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With the advent of the Heliophysics/Geospace System Observatory (H/GSO), a complement of multi-spacecraft missions and ground-based observatories to study the space environment, data retrieval, analysis, and visualization of space physics data can be daunting. The Space Physics Environment Data Analysis System (SPEDAS), a grass-roots software development platform (www.spedas.org), is now officially supported by NASA Heliophysics as part of its data environment infrastructure. It serves more than a dozen space missions and ground observatories and can integrate the full complement of past and upcoming space physics missions with minimal resources, following clear, simple, and well-proven guidelines. Free, modular and configurable to the needs of individual missions, it works in both command-line (ideal for experienced users) and Graphical User Interface (GUI) mode (reducing the learning curve for first-time users). Both options have "crib-sheets," user-command sequences in ASCII format that can facilitate record-and-repeat actions, especially for complex operations and plotting. Crib-sheets enhance scientific interactions, as users can move rapidly and accurately from exchanges of technical information on data processing to efficient discussions regarding data interpretation and science. SPEDAS can readily query and ingest all International Solar Terrestrial Physics (ISTP)-compatible products from the Space Physics Data Facility (SPDF), enabling access to a vast collection of historic and current mission data. The planned incorporation of Heliophysics Application Programmer's Interface (HAPI) standards will facilitate data ingestion from distributed datasets that adhere to these standards. Although SPEDAS is currently Interactive Data Language (IDL)-based (and interfaces to Java-based tools such as Autoplot), efforts are under-way to expand it further to work with python (first as an interface tool and potentially even receiving an under-the-hood replacement). We review the SPEDAS development history, goals, and current implementation. We explain its "modes of use" with examples geared for users and outline its technical implementation and requirements with software developers in mind. We also describe SPEDAS personnel and software management, interfaces with other organizations, resources and support structure available to the community, and future development plans.Electronic supplementary materialThe online version of this article (10.1007/s11214-018-0576-4) contains supplementary material, which is available to authorized users.

© 2015 The Authors. To gain insight into the cellular and molecular cues that promote neurovascular co-patterning at the earliest stages of human embryogenesis, we developed a human embryonic stem cell model to mimic the developing epiblast. Contact of ectoderm-derived neural cells with mesoderm-derived vasculature is initiated via the neural crest (NC), not the neural tube (NT). Neurovascular co-patterning then ensues with specification of NC toward an autonomic fate requiring vascular endothelial cell (EC)-secreted nitric oxide (NO) and direct contact with vascular smooth muscle cells (VSMCs) via T-cadherin-mediated homotypic interactions. Once a neurovascular template has been established, NT-derived central neurons then align themselves with the vasculature. Our findings reveal that, in early human development, the autonomic nervous system forms in response to distinct molecular cues from VSMCs and ECs, providing a model for how other developing lineages might coordinate their co-patterning.

The Lunar Environment heliospheric X-ray Imager (LEXI) is a wide field-of-view soft X-ray telescope developed to study solar wind-magnetosphere coupling. LEXI is part of the Blue Ghost 1 mission comprised of 10 payloads to be deployed on the lunar surface. LEXI monitors the dayside magnetopause position and shape as a function of time by observing soft X-rays (0.1-2 keV) emitted from solar wind charge-exchange between exospheric neutrals and high charge-state solar wind plasma in the dayside magnetosheath. Measurements of the shape and position of the magnetopause are used to test temporal models of meso- and macro-scale magnetic reconnection. To image the boundary, LEXI employs lobster-eye optics to focus X-rays to a microchannel plate detector with a 9.1 × ∘ 9.1 ∘ field of view., Competing Interests: Competing InterestsThe authors declare no competing interests., (© The Author(s) 2024.)

We utilize signaling theory as a foundation for testing ways to decrease reference providers' fear of adverse consequences and increase disclosure of workplace incivility in reference checks. We focus on three reminders-commonly recommended by practitioners-that may be sent to reference providers in the instructions prior to the reference check: reminders of applicant consent, qualified privilege, and confidentiality. 420 supervisors were recruited via Prolific.co to complete a hypothetical reference check for the employee with whom they least like to work. Participants were randomly assigned to one of eight conditions in a two (applicant consent reminder: yes/no) X two (qualified privilege reminder: yes/no) X two (confidentiality reminder: yes/no) between-subjects design. Instructions before the reference check were manipulated in a manner that corresponded to their experimental condition, after which they completed measures of fear and incivility. Results showed no main effects, but two interactions. Applicant consent and qualified privilege interacted in relation to fear of adverse legal consequences, and confidentially and qualified privilege interacted in relation to reports of applicant incivility (p < .10). Collectively, our largely null findings suggest that reference checks may be a limited tool for incivility prevention., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Walsh et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objectives: To describe the quality of pediatric resuscitative care in general emergency departments (GEDs) and to determine hospital-level factors associated with higher quality., Methods: Prospective observational study of resuscitative care provided to 3 in situ simulated patients (infant seizure, infant sepsis, and child cardiac arrest) by interprofessional GED teams. A composite quality score (CQS) was measured and the association of this score with modifiable and nonmodifiable hospital-level factors was explored., Results: A median CQS of 62.8 of 100 (interquartile range 50.5-71.1) was noted for 287 resuscitation teams from 175 emergency departments. In the unadjusted analyses, a higher score was associated with the modifiable factor of an affiliation with a pediatric academic medical center (PAMC) and the nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. In the adjusted analyses, a higher CQS was associated with modifiable factors of an affiliation with a PAMC and the designation of both a nurse and physician pediatric emergency care coordinator, and nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. A weak correlation was noted between quality and pediatric readiness scores., Conclusions: A low quality of pediatric resuscitative care, measured using simulation, was noted across a cohort of GEDs. Hospital factors associated with higher quality included: an affiliation with a PAMC, designation of a pediatric emergency care coordinator, higher pediatric volume, and geographic location. A weak correlation was noted between quality and pediatric readiness scores., (Copyright © 2023 by the American Academy of Pediatrics.)

Purpose: People who stutter often experience significant adverse impact related to stuttering. However, it is unclear how adverse impact develops in children who stutter (CWS) and whether there are protective factors that may mitigate its development. This study examined the relationship between resilience, a potentially protective factor, and stuttering's adverse impact in CWS. Resilience comprises external factors, such as family support and access to resources as well as personal attributes, making it a comprehensive protective factor to explore., Method: One hundred forty-eight CWS aged 5-18 years completed the age-appropriate version of the Child and Youth Resilience Measure (CYRM) and the Overall Assessment of the Speaker's Experience of Stuttering. Parents completed a caregiver version of the CYRM and a behavioral checklist for their child. The adverse impact of stuttering was modeled as a function of resilience (external, personal, and total), controlling for child age and behavioral checklist score. We also estimated correlations between child-report and parent-report CYRM measures to assess rater agreement., Results: Children reporting greater external, personal, or total resilience were more likely to experience lower degrees of adverse impact related to their stuttering. We documented stronger correlations between younger child and parent ratings of resilience and weaker correlations between older child and parent ratings., Conclusions: These results yield valuable insight into the variability of adverse impact experienced by CWS and offer empirical support for strength-based speech therapy approaches. We discuss the factors that contribute to a child's resilience and provide practical suggestions for how clinicians can incorporate resilience-building strategies into intervention for children experiencing significant adverse impact from their stuttering., Supplemental Material: https://doi.org/10.23641/asha.23582172.

Introduction: Simulation tools to assess prehospital team performance and identify patient safety events are lacking. We adapted a simulation model and checklist tool of individual paramedic performance to assess prehospital team performance and tested interrater reliability., Methods: We used a modified Delphi process to adapt 3 simulation cases (cardiopulmonary arrest, seizure, asthma) and checklist to add remote physician direction, target infants, and evaluate teams of 2 paramedics and 1 physician. Team performance was assessed with a checklist of steps scored as complete/incomplete by raters using direct observation or video review. The composite performance score was the percentage of completed steps. Interrater percent agreement was compared with the original tool. The tool was modified, and raters trained in iterative rounds until composite performance scoring agreement was 0.80 or greater (scale <0.20 = poor; 0.21-0.39 = fair, 0.40-0.59 = moderate; 0.60-0.79 = good; 0.80-1.00 = very good)., Results: We achieved very good interrater agreement for scoring composite performance in 2 rounds using 6 prehospital teams and 4 raters. The original 175 step tool was modified to 171 steps. Interrater percent agreement for the final modified tool approximated the original tool for the composite checklist (0.80 vs. 0.85), cardiopulmonary arrest (0.82 vs. 0.86), and asthma cases (0.80 vs. 0.77) but was lower for the seizure case (0.76 vs. 0.91). Most checklist items (137/171, 80%) had good-very good agreement. Among 34 items with fair-moderate agreement, 15 (44%) related to patient assessment, 9 (26%) equipment use, 6 (18%) medication delivery, and 4 (12%) cardiopulmonary resuscitation quality., Conclusions: The modified checklist has very good agreement for assessing composite prehospital team performance and can be used to test effects of patient safety interventions., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 Society for Simulation in Healthcare.)

Introduction: "Excited delirium" (ExD) is purported to represent a certain type of agitated state that can lead to unexpected death. The 2009 "White Paper Report on Excited Delirium Syndrome," authored by the American College of Emergency Medicine (ACEP) Excited Delirium Task Force, continues to play a pivotal role in defining ExD. Since that report was produced, there has been an increasing appreciation that the label has been applied more often to Black people., Methods: Our aim was to analyze the language of the 2009 report, the role of potential stereotypes, and the mechanisms that may potentially encourage bias., Results: Our evaluation of the diagnostic criteria for ExD proposed in the 2009 report shows that it relies on persistent racial stereotypes: eg, unusual strength, decreased sensitivity to pain, and bizarre behavior. Research indicates that use of such stereotypes could encourage biased diagnosis and treatment., Conclusion: We suggest that the emergency medicine community avoid use of the concept ExD and that ACEP withdraw implicit or explicit support of the report.

Workers tend to experience many benefits when they work for supportive supervisors and organizations. But what happens when workers experience changes in perceived support, more or less support than they typically experience? We studied family-supportive supervision (FSS) and perceived organizational support (POS) to test how changes in the perception of support in response to the COVID-19 pandemic may influence workers. Three waves of survey data from 368 workers in the United States and Canada were collected as the human and economic toll of COVID-19 manifested. Random-intercepts cross-lagged panel analyses were used to differentiate between stable associations and the within-person changes of interest. Stable associations among variables were consistent with prior research, but cross-lagged effects painted a complex picture that offered reasons for hope and concern. As hypothesized, we observed evidence for gain cycles such that there were reciprocal positive associations between FSS and POS, and higher-than-normal POS was associated with greater job satisfaction. However, remaining hypotheses were not supported, as changes in FSS and POS were not significantly associated with job insecurity, and heightened FSS was associated with higher levels of anxiety and depression. Our study reinforces prior findings by showing that employees generally benefit when working for supportive supervisors and organizations, while also suggesting that episodic changes in FSS and POS may have limited impacts on workers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Workplace incivility is generally viewed as a deleterious interpersonal stressor. Yet, alternative theories suggest that incivility may have instrumental implications for some targets. Applying signaling theory, we study client-provider relationships in a health care context to unpack linkages between incivility enacted by organizational outsiders and work creativity responses by employee targets. We argue that providers leverage information from client incivility to provide more creative care over time. In Study 1 ( N = 186), results suggest that clients may use incivility to signal perceptions of poor treatment quality to providers. In Study 2 ( N = 416), results from topic modeling of qualitative data show that providers observe client incivility and believe it can contain valuable information about client satisfaction. In Study 3 ( N = 503), providers reported their experiences of client incivility and creativity (incremental and radical) in client care over five waves of data to capture the incubation time that providers may need to reflect on instances of incivility. Employing trait-state-occasion modeling, our findings show that episodic (i.e., higher than normal) client incivility had positive lagged relationships with incremental and radical provider creativity, suggesting that time is needed for providers to process the information contained in the client incivility signal and creatively modify treatment plans. Theoretical and practical implications for workplace incivility and creativity are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Purpose: This study evaluated the relationship between emotional regulation (ER) and adverse impact related to stuttering across the developmental spectrum, in preschool and school-age children, adolescents, and adults who stutter. An additional aim examined how these variables relate to the ways that individuals approach speaking (i.e., their agreement on whether their goal is to speak fluently)., Method: Participants were the parents of 60 preschoolers and younger school-age children (ages 3-9 years), 95 school-age children and adolescents who stutter (ages 7-18 years), and 180 adults who stutter (ages 18-81 years). All participants completed surveys with age-appropriate measures examining ER and the adverse impact of stuttering. Older children and adults who stutter also answered questions regarding their goals when speaking. Multiple regression and ordinal logistic regression were used to examine relationships among ER, adverse impact related to stuttering, and goal when speaking., Results: In preschool children, adverse impact was significantly predicted by a parent-reported measure of ER skills; in school-age children and adults, adverse impact was significantly predicted by measures of the ER strategies cognitive reappraisal (CR) and expressive suppression. Less frequent use of CR by adults was significantly associated with an increased likelihood of having "not stuttering" as a goal when speaking. Differences in the significance and magnitude of these relationships were found across the life span., Discussion: For both children and adults who stutter, ER is a significant factor related to the adverse impact of stuttering; the relationship between ER and adverse impact may change over development. Accounting for individual differences in ER can improve understanding of why a person copes with stuttering in the ways they do, and this has notable implications for individualizing intervention for both children and adults who stutter., Supplemental Material: https://doi.org/10.23641/asha.20044469.

Purpose: To perform an exploratory factor analysis of the Fear-Avoidance Beliefs Questionnaire in patients with chronic ankle instability., Methods: A cross-sectional survey study was utilized. The Fear-Avoidance Beliefs Questionnaire was administered to patients with chronic ankle instability who met the inclusion criteria. Both an unrestricted and restricted factor analysis with varimax rotation were utilized to explore the factor structure of the instrument. Kaiser-Meyer-Olkin values were used to determine sampling adequacy. Bartlett's test of sphericity was used to justify that the correlations were suitable for the principal component analysis., Results: The restricted two-factor analysis resulted in two factors with acceptable internal consistency values. The Keiser-Meyer-Olkin value was acceptable (0.81), and Bartlett's test of sphericity was significant (χ 2 (55) = 515.59, p < 0.001)., Conclusion: The ankle-specific Fear-Avoidance Beliefs Questionnaire consists of two stable factors and should be used to further examine fear-avoidance beliefs in people with chronic ankle instability., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: The coronavirus pandemic continues to shake the embedded structures of traditional in-person education across all learning levels and across the globe. In healthcare simulation, the pandemic tested the innovative and technological capabilities of simulation programs, educators, operations staff, and administration. This study aimed to answer the question: What is the state of distance simulation practice in 2021?, Methods: This was an IRB-approved, 34-item open survey for any profession involved in healthcare simulation disseminated widely and internationally in seven languages from January 14, 2021, to March 3, 2021. Development followed a multistep process of expert design, testing, piloting, translation, and recruitment. The survey asked questions to understand: Who was using distance simulation? What driving factors motivated programs to initiate distance sim? For what purposes was distance sim being used? What specific types or modalities of distance simulation were occurring? How was it being used (i.e., modalities, blending of technology and resources and location)? How did the early part of the pandemic differ from the latter half of 2020 and early 2021? What information would best support future distance simulation education? Data were cleaned, compiled, and analyzed for dichotomized responses, reporting frequencies, proportions, as well as a comparison of response proportions., Results: From 32 countries, 618 respondents were included in the analysis. The findings included insights into the prevalence of distance simulation before, during, and after the pandemic; drivers for using distance simulation; methods and modalities of distance simulation; and staff training. The majority of respondents (70%) reported that their simulation center was conducting distance simulation. Significantly more respondents indicated long-term plans for maintaining a hybrid format (82%), relative to going back to in-person simulation (11%, p < 0.001)., Conclusion: This study gives a perspective into the rapid adaptation of the healthcare simulation community towards distance teaching and learning in reaction to a radical and quick change in education conditions and environment caused by COVID-19, as well as future directions to pursue understanding and support of distance simulation., (© 2022. The Author(s).)

The intrinsic temporal nature of magnetic reconnection at the magnetopause has been an active area of research. Both temporally steady and intermittent reconnection have been reported. We examine the steadiness of reconnection using space-ground conjunctions under quasi-steady solar wind driving. The spacecraft suggests that reconnection is first inactive, and then activates. The radar further suggests that after activation, reconnection proceeds continuously but unsteadily. The reconnection electric field shows variations at frequencies below 10 mHz with peaks at 3 and 5 mHz. The variation amplitudes are ∼10-30 mV/m in the ionosphere, and 0.3-0.8 mV/m at the equatorial magnetopause. Such amplitudes represent 30%-60% of the peak reconnection electric field. The unsteadiness of reconnection can be plausibly explained by the fluctuating magnetic field in the turbulent magnetosheath. A comparison with a previous global hybrid simulation suggests that it is the foreshock waves that drive the magnetosheath fluctuations, and hence modulate the reconnection., (© 2021. The Authors.)

Study Objective: Ventricular paced rhythm is thought to obscure the electrocardiographic diagnosis of acute coronary occlusion myocardial infarction. Our primary aim was to compare the sensitivity of the modified Sgarbossa criteria (MSC) to that of the original Sgarbossa criteria for the diagnosis of occlusion myocardial infarction in patients with ventricular paced rhythm., Methods: In this retrospective case-control investigation, we studied adult patients with ventricular paced rhythm and symptoms of acute coronary syndrome who presented in an emergency manner to 16 international cardiac referral centers between January 2008 and January 2018. The occlusion myocardial infarction group was defined angiographically as thrombolysis in myocardial infarction grade 0 to 1 flow or angiographic evidence of coronary thrombosis and peak cardiac troponin I ≥10.0 ng/mL or troponin T ≥1.0 ng/mL. There were 2 control groups: the "non-occlusion myocardial infarction-angio" group consisted of patients who underwent coronary angiography for presumed type I myocardial infarction but did not meet the definition of occlusion myocardial infarction; the "no occlusion myocardial infarction" control group consisted of randomly selected emergency department patients without occlusion myocardial infarction., Results: There were 59 occlusion myocardial infarction, 90 non-occlusion myocardial infarction-angio, and 102 no occlusion myocardial infarction subjects (mean age, 72.0 years; 168 [66.9%] men). For the diagnosis of occlusion myocardial infarction, the MSC were more sensitive than the original Sgarbossa criteria (sensitivity 81% [95% confidence interval [CI] 69 to 90] versus 56% [95% CI 42 to 69]). Adding concordant ST-depression in V4 to V6 to the MSC yielded 86% (95% CI 75 to 94) sensitivity. For the no occlusion myocardial infarction control group of ED patients, additional test characteristics of MSC and original Sgarbossa criteria, respectively, were as follows: specificity 96% (95% CI 90 to 99) versus 97% (95% CI 92 to 99); negative likelihood ratio (LR) 0.19 (95% CI 0.11 to 0.33) versus 0.45 (95% CI 0.34 to 0.65); and positive LR 21 (95% CI 7.9 to 55) versus 19 (95% CI 6.1 to 59). For the non-occlusion myocardial infarction-angio control group, additional test characteristics of MSC and original Sgarbossa criteria, respectively, were as follows: specificity 84% (95% CI 76 to 91) versus 90% (95% CI 82 to 95); negative LR 0.22 (95% CI 0.13 to 0.38) versus 0.49 (95% CI 0.35 to 0.66); and positive LR 5.2 (95% CI 3.2 to 8.6) versus 5.6 (95% CI 2.9 to 11)., Conclusion: For the diagnosis of occlusion myocardial infarction in the presence of ventricular paced rhythm, the MSC were more sensitive than the original Sgarbossa criteria; specificity was high for both rules. The MSC may contribute to clinical decisionmaking for patients with ventricular paced rhythm., (Copyright © 2021 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.)

The role a geospace plume in influencing the efficiency of magnetopause reconnection is an open question with two contrasting theories being debated. A local-control theory suggests that a plume decreases both local and global reconnection rates, whereas a global-control theory argues that the global reconnection rate is controlled by the solar wind rather than local physics. Observationally, limited numbers of point measurements from spacecraft cannot reveal whether a local change affects the global reconnection. A distributed observatory is hence needed to assess the validity of the two theories. We use THEMIS and Los Alamos National Laboratory spacecraft to identify the occurrence of a geospace plume and its contact with the magnetopause. Global evolution and morphology of the plume is traced using GPS measurements. SuperDARN is then used to monitor the distribution and the strength of dayside reconnection. Two storm-time geospace plume events are examined and show that as the plume contacts the magnetopause, the efficiency of reconnection decreases at the contact longitude. The amount of local decrease is 81% and 68% for the two events, and both values are consistent with the mass loading effect of the plume if the plume's atomic mass is ∼4 amu. Reconnection in the surrounding is enhanced, and when the solar wind driving is stable, little variation is seen in the cross polar cap potential. This study illuminates a pathway to resolve the role of cold dense plasma on solar wind-magnetosphere coupling, and the observations suggest that plumes redistribute magnetopause reconnection activity without changing the global strength substantially., (© 2021. The Authors.)

Simulation is a valuable, immersive educational tool for both health professional trainees and experienced clinicians. By promoting a realistic, collaborative, safe, hands-on, learning environment, simulation allows interprofessional teams to come together and practise both routine and high stakes, low-frequency events. The COVID-19 pandemic and the need for social distancing have shifted traditional simulation-based medical education towards a virtual platform: telesimulation. Telesimulation is an evolving field and the speed at which clinical educators need to adapt to use this platform is unprecedented. Educators must quickly navigate and leverage the differences between traditional simulation and telesimulation to create robust remote educational experiences. Telesimulation has unique goals and objectives, technology needs, and participant roles that need to be understood and properly operationalized to maximize opportunities for learning. This article reviews the authors' recommendations for developing and delivering successful telesimulations., (© 2020 John Wiley & Sons Ltd and The Association for the Study of Medical Education.)

The LEXI and SMILE missions will provide soft X-ray images of the Earth's magnetosheath and cusps after their anticipated launch in 2023 and 2024, respectively. The IBEX mission showed the potential of an Energetic Neutral Atom (ENA) instrument to image dayside magnetosheath and cusps, albeit over the long hours required to raster an image with a single pixel imager. Thus, it is timely to discuss the two imaging techniques and relevant science topics. We simulate soft X-ray and low-ENA images that might be observed by a virtual spacecraft during two interesting solar wind scenarios: a southward turning of the interplanetary magnetic field and a sudden enhancement of the solar wind dynamic pressure. We employ the OpenGGCM global magnetohydrodynamics model and a simple exospheric neutral density model for these calculations. Both the magnetosheath and the cusps generate strong soft X-rays and ENA signals that can be used to extract the locations and motions of the bow shock and magnetopause. Magnetopause erosion corresponds closely to the enhancement of dayside reconnection rate obtained from the OpenGGCM model, indicating that images can be used to understand global-scale magnetopause reconnection. When dayside imagers are installed with high-ENA inner-magnetosphere and FUV/UV aurora imagers, we can trace the solar wind energy flow from the bow shock to the magnetosphere and then to the ionosphere in a self-standing manner without relying upon other observatories. Soft X-ray and/or ENA imagers can also unveil the dayside exosphere density structure and its response to space weather., (© 2021. The Authors.)

Background: The majority of children in the United States seek emergency care at community-based general emergency departments (GEDs); however, the quality of GED pediatric emergency care varies widely. This may be explained by a number of factors, including residency training environments and postgraduate knowledge decay. Emergency medicine (EM) residents train in academic pediatric EDs, but didactic and clinical experience vary widely between programs, and little is known about the pediatric skills of these EM residents. This study aimed to assess the performance of senior EM residents in treating simulated pediatric patients at the end of their training., Methods: This was a prospective, cross-sectional, simulation-based cohort study assessing the simulated performance of senior EM resident physicians from two Massachusetts programs leading medical teams caring for three critically ill patients. Sessions were video recorded and scored separately by three reviewers using a previously published simulation assessment tool. Self-efficacy surveys were completed prior to each session. The primary outcome was a median total performance score (TPS), calculated by the mean of individualized domain scores (IDS) for each case. Each IDS was calculated as a percentage of items performed on a checklist-based instrument., Results: A total of 18 EM resident physicians participated (PGY-3 = 8, PGY-4 = 10). Median TPS for the cohort was 61% (IQR = 56%-70%). Median IDSs by case were as follows: sepsis 67% (IQR = 50%-67%), seizure 67% (IQR = 50%-83%), and cardiac arrest 67% (IQR = 43%-70%). The overall cohort self-efficacy for pediatric EM (PEM) was 64% (IQR = 60%-70%)., Conclusions: This study has begun the process of benchmarking clinical performance of graduating EM resident physicians. Overall, the EM resident cohort in this study performed similar to prior GED teams. Self-efficacy related to PEM correlated well with performance, with the exception of knowledge relative to intravenous fluid and vasopressor administration in pediatric septic shock. A significant area of discrepancy and missed checklist items were those related to cardiopulmonary resuscitation and basic life support maneuvers., (© 2020 by the Society for Academic Emergency Medicine.)

Simulation has been steadily changing the safety culture in the healthcare industry and allowing individual clinicians and interdisciplinary teams to be proactive in the culture of risk reduction and improved patient safety. Literature has demonstrated improved patient outcomes, improved team based skills, systems testing and mitigation of latent safety threats. Simulation may be incorporated into practice via different modalities. The simulation lab is helpful for individual procedures, in situ simulation (ISS) for system testing and teamwork, community outreach ISS for sharing of best practices and content resource experts. Serious medical gaming is developing into a useful training adjunct for the future., Competing Interests: Disclosure Dr. Wong is supported by the Robert E. Leet and Clara Guthrie Patterson Trust Mentored Research Award and the National Institutes of Health (NIH) National Center for Advancing Translational Sciences (grant KL2TR001862). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The other authors have no disclosures., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Calling involves experiencing a sense of purpose to engage in work that benefits others. We contribute to the literature by studying living a calling, which we conceptualize as a resource, to examine how and why it is related to perceived work ability (i.e., one's perception of their ability to continue working in their current job) among women working in domestic violence services. We propose that by living out one's calling, domestic violence services workers may perceive fewer of the salient interpersonal demands in their jobs (relationship conflict among colleagues, workplace incivility from clients served), which may partially explain a linkage to greater perceived work ability. We tested hypotheses using 2-wave survey data. The results suggest that there are direct and indirect positive relations between living a calling and perceived work ability. Workers living out their calling perceive less relationship conflict among colleagues, which partially explains the positive relation with perceived work ability. However, we did not find support for the similarly proposed mediating role of perceived client incivility. Theoretical implications for studying calling and practical implications for career counselors and organizations are discussed. For example, career counselors may consider the presence of a calling when exploring clients' career development in domestic violence work, whereas social service providers may benefit by selecting employees for whom the work aligns with their calling and creating opportunities for their calling to be lived out to facilitate perceived work ability. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Clinical Scenario: Patients with chronic ankle instability (CAI) commonly display lower levels of self-reported function and health-related quality of life. Several rehabilitation interventions, including manual therapy, have been investigated to help CAI patients overcome these deficits. However, it is unclear if the addition of manual therapy to exercise-based rehabilitation is more effective than exercise-based rehabilitation alone. Clinical Question: Does incorporating manual therapy with exercise-based rehabilitation improve patient-reported outcomes when compared with exercise-based rehabilitation alone? Summary of Key Findings: The literature was searched for articles that examined the difference in outcomes for patients with CAI between manual therapy with exercise-based rehabilitation and exercise-based rehabilitation alone. A total of 3 peer-reviewed randomized controlled trials were identified. Two articles demonstrated improved patient-reported outcome scores following the incorporation of manual therapy with exercise-based rehabilitation, whereas one study found no statistically significant differences between interventions. Clinical Bottom Line: The current evidence suggests that incorporating manual therapy in addition to exercised-based rehabilitation may improve patient-reported outcome scores in patients with CAI. Strength of Recommendation: In accordance with the Strength of Recommendation Taxonomy, the grade of A is recommended due to consistent evidence from high-quality studies.

Simulation-based methods are regularly used to train inter-professional groups of healthcare providers at academic medical centers (AMC). These techniques are used less frequently in community hospitals. Bringing in-situ simulation (ISS) from AMCs to community sites is an approach that holds promise for addressing this disparity. This type of programming allows academic center faculty to freely share their expertise with community site providers. By creating meaningful partnerships community-based ISS facilitates the communication of best practices, distribution of up to date policies, and education/training. It also provides an opportunity for system testing at the community sites. In this article, we illustrate the process of implementing an outreach ISS program at community sites by presenting four exemplar programs. Using these exemplars as a springboard for discussion, we outline key lessons learned discuss barriers we encountered, and provide a framework that can be used to create similar simulation programs and partnerships. It is our hope that this discussion will serve as a foundation for those wishing to implement community-based, outreach ISS., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2019.)

Background: Automated electrocardiogram (ECG) interpretations may be erroneous, and lead to erroneous overreads, including for atrial fibrillation (AF). We compared the accuracy of the first version of a new deep neural network 12-Lead ECG algorithm (Cardiologs®) to the conventional Veritas algorithm in interpretation of AF., Methods: 24,123 consecutive 12-lead ECGs recorded over 6 months were interpreted by 1) the Veritas® algorithm, 2) physicians who overread Veritas® (Veritas® + physician), and 3) Cardiologs® algorithm. We randomly selected 500 out of 858 ECGs with a diagnosis of AF according to either algorithm, then compared the algorithms' interpretations, and Veritas® + physician, with expert interpretation. To assess sensitivity for AF, we analyzed a separate database of 1473 randomly selected ECGs interpreted by both algorithms and by blinded experts., Results: Among the 500 ECGs selected, 399 had a final classification of AF; 101 (20.2%) had ≥1 false positive automated interpretation. Accuracy of Cardiologs® (91.2%; CI: 82.4-94.4) was higher than Veritas® (80.2%; CI: 76.5-83.5) ( p  < 0.0001), and equal to Veritas® + physician (90.0%, CI:87.1-92.3) ( p  = 0.12). When Veritas® was incorrect, accuracy of Veritas® + physician was only 62% (CI 52-71); among those ECGs, Cardiologs® accuracy was 90% (CI: 82-94; p  < 0.0001). The second database had 39 AF cases; sensitivity was 92% vs. 87% ( p  = 0.46) and specificity was 99.5% vs. 98.7% ( p  = 0.03) for Cardiologs® and Veritas® respectively., Conclusion: Cardiologs® 12-lead ECG algorithm improves the interpretation of atrial fibrillation., Competing Interests: Stephen W. Smith – None. Christophe Gardella – employed by Cardiologs®, shareholder in Cardiologs®. Jeremy Rapin – formerly employed by Cardiologs®. Shareholder in Cardiologs®. Jia Li – employed by Cardiologs®, shareholder in Cardiologs®. Yann Fleureau – CEO of Cardiologs®, shareholder. Brooks Walsh – In a different study by Cardiologs®, paid a set fee for blind interpretation of ECGs. William Fennell – None. Arnaud Rosier – shareholder in Cardiologs®. Laurent Fiorina – employed by Cardiologs®.

Objective: The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children., Methods: This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed. The transcripts were reviewed independently and followed by group coding discussions to identify emerging themes. Consistent with grounded theory, the team iteratively revised the debriefing script as new understanding was gained. A total of 188 simulation debriefings were recorded in 24 departments, with 15 teams participating from 8 PEDs and 32 teams from 16 GEDs., Results: Twenty-four debriefings were audiotaped and professionally transcribed verbatim. Thematic saturation was achieved after 20 transcripts. In our iterative qualitative analysis of these transcripts, we observed 4 themes: (1) GED provider comfort with algorithm-based pediatric care and overall comfort with pediatric care in PED, (2) GED provider reliance on cognitive aids versus experience-based recall by PED providers, (3) GED provider discomfort with locating and determining size or dose of pediatric-specific equipment and medications, and (4) PED provider reliance on larger team size and challenges with multitasking during resuscitation., Conclusions: Our qualitative analysis produced several themes that help us to understand providers' perceptions in caring for critically ill children in GEDs and PEDs. These data could guide the development of targeted educational and improvement interventions.

Background: Errors in the timely diagnosis and treatment of infants with hypoglycemic seizures can lead to significant patient harm. It is challenging to precisely measure medical errors that occur during high-stakes/low-frequency events. Simulation can be used to assess risk and identify errors., Objective: We hypothesized that general emergency departments (GEDs) would have higher rates of deviations from best practices (errors) compared to pediatric emergency departments (PEDs) when managing an infant with hypoglycemic seizures., Methods: This multicenter simulation-based prospective cohort study was conducted in GEDs and PEDs. In situ simulation was used to measure deviations from best practices during management of an infant with hypoglycemic seizures by inter-professional teams. Seven variables were measured: five nonpharmacologic (i.e., delays in airway assessment, checking dextrose, starting infusion, verbalizing disposition) and two pharmacologic (incorrect dextrose dose and incorrect dextrose concentration). The primary aim was to describe and compare the frequency and types of errors between GEDs and PEDs., Results: Fifty-eight teams from 30 hospitals (22 GEDs, 8 PEDs) were enrolled. Pharmacologic errors occurred more often in GEDs compared to PEDs (p = 0.043), while nonpharmacologic errors were uncommon in both groups. Errors more frequent in GEDs related to incorrect dextrose concentration (60% vs. 88%; p = 0.025), incorrect dose (20% vs. 56%; p = 0.033), and failure to start maintenance dextrose (33% vs. 65%; p = 0.040)., Conclusions: During the simulated care of an infant with hypoglycemic seizures, errors were more frequent in GEDs compared to PEDs. Decreasing annual pediatric patient volume was the best predictor of errors on regression analysis., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Focused cardiac ultrasound (FoCUS) is accurate for determining the presence of a pericardial effusion. Using FoCUS to evaluate for pericardial tamponade, however, is more involved. Many experts teach that tamponade is unlikely if the inferior vena cava (IVC) shows respiratory variation and is not distended., Case Report: A 53-year-old woman presented to the emergency department (ED) with severe orthostatic hypotension, exertional dyspnea, and hypoxia. The evaluation did not reveal an acute cardiopulmonary etiology, but FoCUS demonstrated a pericardial effusion, with several signs consistent with tamponade. The IVC, however, was not distended. She was believed to be hypovolemic, but fluid therapy provided minimal benefit. The patient's condition improved only after aspiration of the effusion. The patient's presentation was likely a "low-pressure" pericardial tamponade. Patients with this subset of tamponade often do not have significant venous congestion, but urgent pericardial aspiration is still indicated. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pericardial tamponade may not manifest with IVC plethora on ultrasound. Patients with low-pressure tamponade do not present with the most florid signs of tamponade, but they nonetheless fulfill diagnostic criteria for tamponade. If a non-plethoric IVC is used to rule out tamponade, the clinician risks delaying comprehensive echocardiography or other tests. Furthermore, the potential for deterioration to frank shock could be discounted, with inappropriate disposition and monitoring., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Background: The differential diagnosis for chest pain in the emergency department is broad and includes both benign and life-threatening conditions-with pericardial cyst as a rare example. Emergency physician-performed point-of-care focused cardiac ultrasound (FOCUS) is increasingly recognized as a useful modality in the evaluation of patients with chest pain., Case Report: We report a case of hemorrhagic pericardial cyst in a young woman presenting with chest pain in which findings on FOCUS contradicted findings on chest x-ray study and thus, accelerated diagnosis and definitive treatment. We also comment on epidemiology, pathophysiology, clinical presentation, diagnosis, and management of this uncommon, potentially fatal cause of chest pain. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case report aims to bring an uncommon case to the attention of emergency providers and emphasize the importance of facility with FOCUS. Although definitive diagnosis and management were not accomplished at the bedside in this case, an abnormal finding on FOCUS prompted further investigation and timely treatment., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: Disaster triage training for emergency medical service (EMS) providers is not standardized. Simulation training is costly and time-consuming. In contrast, educational video games enable low-cost and more time-efficient standardized training. We hypothesized that players of the video game "60 Seconds to Survival" (60S) would have greater improvements in disaster triage accuracy compared to control subjects who did not play 60S., Methods: Participants recorded their demographics and highest EMS training level and were randomized to play 60S (intervention) or serve as controls. At baseline, all participants completed a live school-shooting simulation in which manikins and standardized patients depicted 10 adult and pediatric victims. The intervention group then played 60S at least three times over the course of 13 weeks (time 2). Players triaged 12 patients in three scenarios (school shooting, house fire, tornado), and received in-game performance feedback. At time 2, the same live simulation was conducted for all participants. Controls had no disaster training during the study. The main outcome was improvement in triage accuracy in live simulations from baseline to time 2. Physicians and EMS providers predetermined expected triage level (RED/YELLOW/GREEN/BLACK) via modified Delphi method., Results: There were 26 participants in the intervention group and 21 in the control group. There was no difference in gender, level of training, or years of EMS experience (median 5.5 years intervention, 3.5 years control, p = 0.49) between the groups. At baseline, both groups demonstrated median triage accuracy of 80 percent (IQR 70-90 percent, p = 0.457). At time 2, the intervention group had a significant improvement from baseline (median accuracy = 90 percent [IQR: 80-90 percent], p = 0.005), while the control group did not (median accuracy = 80 percent [IQR:80-95], p = 0.174). However, the mean improvement from baseline was not significant between the two groups (difference = 6.5, p = 0.335)., Conclusion: The intervention demonstrated a significant improvement in accuracy from baseline to time 2 while the control did not. However, there was no significant difference in the improvement between the intervention and control groups. These results may be due to small sample size. Future directions include assessment of the game's effect on triage accuracy with a larger, multisite site cohort and iterative development to improve 60S.

Implicit to the definitions of both family-supportive supervision (FSS) and family-supportive organization perceptions (FSOP) is the argument that these constructs may manifest at a higher (e.g. group or organizational) level. In line with these conceptualizations, grounded in tenants of conservation of resources theory, we argue that FSS and FSOP, as universal resources, are emergent constructs at the organizational level, which have cross-level effects on work-family conflict and turnover intentions. To test our theoretically derived hypotheses, a multilevel model was examined in which FSS and FSOP at the unit level predict individual work-to-family conflict, which in turn predicts turnover intentions. Our hypothesized model was generally supported. Collectively, our results point to FSOP serving as an explanatory mechanism of the effects that mutual perceptions of FSS have on individual experiences of work-to-family conflict and turnover intentions. Lagged (i.e. overtime) cross-level effects of the model were also confirmed in supplementary analyses. Our results extend our theoretical understanding of FSS and FSOP by demonstrating the utility of conceptualizing them as universal resources, opening up a variety of avenues for future research. Copyright © 2015 John Wiley & Sons, Ltd., (Copyright © 2015 John Wiley & Sons, Ltd.)

We proposed that civility norms would strengthen relationships between management commitment to safety and workers' safety motivation, safety behaviors, and injuries. Survey data were obtained from working adults in hazardous jobs-those for which physical labor is required and/or a realistic possibility of physical injury is present (N = 290). Results showed that management commitment positively related to workers' safety motivation, safety participation, and safety compliance, and negatively related to minor injuries. Furthermore, management commitment to safety displayed a stronger positive relationship with safety motivation and safety participation, and a stronger negative relationship with minor worker injuries when civility norms were high (versus low). The results confirm existing known relationships between management commitment to safety and worker safety motivation and behavior; furthermore, civility norms facilitate the relationships between management commitment to safety and various outcomes important to worker safety. In order to promote an optimally safe working environment, managers should demonstrate a commitment to worker safety and promote positive norms for interpersonal treatment between workers in their units.

A middle-aged Hispanic woman presented to the emergency department (ED) reporting of acute new onset pressure-like chest pain developed at rest. It was radiated to the right arm and associated with malaise. Initial ECG demonstrated T-wave inversions (TWIs) in all anterior and lateral leads. Electrolytes, serial cardiac troponin and D-dimer were all normal. Comprehensive transthoracic echocardiogram and nuclear stress test did not reveal a cardiac cause of her symptoms.Serum thyroid-stimulating hormone was markedly elevated (207 mIU/L) and free thyroxine was low (FT4 0.07 ng/dL), consistent with severe primary hypothyroidism. Thyroperoxidase (TPO) antibodies were positive. Therapy with levothyroxine was started. No other cause of the TWIs was identified. A repeat ECG obtained 8 weeks later showed partial resolution of the TWIs. Our observations indicate that Hashimoto's disease is the most likely primary cause of this patient's extensive and profound TWI, which improved after thyroid replacement therapy., (2016 BMJ Publishing Group Ltd.)

Background: T-wave inversions (TWI) can signify serious pathology, but may also represent a benign variant. One such variant has been termed the "persistent juvenile" T-wave pattern (PJTWP). It is characterized by TWI in the right precordium, and has been understood to represent an arrested stage of the normal electrocardiographic evolution from childhood., Case Report: A series of four African-American (AA) women, ages 20 to 43 years, presented to the Emergency Department, and were found to have right precordial TWI that was absent on prior electrocardiograms. The diagnostic evaluation did not reveal acute cardiopulmonary causes for these new TWIs. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: The "persistent" juvenile pattern may not be actually persistent in the individual patient. In an appropriate patient, such as a young AA woman, where acute cardiopulmonary disease has been reasonably ruled out, the finding of new right precordial TWI should not preclude the diagnosis of PJTWP., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Background: McConnell's sign (right ventricular [RV] free wall hypokinesis with apical sparing on echocardiography) is often described as very specific for the diagnosis of pulmonary embolism (PE). We present the case of a patient who, despite manifesting a classic McConnell's sign, was not found to have a PE., Case Report: A 58-year-old woman presented to the emergency department with a cough, dyspnea, and leg swelling. A bedside focused cardiac ultrasound revealed hypokinesis of the RV free wall, with apical sparing, in the apical four-chamber view. A computed tomography angiogram for PE was negative. Ultrasounds of both lower extremities were negative for deep venous thrombosis, and a D-dimer was only marginally elevated. The patient was ultimately diagnosed with pulmonary hypertension due to chronic obstructive pulmonary disease and systemic lupus erythematosus. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should be aware that McConnell's sign is not completely specific for acute right heart strain from PE., (Copyright © 2015 Elsevier Inc. All rights reserved.)

We describe the development, launch into space, and initial results from a prototype wide field-of-view soft X-ray imager that employs lobster-eye optics and targets heliophysics, planetary, and astrophysics science. The sheath transport observer for the redistribution of mass is the first instrument using this type of optics launched into space and provides proof-of-concept for future flight instruments capable of imaging structures such as the terrestrial cusp, the entire dayside magnetosheath from outside the magnetosphere, comets, the Moon, and the solar wind interaction with planetary bodies like Venus and Mars [Kuntz et al., Astrophys. J. (in press)].

Premise of the Study: Single-copy nuclear loci can provide powerful insights into polyploid evolution. Chenopodium (Amaranthaceae) is a globally distributed genus composed of approximately 50-75 species. The genus includes several polyploid species, some of which are considered noxious agricultural weeds, and a few are domesticated crops. Very little research has addressed their evolutionary origin to date. We construct a phylogeny for Chenopodium based on two introns of the single-copy nuclear locus Salt Overly Sensitive 1 (SOS1) to clarify the relationships among the genomes of the allotetraploid and allohexaploid species, and to help identify their genome donors., Methods: Diploid species were sequenced directly, whereas homeologous sequences of polyploid genomes were first separated by plasmid-mediated cloning. Data were evaluated in maximum likelihood and Bayesian phylogenetic analyses., Key Results: Homeologous sequences of polyploid species were found in four clades, which we designate as A-D. Two distinct polyploid lineages were identified: one composed of American tetraploid species with A and B class homeologs and a second composed of Eastern Hemisphere hexaploid species with B, C, and D class homeologs., Conclusions: We infer that the two polyploid lineages arose independently and that each lineage may have originated only once. The American diploid, C. standleyanum, was identified as the closest living diploid relative of the A genome donor for American tetraploids, including domesticated C. quinoa, and is of potential importance for quinoa breeding. The east Asian diploid species, C. bryoniifolium, groups with American diploid species, which suggests a transoceanic dispersal., (© 2015 Botanical Society of America, Inc.)

Purpose: Assessing the potential link between smoking behavior and exposure to mass media depictions of smoking on social networking Web sites., Design: A representative longitudinal panel of 200 young adults in Connecticut., Setting: Telephone surveys were conducted by using computer assisted telephone interviewing technology and electronic dialing for random digit dialing and listed samples., Subjects: Connecticut residents aged 18 to 24 years., Measures: To measure encoded exposure, respondents were asked whether or not they had smoked a cigarette in the past 30 days and about how often they had seen tobacco use on television, in movies, and in social media content. Respondents were also asked about cigarette use in the past 30 days, and a series of additional questions that have been shown to be predictive of tobacco use., Analysis: Logistic regression was used to test for our main prediction that reported exposure to social media tobacco depictions at time 1 would influence time 2 smoking behavior., Results: Encoded exposure to social media tobacco depictions (B = .47, p < .05) was a significant predictor of time 2 smoking, even after controlling for all the aforementioned predictors., Conclusion: Our results suggest that social media depictions of tobacco use predict future smoking tendency, over and above the influence of TV and movie depictions of smoking. This is the first known study to specifically assess the role of social media in informing tobacco behavior.

Working environments that are both civil and safe are good for business and employee well-being. Civility has been empirically linked to such important outcomes as organizational performance and individuals' positive work-related attitudes, yet research relating civility to safety is lacking. In this study, we link perceptions of civility norms to perceptions of safety climate and safety outcomes. Drawing on social exchange theory, we proposed and tested a model in 2 samples wherein civility norms indirectly relate to safety outcomes through associations with various safety climate facets. Our results supported direct relationships between civility and management safety climate and coworker safety climate. Additionally, indirect effects of civility norms on unsafe behaviors and injuries were observed. Indirect effects of civility norms on unsafe behaviors were observed through coworker safety climate and work-safety tension. Indirect effects of civility norms on injuries were observed through management safety climate and work-safety tension for full-time employees, although these effects did not hold for part-time employees. This study provides initial evidence that researchers and practitioners may want to look beyond safety climate to civility norms to more comprehensively understand the origins of unsafe behaviors and injuries and to develop appropriate preventive interventions., ((PsycINFO Database Record (c) 2014 APA, all rights reserved).)

The solar neighbourhood is the closest and most easily studied sample of the Galactic interstellar medium, an understanding of which is essential for models of star formation and galaxy evolution. Observations of an unexpectedly intense diffuse flux of easily absorbed 1/4-kiloelectronvolt X-rays, coupled with the discovery that interstellar space within about a hundred parsecs of the Sun is almost completely devoid of cool absorbing gas, led to a picture of a 'local cavity' filled with X-ray-emitting hot gas, dubbed the local hot bubble. This model was recently challenged by suggestions that the emission could instead be readily produced within the Solar System by heavy solar-wind ions exchanging electrons with neutral H and He in interplanetary space, potentially removing the major piece of evidence for the local existence of million-degree gas within the Galactic disk. Here we report observations showing that the total solar-wind charge-exchange contribution is approximately 40 per cent of the 1/4-keV flux in the Galactic plane. The fact that the measured flux is not dominated by charge exchange supports the notion of a million-degree hot bubble extending about a hundred parsecs from the Sun.

Magnetic reconnection is the primary process through which energy couples from the solar wind into Earth's magnetosphere and ionosphere. Conditions both in the incident solar wind and in the magnetosphere are important in determining the efficiency of this energy transfer. In particular, the cold, dense plasmaspheric plume can substantially impact the coupling in the dayside reconnection region. Using ground-based total electron content (TEC) maps and measurements from the THEMIS spacecraft, we investigated simultaneous ionosphere and magnetosphere observations of the plasmaspheric plume and its involvement in an unsteady magnetic reconnection process. The observations show the full circulation pattern of the plasmaspheric plume and validate the connection between signatures of variability in the dense plume and reconnection at the magnetopause as measured in situ and through TEC measurements in the ionosphere.

Organizational researchers argue that workplace mistreatment scholarship is hampered because of the wide variety of constructs studied. To investigate this concern, we conducted an item-level analysis of the relationship among workplace mistreatment experiences to assess construct overlap. Employed students reported how similar 17 mistreatment experiences were to one another (i.e., from measures of sexual harassment, generalized harassment, and incivility) and subject matter experts indicated the degree to which each experience represented several dimensions including Buss's (1961) dimensions (i.e., verbal/physical, active/passive, and direct/indirect) and others (i.e., sexual/ nonsexual and intentional/accidental). Nonsexual forms of mistreatment (i.e., generalized harassment and incivility) were perceived similarly despite their different conceptual definitions, whereas sexual harassment experiences were relatively distinct. Implications of the findings are discussed.

Objective: Emergency airway situations are relatively rare events in pediatrics with most graduating residents having little exposure to intubate. Newer video technology offers the promise of reducing complications associated with intubation. This study proposes that video laryngoscopy (VL) should aid less skilled residents to intubate an infant mannequin with greater success and speed as compared with traditional direct laryngoscopy (DL)., Methods: Pediatric (PED) and emergency medicine (EM) residents were randomized in a prospective controlled study. A standard respiratory failure scenario was conducted using SimBaby with an uncomplicated airway. Residents who inadvertently performed esophageal intubation were made aware as part of the scenario and allowed to reattempt until successful., Results: Sixty-nine residents voluntarily participated, 49% EM and 51% PED. Seven subjects in the DL group required multiple attempts (21%), compared with 6 subjects in the VL group (17%) (P = 0.718). Median time to intubation was 30 seconds (95% confidence interval [CI], 19-41 seconds) for DL and 39 seconds (95% CI, 36-42 seconds) for VL (P = 0.111). Comparison of programs revealed a 77% PED success rate versus 85% EM success rate (P = 0.578) and median time to intubation of 38 seconds (95% CI, 31-45 seconds) for PED compared with 32 seconds (95% CI, 23-41 seconds) for EM residents (P = 0.316). In a subanalysis, subjects successful at first attempt revealed a 13-second median difference (DL, 23 seconds [95% CI, 18-28 seconds] vs. VL, 36 seconds [95% CI, 29-43 seconds; P = 0.01)., Conclusions: In a simulated respiratory failure scenario involving residents, VL provided no additional success over DL with slightly longer time to intubation.

High temperature luminescence-based sensing is demonstrated by embedding colloidal CdSe(ZnS) quantum dots into a high temperature SiO(2) dielectric matrix. The nanocomposite was fabricated by a solution process method. As-prepared CdSe(ZnS) quantum dots in the nanocomposite sensor show an absorption band at a wavelength of 600 nm (2.06 eV). Photoluminescence (PL) measurements show a room temperature emission peak at 606 nm (2.04 eV). The temperature-dependent emission spectra study shows for the first time a CdSe(ZnS)-SiO(2) nanocomposite-based high temperature sensor. The temperature-dependent spectral and intensity modes of the nanocomposite thin film photoluminescence were investigated from 295-525 K. The sensor shows a variation of the emission wavelength as a function of temperature with a sensitivity of ∼ 0.11 nm °C( - 1). The film morphology and roughness are characterized using AFM.