Spacecraft-to-spacecraft tracking observations from the Gravity Recovery and Interior Laboratory (GRAIL) have been used to construct a gravitational field of the Moon to spherical harmonic degree and ...order 420. The GRAIL field reveals features not previously resolved, including tectonic structures, volcanic landforms, basin rings, crater central peaks, and numerous simple craters. From degrees 80 through 300, over 98% of the gravitational signature is associated with topography, a result that reflects the preservation of crater relief in highly fractured crust. The remaining 2% represents fine details of subsurface structure not previously resolved. GRAIL elucidates the role of impact bombardment in homogenizing the distribution of shallow density anomalies on terrestrial planetary bodies.
This article aimed to synthesize the various triggers of the diving response and to perform a meta‐analysis assessing their effects on cardiac vagal activity. The protocol was preregistered on ...PROSPERO (CRD42021231419; 01.07.2021). A systematic and meta‐analytic review of cardiac vagal activity was conducted, indexed with the root mean square of successive differences (RMSSD) in the context of the diving response. The search on MEDLINE (via PubMed), Web of Science, ProQuest and PsycNet was finalized on November 6th, 2021. Studies with human participants were considered, measuring RMSSD pre‐ and during and/or post‐exposure to at least one trigger of the diving response. Seventeen papers (n = 311) met inclusion criteria. Triggers examined include face immersion or cooling, SCUBA diving, and total body immersion into water. Compared to resting conditions, a significant moderate to large positive effect was found for RMSSD during exposure (Hedges' g = 0.59, 95% CI 0.36 to 0.82, p < .001), but not post‐exposure (g = 0.11, 95% CI −0.14 to 0.36, p = .34). Among the considered moderators, total body immersion had a significantly larger effect than forehead cooling (QM = 23.46, df = 1, p < .001). No further differences were detected. Limitations were the small number of studies included, heterogenous triggers, few participants and low quality of evidence. Further research is needed to investigate the role of cardiac sympathetic activity and of the moderators.
In the first meta‐analysis on this topic, the diving response has been found to be moderately to largely effective in increasing cardiac vagal activity during exposure. Face immersion and total body immersion caused stronger effects than forehead cooling and should be further investigated as potential interventions in psychotherapy and stress management in the work place.
Human infection by malarial parasites of the genus Plasmodium begins with the bite of an infected Anopheles mosquito. Current estimates place malaria mortality at over 650,000 individuals each year, ...mostly in African children. Efforts to reduce disease burden can benefit from the development of mathematical models of disease transmission. To date, however, comprehensive modeling of the parameters defining human infectivity to mosquitoes has remained elusive. Here, we describe a mechanistic within-host model of Plasmodium falciparum infection in humans and pathogen transmission to the mosquito vector. Our model incorporates the entire parasite lifecycle, including the intra-erythrocytic asexual forms responsible for disease, the onset of symptoms, the development and maturation of intra-erythrocytic gametocytes that are transmissible to Anopheles mosquitoes, and human-to-mosquito infectivity. These model components were parameterized from malaria therapy data and other studies to simulate individual infections, and the ensemble of outputs was found to reproduce the full range of patient responses to infection. Using this model, we assessed human infectivity over the course of untreated infections and examined the effects in relation to transmission intensity, expressed by the basic reproduction number R0 (defined as the number of secondary cases produced by a single typical infection in a completely susceptible population). Our studies predict that net human-to-mosquito infectivity from a single non-immune individual is on average equal to 32 fully infectious days. This estimate of mean infectivity is equivalent to calculating the human component of malarial R0 . We also predict that mean daily infectivity exceeds five percent for approximately 138 days. The mechanistic framework described herein, made available as stand-alone software, will enable investigators to conduct detailed studies into theories of malaria control, including the effects of drug treatment and drug resistance on transmission.
Background
Post‐infarction ventricular septal defect (PIVSD) carries a very poor prognosis. Surgical repair offers reasonable outcomes in patients who survive the initial healing period. Percutaneous ...device implantation remains a potentially effective earlier alternative.
Methods and Results
From March 2018 to May 2022, 11 trans‐arterial PIVSD closures were attempted in 9 patients from two centers (aged 67.2 ± 11.1 years; 77.8% male). Two patients had a second procedure. Myocardial infarction was anterior in four patients (44.5%) and inferior in five cases (55.5%). Devices were successfully implanted in all patients. There were no major immediate procedural complications. Immediate shunt grade postprocedure was significant (11.1%), minimal (77.8%), or none (11.1%). Median length of stay after the procedure was 14.8 days. Five patients (55%) survived to discharge and were followed up for a median of 605 days, during which time no additional patients died.
Conclusion
Single arterial access for percutaneous closure of PIVSD is a good option for these extremely high‐risk patients, in the era of effective large‐bore arterial access closure. Mortality remains high, but patients who survive to discharge do well in the longer term.
This paper reports self-assembled multi-component hybrid hydrogels including a range of nanoscale systems and characterizes the extent to which each component maintains its own unique functionality, ...demonstrating that multi-functionality can be achieved by simply mixing carefully-chosen constituents. Specifically, the individual components are: (i) pH-activated low-molecular-weight gelator (LMWG) 1,3;2,4-dibenzylidenesorbitol-4',4''-dicarboxylic acid (DBS-COOH), (ii) thermally-activated polymer gelator (PG) agarose, (iii) anionic biopolymer heparin, and (iv) cationic self-assembled multivalent (SAMul) micelles capable of binding heparin. The LMWG still self-assembles in the presence of PG agarose, is slightly modified on the nanoscale by heparin, but is totally disrupted by the micelles. However, if the SAMul micelles are bound to heparin, DBS-COOH self-assembly is largely unaffected. The LMWG endows hybrid materials with pH-responsive behavior, while the PG provides mechanical robustness. The rate of heparin release can be controlled through network density and composition, with the LMWG and PG behaving differently in this regard, while the presence of the heparin binder completely inhibits heparin release through complexation. This study demonstrates that a multi-component approach can yield exquisite control over self-assembled materials. We reason that controlling orthogonality in such systems will underpin further development of controlled release systems with biomedical applications.
Point of care ultrasound (POCUS) has been endorsed as an important clinical tool by the Canadian Association of Emergency Physicians (CAEP) and is a training objective of emergency medicine (EM) ...residency programs accredited by both the Royal College of Physicians and Surgeons of Canada (RCPSC) and the College of Family Physicians of Canada (CFPC). Our objectives are to describe the national state of POCUS training in RCPSC-EM and CFPC-EM residency programs and to evaluate the implementation of the CAEP core POCUS curriculum in these programs.
This was an online survey study of all POCUS education leads for both RCPSC-EM and CFPC-EM programs. The survey queried participants on program demographics, description of POCUS training, methods of POCUS assessment, and implementation of the CAEP core POCUS curriculum.
The response rate was 100% (39/39). All RCPSC-EM and CFPC-EM programs provide POCUS training for their residents, and 100% of RCPSC-EM programs and 91% (20/22) of CFPC-EM programs have a POCUS lead. All programs provide POCUS training for their residents, but there is variability in how POCUS is introduced to residents, ongoing POCUS instruction provided throughout residency, and POCUS assessment. Only 47% (8/17) of RCPSC-EM and 32% (7/22) of CFPC-EM programs have a quality assurance process for the use of POCUS by their residents. POCUS leads believe their residents are proficient in the CAEP core POCUS applications by the end of training except for advanced cardiac and thoracic ultrasound.
POCUS training in Canadian EM programs is prevalent, but there is variability in support for POCUS leads, delivery of training, determination of proficiency, and presence of quality assurance. While almost all programs deliver POCUS education aligning with the CAEP core POCUS curriculum position statement, more support is required both locally and nationally for sharing best practices for POCUS education.
The rapid proliferation of intelligent systems (e.g., fully autonomous vehicles) in today's society relies on sensors with low latency and computational effort. Yet current sensing systems ignore ...most available a priori knowledge, notably in the design of the hardware level, such that they fail to extract as much task‐relevant information per measurement as possible. Here, a “learned integrated sensing pipeline” (LISP), including in an end‐to‐end fashion both physical and processing layers, is shown to enable joint learning of optimal measurement strategies and a matching processing algorithm, making use of a priori knowledge on task, scene, and measurement constraints. Numerical results demonstrate accuracy improvements around 15% for object recognition tasks with limited numbers of measurements, using dynamic metasurface apertures capable of transceiving programmable microwave patterns. Moreover, it is concluded that the optimal learned microwave patterns are nonintuitive, underlining the importance of the LISP paradigm in current sensorization trends.
Optimal wavefronts to probe a scene with microwave radiation in order to recognize objects therein are learned by integrating a model of the sensor's reconfigurable physical layer into the machine‐learning pipeline used to process the measurements. Thereby the amount of task‐relevant information obtained per measurement is maximized, enabling sensing with low latency and computational burden.
"Whether it's the first-past-the-post electoral system or partisan government appointees to the Senate, Canadians want better representation and accountability from the federal government. Before ...reforms can be enacted, however, it is important to explore and clarify the relationships among Canada's three parliamentary institutions: Crown, Senate, and Commons. In The Constitution in a Hall of Mirrors, David E. Smith presents a learned but accessible analysis of the interconnectedness of Canada's parliamentary institutions. Smith argues that Parliament is a unity comprised of three parts and any reforms made to one branch will, whether intended or not, affect the other branches. Through a timely, nuanced, and comprehensive examination of parliamentary debates, committee reports, legal scholarship, and comparative analysis of developments in the United Kingdom, Smith uncovers the substantial degree of ambiguity that exists among Canadians and their calls for structural and operational reforms. By illuminating the symbiotic relationship between the Crown, Senate, and Commons, The Constitution in a Hall of Mirrors brings government reform closer to reality."--
Nothronychus graffami was a large therizinosaur from the Upper Cretaceous of North America. Much of the skeleton is well-preserved and relatively undistorted. The synovial capsule, extracapsular, and ...intracapsular tendons are reconstructed in N. graffami using existing scars and comparison with the hips of extant theropods and models of extinct theropods. The iliofemoral, pubofemoral, and ischiofemoral ligaments are all modeled. Soft tissue, especially the ischiofemoral and pubofemoral ligaments reduced possible protraction/retraction of the femur at the hip while stabilizing the joint. Therefore, most hindlimb movements took place at the knee. Weight-bearing function in Nothronychus was transferred from the supra-acetabular crest to the pubic peduncle and associated labrum at rest. The femur possessed an intermediately angled neck, convergent with titanosaurs. Therefore, some lateral abduction is proposed, requiring a well-developed meniscus at the knee. Such a posture would result in considerable mediolateral stress along the femoral shaft, resulting in increased transverse ossification. The femur is considered somewhat abducted from the midline, especially when maximally pronated, as the preacetabular ala is more extensive than the post-acetabular ala. This trait would probably result in a laterally divergent femur, as in many birds, resulting in a broad-gauge trackway with wider separation between left and right footprints than observed in many theropod trackways. Limb ratios and ossification patterns suggest a slow, waddling gait. A standard digitiform pose is reconstructed as is common for theropods, but a plantigrade stance cannot be firmly rejected.
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