adolescent/young adult subjects from the Collaborative Study on the Genetics of Alcoholism were followed, with clinical assessments every 2 years. Subjects were genotyped using a genome-wide chip. Separate PRS analyses were performed for subjects of European ancestry and African ancestry. Age of onset of DSM-5 AUD was evaluated using the Cox proportional hazard model. Predictive power was assessed using receiver operating characteristic curves and by analysis of the distribution of PRS.ResultsEuropean ancestry subjects with higher than median PRSs were at greater risk for onset of AUD than subjects with lower than median PRSs (p = 3 × 10-7). Area under the curve for the receiver operating characteristic analysis peaked at 0.88 to 0.95 using PRS plus sex, family history, comorbid disorders, age at first drink, and peer drinking; predictive power was primarily driven by clinical variables. In this high-risk sample, European ancestry subjects with a PRS score in the highest quartile showed a 72% risk for developing AUD and a 35% risk of developing severe AUD (compared with risks of 54% and 16%, respectively, in the lowest quartile).ConclusionsPredictive power for PRSs in the extremes of the distribution suggests that these may have future clinical utility. Uncertainties in interpretation at the individual level still preclude current application.

The United States Environmental Protection Agency held an international two-day workshop in June 2018 to deliberate possible performance targets for non-regulatory fine particulate matter (PM2.5) and ozone (O3) air sensors. The need for a workshop arose from the lack of any market-wide manufacturer requirement for Ozone documented sensor performance evaluations, the lack of any independent third party or government-based sensor performance certification program, and uncertainty among all users as to the general usability of air sensor data. A multi-sector subject matter expert panel was assembled to facilitate an open discussion on these issues with multiple stakeholders. This summary provides an overview of the workshop purpose, key findings from the deliberations, and considerations for future actions specific to sensors. Important findings concerning PM2.5 and O3 sensors included the lack of consistent performance indicators and statistical metrics as well as highly variable data quality requirements depending on the intended use. While the workshop did not attempt to yield consensus on any topic, a key message was that a number of possible future actions would be beneficial to all stakeholders regarding sensor technologies. These included documentation of best practices, sharing quality assurance results along with sensor data, and the development of a common performance target lexicon, performance targets, and test protocols.

SPARC will be outfitted with three systems of x-ray crystal spectrometer arrays. Two of these are designed using cylindrically bent crystals to achieve high spectral-resolution for ion temperature and toroidal velocity measurements via imaging He-like Kr and Ne-like Xe. The last acts as a spectral survey system to monitor Ne-like W and nearby H- and He-like emission from Cr, Fe, Co, Ni, and Cu. Line radiation intensities are calculated using the Flexible Atomic Code for atomic data and ColRadPy for collisional-radiative modeling, then convoluted with a Voigt line shape. Free–free, free-bound, and two-photon continuum radiation is also included. The ToFu code is used to perform volume-of-sight integration to produce synthetic detector images. In addition, presented is cross-validation performed using the XICSRT Monte Carlo ray-tracing code. Ion temperature and toroidal velocity profiles are reconstructed using ToFu via tomographic inversion. [ABSTRACT FROM AUTHOR]

The SPARC tokamak will be equipped with a hard X-ray (HXR) monitor system capable of measuring the bremsstrahlung emission from runaway electrons with photon energies in excess of about 100 keV. This diagnostic will detect the formation of runaway electron beams during plasma start-up and inform the plasma control system to terminate the discharge early to protect the machine. In this work, we present a 0D estimate of the HXR emission in SPARC during plasma start-up. Then we discuss the characterization of a prototype of the HXR monitor. The detector mounts a 1 × 1-in.2 LaBr3 inorganic scintillator coupled with a photomultiplier tube and has been tested with γ-ray sources to find its dynamic range. Finally, two possible modes of operation for spectroscopic and current mode measurements on SPARC are proposed. [ABSTRACT FROM AUTHOR]

The Mars 2020 Perseverance Rover imaged diagenetic textural features in four separate sedimentary units in its exploration of the 25‐m‐thick Shenandoah formation at Jezero Crater, Mars, that we interpreted as probable concretions. These concretions were most abundant in the Hogwallow Flats member of the Shenandoah formation and were restricted to the light‐toned, platy, sulfur‐cemented bedrock at outcrop surfaces, whereas the finely laminated, darker toned, mottled and deformed strata lack concretions. The concretions also had a wide range of morphologies including concentric, oblate, urn, and spheroidal shaped forms that were not clustered, and ranged in size from ∼1 to 16 mm with a median of 2.65 mm. The elemental composition of the concretions compared to the bedrock had greater abundance of magnesium and calcium salts, silicates, and possibly hematite. We compared these Jezero Crater concretions to the geochemistry of concretions from previously published studies and from two new terrestrial analog sites (Gallup Formation, New Mexico and Torrey Pines, California). In addition, we measured organic carbon content of three terrestrial sedimentary analogs of increasing age that contain concretions (Torrey Pines (Pleistocene), Gallup Formation (∼89 Ma), and Moodies Group (∼3.2 Ga)). All measured concretions contained significant concentrations of organic carbon with the maximum organic carbon content (∼2 wt. % Total organic carbon) found in the Moodies Group concretions. Organic carbon abundances in terrestrial concretions was controlled more by the formation mechanism and relative timing of concretion development rather than deposit age. These findings suggested that concretions at Jezero Crater reflect local sites of enhanced biosignature preservation potential. Plain Language Summary: The Perseverance Rover discovered concretions in its exploration of the rock packages at Jezero Crater, Mars and one of the sample return cores was collected from concretion‐rich bedrock. Concretions are resistant cement in the rock that are found in many shapes (usually spherical or oblate) and range from millimeter to meter size scales on Earth; they can be formed through inorganic water‐rock reactions or facilitated by microbial metabolisms. We documented the abundance, size, composition, and shape of the concretions to understand how these features were formed. We found that the concretions are mixtures of salts, clay minerals, and iron oxides. We compared these results to terrestrial concretions with similar mineral compositions and measured the organic carbon in four terrestrial analogs. Comparisons with terrestrial concretions in this study and the literature suggested that the concretion composition in Jezero Crater could have high organic preservation potential. Thus, the concretions in Jezero Crater may retain organic carbon and other biosignatures and might therefore be considered as high priority samples of astrobiological interest out of the current sample suite for return to Earth. Key Points: Jezero Crater concretions are variably enriched in Si, Ca, and Mg salts, and Fe oxidesTerrestrial concretions of similar mineralogy analyzed in this study contain significant organic carbon phasesBased on terrestrial analogs, Jezero Crater concretions may represent sites of enhanced biosignature preservation potential [ABSTRACT FROM AUTHOR]

Faris Alghamdi,1 Catherine Roth,1 Kris R Jatana,2 Charles A Elmaraghy,2 Julie Rice,1 Joseph D Tobias,1 Arlyne K Thung1 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital and the Ohio State University College of Medicine, Columbus, OH, USA; 2Department of Otolaryngology and Head & Neck Surgery, Nationwide Children’s Hospital and the Ohio State University, Columbus, OH, USACorrespondence: Arlyne K ThungDepartment of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USATel +1 614 722-4200Fax +1 614 722-4203Email Arlyne.Thung@Nationwidechildrens.orgIntroduction: An opioid-sparing anesthetic involves a multi-modal technique with non-opioid medications targeting different analgesic pathways. Such techniques may decrease adverse effects related to opioids. These techniques may be considered in patients at higher risk for opioid-related adverse effects including obstructive sleep apnea or sleep disordered breathing.Methods: A prospective, pilot study was performed in 10 patients (3– 8 years of age), presenting for adenoidectomy. The perioperative regimen included oral dextromethorphan (1 mg/kg) and acetaminophen (15 mg/kg) plus single boluses of intraoperative dexmedetomidine (0.5 μg/kg) and ketamine (0.5 mg/kg). Pain scores were assessed in the post anesthesia care unit (PACU) using the FLACC (Face, Legs, Activity, Cry, Consolability) scale. Patients with a pain score > 4 received fentanyl as needed. PACU time, pain scores, and parent satisfaction were recorded. Postoperatively, patients were instructed to use oral acetaminophen or ibuprofen every 6 hours as needed for pain.Results: The study cohort included 10 patients, 3– 8 years of age. All patients had opioid-free anesthetic care. PACU time ranged from 24 to 102 minutes (median: 56 minutes). FLACC pain scores were 0 for all PACU assessments. Nine patients were discharged home and 1 patient had a planned overnight admission. Following hospital discharge, the pain scores were satisfactory during the 72-hour study period and 90% of the patients’ guardians were satisfied or highly satisfied with their child’s pain control.Conclusion: This opioid-sparing approach provided safe and effective pain control as well as parental satisfaction following adenoidectomy in children. Additional prospective studies are needed to determine whether this regimen is effective in a larger cohort of patients with and for other otolaryngology procedures.Keywords: opioid, sparing, analgesia, pediatric, adenoidectomy

Mohammed Hakim,1 Shabana Zainab Shafy,1 Joshua C Uffman,1,2 Julie Rice,1 Vidya T Raman,1,2 Joseph D Tobias,1,2 Ralph J Beltran1,2 1Department of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology and Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USACorrespondence: Mohammed HakimDepartment of Anesthesiology and Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USATel +1 614 680-2552Fax +1 614 722-4203Email mushtaqahmedhakim.2@osu.eduBackground: Various criteria exist for defining difficult peripheral intravenous (DPIV) cannulation in infants and children. With the help of a survey tool, the characteristics perceived to increase the likelihood of DPIV cannulation amongst anesthesia providers were assessed.Methods: An individualized survey regarding DPIV which included pediatric anesthesiology faculty and certified registered nurse anesthetists at Nationwide Children’s Hospital and anesthesiology faculty members of Wake-up Safe was conducted. Anesthesia provider, patient, and procedural characteristics were expressed as a count and percentage, and compared according to group (faculty, certified registered nurse anesthetists, Wake-up Safe faculty) using analysis of variance.Results: Of the 48 local respondents, 33 (69%) reported age as a contributing factor to DPIV, and 32 (67%) reported weight as a factor. Of the 22 Wake-up Safe respondents, 14 (63%) reported age, and 16 (73%) reported weight as a factor. Patient and procedural characteristics perceived to increased likelihood of DPIV cannulation did not differ by respondent role. The factors most commonly mentioned by local respondents as contributing to DPIV included trisomy 21, neuromuscular disorders, and history of many prior IV cannulations. Among the Wake-up Safe faculty respondents, the most commonly mentioned factors were neuromuscular disorders, trisomy 21, and skin injuries or conditions.Conclusion: Age and weight were the two most commonly reported factors from both groups of respondents. Other factors contributing to DPIV included prior history of DPIV, neuromuscular disorders, trisomy 21 and American Society of Anesthesiology status ≥ 4. Patient and procedural characteristics were perceived to increase the likelihood of DPIV cannulation with no difference among respondents.Keywords: peripheral intravenous cannulation, pediatric anesthesiology, difficult peripheral intravenous cannulation

Hina Walia,1 Rita Banoub,1,2 Gregory S Cambier,1,2 Julie Rice,1 Dmitry Tumin,1 Joseph D Tobias,1,2 Vidya T Raman1,2 1Department of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, Columbus, OH, USA; 2Department of Anesthesiology & Pain Medicine, The Ohio State University College of Medicine, Columbus, OH, USACorrespondence: Hina WaliaDepartment of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USATel +1614 722-3846Fax +1614 722-4203Email hina.walia9@gmail.comIntroduction: Children and adolescents identifying as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) may feel reluctant to seek medical care due to stigma and the possibility of negative interactions with health care providers. Due to the short duration of the perioperative period, the interaction in this setting is limited and providers may not have the time to develop a rapport with the patient. It is imperative that staff are trained to address the patient and family in a culturally competent manner.Methods: We undertook surveys before and after a 2 part educational series among the pediatric perioperative staff to understand the impact of providing education and cultural competency training regarding caring for patients who identify as LGBTQ. Providers self-reported their knowledge and comfort on a 1–5 point scale (5 being most knowledgeable or comfortable) in 6 domains of caring for LGBTQ patients. Objective knowledge of LGBTQ issues was assessed using 7 questions based on lecture material. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.Results: The analysis included 90 responses. Before training, median ratings of knowledge and comfort were 3 or 4 out of a maximum of 5 for each domain. The pre-training median score on the 7-item test of LGBTQ cultural competency was 5 (IQR: 4, 6). After training, knowledge and comfort self-ratings did not improve, but the score on the objective knowledge test increased to a median of 6 (IQR: 4, 7; p=0.011) of 7 possible points.Discussion: Anesthesia providers participating in LGBTQ cultural competency training self-reported high levels of knowledge and comfort with providing care to LGBTQ patients even before formal training was provided. On objective assessment, knowledge of LGBTQ issues improved after cultural competency training.Keywords: LGBTQ, health, concerns, competency, training, attitude

Intrinsic torque, which can be generated by turbulent stresses, can induce toroidal rotation in a tokamak plasma at rest without direct momentum injection. Reversals in intrinsic torque have been inferred from the observation of toroidal velocity changes in recent lower hybrid current drive (LHCD) experiments. This work focuses on understanding the cause of LHCD-induced intrinsic torque reversal using gyrokinetic simulations and theoretical analyses. A new mechanism for the intrinsic torque reversal linked to magnetic shear (͉) effects on the turbulence spectrum is identified. This reversal is a consequence of the ballooning structure at weak ͉. Based on realistic profiles from the Alcator C-Mod LHCD experiments, simulations demonstrate that the intrinsic torque reverses for weak ͉ discharges and that the value of ͉ crit is consistent with the experimental results ͉critexp ≈ 0.2 ∼ 0.3 [Rice et al., Phys. Rev. Lett. 111, 125003 (2013)]. The consideration of this intrinsic torque feature in our work is important for the understanding of rotation profile generation at weak ͉ and its consequent impact on macro-instability stabilization and micro-turbulence reduction, which is crucial for ITER. It is also relevant to internal transport barrier formation at negative or weakly positive ͉.

In current critical pedagogy theory, the term "globalization" frequently signifies the rapid homogenization and structural equivalency of material and intellectual differences into a unified, transnational, capitalist rationality. For many composition scholars, this homogeneity signals an interpellation of not just subjects, but any and all differing rhetorical logics. Different nations' peoples, goods, and cultures can interact, but only insofar as the "flowing" aspects of information are determined by the hegemonic and political functions of "the" global language. Though the loss of national and cultural autonomy is almost a prerequisite for globalizing processes, the much more pressing aspect here is the structural dependence on the frictionless exchange between so-called identical contexts. Because information can be exchanged according to the same material and rhetorical presuppositions worldwide, qualitative contextual differences are traded for a paradigm of material and epistemological equivalency. Several critical theories and pedagogies show that globalization complicates current classroom situations far beyond traditional humanist concerns of interpretive emancipation, rhetorical freedom, and civic agency, they likewise demonstrate that acceptance of communicative homogeneity does not make room for systemic differences in either rhetoric or knowledge. If globalization homogenizes discursive possibilities and reduces knowledge to practical utility, can liberatory strategies authorize, either pedagogically or theoretically, spaces for effective social and communicative resistance? To what extent are critical pedagogies' methods and goals commensurate with the restrictive logic of globalization? Since knowledge production, market applicability, and differential rhetorics produce a new pedagogical horizon, how might teachers develop strategies that intervene, and perhaps alter, hegemonic communicative processes? In an effort to complicate and extend these questions, this article suggests that not only the goals and methodologies for liberatory teaching, but also its practical potential for bringing about viable pedagogical and communicative alternatives in a globalized world are fundamentally rethought. Specifically, this article rejects critical pedagogy's humanist and liberal-democratic methodologies on the grounds that they work with, not against, the globalizing processes of capitalism. In their place, the author argues for a return to the speculative dimension historically associated with critical theory and pedagogy.